Reassurance

I was inspired to write this after reading this blog:

It is encouraging to know that there are other practitioners out there that have the same approach as we do. There are two key themes that have stood out for me over the last 15 years. One is the absolute nonsense that people are told about their backs. Disappointingly for me, the more qualified and whiter the coat, the more believable it sounds. Telling clients what the anatomy actually is and what medical research actually says always comes across as less sexy than a forcefully delivered ‘diagnosis’ from the consultant or cutting edge therapist. Especially in private health care, there is a pressure to deliver a pithy title that explains their pain and either saying you don’t know; that it’s not a clear pattern or that in many cases there is no pathology can sound weak if delivered poorly. So we have to have excellent communication skills to tell people that there is good news about bodies – they can adapt, get better, strengthen, stretch.

The second thing was that when I was a junior physiotherapist, my senior said to me:” Peter, you have reasonably good hands on skills but I think you just talk everyone better!”. I was mildly insulted at the time but now I would say that it’s not what you do, it’s how you present it. I am certainly an advocate of manual therapy, guiding patients with their movements, re-learning better movement patterns like our neurophysiotherapy colleagues but explanation, reassurance and de-stressing the client are as important.

In my own experience, when I was horribly mugged at 7pm on an Autumn evening in Clapham and my Acromioclavicular joint split from the force of the attack, the most important thing that my physiotherapy colleague did was to tell me that everything was going to be fine and to crack on with the exercises. I will never forget the relief. And I was a qualified physiotherapists with a few years of experience under my belt at the time.

So, I tell my physiotherapists: look out for any pathology,especially sinister causes of pain and if you established a musculoskeletal cause of the pain, reassure liberally, set goals and rehabilitate the patient back to what they want to do. Being a positive cheerleader that is respectful of injured tissue and worried minds, is a tricky tight rope, but it works, the job satisfaction is second to none.

Just my view.