The “Chronic Rehabber” Part 2 - Change the “fix it” mentality.
The “fix it” mentality is concerning - think about it - having to go see someone often to “fix you” is a little unsettling - we are strong and resilient, thus why do we need to rely on someone else to fix us.
Let’s just consider what this means and put it out there that there are people that see me as someone who can fix them - I am working to change this rhetoric.
The use of passive modalities - meaning the patient does nothing (or maybe some movement) but in large a practitioner is doing something to them …such as: electric stimulation, hands-on therapy (massage, joint mobilization, joint manipulation, active release, Graston, cupping, cortisone shots, taping, and many others), etc. etc. leads to dependency.
Passive modalities lead to dependency, period. Does this mean they do not help, of course not. Does this mean they should ever be used, of course not. The discussion/education behind their use, the words used to describe how they will help, and the notion that we need to constantly have “work done” is simply not true.
There is a lot of research showing that manual therapy along with exercise shows a more positive result than exercise alone. There is also a significant amount of research growing about treating the patient as a whole, including one of the key elements of health - movement and exercise.
In my opinion, the “fix it” mentality should be driven internally and to the individual - showing them what they can do for themselves as often as possible and as a first line of defense whenever possible, vs showing them only what we can do for them. As a clinician it feels good to make someone feel better - but it feels best to make them feel better on their own.
To me, much of health care is a business and financially driven. Lack of focus on what the individual can do for themself is in itself a pandemic. I do not want to see people often, I do not want to see them for the same thing. I want to give them the tools and encourage them to be their best. I want to be the #1 cheerleader and coach with many assists along the way. In the paraphrased words of a mentor of mine, Craig Leibenson - I want to be Alfred and let the people be Batman.
I do not want anyone to take this and think I am totally demonizing passive work (ok, ultrasound - I’ll demonize - it doesn’t work). I use manual therapy in my practice, I regularly seek massages to help more with my mental state and relaxation. Some people use massage, PT, chiropractic care as a maintenance and something they love. Nothing wrong with that.
My issue stands - if you are seeing somebody for the same thing , over and over, or different injuries keep coming up - maybe it is time to be critical of the money and time you are spending and the results you are getting. If you aren’t given tools to self assess, self treat - I’m concerned for the long term product.
This is a call to everybody as well as all healthcare providers. Our bodies are resilient and meant to recover from injury or disease if giving the right tools and put in a supportive environment.