Why most patients fail to complete their rehab

Why most patients fail to complete their rehab

Patients recovering from shoulder injury or surgery will be given a range of physiotherapy exercises to get their shoulders back to full functioning. While the exercises given will vary depending on the particular injury or surgery, the goal is the same – to get you back to doing your daily activities easily and without pain. Unfortunately, up to 70% of patients fail to complete their rehab plans [3]. 

Some patients report that, once they have enough range of motion to complete all of their daily activities, there is little incentive to carry on with tedious rehab exercises. We all have busy lives, with numerous work, family and life commitments. If you struggle to lift your arm enough to get your shirt on in the morning, then you will easily remember to do your exercises. However, once you can use your shoulder without thinking about it, maybe you start to forget your daily exercise program. Or maybe your exercise plan simply starts to slip down the priority list. Getting to the office 5 minutes early to clear your inbox or even playing with your child for 10 minutes before dashing off to catch the train might seem more important.

Consequences of not completing your rehabilitation

However, failing to complete your rehabilitation can have a lasting impact. For example, if you are recovering from a frozen shoulder, you will likely struggle to regain your full range of external rotation. Let’s say you have been diligently doing your rehab exercises, and now have about 70% of your range of external rotation compared with your other arm. With this amount of movement, and with the pain mostly gone, you can generally do everything you need to do in life. However, because of the remaining stiffness, you often have to compensate for your movement patterns. You might end up regularly twisting your back to make up for the fact that your shoulder won’t go any further. Eventually, you could end up with back pain from the repetitive, unnatural movement.

Mental health and social impacts of not fully recovering

Furthermore, it’s not just your physical health that suffers from chronic shoulder problems. Mental health can also quickly suffer when shoulder stiffness sets in. Consider this scenario – imagine you attend a badminton club twice weekly. This helps you stay fit, but your badminton partners are also good friends. You all have busy work schedules, so your bi-weekly matches are your time to socialise. Unfortunately, you were forced to take a break from badminton due to a frozen shoulder. A few months later, you have been progressing well with your shoulder rehabilitation, but you still struggle to get enough strength and range of motion to use the racquet. You continually have to delay your return to your matches, and eventually have to cancel your badminton membership. This means you no longer have that bi-weekly time with your friends. Sure, they do their best to keep in touch, but with your busy work schedules, you no longer have the opportunity for meaningful contact. We all know that friendships are vital for our mental well-being, so you can now see how easily losing your shoulder range of motion can leave your mental health suffering.

How measuring your range of motion can help you stick to your rehab plan and reach your goals

One of the main reasons patients fail to stick with their physiotherapy exercises is that progress is too slow. Your therapist may tell you that your shoulder is moving better, but if you can’t see or feel any improvement for yourself, you will probably start to feel discouraged. You may even feel that the exercises are not working. Also, as previously discussed, you might start to feel that the time spent on rehab is no longer worthwhile.

Regularly measuring your range of motion is an incredibly simple but effective way to visualise your improvements. When you can see small improvements each week, then you know you are on the right track.

Of course, there are many factors that will contribute to the success of your shoulder rehabilitation, but as you can see, regularly monitoring your range of motion is a vital part of the journey. If you are consistent with your rehabilitation plan, but are not identifying any increased range, you will know that a new course of action is needed. However, if you are regularly seeing improvements, then use this data to help encourage you to continue your rehab, even if it seems boring!

 

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References:
  1. Correlates of compliance in physical therapy –  https://pubmed.ncbi.nlm.nih.gov/8234458/

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