As a physical therapist, I help people get moving. My best tools are exercise instruction, biofeedback, manual therapy, and patient education. In my approach, I focus on empowering a patient to help themselves. The benefits to this are a faster recovery with less treatment needed. This requires patients to take an active role in their rehabilitation.
Everyone t
hat I have the opportunity to work with is unique. I constantly find myself trying new techniques in order to bring about the desired results. In this blog I’m going to talk about those techniques which I use to improve follow through with the exercise prescription which is tailored to help the individual to reach his or her goals.
Most people that I see experience pain with movement. One of the surest ways I have found to get a person to perform their exercises is if they can see an immediate improvement as a result of doing them. For example, I recently had the opportunity to help a lady who was experiencing back pain when she climbed stairs. After evaluating her, I took her to the stairs leading into my clinic. I had her to climb them and asked her to make a mental note of how it felt. It was indeed painful for her.
Based on her description of her problem and the results of my physical examination I tested her on exercise that I thought would help to decrease the pain that she was experiencing. After taking her through this exercise we noticed that some of the stiffness she initially presented with had improved. I then asked her to climb the stairs again. I smiled when I saw the curious expression on her face. She was able to climb the stairs with much less pain than she had immediately before performing that exercise.
We had initially planned for her to attend several visits of physical therapy. When she came in for her second follow-up visit she told me that she was ready to graduate, and indeed she was. As it turns out, any time she had a hint of back trouble she did her exercises and her back troubles subsided. I believe that the manner in which I taught her this exercise was instrumental in her understanding that the exercise would decrease her pain and since it was her goal to experience less pain she was committed to its regular performance. Now, it is entirely possible that the first exercise I showed her would not have yielded such a positive result. If that were the case, we would have tried other exercises and treatments until we found what would help her or until we exhausted these efforts.
About half of the people that we see have such a rapid response. Indeed, it is the other half who present with a greater challenge. While the results may not be as rapid, the principle of linking the exercises to a person’s goal remains a key element. 
When the results are not as rapid, I know that the patient must have confidence in the prescribed treatment in order to take an active role. In order to gain that trust I educate them in regards to how the exercises will be of benefit.
For example, let’s look at a person who experiences pain with picking things up from the floor. Oftentimes for this to be accomplished with a minimum of discomfort it is necessary to lift with the knees. However, in the case of someone who does not have the requisite strength in their legs to perform this task they will not be able to immediately derive a benefit. In that case I would prescribe an exercise program to improve the strength in their legs such that they could be used to lift things from the floor with proper body mechanics.
In many ways, this represents to me the most enjoyable part of my work.
