I write on compliance now and then because that is how you get into that "Magic 6" range where the majority of your patients are better in 6 visits or less.
1) Use compliance instead of adherence
Just joking, but seriously, I do not think compliance has more negative connotation than adherence. What's next Patient Acquiescence? I hope not, I had to google how to spell that correctly!
1) Education, education, education!
- If the patient does not understand why they need to do something hourly, several times a day, etc, they won't, period
- if the patient thinks they need passive treatment regularly, they will not do their homework
- you cannot overstress hurt does not equal harm
2) Find their motivation
- here is a recent example
- a family friend was having bilateral knee pain, unable to cycle, use stairs, or kneel in church without pain
- 40 minutes on pain science education - especially because he is an MD
- pre and post test was in kneeling
- emphasized hurt does not equal harm
- light treatment of knees (IASTM to anterolateral thigh and lower leg patterns, repeated knee extension)
- retest tall kneeling (like in church,) one knee is pain free, the other one is painful
- re-emphasizing hurt does not equal harm - he was very worried about joint compression due to arthritis in WB on the patella) - I lightly provided some tibial IR on the painful knee and this completely abolished his pain
- he was amazed and happy he could kneel in church!
- Do these exercises if you want to run again/hold your kids pain free, etc
3) Change it Up
- make sure to emphasize the program will change as needed
- you will not be doing these 10 times/hour forever, just until your brain gives you a green light for 48-72 hours
- then we can integrate strengthening/conditioning
- find different ways of doing the same reset that makes more sense for repeated performance throughout the day
4) Put Out the Fire
- most of us trained in the SFMA or FMS want to work on all the asymmetries we can find
- while a forward thinking patient may appreciate your work on preventing future injuries, you should address what they are seeing you for first and foremost
- find a pre and post test movement or functional activity they cannot currently do, choose your best pain modulatory manual therapies or go directly to repeated motions and get to end range
- immediately re-test for patient buy in, then on a future visit get to those other asymmetries in mobility and motor control
5) Regular communication/follow up
- use an app like Vinitial for HIPAA compliant regular communication for the patients who need a little more encouragement and reminder for HEP
- have your office manager call the patient the day after the first visit and ask if they have any questions, concerns, how they are feeling and how the homework is going
- Use Strivehub to communicate with your patients, give them customized and great looking home exercise programs, and more! - Check out interview with Strivehub founder Dr. Ryan Klepps here! - use coupon code OMPT10 to save 10% on your first year!
Connect with your patient, have your staff do the same! Say hello to everyone, especially those that are not your patients! Ask them how are they doing other than the reason they are here. Those are some of my older tips but more important than ever!
Keeping it Eclectic...
Keeping it Eclectic...