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David J. Conti, DPT, NCS, CSCS is the owner of Revive, Boost, Rebuild, Physical Therapy, LLC (RBR PT), and an adjunct professor at St. Augustine’s University. He has practiced physical therapy for 10 years, with a clinical focus on orthopedic and neurologic patient cases. He is a certified strength and conditioning specialist, and one of only 57 PTs in NC who is board-certified in neurology.

RBR PT treats patients from infants to geriatrics. RBR PT is known as an inclusive clinic and a strong community resource.

Sobering Truths About Rehabilitation

By David Conti, DPT, NCS, CSCS

David Conti

Imagine the despair of falling victim to an event—physical or otherwise—that negatively and significantly affects your quality of life. The understandable and even reasonable reaction may be to feel a sense of angst, fear, sadness, or even hopelessness. Depending on the severity of the event, this threat may be long-term or even permanent. As ominous as this scenario might sound, truth be told, it’s the reality for millions of Americans. The key to getting back on track lies heavily in the ability to navigate through the initial stages of shock and potentially even loss, and to find encouragement in the notion that there are experts and specialists whose sole purpose is the rehabilitation and restoration of function, directly impacting quality of life. As a physical therapist, I hang my hat on my ability to affectively identify, as well as correct and/or compensate for functional loss.

David Conti guides a client through an exercise routine.

Reasonable Goals Plus Optimism

There must exist a delicate balance between empathetic sensitivity, prognostic honesty, and energetic encouragement. These may not be aspects of a skill set acquired within an academic curriculum, but the seasoned therapist has honed these attributes over their career course. Physical therapists are frequently introduced to patients who are currently at their worst. It is, however, essential to provide a sense of understanding for what they have been through, while providing a set of realistic, rehabilitation goals with timeframes, all while instilling a sense of optimistic relief that their journey to recovery, however arduous, has begun.

The element of reasonable, non-lofty goal setting cannot be glanced over. It is frequently difficult to deliver sobering truths. However, as hard as some of these conversations and processes may be, they are paramount to the establishment of trust and hope, while also limiting the potential for perceived failure and disappointment. This is not a process that is obligatory to the rehab experience, but dependent upon the diagnosis and condition, it may very well be needed. For example, patients who come to therapy for minor injuries such as sprains and strains, can reasonably expect remediation and full recovery to their premorbid status, if not beyond. This is also true for many post-operative patients. Individuals who have undergone joint replacement surgery, rotator cuff repair or ACL reconstruction can also expect to eventually return to their premorbid sense of normalcy.

In contrast, consider the amputee or the person diagnosed with a progressive neurological or chronic cardiopulmonary disease. These patients will likely require compensatory strategies to maximize safety, energy efficiency, and, of course, overall function. Informing a patient that their customary, typical, and familiar movement patterns are no longer appropriate or reasonable is challenging but frequently necessary. There is always comfort, however, in the idea that new, compensatory strategies exist.

The Power of Data

Physical therapy is unique. There is a connective power in treating patients with far greater frequency and even duration than any other member of the multi-disciplinary rehabilitation team. The energy derived from the ability to notice small changes in presentation holds great value. It contributes significantly to the ongoing encouragement that fuels the mental and emotional components of the physical rehabilitation process.

Similarly, there is the importance of objective data collection. If indeed we can agree that numbers don’t lie, then we ought to place the appropriate value in establishing baselines to then compare with periodic checkpoints. I’ve had many patients who had initially been disappointed by their own perception of where they were within the rehabilitation process, only to find out that the review of the objective data revealed an appreciable improvement had most assuredly been achieved. It saddens me to think of the number of people who have prematurely given up hope for their rehabilitation potential, simply because they weren’t given the affirmation that often only objective data can provide. It can make all the difference in a patient seeing the process all the way through.

The Power of Encouragement

I treasure my role as a rehabilitation specialist. It is not lost on me that I have the capacity to accelerate the restorative healing process. It is extremely important, though, that I stay in tune and ensure that the patient also remains vested in the recovery course. I earnestly uphold the importance of my role within the process. It is vital to hear clearly, the needs, concerns, and experiences of the individual. It is equally important to establish trust, realistic hope, and to provide perpetual motivation. My mantra as a physical therapist can be summed up in two simple words: Be Encouraged!

The Value of a Fresh Start

As the calendar year comes to a close, there is an instinctive urge to reflect on what was. The ushering in of a new year however, is traditionally a time for ambition and hope! With this opportunity approaching, I strongly urge you to consider the value and significance of a fresh start. Assistance exists in multiple forms and is certainly readily available, but it absolutely starts with you. Accept and embrace the fact that you are indeed your own most influential advocate, and that the path to becoming the healthiest you possible lies squarely within your determination and commitment towards reaching your potential. Be well and stay well.