The Power of Habits: Improve Your Outcomes with Physical Therapy and Exercise

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The Power of Habits: Improve Your Outcomes with Physical Therapy and Exercise

I recently read the most amazing and inspiring book called Atomic Habits by James Clear. I wanted to share some of the wisdom this book imparted, and how it might affect a patient coming to physical therapy. Most of the time when we think about making a change in our lives, we think in terms of goal setting. We hear advice like “set small, realistic goals”, or we are encouraged to have 1, 5 and 10 year goals. When we come to physical therapy, the treating therapist will set short-term and long-term goals to measure the progress of our recovery. What if we adjusted our mindset just slightly? What if instead, we focused on the small, sustainable habits that could make those goals a reality?

When one thinks about habits, one might say to themselves that they have “good” habits and “bad” habits. There is a different approach needed when you are trying to establish a “good” habit rather than eradicate a “bad” habit.  For this post I will focus on establishing good habits.

There are 4 phases of a habit that loop continuously:  a cue, a craving, a response, and a reward.  To use a real world example of the habit loop, let’s think about a green traffic light. The cue is the light turning green, the craving is the desire to move forward, the response is the actual action of pressing the accelerator, and the reward is safely navigating through the intersection. The reward is important because success in this regard will cause the habit loop to continue. Your brain becomes wired every time it sees a green light to proceed through the intersection because you have safely passed through so many times before, and so the cycle repeats. But what kind of cue does a yellow light give? This is where individual experience dictates the outcome. Some of us speed up, some of us slow down. If a person has had enough safe passages through an intersection on a yellow light, the brain says to speed up. If you’ve nearly gotten in a crash on a yellow light, your response is to slow down.

When establishing good habits, there are tricks at every level of the habit loop to get you inspired to make the right choices.  Let’s talk about the first phase of the habit loop: the cue. In order for a cue to grab your attention, it needs to be made VERY OBVIOUS. This can be done in a variety of ways; setting alerts on your phone, leaving yourself a sticky note, setting your running clothes or exercise bands out the night before, etc. If you are trying to make a habit of doing a home exercise program every day, utilize these obvious cues. Have the print out of your exercises taped to your bathroom mirror ( and if you lose it, no excuses….call us and we’ll print you a new one!).  Another way you can make your cues obvious is to “stack” them with another habit that you perform every day. For example, after you feed your dog, you will immediately begin your home exercise program.

Now on to the second phase of the habit loop: craving. How can we crave exercise the same way we crave chocolate chip cookies? You must make it ATTRACTIVE ( and trust me, I relate very much to you if you think the cookie is ALWAYS going to be more attractive than the exercise!). But there is a simple way to make an activity more attractive; you must immerse yourself in a culture or situation that values the habit you are trying to establish. This is why immediately during or after physical therapy/gym time you feel compelled to continue your program! Being around healthy individuals and coaches inspires you to change your identity to be one who embraces health. Humans have an innate desire to be a part of the crowd, so place yourself in the crowd you aspire to be a part of! You can also make a habit attractive by pairing it with a habit that you ALREADY enjoy. For example, do your home exercise program during your Netflix binge.

Third phase: response. How can we actually take action towards a desired habit? The solution is intense repetition in small bouts. In Atomic Habits, James Clear argues that you are more likely to establish a habit by just performing it 2 minutes a day, but the key is to perform it every single day. If you want to get into an exercise habit, it is better to run for 2 minutes a day for a month than to run 30 minutes once a week. By performing a habit daily, no matter how little time you spend, it is like cutting the groove on a record. As the groove gets deeper, it gets easier and easier to perform each day. The idea is that you will naturally increase the time spent on the habit once the habit is actually established.

Finally the fourth phase: reward. The reward must be satisfying. It must yield success, otherwise our brain would have no reason to repeat it once we see the cue. It must also be something small, yet significant enough to do every time we repeat our desired habit. To implement, reward yourself each time you perform a desired habit. For example, if you just LOVE your morning coffee, reading the paper or scanning social media, make that your reward after you exercise.

To summarize, there are 4 phases of the habit loop: cue, craving, response and reward. For each of these phases, there are specific tricks to maximize your outcomes: make it OBVIOUS, make it ATTRACTIVE, REPEAT DAILY IN SHORT BURSTS, and GIVE YOURSELF A POWERFUL REWARD. These concepts only just scratch the surface, and I highly recommend that you check out James Clear’s book, Atomic Habits to learn more tricks on establishing great habits.

Another powerful tool in your habit toolbox is to speak up about your desired health outcomes. We here at Complete Physical Therapy will listen empathetically and help to create a plan that will get you to where you want to be. Having a caring team that will hold you accountable is one of the greatest assets you can have when trying to make a lasting change in your health and well-being.