The Journey to Understanding – What is my Rehab Philosophy?

In coaching, knowing your Philosophy is common practice, and is deemed as one of the most important factors in determining the success of a coach.  Historically, application of such philosophical theory to clinical practice within physiotherapy has not been at the forefront of training and literature. 

Recent lockdown measures have enabled increasing capacity for my own professional development, with lots of self-reflection. PhysioPhilosophy Clinic was named by my son after his love of Harry Potter but now I am left wondering if the name has a much deeper and important meaning for me and my clients. Philosophy goes beyond the science and the traditional hierarchy of evidence,  it permits more comprehensive and coherent reasoning and helps to relate evidence with respect to individual clients (Kerry 2008). On a larger scale, it encourages reflective discussion between peers around the virtues of alternative treatment approaches. 

Cassell’s (2010) definition of a person as “  ..an embodied, purposeful, thinking, feeling, emotional, reflective, relational, human individual always in action, responsive to meaning”, is very thought provoking. He goes on to say “..virtually all of a person’s actions—volitional, habitual, instinctual, or automatic—are based on meanings”. How we see our clients, how we communicate with them, understand their beliefs and expectations, their lived experiences of pain and distress, will help the clinician gain trust, commitment and empower the client in their recovery. 

Here’s the reflection bit.

How did I come to this? Where did my beliefs and expectations come from?

It’s hard to dig deeper into the understanding of who you are, your beliefs and expectations as a person and as a physio. This has been an ongoing process for me whilst making decisions about job roles and career progression after finally settling in one place (over 10 years of moving). Whilst change of jobs and locations makes you dynamic, proactive and adaptable, it  also tars on confidence as a physio and where you fit in. 

A huge turning point in my career; where a lot of my beliefs and values as a person and a physio come from, was the experience I gained whilst working in a multidisciplinary team within the Regional Rehab Units for the Military of Defense (MOD). Here we had the opportunity to assess, treat, rehab, educate and refer on, all under one roof and over an in-house 3-week period. I saw how the military personnel came and left these courses very different people- “a better version of themselves so to speak”. This wasn’t one specific treatment over another, although the sound reasoning and progression of evidence-based rehab definitely was a huge contributor to success. I truly believe it was more to do with the time they were given to discuss their goals, what was their lived experience of pain / injury, their emotional aspects of their pain / injury? For us to understand why they were at the unit, to understand what their expectations were, to listen. It gave them a fun and safe environment to process change and hopefully become more self-directed and self-driven in the process of recovery. All of the time building a consistent trust and relationship with them, making it easier to develop an approach to coaching and helping the physio empower each person in their encounter. 

After this, I moved to Belgium, and worked still for the MOD but more as a sole physiotherapist in the British Medical Centre. I was lucky and was given the time and the space to do clinics whilst also setting up the Spinal and Lower Limb classes and to arrange my own diary according to patient need. This ability to provide exercise and rehabilitation was very important having seen how important it was in recovery from injury. 

After returning to the UK and moving to Herefordshire, I had a fantastic 2 years within a great Medical Practice. However, I could not help but feel frustrated at the lack of time and ability to offer that holistic approach providing exercise based rehabilitation with my patients which was the cornerstone of my beliefs and values so I decided to take the leap into opening my own practice. 

It was then up to me to try and ‘provide this catalyst to change’, to ‘help people reconnect with their former self’, using my own past experiences and beliefs. So I guess my Philosophy has directed me along the path to where we are now.. 

I will still tell my son that he named the clinic, but after reflecting on my Philosophy, my mission statement feels more real and understood.

‘To provide a safe, fun and inspiring environment which empowers you to fully recover and exceed your expectations by living full and healthy lives’.

“We will provide you with specialist physiotherapy treatments and individualised rehabilitation programmes according to your specific injuries and needs.  You will learn ways to keep your body injury free to support your personal objectives”.

I am excited about the future, and the journey I want to take with myself and my clients. 

Whats your journey been like? 

 

References:

Kerry R., Maddocks M., Mumford S. 2008. Philosophy of science and physiotherapy: an insight into practice. Physiother Theory Pract. 24(6): 397-407.

Cassell E. 2010.The person in medicine. International Journal of Integrated Care. 10(5).

Thanks to Uzo Ehiogu @Integrated Clinical Strength and Conditioning