Bold Journeys In Rehabilitation Episode 1

Episode 1: What do our bold patients need from us as clinicians? Clare Fraser

Bold: not hesitating or fearful in the face of actual or possible danger or rebuff; courageous and daring: a bold hero

We all know that it is never easy to create a change in our lives, and strike out in search of something different, something new. Gathering the will power and positive mental attitude is quite tricky, but even trickier when you already feel ‘down on yourself’ and you are the new patient arriving at a physiotherapy clinic.

I am often reminded of how impressive it is, and brave, when a new patient comes to the clinic for their ‘initial assessment’. Coming into a new environment, no matter how friendly, warm and welcoming, can be daunting. And yet our patients do this, arriving for their assessment, because they have knowledge of their own bodies, and their own difficulties, and they know that they could be better than they are now. They know, even if their current recovery journey has been tough, that they can be more ‘recovered’ than they are now. They can improve. And they want that improvement, they thirst for it and dream of it, in their near future. And so they come to us.

So what do they need from the professional physiotherapist that they meet, who takes them through their initial assessment? They need someone who can get under their skin, who can ‘know’ and understand their movement and function issues deeply, and transform that into a clear, clinically reasoned movement diagnosis and hypothesis. And then to deliver the treatment that will start to take them forwards, step by step, one foot in front of the other, dealing with their impairments, guiding them through it, and making it happen.

When we assess a new patient at the clinic, we listen to their description of their difficulties and start our clinical reasoning from the very beginning of meeting them. We listen out for the ‘critical cues’ that the patient shares about their every day life and we start to develop our clinical hypotheses. Why is coming down the stairs more difficult than going up for them? How does that problem link to the difficulty getting their heel down when they walk? Why does their arm stiffen up when they stand up from a chair? Can they be less heavy through their stick? and when they are less heavy through the stick does their shoulder pain reduce? Why are those things linked together?

It is detective work, digging deep into the problem, understanding what they are telling us, and looking at that through the lens of the neuroscience, and neurophysiology. Knowing how the body works, how it moves from various postures, and how we function through movement control as human beings, gives the physiotherapist the background ‘blue print’ that we can compare our patients problems against. And then, with the clear idea of what the problem is, and why it is there, based on the science, and what more ‘efficient’ movement control would look like – we can begin.

The physiotherapist can then understand what the patients potential for change might be, how to tap into that potential to change, and how to formulate the treatment programme that will allow them to achieve that change as best as possible.

And so then, the ‘new’ recovery journey can begin for the patient. We have a clear idea of their impairments, we have formulated a movement diagnosis, we understand the patients potential to change, and we have developed our first clinical hypotheses.

So now; lets get working on making it happen.

If you want to explore your potential to be better than you are right now, why not give us a call and book your ‘initial assessment’ at TherapyMatters? We are always friendly and effective, and we are keen to work with you to help you on your recovery journey.

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