Health Blog

The Challenge of Compliance


My dog’s veterinarian recently told me “If cartilage healed, I wouldn’t have a job.” I laughed because this statement applies to physical therapists also. There are certain tissues that have limited or poor healing capacity, which is why patients have to seek medical care. If optimal healing and improved function could just happen without any effort or work, physical therapists would see a significant reduction in patients.

Over the last few weeks, the importance of rehabilitation and patient motivation and compliance has become a reality in my own life. My dog recently underwent a THO (total hip osteotomy). It’s a fascinating procedure where the femoral head (the highest part of the thigh bone and supported by the neck of the femur) is removed and replaced with muscle and soft tissue. The goal is for the new joint to fibrose and scar down. Initial recovery is 6-8 weeks with optimal function achieved at six months. (Doesn’t this sound familiar to the types of patients we see post-op?) My dog is currently undergoing her own doggie physical therapy boot camp, both at home and with a certified canine therapist twice a week. She walks on a water treadmill twice a week and the therapist provides us with specific instructions on how to progress her at home program.

However, I’ve noticed my dog is not the ideal patient. She doesn’t like to do her home program, would rather take a nap, uses undesirable compensatory strategies, and only is interested in doing her exercises through significant bribery (ie: cookies, bacon, and peanut butter). After a specifically intensive therapy session over the weekend, she refused to sleep in her dog bed in the bedroom. I laugh about it, but I can’t help think of the direct correlation and importance we have with our patients in their journeys to recovery.

Would bribing our patients with cookies make them more compliant? Thankfully, with our patients, there is a greater chance of success of having them understand the importance of doing their exercises. However, I believe I can speak for most therapists when I say that compliance to exercise can be one of our biggest challenges. Most of us have a select group of patients who do their exercises all the time and then feel bad if they report they missed a day or session during the week. However, continual and habitual commitment is often a struggle. Our patients know they should be doing them since they experience the benefits of performing them during therapy first hand. How then can we inspire and encourage them to do them outside of therapy?

It is beyond the scope of this post, but there are many roadblocks that keep patients from moving forward in this direction. This is why we can be grateful for a one-hour treatment model like the one we use at MTI Physical Therapy. We are able to take the time to talk with our patients and truly get to know them. We can ensure that our patients don’t feel rushed, take our time to explain the goal and purpose behind each exercise. We are able to create programs that address their needs, but also fit their personalities and attitudes about exercise, and also ensure that they are able to perform the exercises correctly.

Most importantly, we have the time to actually LISTEN. By taking the time to listen, we can discover what obstacle(s) stand in their way and work toward simple, basic ways to encourage them to push past those obstacles and move forward on the road to recovery.

All of MTI’s Physical Therapist have advanced training in Orthopedic Manual Physical Therapy and as I mentioned earlier, provide every patient with one-on-one care for a full hour. Contact one of our seven MTI Physical Therapy clinics to set up a one-hour appointment today!

photo-29Dawn Eschenbach, PT, DPT
Physical Therapist
MTI Physical Therapy – Bellevue

Dawn moved to the Pacific Northwest from Indiana and joined MTI Physical Therapy during the summer of 2012. After earning her B.A. in theatre, she was inspired to not simply tell stories, but motivate people one-on-one to live better stories. She soon fell in love with both the art and science of physical therapy. Her clinical interests include the nervous system’s role in chronic pain, spinal dysfunction, and the variety of manual techniques to decrease pain and improve mobility. Her other passions include international service and travel, spending time with her family and her dog, yoga, running, hiking, and reading.

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