Dear Physio - I Can Take it From Here | Modern Manual Therapy Blog

Dear Physio - I Can Take it From Here


This is just a short piece, a reflective piece, about a value that makes up the very core of what I believe in and what I strive to achieve as a Physiotherapist - empowering my patients with the knowledge and the skills they need to make them independent. This year has been hectic, trying to understand and adapt to working in America and personally accomodating to a new workload after studying for nearly two years. I'd be lying if I said I wasn't tired or that I didn't get lost in the daily grind. But not today! Today I am going to take a moment to reflect and to celebrate :)
These past few weeks have reminded me of a very special part of treating patients - discharging them. For months now I have worked intensely to help the small patient population I have contact with. After investing so much time in their development and progress, it is a magical moment when they come to me and say "I am not 100% better, but, I know what the problem is, I know how to make it better, what I need now is time to follow through on my goals and I can take it from here." 
What a pleasure it is to hear that. I know that no one will ever be 100% when it comes to discharge and I am fine with that. Firstly, I don't set "being 100% pain free" as a goal and secondly, I think we all suffer from pain at some point in time. What I feel is more important is for patients to functional normally and in the most ideal way for their lives.

STEP 1 - LET ME HELP STEER YOU IN THE RIGHT DIRECTION

It all starts at the beginning. Where life is altered by pain or injury and when patient's seek out care because they don't function in their normal way anymore. It can be tough sometimes to get the ball rolling, to retrain movement patterns and daily habits, to get pain levels under control, and to motivate patients to begin to drive their own recovery. The first step is showing patients what the problem is, setting milestones that help them identify with their own recovery process, and then guiding them through rehab until they reach step 2. 

STEP 2 - START TO TAKE THE WHEELS

Once pain is no longer driving their willingness to come to therapy, who is?
Sure ain't me. As I've said once before - I will sit beside you on this journey to recovery, but I will not drive you there. So step 2 is all about recognising what other barriers need to be overcome or goals need to be achieved before the patient can be functionally unrestricted. 

STEP 3 -  NOW IT'S YOUR TURN TO DRIVE

Once you are functioning well - do you know how to stay that way?
At this point in time I hope that my patients are developing a sound knowledge about how their bodies present/move/behave when they are both feeling good and feeling bad. Developing this self awareness is a key step towards understanding their bodies better and identifying where their rehab needs to go for them to be 100%.

STEP 4 - I AM NO LONGER A PASSENGER

If you're staying good and doing what you love - do you still need my help?
It is definitely sad to say goodbye sometimes but we have to set them free. This past week has been sprinkled with discharge assessments. Patients who come in smiling because they only have good news to report. They are playing the sports they love, they can use exercises to manage any niggles that may come up, they are no longer thinking about their injury or their body part, and they see the end goal in sight. And this is when I ask - do you still need my help to get to the end? And with a smile, they reply, I can take it from here. 
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So to my patients who shared these moments with me - thank you. Thank you for the months you invested in your own life. Thank you for driving the rehab in the direction you chose. Thank you for the endless open conversations trouble shooting problems and setting personal goals. Thank you for stepping up and being the lead part in your own story. Without this attitude, this approach would not be possible. 
And to my readers. Don't take for granted the immense impact we can have on someone's life as physiotherapists. Not for one second to I think I can help everyone and that everyone will get there, I am not that naive. But I am experienced enough to take a moment to celebrate the wins, because they make it all so worth while. 
The journey is always the reward.


Sian Smale is an Australian-trained Musculoskeletal Physiotherapist. Sian completed her Bachelor of Physiotherapy through La Trobe University in 2009 and in 2013 was awarded a Masters in Musculoskeletal Physiotherapy through Melbourne University. Since graduating from her Masters program, Sian has been working in a Private Practice setting and writing a Physiotherapy Blog "Rayner & Smale". Prior to moving to San Francisco, Sian worked at Physical Spinal and Physiotherapy Clinic and has a strong background in manual therapy and management of spinal spine, headaches and sports injuries. Since moving to the Bay area, Sian has become a Physiotherapist for the Olympic Winter Institute of Australia, traveling with their Para Alpine teams. Sian currently works full time at TherapydiaSF as a physical therapist and clinical pilates instructor. 

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