The Benefits of Hands-On Exercise

As therapists grow in their skill-sets it’s beneficial (for both therapist and patient) to occasionally get “back to the basics.” Mary Cater, PT explains why you should take breaks from equipment, and get back to hands-on exercise.

Many of us therapists can become bored with the same routine at work. We get into the habit of performing the same exercises the same way on each patient. It is no wonder patients become bored and we become frustrated that they don’t seem to be progressing. We can get so involved in using fancy equipment and new treatment techniques that we forget the basic exercise techniques we were trained in. Maybe it is time to return to the basic fundamentals of exercise without the use of all our equipment.

So, why return to basic exercises?

  1. Get back to using our hands. Returning to one-on-one, hands-on therapy is beneficial for our patients. Touch can be very healing and provide most patients the interaction they need. Patients are likelier to feel more important, and that they have more of your focus, when you move away from machines and get back to working with them one-on-one. With hands-on activities, I have seen patients express they are getting better treatment and they respond more to those treatments.
  2. Position variety. Hands-on therapy can be applied in a variety of positions and makes it easier to add variance to those “tired” therapy routines. One example is the tendency to get into a habit of performing exercises in a sitting or standing position, forgetting there are supine and side-lying positions, also. Exercises can be varied to provide for gravity elimination, gravity assistance or gravity-resistive activities which provide new and interesting challenges for patients. It is also easier to perform concentric and eccentric muscle contractions with varied positioning.
  3. Promote PTs unique skill set. With our expert attention on basic exercises, it is easier to document the need for our unique training and skills. Anyone can strap on a free weight or climb on a piece of exercise equipment, but it requires our skills to provide for appropriate manual resistance, positioning and grading. Grading can be done for pain, decreased range of motion, weakness or fatigue and for provision of exercises that can be functional.
  4. Range of treatments. Basic exercises can lead therapists to more ideas for improvement/treatment. There are breathing exercises that almost all of our patients can benefit from. Postural exercises and core strengthening, contract/relax exercise, isometrics, rhythmic stabilization and PNF patterns, just to name some more. Stretching and positioning can also be beneficial for patients and staff. Manual therapy can also be incorporated into hands-on exercise programs, with soft tissue mobilization to reduce pain and to enhance muscle elongation with stretching. Try muscle facilitation to increase muscle firing and to improve patient participation, and incorporate therapeutic touch.

I have worked in therapy for 30 years and I still am discovering new and useful techniques to try with my patients. There is no limit to the number of hands-on, equipment-free activities that can be performed. Think how exciting that can be for you and your patients!


Mary Cater, PT has 30 years of experience in orthopedics, manual therapy, hospital-based therapy and SNF settings. Mary has been with RehabVisions since 2009. She is a self-proclaimed “dinosaur” in the therapy field who has touched on many techniques and likes to “think outside the box.”



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