Physical Therapy at Home: What You Should Know

When people think of physical therapy, they picture going to a clinic with exercise machines and parallel bars. But home health PT is different - and for a lot of patients, it's actually better suited to what they need.

I've been doing home health physical therapy for twelve years. Here's what I wish every patient knew before I showed up at their door.

Why Home PT Can Be Better Than Outpatient

In a clinic, you practice walking on level floors and climbing standardized stairs. At home, you practice in the actual environment you need to navigate - your stairs, your bathroom, your kitchen layout.

The exercises I give you are based on what your home requires. If you have three steps to get into your house, we work on three steps. If your bathroom is tight and hard to maneuver in, we practice in that actual space.

Plus, you don't have to get dressed up and drive somewhere when you're feeling lousy. Especially right after surgery or a hospital stay, that alone makes a huge difference.

What the First Visit Is Like

The first session is mostly evaluation. I'm going to watch you move around, test your strength and balance, look at your home environment, and ask you a lot of questions.

What are your goals? What activities do you miss or struggle with? What's your pain level? Have you fallen recently?

I'm also looking at things like: Can you get out of bed safely? Transfer to and from a chair? Walk to the bathroom? Get in and out of the shower?

By the end of that first visit, I'll have a plan. We'll talk about how often I'll come (usually 2-3 times a week initially), what we'll work on, and what your homework will be.

Yes, homework. I'll get to that.

What Typical Sessions Look Like

After the evaluation, regular visits are usually 30-45 minutes.

A typical session might start with some warm-up exercises, then move to targeted work - maybe balance exercises, strength training, walking practice, or stair training. I might work on specific functional tasks like getting in and out of the bathtub or reaching items in kitchen cabinets.

Some sessions focus heavily on education - teaching you proper body mechanics, showing you how to use a walker correctly, explaining why certain movements are risky during your recovery.

I'm constantly progressing things. As you get stronger, exercises get harder. When you master walking with a walker, we transition to a cane. The goal is to keep challenging you appropriately.

The Home Exercise Program (Do It!)

Here's what separates patients who recover well from patients who plateau: the home exercise program.

I see you maybe three times a week for 30-45 minutes. That's less than 3 hours total per week. You're on your own for the other 165 hours. If you're not doing anything during that time, you won't make much progress.

The exercises I give you aren't complicated. They're usually things you can do while sitting or holding onto a counter. But you need to actually do them - every day, ideally twice a day, depending on what I've prescribed.

I'll give you written instructions, usually with pictures. Put them somewhere you'll see them. Set a reminder on your phone. Have a family member do them with you for accountability.

I can always tell when patients are doing their exercises versus just telling me they are. The progress (or lack of it) is obvious.

Equipment You Might Need

Some things the agency provides, some things you might need to get:

A walker or cane is often covered through Medicare. If the hospital didn't send you home with one, we can arrange it.

Resistance bands are cheap and useful for a lot of home exercises. I might give you some, or suggest picking up a set at any sporting goods store.

A gait belt might be used during our sessions if you need help with walking. The agency usually provides this.

Depending on your situation, you might benefit from things like a reacher (for picking things up), a sock aid (for putting on socks without bending over), or a shower chair. I can tell you what would help and how to get it.

Understanding the Timeline

Recovery takes longer than most people expect, and progress isn't linear.

After a hip replacement, you might feel pretty good at two weeks, then hit a wall at three weeks. That's normal. After a stroke, progress might be slow for a month, then suddenly speed up. That's also normal.

I'll give you realistic expectations for your specific situation. Trust the process, even when it feels frustratingly slow.

Most patients receive home health PT for 4-8 weeks, though it varies widely depending on what you're recovering from and how you progress. When you're ready, we'll transition you to either independent exercise or outpatient PT to continue your progress.

When to Call Me Between Visits

If you fall, call me. Even if you didn't get hurt, I need to know - it might mean we need to adjust your program or look at what caused it.

If something I asked you to do is causing significant pain (not just muscle soreness, but real pain), call me. The exercise might need to be modified.

If something changes suddenly - you feel weaker, you're having trouble doing things you could do yesterday, something seems wrong - call me. Or call the nursing line. Don't wait for your next scheduled visit.

Your Family's Role

If you have family members helping you, I want to meet them. At least for one visit, have them there.

I can teach them how to safely help you move around, what to watch for, and how to encourage you with your exercises without pushing too hard. Having a family member who understands the program makes a real difference in outcomes.

The Bottom Line

Home health PT brings rehabilitation into your real life - your actual home, your actual obstacles, your actual goals. It's about getting you back to functioning independently in the place you actually live.

Do the work between visits, communicate honestly about what's hard and what hurts, and trust the process. That's the formula for a good outcome.