Sports are the most captivating scenes in America. We can all identify the iconic sportsmen of our childhood and we all know what it means when we hear, “I wanna be like-Mike”. However, most of us fall short and recognize these sportsman as the lucky few who were blessed with God-given talent that reached super-stardom, effortlessly. This is not true though, the journey of a sportsman is anything but effortless. No journey is effortless. And no journey occurs in isolation.
In reflection of the sportsman journey, I see the journey of a patient. The sportsman is usually part of a team who cohesively works together to achieve a common goal: winning. A team struggles as well as finds success as a singular unit. Similarly a patient is part of the rehabilitation team striving to succeed at restoring functional capacity. However there are often roadblocks that slow this process. Identification of how the sports team and rehab team constructs are similar can allow us to begin to see where our roadblocks may be developing and how we can overcome them.
So here’s the breakdown: coaches = physical therapists, players = patients, opposition = movement/behavioral dysfunction, and the officials = our pain. Recognizing that not only are we a part of a team, but we carry a specific role is powerful.
Let’s dive into each of these to learn how to overcome our roadblocks.
Distinguishment between the opposition and the official is essential. Far too often we hang our hat on “It’s my pain’s fault.” Why? It’s always easier to blame someone or something else. Just like in basketball, it is easier to say “the refs cost us the game.” However we know this is not the case. The officials are present to ensure we play be the rules and to alert us if we do anything wrong just like our pain does. To not get the whistle blown on us again we have to change our behavior. However, this can be incredibly difficult, but it’s not just you, even elite athletes have ordinary habits they struggle to overcome. A recent sport psychology article identified three primary drivers of behavioral change in elite athletes: credibility, reliability, and intimacy. However the interesting part is that these three primary drivers are not about the elite athlete, but rather their coach.
This is no different in physical therapy. A patient and physical therapist must not only trust one another, but they have to trust the process. This starts with effective communication from the physical therapist. An explanation of a patient’s condition or procedure allows the credibility of the physical therapist to be highlighted. Providing knowledge and resources alike ensures a person they are in good hands. The outcome is often improved compliance in their behavioral modifications. Knowledge can be the liberator needed by a patient to break them free of a movement dysfunction.
However sometimes more than one explanation is needed to help break a chronic movement/behavioral pattern. Being a reliable and consistent resource is also critical. Often a person leaves a session feeling good about their exercise program as well as her behavior changes, but return ill-confident in their performance. Utilizing repeated exposures and reassuring a person can go along way. And just because a person struggles doesn’t mean they are doing something wrong and need “more change”. It is quite the contrary, at the point of struggle is the start of learning, so consistency in their performance becomes essential. The physical therapist should highlight this notion and coach each person through their exercises as they learn how to regain control of their movement patterns.
That being said though sometimes frustration sets in and hinders performance. Early recognition of this by the physical therapist is important. This reflects the intimacy of the relationship between a patient and physical therapist. Being able to pick up on differences in mood, verbal language, and/or body language can mitigate the frustration roadblock and allow for a consistent restoration of their movement and resolution of symptoms.
In the end, a physical therapist is in the coaches seat. Their influence drives and guides the success of the players. The role of the coach is to maintain focus on overcoming the opposition and not the officials. To do so hangs on the three primary drivers of behavioral change: credibility, reliability, and intimacy.
Butler DS, Moseley GL, Sunyata. Explain Pain 2nd Edn. Noigroup Publications; 2013.
Halson SL, Lastella M. Amazing Athletes With Ordinary Habits: Why Is Changing Behavior So Difficult?. Int J Sports Physiol Perform. 2017;12(10):1273-1274.