Do The Thing You Are Asking Your Patients To Do

As a student physical therapist, I am tasked with learning many hands-on techniques for evaluating and treating future patients. Part of the learning process entails not only practicing these techniques (with the oversight of clinical and classroom instructors) on other students, but also having people perform these techniques on me as part of classroom “lab” sessions.

In the past month alone– I have been dry needled in my calf and IT band, had multiple joint manipulations performed on my thoracic and cervical spine, and practiced and performed many different therapeutic exercise techniques for lower extremity strength, scoliosis postural training, and improved running mechanics.

It has becoming increasingly evident to me how important this process of being the “guinea pig” is in our education as future health care professionals. In fact, I would encourage ALL healthcare professionals to dive into the realm of “experiencing” so as not to lose sight of what the patient experience is like. The benefits that I have directly noticed in my own life and in working with patients in a supervised setting (while myself having all of these hands-on experiences) are these:

  • Learning what each treatment feels like

In physical therapy treatments, there can be a wide range of different (but expected) treatment responses. This is not only true for the delivery of the treatment technique, but for the after effects of the treatment technique. For example, during the dry needling session on my IT band, I had the experience of feeling an ache sensation with one needle, no sensation of pain with one needle, and the sensation of my tissue “grabbing” the needle with a third needle! These are all very different (but expected) treatment responses. With dry needling of my calf muscle, I had a few twitch responses when the needles were in and then had the (unexpected to me) experience of sustained moderate calf muscle soreness for the next 12-24 hours (again an expected and appropriate response- but now I know what a patient may come back reporting!).

  • Developing empathy for one’s patients

Trying out a treatment approach on yourself gives you a human perspective on what you are asking of your patients. For example, recently in one of my classes we were practicing physiotherapy scoliosis specific exercises (PSSE) and specifically “Schroth Method” exercises to correct and manage scoliosis (lateral curvature of the spine).  This practice gave me a great appreciation for how hard it is to feel some of these nuanced movements. Even when watching myself in a mirror and getting tactile feedback cues, I struggled to “lengthen on one side” and “breathe into” the specific area of my rib cage as suggested. However, with practice, even over the course of 30 minutes, my awareness and body control for these motions did improve some! In experiencing this treatment technique, I found a great appreciation for the frustration and difficulty that a patient may experience while performing these techniques for the first time. I now have a greater capacity to empathize with patients that I may work with in similar situations in the future.

 

  • Addressing barriers to exercise compliance and lifestyle changes

How difficult is it to change your habits? When was the last time YOU as a physical therapist or student physical therapist made a significant lifestyle change? Have you recently tried to exercise more? Eat more nutrient dense foods? Get more quality sleep at night? Even just trying to implement positive lifestyle changes can bring about a renewed perspective and improved “trouble shooting” for your patients in the clinic. For example, after having a running evaluation performed on my running gait in one of my classes this semester, I asked a fellow classmate to give me some corrective exercises to address some of the deficiencies in my running form. Over the past few months of trying to integrate these exercises into my weekly schedule, I have a renewed appreciation for the effort it takes to consistently perform new exercises at home. I also feel that I have a more reasonable expectation for patients and will tailor my exercise prescriptions with this in mind (e.g., pick the 3-5 BEST exercises and keep the time commitment to a minimum) in order to improve the likelihood that they will get done!

Some other potential benefits to “Doing the thing you are asking your patients to do”:

  • Improving your ability to effectively dose treatment/exercise prescription
  • Improving your ability to communicate about likely responses to treatment
  • Improving your ability to deliver effective movement and exercise cues (e.g., when you do “X” it should feel like “Y”)
  • Helps with patient buy in (the more you understand the treatments and are comfortable with them, the more you will communicate that confidence in your non-verbals and the more comfortable your patients will feel)
  • Improves your ability to prescribe appropriately challenging yet doable exercises
  • Keeps you fresh and learning/trying new things (after all this is what we ask of our patients)!

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