How to Know You’re Doing Your Rehab Exercises Correctly

(A PT’s perspective with science-backed cues)

Patients often have questions about whether they’re doing their exercises right. After their first exposure to a new exercise they often ask, "How am I suppose to do this on my own?". We’re trying to teach your body something it doesn’t know how to do and that can be really challenging!

I try to make it as easy as possible by finding a way that their body and brain can connect to such as getting repetition, providing detailed instructions, providing additional specialized notes, and videoing them performing the exercises with their unique individual cues.

There are other strategies that can be helpful as well. Doing movement is easy; doing movement correctly, is sometimes not. However, proper internal cues is what changes tissue, neuromotor control, and ultimately function. 

Here’s a framework I use in the clinic, broken into three domains of internal feedback:

Domain	What to Observe	Why It Matters	Research Context
Internal Pressure / Airflow	Where does the air go? Which spaces expand or relax?	It reveals how your internal tension system is organizing. If air finds new room, it suggests you’re offloading compensatory zones.	Breathing patterns interact with posture and abdominal muscle activation. Nature A recent paper also shows that external and internal cueing changes core muscle activation during stability tests. PMC
External Pressure / Grounding	What do you feel pressing against surfaces (floor, wall, ground)?	It indicates whether your center of mass is well positioned and forces are being directed appropriately.	Proprioceptive training (sensing your body in space) is well-established to improve motor performance and joint control. Frontiers+1
Muscle Work / Activation Awareness	Which muscles are turning on? Do you feel recruitment in the intended area, or in compensatory muscles?	You want the right muscles doing the right job—no sneaky overdrive from habitual compensations. Pain is often the signal you’re still relying on the wrong patterns.	The interplay of breathing, muscle recruitment, and posture is being explored in biomechanics and neuromotor control research. Nature

Below I expand each domain—why it’s essential, how to train your awareness, and practical check-ins you can do during your exercises.

1. Internal Pressure & Airflow: Listening to Your Breath

Your breath is a window to your internal pressure system. Air goes where there's less resistance. If certain zones are chronically tight or dysfunctional, air will avoid them. One sign of progress is when you begin to feel expansion in areas that previously didn’t move. Often the question of where does are go, or does this move is confusing for people. It’s not something that has registered at all because the rib cage has not been moving. But it’s really important!

Why it matters physiologically

• Intra-abdominal pressure (IAP) is controlled by the diaphragm, abdominal muscles, pelvic floor, and the deep trunk musculature. How you breathe affects how those systems interact. Nature+1

• Forced exhalation (e.g. fully letting air out) in controlled postures can raise IAP and engage deeper abdominal muscle activity (e.g. transverse abdominis / internal oblique) more than passive breathing. Nature

• Breath control practices also have downstream effects on autonomic balance and mental state, which can influence motor control, attention, and recovery. Frontiers+2PMC+2

• The ability to expand and compress areas of the rib cage, front, back, left, right, are important for ensuring adequate compressive states of the body to appropriately transmit force through appropriate muscle chains into the ground. Without this, we lose efficiency, we overuse neck and back muscles for stabilization and rotation. We need to allow for correct thoracic rotation and displacement of air so that our body can move into and through space.

How to train internal awareness

• Start with your assigned position during your exercise. Take a slow inhale and observe which regions expand.

• On exhale, feel rib cage compress, abdominals engage.

• Observe how changing position changes function during your exercises to see how the inhale-exhale shifts internal pathways of least resistance.

• If you can’t sense it, it’s probably not happening. You can use your hands to help improve awareness if your brain isn’t well connected to that area.

Check-in cues during your exercises

• “Is there a new sensation of room in my lower ribcage, lungs, back, or pelvis that I didn’t feel before?”

• “Do I only feel my stomach move or can I also feel rib movement?”

• “Does shifting my posture change how air distributes?” “Does looking up by slightly lifting my chin help?”

2. External Pressure: Grounding Your Body in Space

If internal pressure is your inside feedback, external pressure is your outside feedback. Feeling how your body presses against surfaces (floor, wall, ground) gives you tangible clues about your alignment, balance, and force direction.

Why it matters

• A well-positioned center of mass will transmit force through optimal pathways (e.g. feet, sit bones, scapular contacts) rather than leaking through joints or soft tissues.

• This external pressure sense is a kind of proprioceptive feedback system. Proprioceptive training has been shown to significantly improve motor performance and joint control in healthy and clinical populations. Frontiers+1

• Exercises that use both internal and external cues (e.g., pressing into the floor while engaging your core) often induce superior muscle activation patterns. PMC

How to heighten external feedback

• Before each repetition, pause and feel the contact points: feet (mid-foot, heel, toes), sit bones, back against wall or floor, hands if applicable.

• Shift body weight, create rotation as needed to sense area

Check-in cues during your exercises

• “Am I losing contact or awareness in one foot or sit bone?”

• “Do I start clenching my toes, glutes, upper abdominals, neck, or lower back instead of my intended zones?”

• “Does a small postural tweak change where I feel pressure?”

3. Muscle Work: Who Is Doing the Work?

This is often the most intuitive feedback—“Which muscles are turning on?” But it’s also the trickiest, because compensation is sneaky. You want the correct muscle to do the work, and want to avoid letting compensations occur. Don’t assume that because you’re doing the exercise the right muscles must be working. Not so. Make sure you can feel them, and sense with your brain, not by having to touch the muscle and feel that it’s active with your hand. If it’s "I’m not sure", "I don’t know", "Maybe", or "It might be", it’s a no.

Why it matters

• Neuromotor control is not just about strength: it's about coordination, inhibition, and timing.

• You can’t strengthen what you can’t activate

• Pain often shows up when you’re using the wrong muscles. Your central nervous system is defaulting to a familiar but inefficient pattern.

How to refine muscle awareness

• Make sure you’re in the right position, with the right external references

• Consciously relax muscles that shouldn’t be working, neck, chest, low back, face.

• You may use your hands to help sense an area. Over time, progress to less tactile guidance, relying more on your internal and external cues.

Check-in cues during exercises

• “Do I feel tension in the neck, face, or jaw when I shouldn’t?”

• “Is the target muscle the one with the dominant sensation, or is something else doing the heavy lifting?”

• “Am I shaking?” This is almost always a sign our nervous system is trying to learn how to use these muscles and is typically positive.

Pain Is a Signal, Not a Goal

Nothing should hurt. Pain suggests:

• You’re using the wrong muscles

• You’re holding excessive tension

• Your positioning or inhibition is off

If you feel pain, stop. Reassess your internal, external, and muscle cues. Once those are aligned (see below), the movement should feel challenging but safe.

Putting It All Together: Position Drives Function

If you can guide your body into a good starting space, the internal pressures, external feedback, and neuromotor control tend to fall into place. Learning where this is and how to get there is a challenge and a big piece of the process.

Here’s a simplified workflow for any given exercise:

1. Set up your position (posture, alignment)

2. Check internal airflow (let the breath settle)

3. Sense external contacts (feet, sit bones, wall, floor)

4. Initiate the movement slowly, pausing to scan muscle activation

5. Adjust micro-positions if any of the three domains feel off

6. Proceed with awareness, not force

Over time, your body learns to self-correct using this feedback. You’ll begin to feel more comfortable with the sensation you’re looking for and the skills become more automatic.

Please note, while details are important, you also don’t have to be perfect. Anything that gets you closer to optimal function and changes your current motor pattern can be beneficial. We can continue to refine, learn and build on the skills you acquire.

Final Thoughts & Further Reading

This three-domain model aligns with how human physiology, neuromotor control, and sense systems interact. While the research is still emerging, there is growing evidence:

• Breathing patterns and posture modulate muscle activation and internal pressure behavior. Nature

• Cueing (both internal and external) significantly influences core and stabilizer activation patterns. PMC

• Proprioceptive training enhances sensorimotor performance across many populations. Frontiers+1

I encourage you to integrate this model into your rehab practice or personal exercise routine. With consistent feedback tuning, you begin to feel when an exercise is working—not just because it burns, but because everything lines up (internal pressure, external grounding, and muscle activation) in harmony. This helps our brain begin to automate function. If you can’t feel where you are, you’re not getting appropriate feedback for your brain to regulate your function. Our goal is to have autonomous functioning and this awareness helps our brain figure out how.