Health & Fitness
December 2019
The Newsletter About Achieving and Maintaining Optimal Well-Being
LAST month we discussed how investing in yourself through an individualized physical therapy programcan not only be an effective way to correct a non-ideal situation in your spine or extremities, but also gain a great deal of satisfaction in being in control of some chronic health problem again. Why does it feel so satisfying? It is because you had a direct hand in making it happen, and you can now depend more on yourself to keep it working properly. SUCH an accomplishment creates an internal feeling of independence and self- reliance; qualities one values deeply as they get older. These feelings occur as a result of an active care program which is in contrast to a program which uses only passive inputs (medication, massage, adjustments, rest, injections, surgery, or ice/heat). These are all potentially helpful but not the final piece to a solution that ultimately creates self-reliance. BEING an active participant in overcoming a stubborn issue or solving a difficult body problem can be an enriching experience because it reinforces a deep desire in all of us to be in charge of our body and quite directly – our lives. From my observation, true solutions often require a personal investment in effort, interest and time to get lasting results. So let’s take a look at what is involved in making this happen. A muscle or joint problem that time and passive care has not solved needs to be better understood. Obviously, the first step is identifyingwhat is wrong, what is deficient, and fundamentally what are the causes behind the pain pattern. I know of many people who have reached for exercise in one form or another to overcome an non-ideal body situation only to find this aggravated their pain. So an evaluation is key to knowing what the issues are and in what order (this is important) they should be addressed. THIS is a skillful process of which a physical therapist at Full Potential is fully trained to do. In the examination, the PT can inform the patient on the essential issues and what level of effort will be needed to overcome these problems. I like to call this the effort to need equation. High need (many identified issues) will require an adequate effort to reverse habits in the body that need to be retrained. Remember, muscles develop habits or biases which are essentially THE GETTING BETTER EQUATION by Vincent Hanneken, PT
trained into the system by months to years of compensation and coping. So understanding this equation gives the patient the right expectations in terms of time and effort to getting better. THE beauty of this equation is as one does their program over time, the body almost magically begins the process of changing the basis for the pain and meeting the body’s needs. The proper effort will eventually create the sought after changes. We call this phase, where effort is meeting the need, the investment phase of the getting better process. When the investment phase is not consistent and of the right effort, PT can fail in its goals and the conclusion by the patient and doctor is PT did not help. But, that may not be the reason results did not happen. The patient’s lack of commitment may have been the more accurate reason. Look at the graph below and see the relationship between time/effort and improvement. AS one commits to the investment phase, their body takes these inputs and starts the process of reorganizing. In this phase, the sought after changes are not yet obvious but forces are at work to alter the deficits identified at the exam. This phase requires some dedication because each person is unique and their resistance to change will vary. I like to tell my patients in this phase that they have to bementally stronger than their problems so they stay with the program. SO consistency is one of the key elements for therapeutic changes to occur. When patients keep their appointments and do their program as instructed, essentially making their PT a priority. This will have the effect of meeting the need with the right effort and improvements will begin to occur. THERE is another key concept to this phase of care; it is called form follows function. What this means is that the body’s form reflects the functional habits it experiences over time. People who sit slouched over a computer for years will eventually be stuckmore rounded. On the positive side, correct application of exercises and postural advice over time can reverse these negative changes and their painful consequences. We use this concept all the time in PT and if this was not the case, it would be hard to help our patients.
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