Too Many Exercises!

One "exercise" (pun intended) I’ve found incredibly useful in my professional growth is gathering feedback from patients, whether through direct conversations or online reviews. Understanding what works, what doesn’t, and what can be improved has been invaluable over the years.

A Common Patient Frustration

One consistent theme that has emerged from patient feedback across various clinics is frustration with being assigned too many exercises in their home programs.

This might seem counterintuitive. After all, in school, we were taught countless exercises for strengthening different muscle groups, like the hip abductors or rotator cuff. Naturally, you might think patients would be eager to complete a large number of exercises to improve their condition—but in reality, this is often not the case.

Why Too Many Exercises Can Backfire

Assigning too many exercises can lead to several negative outcomes:

1. Overwhelm: Patients may feel burdened by the sheer volume of exercises and end up not doing any of them.

2. Time constraints: Extensive home programs can become too time-consuming, forcing patients to either cut them short or sacrifice other aspects of their life, leading to frustration.

3. Confusion: Patients may struggle to remember which exercises to prioritize and why they are doing them.

4. Lack of adherence: Without clarity on which exercises are essential, patients may skip or abandon the program altogether.

Avoiding the Pitfall

A common mistake among younger clinicians is assigning 10+ exercises on day one, followed by another 8 in the next session, and so on. Before long, the patient is overwhelmed with 25+ exercises—a situation that is both confusing and demotivating. While there are some highly motivated patients who can handle this workload, they are the exception rather than the rule.

Instead, engage in a collaborative discussion with your patient to create a realistic and manageable home program. Here are some useful questions to ask:

• “Can you fit in a home program outside of the clinic?”

• “What barriers do you foresee in completing these exercises, and how can we minimize them?”

• “How many exercises do you realistically think you can do between now and the next visit?”

• “Would it help if I prioritized the top 3-4 exercises for days when you’re short on time?”

These questions help set mutual expectations and allow you to tailor the home program to the patient’s lifestyle and preferences.

Handling Non-Adherence

As discussed in other posts, it’s important not to expect every patient to fully adhere to their home program. It’s common for therapists to feel frustrated when patients don’t complete their exercises, but this frustration doesn’t benefit anyone.

Instead, adopt a problem-solving mindset. Ask the patient directly why they didn’t do the exercises and seek to understand their perspective. Often, providing additional education on the benefits of the exercises can help improve adherence.

Minimizing Your Own Stress

Prescribing too many exercises isn’t just overwhelming for patients—it can also create unnecessary stress for you as the therapist. If you assign 12 new exercises in one session and another 12 in the next, that’s a lot to keep track of:

• You have to remember the parameters for each exercise.

• You need to monitor how the patient responded to each one.

• You must ensure proper form during execution.

By reducing the number of exercises you assign, you can free up mental energy and focus on providing more effective care.

Final Thoughts

Assigning too many exercises can be counterproductive for both patients and therapists. By collaborating with patients to develop a manageable home program, you improve adherence, reduce confusion, and create a more positive treatment experience. Remember, sometimes less is more—fewer, well-chosen exercises can yield far better results than an overwhelming list of tasks.