It’s all about the “why.” Why we do things determines the how and what. (I was exposed to this TED Talk by Simon Sinek. It’s superb, and all about the “why”… but this post is not about your personal why.)
“You should eat your veggies.” Why? Well, the answer to this question defines the action. If the “why” is because eating your veggies will turn you into a super-human robot, or make your skin green, or cure cancer, or entice the opposite sex… well then eating veggies is silly. Because of the “why.”
Some things are sensible enough on their own for reasons that seem clear (eating veggies) but a poor “why” can distort them.
Let’s take this into the realm of PT. When prescribing exercises for your patients; What is your “why”? Do you know? If not some honest reflection needs to occur. (sometimes the answer is ‘I don’t know’… what do you do then?) Knowing why is by far the hardest part of treatment… or the hardest part of any action that you take at all.
For example: The ‘why’ of non-specific effects should be known to you as well (practice the ‘golden circle’ from the above TEDtalk!). Don’t get me wrong, I LOVE non-specific effects and the implications that they have. Here is an Evidence In Motion blog about some of that. I find them fascinating. Creating Therapeutic Alliance with the patient is certainly a goal. I do not, however, feel that we as PTs do nothing and it’s all about how I smile, or lay my hands on their shoulder when I introduce myself or how clean and clear the clinic is that get’s the patient better. These things contribute. How much? Depends on the patient, but all patients appreciate a nice therapeutic environment with quality care (it’s also good business practice, eh!). My point is, I don’t find all the research about non-specific effects to be inflammatory to our profession’s bread-n-butter (manual therapy, exercise, gait training, motor control, etc). It is simply something to be cognizant of and to maximize. Why do the outcomes from non-specific effects not threaten Physical Therapy? Because of our “why.”
The things we do for our patients and instruct them to do themselves have a grounded basis in biology, science and outcomes. Our ‘whys’ are solid.
It all comes down to the ‘why’.