Physiotherapy Case Study
The following case study illustrates how positively influential physiotherapy can be when delivered correctly.
A positive case study from an employee with access to PAM Wellbeing services through their employee occupational health programme
In 2006 the employee started experiencing pain in her right groin, and was informed this was subsequent osteoarthritis. The years passed and she became reliant on medication and walking aids. She reported to having marked restrictions in all activities of daily living.
Employee: “I couldn’t put my own socks on, cut my toenails, tie shoe laces, all things we take for granted.”
Due to the longevity and severity of symptoms a total hip replacement was completed in 2011. Unfortunately, her initial experience with physiotherapy services was less than desirable.
“she showed me how to walk up and down the stairs and gave me a slip of paper which had exercises for me to do at home. I did what I could with the exercise’s, this was left to my own interpretation of how I thought they should be done.”
Unfortunately, her less than desirable experience was not solely from physiotherapy.
“I was also seen by my consultant, he told me to STOP all physio. I was told all I needed to do was walk. In hindsight, I believe this was the worst advice he could have given me, although my walking improved, I could not do any of the things stated above. Even getting in and out of a car I would swivel round on the seat to get in.”
Over the subsequent years her physical limitations started impacting upon her mental health.
“My exercise regime was hardly anything. I gained weight, generally feeling miserable. My confidence level was very very low.”
To compound her health further the left hip became symptomatic in 2017 which resulted in another total hip replacement. As before, the treatment received was of little benefit.
“I was given an exercise sheet to follow at home, again I interpreted how I should do the exercises. I waited several weeks for a physio apt, I called the hospital and they told me that they had forgotten about me. A few more weeks went by and I was finally seen by the physio at my local hospital. This I can only describe as a total waste of time, he was ready to discharge me at week 2. I told him I couldn’t and didn’t know how to even kneel, he said why do you need to do that. I lost faith in the NHS physio team and I tried to do the best I could at home.”
Despite on-going issues, she returned to work on reduced hours in September 2017 and by December was back full time.
“This has been a nightmare, sitting down has been painful, getting up from the chair my hip and back have been hurting. Still feeling low and just didn’t really know how to change my life around.”
It was subsequent to the reported discomfort at work that this individual was referred to PAM OH. Initially via PHIL, then for a WSA. Following the WSA it was deemed appropriate that current treatment had not been sufficient and that improvements could be made with the right input.
“I met Matt through a works referral and I feel my life has been turned around. Matt has shown me how to do exercises, he gave me the instruction, he showed me by doing it himself, then together. He told me the reason for the exercise and what it does for the body. He explained that Quality is better than quantity, quantity can follow. I have followed a regime of physio and I feel great. Every morning without fail I do exercise’s and finish the rest in the evening. I walk my dog for longer periods, swim. I have lost 22Llbs.
I have recently knelt down for the first time in years, I get into my car like most people do, I don’t need to swivel around. I actually knelt down over the weekend and managed to put my own socks on without using the sock aid that I have used for 10 years. I can now, to my husband’s relief cut my own toenails. I feel so much happier in myself, I feel a confidence that I haven’t felt for many years.
I don’t want this feeling to stop, so I am determined to continue with what Matt has shown me, I get great pleasure when I can do something that I haven’t done for many years.”
If we consider the perceived lack of guidance and reassurance from health care professionals we have individuals deemed to be in hierarchical positions, who from the patient’s perspective were expressing negative connotations regarding their condition.
Darlow’s research details that patients who receive what are deemed as negative expectations often view new episodes of pain as recurrences of the previous problems. It easy to see how this can easily result in a potential vicious cycle of chronic pain and physical de-conditioning.
Finally, this employee did not receive ground breaking treatment. What she did receive basic and had she received this attention earlier on she may have avoided years of physical and mental distress. Physiotherapy doesn’t have to be complicated, this case is the perfect example of what can easily be done with the appropriate input.