Athletic Therapy, Chronic Pain, Equestrian, Posture, Weight Loss, Wellness

On Expectations

“When will I be better?” 

“Why haven’t I made any progress?” 

“What can I do to speed this process up?” 

Part of my job as a clinician and a trainer/health coach is to help my client’s set reasonable expectations. However, I struggle sometimes with answering the “how long” and “why me” questions. Honestly, there isn’t always a clear answer. 

Yes, there is the textbook answers like.. a sprain, depending on severity will take anywhere from 2-6 weeks to heal, a fracture will take 6-12 weeks, a surgery incision will take 6-8weeks to heal, nerve damage can take years, and a muscle strain will take 4-6weeks. But, from real life experience, these are pretty darn generic time frames. 

Those time frames don’t cover things like non-specific back pain, tendinitis, chronic pain conditions, or how long it should take to improve other health factors like stress, blood pressure, blood sugar, cholesterol, etc etc. 

Those textbook phrases also don’t take into consideration life in the real world. A world that is chaotic, full of surprises, strapped into a never ending roller coaster that we aren’t usually in full control of. 

With all that considered, answering the how long, what if, when can I interrogation gets a little trickier from my end. I want my clients and patients to be set up for success, not frustration. Giving a general time frame can be helpful in setting goals, but not so helpful if the personality type takes it and sets it on a pedestal. 

When it comes to personal training, the golden standard in expectations is that in 4 weeks you personally should start feeling different in your clothes, in your mood and energy, and in other little things day to day. By 6 weeks you should visibly see yourself in a different light, maybe a different pant size, or catching yourself in the mirror and noticing small changes, and within 8 weeks you should notice other people noticing. This is what they taught us in school, anyway. That time frame generally does ring true, but at the same time that is a true fact when conditions are perfect. I always recommend being on a regular, guided program for at least 3 months to get a true sense of if a program is working or not. 

When it comes to rehabilitation and pain relief, honestly- anything those. I’ve had the most textbook cases throw surprises and end up taking much longer then expected to clear up or improve- and I”ve also had very complex cases surprise me with almost miraculous improvements in a short time frame. Pain in itself is a very complex thing, and factors in pieces from every other part of our life. 

So. What do I say when I have someone needing a time frame? I always phrase it with a “there is no guarantee of anything, but optimistically I am hoping for…. *insert pre-formed time frame based on the case, goals, and needs”. So really, I am saying I’m not sure but let’s see what happens. 

As a practitioner and a trainer, I want to see my clients having some sort of reaction to whatever I”m implementing into their program. Whether that’s small and steady improvements, the body throwing new curve balls as a reaction to a change in routine, one injury going away to reveal a bigger underlying problem, body changes, mood changes, energy changes, etc etc. Any change is often a sign of progress. That’s the other reason I don’t love the idea of setting a golden standard time frame for anything- one thing improved or modified often reveals something else under the surface. Many of the cases I take are cases that have levels of complexity hidden. 

My expectations change every time I see a patient week to week or session to session. Your progress from session to session is always occurring, if it wasn’t.. if there wasn’t some sort of change.. I would know I’m on the wrong track. Then it’s up to me to change my plan, or refer to you to a better resource or do more research for you. I want my client’s to expect that they are going to get somewhere, and they are going to reach their goals. I hesitate on asking them to form set timelines- as in my experience it only leads to negative stressors down the road. Setting reachable goals is of course paradigm in all health endeavours, and I strive to motivate each client in whatever way works for them- but reachable goals is also a very adaptable term. Our bodies generally tell us when we’re on the right track, or if we’re just beating a dead horse. Sometimes the horse slows down because it’s being pushed too hard, or concentrated on too much It’s my job to keep that horse alive, paced appropriately and encourage it forward. 

All this being said, you as a client/patient have a reasonable right to question any practitioner on exactly these things. How long do you expect to have me in care? How often will I need to come? How often will I need to come that often? I don’t feel like I”m making any progress, why? I know when my patients ask these types of questions that they are just looking for their own way to make sense of the process, and I respect that. If a practioner doesn’t take kindly to these questions, they might not be the right person to get you where you need to go- horse intact. 

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