Your physical therapist signed you off. You’re ready to get back to exercising, and nobody handed you a list of what’s safe to do now.
But there’s a good reason nobody did. That list doesn’t exist.
Key Takeaways
- After physical therapy, no exercise is automatically safe or unsafe for you. Your own screen and the load you lift decide.
- Physical therapy is built to get you back to acceptable, and getting past acceptable takes a different kind of training.
- A lighter weight is not automatically the safer choice, and it is less likely to make you stronger.
- The first few weeks after discharge start with a screen and work with your physical therapist wherever possible, and load goes up as tolerated, never on a schedule.
Contents
- Is There a List of Exercises That Are Safe After Physical Therapy?
- What Physical Therapy Is Built to Do
- What Makes an Exercise Safe for You
- Is a Lighter Weight the Safer Choice After an Injury?
- What the First Few Weeks Look Like
- Why Going Back to Your Old Class May Not Be Enough
- Where to Start in Timonium
Is There a List of Exercises That Are Safe After Physical Therapy?
Unfortunately, no. Squats, rows, presses and step-ups aren’t safe or unsafe on their own.
An exercise that’s right for your friend can be wrong for you. It can even be right for you at one weight and wrong at another.
Two things decide whether an exercise is safe for you:
- What a screen shows about how you move today
- How much weight you use, and how it goes up from there
Lists get passed around because they’re easy to print. But a list printed for everyone can’t account for your knee, your back or the shoulder injury that put you in physical therapy in the first place.
What Physical Therapy Is Built to Do
Physical therapy did its job. It took you from hurting and limited to moving well enough to get on with your life.
That’s what it’s for. Acceptable is a real result, and your therapist got you there.
But if you were active before you got hurt, acceptable probably isn’t where you want to stop. Discharge means your therapist’s part is done. Discharge doesn’t tell you what to lift next, or how much.
What Makes an Exercise Safe for You
A Screen Comes Before Any Load
At 29 Again, nobody trains without a Smart Start first. No drop-ins, no guests.
The Smart Start begins in the office, sitting down, going through your goals, your health history and your exercise history. Then comes the physical part: a Functional Movement Screen, a musculoskeletal screen and postural photos.
You’ve just finished physical therapy, so your Smart Start also includes working with your physical therapist as closely as possible. Nobody knows your recovery better than the person who took you through it.
Your program gets built from what your screen finds. So your program won’t match anyone else’s, even someone who went through physical therapy for the same knee.
The Load, and How It Changes
The second half is the weight on the dumbbell. It has to be “appropriately challenging” for the strength you have today.
Then it goes up as tolerated, never on a schedule.
Is a Lighter Weight the Safer Choice After an Injury?
It feels that way. You’ve spent months being careful, so the lightest dumbbells on the rack feel like the responsible pick.
But a lighter weight isn’t automatically safer. It’s only less likely to make you stronger.
One of the best-known trials in women over 50 tested the kind of loads most people would call risky:
Watson SL et al., Journal of Bone and Mineral Research, 2018. PMID 28975661.
That trial screened out women with a current musculoskeletal injury, so it doesn’t tell you to load an injury. What it shows is that the screen, the coaching and the supervision made “heavy” work. The number on the dumbbell didn’t.
And underloading is the single most common mistake Stephen sees. Right after physical therapy, you’re easy to underload, because everyone around you is being careful, including you.
What the First Few Weeks Look Like
There’s no week-one exercise list. The first few weeks follow what your Smart Start finds.
Stephen knows what those protocols look like. He volunteered in the Physical Therapy Department at Union Memorial Hospital in the early 1990s, and he completed a supervised internship with two physical therapists.
What you can count on after discharge:
- Nobody trains without a Smart Start first.
- Your program is written around your own screen, not a class plan.
- Every joint gets watched, every session, and the program adjusts in real time.
- Load goes up as tolerated, never on a time frame.
- You’re measured against yourself, never against anyone else in the gym.
Why Going Back to Your Old Class May Not Be Enough
You may be tempted to go straight back to what you did before you got hurt: yoga, Pilates or a group weights class. Those keep you moving, and there’s nothing wrong with any of them.
But a class planned for a room full of people can’t set the load for your shoulder. It can’t change that load as you get stronger, either. So the dumbbells you picked up a year ago are still the ones you use.
You can already exercise and still get stronger once the resistance is set against your own strength. One trial showed exactly that:
Nichols JF et al., Journal of the American Geriatrics Society, 1993. PMID 8440838.
Those women weren’t beginners. What changed was that the resistance finally matched what each of them could do.
Keep Reading
Where to Start in Timonium
You finished physical therapy. You used to be active. And you still don’t know what’s safe to lift.
Start with the Smart Start. It’s part of the free 1-week trial at 29 Again Custom Fitness in Timonium: the screen plus up to two coached sessions, so you can see how your own body responds before you decide anything.
Physical therapy got you back to acceptable. A program built around your own screen is how you get back to the things you used to enjoy.