How To Know You Have Prescribed The Right Exercises For Your Patient
Posted By: Andy Barker
Maybe your writing your notes, driving home from work or maybe you worry when your trying to drift off to sleep at night about whether or not your patient will come back the week after, for their next appointment, better or worse…
This is so common for New Grad’s and if this sounds like you then keep reading as in this blog you will discover how to link your patient assessment findings and your rehab together, so you don’t second guess yourself as you will KNOW you have prescribed the right exercises, even before your patient leaves your clinic room.
A Good Assessment = Problems
Whilst gaining a diagnosis is part of any patient assessment, it is NOT the main aim.
Gaining a diagnosis is good, but what is better, is that you finish the assessment with a list of problems.
No therapist can treat a patella tendinopathy, disc related lower back pain or a post-op shoulder.
What you can treat is a loss of knee range of motion, poor lumbo-pelvic movement or reduced shoulder strength.
There is a big difference…
Your patient assessment, firstly your subjective and then your objective, should link together and at the end of the assessment, give you a list of problems.
You can fix problems, but you can NOT fix a diagnosis.
Once you have a list of problems to work with, you can get to work and start helping your patients out of pain and back to full health.
If you do sometimes question if you have given your patient the right rehab exercises…
…maybe your problem at selecting the right rehab is not actually a rehab problem at all…
…maybe you are just not asking the right questions or doing the right objective tests during your patient assessments, to give the right information you need, so you can prescribe the right rehab exercises.
A Problem Needs A Solution
Your solutions to the problems you identified in your patient assessments are your interventions – your treatment and rehab.
Whether you use hands-on treatment techniques or rehab, or a combination of both, ANY intervention you use MUST aim to fix one of your patient problems.
If you are finding yourself using the same ‘go-to’ exercises, choosing exercises because they worked well previously with a similar patient or selecting an exercise because it looked good on Instagram then you are missing a trick.
You will never be in doubt if you have prescribed the right rehab exercises, or used the right hands-on treatment technique, with your patients if you link your interventions to your assessment findings.
If you have identified a lack of range of movement at the knee, then treat that and give an exercise to restore it.
If you have identified your patient has poor movement control in their lumbar spine then give them an exercise to fix it.
If you have identified a loss of strength in your post op shoulder patient then give them an exercise that is specific to what you found in your assessment…
…not just some random exercise that you have used before or you saw last night on social media.
To confirm your interventions are the right interventions, you just need to test it and this is the easy bit…
Test – Retest – Test – Retest…
With any intervention you use, you should always immediately re-test your patient.
Whether this is a hands-on treatment technique or a rehab exercise, you do a technique or do the rehab exercise, then you retest.
Using an objective marker, like range of movement or strength or a subjective marker, such as pain or quality of movement, you can immediately find out if your intervention has worked.
In short if it improves their symptoms, it most likely is a good exercise choice.
If it does not, firstly recheck they are doing the exercise correctly, then consider whether the exercise might just not be the right exercise for them, at that time.
However, if you have done a good job with your patient assessment and linked your treatment and rehab exercises directly to the patient’s specific problems you will rarely go wrong.
In cases where exercises make no change or sometimes make symptoms worse (assuming good exercise technique), the exercise is usually just to advanced for them at that time and you may need to regress.
Using a test-retest system like this is simple and it helps you to confirm if you have selected the right rehab exercises (or treatment technique) immediately in clinic.
It will stop you worrying how your patient will respond and you will be confident that your patient will arrive at their next appointment in much better shape than when they left.
1) A Good Assessment = PROBLEMS: Whilst a diagnosis is important what is more important is a list of problems. You can treat problems but, you can NOT treat a diagnosis
2) A Problem Needs A Solution: Once your assessment has given you your patient problem list you can link ANY intervention you do, treatment or rehab, directly to one of those problems
3) Test-Retest: Use this system to check immediately if your intervention has made a positive change to patient symptoms and be sure you are sending your patients away with the right rehab exercises as part of their home exercise programme
>>>If you struggle to piece together your patient assessments and rehab, then you will find massive value in my New Grad Physio Courses.
I run courses for both the lower limb and upper limb and the content I teach will help you make sense of your patient assessments and show you how to take information from your subjective and objective assessments so you also know exactly what treatment and rehab exercise to give to your patients.
You will learn how to better assess gait (even for upper limb problems) and how to use simple standing movement tests to identify what is causing your patients pain, NOT just where their pain is.
You will learn why traditional manual muscle testing might not give you the answers you want and discover another way to test muscle strength.
You will also see my ‘6 Step Rehab planner.’
This is the exact system that I use for EVERY patient or athlete I work with, and I use this for ANY lower limb or upper limb injury.
It tells me how to progress (and regress if needed) patients, get them back to full fitness quickly, with the confidence they will not break down again.
You can find out more details HERE