Too often in the physical therapy world, we see our patients drop off from our caseload. While there may be a variety of reasons for this, one of the big ones can be our delivery of the content that we prescribe for them to do between sessions…otherwise known as the “Home Exercise Program (HEP).” Hear the groans. We often prescribe exercise in the way a doctor might prescribe medications, and we back these exercise prescriptions up with scientific research to suggest that it works…if our patients do it exactly and enough.
My point here is not to bad-mouth good, solid data or the instillation of hope for our patients regarding what we know is possible for them if they commit to their rehab process. The challenge for me is in the ‘how.’ It is in the context and in the motivation for doing them.
As I work through the amazing content in a program I am studying to up-level my work with women who experience pelvic organ prolapse (more to follow in a later blog), a study was cited that reminded me about this ‘how’ of delivering exercise or movement prescriptions.
The author cited that different people assign different meanings to physical activity in their lives. Some see it as a joy and a “flow” to engage, some find its primary meaning as a social engagement to be most important, others see it as an investment in their health, and still others, a “necessary evil”, maybe like eating broccoli (I know, some people like it, but personally, I see broccoli as a necessary evil unless there’s lots of bacon and smoked paprika involved 😊
In all, the author encountered ten different primary “driving forces” behind physical activity engagement, all perfectly fine options. However, of these ten, the author concluded that “Joy and passion were the strongest driving forces to physical activity.” No kidding! We probably know this innately, but I, for one, can fall into the trap of the movement needing to be prescriptive in order for it to work. I have fallen into this trap many times, both with my own personal program, as well as that of my patients.
Now, there is something to be said for having a plan and following steps to achieve a movement or fitness or rehabilitation goal. However, what this reminds me to do is to consider the “why” that I and my patients possess. In one frame of mind, I use movement to solve problems, but could I also say that I use movement to help myself and others encounter greater joy and freedom? Sounds different, and feels different in my body. And, what does it need to look like?
Maybe instead of hands-and knees prolapse or separated ab exercises, it’s crawling on the floor to play with your kids for 3 minutes with a little mindful attention to your breath, or better yet, making high and low animal noises as you chase them around the living room.
Maybe instead of quiet breathing on your back tracking pelvic floor movement with relaxation, it’s slowly rolling down a grassy hill with your kids or your dog while placing some of your attention on deepening exhales through your abdomen. Or it’s singing in high and low tones at bedtime as you tuck your child in because of pelvic floor connection to the vocal diaphragm.
This article was instructive to me for continual improvement at supporting my patients to encounter their visionary ‘why’ for being in physical therapy, and to help them discover ways to accomplish the important movement patterns to re-build their bodymind in ways what align with their sense of joy and purpose. There is no “right” way here, and this brings me a sense of freedom both personally and professionally.
What’s your movement ‘why’? I would love to hear from you! Email me at firstname.lastname@example.org to share more about how this article may have inspired your movement practice, affirmed what you are already doing, or prompted you to add some more creative variety and variability to encourage more joy in your body.