Every physio in New Zealand prints out a sheet of three to five exercises at the end of your appointment, hands it to you, and says "do these twice a day." They know full well that most people won't do them. We all know it. We do it anyway. There's a reason, and it isn't a good one.
The honest truth about exercise adherence
The research on this isn't ambiguous. Adherence to home exercise programs in musculoskeletal physio sits somewhere between 30% and 50%, depending on which study you read. Half the people who walk out with a printed sheet never seriously do the exercises. Of the half who try, most stop after a week.
We know this. Every physio knows this. We've all asked patients at week three how the home program is going, watched them go a bit sheepish, and made a polite note in the file to "review adherence next session."
Why we keep prescribing them anyway
Three reasons, in descending order of how often they're admitted out loud:
One. The exercises are the correct treatment. If you actually did them, they'd help. So we hand them over and hope.
Two. Handing over a printed sheet looks like treatment. It's a tangible artefact at the end of a session that makes the appointment feel complete. The sheet is part of the theatre of being looked after.
Three (the quiet one). If we prescribe the exercises and you don't do them, the recovery being slow is now your fault, not ours. The system protects the practitioner. The practitioner gets to feel like they did their job. The patient gets to feel guilty. Nothing about your shoulder gets better.
The actual problem
You don't do the exercises because the printed sheet is the weakest possible delivery mechanism. The cues are wrong, the intensity is guessed, the form is unobserved, the context is your lounge floor at 9pm when you're tired. Add normal life on top of that and the sheet is in the recycling bin by week two.
This isn't a discipline problem. It's a design problem. The prescription is set up to fail and then everyone blames the patient for failing.
What we do instead
Three things that aren't standard at most clinics, all of which we'd argue should be:
We take you out of the clinic room and into the gym
Recharge is set up with a fully equipped rehab gym next door to the treatment rooms. When the exercise prescription is the treatment, the exercise prescription happens in the gym, with the physio, on the actual equipment, with the actual load, watching your actual form.
You leave with the movement already in your body, not just on a sheet. You know what 80% effort feels like for your specific case because we just had you do it. The first time you try the exercise isn't alone at home that night. It's with us, today.
We send you video, via WhatsApp, of you doing it
When you go to do the exercise at home that night, you're not trying to remember what we said. You've got a 30-second clip of yourself doing it correctly, sent to you while you were still in the gym room. You can play it back next to you on the floor. Your kids think it's funny. You actually do the exercise.
We use WhatsApp because that's where you already are. You don't need to log into a portal, you don't need to install our app (we don't have one), and the videos sit alongside your messages from family. They get watched.
We don't charge for the check-ins
Three days in, you message us: "the second one is making my hip sore, is that the right kind of sore or the wrong kind." We message back. No fee. No "please book a follow-up appointment to discuss." If the answer needs a 90-second voice note, you get a 90-second voice note. If it needs us actually seeing you, we'll tell you that too, and book you in.
We don't charge for the small stuff because the small stuff is what makes the big stuff work. A two-line WhatsApp at the right moment saves two weeks of doing the wrong thing and ending up back in the clinic. That's better for you and it's better for us. The arithmetic only looks generous if you're thinking like a per-visit revenue clinic.
The bigger principle
Value for money doesn't stop at the EFTPOS machine.
Most healthcare is structured around the appointment. You pay for the time in the room. Outside the room, you're on your own. That model made sense when phones were a billable hassle. It doesn't make sense now, when a 30-second video and a four-word text would have prevented six weeks of guessing.
So we don't run it that way. The appointment is the start. The check-ins are part of the work. The video clips are part of the work. The "is this the right kind of sore" message at 9pm on a Thursday is part of the work. None of it is billed separately because it's all one job: getting you better. And getting you better is what we actually sell.
If your last physio handed you a sheet and never mentioned it again
That's not unusual. It's also not the best the profession can do. Ring us on 07 394 4227 for a free 15-minute phone chat. If you've been bouncing through clinics without anything sticking, we'll talk about what's been prescribed, what you've actually done, and what would change with the way we run things. Sometimes that means booking with us. Sometimes it means a different recommendation. Either way, the first conversation is free.
