A question that invariably comes up when discussing the course of treatment with a patient is how many sessions they’ll need until they have a desired result. The first step to come up with this number is determining your diagnosis. From there, physical therapists combine their assessment of you along with their research on tissue recovery and treatment to help decide the frequency and duration of your therapy. As exercises are added to your program it is crucial that they done with good form, so the feedback and reinforcement from your therapist is vital. After a few visits, hopefully you are beginning to feel better, but this is just the beginning! Muscles, tendons, and other structures take weeks to adapt to the new stresses on your body from therapy. Often the focus is on pain, but when you begin to feel an improvement it is important to continue addressing the cause of that pain to make those positive changes more permanent.
The length of time you may need to come to PT will vary based on the injury. For a case like shoulder impingement (compression of rotator cuff), research recommends 8 weeks of therapy to allow the PT time to improve flexibility and strength as well as educate the patient on postural awareness and how to control symptoms at home. The case of a surgical procedure like rotator cuff repair with a greater amount of tissue healing may require therapy over a 16 to 20 week period, as it is key to gradually stress the tendons involved. The average frequency of physical therapy recommendations is two visits per week, however there could be a routine that consists of one visit per week or 3 visits per week, depending on the extent of injury and urgency to return to activity.
Factors that can impact the amount of time it takes for your body to adapt:
- Physical activity level
- Posture
- Age
- Diet
- Medications
- Smoking
It’s important to keep all of the following in mind when talking with your physical therapist about frequency and duration of a physical therapy program.
References:
Mueller MJ, Maluf KS. Tissue Adaptation to Physical Stress: A Proposed “Physical Stress Theory” to Guide Physical Therapist Practice, Education, and Research.
Tate AR, McClure PW, Young IA, Salvatori R, Michener LA: Comprehensive impairment-based exercise and manual therapy intervention for patients with subacromial impingement syndrome: a case series.