When I first started my career as a physical therapist I had a great mentor. He was a few months younger than me but had this self-confidence I admired and hoped one day to have myself. His confidence seemed to infiltrate all aspects of his interactions with patients. He never seemed phased, no matter how stressful the clinic got, he always seemed in control of the situation and had this amazing ability to provide the most effective therapy programs his patients needed.
After about a month working with him he asked me a question that changed the course of my career. I had just completed an initial assessment of a new patient and started a bunch of exercises to help the patient. In a very innocuous way he asked me, “why are you doing that?” I don’t remember what I was doing but I do remember giving him an answer that would get me a passing grade in school.
He simply said, “I don’t care what the book says...I want to know why YOU are doing that.”
I was upset because I had given him the “right” answer. I was doing it because it was the “right” exercise for the condition.
Later that night and for the next several days I stewed on what he said. I would talk to myself and say things like, “Who the hell is this guy to question why I’m doing something!” Or “I’m doing it because that is what you are supposed to do!” I was more and more angry and started thinking of things to say if he asked me in the future and I had a bunch of great comebacks and smart alec responses I was hoping to use. In the end he never asked me again.
As the days turned into years I am able to look back and see how that was a pivotal point in my career. Since then I continue to question my methods and choices for therapy programs. As recently as this afternoon I realized a way to verbalize a couple crucial ingredients that are needed for the most effective results.
I would like to share these with you and hopeful help you answer the question,“why am ‘I’ doing this?”
Number one, doing something for the sake of doing it is not the most effective or productive way of going about therapy...or life for that matter.
A new patient recently told me that he had been doing a series of “stretches” every morning to help his lower back. He described the extensive series of exercises he was doing and when I asked him why he was doing them, he answered, “because I was told they would help.” He thought the stretches were the “right” answer.
I recommend he be more intentional, more focused. If he was using the stretches to improve his pain or to improve his mobility then they should have that affect when he did them or immediately after. I also suggested that rather than doing “a lot” he be more intentional and do the ones that seemed to have the most benefit.
Don’t confuse activity with results!
It is not the quantity of “good stretches” or “good exercises,” it is the quality of the results that matters most.
Another key ingredient is realizing that the “old school” way of doing therapy and exercise prescription is not always the most effective strategy. Instead of the “old school” mindset of a routine where we do things three times a day for 10 repetitions each time, we need to take a more effective approach and do things with a more specific purpose and that has a more predictable result.
For example, if you are getting worse doing an activity, continuing the activity or doing it more is not the most effective way to improve.
If you have found an activity that helps you feel better and you are only doing it as part of your morning routine, perhaps doing it more frequently...like every time you need to feel better...is a more effective strategy.
So often a patient will tell me that their exercises help “temporarily” and I often think “Great!” That means you found something that works.! But instead of being happy and doing MORE of what helps us improve, we complain and add more things to try and help resolve the issue.
For some reason it does not register that if something, a movement or position, is making you “worse,” then doing it more will not be helpful. AND OF EQUAL IMPORTANCE, doing an “old school” routine once or twice a day, misses the point that doing what helps more often will help you MORE OFTEN!!
Please re-read this… “Doing what helps more often...will help you more often!!”
The “old school” belief that doing a set routine will offer the most effective solution is simply not the most effective way to get results. When you find something that helps your pain and improves your mobility, do it any and every time you need to feel better and move better. The more frequent you do it the more likely you will just keep feeling and moving better!
There are times that the “doing” is the problem and rather than doing more, we should be looking at possibly doing less. That maybe instead of adding more exercises we should be more focused in our approach to do the things that would be most productive. Remember, “Don’t confuse activity with results.”
If you are struggling to know what do and “why” to do it, please give me a call at 518-332-4614 or email me at This email address is being protected from spambots. You need JavaScript enabled to view it.. Goodemote Physical Therapy PLLC is located at 3 Maple Dell in Saratoga Springs.
I will be joining Dr. Richard Kim of Kinetic Sports Medicine February 26, 2018 from 2:00 - 3:00 p.m. on WAMC’s “Medical Monday” (90.3 WAMC NPR), We will be taking calls and discussing the interaction between a physical therapist and a physician and how to improve a patient’s outcome.
