I first went to a physical therapist two decades ago, in my 40s, when I injured my shoulder in yoga. Young, fit and overly sure of myself — a runner and bicyclist, an aerobics instructor — I didn’t do the exercises with any consistency, and I live with that mistake to this day.
After visiting a different PT twice in my early 60s for a pulled hamstring and another shoulder injury, I figured out that physical therapy, like yoga, only pays off with regular practice. If you commit to performing the highly specific, often tedious exercises every day — or nearly so — your body will heal and feel better. Otherwise, you likely will remain in pain.
Given that reality, how practical is the growing trend of providing physical therapy not in a clinical setting but via a mobile app that people can access at home?
My experience as a physically active 68-year-old woman dealing with the normal wear and tear of aging proves that it can, indeed, work. Hinge Health, a San Francisco–based company whose services are free through my Medicare Advantage plan, has been nothing short of a godsend for my stiff neck and perpetually impinged left shoulder.
Initially, I was skeptical whether video visits with a PT and a health coach could possibly be effective. But I was so tired of shoulder pain, which was hindering my spring bike riding, that I decided to try it last May.
“People come to us with a wide range of goals,” says Doctor of Physical Therapy Melanie Cosio, based in Mobile, Alabama, and serving members (the word Hinge Health prefers to “patients”) across the country. “We often see people getting ready for a surgery, whether sports-related or they slipped and fell at their house.”
She sees plenty of older people like me, who’ve been athletic our whole lives and — seemingly out of nowhere — are now more prone to injury or sudden aches and pains. “They want to stay on top of their mobility,” says Dr. Mel, as the program calls her.
Hinge Health also serves older adults who may be housebound, lack access to in-person appointments or want a daily dose of motivation, backed by scientific research. “Hinge Health gets us into people’s homes, no matter how rural they are,” she explains. “The connection I can make via video is really impactful. We’re also making programs that are easy to digest and access from someone’s phone.”
“Our stretching and strengthening exercises help your body get more resilient and train your nervous system to better cope with pain.”
Hinge Health mobile app, education library
Traditional physical therapy states that movement is medicine. Hinge Health translates that time-honored philosophy into a 21st century AI-powered program that potentially reaches more people and keeps them exercising longer.
Rewards, including free exercise gear and performance badges, are woven throughout the program. Key to why Hinge Health works, however, is reliance on the foundations of successful physical therapy — motivation, consistency and education — but with a modern, more accessible twist.
Daily texts provide chipper reminders to “exercise for better sleep and a more vibrant you,” “keep marching forward” and “get up and glow.” Those prove to be more motivational than annoying. In fact, the messages work to plant a seed: I’d better do this today if I want to hit my weekly goal.
The daily playlists are no more than 11 minutes, and each session earns points that eventually push you to the next level, with progressively harder exercises. At the end of each session, you can indicate whether a particular movement was too hard or too easy, and the system will adjust your playlist’s difficulty.
An assigned physical therapist and health coach are within easy reach through the app and typically respond within a day. More immediately, Hinge Health’s TrueMotion® AI technology, or “real-time feedback,” lets you track through your smartphone whether you’re performing the exercises correctly.
“Laser beams of light are being shot so they can monitor where you are,” explains Tony Schmitz, a Hinge Health member from St. Paul, Minnesota. “It’s a little Wizard of Oz-ish: Who’s behind the curtain, really? Maybe it’s all AI and there is no person.”
More enticing for me than the technology was the free equipment. Hinge Health sent a phone stand when I finally enrolled last spring, after my insurance provider, Blue Cross Blue Shield of Minnesota, mailed out two invitation letters (“move better and feel better with online physical therapy”). A set of resistance bands, which I had never used in weight-training workouts before, and a yoga mat soon followed. I even got an electronic muscle- and nerve-stimulating device called Enso 3, once I had demonstrated that I was serious about the Hinge Health program.
“They’ve really dialed this in,” says Schmitz, 72, an author, retired journalist and self-described gym rat who’s endured a series of health challenges and now practices his Hinge Health exercises every day. “They’re giving you this stuff early on to really get the hook in. Mission accomplished.”
“It’s possible to retrain your pain system by considering all the factors that may contribute to your pain: sleep, stress, relationships and worries.”
Hinge Health mobile app, “Pain Is Your Protector”
Founded in 2014 and holding a “moderate buy” consensus rating on the New York Stock Exchange (HNGE), Hinge Health serves 1.5 million people through 2,350 client companies and over 50 health plans. The program focuses on musculoskeletal care, with the low back, knees, shoulders, neck and hips being the most common areas treated.
Given how strongly Blue Cross Blue Shield promoted the program, I found it odd that the company refused to comment for an article I wrote about Hinge Health in Next Avenue, an online magazine produced by Twin Cities PBS for people 50 and older. After being turned down for an interview, I asked the media relations team via email: “Could anyone explain how Blue Cross selects the clients to target for Hinge Health? For example, I got two unsolicited letters, possibly because I had used PT before.”
No response may indicate an answer. On November 21, two weeks before the open-enrollment period ends for 2026 Medicare plans, Blue Cross Blue Shield of Minnesota announced that “high cost pressures across all Medicare programs” were forcing the insurance giant to cut its SilverSneakers benefits at two of the Twin Cities’ most popular workout facilities, Life Time and YMCA of the North. The loss of free memberships will affect 26,000 seniors, according to the Minnesota Star Tribune.
Even if Blue Cross discontinues its sponsorship of Hinge Health, I’ve learned enough to do the exercises on my own and to recognize that a home-based routine of physical therapy augments more rigorous workouts outdoors or at a health club.
The program’s wholistic approach includes an emphasis on education. A new article appears at the end of each daily playlist focusing on sleep tips, mindful eating, building goals and habits, breathing and meditation, and mental health. One article features author and podcast star Brené Brown and “Atomic Habits” author James Clear describing how all-or-nothing perfectionism can undermine new habits. Instead, “plan for failure,” the article says. Don’t beat yourself up if you fall short of a particular goal. Reset, reevaluate and try again.
My biggest learning from Hinge Health is that the pain in my body gets fed in my brain. Emotions affect it, especially fear. I’ve learned how to carefully, mindfully move toward my shoulder pain (and my emotional pain, for that matter) rather than freezing up or backing away.
“Pain typically goes a lot deeper than the physical pain that someone’s in,” explains Dr. Mel, the PT with whom I work. “Knowing that pain is multifaceted, we encourage people to move. It’s often the best way to support healing.”
Maintaining health becomes more challenging and time-consuming as we age — whether building muscle mass and strengthening thinning bones or figuring out how to consume enough fiber and protein. Hinge Health asks members to articulate a North Star goal when they enroll. Mine is simple but not always easy: Keep moving well, and well into old age.
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