I’m sure you have seen plenty of goals so far this summer in the Football World Cup in Russia, with Wales not reaching their goal to qualify for the world cup I am sitting back as a neutral and watching goals goals goals. What is your goal?
When patients come to my clinic I always ask them what their goals are. For me this is very important because we have something to aim for and know that we have reached our ultimate aim whatever the activity that was for the patient. This also motivates the patient because he has a target to reach and I can help him/her reach that target. Some goals may take a little time to reach so we can set small goals in between which are realistic, and I think this is important because if you don’t set realistic goals and the patient is unable to reach it, they will certainly get discouraged and lose the motivation to go further and press on. Of course, when I am setting patient goals, I have to be guided by patients’ symptoms and tissue healing, so I do tell patients to monitor their symptoms during the rehabilitation exercises and after the exercises and the next morning. If symptoms have flared up significantly then I can reduce the exercise dose or the exercise itself and replace it with something they can tolerate but also most importantly challenge them too so they can adapt and progress and later come back to the exercise that they found was very challenging.
Most patients who come to my clinic would like to get back to doing activities they enjoyed doing and for me to help them restore function with minimum to no pain. Some patients would like to get back to work duties and low back pain or shoulder pain is stopping them carrying out their duties. Then there are some patients who want to get back into the gym or be able to run again or play football. All these type of patients have different goals to aim for and so the rehabilitation for these will be unique and individualised. These goals help me as a practitioner immensely and from this I can devise a plan to help these people get back to their desired activity. So, for example if I had a patient who came to my clinic with shoulder pain from the Rotator Cuff and this pain was stopping her from stacking shelves at Aldi then I would work on getting her shoulder strong enough to meet the demands of the job providing she has no other goal. For this patient, I will not have her doing exercises for the shoulder let say for example a person who wants to get back to playing tennis or cricket or swimming where there are huge demands on the Rotator Cuff so the exercises for these activities will be different.
Another example, if someone ruptures their ACL (Anterior Cruciate Ligament) playing football and decides not to go ahead with surgery for a reconstruction because they do not want to play football again but would rather just train in the gym and run then the aim for him will be to get strong enough to meet the demands of running. As we know going for a run is different than playing football where you have to accelerate, decelerate, stop change direction, jump, get tackled and so forth. If another person who has had his ACL ruptured and went ahead with surgery because he has told his consultant that he would like to play football again then the rehabilitation for this person will be a lot different because his knee and body will have to be able to handle the above demands and can take up to 9-12 months for an elite footballer and probably more for a novice or semi-elite footballer. So next time you watch a Instagram video or a Youtube video showing someone doing box jumps or hand stands (very impressive indeed!) then what you really need to think about is do you need to do those exercises for your activity and what is your goal? Once we established that then we can have some fun and reach our targets.
