All physical therapists have had them: patients who—despite your best efforts—miss a few sessions, don’t listen to your recommendations, or stop showing up altogether.
Though physical therapy exercises are crucial for some patients’ recovery, they can be arduous to finish, for more than one reason.
Steven Marano, PT, DPT, OCS, Facility Manager at Midwest Orthopedics in the Chicago-based Rush University Medical Center, estimates that most physicians will provide a four to six week prescription for PT; for post-operative patients, the length of time can be increased between 12-16 weeks. Most of his non-surgical patients will complete 75% of their prescribed time.
As for that other 25%: “There are always reasons people are going to have difficulty adhering to the program,” he says.
Slow And Steady
As physical therapists know, the body takes time to change. PT is effective, but it isn’t necessarily quick. If patients come in expecting a rapid tune-up, they’ll be easily discouraged.
“Some of it is just patient expectation,” says Steven. “A lot of the time, people are unaware of how muscles are built, how mobility is increased, and how flexibility is increased. And I think it’s important on the first day to give them timelines for how long it’s going to take.”
During an hour-long evaluation, Steven outlines what patients can expect over the course of the next six weeks.
“If I can set that expectation in the beginning, I find that full adherence to the program is a lot higher,” Steven explains. “But you always will get those patients who want quick, immediate results and will not want to go the full six weeks.”
Life Gets In The Way
Patients have lives outside of the PT office, and that can often get in the way—even for motivated patients.
The biggest culprit: work.
“Let’s say they’re coming in for something with cervical or neck issues, and they have a really stressful job,” Steven says. “They tend to not sit with good posture, and they’ve got their computer in a bad position.”
“Those things are going to play into their neck not getting better,” he adds.
Cost, of course, is also a factor. “Any sort of changes in insurance can also be difficult, whether they have a lot of co-pays and whether their insurance coverage is good,” says Steven.
Advocate on their behalf with insurance companies, and try to teach them good habits to carry outside of the PT office.
As with any type of medical treatment, the best practice is to treat the person, not the symptoms. And sometimes, that goes beyond their simple muscle injury.
Chronic pain is an emotional issue as much as it is a physical one. Those with chronic pain have elevated levels of stress and commonly suffer from depression, according to the US National Library of Medicine.
“When you’re dealing with someone who has been in chronic pain for six, seven, eight years, there’s going to be an emotional component to their recovery process independent of what goes on in therapy,” says Steven.
“You’re really dealing with someone who has changed the way they’re living because of their pain,” Steven explains. “So, it’s not just, ‘Okay, your knee is moving better,’ but it’s having them believe that they’re actually going to see a difference. And that takes even longer.”
“Usually, the length of time they’re in PT can be related to the length of time they were in pain before,” he adds.
Patients can get frustrated with PT for reasons beyond your control. To prevent this, contact a rep to learn more about physical therapy exercises on the AlterG Anti-Gravity Treadmill, so your patients feel like they’re progressing rapidly without exacerbating their injuries.