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Writer's pictureKhushboo Shah

Expectation vs Reality:

This blog is about expectations!! Setting up the right ones. It applies to patients and physical therapists (for that matter any rehabilitation specialist). It is about how right expectations can play an important role in rehabilitation starting day one. Communication through patient education is the master key to develop rapport and work together towards finding a solution.

Following are expectations patients come with in my daily practice along with my explanation for their reality check.

Here I am, fix me: Love it when patients say that!!

Expectation: I am here to visit a Physical Therapist (PT), to address the problem I have. They will show me a couple exercises, I should be fine.

Reality: Physical Therapy is a Process!! It takes a detailed physical evaluation to understand one’s problem with follow up visits to monitor progression. It’s crucial to remember that we can only help you deal with the problem through exercises but permanent fixing of the problem will depend on both, patient and the therapist.

Can I come every day for Physical Therapy?

Expectation: If I get physical therapy every day, my injury will heal faster!

Reality: Physical therapy is rehabilitation process with a designed treatment plan which can help in progressive recovery from the injury in a protective way. Can increase in frequency of PT sessions, increase the rate of healing? NO! body will still take its own time to recover. Depending on your treating therapist, twice or thrice a week is common treatment dosage.

How long will I have to take Physical therapy?

Expectation: I want to quickly get treated and get back to my routine.

Reality: Physical therapy is not a quick fix (in most cases)!! “Massage therapy (manual manipulation of the soft tissues) is a passive technique which has short-term benefits”1 and should be followed with enduring methods like strength training. Strength training of muscles in rehabilitation takes longer and so has long lasting effects. No one ever built a muscle overnight!

Can you give me some “massage”?: Most PTs dislike this term!

Expectation: I want to feel good, and I guess it helps!

Reality: What appears to be massage is actually a very skilled and specific technique for mobilization of any soft tissue (Soft Tissue Mobilization aka STM) for an optimal muscle function. It can be addictive, but is not always pleasant. However, it is worth keeping in mind that it is a passive technique for a temporary purpose of reducing muscle tightness. STM requires a specific indication and should be followed up with muscle strengthening and conditioning.

Do I have to do these exercises forever?

Expectation: No, I will do some exercises and stop as I feel good!

Reality: Yes, why not! We eat and drink to keep our body functions going, every day and forever. Why not exercise regularly? Exercise, in any form, is a good way to maintain strength of the muscle and in turn limit joint damage. It is essential to gradually progress with the exercises for better endurance and conditioning.

Why am I not better yet?

Expectation: I have been going to the PT for 3 visits now, I don’t feel completely better!

Reality: Injuries take time to heal, that’s how body works. Several processes in our body are designed to come together and heal the damaged tissue. Injuries related to posture or chronic muscle imbalances, have been stressed for a long period of time. Thus, to reverse the effects and retrain the muscles to work a certain way, requires time and patience!

However, if one is experiencing sharp pains or constant discomfort, it must be discussed with your treating physical therapist or referring doctor.

Rehabilitation is a process of recovery from injury which it can be complex for the patient but can be made very simple by educating them for the diagnosis and setting up right expectations for its recovery. This makes it easier for the patient to build trust and act as a team towards their recovery.

“What screws us up most in life is the picture in our head of how it’s supposed to be!”-unknown (someone wise)

Hope this blog helps both the patients and rehab specialist to reanalyze their understanding and expectations about rehabilitation better.

Reference:

  1. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. (2015)

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