How many practitioners meet their patients where they are at, right at this moment?
Week 2 of the NFL season and my team (see Football and Therapy) lost again. I spent the last weekend teaching one of my Foundations in Myofascial Release Seminars. The DVR was set to view the game later, but a few students were tracking cores on their cell phones. No big surprise that the Buffalo Bills lost again.
Many of my clients come to me with a repeating theme. They will state something like: “My doctor/therapist said that if I lose weight and exercise more, my pain will be better”. There certainly may be some truth to this prescription, but what does that do for them at this moment?
I try to meet them at this place, in this moment, and ask what I can do for them right now. Myofascial Release certainly might be one of the things that can help them right now, but I also ask them what their goals are and how successful they have been thus far in reaching them. Weight loss seems to be the goal of the most people, whether pain related or not. How successful have they been in reaching this goal. For many, it is just a carrot that is held out in front of them. Lose weight and ……. will change. Many never reach that carrot, it just remains out of reach.
Once I am able to help someone make changes in this moment, reducing pain or improving function, doors can open to help them reach other goals. Or, they simply may accept who they are and be fine with that.
I know the Bills may never reach where I want them to reach. I’m OK with that. I’ll still watch.
Walt Fritz, PT
On a side note, I think there has to be a balanced approach to motivating people to participate in their home program. I know an MFR therapist who grills the clients about their home program much the same way that the traditional therapist would grill the patients about the strengthening exercises. Neither one is productive and really shames and discourages the client. I know the intent is to get the client to take some responsibility for his health, but the questioning sounds more condescending than part of teamwork.
Janet,
I could not agree more. I do ask clients about their home stretching that I taught, but only to judge response to that stretch. Most act ashamed if they did not get around to them, but I assure them that it is their choice, I only want to know what response they noted.
I find that most clients, when they see the changes that can take place with myofascial release, eventually find a comfort zone of home stretching.
Making their progress contingent on doing everything that I ask assumes I’m certain that everything I request is correct (presumptuous) and that failure is then only their fault. If you are using a faulty model, blame the patient!