Over Achievers: Listen to your therapist

Having provided physical therapy services for nearly 20 years, I have observed numerous patient attitudes.  There are the classic over achievers, there are the patients that do only what they are told, and then, unfortunately, we have the patients that are not truly motivated.  The unmotivated patient follows the saying; you can lead a horse to water, but you can’t make them drink.  We can try to connect with them, can try to help the patient understand, and we can attempt to motivate them; but in the end, this behavior/work effort typically has been ingrained for a lifetime.  The unmotivated patient may not reach their maximal abilities, however they are also less likely to further injure themselves than the classic overachiever.  The overachiever may be the most frustrating patient at times but in my opinion, it is easier to change this group’s behavior with persistent education, and when this occurs, the outcomes are typically excellent.

If you cut your arm, it bleeds, and then a scab develops; what would you do to help this heal?  You might put a Band-Aid on it, you might put some antibiotic ointment on it, or you may just protect it and not pick at it.  If we don’t protect our scab or we pick at it, the wound will typically re-bleed, form another scab, and then take longer to heel.  This makes sense to most of us, however many patients that are over achievers do not apply the same logic to rehabilitating their bodies.  I may ask you to perform 30 arm curls with 1lb per day and you perform 100 repetitions with 5lbs, thinking more is better.  Well, you may have just made my job much harder; you may have broken down healing tissue, you may have created increased inflammation or developed a tendonitis in a tissue that was only mildly irritated, or worse yet, and you may have torn tissue that was surgically repaired.  Just go back and think how that scab heals, and apply that to your physical therapy problem.

Some problems generally do require aggressive strengthening, such as multidirectional instability of the shoulder, but please let your therapist direct you in the vigorousness of exercise and the appropriate exercises.  However, when your therapist tells you that you have a moderate ankle sprain, please listen to them, because your ankle sprain needs time to heal and your body needs time to allow the ankle ligaments to stiffen up.  Motion that is stressed to early or aggressively will likely become permanently lax.  A therapist can generally take stiff tissue and make it looser but does not have the ability to make lax tissue tighter.

All you over achievers, please let us help you.  We want you to work hard and we will let you work hard when it is appropriate.  We want you to get better as much as you do and want you to achieve your goals but sometimes you have to listen to your therapist more than your body!


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