Are we just lifestyle changers?
Through our rehab, we try to focus on improving muscle timing, recruitment, strength, endurance or whatever you want to call muscle performance. We unload and then load joints, the connective tissues, the neurological and skeletal system. We talk about our weekend and our patient’s weekend, as well as their life problems. We educate about posture, changing positions through the day, avoiding repetition, overuse and decreasing stress. But with all of this intervention, can we just call ourselves lifestyle changers? With the exception of acute sport injuries, fractures, etc., doesn’t most of your caseload during the day involve pain that has been going on for quite some time and recurrent? I will say mine at least, maybe because most of my caseload is spinal pain. Maybe we should focus on day 1 on just education. The goal of the education: Remove habitual patterns of repetition and chronic static positions.
Then, see the patient back in 2 weeks and see what happens. Do they really need to perform a home EXERCISE program, consisting of 5-10 exercises that we simply print out to provide a visual staple of a job performed that day? Does this fulfill our sense of accomplishment? Or is it simply that patients NEED exercises? Comparable to a doctor providing a diagnosis and/or a prescription, patients WANT more than just advice and education. Staying at home and drinking plenty of fluids while allowing time to tick just isn’t good enough for someone with the flu…they want something SPECIFIC?
There may not be an answer for this right now, and who knows down the road. I don’t think I’ll have a job if I simply educated and provided advice, guidance, mentorship WITHOUT providing a prescription; but something to mull over.
My personal approach is to rank my priorities and advice/education is first. This usually simply looks at repetitions, sustained postures and advising to keep moving during the day. The movement needs to be specific (a directional preference you may say) into the right direction, which is usually the opposite path of pain.
I had a first year DPT student ask me once what I thought of the 3 sets of 10 reps whole deal. I think I gave a rather lengthy answer and probably bored him 🙂
Who really needs 3 sets of 10 reps and 6 weeks at twice/week anymore, or will this pattern of repetition stay the same?