“X Patient doesn’t do their exercises, that’s why they’re not getting better”.
“X athlete has the worst squat I’ve ever seen – they’re going to injure themselves and they don’t listen”.
If I got paid every time I’ve heard a colleague, physio, bio, coach or anyone involved in sports or exercise medicine say this – I could retire from physio – no jokes!
My issue with this (and I too am guilty of wanting to pull this trigger) is that we play this excuse on repeat like a get-out-of-jail card. Even if we just unpack the sentence:
“they don’t listen” “they don’t do their exercises” “and that’s why they’re not getting better/getting injured” – no other reason. Its CLEARLY NOT OUR FAULT!
The problem with this statement is that it doesn’t allow any growth or chance for us to take responsibility for the outcome.
I’m going to elaborate on this even further, but you’ve been warned. If you’ve already been offended in these opening statements, you might not want to read on. I’ve copped some flack recently (which I encourage, feedback and discussion is always welcome) about who is and who isn’t allow to prescribe/treat/correct movement and give exercise and healthcare based advice – there is no right or wrong answer here unfortunately, and I have no control of who practices what and gives out whatever advice they do – however – there are some fundamentals in rehab, exercise physiology and science that are absolutely bulletproof – so how about we stop making excuses and take a look at ourselves before we start playing the blame game #sorrynotsorry.
Let’s say that we take COMPLETE ownership of the outcome, what might we learn?
1. Why was the outcome negative?
Did we not reach our desired therapeutic goal? Did we even set one in the first place? Did we map out with our client how we would get there together?
If we feel like the person hasn’t bought into the process, have we explained it properly? Did we take the time to develop rapport and trust before expecting them to diligently put in all the work. Have we communicated the reasons WHY the ‘homework’ was important? Did we casually rattle off 10 exercises, reps and sets as they were walking out the door? Did we write it down for them? What if they forget our fancy names for movements, is there a plan B in place? Did we give them a million cues and pointers or did we carefully give our feedback and advice in concise pieces of information.
This is becoming what the “exercise”/ “active treatment” movement was years ago. The words we use when talking to patients can make or break the outcomes before we even get to exercise and treatment. We can unknowingly use “NOCEBO’s” and reinforce pain avoidance behavior with things like “You have a butt-wink when you squat, you shouldn’t squat anymore”, “running is a very high impact sport and is bad for your knees” – sometimes we need to challenge our own beliefs to find out if the advice we dish out is actually accurate, and find out how to navigate our clients beliefs to get to our desired outcome.
Simple. Support our clients give them the tools to achieve and support them in the process. I’m a huge believer in showing compassion. Forget about the fact that people pay us to do what we do, let’s just genuinely care about people. Let’s guide them through the process, even when that means sending them to other professionals inside or outside of our scope. Let’s support each other as professionals as well and reach out, collaborate and ask questions about staying up to date and improving our communications and outcomes with clients.
The only way we can learn, is if we acknowledge that we don’t know it all. There are a few cliched sayings I enjoy around here: “You cannot learn anything new if you know everything already”, “A little bit of knowledge is a dangerous thing”. We forget that we have many patient interactions, which on our end seem like a drop in the ocean, but for our clients or athletes, our words really matter and echo not like a drop in the ocean but like rain on a tin roof. I’m a huge believer in self reflection. Whether you’re “doing well” or “failing dismally” – reflecting allows you to turn good to great, or an opportunity to improve going forward. It all depends on if we’re willing to take some responsibility instead of playing the blame game.