A couple of months ago, I had a potential patient call. She had fallen and broken her wrist, had surgery to put in a plate to stabilize the fracture, and had gotten out of the cast about a month ago. She had started therapy at another facility in town. She wasn’t happy with the care and progress so far. She felt she wasn’t going to get better as fast as she wanted. She was asking if she could switch to see me. I obviously said yes.
When she came in for an initial evaluation, she was EXTREMELY stiff. Poor wrist flexion and extension, as well as an inability to turn her palm up. This is very normal for someone with a significant wrist fracture. I gave her an extensive home exercise program (HEP). Then, as we still had time, I started her with something called heat and stretch. This is where you apply a heat pack on the wrist and apply stretch (with a weight) in a specific direction. In her case, it was wrist extension. After this heat and stretch, I manually stretched her wrist joint and performed something called joint mobilization (which stretches individual ligaments that were tight after her fracture). Now, I explain EVERYTHING to patients. I told her why we were doing this and what it should do, as well as how it should feel. I never do anything to patients that I myself have not experienced, so I know what it feels like.
She was so confused. What was I doing? Apparently, the therapist she had before measured her motion, but then gave her some exercises and walked away. When she came in for subsequent treatments, they never applied heat, and NEVER touched her. WHAT?? With a wrist that is that stiff, a patient needs manual stretching, they need joint mobilization, they need to know how much they can passively push it on their own.
There are a lot of needs and a fair amount of wants. I this case, the patient wanted something, but more importantly, she needed it also. The patient was proactive and went looking for what she needed. All patients need a home exercise program, a knowledge of why they are doing a specific task, and the confidence to know they are doing something correctly. They also need a therapist present and accounted for to make sure they are having all their needs met.
So if you are in therapy, get what you need. If your therapist leaves you while you are performing things you can be doing at home—why are you paying for that care? Speak up. Tell your therapist what you NEED. Make them understand. If they don’t listen, come see me. I promise I will listen to your wants and help you determine what your needs are.