Boy, I was over optimistic!
I soon learned that my grand plan of successfully treating these problems by instructing patients to perform a long list of exercises was flawed. The fault was not in the exercises. The exercises actually were very good and if performed diligently would likely have made a significant positive difference. The fault was not the patients. They were not lazy or intentionally non-compliant. The problem was my plan of combining lengthy lists of exercises with the unrealistic belief that most people had an entire day to perform these exercises having no other obligations. “What do you mean you have kids you need to care for during the day?” “You mean you have to go to work?”
I then developed much more reasonable treatment plans for the majority of my
Hmm. Less is better?
Yes. A shorter list of exercises focused on specific patient issues is much more effective simply because the patient will do them! I now educate patients in ways to fit these exercises into idle and wasted time during the day. Patients are impressed. They learn what television advertisements are for, what the time waiting for copies at the machine are for and what being on hold is for. Computers need to boot up, printers print and you must wait for kids at sports practices. These events are for doing your exercises. I surely have patients schedule time for slightly longer periods of consistent specific exercise performance during the day, however to also take advantage of the many wasted moments where they can fit in additional exercises.
Patients now express not feeling as overwhelmed by exercise demands, and less likely to simply throw up their arms (if they can) and quit. I also find that patients are more apt to take my recommendations regarding the benefit of continuing the performance of these exercises even after pain has subsided, function has returned and they have been released from my care.
My hope is that a significant number of patients will simply incorporate the ‘simple’ exercises throughout their daily routine. This will result in reducing the chance of their problem returning and them generally feeling better.