A practical guide for beginning physical therapy, from your initial evaluation through building a home exercise program and tracking your progress toward recovery goals.
Get a referral from your doctor if required by insurance
About 50% of insurance plans require a physician referral for PT coverage. Check your plan details. In most states, you can see a PT directly without a referral, but insurance may not cover it.
Verify your insurance covers physical therapy visits
Call the number on your insurance card and ask: how many PT visits per year are covered (typically 20-60), what is the copay per visit ($20-75 is common), and is pre-authorization required.
Ask about visit limits per calendar year
Ask about copay or coinsurance amounts
Choose a PT clinic and therapist
Look for a therapist with experience in your specific condition. Clinics with 1-on-1 care (not 2-3 patients at once) produce faster outcomes. Call ahead and ask about their treatment style and average session length (45-60 minutes is standard).
Gather your medical records and imaging results
Bring MRI, X-ray, or CT scan reports from the last 6 months. Include surgical notes if applicable. Having these saves 1-2 visits of diagnostic time and helps your therapist create a targeted plan from day one.
Write down your symptoms and goals
Note when the pain started, what makes it worse or better, and a pain rating (0-10) for different activities. List 3 specific goals, like "walk 1 mile without pain" or "return to jogging by month 3."
Your Initial Evaluation
Wear comfortable, loose-fitting clothing
Your therapist needs to see and touch the affected area. For knee issues, wear shorts. For shoulder issues, wear a tank top. Avoid jeans or restrictive clothing. The evaluation lasts 45-60 minutes.
Be honest about your pain levels and limitations
Downplaying pain leads to an overly aggressive program. Rate your pain accurately on the 0-10 scale. Mention all activities that cause pain, even if they seem minor. Your therapist adjusts the plan based on your honesty.
Ask about your diagnosis and expected timeline
A typical PT program lasts 6-12 weeks with 2-3 sessions per week. Ask your therapist for a realistic recovery timeline with milestones at weeks 2, 4, and 8. Most patients see measurable improvement within 4-6 visits.
Discuss your treatment plan and home exercise program
Your therapist should provide a written home exercise program (HEP) with 4-6 exercises by your second visit. Patients who do their HEP 5 days per week recover 40% faster than those who only attend clinic sessions.
Build Your Home Exercise Routine
Set up a dedicated exercise space at home
You need a clear floor area of roughly 6 feet by 4 feet. Place a yoga mat or thick towel on the floor. Keep a resistance band, ice pack, and a timer within reach. This setup takes 5 minutes and removes excuses.
Purchase any recommended equipment
Common PT equipment costs: resistance bands ($8-15 for a set), foam roller ($15-25), exercise ball ($12-20), and a set of light dumbbells ($15-30). Ask your therapist for exact specifications before buying.
Schedule your home exercises at a fixed daily time
Morning exercisers show 20% higher adherence than those who plan to exercise "sometime today." Set a daily alarm. Most home programs take 15-30 minutes. Consistency matters more than duration.
Follow the prescribed sets, reps, and hold times exactly
If your therapist says 3 sets of 10 reps with a 5-second hold, do exactly that. More is not better in PT — overworking an injured area can set you back 1-2 weeks. Increase only when your therapist adjusts the plan.
Apply ice after exercise if instructed
Ice for 15-20 minutes within 30 minutes of completing your exercises. Use a thin cloth between the ice pack and your skin. Icing reduces post-exercise inflammation and soreness by up to 25%.
Track Progress and Communicate
Keep an exercise and pain log
After each session, note: exercises completed, pain level before and after (0-10), and any exercises that felt too easy or too hard. Bring this log to every clinic visit. It takes 2 minutes and saves valuable session time.
Report new or worsening symptoms immediately
Some soreness after PT is normal and should fade within 24 hours. Sharp pain during an exercise, pain that lasts more than 48 hours, or new symptoms like numbness or tingling require an immediate call to your therapist.
Measure your progress against baseline every 2 weeks
Track range of motion (how far you can bend or extend), strength (what weight you can lift), and function (stairs climbed, distance walked). Most patients see 10-15% improvement every 2 weeks in the early phase.
Discuss your plan for transitioning out of PT
Around week 6-8, discuss a maintenance plan with your therapist. This includes a long-term exercise program you will continue independently. Patients who follow a maintenance program have a 50% lower re-injury rate at 1 year.
Maximize Your In-Clinic Sessions
Arrive 5-10 minutes early to each session
Use the extra time to warm up with light walking or stretching. PT sessions are typically 45-60 minutes. Late arrival cuts into your treatment time, and most clinics cannot extend the session.
Ask questions about every exercise
Understand the purpose of each exercise: which muscles it targets, why it helps your condition, and what correct form looks like. Patients who understand the "why" have 30% higher exercise compliance at home.
Request exercise modifications if something hurts
Pain above a 4 out of 10 during an exercise means it needs modification. Your therapist can adjust the angle, resistance, or range of motion. There is always an alternative that works the same muscle group safely.
Frequently Asked Questions
How many physical therapy sessions will I need?
Most treatment plans run 2-3 sessions per week for 4-8 weeks, totaling 8-24 visits. Post-surgical rehab (like ACL reconstruction) can last 6-9 months. Your PT will set specific goals at your first visit and adjust the plan every 2-4 weeks based on your progress. Consult your doctor for advice specific to your situation.
Does insurance cover physical therapy?
Most health insurance plans cover PT with a referral from your doctor. The typical copay is $30-$75 per visit. Many plans cap coverage at 20-60 visits per year. Medicare covers PT with no visit cap but applies a financial threshold of about $2,230 per year, above which additional documentation is required.
Should physical therapy be painful?
Mild discomfort during stretching and strengthening is normal, but sharp or worsening pain is not. A general guideline is that exercise-related soreness should resolve within 24-48 hours. If pain during a session exceeds a 5 out of 10, tell your therapist immediately so they can modify the exercise. Consult your doctor for advice specific to your situation.
What should I wear to physical therapy?
Wear loose, comfortable athletic clothing that allows full range of motion and gives the therapist access to the affected area. Shorts work well for knee or hip issues, and a tank top is best for shoulder treatment. Bring clean athletic shoes with good support. Avoid jeans, belts, and bulky jewelry.
Can I do physical therapy at home instead of in a clinic?
Home exercises are a critical part of every PT program and typically make up 80% of your recovery work. However, in-clinic sessions provide hands-on manual therapy, specialized equipment, and professional oversight that home programs alone cannot replicate. Most therapists assign a 20-30 minute home exercise program to do on non-clinic days.