Within my day to day job as a physio I see different people every day. Sometimes I am fully booked and see 14, sometimes I have a quiet day and maybe see 2 or 3 but on average I see 8 people. My job primarily is to "fix them up" or at least that's what the general population believe I do. Really, my job is a mixture of being an educator, being an inspiration, occasionally being a shoulder to cry on, and more often than not a sounding board for beliefs, behaviour patterns and most commonly - fear. I don't think any injury comes without it - and often takes many forms. It is similar to grief in this way, and affects everyone slightly differently - which makes me enjoy the challenge of assisting to unwrap the various barriers people face within their recovery.
If I can speak to those 8 people and create a space where they can feel comfortable, speak about the way they feel and offload any anxieties - surely this will help with their recovery. In actual fact I believe it is the thing that propels them through their recovery.
This is why I wanted to write this blog about the power of spoken word. It is the single most useful thing I can do in my job as a Physio, and the effects can be awesome.
Let's take an example. Mr Smith comes in to see me today as he has slept badly on a return flight from Singapore and as a result has a stiff and painful neck. After the clinical assessment and questioning (ruling out anything more sinister) I tell him not to worry, this is a simple case of neck pain after poor neck position for a prolonged time, it is temporary and it will get better. Perhaps he may need 1 or 2 sessions of physio to help with pain relief and correct movement once more but after that he will be fine, and will just need to stretch, exercise and keep his neck moving, being aware of posture etc.
All seems pretty straightforward? Ok, next in the clinic is Mrs Jones, she had to return to the UK and cut her bank holiday break shortin Singapore as her father is ill in hospital with a chest infection. She has pain in her neck and upper back, and is finding it difficult to move properly. I could tell her the same as Mr Smith, the problem is a temporary thing and her pain is most probably heightened by her increase in recent stress level with her hospitalised father. However, I could also tell her that this is a serious neck condition, she has degeneration in her neck and her pain will take 6-8 sessions to improve. She may require an X-ray and MRI scan to check for any further damage.
These 2 people will have a very different experience when they see me - and I need to be able to assess and judge this when I first meet them. (I also have a responsibility to be ethical in treatments and not to dupe people into believing they are worse than they really are you'll be pleased to know!). Now in these two examples I’m not saying everyone is as straight forwards as this, and when we are on the vast subject topic of pain and managing pain, and the psychological impact of pain - there is much more to it than just telling someone they will be ok and not to worry! My point is that this is just the start of good and honest communication, with reassurance and support at the heart of the message.
There is of course the timing and delivery of the message, the subtle psychological aspects to the message and the empathy with the way in which it is delivered. But this blog is not long enough (and I am not qualified enough!) to go in depth into this realm of communication and the way in which we do this. I'll briefly say that as a physio I must choose my words carefully!
A lot of my day job is to do with good communication, and the method in how you explain a problem to someone can put them at total ease, or cause added stress to the situation - which in turn then can then cause further break down of confidence, cause a negative belief that they will not get better and thus expand their overall recovery time.
I'm not saying all cases are as straight forward as the 2 above, but the power of the words we use can have a dramatic effect on the people we see. I have found through my clinical experience the more encouragement you give someone to get moving again, and reassurance that the problem is more minor than they think (so long as ethically it is!) they generally tend to have a better outcome.
So, yes as Physios we sometimes have a tough time convincing patients that movement is the best thing for them, as for years we have the belief that bed rest is best. However, movement is the best way in many cases to assist people to get on with their lives and progressing swiftly and confidently through to their full recovery.