One of the biggest problems you face as a therapist will be getting your clients to ACTUALLY DO their exercises.
And lets face it, why would they want to?
Some of them may be there because of an acute injury or illness like a surgery, sports injury or Pneumonia. But the majority of them are there after years of living with pain and dysfunction that finally became unmanageable. Or it’s the end of the year and they remembered to finally use their health insurance.
When you live with it day in and day out, the uncomfortable becomes normal. The motivation to change either just isn’t there or they feel like crap and simply don’t want to do anything that may make them more uncomfortable.
That’s where we come in! They either don’t, won’t or can’t see the long term benefit that doing therapy right now will bring.
I like to think of myself as a coach and not strictly a PTA. (It doesn’t actually change anything, it just helps my mindset) Mainly because it changes my approach to working with a client.
Instead of being —-> the person they come to for help. I am now —> the person they come to, to learn about all the things they need to be a better version of themselves. Physically and functionally at least…
That is the main difference between a trainer and a coach. A trainer will run you through a program. A coach will teach you what you need to know about the program so it goes with you forever.
How to Convince Your Patient/Client to Actually Work With You
Don’t laugh at the techniques because they truly work. I have been using them for the past decade or more as a PTA and since implementing them, I have seen dramatic changes in the way clients respond.
There is a lot of psychological maneuvering involved when working with the public. Just like advertisers for any company play on your wants and needs to make a sale, you have to do the same thing to get what you want from your patients. (Because honestly.. the thing you want is for them to do their part so they can have a better outcome. So it’s not even a selfish want.)
Technique #1: Ask for a favor
This one works especially well with the older male clients that don’t want to be there in the first place. They usually know they could use some assistance, but don’t like having to show weakness. That pride is understandable. No one likes to be seen as helpless or less than.
If you take that aspect out of the equation by making it seem like they are doing this for you and NOT because they need it, you have a good chance of getting their full compliance.
I got this one from a tv show of all things. The Good Wife. One of the political figures gave this advice to gain loyal followers. Their reasoning –> when people think you owe them something, they will willingly do what you ask of them and think it’s their idea all along. Like an illusion of power.
Ways I go about this: I like to say something along the lines of “Hey, I know you may not need this but… could you try it once as a favor to me please? Or, “It would really be something if you could help me check some of these boxes.” and then run them through an assessment or treatment protocol.
Technique #2: Give them ALL the education
This is most definitely the one I use the most often.
Educate them on not only the reason why they are doing each move, but also the physiological benefit they are getting if they do, and what will happen if they don’t.
Example = Ankle pumps. Every person and their grandma know to do ankle pumps, but I would bet only 1% of them know why they are supposed to do them. Which means… They don’t do them! But what an easy way to segway into talking about the benefits of exercise, walking and movement in general. Give them a basic (very general) rundown of how the valves in the lower leg work and how the calf pump aids everything and then show them how it looks in sitting versus standing and walking and you will have a believer on your hands! That person will actually get up and move because they not only understand what the movement is, they also understand what it will do for them. This education may take all of 3 minutes. It’s not a lot to go over, but the benefit will last them the rest of their lives.
The same thought goes for gait training, squat mechanics, lifting, exercises prescription, etc… Everything really. Any and everything they do has a reason behind it. Let them know it and they will let you lead them. And then when they finally leave your service, they will have that knowledge to take with them forever.
I live in a small area so I run into old patients all the time at places like the grocery store or post office. And they will tell me things like, “I still make sure my knees don’t collapse when I stand up.” and “I squeeze my butt all the time.”
The skill will be determining that fine line for that particular person on where the information is too much. No one does well with info overload. But every person deserves to have the info on everything they are doing, so why not give it to them.
Disclaimer: there are some people that Do Not want information. They will let you know real fast if they are that type.
Technique #3: Repetitive self cuing
To be consistent with their form or technique, people need to know how to cue themselves. Or if they are the one helping their loved one, how to cue them properly.
It’s the same concept as “Perfect practice makes perfect”. It isn’t enough to practice, you have to practice correctly.
Teach them how to talk to themselves out loud. This not only reinforces their learning in a way besides physical, it also increases their confidence in you. They see that you are not slacking off and giving them half ass work. You are engaging with them and making sure they are doing things the right way. When they trust you and feel like you care about their performance, they are motivated to continue.
Technique #4: Make it part of a task
What better way to show someone that the movement you are asking them to do is actually functional and affects their everyday life than by making them do it during a task?
Load shelves while doing ab isometrics, fill boxes while doing RDLs, get off a table or bed while doing shoulder abduction, stand up or sit down on a couch while doing squats… The list can go on for days. When they can relate a movement to something they do ALL THE TIME, they will see the reason why you want them to do it.
Technique #5: Build their home program into their current routine
This one is probably the most important one and essential to getting your clients to actually comply with their HEP.
Rarely will someone go home and just do their program. When they get home they are worried about more than that. They have bills and chores and family members and pets and so on and so on… (and don’t forget a nice comfy recliner)
It’s not enough to simply go over their HEP and make sure they know how to do it. And while technically it isn’t our responsibility to make sure they actually do it at home, why wouldn’t we want to set them up for success?
This is actually not that hard to do, it is lengthy though. It may take a full session or 2 to do properly but it is worth the time.
- Go on a fact finding mission on what their typical day and week looks like.
- Find out the layout of their common area. Either at work or at home, wherever they will be doing their program.
- Find out what equipment they have access to (like couches, bands, the floor, hand weights, exercises balls, etc…)
- Teach them ways to incorporate it into their existing schedule with the equipment available to them
- Write it down. For real, make them write down the times they plan to do it and where.
The info gathering doesn’t take much time, it may be about 5-10 minutes total. The time eater is having them demonstrate to you what they will be doing and how, so you can make sure they are set up right. For example, they could do their hamstring stretches during commercial breaks while watching the news at 11 AM from their couch. Or, they will do their calf raises, holding onto the kitchen sink at 8 AM while they wait for their coffee to brew.
Have them show you what they will be doing and make a plan to do it. At that point it is completely up to them to then perform like they say they will, but having an easy to follow roadmap will show them how easy it can really be and will seem less overwhelming.
When you take the time to show them you care about their future progress and that you really are on their side, they will more willing to work with you in the moment. And in the future, if they ever do need to go back to rehab, you will be the one they remember.
That’s it! Those are my 5 tips for working more like a coach than a trainer when treating your rehab clients.
Do you have any tips for me that have worked for you? OR Do you have any ways to for finding time to work out every day that I can pass along to my clients? I would love to hear them.
More from LGM:
WHY YOU SHOULDN’T WAIT TO “FIND YOUR PASSION” TO SWITCH CAREERS
HOW TO CHANGE YOUR COVER LETTER AND RESUME WHEN YOU WANT TO SWITCH CAREERS [4 STEPS]
North Carolina, USA