To help a stroke survivor with exercises safely, stand on their weaker side, never pull on the weak arm, let them do as much as they can themselves, and only practise the exercises their physiotherapist has taught you. Little and often is better than long, tiring sessions. This guide is for families and carers, and it explains what to do, what to avoid and when to stop. Your relative's stroke team and physiotherapist know their needs, so follow their instructions first.
It can feel scary the first time you help someone you love who has had a stroke. You may worry about hurting them or doing the wrong thing. A few simple rules go a long way, and the best way to learn is to ask the physiotherapist to show you in person.
Start with the plan from the physiotherapist
- Ask for a written exercise plan, with pictures or videos if possible. Make sure you know how many repetitions, how often and which exercises to avoid.
- Ask to be shown. Ask the physiotherapist to watch you practise, so you can check your technique and ask questions.
- Agree on safety limits. Find out about blood pressure, pain, breathlessness, dizziness or fatigue that should make you stop.
- Do not copy exercises from the internet if they are not suited to your relative. A stroke can affect the shoulder, balance and feeling in ways that make some exercises unsafe.
The NHS explains how stroke rehabilitation works, and the Stroke Association has a guide to physiotherapy after stroke. Your own team's plan is the one to follow.
Golden rules for safe helping
1. Protect the weak arm
After a stroke, the shoulder on the weak side is easily hurt, because the muscles that hold it in place are not working properly.
- Never pull on the weak arm or hand to help someone stand, sit or turn over.
- Support the arm on a pillow or table when sitting, and in a sling only if your physiotherapist advises.
- Do not lift under the arm. Support from the trunk, waist or hips instead.
Our guide to managing shoulder and arm pain after a stroke explains why this matters.
2. Stand on the weaker side
Standing a little behind and to the weaker side means you can catch a loss of balance and support the trunk. Keep your feet apart and your knees slightly bent. Have a clear path, and keep your own back straight. Do not try to catch someone who is falling. It is safer to guide them down gently and call for help.
3. Let them do the work
It is tempting to do everything for someone you love. But recovery depends on the brain and body practising, not on you doing it for them. Offer just enough help to stay safe, and let them do the rest, even if it is slow. Ask yourself: "Could they try this first?"
4. Encourage the weaker side
Many people stop using the weak arm or leg because it is easier to use the stronger one. The physiotherapist may give exercises to use the weaker side in everyday tasks, such as holding a cup, folding a towel or pushing up from a chair. Our article on regaining hand function after a stroke has more ideas.
5. Little and often
Because of fatigue, short sessions work better than long ones. Aim for several short practice periods through the day, with breaks. See our guide on how often a stroke patient should do physiotherapy at home for more.
6. Never push through pain
Some effort is expected, but sharp pain, dizziness or breathlessness are signals to stop. Pushing through can make things worse.
Safe ways to help with everyday movements
Standing up from a chair
- Make sure the chair is firm, stable and not on wheels. Place it against a wall if you can.
- Ask them to shuffle forward, put their feet flat and slightly apart, and lean forward "nose over toes".
- Count "one, two, three" and have them push up using their legs. Their stronger hand can push from the chair arm.
- Stand to the weaker side, with your hands near their waist or hips, ready but not pulling.
- Wait a moment before walking, to check they feel steady.
Walking
- Stand slightly behind and to the weaker side, with a hand near the waist or a gait belt if the physio has taught you to use one.
- Give them the time they need. Do not rush or hurry them.
- Keep the floor clear. Make sure they wear supportive shoes.
- Do not hold them by the weak hand or arm.
Sitting balance and reaching
Seated exercises are a safe place to start. Our guide to seated balance exercises after a stroke shows eight options.
Do and don't
| Do | Don't |
|---|---|
| Ask the physio to show you the exercises | Copy random exercises from online videos |
| Stand on the weaker side | Pull or lift by the weak arm |
| Let them do as much as they safely can | Do everything for them |
| Keep sessions short and regular | Push through pain, dizziness or breathlessness |
| Praise effort, not just results | Compare with other people's recovery |
| Rest when tired | Practise when very tired |
| Keep the area clear and well lit | Rush or distract them while they are concentrating |
Communication and mood
If your relative has difficulty speaking or understanding (aphasia), speak slowly in short sentences, give them time to answer, use gestures or pictures, and reduce background noise. Do not talk over them or finish their sentences unless they want you to.
Frustration, tearfulness and low mood are common. Be patient, notice small improvements, and let them talk. Tell the GP if low mood goes on, because help is available. Our guide to post-stroke fatigue explains how tiredness affects practice.
When to stop and get help
Stop the exercise and let them rest if they have:
- New or increasing pain, particularly in the shoulder
- Dizziness, nausea or a sudden headache
- Shortness of breath, chest pain or a racing heartbeat
- Extreme tiredness, or they ask to stop
⚠️ When to call for help
Call 999 immediately if you see any signs of a new stroke: face drooping, arm or leg weakness, slurred or confused speech, sudden loss of vision, or a sudden severe headache. See the NHS stroke guide.
Call 999 or go to A&E after a fall if they hit their head and feel drowsy or sick, have severe pain, or cannot move a limb.
Call the GP or NHS 111 if there is a new swollen, painful, warm calf, or a fever.
Looking after yourself
Being a carer is demanding. Use correct lifting technique, ask for help, rest, and accept support from friends and services. Ask your local council about a carer's assessment, and call the Stroke Association helpline on 0303 3033 100 to talk through what you are facing.
Where physiotherapy fits in
A neurological physiotherapist can teach you safe ways to help, adapt exercises to your home and update the plan as recovery changes. Over time, you should be doing less and your relative more, which is a sign of progress.
Want a physiotherapist to show you and your family how to help safely? Book a stroke rehabilitation home assessment. The cost is £90 for 60 minutes, and no GP referral is needed.
This guide is general information, not personal medical advice. Always follow the instructions from your relative's stroke team and physiotherapist.
Frequently Asked Questions
Ask their physiotherapist for a written plan and to show you how to help. Stand on their weaker side, support rather than pull, let them do as much as they safely can, and keep sessions short and regular.
After a stroke the muscles that support the shoulder may not work well, so pulling can damage the joint and cause pain. Support them at the trunk, waist or hips instead.
Short sessions several times a day usually work better than one long session, because fatigue is common. Your physiotherapist will advise how long and how often for your relative.
Ask why. They may be tired, in pain, low in mood or worried. Try shorter sessions, choose a better time of day, link the exercises to something they enjoy, and tell their physiotherapist or GP if it continues.
Stop if there is new pain, dizziness, breathlessness, chest pain or extreme tiredness. Call 999 if you notice any signs of a new stroke or after a serious fall.