If you stop and listen when you are in the clinic today, what phrases do you hear?
Through the various sounds bouncing off the clinic walls, I am sure some phrases will stick out to you. Here are a few that I have heard in my time as a clinician that I feel need to stop.
“Squeeze your Glutes”
This is often times used as a verbal cue. Although the PT may be targeting the gluteal muscles for a good reason, I often visualize the patient ambulating of descending stairs. Even though the gluteal muscles may need to fire, the cue “squeeze” just doesn’t seem to fit into true functioning. When was the last time you truly and consistently “squeezed” your gluteal muscles when ambulating or descending stairs. I am all for engaging the gluteal muscles when needed, but let’s pick a better phrase than “squeeze your glutes.”
“If you feel pain, stop.”
As I reflect on my early career, I used this phrase often. The major issue here is that this only contributes to the ‘hurt equals harm’ mindset. If we are using best practice we should empower patients not to be fearful of pain. This phrase misses the mark. If a patient feels pain, we should investigate further – is it getting worse, how intense is it, etc.? We should not just immediately abort the mission. If someone feels pain with an activity, explore and empower.
This is a pet-peeve of mine and I hear this often when PTs are performing manual techniques or passive movements usually in an attempt to make the patient relax so that they can perform said technique. This verbal phrase is usually followed by the therapist wiggling the arm, almost in the same way we might wiggle the cord to the vacuum cleaner when it gets hung up on something. I don’t know about you, but this motion plus a verbal cue of saying RELAX does everything but allow the patient to relax. If the patient is not allowing you to freely move him/her it is probably more about you than the patient. Make sure your manual non-verbals say “I got you” and let that do the talking.
“They are faking their pain.”
All pain is real. This phrase is usually the one that comes after working with a challenging patient, usually one who is suffering from persistent pain and has been passed around the medical system for some time. They are often lacking trust in any healthcare provider and often feel like no one believes them. If your mindset is that the patient is faking their pain, you have not done your job of digging deeper to see what other factors are going on in the patient’s life. As healthcare providers, we should do all we can to treat with empathy and respect – this phrase does little to support that notion.
Of course there are probably more out there that you hear on a daily basis and my phrases are mostly biased to the outpatient setting. My question to you is what phrases do you want to have stop?