What Is Exercise Therapy? How It Helps and How It Works
Exercise therapy is similar to physical therapy. Learn how it can help reduce your pain, build strength, and get you back to doing the things you love.
Here at Hinge Health, we believe that movement is medicine. Staying active in general — whether it’s swimming, gardening, power walking with friends, strength training, or playing games with your kids or grandkids — can keep you strong, reduce pain, and add life to your years. But if you’re dealing with pain or injury related to a musculoskeletal-related issue, exercise therapy may be a particularly beneficial form of movement. It could not only help you feel better, it’s also been shown to significantly reduce healthcare costs — a win for your body and bank account.
So what does exercise therapy involve — and how is it different from physical therapy or just regular exercise? All good questions! Let’s jump right to some answers.
Our Hinge Health Experts
Dylan Peterson, PT, DPT
Jonathan Lee, MD, MBA
What Is Exercise Therapy?
Exercise therapy is a type of physical activity that’s tailored to your unique needs, with a goal of reducing pain and improving function, says Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. It’s prescriptive, as opposed to being a general kind of movement.
If you have low back pain, for example, the exercises that would be best for you — ones that would help improve your symptoms and keep them from returning — would likely be different from the exercises that someone with knee pain or hip issues would do to ease their pain.
When you experience pain, there’s a tendency to want to avoid physical activity out of fear that it could make your pain worse. It’s a totally natural human response. However, reduced activity can lead to losses in strength and mobility that only exacerbate your symptoms, making you want to move even less. And that creates a whole pain cycle: You move less, and feel worse, so you decrease your activity and feel even worse. This negative loop of chronic pain and inactivity can be a difficult cycle to break.
On the other hand, there’s good evidence that moving through a bit of pain — especially with cardio, strength, and stretching moves that are targeted to your pain areas and needs — can break that cycle and put you on a path to healing.
Exercise Therapy vs. Physical Therapy
Okay, onto the next question that’s probably on your mind: Is exercise therapy the same thing as physical therapy? Not exactly.
“There's similarities between physical therapy and exercise therapy, but they also have their separate parts that are unique,” says Dr. Peterson. “Physical therapists are trained to help you modify your daily activities — like how you sit at your desk, lift heavy objects, walk, or play tennis — to address weaknesses and imbalances, improve your function, and reduce pain symptoms. And that includes an exercise program that you can do on your own. That’s the exercise therapy part.”
Exercise therapy and physical therapy are not interchangeable. Physical therapy means you are getting treatment from a licensed physical therapist or physical therapy assistant. At Hinge Health, our members can see their own licensed physical therapist who personalizes and oversees their care plan. Our physical therapists prescribe exercise therapy to our members.
Exercise therapy doesn’t always require in-person care from a physical therapist. And that’s one of the major benefits: the convenience factor. With exercise therapy, you get the perks of a plan that’s designed just for your needs — like the kind you get when you sign up for Hinge Health and describe your pain symptoms — yet you can do it at home on your own time. A good exercise therapy program is also designed to progress as you get stronger and feel more confident, so you keep getting results.
Exercise Therapy vs. Working Out
We’d never knock “plain old” exercise — because any type of movement can be beneficial for you. Being active helps maintain strong muscles, mobility, balance and flexibility, reduce pain, and have all sorts of protective effects from improving heart health to reducing the risk of type 2 diabetes, stroke, and overweight and obesity.
There is a key distinction between working out and exercise therapy, though.
“Working out isn’t necessarily aimed at improving musculoskeletal pain symptoms — so the goals may be different,” explains Dr. Peterson. Think of it this way: If you have arthritis, swimming could be a good form of exercise therapy for you that increases mobility in your joints, boosts muscle strength, and reduces your pain, while the person in the lap lane next to you without arthritis might be swimming just to get a good cardio workout.
Benefits of Exercise Therapy for Pain
So what are the key benefits of exercise therapy? We’ve touched on some of them, but they’re worth mentioning again. They include:
Reduced pain, which often means less need for medication and expensive screenings and procedures. In fact, exercise can help retrain your pain system (more on than in a moment).
Improved mobility and range of motion.
Faster recovery if you do get injured.
Ability to find more comfortable standing and sitting positions (posture).
Fewer age-related issues, such as arthritis, osteoporosis, and sarcopenia.
Greater life satisfaction and better mental health.
Exercise Therapy and Retraining Your Pain System
Yes, it’s true: Exercise therapy can actually help change the way your tissues feel pain. How is that possible?
Pain is a protective response that in most cases is a good thing. It tries to buffer you from injury or danger, right? After injury, it is normal and helpful for this protective buffer to become bigger. This means feeling pain more quickly and easily. However, if the protective buffer does not re-calibrate as your injury heals, you continue to feel pain quickly and easily without it being helpful. It’s kind of like a fire alarm going off when a candle is burning in the next room, instead of when there is a fire.
“Exercise therapy can help recalibrate an overprotective buffer in the tissues. By doing movements, like stretching and strengthening exercises, you’re reteaching your pain system what a normal protective buffer should be with different activities and movements. As the pain buffer recalibrates, so does the sensitivity of the tissues,” says Dr. Peterson. The result is often less overall pain and the ability to do more.
Exercise Therapy for Mental Health
Exercise therapy not only helps pain, but also can help improve mental health symptoms like anxiety and depression. This is important because mental health and pain are closely connected. Improving symptoms in one area may help you experience improvements in another.
Research shows that people who experience chronic pain are more likely to have symptoms of depression and anxiety — and, vice versa, that those with mood disorders are also apt to report more pain. In fact, among adults with depression, 65% also experience chronic pain. And of people with chronic pain, up to 50% have depression.
“Many kinds of stressors can sensitize and affect the body,” says Dr. Peterson. “For example, we know that people going through financial hardship are more likely to have symptoms of physical pain than those who aren’t experiencing issues with money. Despite no changes we can see from the outside, there is likely a lot of change happening right under the surface, such as an increase of inflammation throughout the tissues and body.”
A recent meta-analysis of 97 studies involving more than 128,000 participants published in BMJ Sports Medicine found that regular exercise (of any kind) was 1.5 times more effective at reducing mild to moderate symptoms of depression, anxiety, and psychological stress than medication and cognitive behavior therapy (CBT). The researchers concluded that physical activity should be the first-line treatment for those living with mental health issues.
And then there’s the endorphin factor: In addition to the mood changes in the brain that exercise therapy can induce, the feel-good chemicals (endorphins) that are created when you move your body are also known to reduce depression, anxiety, and stress and to boost mood.
As symptoms of mental health improve, this can also positively impact pain. Research suggests that having a positive mindset can alter brain structure and how it processes discomfort after just a few weeks, which in turn reduces pain signals.
PT Tip: Push Yourself, but Not Too Far
“When it comes to exercising, the goal is to push yourself to the edge of your comfort zone most of the time, but try to not go too far past it,” says Dr. Peterson. “It is common and normal to overdo it here and there, but that’s a good goal to aim for and is an important step toward ultimately feeling better. That might mean moving through a certain amount of pain at times, so you can keep challenging yourself.”
How Hinge Health Can Help You
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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Denninger, T. R., et al. (2018). The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis from a Physical Therapy Patient Registry. Journal of Orthopaedic & Sports Physical Therapy, 48(2), 63–71. doi:10.2519/jospt.2018.7423
Allen, K. D. (2020). Cost-Effectiveness of Physical Activity and Exercise Therapy Programs for Knee Osteoarthritis: Making the Case for Health Plan Coverage. Osteoarthritis and Cartilage. doi:10.1016/j.joca.2020.02.833
Butera, K. A., Fox, E. J., & George, S. Z. (2016). Toward a Transformed Understanding: From Pain and Movement to Pain With Movement. Physical Therapy, 96(10), 1503–1507. doi:10.2522/ptj.20160211
Anderson, E. & Durstine J. L. (2019). Physical Activity, Exercise, and Chronic Diseases: A Brief Review. Sports Medicine and Health Science, 1(1), 3–10. doi:10.1016/j.smhs.2019.08.006
Sun, E., et al. (2018). Association of Early Physical Therapy with Long-Term Opioid Use among Opioid-Naive Patients with Musculoskeletal Pain. JAMA Network Open, 1(8), E185909. doi:10.1001/jamanetworkopen.2018.5909
Bielecki, J. E., & Prasanna T. (2021). Therapeutic Exercise. PubMed, StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK555914/
Louw, A., et al. (2019). Pain Neuroscience Education: Which Pain Neuroscience Education Metaphor Worked Best? South African Journal of Physiotherapy, 75(1). doi:10.4102/sajp.v75i1.1329
Nijs, J., et al. (2015). Exercise Therapy for Chronic Musculoskeletal Pain: Innovation by Altering Pain Memories. Manual Therapy, 20(1), 216–220. doi:10.1016/j.math.2014.07.004
Simons, L. E., et al. (2014). Psychological Processing in Chronic Pain: A Neural Systems Approach. Neuroscience & Biobehavioral Reviews, 39, 61–78. doi:10.1016/j.neubiorev.2013.12.006
Hubbard, C. S., et al. (2014). Altered Brain Structure and Function Correlate with Disease Severity and Pain Catastrophizing in Migraine Patients. Eneuro, 1(1), ENEURO.0006-14.2014. doi:10.1523/eneuro.0006-14.2014