Thursday Thoughts: Bring Your "A" Game | Modern Manual Therapy Blog

Thursday Thoughts: Bring Your "A" Game

We all have off days, waking up on the wrong side of bed, a lack of sleep, kids giving us a hard time before going off to school.

A few years ago, for whatever reason, I was having such a day. I had a lack of sleep, one of my kids was sick and the morning coffee was just not doing it. With a lack of sleep comes many things, it could be a lack of

  • Patience
  • empathy
  • Positive vibe
I was not a jerk or anything, but I certainly was not myself. I got a few "you look exhausted" from the staff. At some point that morning I had an eval. Despite the eval going the way I thought it should, that eval did not schedule another visit, nor return our phone calls. I still gave my usual explanations, self treatment, simple assessments etc, but I am fairly certain that "vibe" I gave off was not one the patient wanted trust their well being with. 

Since then, when I am having an off day, before stepping into an evaluation and trying to establish a rapport with someone I have never met before. I concentrate on my breathing patterns, compose myself, and bring my "A" Game.

Has this ever happened to you? Chime in below or on the facebook page.

Keeping it Eclectic...  


  1. After my second child was born we were not sleeping much, and at the end of the day I would hit a wall. I felt like I was missing a lot and not providing the care my patients were used to. So, I actually changed my routine with my patients, added more testing at the beginning vs just using SFMA to get my brain going. In addition, I changed the warm-up to a more dynamic warmup for the patients and utilized the time to map out exactly what I wanted them to do in the session. The carryover from that has been great: I was more efficient, more organized, and used more test-retest scenarios.

  2. Thank you I'm korean physical therapist. I get realized and thanks to this post.
    sorry for my poor english :)

  3. You're welcome! Hope you got the general idea!

  4. Kids are game changers! Guess your first one was a better sleeper?

  5. The first was a much better sleeper, but then add the first one waking up when the new baby is crying at night.....double whammy!

  6. Sorry, Erson, but it does not get any better as they get older...these days, instead of them keeping me awake, I lie awake worrying about them. My strategy for when I'm having those days is to "fake it to make it" but sometimes the patient is too tuned in or too sensitized and picks up the vibe. I usually turn to self-deprecating humor and just tell them to be thankful I'm not their surgeon today. And then just try to give them lots more the next visit (if there is one). It would be great if we could be awesome for our patients every day but, unfortunately, we are human and have "those kinds of days" every once in a while.

  7. Thanks for the advice Max. Yeah, I am worried about having 4 beautiful daughters as teenagers someday (and beyond). Fake it to make it is the best we can do, great motto!

  8. Yeah,our first woke up every 2 hours and stayed awake for 1 hour for FIFTEEN MONTHS! Finally cried it out, started sleeping all night after 3 nights, in one month, bam, expecting again.