Feb 28 2018
We have all had those clients that come to us in agony with goals of getting moving and staying moving. In their first session, they say that they realize that the reason for their pain is because they haven't been moving enough or not in the right way. If they could just get back to moving well, they would feel great, they say.
Fast forward a few sessions, and their pain has resolved due to your thoughtful and strategic program of effective movements. It's time to talk about additional sessions and all of a sudden the motivation shifts to...
"Well, I feel great now, so I think I'm good"
"I think I'll go back to that bootcamp class again. I feel good thanks to you."
"We've done 5 sessions, I'm fixed right?"
So they leave. Then 3, 6, 9 months later they inevitably return with the exact same story of woe.
It's like people forget how they got into this mess in the first place as soon as the mess is cleaned up. Think back to when you were a child. How many times did you do something (touch something you weren't supposed to, use your outside voice inside, wander away from you parent) then were punished before you learned 'wait a minute, if I do that, I'm gonna get in big trouble'? So that must mean that adherence is a learned behavior! Great, we’re teachers!
So let's talk about exercise adherence for a second. How do we ensure people see the value in continuing to move long after the pain symptoms are gone? It is our responsibility to foster a relationship with movement in our clients that allows them to feel that there are tangible benefits, that their goals are attainable, and that movement is about functional daily living not just exercise. However, adherence to an exercise program is a behavior that is voluntary and self-motivated on a psychological level. We can't force people to participate if they don't want to, it's that simple. We can help change their mindset though by understanding some other factors that may contribute to non-adherence, such as:
Everyone wants a quick fix. The world moves so fast these days that no one has time to spend on themselves or to take care of themselves unless it comes with a "results in 30 days or your money back" guarantee. Oh, and even better if it's available online!
At the mercy of the insurance companies, Physical Therapists have been forced to follow a protocol with patients that allows 6 weeks of treatment then you're on your own. At that point you must be fixed, so is it any wonder that some PT patients return to therapy for the same issue over and over?
We all want the easiest route from point A to point B, our brain says so.
Exercise = effort = feel good
Sit on the couch = no effort = so comfy
Who would ever be compelled to do something to keep them feeling good when they already feel fine right here on this couch? In this scenario exercise is broccoli.
For decades, the medical community has emphasized treatment over prevention. We have learned not to pay attention to our bodies until something goes wrong. If it ain't broke, don't fix it, right?
Money can be a major factor in non-adherence, and for good reason. If people don't have the means to go to a fancy gym or studio to workout in their over-priced but super cute outfit, they just don't. It is our job to provide them with all sorts of cost-free options to move outside, or to more affordably continue at your facility.
As they say, "you can lead a horse to water, but you can't make him drink". You can however educate your clients and help them incorporate all types of movement into their lives so that it becomes an enjoyable routine, not a chore. If they do leave, most often they will come back, and likely they will stay when they do. Learning!