Keep Your Hands to Yourself

What happens when a practitioner places their hands on a client or patient in a purely professional manner? Just like anything else, it depends on your perspective AND the expectations of your client or patient. A chiropractor is likely to respond that that is the only way they can perform an adjustment. A cardiologist may say that she has no need to touch the patient. Exercise professionals may say that it helps facilitate what they are doing with their clients.

The power of the human touch cannot be underestimated. To the client/patient it may bring a sense of connection with you, confidence in your ability and reassurance. The opposite may be experienced by the patient whose doctor provides a diagnosis only through oral communication and visual observation and never touches the patient.

I believe that some good and some bad come from the hands on approach. The chiropractors, physical therapists and massage therapists clearly have a need to contact their patients with their hands to practice their disciplines. The hands are used as both an assessment tool and to deliver an intervention. The accuracy of a skilled practitioner is used for reducing joint subluxations, mobilizing joints and relaxing and manipulating soft tissue. All of which have been scientifically proven to be beneficial to the patient.

The exercise professional may need to place their hands on the client for assessment purposes such as measuring body composition or pelvic landmarks. Some trainers will also use their hands to provide manual resistance for certain exercises and over-pressure to aid in flexibility. And at times, the hands are placed on the client to guide them through desired movement patterns.

With so much to gain how can there be a downside? What if the question was not what was provided to the patient with contact but instead, what is the patient being deprived of? And this question can completely change our perspective on the “hands on” approach to care.
hands on therapy
Whatever is provided to the patient/client by the practitioner removes the need for the patient/client to do it themself. We obviously don’t want people going around adjusting or attempting to adjust their own necks or manipulating their own gleno-humeral joints. We do want an attitude and belief system that ALL practitioners are simply adjuncts to the individual’s own abilities. We are facilitators.

Could chiropractic care and manual therapy create learned helplessness? Do clinics relying predominantly on passive modalities like ultrasound and electrical stimulation fool the patient (and themselves) that the modality is making them better? Is a client psychologically and emotionally dependent on the trainer if she refuses to work out unless the trainer takes her through a workout?

If I ask a client what he does regularly for his health and he tells me chiropractic care, I respond by telling him that is what the chiropractor is doing for his health care. I then ask again, “What are YOU doing?”

Could this kind of learned helplessness and dependency even be contributing to the obesity epidemic? It may not be that big of a leap from the dependent patient to the obese individual. If my healthcare consists solely of people doing something to me, how can I be expected to eat right and exercise on my own? The psychosocial behavior of anyone who is not responsible or response-able for their own musculoskeletal health will ultimately suffer from comorbidities.
This certainly is not a knock on any kind of manual care. I’ve personally benefitted from chiropractic care, manual physical therapy, acupuncture and Structural Integration. Of course I also have a specific corrective exercise strategy I follow along with my general fitness routine.

I believe one of the greatest gifts we give our corrective exercise clients at Function First is the ability to produce the same result at home that we produce with them in our facility. That is why we only need to see our clients once a week. They are expected to continue with their home program daily. If they don’t do their homework-they are fired. This is an expectation of all our clients before they begin with us for a corrective exercise program.

For this reason, the referral from me to a chiropractor is much easier than the referral from the chiropractor to Function First. Our clients are already engaged in a comprehensive corrective exercise program. The chiropractic or other manual care is an adjunct to the exercises and can often help us expedite the results.

A referral to Function First often requires a complete paradigm shift for the person referred to us. They now have to go to work on themselves. And quite frankly, many long-term recipients of manual care just aren’t willing to do that.

We might say people are lazy and don’t want to do the work. Or, can we say that people have been conditioned that they don’t need to do the work?

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2 Responses to “Keep Your Hands to Yourself”

  1. Aloha,
    It is interesting and I have been dealing with this issue also for a long time. To answer your question, I think both…people are conditioned to think they don’t need to do the work, and some are lazy and don’t want to do the work. I do massage therapy, hypnotherapy and PT and I have more massage therapy patients who are lazy than training clients that are lazy when it come to moving their body for themselves.
    There are sometimes very wealthy clients I have who really think that getting a massage is exercise…they wouldn’t be caught dead working out…maybe a status symbol of having made it, perhaps?
    I figure at least they are doing something, rather than taking pills they get a massage or they go to the chiropractor. I think getting them to take control is not such a matter of””will power”, but of “want power”. Some just don’t really want it that bad. I fire them too. 🙂 Mahalo CLaudia

  2. Doing the simple, good things in life isn’t always easy. In some areas of our lives we are quite self-motivated and our behaviors are consistent and effective. In other areas, perhaps not.

    For many otherwise successful people, fitness is an area where they don’t function well. In that case, they may benefit from some personal help. People can do better with guidance, structure, and personal support.

    Every successful business knows this and that’s where employee management comes in to play. Some people can be mentored into self-sufficiency. Others may, in reality, actually need continued coaching or support from another person – for life!

    We have created personal training “programs” where we provide much of the support many people need, but not only the limiting, traditional one-to-one approach. With creative, hybrid programs we can lower the cost, get people to put the program into their monthly budget, and try to find just the right amount of support they need to be successful, no more, no less.

    Until we can find the way to make certain people fully self-sufficient, this is the best and most reasonable approach we have found.

    Randy Bengtsson, M.A.

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