Building a relationship with a physical therapist often involves meeting with them weekly, which means they can quickly start to feel like a trusted, albeit professional, family member. Casual conversation during manual adjustments and exercises is a natural part of the process. However, as with any professional relationship, many people wonder: Are there professional boundaries that should be respected when communicating with your PT?

Open, Honest Communication Is The Cornerstone of Physical Therapy

At Acucare Physical Therapy in Sioux Falls, our priority is always open and honest communication for the sake of best outcomes. We have compiled this comprehensive guide detailing certain types of information you should never withhold or misrepresent to your physical therapist. While some of these points might appear overly strict, please understand that we wholeheartedly encourage all communications, questions, and concerns. We are always eager to hear important details about your health and treatment plan!

Don’t Downplay or Mask Your Symptoms

It is common for individuals struggling with chronic pain or a persistent injury to develop a “brave front.” Over time, you may become accustomed to minimizing or ignoring discomfort, and this behavior can subtly carry over into your physical therapy sessions.

The Danger of Downplaying

Hindered Adjustment: Are you experiencing mild knee pain, neck stiffness, or any discomfort before or during a session? Hesitating to mention mild symptoms can severely backfire. Your physical therapist needs to know exactly how you are feeling moment-to-moment. They are not trying to push you to your limit; they are aiming to work within your current level of comfort and physical capacity.
Risk of Overexertion: If you mask or minimize pain during an exercise, your therapist might incorrectly assume you can handle more intensity or repetition. This can lead to unnecessary inflammation, delayed recovery, or even a new injury.
Accurate Assessment: Discomfort is a crucial diagnostic tool. Reporting even mild, seemingly insignificant pain can help your therapist pinpoint a subtle biomechanical issue or identify an exercise that needs modification.

The Solution: Never hesitate to detail any discomfort. Remember, your PT’s ultimate goal is to make you feel better, and they cannot achieve that if they are working with incomplete information.

Don’t Lie About Completing Your Home Exercise Program (HEP)

Your physical therapist assigns homework—which typically includes specific exercises, stretches, or activity logs—to maintain and accelerate the progress made during your sessions. This HEP is arguably the most vital component of your recovery plan.

The Temptation and the Reality

The Scenario: When asked if you completed your exercises, you might be tempted to offer the desired answer, perhaps because you only managed a couple of days of activity instead of the recommended seven.
The Professional Perspective: You must never tell your therapist a lie about your progress or compliance. Don’t worry about disappointing them; there is no judgment whatsoever! We understand that life gets busy, you might forget, or you might have been too sore.
Why Honesty Matters: The truth allows your therapist to accurately assess the situation. If you are not making expected progress, but claim to be doing your homework, the therapist will incorrectly assume the treatment plan is ineffective and might unnecessarily intensify your in-clinic exercises.

If you admit to limited compliance, the therapist understands the pace of your recovery is simply slower than expected and can offer support, adjust the HEP to be more manageable, or help you find ways to fit it into your schedule.

Avoid Rushing Your Physical Therapy Session

Physical therapy sessions are carefully structured to include necessary warm-ups, manual therapy, targeted exercises, cool-downs, and client education. Rushing through any of these phases can compromise the quality of your treatment and introduce risk.

Avoiding the Rush

Risk of Injury: Trying to speed through an exercise or cutting a warm-up short to leave early significantly increases your risk of an acute injury. Proper form and controlled movements are essential for safety and efficacy.
Schedule Conflict: If you have a pressing appointment, it’s best to let your therapist know about your time constraint at the beginning of the session. They can then structure the time to ensure they cover the most critical elements and get you out safely on time.
Rushing Recovery: Additionally, never hesitate to voice concerns about the speed of your progress. If you feel your injury is taking too long to heal, discuss it openly. Your therapist can provide crucial information on the biology of healing, explain why your specific injury may require more time, and if appropriate, make changes to your treatment plan to better meet your recovery goals.

Don’t Claim to Understand an Exercise If You’re Still Unsure

When a new exercise is integrated into your program, your therapist follows a specific teaching protocol: they explain the steps, demonstrate the correct form, and then invite you to try it while they observe and adjust.

The Importance of Clarity

The Zone-Out Factor: Perhaps you were distracted during the explanation, or the technical terms used simply didn’t make sense. It is tempting to nod and say, “I got it,” just to move the session along.
The Critical Danger: Moving an injured area with incorrect form is the quickest way to worsen your pain, create a new injury, and completely stunt your healing process. It is impossible to achieve therapeutic results if the movement is executed improperly.
The Simple Solution: If you don’t fully grasp what your physical therapist, or any medical professional, is asking you to do, use a simple, effective phrase: “Please talk to me like I’m a 5th grader,” or “Can you re-explain that in simpler terms?” Your therapist will be genuinely happy to break down the instructions into easy-to-understand language until you feel completely confident in performing the movement.

Don’t Lie About Why You’re Canceling an Appointment

Thinking about canceling your next physical therapy session? It’s completely understandable if you genuinely forgot about an appointment or double-booked yourself. However, there is one reason you should never cancel: because you are experiencing an increase in pain.

Pain is a Reason to Come In, Not Stay Home

The Misconception: Many patients believe that forcing themselves through a therapy session while experiencing heightened pain will only exacerbate the issue.
The Reality: Your therapist is trained to deal with fluctuating pain levels. If your pain is higher than normal, they can immediately adapt your program—perhaps focusing on gentle manual techniques, utilizing modalities like heat or ice, or teaching modified, low-impact exercises—to ensure your safety and maintain momentum.
The Necessary Reassessment: More importantly, a sudden spike in pain requires assessment. Your therapist needs to see and understand why your pain levels have increased. This crucial diagnostic information might lead them to modify your HEP, change your in-clinic exercises, or refer you back to your primary care provider if a serious issue is suspected. Canceling delays this necessary intervention.

The Cardinal Rule: Be Open and Honest

The most critical takeaway for what you should never tell your physical therapist is simply: “a lie.” Your therapist’s ability to provide the best possible, personalized, and effective care is entirely dependent on having an accurate understanding of your condition, adherence to the program, and overall experience.

Speak With Our Compassionate Physical Therapists Today

At Acucare Physical Therapy in Sioux Falls, SD, we believe communication is the cornerstone of every successful physical therapy program. We never want you to feel uncomfortable communicating anything to your therapists. In fact, we actively invite and encourage your candid feedback, concerns, questions, and comments.

The most important truth is that we need to know exactly how you are feeling, exactly what you are doing at home, and exactly how much you understand so that we can provide the absolute best, most effective, and safest care for your recovery.

Contact Acucare Physical Therapy in Sioux Falls, SD, today for comprehensive, patient-centered physical therapy services and to book your initial appointment.

Open Communication: What You Should and Shouldn’t Tell Your Physical Therapist