Beating Up Your Back: Part 4
Putting it all together: Treatment
You’ve now completed your medical history, you’ve been observed, you’ve been put through all the physical tests…
So what does it all mean?
The treatment component of the physiotherapy visit is where everything should come together and get you started back on the path to doing what you love to do, be it playing with your kids, gardening or high performance sport.
As discussed previously, the history and observation gave us the clues to set up the physical tests. The physical tests in turn gave us your baseline data; the “what you need to fix”.
The treatment is where all that information is put to good use. This is where it is processed, analyzed and converted in to a physical rehabilitation or performance program.
What exactly does this program entail?
Well, in my books, each program should cover three major aspects.
If any of these three are lacking, there is risk of perpetuating or exacerbating the injury or dysfunction.
Using a client with low back pain as the example, this is how I would potentially set up a treatment plan.
Knowledge is power
1. Knowledge: Does my client know what component(s) of his or her life is/are causing or contributing to the low back pain? Is he or she aware of how to remove some, if not most, of these or minimize their impact? Have I helped my client realize the impact of both internal and external factors (e.g. body structure as internal factor, work environment as external factor)? Basically, does my client understand what steps need to be taken consistently to resolve the issue(s)?
2. Motor Control: This is where I make sure that my client is clear on the impact of his or her daily postures and how he or she can improve/modify them. After treatment, my client should be comfortable understanding how any muscle imbalances play a role, how mobility (excessive or lack thereof) at various joints (e.g. immobile hips, hypermobile lumbar spine) may influence tissue damage and how specific movement patterns may determine repetitive stress or overuse (e.g. poor sit to stand mechanics).
Not only should my clients understand these motor control areas, they should be able to teach me what they need to do to resolve them (e.g. stretches, exercises, proper movements/postures etc).
3. Conditioning: Have you ever been injured only to use that injury as your reason to stop all physical activity? Or have you had your healthcare provider tell you to “take rest” for extended periods of time? This break from exercise has the potential to lead to significant de-conditioning and further prolong healing time. Often, it is quite possible to work “around” an injury by choosing the appropriate exercises or activities to maintain or even improve overall conditioning levels while allowing injured tissues to heal!
And there you have it.
A treatment plan outline for a client suffering from low back pain. Using this outline, the details would be specific to the individual coming in for treatment. It would represent what that individual would likely have to do to work towards relieving low back pain.
Yours in movement.
Dev Chengkalath
