Physical therapy exercises at home

The NHS describes the program the way most people meet it: after each session, you may be given some exercises to do at home before your next appointment, and it's important you do them regularly to help with your recovery (NHS, Physiotherapy, last reviewed 3 April 2025). APTA says education is an important part of physical therapy and that your physical therapist may teach you special exercises to do at home (APTA ChoosePT, Preparing for Your Visit).

APTA's instructions for the program are short and specific (APTA ChoosePT, Preparing for Your Visit):

• Do your home program as often as prescribed, because it is essential to your recovery.
• If the instructions are unclear, ask your physical therapist to explain them.
• Only do exercises that your physical therapist prescribed.
• Follow their instructions for how often (times per week), how many times (repetitions), and the specific resistance (weight in pounds or band color).
• More is not always better and may cause injury.
• After you finish formal physical therapy, continue your home exercise plan and follow all instructions given at discharge.

The same page asks you to talk with your physical therapist about what to do if you have questions after discharge or if your symptoms or condition worsens (APTA ChoosePT). It also says missing appointments can delay your recovery, and if you plan to stop therapy or change how often you receive treatment for personal or financial reasons, to discuss this with your physical therapist (APTA ChoosePT).

The WHO's definition of adherence covers exercise along with medication, as the extent to which a person's behaviour corresponds with agreed recommendations from a health care provider (WHO, Adherence to Long-Term Therapies, 2003). The physical therapy reviews give several figures for how often home programs fall short, and each one is printed here with its owner because they are not the same number.

• Non-adherence to self-managed, home-based physical therapy can reach 70% (Essery et al., Disability and Rehabilitation, 2017).
• Non-adherence with treatment and exercise performance could be as high as 70%, a figure the review attributes to a 1993 study (Jack et al., Manual Therapy, 2010).
• Non-adherence in physiotherapy can be as high as 70%, particularly in unsupervised home exercise programmes (Ley and Putz, Systematic Reviews, 2024).
• Non-adherence to exercise therapy is often exceeding 50% in patients with chronic diseases (Ricke et al., Frontiers in Sports and Active Living, 2023).
• Adherence to home exercise programs supplied by physiotherapists could be as low as 50% (Lang et al., Archives of Physiotherapy, 2022, citing an earlier paper).

The same review that gives the 70% figure calls the true extent of non-adherence with physiotherapy unclear, and notes one study where 14% of physiotherapy patients did not return for follow-up appointments (Jack et al., 2010). Two of the reviews single out the self-managed, unsupervised home program as the part where non-adherence runs highest (Essery et al., 2017; Ley and Putz, 2024).

Three systematic reviews looked for the factors that separate people who keep going from people who don't, and their lists overlap.

A review of 30 studies found relatively strong evidence that intention to do the program, self-motivation, self-efficacy, previous adherence to exercise, and social support predicted adherence to home-based physical therapy (Essery et al., 2017). A review of 57 studies in people with chronic diseases found moderate to high quality evidence that more self-efficacy, exercise history, motivation, and perceived behavioral control predicted higher adherence, and moderate to low quality evidence that fewer other conditions, less depression, and less fatigue did too (Ricke et al., 2023).

A review of 20 studies of musculoskeletal outpatients named the barriers. It found strong evidence that poor adherence was associated with low physical activity at baseline or in previous weeks, low adherence with exercise during treatment, low self-efficacy, depression, anxiety, helplessness, poor social support, a greater perceived number of barriers to exercise, and increased pain levels during exercise (Jack et al., 2010). The authors add that most research has looked at patient factors, and the barriers introduced by health professionals and organizations need study too (Jack et al., 2010).

The strategy evidence is modest, and the reviews say so in print.

• Booster sessions, supervision, and graded exercise. An overview of 19 systematic reviews found moderate evidence for these three, a small overall effect across four meta-analyses (SMD 0.24), and low certainty overall, with most of the evidence covering the short to medium term (Ley and Putz, 2024). The same overview found that combining more behaviour change techniques worked better (Ley and Putz, 2024).
• Written instructions, activity monitors with feedback, and goal setting. A review of 12 randomized trials listed these, along with a behavioural program with booster sessions, as potential adherence aids, and concluded there is insufficient data to endorse their use in clinical practice (Peek et al., Physiotherapy, 2016).
• Digital tools. A review of 10 randomized trials found that adding a digital intervention to a home program improved adherence in 7 of them, and concluded it can likely increase adherence in the short term, with longer term effects less certain (Lang et al., 2022).
• Fewer exercises. A small trial of 15 adults aged 67 to 82 found the group given 2 home exercises performed them better than the group given 8, with no difference in self-reported compliance (Henry, Rosemond and Eckert, Physical Therapy, 1999). The authors call the optimal number a question for further study, and the number on your sheet belongs to your physical therapist.

The long-term evidence is weaker. An earlier review found strong evidence that adherence strategies are not effective at improving long-term adherence with home exercise, and moderate evidence that a motivational cognitive-behavioural program improves attendance at clinic sessions (McLean et al., Manual Therapy, 2010).

AHRQ's show-me method belongs here as well. It asks patients to demonstrate an instruction to confirm they can follow it (AHRQ, Tool 5, last reviewed April 2024), and doing each exercise once in front of your physical therapist before you leave is the plain version of it.

APTA separates the two. Normal muscle soreness and fatigue peak between 24 and 72 hours after a muscle-stressing activity and should go away on their own after a few days (APTA ChoosePT, Soreness vs Pain, revised June 7, 2024). Injury pain usually sits in a specific body part like a tendon or a joint, can be more intense and more constant, may be a constant ache even without movement or a sharp pain during movement, and can keep you awake at night (APTA ChoosePT, June 7, 2024). If you limp because of pain or favor one side, APTA says it may be a sign of an injury (APTA ChoosePT, June 7, 2024).

APTA's instruction for pain is to stop any painful activities and change what you do, and not to push through the pain, because pushing through can make the problem worse and lead to further injury (APTA ChoosePT, June 7, 2024). MedlinePlus draws the line tighter: you can expect sore muscles after a workout, but you should never feel pain when exercising, and if you feel pain, stop right away (MedlinePlus, How to Avoid Exercise Injuries, reviewed September 15, 2024). Both sources allow soreness and neither allows pushing through pain.

The time limits differ by source. APTA says pain that doesn't go away even after seven to 10 days needs your doctor or physical therapist (APTA ChoosePT, June 7, 2024). MedlinePlus says to contact your provider for any muscle or joint pain that does not go away after self-care (MedlinePlus, September 15, 2024). Some programs come with their own pain instructions from the physical therapist, and those instructions are the ones to follow.

APTA says your physical therapist checks your response to each treatment and makes changes as often as needed (APTA ChoosePT, Preparing for Your Visit), and that works best with a real account of the days between. From the sources above, the useful notes are:

• Which days you did the program, including the missed ones, since previous adherence predicts future adherence (Essery et al., 2017).
• Any pain, with where it was, when it started, and whether it went away within the time frames above (APTA ChoosePT, June 7, 2024).
• The instructions you weren't sure about, since APTA says to ask your physical therapist when they are unclear (APTA ChoosePT).
• What got in the way, since perceived barriers and pain during exercise are both linked to poor adherence (Jack et al., 2010).

APTA also suggests bringing a family member or trusted friend to an appointment to help remember details and take notes (APTA ChoosePT, Preparing for Your Visit).

I carry the program your physical therapist gave you. Send me the sheet or a photo of it and I keep it as they wrote it: the exercises, the sets, the reps, the band color, the days. We agree on a time, I text you then, and you text me after the exercises so the day goes on the record. If something hurt, tell me where and when and I keep it with the date. When you miss a day, we pick the next one back up without starting over. Before your next session, ask me and I read back the weeks: the days done, the days missed, the pain you reported, and the questions you saved.

I never add an exercise, change a rep count, or tell you whether a pain is safe to work through. If you tell me about pain that matches the warning signs above, I say so and tell you to call your physical therapist or doctor, or 911 when the sources say to.

No clinician reviewed this page. It restates the APTA, NHS, MedlinePlus, WHO, and AHRQ documents and the systematic reviews linked below, and those, and your own physical therapist's instructions, are the documents to trust over anything here.