The Power of Trust

As I sat on my couch the night before the start of our first clinical rotation, I began to truly appreciate the enormity of the transformation we endured through our first year of PT school. I believe I speak for the entire class when I say we entered into our respective clinics with a strong confidence in our clinical skills and decision-making: a stark contrast to our first days in the program.

Throughout the ortho module we continually heard, “You will know more than you think you do once you start your clinical.” Those were hard words to swallow with a squadron of nitpicky professors watching your every mobilization and listening to every syllable of your clinical explanations. The immensity of their expectations and the relentless nature of their questioning drove us to adopt the “clinical mindset.” Within this mindset, one exists in a state where every clinical decision is self-questioned, which in turn incites an eternal hunger to consume current EBP literature in order to fortify ones toolkit (of knowledge) for the arduous journey towards the mystical peaks of clinical perfection.

For my clinical rotation, I was placed at Aquatic Physical Therapy and Beyond in Raleigh, NC. Prior to the clinical I had little experience in the aquatic setting. (a half-day lecture/lab) Now, having completed my rotation I am a big proponent of aquatic rehab for a number of reasons:

  • It opens a world of pain free movement or at the least movement with less pain to patients with chronic pain conditions (severe OA, chronic LBP, CRPS). Often, pain leads to a sedentary life thus resulting in extreme deconditioning. The water facilitates the transition back into a more active lifestyle and allows for an individual to obtain a ‘foundational strength’ before transitioning to land based therapy.
  • It allows the post surgical populations (mainly LE) to return to ‘normal’ motion at a faster rate. I saw several patients post-ACL repair and a patient with a full patellar rupture repair begin to walk, jog, and perform functional movements (squats, lunges, etc.) at an earlier time than possible on land.
  • It builds confidence! Confidence is key to rehab, especially with individuals who fear movement or do not trust their ability to balance. The water creates a safe environment to rebuild and reshape their self-perceived capabilities and confidence.

Overall, the transition from classroom to clinical was a tad overwhelming to start between learning the clinic routine, documentation system, meeting new co-workers, and coming to the realization that I was working with real people (as opposed to a role playing classmate). The most enlightening part of the clinical experience was realizing the worth of my ability to build rapport with the person in front of me. Through school you gain a massive toolbox of clinical test and measures, you understand what questions to ask and what signs/symptoms to look for; however, the ability to connect at the human level is a skill that cannot be taught. Trust is the foundation of the therapeutic relationship; without it the path to rehabilitation becomes clouded. Never underestimate the therapeutic power of a strong, trustworthy relationship. To end this first post of 2017, I want to extend a warm welcome to the class of 2019! The class of 2018 looks forward to meet y’all and best of luck with your first year. There will be more to come on the wonders of our next module, Neuro!

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