Developing Mental Toughness
Here are a couple of case study vignettes. This is what gets me out of bed in the morning. I would be interested in what you thought about this aspect of your practice.
Last week I was referred 2 very different people, yet both were on struggle street with their injuries and perceived futures. One was a younger person that significant foot, tibia and knee injuries due to a mechanical accident. After 18 months of surgeries (foot reconstruction, tibial fixation - internal and external, skin flaps and grafts, ACL cleanup) he presented on two crutches, not wearing a shoe, foot NWB and pretty much blue and sweaty. He had constant pain, was online gaming pretty much all day, went to bed around 2-3 am (still gaming) and got up at noon. He didn't sleep well, ate minimally and lived with a family that was not his own. He had completely exhausted all his WC medical benefits ($150K). He had been referred six weeks prior
The other person was an older female shearer that had
How would you assist these people? Do you think we have an intervention role at this stage, or should we send them off for 'psychological' management before commencing 'physical' management? My experience is that following an appropriate screening examination, we can provide these people with practical guidelines and develop a plan going forward. Providing clear direction, education and physical boundaries relax their minds, opens up positive opportunities and invariably there are significant physical and correspondingly psychological gains over the next few weeks.
Key issues for the young man, from my perspective, were lack/fear of weight bearing, poor sleep routine & hygiene, lack of self-worth. We discussed the benefits of making some changes and how this could occur. After a week, he is weight bearing walking with one crutch (and two shoes), completing a range of WB exercises, and on an exercise bike for 15 -20 minutes daily. He is using a combination of breathing exercises and CBT, to wind back his bedtime and his sleep latency has gone from over an hour to 20 minutes (normal). He sleeps soundly, wakes still later than ideal, but is working on developing a regular waking time and is refreshed. His foot is pink, with minimal pain and nil sweating. I have suggested he contribute to mealtime preparations and eat at the kitchen table with the family instead of the sofa (said this was always necessary to elevate his now non-painful foot) to increase social interaction and +ve feeling from contribution to others. He is positive about the changes he has made and the effect this is having on his leg.
I explained to the lady that her neurological and isometric testing was normal, so the
I feel very privileged to have been given the skills to assist these people to move from a place of confusion and darkness towards one in which they smile and again enjoy the life that is around them to be lived. I find it fascinating how structure, exercise, support and education, can assist people to overcome some significant problems.
I have included a pic of awesome list of attributes, commonly found in mentally resilience people and encourage you to share and foster these with your clients. If you would like to share your thoughts or other strategies to develop resilience in our clients please do in the comments or on our FB page.