The Monday Memo
June 12, 2017 PITT DPT STUDENTS
As is typical with most physical therapy students, I had a very active and healthy lifestyle growing up. I was a competitive swimmer in high school and spent nearly 20 hours a week in the pool training. I got into triathlon, weightlifting, and played intramurals throughout my academic career at Virginia Tech. My personal interests always revolved around physical activity and training, so naturally pursuing a career in health care made sense.
Like many, I figured I would apply to medical school upon graduating, but I slowly started to realize that physical therapy was much better suited for me. This profession gives you the opportunity to analyze a patient’s movement system, determine the best course of treatment, and help initiate their path to recovery. This path may include some passive methods, such as employing the RICE method or prescribing orthotics, but these typically lead us to the more effective and vitally important method that we utilize: active therapeutic exercise.
Your TherEx protocol is the “meat and potatoes” of your therapeutic protocol. This is what will provide true adaptation to your patient’s issue. At least for me, it’s also the aspect of PT that as a clinician you are most excited about. You’re creating an exercise regimen that will help the patient grow stronger, safer, and more resilient, and all they have to do is follow your instructions! What could go wrong?
The answer: A lot.
For instance, the patient may not do it. Unless you have the opportunity to work with the elite athletic population whose paychecks are on the line, you’ll be fighting the constant battle of patient adherence. Your patients are busy. They have jobs. They had kids. They have other interests and other priorities, and completing your 3×10 sit-to-stand protocol is likely very low on the totem pole.
We know how important exercise is. We understand the consequences of working a desk job 50-60 hours a week and coming home to eat a microwaveable meal and sit on the couch for the remainder of the evening. It is up to us to create patient buy-in; and to educate the public on the importance of regular physical activity and adherence to our therapeutic protocols.
This concept applies to all therapeutic settings: in-patient neuro, outpatient ortho, pediatrics, etc. We must work everyday to connect with our patients and show them how improving their functional deficiencies will lead to improved participation in the activities that they truly care about. Our goals and protocols must be patient-centered. They must be dedicated to helping the patient get back to the activities of their choice. This will not only enhance patient adherence, but also result in improved outcomes and reduced healthcare costs further down the road.
- Charles Badawy, SPT, CSCS, USAW,
Pitt DPT Class of 2019