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Therapeutic exercise and home programs

Therapeutic exercise is a program of specific strengthening, mobility and balance exercises, shown in the office and continued at home. It is part of care here because clinical guidelines for back pain, neck pain and many joint problems include exercise among their recommended treatments. Dr. LeGault provides it, with your home program in the Physitrack app or on printed handouts, progressed over your visits.

Reviewed by Dr. Steven K. LeGault, DC on

Why is exercise part of chiropractic care here?

Because the guidelines for back pain, neck pain and common joint problems name exercise among their recommended treatments, and present hands-on care as one part of a plan that includes it.

Exercise is part of our care for back pain, neck pain, sciatica, tension-type headaches, ankle, shoulder and knee problems and back and pelvic pain in pregnancy, and it can be combined with adjustments.

What does a home exercise program involve?

Dr. LeGault shows you each exercise in the office, gives you your program in the Physitrack app or as printed handouts, and progresses it over your visits.

  1. Shown in the office

    Dr. LeGault shows you each exercise at your visit, so you know how it should feel.

  2. Your program at home

    You get your program through the Physitrack app on your phone or as printed handouts.

  3. Progressed over your visits

    Your exercises are progressed over your visits as you are able to do more.

What do guidelines recommend for back pain, sciatica, neck pain and headaches?

Each of these guidelines includes exercise, from group or supervised programs for low back pain and sciatica to strengthening and range-of-motion work for neck pain and specific neck and shoulder-blade exercises for tension-type headache.

What do guidelines recommend for ankle, shoulder and knee problems?

Exercise is the main recommended treatment for all three: a structured program after an ankle sprain, exercise first for common shoulder pain, and exercise for knee osteoarthritis.

How do I fit exercise into daily life?

Do your program a little at a time on a regular schedule, keep up your normal activities as much as you can, and bring your questions to your next visit.

  • Pick a regular time of day, such as before work or after dinner, so the exercises become part of your routine.
  • Follow the app or your handout, so you do each exercise the way you were shown.
  • Keep up your normal daily activities as much as you comfortably can.
  • Tell Dr. LeGault at your next visit what felt easy or hard, so your program can be progressed.

Who provides therapeutic exercise?

Dr. LeGault provides therapeutic exercise and home programs at our office.

Can exercise make things worse?

Exercise can bring some extra soreness, and in knee osteoarthritis research it slightly increased side effects, mostly minor ones, which is why your program is progressed step by step.

When should I stop and get medical care instead?

Stop and get medical care for warning signs such as loss of bladder or bowel control, weakness in both legs, sudden stroke-like symptoms, a possible broken bone, or a pregnancy warning sign.

Questions, answered

Can I follow my exercises on my phone?

Yes. Home programs are given through the Physitrack app or as printed handouts.

Is therapeutic exercise covered by insurance?

Coverage depends on your plan. Call 412-364-4100 and we can check your benefits before your first visit.

Dr. Steven K. LeGault, DC sees patients on Monday, Tuesday, Wednesday and SaturdayJust off McKnight Road, on-site parking

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References

  1. American College of Physicians low back pain guideline (2017): Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367 (ACP now lists this guideline as inactive) (opens another site)

    For chronic low back pain: non-drug treatment first (strong recommendation); exercise among the options (moderate-quality evidence).

  2. WHO low back pain guideline (2023): World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. Geneva: WHO; 2023. ISBN 978-92-4-008178-9 (opens another site)

    Structured exercise programs, and education and advice, as part of care (conditional recommendations, low and very low certainty).

  3. Canadian chiropractic neck pain guideline (2016): Bussières AE, Stewart G, Al-Zoubi F, et al. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther. 2016;39(8):523-564.e27. doi:10.1016/j.jmpt.2016.08.007 (opens another site)

    A combined approach of hands-on care, self-care advice and exercise (weak recommendations, generally low-quality evidence).

  4. NICE low back pain and sciatica guideline (NG59): National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. Published 2016, last updated 2026 (opens another site)

    Consider a group exercise program for a flare-up of low back pain with or without sciatica (a “consider” recommendation).

  5. Neck pain clinical practice guideline (2017): Blanpied PR, Gross AR, Elliott JM, et al. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017;47(7):A1-A83. doi:10.2519/jospt.2017.0302 (opens another site)

    Thoracic manipulation with range-of-motion and strengthening exercise for recent neck pain with limited movement (Grade B); screening for serious problems.

  6. 2025 Cochrane review of manual therapy with exercise for neck pain: Chacko N, Gross AR, Miller J, et al. Manual therapy with exercise for neck pain. Cochrane Database Syst Rev. 2025;12:CD011225. doi:10.1002/14651858.CD011225.pub2 (opens another site)

    Manual therapy plus exercise may give a large short-term reduction in neck pain versus no treatment (low certainty).

  7. OPTIMa headache guideline (2019): Côté P, Yu H, Shearer HM, et al. Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. Eur J Pain. 2019;23(6):1051-1070. doi:10.1002/ejp.1374 (opens another site)

    Low-load neck and shoulder-blade exercises for tension-type headache; benefits small at best.

  8. Cochrane review of pregnancy back and pelvic pain (2015): Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;(9):CD001139. doi:10.1002/14651858.CD001139.pub4 (opens another site)

    Exercise may reduce pregnancy-related low back pain (low quality); fewer women reported pain after 8- to 12-week programs (moderate quality).

  9. Ankle sprain clinical practice guideline (2021): Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302 (opens another site)

    A structured exercise program after an ankle sprain (Grade A); prompt assessment for a suspected fracture or inability to bear weight.

  10. Shoulder pain umbrella review (2020): Pieters L, Lewis J, Kuppens K, et al. An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. J Orthop Sports Phys Ther. 2020;50(3):131-141. doi:10.2519/jospt.2020.8498 (opens another site)

    Exercise therapy as the first-line treatment for subacromial shoulder pain.

  11. Cochrane knee exercise review (2024): Lawford BJ, Hall M, Hinman RS, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2024;12:CD004376. doi:10.1002/14651858.CD004376.pub4 (opens another site)

    Exercise probably improves knee osteoarthritis pain, function and quality of life in the short term (low to moderate certainty); may slightly increase mostly minor side effects.

  12. NHS sciatica guidance (reviewed 2024): National Health Service (England). Sciatica. nhs.uk, page last reviewed 3 December 2024 (opens another site)

    Keeping active and gentle exercise can help; emergency signs of a serious back problem; see a doctor if sciatica is not improving.

  13. 2015 Cochrane review of exercise for neck pain: Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;1:CD004250. doi:10.1002/14651858.CD004250.pub5 (opens another site)

    Stretching alone may not change pain or function (low-quality evidence); when only stretching exercises were used, no beneficial effects may be expected.

  14. CDC urgent maternal warning signs (2024): Centers for Disease Control and Prevention. Urgent Maternal Warning Signs and Symptoms. HEAR HER campaign (opens another site)

    Seek medical care immediately for urgent maternal warning signs.

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