At some point in the course of rehabilitating an injury, one has to begin the transition to self-care, the daily activities by which an individual takes care of his or her own health needs.
As the word “transition” implies, this phase involves reduced dependence on the healthcare provider and becoming independent with one’s own exercises program. Generally, this is achieved through reduced treatment frequency to help the patient form a sustainable new habit: self-care strategies and exercises.
The successful transition will significantly reduce the probability of reinjury and improve long-term function. It sounds simple enough, but depending on the individual and the complexity of the injury, this is often very difficult.
I find this phase presents the greatest challenge to patient compliance. As a patient in the transition state myself, recovering from a ruptured Achilles tendon 3 1/2 months ago, I’ve found that I am struggling with the same challenge. Multiple factors contribute to this phenomenon: Decreased symptoms reduce motivation to continue care and forming a new habit takes time and dedication.
Speaking as the provider, I found that the patients who have the easiest time staying compliant during this phase of care are seasoned athletes. So why do they have an easier time and what can we learn from their mind-set.
I believe the reason has a lot to do with their motivation to excel and a foundation of daily practice that makes forming a new habit (particularly adding new exercises and self-care strategies) easier. The seasoned athlete also values function above lack of pain. If you ask most athletes, they will tell you that some physical pain or discomfort is a part of their daily experience; given the opportunity, however, most would rather discuss the current state of their performance. In other words, they focus on function.
If you are recovering from an injury and making a transition to self-care, my advice is to:
– Focus your mind on something you want to achieve or an activity you want to get back to. This will give you the motivation to focus on improving your function. Additionally, this will help you stay compliant to take advantage of the transitional treatment sessions you have scheduled instead of seeing them as a chore.
– Be patient with yourself. Researchers estimate that it takes at least 60 days to form a new habit. If you simply can’t make time to do all your exercise, then do some or one. Keep practicing, as this will eventually become a habit.
– When you don’t understand the purpose of a prescribed self-care exercise or strategy, ask why. I’ve found that when I communicate the purpose of an exercise, stretch or self-care strategy, the patient is more likely to comply. Random do’s and don’ts rarely build a good habit. On the other hand, understanding the benefits goes a long way to stimulating action.
From the provider perspective, there is nothing more frustrating than seeing a patient return to the office with a reinjury that could have been avoided had the patient invested the resources and time during the transition to self-care phase. Ultimately, the benefit to transitional compliance can be dictated only by the patient.
If you are on the fence and thinking about canceling your next appointment, ask yourself, what would a professional athlete do?
— Sevak Khodabakhshian is a doctor of chiropractic with Thousand Oaks-based Omega Rehab & Sport, where a team of physical therapists, chiropractors and athletic trainers applies an active-care approach to healthcare. He can be reached for comments, questions or suggestions by e-mail, at Sevakk@omega-rehab.com.