How to predict your outcome? Some tips….
Name two things that predict a bad outcome from rehabilitation (no matter what injury)?
Terrible range of movement? Swelling? Pins and needles? Bad fracture?
Nope. Fear of moving and anxiety. Or in fancy science-speak: Kinesephobia and catastrophisation.
Obviously fear of moving a swollen ankle and being worried about it are normal behaviours. It’s a bit more complex that I’m suggesting. But if time progresses and after a reasonable time for tissue healing has occurred and you still are afraid to move the limb and you have a thought process that is a little out of control (i.e I will never walk again), then we have a problem. Again, this isn’t a criticism or a sign of a flaky personality type. It could happen to any of us. If you are a millionaire on a yacht and you sprain your wrist, well, I guess it will heal and you may or may not need help with it. If you are a physiotherapist/plumber/overhead power engineer (especially if you are self-employed), then mild anxiety for one person can feel like a catastrophe for another. Same injury.
So smart physiotherapists (like us) factor in this from early on. Reassurance, a graded return to more challenging movements, a focus on sleep, relaxation, a return to other activities as soon as possible and a plan for increasing movement and high level activities. It sounds basic but you’d be surprised how many clinicians just slap on some ultrasound and tell you the worst case scenario.
So top tip for patients: if you have worries about your result or any aspect of treatment, voice them early. Ypour physiotherapist should be able to either reassure you about it or factor it in to their rehabilitation plan. It’s simple but there’s good science behind it. Change the fear of movement and the anxieties and rehab results improve.
Patient thoughts on this most welcome.