Rehabilitate With A Purpose

Vern Gambetta says 'Train With A Purpose' and when I work with physiotherapists and allied health professional during my 2-Day courses, I switch the word train, to rehabilitate.

You see, whilst it seems like an obvious statement there are many health profressionals that don't really drill down into the purpose of the rehabilitation programme. They get stuck a managing the pathology without giving much though to the patient and what they actually want to be able to do in day to day life. I know this is a common concern because the physio's attending my course tell me!

Here's a selection of the learning outcomes posted by phsyios at the start of the two days.

'Learn more about the principles of strengthening to ensure exercise programmes are as effective as possible.' Anonymous

'How to better adapt training programmes to patients to achieve better outcomes.' Scott Smith - MSK Physiotherapist

'Appropriate levels of exercise prescription for goals (strength, hypertrophy etc)' Gareth McCoy

'Tailoring exercise parameters to meet specific goals.' Anonymous

'Different ideas - make treatment exercises more interesting.' Michelle Glenn

'Recent research on best practice. How to motivate patients to stick to exercises.' Rachel Stevenson

One of the first things to understand when developing an effective injury rehabilitation plan is the end game. What does the patient want/need to be able to do. Do they need to be able to catch their grandchild when they jump on them? Do they want to be able to walk up stair two at a time? Do they want to be able to get in and our of their chair comfortably? Do they want to run a marathon?

Writing an effective rehabilitation programme begins and ends with understanding the patients end game. When you direct your efforts (and the efforts of the patient) at an 'end game' they will start to understand what they need to do day in, day out, and why, and so will you! If we really get a good feel for their 'rehabilitation purpose', everything else starts to fall into place. Questions about adapting programmes, appropriate levels of exercise prescription, tailoring exercises parameters to meet specific goals or just making the rehabilitation process more interesting become pretty simple to answer!

It's important that we take the time to really clarify what the rehabilitation programme needs to achieve before we get too bogged down in the minutia. A couple of great books that I've read support that notion and are well worth looking at.

Plan all the way to the end is law 29 of The 48 Laws of Power (great book) and in The 7 Habits of Highly Effective People - the second habit is, begin with the end in mind.

If you don't understand the rehabilitation purpose you're going to struggle to write an effective programme. You can't guarantee that your patient will reach the rehabilitation goal but not having an end in mind is a guarantee they won't (adapted from The Daily Stoic by Ryan Holiday).

When your efforts are not directed at a cause or a purpose, how will you know what to do day in day out?