Most of you reading this article are former patients so you know the value of an independent home exercise program, or at least you should know the value of an independent home exercise program. Chances are, if you are someone who did really well with us (i.e., your condition greatly improved and may have done so on the quicker side), then you were diligent about performing those exercises. Now, by a show of hands, how many of you are still doing the exercises that were prescribed as part of your “maintenance program” at discharge? Come on, get those hands higher! You think I can’t see you, but I can…
Regular exercise was not only a key contributor to your improvement but is key to your staying clear of PT (and hopefully other healthcare practitioners), or at least limiting your likelihood of needing our services in the future.
I’ve often said if I had a nickel for every patient that returns to PT for a recurring condition and answers “No” to the question, “Are you still doing your home exercises?” I would be retired on an island somewhere.
Changes in aerobic performance have been noted in highly-conditioned athletes within 2-4 weeks of training cessation. Changes in strength output take a little bit longer to notice but if it only takes that long to notice the change (and this occurs to the most highly-conditioned people out there, think what happens to the rest of us), then minor changes likely begin happening very quickly. For our bodies to function properly, regular exercise must be a part of your daily (or at least weekly) life.
Most of the time, we find that it is not that people don’t see the value of exercising but that other things in their lives get in the way – it’s not the physical performance of the exercises that’s the barrier, it’s other things. Here are suggested ways to keep your compliance high. There is no one-size-fits-all, use what approach works for you!
1. Set up a plan – Rather than assuming you will “get to” your exercises at some point during the day, make an appointment with yourself for a specific time to do them. If your schedule allows, make it a priority by scheduling it before earlier than other activities or meetings. Morning time is also nice because you tend to have higher energy and, once it is over with, you have the rest of your day to look forward to!
2. Find someone to exercise with – Exercise, like most things in life, is more enjoyable when performed with a partner. Even if you don’t perform the same exercises as someone else, if you exercise in the same space you can make it somewhat social. This will also help you in setting up and appointment time to exercise, and you may encourage each other on days when the other just wants to sit on the couch.
3. Split up the program – If the idea of setting aside a large block of time is daunting or you don’t want to exercise for a large block of time, then break it up into smaller chunks. You will benefit as much by doing some exercises in the morning and some in the afternoon (or doing some throughout the day). You also might decide to do half the exercises one day and then the other half the next (and there’s something to be said for variety).
4. Track your workout – If you are the sort of person that is motivated by data or benefits from concrete reminders of progress, keep a chart or log of which exercises you performed, how many, with what resistance, etc. so you can see how you are progressing over time.
5. Set exercise goals – Unless you know what you are trying to achieve, you won’t know when you’ve achieved it. Even if you have a long-term goal (for example, “lift up my 25-pound grandson”) you might set a more easily achievable but related shorter-term goal (“lift a 20-pound weight from the floor to the waist by August 1st”).
6. Reward yourself – make a deal (an actual contract) with yourself that if you perform the exercises for a specified amount of time (e.g., a week?, a month?) without any missed episodes that you will treat yourself to something outside of your usual (a night out, an ice cream cone, a splurge purchase).
7. “Punish” yourself – make a deal (an actual contract) with yourself that for each day you fail to perform the exercises you will go without something you typically enjoy (e.g., no morning coffee takeout the next day, no dessert that night) or you might have to do something you ordinarily wouldn’t (e.g., you have to perform someone else’s chores, you have to make a contribution to your favorite charity).
It takes time to develop a habit – in a 2009 study in the European Journal of Social Psychology, researchers found that it took between 18 and 254(!) days (average 66) for participants to turn a novel task into a habit which they performed automatically. So, stick with it—it may take a while. Also, don’t beat yourself up over a missed day—the researchers also found that “missing one opportunity to perform the behavior did not materially affect the habit formation process.”
If not, and I see you again, you’ll owe me a nickel.
written by Tom Fontana, MSPT