At our last OPTIM COMT Course, I gave two separate lectures on tissue mechanics and patient education. While seemingly unrelated at first, when preparing the lecture I discovered how interconnected the two topics are. For example, understanding basic tissue mechanics (collagen synthesis, healing time frames, etc...) has a direct connection into the patient's prognosis and plan of care. This post is about how we can turn our in-depth anatomical knowledge into patient friendly education. Essentially, how can we sell exercise to our clients!
First and foremost, as physical therapists, we must understand we are selling something people struggle to buy. Exercise is hard work! It takes effort and commitment. It takes a life change. Before selling exercise, the PT needs to determine if the patient (customer) is ready to buy. From my experiences, many patients are truly ready for change or at least capable of persuasion. Once we confirm the patient is appropriate for therapy, then we can really delve into treatment and education.
On the physiological level, the body undergoes three phases of tissue healing: inflammation, proliferation, and maturation. Inflammation lasts 48-72 hours. In this phase the cells have an influx of white blood cells and fibroblasts to help facilitate healing and decrease waste products in the cell. As healing progresses the cells continue to develop and repair in the remodeling and maturation phases. Collagen synthesis occurs for up to 1-2 years meaning the injury may take longer than the patient anticipates. (See previous post regarding Expectations and Time Frame of PT.)
The Proper Education
Since we know the body will undergo three phases of healing, we need to provide appropriate education to make these changes occur as efficiently as possible. There are several factors that influence collagen remodeling: adequate blood supply and oxygen, movement, pharmacology, protein intake and vitamin C intake. In physical therapy terminology, exercise aligns the collagen fibers, provides cellular lubrication, and increases elasticity of the tissue. In patient friendly language, we can explain the importance of gentle movement early will decrease swelling, increase blood flow to the region, and allow the tissue to remodel appropriately. Protein and vitamin C directly effect collagen strength and fibroblast production. Proper nutrition following an injury will give the injured tissue the greatest chance for healing. Simple education points like the ones above can make selling your treatment sessions much easier. Do not be ashamed to think of yourself as a salesperson because we are in the health care field!