Just when I thought I was out, the clinic pulls me back in.
Though I’m glad to be back. There’s just a different vibe, different pace, and ever-constant variety of challenges that being in the clinic simply provides. This has been especially true working in a rural area. You see a much wider variety, which challenges you to broaden your skillset.
Previously, I was all about getting people in and out of the door as quickly as possible; and with very few visits. I would cut them down to once a week or every other week damn-near immediately, and try to hit that three to five visit sweet spot.
This strategy no doubt worked, and people got better, but I had noticed I’d get repeat customers. Maybe it wasn’t the area that was initially hurting them, but they still were having trouble creep up. Or maybe it was the same pain, just taking much more activity to elicit the sensation.
It became clear that I was skipping steps to try and get my visit number low, when in reality I was doing a disservice to my patients. This was the equivalent of fast food PT—give them the protein, carbohydrates, and fats, forget about the vitamins and minerals.
Was getting someone out the door in 3 visits for me or for them? The younger, big ass ego me, wanted to known as the guy who got people better faster than everyone else. Yet the pursuit became detrimental to the patient’s best interest. There were so many other ways I could impact a patient’s overall health that I simply sacrificed in place of speed.
I only got them to survive without pushing them to thrive.
I see a lot of individuals proudly proclaim how many visits it takes for them to get someone out of pain, but pain relief is only part of the equation. There are so many more qualities we can address before we consider a rehab program a success.
This stark realization has reconceptualized how I structure a weekly rehab program. I now emphasize all qualities necessary to return to whatever task the patient desires, and attempt to inspire them beyond those initial goals.
You want to know what my visit average is right now?
I stopped counting, and started treating.
Let’s look designing the rehab week to take your clients to the next level.
75 is the number of continuing education classes, conferences, home studies, etc that I’ve completed since physical therapy school.
Though the courses are many, it was probably too much in a short period of time. When quantity is pursued, quality suffers. Sadly, I didn’t figure out how to get the most out of each class until the latter end of my career.
Yes, the content was great, but these classes stood out for a different reason. You see, instead of just doing a little bit of prep work, I kicked it up a notch. I extensively reviewed supportive material, took impeccable notes, and hit all the other essentials needed to effectively learn.
I was prepared, and because I was prepared I got so much more out of these classes than my typical fair. The lessons learned in those courses stick with me to this day.
For the stuff you really want to learn, I’ll encourage you to do the same. Here is the way to get the most out of your continuing education. By the time you are done reading this post, you’ll understand why I now recommend a more focused learning approach and fewer courses.
If there is one thing I’ve struggled with over the years, it’s long term retention.
Though remembering course materials has had it’s challenges, the struggle is worse with books.
Overconsumption was part of the problem. Trying to read faster, and across multiple unrelated books caused more detriment than use. Much as our attention spans can be overstimulated by abundant information on the internet, so to can we suffer this fate with reading. There are a lot of books after all.
I remember one summer I made it my goal to learn how to shuffle cards. We played A LOT of cards on my family vacations, and I was tired of having to use the automatic shuffler or having someone else shuffle for me at the family card game.
It was time to become a man, damnit!
I shuffled anytime I had some free time during the day; which back when I was a kid led to multiple bouts of daily shuffling.
By the end of the summer, I was unconscious with shuffling, and still am to this day.
Frequent, quality repetitions at any task will likely lead to improvement. Learning material is no different, we must just foster an environment of multiple exposures to said material.
The most important thing you can understand is that no one has the answer for all pains. Pain is entirely individualistic, hence requiring different answers. There are several strategies which one can undertake to triumph over pain.
Tool 1: Education
Knowing how pain works is one of the most important components to overcoming pain. Instead of no pain, no gain, the authors like to use “know pain, or no gain.” Understanding pain is essential for squashing fear of pain, which leads best toward the road to recovery.
Here are some important concepts to be known about explaining pain.
Anyone can understand pain physiology.
Learning about pain physiology reduces pain’s threat value.
Combining pain education with movement approaches will increase physical capacity, reduce pain, and improve quality of life.
Tool 2: Hurt ≠ Harm
It is important to understand that when someone feels pain it does not equate with damage. The same can be said with recurring pains. These pain types are often ways to prevent you from making the same mistake twice. If your brain sees similar cues that were present with a previous injury, the brain may make you experience pain as a way to check on you and make sure you are okay.
Just because hurt does not mean harm does not mean you can get crazy though. Because the nervous system is trying to protect you, it will take drastic measure to prevent re-injury. Therefore, the best option is to gradually increase activity levels without pressing past the nervous system’s threshold.
Tool 3: Pacing & Graded Exposure
All the body tissues are designed for movement, therefore this is how we will increase activity. Here are the steps to pacing and graded exposure.
Select an activity you want to do more of.
Find your baseline – The amount of activity you can do that you know will not cause a flare-up. A flare-up is an increase in pain that leaves you debilitated for hours to days.
Plan your progressions.
Don’t flare up, but don’t freak out if you do.
It is a lifestyle change, requiring a little bit more planning.
Take walking for example. Suppose you know you could walk for 5 minutes, but if you did 7 you would pay for it over the next couple days. You might walk for 5 the first day, then 5:15. Eventually, you would work up to past 7 minutes, then so on and so forth.
Access the Virtual Body
Just like the body, the virtual body can be exercised as well. Ways to work on the virtual body are as follows: