As pediatric sports therapists, we have to wear many hats during an athlete’s rehabilitation. We play the part of clinician, coach, cheerleader, and counselor within every session, while maintaining the ability to shift into being a drill sergeant when necessary. If we slip too deeply into any of these roles, we risk losing either our credibility or the connection that we need to have with our patient to keep him or her motivated through a challenging time. We need our patient to follow the medical plan of care that we have developed, but really need them to “buy in” rather than just follow blindly.
One of the most important things I’ve learned as a physical therapist is not a treatment technique or evaluation skill. It is the simple realization that my patients really don’t want to see me. I don’t take this personally. When an athlete comes in to our clinic to see a physical therapist or athletic trainer, it really is the last place they want to be. They’ve recently been diagnosed with an injury of some sort, and in many cases, have been told they need to take a break from the sport that they love.
Therefore, in order to get them to follow the physical therapy plan that is necessary for them to recover; I’m digging myself out of a pretty deep hole right from the start.
As physical therapists we have master’s or doctorate degrees to support our decision making, treatment planning, and differential diagnosis. This may matter to our patients’ parents, but it certainly means very little to the teenager who spends the majority of his or her waking hours blocking out the world with a pair of headphones on.
What is it that I do to get teenagers to actually pay attention to what I’m saying?
I listen…just listen. I listen a lot, I let them vent, I acknowledge that they shouldn’t like the situation that we’re in, I tell them that I’ve gotten through injuries, and so have many others. However, I make it clear that my empathy should not be mistaken for pity, and I expect them to work as hard as they can while in rehab.
I also make them accountable for their own outcomes by providing home exercise that need to be done independently and give them some input regarding the choice of exercise during our sessions. Finally, I make sure to show that I’m not afraid to practice what I preach and jump in and do an exercise with them, or finish the last session with a game of one on one.
In spite of the initial unwillingness that most patients have when they first walk into our clinic, we usually see a different kid in front of us by the end of the first visit or two. This willingness to play a part in his or her own recovery not only improves our outcomes, but it makes our sessions a lot more enjoyable.
Timothy Duer, PT, MSPT, CSCS, SCS is the Therapy Services Supervisor for the Center for Sports medicine at Nemours.