As a physical therapist, exercise prescription is one of my go to tools. Probably the one I use the most. However, things don't always go to plan so adaptability is key. In a job interview I was once asked, "what is the best exercise for.....?" I don't remember what the last detail of the question was, but I do remember that I answered, "the one that gets done."
Physical therapy is very effective when dealing with symptoms that would benefit from behavior or habit change. So consistency is key. When a client comes back to me and hasn't performed their home program, for one reason or another, I take it as a professional challenge to find something better suited than I initially recommended (although there are surely times where the tough love is the way to go).
How does one go about that? Great question, and the answer varies, but there are usually some principles that I follow to remove all barriers possible:
1) Find out what the person has at their immediate disposal. If I recommend something the person doesn't have access to (because of time, financial, or other constraints), even if it is technically the best option, it won't get done. So an alternative needs to be found. Sometimes good enough is okay, and way better than nothing at all.
2) Can I make it fun? If it's fun, it get's done (pretty sure I learned this from Ben Cormack. If you're a PT reading this, go take his course).
3) Get the patient/client opinion. Too often I feel like medical advice is a dictatorship, with the patient being told what to do with no input on how it will affect their life. This simple tactic has led to many creative solutions, that were decided on jointly with the client.
As I sit here writing this I am staring at one of my own reminders to get off my butt and help myself. During the pandemic I've been spending most of my free time on streaming services, as I'm sure many of you have as well. As a result of staying in the same position for the better part of the last 9-12 months in front of the TV I am now the not so proud owner of radicular shoulder pain.
And boy it is easy to not do a thing about it. I mean the TV is right there......So basically I've resulted into shaming myself into the solution. I've stuck this red band where I can't ignore it for the past few days and so far, shoulder's not perfect, but definitely better.
4) My final pro tip is to set reminders. Life happens fast and it's easy to ignore your own needs for other responsibilities and hobbies. Set up an alarm on your phone, actively schedule or set aside time during the day, or have that token stare you in the face when you're doing the opposite of helping the problem. Whatever works.