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Programming your patients

by David Pope

Talking the talk.


Have you ever wondered if you are giving patients the best explanation possible of how to get better?

“I don’t want you to think about falling over.” What sprang to mind?
“Now, I don’t want you to freak out…” Sounds like you have 24 hours to live…
“I want you to focus on not allowing your shoulder to lift up near your ear as you lift your arm”

What do they all have in common, and how could we improve these? These are all examples of negative language, and I am going to call this negative programming – asking someone not to think about or focus on something.

When asked not to think about falling over, you have to first think about falling over to then “not think about it”. As Physiotherapists, we are often trying to change motor patterns, the way people live in their bodies, so we can help them get over their musculoskeletal problems. This might involve teaching them to use overactive muscles less, have better alignment in their posture or movement, activate their deep stabilisers, or possibly perform an activity totally differently.

If we are focussing our explanation on what the patient is doing “wrong”, we are likely to be reinforcing their current patterns (just like we asked them to think about “not falling off their bike”). What about “You need to stop allowing your chin to stick out (protract)”? Positive or negative?

In the next post we will go more indepth on using “Positive programming” to get even better results with your patients.

Tell me below, what negative programming language have you found yourself using in your clinic, that could be reinforcing your patients current way of doing things?

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