The Advice We Give

Do this drill: Ask yourself "Do you think that everything you believe or think about the world is the truth?" (Most thinking people will say 'no.') Follow-up with this question: "What are you wrong about?" ... hmm...

We often think our way of thinking and understanding the world is correct. Well, we always think we are correct and act on it, but we know deep down that, since we are human, we cannot always be right. This is besides the point a bit, but this post deals with our advice, our own beliefs in what we and others should do. Sometimes there is a disconnect.

Often you will give advice, for example on how to move to reduce pain. Whether it be lower trunk rotations in supine for LBP, or isometric calf loading and posterior chain stretches for heel pain or manual maneuvers or modalities, etc. This is your advice to others, but do you do these things when you hurt?

What do you do? Is it different than what you advise? Perhaps because you have some sort of self motivation and movement curiosity, you just "hunt around" for things that work. That stretch. That squeeze of this muscle or that. I propose that this self -lead search yields the best results, yet we rarely say "Ok patient, please hunt around, try something. I'll be back in 5 minutes." (Caveat: this is what I do to work things out. See the first paragraph, perhaps this is not right, but I'm going with it.)

This advice-disconnect is clearly seen in gyms and personal training as well. The coach (who the client wants to look/be like) personally does simple, heavy, consistent, repetitive movements. Perhaps on a periodization, mixed with rest-weeks or sports-weeks, etc. The client, based off the advice of the coach, however, is doing some weird bosu ball exercise, then to a SwissBall, then to the cable column for some single-leg shoulder row thing with their eyes closed or whatever.

How does this disconnect occur? Do we think we know what others want? Do we assume they can't handle what we do to address an issue or get strong, etc. I make assumptions daily that people want us to be involved and fix things and that if I asked them to hunt around for a motion, then they would be unsatisfied and not have the patience for the process. Am I wrong?

I am really starting to think that the process is where the magic is for pain reduction, the figuring it out, the learning, not necessarily the 3x10. The more self-lead then the more self-efficacy and internal locus of control is developed and the more permanent the outcome. And for strength and other exercises, know your purpose, your why. If you want strength, do a heavy 8x3 or 5x5, etc. Let the patient learn about the patience in the process. Just like you do it.

I simply ask you to reflect on the advice you give...

- Matt Dancigers, DPT

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...