Bird Flu Guard

Danny Green, a star basketball player for the University of North Carolina, had a tough week in the middle of March this year just as March Madness was getting started.  He's known for his exceptional shooting skill yet Green was 3 for 25 in two games and even missed three layups. I mean, come on, I can make a lay up. The media was all over him.

It would be easy to slip into a serious funk. It would be easy for his coach, Roy Williams, to tell him to shape up, pay attention, be a stud, whatever. It would easy for Green to think it's over. He's finished. He's lost his mojo.

Instead, what was did Roy Williams tell Green?

Keep shooting.

Green took his advice and within a couple of games, found his mojo and UNC won the National Championship.

You can think things are too hard, or why bother, or it's not worth it. You can quit. You can go hide somewhere and sulk. Injuries tend to do that to you.

Or, you can keep shooting.

DK

From About.com:

"A home exercise program is essential to doing well in your rehabilitation program. If your physical therapist has not reviewed several exercises for you to do at home, you should ask to do so. A home exercise regimen should be performed two to three times per day. Being active in your own rehab will greatly pay off!"

Ok, so this pushes a button. I admit it. Global, one-size fits all, you-should statements are useless.

I agree with the first sentence - sort of. I think a better word is "independent" or "unsupervised". You may not be doing the exercises at home. The term is a hold over from a hospital based practice environment. The patient is about to be discharged and they need "home instruction" which turned into "home program". It's not in sync with reality. It is essential, at some point, for you, as the client, to be able to execute a plan on your own that will maintain your improvements. Agreed.

The second sentence seems reasonable. Any client would likely want to know the answer to, "What can I do at home or on my own?" Now, depending on the case, all that the person might really be able to do is to change sitting positions, sleeping positions, duration of sitting, etc., to relieve symptoms, for example, of back pain. None of these things are "exercises" but all of them are part of an overall plan. And, why is it so important that you, the patient or client, get "several" exercises? What's wrong with one or maybe two that really work?

Third sentence. Wait a minute. Just exactly what should you be doing two to three times per day? Quad sets? Ok. I'll buy that. Jogging intervals? Don't think so.

Exercise is controlled trauma. Used wisely, exercise can heal injured tendons, ligaments, and bones; strengthen muscle; improve posture. In fact, mechanical load via exercise is the most important thing in your life. Without it, you die. Through exercise, you stress tissue. Through rest and recovery, that tissue adapts; grows stronger. Too much exercise with too little recovery leads to progressive weakness.

Part of the problem is that some clinicians use passive techniques (massage, mobilization, physical agents like ultrasound, etc) as their primary intervention and leave the "exercise" up to the patient or client to do on their own. So, if the patient has not been instructed in a "home program", then, well no exercise happens. The decision to use manual therapy or a physical agent or exercise is a clinical decision making issue and one that cannot be solved by a blanket statement that everyone should be on a "home program" and should be doing that program two or three times per day. That's just stupid.

To suggest that somehow a physical therapist has missed something because he or she did not prescribe an exercise to be performed two to three times a day is like saying a physician goofed by suggesting you should take a medication only once a day. It depends on the problem and the "medicine" you've chosen.

"Being active in your rehab will greatly payoff!" Only if you're doing the right things the right way.

More is not always better. And more at home could be a disaster.
DK

52

Do you know me now?

What does “age” tell us?

What if my blood pressure is too high, my cholesterol is out of control, I can do 2 push ups, cannot stand on one leg for more than 2 seconds, cannot walk around the block or up a flight of stairs without being winded?

And what if now I told you I was 32?

Age is not a number. Age is a collection of numbers.

Focus on the collection.

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