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You didnโ€™t fail rehab, you just didnโ€™t do the right rehab

You didnโ€™t fail rehab, you just didnโ€™t do the right rehab

May 07, 2023โ€ข3 min read

๐—ช๐—ต๐˜† ๐—บ๐—ผ๐˜€๐˜ ๐—ฝ๐—ฒ๐—ผ๐—ฝ๐—น๐—ฒ ๐—ณ๐—ฎ๐—ถ๐—น ๐—ฟ๐—ฒ๐—ต๐—ฎ๐—ฏ ๐—ฎ๐—ป๐—ฑ ๐˜๐—ต๐—ฒ ๐—น๐—ถ๐—ธ๐—ฒ๐—น๐˜† reason ๐˜†๐—ผ๐˜‚ ๐—ต๐—ฎ๐˜ƒ๐—ฒ โฃ

๐˜•๐˜ฐ๐˜ธ ๐˜ฉ๐˜ฆ๐˜ณ๐˜ฆโ€™๐˜ด ๐˜ข ๐˜ต๐˜ณ๐˜ช๐˜จ๐˜จ๐˜ฆ๐˜ณ ๐˜ธ๐˜ข๐˜ณ๐˜ฏ๐˜ช๐˜ฏ๐˜จ. โ—๏ธ โฃ

Most people ๐—ณ๐—ฎ๐—ถ๐—น ๐—ฟ๐—ฒ๐—ต๐—ฎ๐—ฏ, itโ€™s estimated around ๐Ÿน๐Ÿถ% ๐˜ฐ๐˜ง ๐˜ค๐˜ญ๐˜ช๐˜ฆ๐˜ฏ๐˜ต๐˜ด ๐˜ข๐˜ฅ๐˜ฉ๐˜ฆ๐˜ณ๐˜ฆ ๐˜ต๐˜ฐ ๐˜ข ๐˜ฑ๐˜ฉ๐˜บ๐˜ด๐˜ช๐˜ฐ๐˜ต๐˜ฉ๐˜ฆ๐˜ณ๐˜ข๐˜ฑ๐˜ช๐˜ด๐˜ต๐˜ด ๐˜จ๐˜ถ๐˜ช๐˜ฅ๐˜ข๐˜ฏ๐˜ค๐˜ฆ of prescribed exercisesโฃ

From my experience personally and as a clinician I can break down why these numbers are so low, and how I manage to get my clients to engage to get long lasting results. โฃ

๐—™๐—ถ๐—ฟ๐˜€๐˜๐—น๐˜† ๐˜„๐—ต๐˜† ๐—ฝ๐—ฒ๐—ผ๐—ฝ๐—น๐—ฒ ๐—ณ๐—ฎ๐—ถ๐—น:

  • The assessments been too generic which has lead to basic exercises givenโฃ

  • The movements donโ€™t hold value to the persons pain experience โฃ

  • The exercises donโ€™t fit the persons true lifestyle and options - 10 sets of exercises 3 x daily doesnโ€™t cut it โฃ

  • The therapist hasnโ€™t found a meaningful change in the session to show the clients body it has the ability to move without painโฃ

  • There hasnโ€™t been expectations set between therapist and client โฃ

  • There is no structured plan for how the exercises are going to change in the persons real life goals โฃ

Now we ๐˜€๐—ฒ๐—ฒ ๐˜๐—ต๐—ฒ ๐—ฝ๐—ฟ๐—ผ๐—ฏ๐—น๐—ฒ๐—บ๐˜€ ๐˜„๐—ฒ ๐—ฐ๐—ฎ๐—ป ๐—ฐ๐—ฟ๐—ฒ๐—ฎ๐˜๐—ฒ ๐˜€๐—ผ๐—น๐˜‚๐˜๐—ถ๐—ผ๐—ป๐˜€. โฃ

Overtime I have created ๐˜€๐˜†๐˜€๐˜๐—ฒ๐—บ๐˜€ to allow me to navigate these challengesโฃ

Using a ๐˜ฎ๐˜ฐ๐˜ท๐˜ฆ๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต ๐˜ฃ๐˜ข๐˜ด๐˜ฆ๐˜ฅ ๐˜ด๐˜บ๐˜ด๐˜ต๐˜ฆ๐˜ฎ combined with ๐˜€๐—ผ๐˜‚๐—ป๐—ฑ ๐—ฟ๐—ฒ๐—ฎ๐˜€๐—ผ๐—ป๐—ถ๐—ป๐—ด it has allowed very simple strategy to give people actionable changes. โฃ

Step 1 ๐—ณ๐—ถ๐—ป๐—ฑ๐—ถ๐—ป๐—ด ๐˜๐—ต๐—ฒ ๐—ฟ๐—ผ๐—ผ๐˜ ๐—ฐ๐—ฎ๐˜‚๐˜€๐—ฒ :โฃ

Not just looking at the point of pain, but looking back in the persons movement history can show why they move the way they do. โฃ

This is then reinforced in a movement assessment to see objectively does it pair with their historyโฃโฃ

What lead to that area becoming sensitisedโฃโฃ

Now we have an idea as to the zoomed out picture we can look to treat. โฃ

Step 2 ๐—ฝ๐˜‚๐˜๐˜๐—ถ๐—ป๐—ด ๐—ผ๐˜‚๐˜ ๐˜๐—ต๐—ฒ ๐—ณ๐—ถ๐—ฟ๐—ฒ ๐Ÿ”ฅ :โฃ

We then use whatever interventions best desensitise the painful area, whether it be a treatment of the local tissue, something for the nervous system or simply offloading that areaโฃ

Step 3 ๐—ฟ๐—ฒ๐—ถ๐—ป๐˜๐—ฟ๐—ผ๐—ฑ๐˜‚๐—ฐ๐—ฒ ๐—ฝ๐—ผ๐˜€๐—ถ๐˜๐—ถ๐˜ƒ๐—ฒ ๐—บ๐—ผ๐˜ƒ๐—ฒ๐—บ๐—ฒ๐—ป๐˜ :โฃโฃ

By this stage we should have made a simple win where movement doesnโ€™t hurt like it did. โฃ

Now we use movement exercises or drills to reinforce to the persons body what movement options it needs or is missing. โฃโฃ

โฃWe can then follow a structured programme of building from this to regain what the persons body is missing โฃ

And using graded exposure, strengthening and small wins it keeps the success frequent and gives obvious progress โฃ

Working with many clients who have failed traditionally therapy i commonly see step 1 and 3 completed poorly. โฃ

๐—ง๐—ต๐—ฎ๐˜โ€™๐˜€ ๐˜„๐—ต๐—ฒ๐—ฟ๐—ฒ ๐˜๐—ต๐—ฒ ๐—บ๐—ฎ๐—ด๐—ถ๐—ฐ ๐—ถ๐˜€ โฃ

โฃYou can have the ingredients for a cake, but if you just chuck it all in a pan and hope it works itโ€™s likely to come up shortโฃ

Youโ€™re destined for failure. โฃ

โฃThereโ€™s more to this game than just a couple generic exercises for knee pain, if it worked that easy then so many people wouldnโ€™t fail. โฃ

๐—œ๐˜โ€™๐˜€ ๐—ป๐—ผ๐˜ ๐˜๐—ต๐—ฎ๐˜ ๐—ฟ๐—ฒ๐—ต๐—ฎ๐—ฏ ๐—ฑ๐—ถ๐—ฑ๐—ปโ€™๐˜ ๐˜„๐—ผ๐—ฟ๐—ธ ๐—ณ๐—ผ๐—ฟ ๐˜†๐—ผ๐˜‚โฃ

๐—ฌ๐—ผ๐˜‚ ๐—ท๐˜‚๐˜€๐˜ ๐—ต๐—ฎ๐˜ƒ๐—ฒ๐—ปโ€™๐˜ ๐—ฑ๐—ผ๐—ป๐—ฒ ๐˜๐—ต๐—ฒ ๐—ฟ๐—ถ๐—ด๐—ต๐˜ ๐—ฟ๐—ฒ๐—ต๐—ฎ๐—ฏ

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