Hey gang hope all is well,
I was recently on a prac where i came across a gentleman who had been referred to the clinic from a public hospital. He had a longstanding history of widespread thoracic and cervical OA and spondylosis that had been primarily managed from the previous physios with hydrotherapy and exercise therapy. The man was middle aged and not as old as i had expected upon presentation.
Following the examination and discussion from my supervisor we conluded that this man would benefit from gentle mobilisations of the affected segments and soft tissue work of the tight/tender musculature along with some exercises for home and general education and advice.
As planned i proceeded with the manual conponent of the treatment which seemingly worked with improvements in the restricted ranges but as i was about to proceed to show him his home exercises he quipped: "is that all your going to do can't you fix me up".
From here i had to explain his situation and pathology and tell him that although manual treatment is beneficial his home exercise program is of paramount importance as we only see him for a short time in the clinic whereas he is at home for long periods of time. I had to make him realise that although treatment is an important component, management of his condition is even more important.
This encounter made me realise that people attneding physio often see it as a "quick fix" and that we should be able to fix their pathology single-handedly. It often has to be explained that both parties have the power to influence their condition and that their role away from the physio clinic is even more important to improve. I will now be able to identify patients with this attitude in the future and hopefully educate them on how it is both our responsibilities to favouable influence the condition.
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This is similar to my situation where these chronic cases easily become dependent on physiotherapy to manage their pain while half-heartly doing their HEPs. What I often find interesting also is that although this patient has had their pain for years, they think a few essions with physiotherapy is going to make them perfect. I find it quite surprising that so many patients think that they should be able to get back into perfect condition despite the bony degeneration and changes. Therefore one big part of my explanation is just highlighting the this is a problem that they are going to have for the rest of their lives, all they can do is try to decrease compensations and maintain optimal function by self Mx.
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