Physical Injuries, Mental Rehab
I remember sitting in class one day in PT school way back and listening to my professors talk to us about the importance of listening to your patient. The research and likelihood ratio of better diagnosing your patient’s issue is around 10:1 based solely on taking a sound patient history. It turns out that if you listen to your patients, they will likely tell you what is wrong! A solid patient interview is a stronger predictive factor than any special test or physical measure you could do in the subsequent examination.
Interviewing patients is one thing I have truly appreciated over the last 19 years of treating is everything that comes along with the physical problem that brought someone into the office.
Whether it’s a “basic” ankle sprain at a pick-up basketball, a runner developing overuse irritation from their marathon training, or the athlete recovering from a first ACL reconstruction, they all have one common denominator - there is a degree of emotional trauma that accompanies the physical. And to hopefully no one's surprise, that requires therapy as well! We would argue for most people, the emotional and mental aspects become equally as important, and potentially even more challenging than the physical aspect of physical therapy.
Now, we are definitely not psychologists. But, I would stress that a good therapist has a strong ability to listen, sympathize, and even at times empathize with the plight of the patient. No issue is too small; it can be devastating to anyone when all of a sudden they cannot do the things they love because of their injury. Depression, loneliness, and feelings of loss can definitely occur in clients, and without too much difficulty!
I had a patient some years ago who was a fellow healthcare provider. One day, they came in and told me all about this book, entitled, “Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries,” by Cindy Kuzma and Carrie Jackson Cheadle. After a few pages, I immediately fell in love with the vision and purpose of this book. Focusing on the mind and developing strategies to cope and navigate through injury is so critical to the patient-therapist dynamic. I cannot tell you how many times in my career I literally spent the ENTIRE session just talking and listening to the patient; and then 45-60 minutes later, after having literally done nothing physical with them, they were like, “Thanks, I really appreciate you allowing me to have my emotions heard.”
While it is easy for us as humans to know what it is like to struggle with hardship, it can be hard to really be in someone else’s shoes when they deal with their injury. But, it can turn people’s lives upside down! Some days, what patients really need is someone to talk to and hear them, and be there for them mentally, more than the next exercise.
I urge everyone to remember the power of the mind in your rehabilitation or training program. As a therapist, getting your patient to cope in healthy ways mentally is 100% as important as the mobilization or exercise program you develop for them. As a patient, feeling comfortable to share and having the time to express what is truly affecting your life, physically and mentally. A genuinely open, and communicative relationship between therapist and patient will lead to better outcomes!
If you haven’t had a chance to read Rebound, I recommend it to patients and therapists alike. It is a strong reminder that while the feelings may be unique, you are not alone in the journey!
A Note from Dr. Daniela: At The Obstacle Doc, we spend at least 60 minutes with our patients, one on one, every time. Christopher goes into what made him fully appreciate this in the post below. As a pelvic health therapist, and who primarily treats women and mothers, I see the need for these patients to be heard daily. These 60+ minutes we spend may be the only time away from kids, stressors, work, or other things in life that don’t stop for you to share your feelings. We see the power of a patient ear, the gratitude of an open conversation, and the benefits of knowing you are being fully seen by your provider. We are equally grateful to all of you for continuing to trust us with the care of not only your bodies but your minds and your hearts.