Why Your Physical Therapy Program Should Be Specific to You

When it comes to physical therapy, a tailored approach can make all the difference. While many traditional physical therapy facilities offer generalized programs designed to address common issues, these cookie-cutter solutions often fall short in effectively alleviating pain or promoting recovery. There is also a common trend of ending the rehab journey when pain has subsided, which fails to address the root cause of pain and leaves patients in a never ending cycle of repeated injury. Here’s why a personalized program, crafted specifically for your needs, is essential for successful rehabilitation:

Finding the Root Cause of Your Pain:

Many physical therapy facilities follow a standard approach, which might involve a basic set of exercises meant to address common conditions. While these programs can be beneficial for some, they often fail to provide meaningful improvement for others, especially athletes and the active population. This is because they do not take into account the unique aspects of each 

individual’s body and condition and often do not look beyond the area of injury. As a result, you might find yourself performing exercises that don’t target your specific issues or provide the relief you need. If this is the case for you,  you could probably find more effective exercises on Google and avoid spending your time and money on a generic, one-size-fits-all program. A good physical therapy evaluation should look at the area where you feel pain and all other areas of the body that can affect that area. Here at Conquer Movement, we take a joint by joint approach to addressing pain. This means that you could come in with pain in your foot and be given an exercise for your neck, as the nerves in your body travel down from the base of your skull all the way to your toes. If your physical therapist has not looked at all possible areas of your body that could be contributing to your pain and has only focused on the specific area where you feel pain, they could be missing the root cause of your pain. 

Avoiding a Cookie Cutter Approach and Focusing on the Individual:

Every person’s body is different and has variances in anatomy, strength, and range of motion. A one-size-fits-all approach does not account for individuality in the following categories:

1. Strength Levels: Your muscle strength and endurance are unique to you and can influence the effectiveness of your prescribed exercises. A generic program might not align with your current strength levels, leading to ineffective results or even potential injury. Load and the individual’s capacity to load should be a primary consideration in all programming to avoid the mistakes of over or underloading. At Conquer Movement, your first appointment is called your Initial Evaluation where your physical therapist will thoroughly evaluate your entire body, including the strength of the muscles that have an influence over your pain and injury. This is important for dosing your specific exercises in your rehab program. A good physical therapist will avoid the cookie cutter approach of prescribing 3 sets of 10 reps for all exercises and tailor your rehab program to fit your individual strengths and deficits. Read more about how we address your whole body and our 3 Step Process in this blog!
2. Anatomical Differences: Variations in bone structure and joint alignment can significantly impact how exercises should be performed. The same cues and positioning that work for one person should not automatically be applied to everyone else. The anatomy you see in a textbook is certainly not applicable to every individual, it is more of a framework. Every human has unique differences in anatomy, there are variations in each individual regardless of being diagnosed with any type of disorder and even more so in those with commonly known disorders such as scoliosis and hip dysplasia, or hypermobility disorder such as Hypermobile Ehlers Danlos Syndrome. 
3. Range of Motion: The extent of your joint movement is crucial in selecting appropriate exercises. Generic programs often overlook these personal variations, which can affect how well you perform each exercise and how much benefit you gain from it. Your physical therapist should be searching for range of motion and mobility deficits, then giving you the tools to improve your specific deficits. In some cases, there can also be too much mobility as discussed in previous blogs about building a stable base for a hypermobile athlete and what it means to be hypermobile. In these cases, stability exercises may be required rather than mobility exercises. A good physical therapist should be accounting for your specific range of motion. 

Common Programming Elements Seen Utilized in Physical Therapy

When developing a personalized physical therapy program, there are several programming styles that might be used, either individually or in combination. Understanding these styles can help tailor a program to your specific needs:

1. Resistance Training: This focuses on building our muscle’s capacity through load, which can be crucial for rehabilitation. Resistance Training indications training under load (weights) and involves exercises designed to increase muscle power, strength and endurance. Loading muscles is something that is commonly overlooked in traditional PT practice, especially for high level athletes. Your PT should be looking for deficits in your muscle capacity and have the available equipment and tools to address these deficits. In the last blog, the different methods of resistance training are explained in depth. 
2. Mobility and Stability Work: Mobility exercises are essential for improving the range of motion and reducing stiffness and traditional PT often fails to improve these deficits by allowing individuals to train deeper into that deficit. Resistance training can still be programmed while implementing various mobility exercises for your specific deficits, but it is important that mobility deficits be addressed early on in your rehabilitation journey so you are not strength training into a lack of mobility and causing more deficits. Stability includes any exercises that challenge the stability of a joint or muscle, commonly utilizing single limb unilateral exercises, unstable surfaces, equipment that can apply perturbations and/or challenge balance, and more!
3. Cardiovascular and Endurance Training: This involves exercises aimed at improving cardiovascular fitness and overall stamina. The cardiovascular system can play a huge role in the reduction of pain by influencing our central nervous system. If you are in any type of pain, regardless of whether or not your normal training routine involves cardio, your rehab program should be challenging your cardiovascular system in order to provide relief in pain. 

Each of these categories will apply in some way to each individual. Going to a physical therapist is essential to determine how to apply these concepts in a way that emphasizes the proper exercise demands while avoiding exceeding one’s capacity. A good physical therapist will be able to determine the sweet spot for recovery and adaptation to occur!

Tailoring Your Program

The most effective physical therapy programs combine these styles based on individual needs and progress. A thorough assessment by your physical therapist will help determine which programming styles should be prioritized and how they can be adjusted over time as you progress, especially for your specific sport and desired recreational activities. It is important to ensure that each exercise addresses your specific limitations and goals as all exercises can be adjusted according to individual needs. Investing in a program that is specific to you is investing in your recovery and overall well-being. To find the right program for you, schedule a call with one of our doctors of physical therapy to get started today. 

Dr. Kylie Miller

Performance Physical Therapist

Wilmington, NC

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