We've all heard it before. "I went to PT before and it didn't work." We expect that the didn't work part to be...
- excessive use of modalities as primary treatment
- unsupervised exercise on machines like circuit training
- biw-tiw for months of the same thing over and over
However, despite that being common, what if the patient said, well it was
- dry needling
- repeated motions
or any of your go to resets? Does this mean they are a slow responder?
It's all in the presentation!
How do you make the same treatments work when they have not for others in the past?
- make sure the patient understands the indications and what the treatments do
- healthy dose of pain science to reduce fear avoidance
- present the treatments as comfortable and novel, we're not physical terrorists!
- the patient has to be made aware that the effects of the treatments are transient
- the improvements must be reinforced by the patient actively with a custom home exercise program, not some generic booklet
Above all, spend time with your patient. Some will get it and have a good session in 10-15 minutes, others need 30-45 minutes of education before the treatments stick. I realize not all of you have that kind of time, but instead of beating a dead horse, maybe refer out to a practice that is able to spend more time with their patients. People tend to pay it forward.
Many course participants and mentees are shocked to find that in a 60 minute session, I may educate and interact with a patient for up to 30-40 minutes (counting movement assessment and repeated motions). Treat for 5-10 minutes, then reassess and reinforce the improvements with HEP. I'll cap it off with a patient quiz on what they need to do between visits.
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!
Keeping it Eclectic...