The end goal is not some set destination

So I am a lover of all analogies. I find they work well with my biases, and help me understand things better.

I use them successfully in my clinical practice, so I thought I would try to find one to describe physiotherapy. I think using the words, postural structural biomechanical versus bio psychosocial probably puts a lot of people on the backfoot. Not that people aren't intelligent enough to understand this, but it kind of makes me sound unlike me. I prefer to use words that most people understand. I like to be able to convey myself in a way that people can really connect with me. And sometimes, to be completely honest I don't understand all the sciency words.

My analogy to describe physiotherapy is that of getting on a bus. There's several different ways to go through a physiotherapy process.

🚍 The first one is a bus that goes near your house, stops at your local bus stop, and takes you close to where you want to be, not quite there, but close enough. You paid your set fee. You can go on that bus every day or a couple times a week, and generally, it will get you where you're going, you'll be happy. It doesn't get you everything you want, but It's predictable, and reliable. It's structured, so it is somewhat easy to follow. This is how I think of the postural structural biomechanical model. We see the problem with the muscle, the joint or the movement, and we correct it. And we work hard to correct it through whichever means possible.

🚌 Next step, we have the tour bus. So the tour bus is a little bit different, because it just doesn't just take you from point A to point B, it takes you around to lots of things you might be interested in seeing. There's a guide who explains things to you, and there'll be set stops where you're welcome to get off and discover what's going on around you. Again, this to me is kind of that biopsychosocial model. There's lots of different stops with different things to look at. When you get to each stop, you can go to different places, but again, I don't think it covers the whole process.

🚐 There's a third option. The bus with a driver, who is also your guide, but you get to choose where you go. This to me is this client led encompassing both models type of physiotherapy. So the person wants to go to a certain place, but there's a bunch of other places in between they'd like to go, and they need to go. My job as a guide is to take you there. When you get there to give you the absolute best options possible, to help you discover the world around you. And in the case of physio, what your body is capable of. You might have to stop for lunch. We might have to go in a different direction from time to time, but because this is a customized personal tour, you have complete control. You choose when we start you choose when we stop. The end goal is whatever you want it to be, not some set destination.

This is my analogy for physiotherapy. I feel the way I work is somewhere between a tour bus, and a personalized tour, but I'm not quite there yet.

How am I going to become that personalized tour guide? As I've discussed in previous reflections, I am going to readdress my assessments, I am going to reflect, and I'm going to try something different.

I'm going to try to give as many patients as possible experience before knowledge.

NIcola Robertson

Registered Physiotherapist