Why You're Not Learning Anything New at Therapy

Welcome to the Performance Place Sports Care podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey guys, thanks for joining me again. Again, it's Sebastian Gonzales. That's Dr. Sebastian Gonzales with Performance Place Sports Care. In case you guys don't know, I'm right here in Huntington Beach. That is in Southern California. If you're local here, and you've been listening to the podcast, I'd love to meet any listeners. Just reach out to me, and if I have time, I'll definitely have a cup of coffee with you. I love to brainstorm and meet people, so just go ahead and reach out to me, info at p2sportscare.com, and set something up.

So, today's is about, I was looking through YouTube on some stuff, and I browsed a couple comments from someone else's video, and I saw this, and the, actually the topic, or the, the video really isn't too important, but the, the channel it was on, in case you guys want to see them, they're actually pretty good. It was physical therapy videos, it's their channel. They're actually, they're really good. They have some great stuff. They spend, it's two guys spending some time, and just explaining rehab, and the reason for rehab to people. So, there was a comment below their video, which, it said, I learned more in 10 minutes from you guys than 10 weeks of therapy. Thank you.

And it was really, really nice of the person to say, but then I questioned what happened in their therapy, and they didn't really elaborate too much into it, but most people in healthcare, like are, like a lot of them are pretty good, and I'm not going to vouch for everybody, just because there's bad, and great, and mediocre in any profession, and it goes for plumbers, and CPAs, and so on. And so there, I don't want to vouch for everybody, but for the most part, I think patients need to realize that, or you guys need to realize that communication is really key, and I've actually started this, this year of trying to communicate better with my patients, and not that I didn't care to communicate well before, I just didn't realize what I was lacking in, because some of the terms that I use are ones that you guys aren't familiar with.

So it might take like four or five times for, you don't understand a concept, but really I want it to be, we start building on your knowledge, and understanding why your condition happens, you know, as time goes on. So I guess, I was just kind of brainstorming this comment, and trying to figure out, you know, what are the possibilities of things that have happened in this case, and why this guy has such a bad experience in his 10 weeks of therapy. And also, side note too, I have met, I have met a lot of patients that were disgruntled about their time in another sports injury clinic, or, and I'm not naming names of anybody because it's really not that important, but the fact of the matter is that they were very frustrated about time that was spent with them, or lack of understanding, or lack of showing proper exercises.

And they just had, they just, they just felt like they either weren't heard, or they felt like they didn't understand what was going on. So overall, I feel like to sum it up, they felt like they had a loss of control, because I think that's a big issue with healthcare. It's, I mean, anatomy and, and the body, I mean, it is, it's another language, it's, it's Latin based, you know, so a lot of people won't understand it. So there's two sides of the coin here, you know, like, is the, did the patient ask questions? Or did the healthcare provider not offer any information? Was the patient not listening?

Did the healthcare provider just not take any time? So either way, there has to be desire on both sides. Just like a relationship, like, you know, you can't go to, you know, meet someone the first time, expect for one person to do all the talking, the other one just listens. You have to, you have to, it has to be a give and take. It has to be a give and take to, you know, understand each other's position, or to understand more about the topic at hand, or just to even, like, understand each other's intentions. Because I know some people feel like their doctors just don't care, and that might not be it at all.

Maybe they're just rushed. Maybe they're having a bad day. Maybe they, you know, it's, their intention probably wasn't bad at all. It's just, they came off that way. So I think to have better communication is the thing that will get rid of this miscommunication on that part anyway. So also, too, I thought I'd bring another possibility up is that maybe their, maybe their therapist didn't have time. And I know it's not like a big, or it's not a big reason why they should not have explained. But this is really, really how things go now in places that are a lot of times insurance-based and so on that, I mean, they have to get to eat new people.

Sometimes insurance clinics, actually, I have some friends that they work with insurance that they, I mean, I saw one guy get a check for, seriously, I'm not even lying. He got a check for two, like two or three cents. I had another colleague who got a check for, I think it was like $5 to see someone for like 30 minutes. So just thinking about that, I mean, it's what if they saw four people an hour, which I guess would be hard if they had to do it for 30 minutes. But I mean, they'd be making, so two patients in an hour, $5 each plus a copay. I mean, they're not making a lot. And you might be thinking, well, they're making more than I am, but they actually have student loans, too.

I mean, they have student loans to pay off. I mean, I got out of school owing, you know, well over $100,000. And some of my friends, they owed a quarter million dollars. So, I mean, you're broke for a long time, and you got to make a living. And so I understand if the guy was busy, or I don't want to say PT because I don't know who it was, if the doctor or therapist was busy, it could have been a reason that they were being pressed to see more people. And in that case, I'm not blaming the guy. I'm blaming the system. I think that there should be more time spent with patients when they actually need it.

But it'd be nice to get the repayment to live, to pay off your student loans, to, you know, take your wife on vacation or whatever it is, you know. So a lot of times, they don't get that when they work in an insurance world. So next is, did the patient really understand what was being explained? And I know that I'm really trying to take this by the reins when I see a patient now. And I actually started an intro course with my patients where I'm giving them access to podcasts such as this that are categorized based upon the injury they have. Also, too, there's a start here section where the common questions they're going to ask me are on there.

You know, how long will this take? What's it going to feel like? How much does it cost? Can I do some at home? Things of that nature, you know. And I want to make sure that the time that they're there is time best spent letting them understand their condition. So I don't want to let things fall through the cracks either, but I want to make sure that they can access their information. Because I know it's going to seem like a cop-out where, you know, I put it online and let them listen kind of, you know, to a podcast or a video or so on. But honestly, a lot of things or a lot of new patient encounters that I have, a lot of them have the same questions.

And I end up saying the same answer over and over again. And not to say that I won't do it, but, you know, I think it's better to work smarter, not harder. And if I'm going to spend some time with a person, I would rather them learn some of that basic stuff through an automated format. And if they have secondary level questions, I mean, I'll gladly answer them. I'd love to answer them. But going through and say we have a shoulder case, like it's to really understand a shoulder case, you have to stand the shoulder blade, the muscles around it, centralization of the head. You have to understand, you know, winging and flare of the scapula, how the trunk correlates to it and so on.

And I know I just blew through a lot of stuff, but really, that's really fundamental stuff. And it's, you know, it's anatomy and biomechanics. And that's, I want to make sure that there's a, you know, really basic anatomy and biomechanics course online, which is why I put them up there. So there's a possibility that, you know, this clinic didn't have all those types of systems in place, you know, to establish, you know, the communication barrier between anatomy and biomechanics. And maybe the doc, maybe the guy was using Dr. Lingo that you guys didn't understand. Maybe he slurred his words. Maybe he didn't speak clearly.

I know I've been, you know, blamed to that quite a few times. So by the way, I really hope I'm cleaning up any slurring words that I, I tend to slur my words a lot. And I'm really hoping on the podcast that I'm not doing that. So if you guys hear it, just let me know and I will speak slower and make sure that you guys hear it. So, you know, this kind of reminds me of actually, I went and spoke with a local baseball team. It's actually the team that I played on in high school. So I was educating them about, you know, shoulder conditions or mainly rotator cuff tears. And because I was alerted by, you know, some of the coaches that, hey, these kids are coming back from, you know, summer, summer programs with shoulder injuries.

And, you know, they're only 16 to 17 years old, sometimes 15, you know, they shouldn't be having shoulder conditions. And so I went and talked to them about it. I hadn't raised their hands of, you know, of who's actually looked up or at first I said, hey, who's having an injury right now? And I'd say probably about, you know, five to six people like raised their hands. So I said, okay, next, who's actually looked online to see what it is? And probably about half of them raised their hand. I'm like, you know, have you guys, you know, did you look up how to rehab it? Did you look up educational pieces on it?

Did you look up anatomy? You know, so they gave me like sporadic answers. So I pinned down the ones who said, who didn't raise their hand the second time. And I said, you know, why? You, you know, you, I pointed at this kid. I'm like, hey, you, why, why didn't you look up anything about your, your butcher injury? And he didn't really have a response in it. And I was like, I'm going to be straight with you guys. You know, like everything that I know is probably on the internet somewhere. You know, all this stuff that I'm showing you guys, because I showed them, you know, Oasis Green, I showed them, uh, some exercises and warms they can do.

Like all this stuff is on the internet. Like, I'm not going to say I'm not revolutionary on anything. Hopefully I am. I don't know if I am, but, um, you know, a lot of the stuff is just recategorized, repackaged. It's information that's, that's out there public. You can find a lot of it on Google Scholar and other types of articles or podcasts such as this. So why have you not looked anything up? You know, you should at the very least invest a little bit of time in your own injury. So I'm like, why didn't you do it? Again, being straight with the kid, I just told him like most of the time it's because you're too busy doing other things or you really don't care enough.

And I'm sure there's other reasons too, but I mean, for the amount of capabilities that kids have now, I mean, shoot, by the, by the time you're like one, you can swipe on an iPhone and like, you know, find YouTube or surprise eggs or something like that. You know, like there's, there's, you have capabilities of finding things probably more so than, than parents do. Um, why not find it and at least look up and be interested in your own body? Cause that's a huge part. And the reason I bring this up is because although this person said they didn't learn anything in the 10 weeks of rehab, they obviously went online and learned something from these guys and you know, it's out there.

And I bet if he looked, watched this video and went into rehab after, or he was currently in rehab, he'd be so much more invested in his rehab with therapy, probably so much more because he'll, he'll be asking great questions, really great questions. Um, I haven't seen too many bad, uh, references online of different things to try for injuries. I mean, granted, they might not be the most current or up to date. I've seen some really old stuff out there, but you know, they, they worked for years in the past. And although over the last few years, like people have been talking about like movement patterns and you know, things of that nature.

And, uh, there, there's less, there's less weight on the old stuff. I still think there's some merit to them. I mean, we used to use them. People got better, you know, the new flashy, like, uh, you know, quarter or the new flashy toys, like, yeah, they're, they're cool and all, but you know, the old stuff does work too. So, um, all this information, a lot of it is on the web again, like some of the new stuff you'll, it'll be, you'll be struggling to find. And a lot of stuff does need to be coached, um, the newer stuff or the more complex stuff, but it doesn't mean you can't look and at least kind of get some basic information on it.

So I guess to follow up or to finish on this, like, I would just say, you know, you got to trust your doc, trust your therapist and have some good rapport with them. Um, because if you're intimidated or, you know, you are, you don't, or you're scared to ask questions or whatever it is, like that's on you, you know, like it's, if you don't understand something or you want to know something, ask, you know, perhaps even the, the PTA or the physical therapy aid might know the answer to that question. Front desk might know the answer to that question. Shoot. If you Google it, you'll probably find me talking about that same question.

So I think there's a reason for people to urge for patients to take, uh, they need to take some responsibility over their care and to do that. They need to make sure that they're self-educating at least to some degree. Um, and I don't know if you guys have, if you listened to some prior podcasts, I've spoken about our online courses. Um, I really tried to include, you know, educational pieces in there. And I talked to one of my friends who was, uh, he's, he's helping me out with the course, at least improving like the user experience. You know, he's like, he's like, I think you need to have reminders for people to do, you know, the exercises and stuff.

And I'm like, why? And he's like, well, because, you know, they'll forget. And I'm like, well, no. I'm like, if they understood the reason for it better, they understood the anatomy and the mechanics. And what happens if they don't do the rehab or what happens if this thing carries on for five to 10 years? What happens then almost quote unquote scare tactic, they'll want to do it. And they won't forget. I'm like, I think everybody now knows that, you know, you should eat your fruits and vegetables and eat clean foods and don't eat a bunch of like candy and so on. But everyone does it or a lot of people do it.

So reminding them kind of like a mother doesn't always work. So anyways, I include educational pieces in my courses as well as the rehab exercises and so on. Um, I really, really hope it goes extremely well. And I, I see this as how healthcare will be going. Um, there will never be a substitute for going in and seeing a doctor and, um, seeing a therapist and being coached through something because like I, I've definitely seen over the, over my years of teaching, um, squatting and deadlifting. I think I've only seen like two people come in with ever seen a legit, perfect deadlift. Most of the time you need, they need correction at least a couple of times, um, to make it safe and effective for them.

And the same thing goes for rehab exercise. You need to often be coached through it, but the learning curve is so much quicker if you've already known what you're, what's expected of you. So if you haven't checked out our courses yet, um, currently, uh, since we're doing a website redesign, they are on, there should be a link on p2sportscare.com. You'll find it. I'll make it very easy to find. Um, and also our other website is performance place HB. That's ideally where the courses are going to go over the longterm. Um, but we've been really tinkering with that side a bit. So I don't know if it'll be live when this podcast goes live, but the p2 sports gear site is the one where I, I mean, that one's always live because it's my main business.

It's my clinics website and so on. Um, I, that's where I put the best, best information, at least in text form and all the best, best, best stuff is going on the courses. Um, so, uh, hope this was helpful to you guys. And if you have a question for me directly on what you want to hear about in these podcasts, um, go on to p2sportscare.com and there should be a click button. So you can just leave a voicemail straight through your computer or your phone. So you don't have to call my office or anything like that or write me an email. Just, just get right to it. Just give me as much detail as you can.

Give me something to go on and, uh, I'll try to answer it the best I can. So, um, remember if you have an injury, you should really, really go see a doctor. There's no substitute for seeing someone and getting a correct diagnosis. I'll talk to you guys soon and hopefully you have a good day.