#23: Getting More Out of Physical Therapy (Simple, Actionable Steps)

No one likes being injured or hurt. No one likes to experience limited movement and functional capacity. But we all like healing and maximizing the rate and extent of our recovery. Which is exactly why it's worth knowing how to get more out of the injury recovery and rehabilitation process. 

Whether you've got a minor injury, or you're battling through multiple chronic and debilitating issues, implementing a few key action steps throughout your rehabilitation can yield some drastic results; from feeling more confident, to healing a quick rates, to improved mental health, there are numerous rewards that can be reaped with the right approach.

So, sit back and relax, as this episode covers all sorts of powerful and practical steps you can take to make your physical therapy experience as optimal as possible.

EPISODE HIGHLIGHTS:

0:00 - Intro

2:30 - Quick update: I broke & separated one of my ribs

9:30 - The problem to solve & big takeaway

14:53 - The right mindset (the foundation of it all)

22:14 - Maximize your time

25:01 - Bringing extra info

31:55 - The process (being engaged in your recovery)

36:33 - Learn the basics

42:14 - Know your exercise objectives

46:06 - Take advantage of technology

53:18 - Utilize inter-session tracking

57:30 - Record your questions

58:34 - Utilize outcome measures

1:00:59 - Set your goals

1:02:37 - Stockpiling “ammunition”

1:06:29 - Chaff in the blast (a powerful quote)

1:08:23 - Key takeaways from this episode

1:09:40 - A small request

Transcript

SPEAKER_00 0:00

If you're going to go through something unpleasant, then you might as well do it in a manner that allows the process to go quicker while permitting you get the most optimal outcomes possible. Pain is rough, and being unable to move your body in ways you want is beyond a lousy experience. And the only thing worse than these particular scenarios is to have to experience them for longer than you otherwise should. So in this episode, we're going over how to squeeze the most juice possible out of this whole physical therapy process, allowing you to move in the right direction as quickly as possible so that you can start sharing your comeback story with others. So let's talk about it. Hello again, everyone. Welcome back to the Strength Resurgence Podcast. This is episode number 23, where we are talking about getting more out of physical therapy. I appreciate you joining me and being here for this podcast episode. We've got a lot of really neat concepts to talk about here. Whether you're someone who's got, you know, just a sore sprained ankle, or perhaps you've gone through some really significant injuries or are fighting a nasty physical condition. I'm really hoping that the contents in this particular episode will help inspire you and empower you and perhaps point you in the right direction for you to start working on reclaiming your health and well-being in the most ideal extent possible. So, hey, if this is your first time here, just so you get to know me, my name's Jim, and I am a physical therapist. I'm a strength and conditioning specialist and all around. It's just really geeky guy when it comes to helping others get out of pain and move better, become stronger. It's something that I love to do, and obviously that's why I have this podcast, because I don't like just taking my knowledge and kind of, you know, confining it to within a particular gym environment or clinical setting. I love sharing it with others in ways that can hopefully enrich their life experience to some capacity. Because, hey, we all have to be a geek about something. So here I am geeking out with something I love to talk about and love to do. And I really appreciate you taking some time to be with me here for this episode, because I know there's a lot of podcasts you could be listening to or other things you could be doing right now. So the fact that you're sharing your time with me really does mean a lot to me as this kind of solo content creating physical therapist who uh does a lot of hard work uh and kind of labor of love with all this stuff as a means to better serve others. So if you've never listened to an episode before, uh I always start out with a quick fact about myself, just so you can get to know me on a personal level. Uh, I always like listening to people whom I feel I get to know on a little more of a personal uh level as uh as I spend more time with them. And boy, oh boy, do I have a good fact for you here, uh this particular episode, because it actually ties in quite nicely to not only this particular episode, but just this podcast in general. Normally I give you a fun random fact about me. Uh, but this one, the fact for this episode is that I actually had to delay recording this particular episode uh because I actually broke and even separated one of my ribs last week. So I was supposed to record this episode, but then uh obviously I got injured. And I will tell you firsthand that uh a broken rib or a separated rib, which I also have, which just they're kind of the same, but they're a little bit different. Breaking a rib, you know, the bone breaks or cracks a little bit, but separating a rib refers to where the rib kind of plugs into some of the cartilage. I actually kind of tore that interface there, and now I'm fighting through that as well. Uh, it's extremely painful stuff. And I couldn't breathe very well last uh this past number of days in terms of I could I could breathe, but it was it was painful, and I just wasn't really feeling like I could not solely focus on presenting this podcast episode based on the pain I was having. So doing better now. I'm one week out from the injury, so I still have a ways to go. But there's silver linings in all of this stuff, right? Obviously, breaking a rib and having this horrible pain. I mean, it is it is not a pleasant experience. Please don't ever break your rib. Uh, not that I'm thinking you want to. Uh, it's downright painful, just as I have been told by so many other people who have, and I can attest for a stand, it's pretty lousy. But, you know, the the thing is, you look for the silver lining and stuff like this. And one of the many silver linings that could be uh found would be that this helps to kind of really just deeply reconnect myself to what a lot of my patients are going through when they see me in the clinic, being in horrible pain, or maybe even connect deeper with you, whether you're just listening for the sake of listening, but you've had pain in the past, or you're going through a lot of extensive pain right now. I absolutely empathize with that. I've had my fair share of injuries before, and uh now I've got another one. Uh and this one's been pretty, pretty gnarly to fight through, but I'm very thankful in that as I've been going through this, a lot of my colleagues at work have really been offering to help me out as best as possible. A lot of my friends and even my family are letting me know that they're there to help me uh to make life uh easier because I can't really pick anything up right now, moving very slow, uh, terrified to cough, terrified to sneeze. So hopefully that uh won't be happening um anytime soon. But choosing to say, hey, there's a lot of good that can come from this if I acknowledge the negative, but really dwell on the positive. So I'm gonna be dwelling on that. But that's a fun little fact about me is I'm currently going through this whole broken rib and separated rib issue. But I will come back stronger for it, getting my rehab already going in this whole process. And nonetheless, I'll keep you guys updated with all of that. But yeah, anyways, I figured that'd be a fun fact to share about me for this episode. But with that being said, let's let's quickly dive into the contents of what we'll be covering in this uh particular episode, and then from there we'll really kind of start deconstructing everything. So in this episode, we're gonna start out by the concept of building a brick wall. I'll start to kind of dive into that and elaborate on that, and then really after that, kind of talk about or even kind of tie it into just the having the right mindset to work through the physical therapy, physical injury rehabilitation process. And then from there, we'll talk about little concepts like just maximizing your time to get the most out of your sessions if you're in the clinic. Important little thing to go over. We'll talk about the concept of being engaged throughout the process, because if you're not engaged throughout the process, what a recovery is going to be tough, at least for it to be in a timely fashion or to get as much of a robust recovery as possible. So I did want to mention that. We'll talk about utilizing technology as well and how that can help you to get more out of the whole physical therapy process. And then the last one that we'll talk about from a conceptual standpoint is gonna be what I like to call stockpiling ammunition. This is a fun one to go over. I don't think it gets talked about in the rehabilitative world as much as it should. So we'll wrap up with that one. That's that's a great little one that I use for myself all the time. And I'm absolutely using using it right now with this whole rib thing that I got going on. But I wanted to throw a quick quote at you guys, like I always do, just to kick things off here, maybe to get you mentally start kind of chewing on some of the concepts that we'll be going over in this particular episode. And I got a quote here uh as I was putting this episode together uh from Abraham Lincoln, at least that's who it was attributed to. And I liked it because it was to me, it's all rooted around intentionality, which is an important theme or kind of concept when it comes to being committed to get the most out of physical rehabilitation. We've got to really kind of have an intentional mindset and use a lot of intentionality and not be haphazard with our recovery pursuits. And so the quote, I really liked it, I thought it fit well with the contents of this episode, is the quote that says, Give me six hours to chop down a tree, and I will spend the first four sharpening the axe. So, again, apparently that's attributed to Abraham Lincoln, but I love that because it really implies that there's a mentality uh and kind of forethought that needs to go into important tasks and important activities or important processes. And so I felt that tied in quite nicely to the contents of this episode. So there's a free little quote for you. So if we talk about the problem to solve here when it comes to this whole getting the most out of physical therapy thing that we're talking about. You know, physical therapy itself is often a physically and emotionally challenging process to go through. I think if you've been through uh, you know, some intense injury recovery, you can certainly attest to that. Or um, you know, if if you haven't, maybe you know someone who could potentially attest to that. And where that leads us is that if we're gonna go through a physically or emotionally taxing process, then how do we ensure we get as much possible out of each individual session if we're in the clinic? As well as how do we get the most out of the overall experience itself if we're gonna create healing to the most ideal extent possible? And that's what we're gonna pick apart here as we go through this episode. But a question I want to ask for you, real quick, to get you engaged a little bit more in the content that I'll be dissecting here in a moment. Wanted to ask you, what are some strategies that you adopt when working through an inconvenient or an unpleasant process to ensure that you get as much out of it as possible? And that doesn't necessarily have to be in terms of a physical therapy rehabilitative experience. That can be just anything that you find to be uh inconvenient or unpleasant. I'm curious if you have any strategies or mindsets or just techniques that you adopt to get a little bit more out of it than maybe you otherwise would, or to make it feel like uh you uh got more growth uh personally or professionally or whatever it's gonna be, out of something that would otherwise be classified as perhaps a lousy experience. I've certainly got my strategies, and uh I think I'm always looking for more as well. I don't think it's a uh a process where once you collect a few strategies, um, you maybe have all the ones that you need. I think as we move through life, just having a multitude of strategies and mindsets can be good because I think every tool maybe has a time and a place. That's how I would phrase that up. But the big takeaway of everything that we're covering here in this episode is that um a lot of steps or actions that we can take to get the most out of our uh physical recovery are perhaps you know quite self-evident things. I think a couple of the things that we're going to be working our way through here in just a moment, you might find yourself going, well, yeah, duh, that makes perfect sense. But I think just because they're self-evident doesn't necessarily mean that we take them less seriously or that they're less effective. I think a lot of times we can know things but not necessarily be all that good at applying them. An example I always use for that is I think a lot of people know that uh, you know, maintaining a healthy body weight is important and that eating junk food isn't ideal for our overall health and well-being. I think the vast majority of people know that and understand that. But we've got this obesity epidemic going on globally, which suggests that a lot of people might know something, but it doesn't necessarily mean that just because we know something or are aware of it doesn't mean we can necessarily apply it all that well. And that's not a concept where I'm judging people in any sort of way. I'm just I'm using that as maybe an example to reiterate the fact that some of the things we might be talking about here are gonna be self-evident, but doesn't necessarily mean that we'll be able to uh apply them all that easily. There's gonna be some work involved uh maybe to make that happen. But with these concepts and strategies we're gonna be talking about, I think the big takeaway is that we want to look at each one of these individual, maybe self-evident concepts like a brick, uh, and that we're we're trying to build the strongest brick wall possible out of this whole process. And so individually, each little concept or action we take might not seem like much on its own. But if we lay and align every brick precisely and with intentionality, we start to build a really, really strong wall. And the stronger the wall, uh the more robust it is, with the more bricks we lay and the more actions we take and execute, then the more profound our benefits tend to be when all is said and done. So if you're gonna go through this physical rehabilitation stuff, then you might as well lay as many bricks as perfectly as you can. Because no one wants to just kind of create a haphazard wall with laying bricks in a haphazard manner and uh just you know not have this optimal experience in the end. Um a little bit of a silly analogy, perhaps. But I think you get the idea. So, in that regard, if we're talking about this whole concept of you know, laying every brick as if it were uh needing to be laid perfectly in place, and every concept is one of these bricks, and we're building a strong brick wall, I think we start to build this brick wall with the right mindset because this is your body and this is your health and this is your well-being. And in that regard, I think you need to start out by knowing that uh you are absolutely worth the investment and the effort uh that you need to put in to look after yourself. I think I don't think everyone on this planet um maybe values himself in the way that they should. I think uh some people are able to say, hey, this is my health and well-being, and this is important to me, and I need to do all I can to protect my health and well-being and get the most out of um this body that I have. But the right mindset, if we don't start with this, I think we're kind of perhaps short-changing ourselves in terms of what we can get out of the overall process. And if you're someone who struggles to believe in the value of your body and the value of your health and wellness, maybe you feel you're not worthy, or maybe you feel, hey, you know what, um other people are more important in me than me for being physically healthy or, you know, whatever, whatever it's gonna be. Then my hope would be that if you can't advocate for yourself about how important you are in this process, then maybe you could look at treating yourself as if you were looking after a loved one with your same physical status or physical injury or physical condition. Because I want you to know that you are so worth it when it comes to putting forth the effort and the investment and the time and the energy and even the resources that it might take to move yourself in a positive direction. And yeah, we're gonna talk about other concepts in a moment that absolutely can and still should be applied. But I think it it's almost as if the concepts we're talking about, and we're kind of talking about each one as a brick. It's almost maybe as if the right mindset of you knowing your value and your God-given worth in helping to look after yourself. It's almost as if this is not even the brick wall that we're building, but this is the foundation that we're laying the bricks on. Maybe that's a better way to look at it. But I think we live in a world where there's a lot of people out there who do care about you. And I think that's incredibly important. But I I would advocate that the belief be that you yourself can know that you're absolutely worth it and dig deep and find a reason as to why you believe that your recovery is worth it. Because I've seen in my years of doing all this stuff that the people who tend to believe that they are worth it, that there is a reason to commit to this process of getting themselves through uh and onto the other side of their injury and getting their life back on track to the best extent possible. The people who believe that they're worth it tend to have the best outcomes versus the people who maybe don't feel that they're worth it or that their health and their well-being isn't important. And so I think where that leads us then is the concept of knowing that not only you're worth it and you are important, but also that you need to be brave in this whole pursuit. Uh I think fear holds us back in so many ways. And I think one of the ways it can start to hold us back in terms of experiencing the best outcomes possible for getting through pain or rebuilding our functional capacity and getting our uh physical abilities back on track. I think I think we can run into problems right away if we're fearful of maybe um how we might be perceived in the process. And so an example that I came up with as I was putting this episode together was even just being fearful of asking questions about your injury or your condition or what the recovery process will look like. And going, well, I I want to ask this question uh because I want to get an answer so I know I'm making the right decision for myself. But I'm scared. I'm I'm scared of maybe it's being a stupid question and someone will judge me. Um I think this is one such of many examples I could have used to say that as you start going through your journey of recovering from what you're up against and trying to battle your way back to where you want to be, um you need to be brave and you need to be bold and ultimately not care what maybe what others think or how they perceive you. I think a lot of times if I talk about this example of you know not being afraid to ask questions about, hey, what are my recovery timelines going to be like, or what should I expect in this process, or I don't understand what this injury means. I think if you can be brave and and start to ask you know the right questions, uh then what's gonna happen is you're gonna get better outcomes. And so I I find for myself in this whole rehabilitative stuff that I do that the patients who tend to ask the most questions also tend to experience the most optimal outcomes. And I think it's because it correlates to being more actively engaged in the recovery process. And when you have a little bit more understanding of what you're up against, I think then you tend to make fewer mistakes throughout the recovery process. I think you also tend to have less anxiety about what the process might look like. I think you have better expectations and there's less frustration involved. But as we start to open all this up here, again, the right mindset, I think, needs to be one that's from a place of believing that you're absolutely worth it and that it's your body and your health and your well-being. And you you have to value that more than you value the comfort of not looking silly or not looking stupid. You have to value your physical well being and your body more so than you value comfort. I think you have to be brave. If you value your well being more than you value your comfort, I think you've set yourself up on some powerful. Foundations for beginning to get the most out of what it is that you're going to need to go through for physical rehabilitation. So that's this kind of big, broad conceptual approach that we're kicking it off with. But I think now let's talk about one that's maybe seemingly pretty straightforward, but very, very important nonetheless. So assuming you are going to be going to physical therapy and you're going to be going into a clinic and doing physical therapy sessions with your physical therapist, this is where this might start to sound a little bit self-evident and obvious, but it really does make a big difference. I think I can tell this uh firsthand with my anecdotal experiences with my patients. I think my colleagues could say the same thing, or even my friends who are physical therapists who work in other countries, uh even far away from me. I think this applies to everyone. And that's simply that if you're going to go to physical therapy and put in the time and effort, start uh by just simply making sure that you show up uh, you know, on time or a bit early for your appointments so that you don't lose any of these precious minutes of your session that could perhaps be otherwise spent on your treatment. I think it's really unfortunate when someone's booked in for an appointment, and it has to almost be uh you know cut short in a sense because you know you only got half as much time out of the session as you could have because uh we just showed up late and uh couldn't cover as much ground as possible. Um, you know, as physical therapists, we tend to have tight schedules depending on the type of practice that we're in. And so sometimes we just can't uh give as much time as we otherwise would be able to give in terms of, you know, we can't extend time beyond what maybe a patient is booked for. So it's a simple step, but it's a it's a powerful one. Just make sure you're showing up on time to your appointments, and uh the extra ground that you'll cover by showing up on time will start to add up each and every time, and you'll start to get a lot more out of your process. And I think importantly, too, if we even dig a little bit deeper here, is that you know, if you arrive early for your appointment and you have a few extra minutes before your appointment starts, you know, if you're going to um, you know, a clinic that you have to drive to, right? Not necessarily a hospital where if you're already in a hospital and physical therapist coming to you, but more so of a what we call like an outpatient clinic, well, then just if you arrive early, if you have a few extra minutes, you can settle down and even mentally prepare uh and even physically prepare for your session. And sometimes you wouldn't think that it would do that much, but just being a little bit more mentally prepared, having a few minutes to settle down and unwind before you kick things into gear, I think can make some pretty big differences. And then, you know, if you're gonna be in a clinic and you're committing to the time and energy required to get yourself moving in the right direction with all this kind of physical therapy stuff, it's pretty helpful if you're getting ready to show up for your first appointment with your physical therapist, uh, is to just simply make sure that you bring any extra information pertaining to your injury or your condition uh that uh that you're showing up to physical therapy for. And if you bring some of this extra information, and I'll I'll give you some ideas here in a moment, can really greatly assist the overall process, especially for that first particular uh session, maybe with your physical therapist, which we call like the initial evaluation. Because there's there's a lot of information that uh if if us physical therapists can get right away, uh it just helps to get the ball rolling quicker. So it's not that we always need it, but I would say it's we always want to have it, is what I would say. So if you're gonna go to physical therapy and you're showing up in a clinic, maybe it's because you got some nasty elbow pain, or maybe it's got some horrible back pain or whatever it's gonna be. It's good to remember that you know, if if you have any medications that you're on, just bringing a list of those medications can be really important and valuable for us physical therapists. You don't have to actually bring the medications, I would say, but uh just a list of what you're on, because a lot of times certain medications will give us information about things that may be going on with your body or why certain things might feel certain ways. Um, comes in quite handy. Um example would be uh, you know, patients come to us a lot and they say, Hey, you know, I've got this pain where I'm kind of aching all over. It feels like all my muscles are really sore. I've never had this before, I'm not really sure why. And you kind of start to wonder in your head, okay, well, that's maybe a bit unusual. And then you might ask them the question, okay, well, are you on any particular medications? And they might say, Oh, yeah, well, uh, you know, my doctor just put me on a statin drug recently, um, which is to help, you know, uh lower cholesterol, because my cholesterol is a bit high. And that's important for us to know as a physical therapist or other healthcare uh professionals, because this is an example where sometimes going on these statin drugs, which are designed for, again, helping with uh cholesterol, uh, can actually make you very, very achy or create what we would call a myalgic pain. And I've had a few times where someone comes to me, and this is a uh scenario that's played out a few times, where uh we kind of dig a bit deeper and I chat with their maybe their doctor about what might be going on, and it's yeah, it's pretty much it's nothing uh wrong from an injury standpoint, but it's actually a side effect of the medication that they're on. So one of many examples I could give on medications, but a list of medications, you bring those to your appointment, that can help out quite a bit. And then another one would be if you have any previous imaging uh reports for this particular uh issue that you're going into physical therapy for. So maybe you're going in with hip pain or back pain. And if you've had an MRI on your back or your hip in the past, or you've had an X-ray or a diagnostic ultrasound. Well, if you do have access to those reports, the the write-ups that the radiologists type up or uh voice dictate onto paper about what the findings of those imaging results are, that can be really helpful for us a lot of the times. Uh, what I like to do a lot of the times, not all the times, it really depends on the scenario. But I need to absolutely know what's going on from an imaging report standpoint. But sometimes I'll wait until the after my initial evaluation of the patient, uh, before I look at that report, just to see if there's uh like a clinical correlation is what we would call it, where my assessment in the clinic matches uh what I would expect to be found on the report. I don't always do that way, it always depends on so many factors. Uh, but the the point being is that um what us physical therapists do for evaluation is very important, but imaging is also very important a lot of the times. And we don't want to solely rely on just one. Uh we want to kind of look at what the evaluation from the physical therapy standpoint reveals, but what imaging reports reveal as well. But obviously, as a physical therapist, I don't know what those imaging reports reveal if I don't have access to them. And patients, obviously, medical records are private. So typically you either have to sign consent forms and then we have to hunt them down, or uh you just bring them to the clinic if you have them on hand. And it's a powerful step, believe me. It really is. There's times where patients come in and they have these reports all ready to go, and it just gets us rocking and rolling much quicker about what needs to be done and how the problem is going to be solved. Start to generate better discussions with the patients right away about what the timelines for recovery might be or how long it's gonna be until symptoms start to improve or anything along those lines. So if you have any previous imaging reports uh pertaining to what's maybe bringing into the clinic, or just you know, important imaging reports in general, it doesn't hurt to bring them in, even if they're not gonna be relevant for uh your physical therapy, uh your physical therapy process. And another thing you might want to bring in is just a list of your questions. If you have been wondering about, hey, I'm not sure what this means, I want to ask, or you know, I really want a better idea of this or that. Writing down your questions beforehand, I think, is really a smart move to make. Because I often get a lot of patients who go, Oh, yeah, I had a question, but can't remember what it was, or they go, Yeah, you know, I had a whole bunch of questions, but um just they're not coming to mind right now. And and that's fine. You can recall them later and you know, ask them on a uh a follow-up session. But just writing them down and getting them answered right away, uh, to the best extent possible, is always a smart move to make. So bringing this extra information uh for your first uh initial evaluation or maybe any other subsequent follow-up treatments, that's a good idea. You know, some any medications you're on, previous imaging reports, a list of your questions. And uh there can be more than just this. These were just three examples that came to mind as I was putting this uh episode together. But let's talk about another brick to lay right now. And this is uh the brick about being engaged in your own rehabilitative pursuits, or what we call taking an active role in your injury recovery. So you can you can be largely passive when it comes to this injury recovery stuff, which is a mindset of, hey, I'm you know, I'm gonna be in physical therapy, but I'm just gonna lay on the table and let the therapist do something to me or hook me up to a machine and just let the machine do all the work. And there's absolutely times where passive interventions are very important. I've talked about this in a previous episode, uh, which was episode 21, which was titled What PTs Want You to Know for Maximal Recovery, which covered the same concepts uh to an extent as what this episode does, but this episode is different enough that it, you know, it needs to be its own episode. But it's very important to understand that if you're going to be in physical therapy and you want to get yourself better, you need to take this active role. Meaning you need to put forth effort in various ways, and you will get more out of it and you will be rewarded for it. So when I say an active role, what's important to understand here is that we often think of an active role as, oh, okay, I need to, I need to exercise, I need to be the one who's moving, I need to be the one who's stretching, who's strength training, who's walking on the treadmill to improve my heart and lung function or whatever it's going to be. That's a great example of an active role. But even if you're in a very early stage of an injury where you're in so much pain, you can't move. Maybe you're fresh out of a big surgery where you're really just laying down in bed for a few days. Um, maybe you can't do the active role that I just described a moment ago. Okay, you can't walk on a treadmill yet, you can't stretch yet, you can't lift weights and exercise yet. But the active role extends far beyond that. And there's always something that you can actively do, even if it doesn't pertain directly to physical movement or rehabilitative exercise. And so, what do I mean by that? Well, here's some things that you can always do. You can always just learn more about your condition or what it is that you're up against. And in addition to that, you can always work on your overall health. And maybe you're saying, well, hang on, if I'm laying in a hospital bed, I've just come out of a gnarly, nasty surgery, I can't exactly do a lot for my physical health. And maybe not yet for your physical health, but you can do something for your mental health. If you're laying there and you can't you can't move physically, uh, which most of the times there's even little things you can do physically right out of surgery. You can do ankle pumps to help prevent blood clots and all that type of stuff. But even if we're going to put the physical aside, you can you can likely lay there and and do meditative thinking or dwell on positive thoughts in a manner that uh helps helps your mental health, right? Keeps you a little bit more calm. And that calmness actually helps to calm down your nervous system and helps to create hormonal changes in your body. But thinking about just even pleasant thoughts or working on deep breathing as a way to control anxiety and and and feel more at peace mentally and emotionally, man, that's an active role and that's an important thing to do. So you can even do that. Or again, maybe you go, hey, I'm I don't feel like I have much in me tonight to actually walk or to move around or whatever it's gonna be. But maybe you just say, Well, I have I do have a couple of questions I want to ask my physical therapist next time I see them. So maybe you take five minutes and write down those questions. That in itself is taking an active role because you are you're putting forth effort in a way that's gonna help get you uh moving in the right direction. So, point being, you need to be engaged in the process. There's days where it's gonna feel tough to do that, perhaps, depending on what you're up against. And that's fine. There's good days, there's bad days in all of this. But the importance of taking an active role in this recovery process, it it can't be it can't be overstated. Now, in that regard, another brick that we'll now lay down to start really building the wall is all about the importance of learning the basics about what it is that you're up against. Because a little bit absolutely goes a long way. And whatever it is you're up against, a physical injury, you broke your leg, and now you've had surgery, and there's these rods and screws in your leg, or you've got nasty back pain because you had this injury, or you've got arthritis in your knee, or you've got a condition called tennis elbow, or uh you have um you know ridicular pain in your neck, all these things, whatever it's gonna be. Well, a very rudimentary understanding of your injury or your condition or whatever it is that you're physically up against, just a basic amount of what that condition is and what it's about will help you in numerous ways throughout your recovery. And this is not me saying that you need to go start reading a bunch of scientific articles on it, or you need to plow through hours and hours of content to understand all the details. I'm not saying that. You certainly could if you did want to do that. Some people really like that. Uh, they find it quite interesting or quite uh valuable to know things in certain amounts of details, but basic knowledge, a basic understanding of what is causing your pain, uh, of what's causing you uh to have difficulty moving or what um what the physical condition is in your body. It will help to do a lot, including reduce anxiety and frustration. Because if you don't know what's going on with your body or you don't know what you're up against, that's uh kind of an open, open-ended loop for your brain to kind of kind of ruminate on all the scenarios about the unknowns and and what might potentially happen and and what might go wrong because you don't really have anything that you're anchored to. But when you're anchored to a basic understanding of what it is that's going on and what you're up against, it does a lot for just reducing anxiety uh and frustration. And the frustration part a lot of times is just from the fact of people they don't know anything about what's going on. Well, hey, my physical therapist or my doctor or whatever didn't really tell me what's causing my pain. Um, well, that's frustrating in and of itself. But if you don't know maybe how long it's going to take before you start to perhaps feel better or to start seeing or feeling the improvements that you want, that's incredibly frustrating. But if you know, hey, I've got three weeks before things start to feel better, or you know, in three weeks I should be feeling, you know, notable improvement, that takes away a lot of anxiety and frustration. So with me, if we think about this whole kind of broken rib that I've got uh I'm going through right now, you know, it's like four to probably more likely six weeks of dealing with a lot of the pain, specifically from the fracture as it starts to heal up. The um the cartilage that kind of the interface that got torn that might even be a bit longer because cartilage has a terrible blood supply. So that might be a few months. Um, so me knowing that certainly helps in a lot of ways because now I'm kind of anchored in some timelines that helps me to just make sure I can stay on track with how my recovery is going and making sure that things are proceeding at an ideal optimal rate. And then again, that kind of leads into the basic knowledge that you acquire about what it is you're up against. It will help to align recovery expectations. Because if you don't know what to expect, uh that's a lot of mental duress that you might go through and anxiety and frustration. So when you know what it is that you're up against and the extent of the injury or the condition, uh you can you can align your expectations in a manner where you're not gonna get your your hopes up uh or you're not gonna get frustrated when you go, it's been three weeks. Why am I not better? Well, because maybe your condition or that injury is gonna take eight weeks. So you just want to have a basic knowledge on this. It'll it'll go a long way. The other one that I would mention as well is that this basic knowledge helps to avoid mistakes and setbacks. And so if you don't know what you're up against, you go, oh, maybe well, maybe it's not that bad. I can push through it, and that's a big mistake. And then all of a sudden, you've now taken a six-week injury and you've turned it into an eight-week injury or 12-week injury because you pushed through something that you probably shouldn't have, and kind of re-irritated or re-agitated or even re-injured your body. So you avoid mistakes and you avoid setbacks because you're a little bit more better armed of knowing uh what you should stay away from and maybe why you should stay away from it for certain time frames. It's really going to make a big difference. And then how about this one? Reducing feelings of helplessness. That's a pretty powerful one, I would say. I think there's few things worse than feeling feeling helpless as you're in physical pain or you you can't move in the ways that you uh normally should or want to be. That's a that's a pretty lousy, uh, lousy situation. So learn a little bit about what you're up against, and it's gonna go a long way. Now, another powerful one here is that if you are going through injury recovery and uh you are given exercises, which people most often are for their recovery, whether it's a physical exercise or whether it's any other type of exercise that's designed to rehabilitate your body in some capacity, you know, cognitive exercise or anything like that, it's super important to know the objectives of what those exercises or tasks or activities are trying to achieve. And so, really, what I'm getting at here is back to this concept of intentionality, where you need to be intentional with your movement, whether it's physical strength training, or maybe you have to walk on a treadmill to improve your heart and lung function. Maybe it's an exercise designed to settle down some nerve irritation. Maybe it's an exercise designed for whatever else it's gonna be. Um, again, whether it's actual physical movement or a cognitive exercise or things like what we call like a sensory motor retraining exercise, whatever it's gonna be, the fact is that most conditions are gonna require therapeutic interventions uh through some type of exercise. And you need to know what that exercise is trying to achieve. Because if you're just mindlessly performing an exercise or an activity, because, well, I don't know, my physical therapist told me to. I don't know what it's supposed to be doing, but I'm just whatever, I'm just gonna do it. Well, then you probably won't get as much out of it if you're just mindlessly performing it, versus if you're concentrating on the movement or on the exercise and you're really. Really focused as to what you're trying to achieve with that exercise. It will tend to yield superior outcomes than if you go, well, I don't know why I'm doing this, but I'm just doing it. Sure, like it's it's great to kind of blindly trust your physical therapist, but I never want, you know, in the in me personally as a physical therapist when I work with others, I'm honored when people blindly trust me, but I don't want them to necessarily just blindly trust me. Um, I want them to understand what the objective is and how to best achieve that objective with the exercise that they have. And a lot of times I think we do want to just turn our mind off when we do a boring exercise. Because I think a lot of these exercises are quite boring, whether it's physical strength training exercises or whether it's different exercises designed to achieve different therapeutic effects on the body. But if you can just be mentally dialed in to focus on that task at hand, I think you're going to find that you're going to get better outcomes than someone who just shuts their brain off and haphazardly performs an exercise without thinking about getting the most out of every repetition that they're doing. I think a lot of people, if we talk about strength training, for example, people who perform a strength training exercise and they imagine or they're visualizing what's taking place in the body part that they're working, or they are really, really tuning in to what that body part is feeling and experiencing as they're going through an exercise. Those people tend to execute the movement better in a more ideal manner so that they get more out of every repetition, but also they become so much more in tune with their body through the process that they get these really powerful uh benefits over the people who just want to do the exercise just to get it over with. So this all comes down to being intentional with your movement. I guess that's the big one that I'm trying to trying to emphasize here. But another one that we can talk about, and this I think is a pretty fun one, is just that we live in a world now where technology is pretty wild, not only with what it can do, but what we as just average people have access to. There's so much technology at play here that can help with this whole physical rehabilitation pursuit that just wasn't available a decade or two decades or three decades ago. So we've got smartphones and we've got apps on these phones, and we've got things like YouTube and whatever else it's going to be. And I think there's a lot of times and ways that we can bring this, uh, we can bring all this technology into our own rehabilitative journey. And maybe I should do a whole podcast episode on this, uh, because I think there's a whole world of stuff we could talk about. But ultimately, with so much technology at our fingertips, you really do have some serious leverage for uh your physical and mental and social health uh uh in terms of recovery. I think it's uh it's exciting in a lot of ways where you can you can almost get creative with how you want to use technology to help you out in your physical rehabilitative pursuits. So I'll give you a couple of quick examples here. I could give you so much more than what I've jotted down here, but in in terms of keeping this podcast episode at a reasonable length, um, a great example, and I do this all the time in the clinic with my patients, is um, you know, if if we're giving someone a specific exercise, and whether it's a standard exercise or it's very, very unique and individualized for them in their situation, is to simply record a video on their phone of me showing them that particular exercise. Sure, I have pre-made videos, I have pre-made exercise sheets and handouts that I can give. But oftentimes I will try and individualize an exercise to the best extent possible for that patient based on their needs or their abilities or their particular situation. And having a video right there on their phone that they can they can watch over again can help immensely with the fine details of not just how the movement should be done, but I'll talk my way through that exercise. I'll talk about tempo. I'll talk about uh feeling and controlling the movement in certain ways, or modifications maybe that they may need to make based on how they're feeling. And and it's it's cool because what you do is you say, look, let's make uh put let's make a folder on your phone and let's every time you get a new exercise, let's let's put that into your folder on your phone. And some people like the pre-made sheets, and okay, cool, I can print those out. But if you have you know a video right there on your phone where I've executed a movement for you while you've held the phone and recorded it and I've talked my way through it, it's like you're getting a piece of that particular uh session that you can just replay over and over again, which I think is super cool. Uh, there's a lot of helpful apps out there that can be used for various types of injury recovery or various physical conditions uh or issues that people have that can be profoundly helpful that you can do at home. So, a great example here. Uh, there's an app out there called the Recognize app. I have these on my iPad that I'll use with patients in the clinic when it's appropriate for them. This is an app that is designed for uh treating very specific types of pain, mainly what's called um neuropathic pain. Um and it works through this whole recognize app, works through what's called graded motor imagery or a GMI protocol. And again, it's designed by people at the, I believe the recognize app is from the folks at the Neuroorthopedic Institute, NOI. Maybe it's not. Um, I I think it is, but don't necessarily quote me on that. But it comes from uh remarkable and very trustworthy and renowned sources. But when you when pain doesn't play by the rules, and I've got an episode coming down the pipeline with this about talking about graded motor imagery, when pain doesn't play by the rules, you can't just do the standard uh exercise approaches that most people are familiar with. Uh, it won't work. And it'll be horrendously painful uh oftentimes as well. And so you have to kind of rewire the brain because the brain is basically getting, a lack of better words, getting some wires crossed in terms of what's going on, uh, where patient's pain is very real, uh, but it is uh it is spinning out of control. And you'll get these situations where you're touching someone's skin, uh, but you'll get uh in your brain, you will feel like there's a blowtorch on your skin. And so you can get these conditions uh that are called um allodynia or hyperalgesia. Uh, in the case of allodynea, that's a painful response to a non-painful stimulus. And so the Recognize app, fantastic way that patients can start to work on the stuff at home. Or they can work on it in the clinic uh since I have it on my iPad. But it's it's so cool that we have access to this stuff. Or another example is um for patients who want to learn a little bit more about anatomy and seeing what's going on with their body. I have my anatomy apps that I always show uh patients what's going on in the clinic. Hey, let's look at this three-dimensional model and let me show you what's going on here. But I have a lot of patients who have found that downloading anatomy apps onto their phone uh on their own time, they go, Oh, this makes more sense now that I can see the anatomy and I'm playing around on this app, it makes sense why I have this condition or it makes sense what's going on. Um, so an example would be an app called Essential Anatomy 5 by the uh the folks at uh 3D for Medical, I believe. Uh it's an app you can download, and you get some, you basically get a whole entire textbook of amazing anatomy that you can look at for the human body right there on your phone or on your uh tablet. And it can really, really help people get a better understanding of the anatomy that's involved for their particular situation. And then, of course, there's technology out there. Uh, there's apps and websites that you can use to help track and monitor your exercise uh progress and your overall kind of health and well-being, whether that's through an app or just on a website. This technology, it's remarkable with what it can do for help make sure that you're getting the most out of this whole physical therapy process. Now, do you have to use it? You don't have to, but I think for the right people in the right uh context and situations, it's profoundly helpful. So don't be afraid to bring technology into your pursuits. I think that's going to be a big, powerful payoff for you. And then, of course, one more brick that we can lay down here is uh to basically track everything that's going on between your physical therapy sessions, or uh even just kind of day by day, or just week by week. And there's a lot that you can track uh from one physical therapy visit to the next, or day by day, or week by week. And we can do that through actions such as uh journaling uh our pain and maybe our overall symptoms. So recording all sorts of valuable information. So as we look back, we can start to maybe notice patterns, or we can notice trends, or we can be more confident that we're making progress. And that's a pretty empowering thing to do. So keeping a journal to note various aspects of your injury and your condition basically helps you kind of collect more data points on the recovery or rehabilitative process. And there's no one way to do this, and I'm not gonna spend a lot of time on all the different ways it can be done, but some examples of what you can track is you can track your pain levels and your symptoms. Okay. Every day when I wake up, you know, I jot down what my pain level is zero out of 10, right? And then maybe I jot down my pain level right before I go to bed every night. And hey, look at that. The first couple of weeks, I was always waking up with a four or five out of ten for pain. And last week, you know, it's it seems like I'm waking up at a two or I'm waking up at a three out of ten. Or you're tracking your symptoms. Hey, this whole entire last 10 days, um, my left elbow hasn't hurt. It's only now my left uh shoulder that's hurting, whereas before it was a shoulder and a wrist, and now it's only my elbow. And you may maybe you think it's silly to track these things when you go, well, I can I can certainly remember or feel these changes take place. Um, you don't have to track them, but a lot of times there's just a lot more that we start to realize uh when we kind of look back through this maybe pain or symptom journaling that we're that we're doing. So if you're someone who likes to track this stuff, I think it's well worth it. And I'm starting to do that with my own rib injury, starting to track. Um lately, I've been just the last couple days, tracking kind of how long it takes me to get into bed or out of bed, because it's kind of the horrendous, uh, horrendous process to go through. Um, so I'm starting to track some of that, tracking a few other things. You can track your sleep quality, and maybe you find that you wake up every morning and you grade your sleep from zero out of 10. 10 out of 10 is perfect sleep, zero is the worst. And maybe you find, okay, well, maybe my sleep quality is getting better, but maybe you also find, hey, look at that. Every time I have a lousy sleep, I wake up and my pain levels are higher because maybe you've been recording your pain levels in the morning. So now you're starting to kind of collect data points and put some puzzle pieces together. And you say, well, I tend to feel better every time I get some better sleep. So I'll make sleep quality a little bit of a higher priority. And then you can record your movement quality. You can record, hey, you know, your active ranges of motion or A-ROM as we might call it. Go, hey, you know what? It just my knee has been feeling stiff going up the stairs. It hasn't been bending as well as it should. But now that I've been doing those exercises the past two weeks, I feel like my movement quality when I go upstairs is getting better. So simple examples, but they really, really can help you to connect a few extra dots if you're willing to put in the time and effort with that. And again, if you've got a simple sprained wrist or a simple sore shoulder, you don't have to do this stuff. But for people who are maybe in a little bit of a longer term battle or a bigger dog fight, if you will, with some really nasty conditions or nasty pain, these can be great things to do. And there's a lot of great information online about uh doing this pain journaling stuff. So you can certainly Google search that and you'll you'll get some helpful ideas. And all of this really leads into another action that you can uh perform. And I mentioned it earlier, but just kind of tying back into it, just maybe a small simple brick to lay, but one that's really important, is just jot down any questions that arise between one physical therapy session to another. And you just you'll be better prepared for your next session. So if they're non-urgent questions uh that arise, then again, when you jot them down and you come into the clinic, you can fire them right off and get them answered, and even write them right down there in your little journal or your book that you have. Because sometimes I find for myself, I go, oh, I'll remember to ask that next time. And then sure enough, you totally forget. Maybe I remember that I had a question, I don't remember what it was, but oftentimes I'll probably just even forget that I had a question. So um, and again, remember that there's there's no stupid questions with this. You need to value your health and well-being more than you need to value your comfort around uh, you know, not looking silly by asking a question. One more brick that we'll lay here as we start to kind of get ready to wind all this down, um, is simply to use outcome measures, uh, which are just ways that we can track and monitor progress to help take out the guesswork as to whether or not you're getting better. And so when I say outcome measures, what I'm talking about are these kind of scientifically validated measures, and validated meanings that they're measuring what they're supposed to be measuring. Uh, there are these validated questionnaires that we use to track progress. And there are some that you can use uh and can be what we call self-administered, and then there are some that need to be administered and perhaps interpreted by your physical therapist or your healthcare provider. But ultimately, these serve as great ways where you're you're kind of working through this sheet of paper or this series of questions, and you you kind of tick off a box that corresponds best to each answer for you. And a lot of times what we do is we score these overall questions and kind of the overall sum of uh the scoring to help get a baseline about where you're at with your condition uh or what it is that you're going through. So we have outcome measures for pain and disability. We have outcome measures for functional ability, and then we even have outcome measures for cognitive function, so um, you know, concussions, um, those types of issues are traumatic brain injuries, um, you know, functional abilities. Uh, we got things like the upper extremity functional scale, the lower extremity functional scale, pain and disability. You know, we have the Oswestri uh disability index questionnaire, we have the neck disability index questionnaire. All these, you know, so many questionnaires. So the point isn't necessarily to tell you which ones you need to be considering or want to consider, but simply maybe ask your physical therapist, hey, are you know, are there outcome measures that we can use to better track this? And it's quite possible your physical therapist will do this already for you. But if not, uh, this is something that maybe you want to ask them, because there's nothing worse than having to guess as to whether or not you're getting better. And when you have these validated outcome measures that measure and track what they're supposed to, it takes out the guesswork. And that's really, really important. Um, another brick that we'll talk about here, just setting goals, right? Without goals, you're kind of aimless as to where you're gonna be going. And if you really want to get into the meat and potatoes of this, I devoted an entire episode to this uh whole goal setting process in episode 20, which was called Powerful Goal Setting Methods for Optimized Outcomes. Very um, very fun episode to put together, one that would be uh worth listening to if you're interested in this goal setting stuff. And what I would say is please do not discount the power of goal setting when it comes to optimizing your progress and overall journey. So, some quick tips. Uh again, listen to the episode 20 if you want uh, you know, the whole entire spiel on this. But make behavior-based goals as well as outcome-based goals. Most people make outcome-based goals, uh, but very few people tend to make behavior-based goals, at least in my anecdotal experiences. And behavior-based goals, very important to set. Make your goals SMART, that's an acronym for specific, measurable, attainable, uh, realistic, and time-oriented. Uh that's just, again, the more specific you make these goals, uh, the better it is that you'll likely experience the outcomes you want. And then make all of these goals short, medium, and long term. Break them down into different lengths of time based on what you want to be achieving along the way. And then, of course, track your progress to make sure you're eliminating any guesswork. So, listen to episode number 20 if you want more details there. And then let's talk about the fun one here, at least what I think is really fun. Um, basically, stockpiling ammunition. Really fun brick to lay down here to help solidify building a strong and robust wall. So, stockpiling ammunition, what I'm talking about is motivational and inspirational sources that you get to collect and gather that will help kind of keep you going throughout the recovery process. So uh any content, whether it's um a video, a song, whether it's a visual, it's it's uh it's a it's a poem, it's it's a picture, whatever it's gonna be. Any content that you find to be um inspirational or motivational or comforting, or in um, you know, I already said inspirational, but inspiring, you know, stockpile it. Find some way to kind of collect all of it so that you can just always uh pull it out and utilize it when you feel like you you need a boost. So it's it helps with times when you're feeling frustrated, helps when you're feeling discouraged or maybe you're lacking motivation. Uh it you don't have to share it with other people either. I think that's the beautiful thing. You can just keep it as your own private little personal stockpile of you know ammunition to fight back against, so to speak, against uh the days where things maybe aren't feeling as good as they should. So, some personal examples. Uh, I'll just quickly share a few with you here. Uh, there's a video on the internet that I really like, and I've been kind of reiterating it to myself with my rib injury. Uh, it's a video by Jocko Willink, if you're not familiar with him, former Navy SEAL, who's now uh kind of a in a leadership position, teaching a lot of leadership. He's got a video, it's about two minutes and 20 seconds long. It's called Good, and it's about uh his mindset and the word he would say, which was good, whenever things went wrong when he was uh on deployment over you know in the Battle of Ramadi and when he was uh his uh kind of platoon leader uh when he was a navy SEAL. That's a it's a video that's all about again that that mental perspective of how we frame things when we're going through hard times. So I really like that video. I like watching that one quite a lot. I've got a lot of quotes that I keep on my phone. I've got quotes that uh I have in my little studio here uh up on the back wall. I've got the serenity prayer right over there. Um these are things that I dwell on and really take time to read and um and really focus on when I feel like I need to make sure that um I need to um utilize some ammunition, if you want to say it that way. I also have a lot of songs that I love listening to based on how I'm feeling. Songs for maybe um when I'm a bit frustrated and need to be lifted, songs when I feel like I need to kind of get my act together and get a bit more energy. Um a lot of valuable songs I have on my playlist, believe me. And then I even have a lot of scripture, uh biblical scripture that I'll dwell on. Really helps bring me comfort in a lot of times when I feel I'm. Anxious or feel like I'm uh struggling uh to uh to ground myself and feel connected more so to the spiritual side within me that I need to reconnect with. Uh these are all simple little um bits of ammunition, so to speak, that uh I will stockpile and then utilize uh to fight back uh against uh you know the darkness or fight back against the uh then the unpleasant situation that I'm up against. And so with that being said, I'm gonna leave you with one of my favorite quotes of of all time. Take this quote for what it's worth for you. I might have read it in another episode, I can't remember. I don't think I have. Uh, but it's it's a quote that I I love from a behavioral mentality standpoint of doing things you don't want to do uh because you know they're ultimately going to benefit you. And I think we can apply this to when we're in the middle of injury rehab, or even when we're not injured, and we want to do all we can to stay physically strong and mentally strong, even spiritually strong for that matter. Uh it's a quote by William James, and it's absolutely one of my favorites. Uh I will read it to you, and uh, and then we'll do the uh the takeaways of this episode. So here's a quote by William James. It says, keep the faculty of effort alive in you by a little gratuitous exercise every day. That is, be systematically heroic in little unnecessary points. Do every day or two something for no other reason than its difficulty, so that when the hour of dire need draws nigh, it may find you not unnerved and untrained to stand the test. Ascetism of this sort is like the insurance which a man pays on his house and goods. The tax does him no good at the time, and possibly may never bring him a return. But if the fire does come, his having paid it will be his salvation from ruin. So with the man who has daily inured himself to habits of concentrated attention, energetic volition, and self-denial in unnecessary things. He will stand like a tower when everything rocks around him, and his softer fellow mortals are winnowed like chaff in the blast. That is a quote by William James. Okay, so here we go. Key takeaways. Everything we've talked about. Let's wrap it up really quickly into this. Key takeaway number one, build the wall brick by brick. Think of every action that you can take in your recovery like a brick being laid down to fortify a wall. Every brick matters. Takeaway number two, commitment to the process. So if you're going to physical therapy, show up on time, be actively engaged in the process and put in the work. The people who do that have far better, far more optimal outcomes than people who don't. Takeaway number three, establish the roadmap. Set your goals and track your progress to ensure you know where you want to go and how you plan to get there. Without goals, you're aimless. You don't want to be aimless. That's hard to get optimal outcomes when you're aimless. And then takeaway number four, arm yourself with inspiring resources. Make a collection of anything that you find to be life-giving, empowering, and inspiring, motivating, etc. And if you do this, it will keep you going with your recovery. So, thanks for staying. Um, real quick before you uh take off here, if you did get something helpful out of this episode, uh please consider leaving a review. I will tell you all the time, I am not trying to get famous. I don't like being in front of cameras, but I like helping others who are in pain and people who need to perhaps get pointed in the right direction and maybe have a bit more hope for how they're going to get through the situation that they're currently finding themselves in. Uh, so if you got something helpful out of this episode, please leave a review. Um, or if you feel that others could benefit from this episode or any other episodes, feel free to share it with them. That would be wonderful. Uh, if you want more content and things I'm up to, you can find me on YouTube, you can find me on Instagram. My handle for both is Strength Resurgents. You can find me on my website, strengthresurgents.com. Hundreds of blog articles up there on all sorts of stuff pertaining to physical therapy, physical health and wellness. Um, lots of good stuff there. And hey, if you do want to support this project uh that I'm uh pouring my kind of heart into in terms of how much I love this to help other people, uh, if you want to support, you can buy me a coffee on buymeacoffee.com slash resurgence. Uh, just small little donations, every dollar helps. It offsets the costs, it offsets the costs of my website, uh, some of the equipment that I have to purchase to make all this content. Um and uh that that would mean the world to me. But nonetheless, with that being said, I'm going to wrap this up like I always do. Everyone, please keep looking after yourselves, keep looking after one another, keep making great things happen, and I will see you in the next episode.