When you come to physical therapy, patients have certain expectations and assumptions. Patients assume that we will work tissue and mobilize/manipulate joints. They assume we will give them a workout and home program. They assume that we will make their symptoms get better. They assume we will find out what’s wrong with them and tell them what they are doing wrong and how to fix it.


As a profession I think we successfully do this. Physical therapy is rapidly becoming the primary orthopedic gateway to betterness in a culture where cost and effectiveness are taking precedence. Physical therapists do rehab better. (Sweeping generalization I know). But it is the last point of assumption that I think our profession should stop being so darn good at.

As physical therapists, we are exceptionally good at telling people what isn’t working for them. We tell them their posture is lacking. Their strength isn’t adequate. Their core stability is laughable. (Well-maybe not so bluntly). What I feel separates out the good therapists from the best therapists is the ability to tell the patient what they do RIGHT.

The vast majority of patients out there have taken steps to betterness. They are making an effort. And often, these efforts become confused thanks to the interweb and the google machine, Dr. Oz, The Doctors, Oprah etc. You can find out how to be a better you in a few clicks. Not all of these are good for everyone. But patients are trying. I realize how upsetting it can be to find out that all those hard sweating attempts in boot camp or crossfit were misguided, inappropriate, or flat out dangerous.

We educate with the best of intentions. But I think we can be better at recognizing the drive, effort, consistency, and oomph patients put forth on the road to wellness.  The patient effort is a crucial aspect of physical therapy. By acknowledging the patient and encouraging/redirecting already consistent efforts not only is a bond formed, but a team mentality is proposed, rather than a passive patient mentality. The truth is, patients are in charge of their wellness. The more we can elevate their achievements, the more likely they are to continue.

When patients are consistent, patients get better.

In physical therapy, we gather together a problem list  to accurately detect and diagnose the root cause of pain. I think maybe we should also gather together a solution list. This list would be composed of habits, traits and qualities the patient possesses that will benefit, accelerate, and predispose the patient to wellness. While I suspect evidence isn’t focusing on measuring such an abstract concept, I believe the more of these qualities a patient possesses, the more likely they will get better.