Advice guide
How to Do Your Physio Exercises Properly, and Why Form Matters
The exercises are where most of the recovery actually happens, and yet they are the part most likely to be done in a rush, half remembered, on the wrong days. That is not a criticism of patients, it is a criticism of how exercise programmes are usually explained. This guide covers the principles that make rehabilitation exercise work: how much discomfort is acceptable, what tempo means, how to progress, and the handful of mistakes we see most often. It is general guidance and does not replace the specific programme your physiotherapist gives you.
How much discomfort is acceptable
The most common question, and the one that stops people in their tracks. For most musculoskeletal rehabilitation, working into a mild to moderate level of familiar discomfort is generally considered acceptable, provided it settles within roughly twenty four hours and is not worse the next morning. Sharp pain, new pain in a different place, or pain that lingers into the following day suggests too much load, too many repetitions or a technique problem. Your physiotherapist may set different limits for your specific case, and where they do, theirs takes precedence over any general rule.
Reps, sets and why the numbers differ
Different goals need different doses, which is why one exercise might be three sets of five and another three sets of twenty. If you are unsure why a number was chosen, ask, because understanding it makes people far more likely to stick with it.
| Goal | Typical reps | Typical frequency | What it should feel like |
|---|---|---|---|
| Range of movement | 10 to 15, held briefly | Daily, sometimes several times | Gentle stretch, no straining |
| Tendon loading | 8 to 15, slow tempo | Every day or every other day | Steady effort, familiar ache acceptable |
| Strength | 6 to 12, challenging by the last rep | 2 to 3 times a week | Hard work, good form maintained |
| Endurance and control | 15 to 25 | Most days | Fatigue rather than pain |
| Balance | Timed holds, 30 to 60 seconds | Daily | Wobbly but safe, near support |
Tempo and control, the parts people skip
Speed changes what an exercise does. A slow lowering phase, typically three seconds, loads a tendon or muscle far more than a quick drop, which is why so many rehabilitation exercises specify it. Rushing through repetitions lets momentum do the work and the target tissue does very little, which is one of the main reasons a programme can be done religiously for six weeks with disappointing results. If you can only manage six good slow repetitions where you were asked for ten, do six good ones and tell your physiotherapist.
The mistakes we see most often
None of these are anyone's fault, and all of them are easily corrected once spotted.
- Doing everything as fast as possible to get it over with
- Holding the breath, which raises tension and makes control harder
- Compensating with a bigger muscle group, such as using the low back during a hip exercise
- Only doing the enjoyable exercises and dropping the hard one, which is usually the important one
- Stopping the moment pain improves, well before strength has come back
- Doing three times the prescribed amount on a good day and nothing for the next three
How to progress without guessing
Progression should be planned rather than improvised. The general principle is to change one variable at a time so you know what caused any change in symptoms. Add repetitions before adding load, add load before adding speed, and add speed before adding impact or sport specific movement. If a step up causes symptoms that persist past the following day, step back down to the previous level for a week rather than abandoning the exercise altogether. If you are unsure, that is exactly what your review appointments are for.
- Week one to two: establish the movement pattern with light load
- Week two to four: increase repetitions, keep technique clean
- Week four onwards: increase load or difficulty, reduce repetitions
- Later stages: add speed, direction changes or impact where relevant to your goal
Fitting them into a real week
The best programme is the one that gets done. Attaching exercises to something that already happens, such as the kettle boiling or the end of a work call, works far better than intending to do them at some point. Two short sessions usually beat one long one for consistency. If a programme is not fitting your life, say so at your next appointment, because a shorter programme done four times a week is worth more than an ideal programme done once. Stop and seek advice if you develop sharp pain, significant swelling, giving way, or symptoms that spread into a limb, and seek urgent medical care for chest pain, sudden weakness or loss of bladder or bowel control.
Common questions
Is it normal to be sore after physio exercises?
Mild muscle soreness in the day or two after a new exercise is common and usually settles. Soreness that is worse the following morning or lasts beyond about forty eight hours suggests the dose was too high.
Should I stop if it hurts?
Not necessarily. Familiar discomfort that settles quickly is generally acceptable. Sharp, new or spreading pain is a reason to stop and check in with your physiotherapist.
How long before exercises make a difference?
This varies widely by problem and by person, so we avoid promising timescales. Many people notice changes in confidence and movement before they notice changes in strength, which takes longer to build.
What if I miss a few days?
Pick up where you left off rather than doubling up. Missing a few days does not undo progress, whereas a sudden large increase in load often provokes a flare.
Can I do my normal gym sessions as well?
Usually yes, with adjustments. Tell your physiotherapist what your training looks like so the rehabilitation work is built around it rather than competing with it.
Do I need equipment at home?
Rarely at first. Body weight, a resistance band and a step cover most early rehabilitation. Later stages sometimes benefit from heavier load, which is where a gym or the clinic helps.