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Treating folks, like you, who move for a living and love to move


Author: Richard Symister

Not Knowing is the Worst Part of Any Injury — A Physical Therapist's Perspective

Ever suffer an injury? Did you stay calm or catastrophize the situation? “Is it torn?” “Do I need surgery?” ‘Will I ever run again?” 

Client education at MovEvolution Physical Therapy is paramount when alleviating our client’s injury angst. Take for instance our client, Bianca, coming to us with a new anterior cruciate ligament rupture, prepping for an upcoming ACL surgery. The first thing I found out was that this was Bianca’s first real injury. I am not exaggerating when I say she was shaking, sweating and extremely guarded, even before I put my hands on her knee. 

I took a step back, and explained to Bianca the anatomy and physiology of a torn ACL, my primary role and protocols for that session and that, although she was scared and in pain, my bending the knee was not going to affect an already fully torn ACL. “What am I going to do when I bend your knee?” I asked her, smiling. “Tear your already torn ACL.” This brought on an immediate smile of comprehension and she relaxed a bit …but just a bit. 

During the “gentle” exam, I proceeded to discuss the 9-12 month journey she had ahead of her post surgery, what to expect and home maintenance tips for after the surgery and monthly milestones she should be expected to reach (i.e. full knee extension, transitioning from 2 crutches to 1 crutch to a cane). 

Did I get through the full exam? No, but it’s not just about gathering ALL the info. It’s also about calming the client’s mind, making them part of the healing “team, empowering the client to become their own clinician at home. 

Yes, slow progress for the 1st few days, but great outcomes overall so far. 

I took it easy on Bianca the first day, focusing a lot on breathing, pre-surgery goals and gentle bodywork to encourage patella mobility, increase her knee range of motion, decrease swelling. She also took a few videos on her phone of her “homework”. 

My short-term, pre-surgical goals for Bianca:

  • swelling: L knee circumference = R
  • range of motion: knee extension to = – 3 hyperextension degrees and 125 degrees flexion
  • weight bearing: full weight bearing, community ambulation without brace/crutches 
  • stairs: 0 apprehension up/down stairs w/o brace
  • travel: tolerate upcoming vacation in Thailand in 12 days

Read about Bianca’s first visit with us through her eyes here.

Heal. Move. EDUCATE. Evolve.