September 25, 2016

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by: backFoCuSadMin

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Categories: Physiotherapy, Rehabilitation Programs

Injury rehabilitation and maintaining motivation

Injuries can take as much of an emotional toll as they do physical, so when it comes to injury rehabilitation, it is best to be prepared.

Rehabilitation programs assist you, but still you must pass through many stages in the journey to recovery. Each type of injury, combined with an individual’s unique physiology, translates to a wide variety of treatment and injury rehabilitation needs.

Whether a planned surgery or a sudden accident, the true impact of an injury may not be felt for some time. It is worth predicting and planning for the possible effects an injury will have on your family, work, sport and social life before they arrive. For example someone who is extremely active and then is suddenly incapacitated may be prone to depression. Being aware of this and seeking treatment sooner may minimise the compound effect of dealing with the frustrations of an injury, whilst having a lowered level of self esteem. At the same time it will also mean that, in the long term, you have a greater margin of success.

Emotional stages of an injury

At the onset of an injury, it is worth while noting that the stages of grieving we normally experience at the loss of someone can also apply to an injury. This may seem strange at first but consider that any injury brings with it a loss of a previous level of ability. Being aware of the stages of grief therefore may help identify feeling or behaviour that is out of character at different stages throughout injury rehabilitation. Awareness at the very least will lessen the possibility of these feelings impeding the reaching of goals and thus impacting your level of motivation.

Following an injury the first of five emotional stages may be experienced, this being denial. It is natural to consciously or unconsciously refuse to accept the facts of the situation created as a result of the injury. Secondly anger, which can manifest in a variety of ways, may be directed at oneself or others, especially those who are close. Next may be bargaining or seeking to negotiate a compromise followed by depression in fourth place, which involves a sort of acceptance with an emotional attachment. The situation at this stage may seem bleak but it is natural to have these feelings of sadness, regret, fear, or uncertainty. The positive from this is that it shows the process of accepting the reality of the injury has begun. Finally the fifth stage of acceptance indicates that there is some emotional detachment to the injury and with the arrival of objectivity, the process can now begin towards rehabilitation and ultimately, overcoming the injury.

Assisting your rehabilitation

Most injury rehabilitation will require assistance such as physiotherapy and it is important that you play an active role in the design and implementation of the program. After all the person with the injury must experience the mental and physical effort required for rehabilitation and their feedback to whoever is managing their progress will be vital for success.
Along with any physical pain or emotional demands, finding the commitment and motivation to successfully complete a rehabilitation program can be a challenge within itself. The main thing that will assist you is the successful completion of goals that you have set.

Thankfully goal setting is something that we all do throughout our lives, from school, to our working life and in our sporting endeavours, so setting goals within rehabilitation should be less confronting. Creating a goal or goals that are accompanied by a strategy from the beginning, with your therapist, will set you up for success.

The setting of goals in injury rehabilitation

As a guideline for goal setting it is important to ensure the goal or goals are both meaningful to you and whoever is in charge of management of your rehabilitation and that the goals are performance rather than outcome orientated. So a goal of winning your next event is an example of something as an outcome, rather than a performance goal, such as doing 20 squats within one minute.

Having a goal that is specific and clear, realistic but challenging, means that you will have an objective that is measurable. If your goal in the first week is to walk 50 meters, the second 500 meters and the third up a hill 100 meters, then a sense of achievement will be realised once you reach each of these goals. Also setting a criteria and writing this down with your physiotherapist, of what constitutes a successfully achieved goal, is important when you return in the future to analyse the level of your success. For example you may want the completion of the goal to be relatively pain free and if it is not, then you will stay at that level for one more week.

In the instance that a goal is too easily achieved or not met, it is up to you and whoever is managing your rehabilitation, to review what needs to change. This may be a shift in how the goal can be reached , for example a walking aid may be introduced, or the goal itself might change to better meet your capabilities. Similarly once a goal is met it is important to recognise the implications of reaching this goal and if needed review and adjust the remainder of the goal plan. This could mean adding in more repetitions of an exercise or greater complexity of movement.

A goal should also have a target date of completion, and if there is more than one goal, and there should be no more than three or four, these must be prioritised. Writing these down is essential and when doing so ensure that all goals are stated in a positive manner. This way your progress can be better recorded and monitored together with your physiotherapist. Once your goals are set up correctly, then finally, accountability for success must be taken by both the injured person and the therapist.

Achieving the goals you set

Taking ownership of the injury rehabilitation process can be empowering and also daunting. The more complex or severe an injury, the bigger a rehabilitation goal can become. Sometimes just the thought of achieving a rehabilitation goal, can be overwhelming. So instead of looking up to a big goal, as suggested earlier it may be better break it down into smaller parts. Progressively achieving smaller short term goals, will inevitably lead to better prospects for the successful completion of a bigger long term goal. So if your goal is to hike 10 kilometres in a day, start with walking without a pack on a flat surface for 1 kilometre and then build up to 10. When this is completed try building up the distance on an inclined footpath and then on rougher surfaces. You could go back to a flat surface and then introduce carrying a pack and work once again towards inclines and rougher surfaces.

To achieve a rehabilitation goal though, much effort and persistence is required and the motivation to keep going will be essential for success. The fact that you have clear goals, and as such are taking personal responsibility for your recovery, will play a major role in motivating yourself, yet there are some other elements that can help you get to where you want to be. These will be covered in our next article.

Until then one simple thing to remember is to ask yourself with any injury is, have I had a good or bad day? Answering this each day and adding to a calendar or your notes will in simple terms enable you to track how you are feeling. Then when you are having any doubts, look back through the days, and as long as you are having more good days than bad, you are getting somewhere.