Monday, May 15, 2006

Pilates Observation and Professional Collaboration

I have a new patient with a history of back and hip issues. As part of his recovery, he is taking Pilates lessons. At the request of the MD and the patient, I met with this man and his physician at his last appointment and we decided it would be a good idea if I observed the Pilates lesson, so everyone was on the same track and no one was doing anything counter-productive.

Lesson #1: It is optimal if the physical therapist and treating physician can meet with the patient together. This rarely or never happens in traditional orthopedic cases.

The Pilates lesson and instructor were fantastic! This woman used manual and verbal cues, in gravity-lessened situations, to teach this man body awareness and generate improved mobility and posture. My job, as physical therapist, is to build on this foundation she is creating by teaching him use his body more effectively in weight-bearing situations. Our last PT session focused on simply engaging his R hip extensors during a sit-to-stand activity. In just a few minutes, with one manual and verbal cue, I was able to completely change his physical strategy for standing up; he couldn't believe how much easier it was to move his body. He was no longer struggling just to stand up.

lesson #2: One-on-one instruction and time to reinforce new motor patterns are critical for many patients, if one is to truly move better and regain physical health and performance.

Between the Pilates lessons and my sessions, this guy is getting FOUR hours plus of instruction per week. I do not apply any modalities and he is under my watch the entire session; he never has to "ride the bike" or go off in a corner by himself to do his therapeutic exercise because I am juggling other patients. He experienced this in two other PT stints and refused to return after realizing his care was being compromised.

Why can this guy get individual attention? Because he and we (Pilates and PT provider) do not have to depend on third party payment. He is paying for our services out of his own pocket. Sound radical? It really isn't. It is just a matter of changing your attitude toward your health. You truly do get what you pay for.

So here you have an MD, a PT and a Pilates instructor all working in concert, with a very proactive patient, to address his issues. No egos; just communication, care and time. This is how it should work.

No comments: