The best "tool" to have in your treatment "Toolbox"

I'll be honest, I've never liked this saying... It makes a practitioner sound like a mechanic or a builder, off to "fix" a car or some kind of structure. We all know working with humans or animals is much more nuanced than suggesting they can be "fixed" by a practitioner using their hands or a machine. But if I had to choose one thing I rely on the most after over 20 years of clinical practice, it's probably not quite what you would expect...

Throughout my career, first as a human physio, and then later as an equine physio, I always felt I had to “do” things to my patients. I had to fill a session with a number of different modalities - dry needling, manual therapy, taping, electrotherapy. I’d spend so much time focusing on what I was doing to the patient, that I’d get to the end of the session and not have time to spend on the important stuff.

Exercises would be demonstrated but not really practiced. This made it hard to determine the correct dose, so a standardised amount was routinely prescribed (3 x 10 sound familiar?) I’d spend so much time explaining what I was doing throughout the session, limiting the time I had to educate on what they could be doing themselves to help manage pain and improve symptoms.

Working in this way created a sense of dependency on me to be the “fixer”. Home exercises often wouldn’t get done. And ultimately patients wouldn’t always get the outcomes I had been hoping for.

We all know patients like the idea of laying there while you "fix" them. But is focusing on this really what is best for them in the long-term?

It took me longer than I would like to admit to realise that I actually got better results once I stopped focusing on filling sessions “doing” things to my patients and spent my time “working with” the patient. Exercises would be done well at home if a session was spent practicing them and working together to get the right number of sets and reps. Patients were better able to manage pain and symptoms when they were armed with knowledge and a management plan. Sure, I’d still put my hands on to feel and assess initially, but many times my “treatment” was often simply talking through what our plan was and practicing the strategies or exercises. I felt I was better using my skills and experience as a physiotherapist to help my patients, and they could still have manual therapy sessions that focused on pain relief with therapists such as a massage therapist to help alongside sessions with myself.

I’m not saying that treatment modalities can’t be effective. However, they should never be applied routinely simply because you think your patient expects them, or that having a large array of “tools” at your disposable makes you a better therapist.

So many patients/clients now end a session saying, “it’s so good to finally have a plan”. To them, the most value lies in being an active participant in their injury management and rehab.

The one "tool" I do use to help me do this well is EQ Active. My client or patient having access to their program in an app with video, instructions and diagrams, along with a tracking feature, educational resources and in-app message feature means we are both on the same page and are working together.

Trial it for 30 days to see how adding EQ Active to your toolbox will help improve your patient outcomes!