3 Factors That Affect How Well You Will Do With Physical Therapy: Education, Consistency, and Compliance

Contributed by expert: Shaun Logan, PT, DPT

Some of the biggest, actually probably the biggest, predictor of success or failure with physical therapy is consistency, compliance, and education or understanding. Compliance is a huge issue that tends to be frequently overlooked.  I would bet that the majority of the general population does not actually have a good understanding of physical therapy or they have had a previous experience with physical therapy that was bad physical therapy, which is an issue for another day.

Physical therapists are experts in human movement and injuries of the musculoskeletal system. We study, analyze, and break down human movement to determine where there are imbalances in muscle strength, muscle activation patterns, mobility, and movement patterns that have caused injury or will lead to injury.

Humans develop compensation patterns as reactions to our environment (daily life, work, sports, exercise, etc.) throughout our lives that change the way move. Our bodies are great compensators or adapters. These patterns are often the cause of non-contact, non-traumatic injuries. These compensation patterns develop over time and typically turn into more of repetitive, over-use injuries that can lead to pain, muscle strains, ligament tears, etc. Being pain-free does not mean the issue is gone. Pain is just one of the results of the poor movement pattern, and will continue to arise if the underlying issues are not addressed. Physical therapists find and address these patterns and work to improve the quality of movement, so in the end, the body works more efficiently and safely.

So what makes people think that there is going to be a quick fix? Why do they think they can continue to perform the activity that lead to the pain in the first place? Why do they think they can just disregard what they do in physical therapy as soon as they walk out the door? Why do they often not take their physical therapists advice? In general, why do people tend to trust medical doctors more for when they can return to physical activities, such as exercise, running, sports, etc.?

Is PT a quick fix? I don’t think so…


The answer is fairly simple; it’s poor education on physical therapy.

Typically, the medical doctor only sees an individual once every 4-6 weeks, if that; meanwhile that same person spending 2-3 hours a week with the physical therapist – who is constantly studying their movement patterns, strength, mobility, and response to all of these exercises and activities. Let’s get something straight, injuries do not have set timelines, it is almost impossible to predict when an individual is going to be ready to return to their specific activity. Everyone responds differently to injury and treatment. Each timeline has to be on a constantly changing, sliding scale that is individualized for that specific person.  To progress the individual back to activity, the physical therapist is using the information that is constantly being collected and assessed during each movement and exercise at every visit.  By the way, most physical therapists,  are doctors as well.  Just as physicians have their doctorate in medicine (M.D.) or doctorate in osteopathic medicine (D.O.), we have our doctorate in physical therapy (DPT).

There is no question about it, physical therapy takes a lot of hard work. If physical therapy is not challenging, then that it is likely not good physical therapy. The ultimate goal is to get back to pain or symptom-free activity, which is accomplished by changing how an individual moves, using and strengthening muscles that are weak, and mobilizing joints and tissues that are tight. Most of the time they are muscles that people don’t even know exist. As physical therapists, it is our job to educate these individuals and guide them towards a pain-free level of function and safe return to their activity, or activities, of choice; with the goal of them having a better understanding of their body, and the way they should be using their body. This is how injuries are prevented. However, physical therapists have to be able to perform their jobs correctly, which takes us back to the issue of compliance and consistency.

For physical therapy to work at its best, the individuals need to realize that what they are doing and learning at physical therapy is what they need to do every time they move throughout the day.  They need to stop performing the poor, compensatory strategies and work on the movements that are difficult for them. Otherwise, they are constantly feeding into the problem and counteracting everything that is trying to be accomplished in physical therapy. Typically, they are only in physical therapy 1-3 hours a week, so what is being done outside of PT, for the other 165 hours of the week, is the most important and crucial aspect to how well their recovery will go. One of the most important aspects of physical therapy is education, consistency, and compliance.  The individuals that have the best results with physical therapy are those who are compliant and work hard. That is a very important and often over-looked key to a successful physical therapy experience.


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