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Considering Psychosocial Components in Patient Rehab; Jessica Werth, SPT

Since I have started PT school, I have had one ACL repair and a second ACL and meniscal repair. I have realized how hard it is to make appointments with a busy Monday to Friday schedule, how expensive physical therapy actually is even with insurance, and more importantly the psychological impact of recovering from an injury.

While going through my first recovery, I was extremely determined and motivated during the rehab process. Unfortunately, the second time around (9 months after my first surgery) was not as smooth. Currently still going through rehab, I have realized more than ever the struggle many patients face that they don’t always express to their therapists.

A few weeks after my second surgery is when I really began to feel depressed, helpless, and discouraged. With all the time I had resting, I began to think a lot about my situation. I began to question why this happened again… and so soon. After questioning this, I began to feel frustrated at my situation; especially thinking about how active I was just a few weeks before this and how I was once again at rock bottom. After the frustration wore off, I started to feel sad and hopeless. I convinced myself that all my hard work from my first surgery was pointless, and if it didn’t work the first time there was no way it would work the second. I was frustrated that once again, I was doing quad sets, scar and patellar mobilizations, and range of motion for my “exercise.”

When I felt up to it, I started to go back to the gym to do some upper body strengthening. This proved to be more often destructive than not. Not only was navigating ever so slowly on crutches through a crowded gym trying to ignore the quick glances, but I found myself watching other people and envying how much they were able to do. I would leave feeling frustrated, longing for when I could return to my normal healthy self. So once again, I was swimming in negativity.

Admitting to my PT that I was constantly discouraged and down was not an easy thing to do. I would hide my feelings during sessions, which is not what I should have been doing. I convinced myself it was not their job to listen to my problems and they were just getting me to where I needed to be physically. I was wrong. I finally opened up when I realized that my negative attitude was actually impacting my therapy and healing. Of course, they were very sympathetic and understanding and utilized it during my recovery to my advantage. Quickly, I started to feel more motivated and ready to work.  

Months after the worst of these feelings occurred, I still have days when I feel frustrated I don’t have great proprioception, I lack sensation on parts of my knee, and my muscles still aren't quite where I want them. However, I started to transform my emotions into a resource for my future patients. I realized how emotionally taxing it can be for patients during the recovery process and even more so the second time around. It is important to consider all aspects of patient’s life because an injury or a body part does not define someone. All of the patients we will encounter during our career will cope with things differently. It is crucial we do not stereotype and that we understand how they are doing physically and mentally in an individualistic manner to provide proper care to each patient.

Patients might not always voluntarily tell you if they are feeling discouraged or frustrated during a treatment session. Do not be afraid to ask, ensure they are aware that you are there for them in all directions. Building a good relationship with your patient requires understanding and attention to the patient as a whole, rather than just a body part. By integrating this into your practice, patient satisfaction and treatment can be increasingly better.

Jess Werth, SPT