2019 in review...
I’ve had so many tentative blog posts regarding the physio profession, and what feels like a long, confusing journey I’ve been on with my healthcare practice. I’ve almost summarised my thoughts on the matter for a future blog post, but I thought I would direct this particular post to my most recent year of practice. I hope it’s helpful to other young practitioners, and to physio-seeking patients seeking some insight on what to expect from healthcare treatment. I find what gave me the greatest purpose when I was faced with treatment philosophy dilemmas is focusing on how I can help people the absolute most, for the long term, in each session. I could do some soft tissue and joint work and that could make someone feel better for the short term, but how will that effect them long term? Will they tend to think of that as problem area that continually needs to be released/adjusted? The answer is complicated and certainly patient and context specific, but I found a couple key concepts have been the most helpful for framing treatment plans.
1) Do no harm.
I don’t think anything stopped me in my tracks as hard as it did when I realised the negative effects our words have on people. The way we describe/label why someone is having pain can actually increase their experience of pain, create distrust, or- the reluctance to move or be active. We need to be careful how we explain concepts to our patients. Our words have significant impact and using words such as “chronic, degeneration, instability” can create feelings of helplessness and vulnerability. I’ve had at least 30 different patients this year who gave up hiking, running, cycling etc because they were told their joint was now “bone on bone”. Their pain levels did not go down, but their activity levels certainly did. I have also had patients who were fearful to bend to tie their shoes or lift their child because they didn’t want to “slip a disc”- I’m glad this is becoming somewhat less common and has started to be addressed and retracted from our health practitioner lingo, but this concept also applies to what we have labeled as “movement faults”- pronation, knee valgus, spine movements, etc. Telling people natural movements (that they likely had before they had pain) are bad and causing their problems isn’t always accurate and could be causing more problems. Our joints are meant to MOVE, just as we are. Whatever your treatment philosophy is as a practitioner, make sure that the words you choose and the treatment you use doesn’t have the potential to worsen the patients view of their body or capabilities. If someone is nervous of a movement or activity, it’s our job to build them up to the task. Bottom line, both our words and our treatments should build UP the patient for their activities of choice.
2) Make sure they have an activity plan.
The more I work with the general population the more convicted I feel that it is physiotherapists SOLE responsibility in an appointment to make sure that our people are being physically active, or at least on a pathway to become physically active. If someone comes to see me, it’s one of the first questions I ask. At the end of the appointment, we have hopefully come up with a reasonable plan for that patient to become active regularly.
I get a wide range of clientele, from professional athletes, to recreational athletes, to sedentary office workers who hate the idea of the gym. I feel privileged to get to work with any population, but I’ve realised I have a soft spot in my heart for those who would label themselves as inactive. The reason I love this is because I see it as the best part of a physiotherapists (not often used) job description- an opportunity to help someone fall in love with exercise and change their lives. This sounds like an exaggeration- it’s not. People can have a lot of barriers to exercise (another blog post for another time) but if they can have someone help them set up goals, take down barriers, and encourage them regularly to be active, it will have a positive effect on their life for years to come. Physicians, nurses, surgeons… they simply do not get the face time that physiotherapists usually get with our patients. It’s our job.
Which brings me to my two professional highlights of this year! My first was opening up my own space inside Fort Strength gym. I create my schedule, with each person getting one on one time for at least 30 minutes. If it’s my first time seeing them, I get to spend at least an hour. This gives me adequate time to get to know the person, talk about their history, come up with goals etc. It has been the absolute best, mostly because I can also teach people basic lifts (squat variations, deadlifts) and set them up with an appropriate strength and conditioning plans. For my athletes, I have all the equipment I need to properly challenge, test, and load them up. I love being a part of the Crossfit community, and having some of my patients move on to the gym side and become physically active is awesome.
My second highlight was my beloved run club!! This year I partnered with a Lululemon pop up and started a free run club. I wanted a club that would be appropriate for absolute beginners, injured athletes, and to give my patients more options to be active. I had two patients say to me at the end of accomplishing a 5km run goal- “I genuinely learned to like running with this club”. Seriously, is there a better professional goal than that? Having a patient guided from injury to a regular exercise program they enjoy? We have the best job in the world, and also the best opportunities. If you’re feeling discouraged by professional debates online, treatment philosophies, etc- focus on the opportunities to improve their lives for the long term, and get our peoples active and STRONG :)