by: Torin Berge, PT, PRC
As you may or may not know I have 5 kids, and as they get older, they get more independent and rely on me less and less for everyday things. It’s awesome, even though they still need my money! One step at a time, I guess. Recently our middle child has started being able to make dinner for us, though the menu of things he feels comfortable cooking is fairly limited. He does make a decently good box of mac and cheese though (as good as boxed mac and cheese can get anyway).
So as Bailey is learning to make his “gourmet” mac and cheese he follows the recipe on the box. Get your ingredients lined up… 6 cups of water, ¼ cup milk, ¼ cup margarine or butter. Step one: Boil 6 cups of water… So, of course Bailey measures out exactly 6 cups of water and starts to boil it for his Mac and Cheese… And that’s when it hit me. Why in the world does it need to be 6 Cups of water? Isn’t that overkill? Who measures 6 cups of water to make Mac and Cheese? As long as you have enough water so the macaroni can boil and expand that’s fine, right? Of course.
Well, obviously the point of the recipe is to ensure you can make a consistent meal. They know if you follow the recipe (as long as it has the correct steps) you will have a specific desirable outcome of mac and cheese. Now that’s not the only way to make mac and cheese (thank goodness). My kids like it a little creamier so I use a little less milk and a little more butter, and they like hotdogs cut up in it so I add that step if we have hotdogs. We’ve tried with a little hot sauce, or buffalo flavored chicken. Some people like veggies in their mac and cheese (gross…). Whatever tastes good to you Do it. However, you still need the main ingredients (Water to boil the mac, cheese, milk, butter etc.) for it to be mac and cheese.
Now what does this have to do with being a better PRI therapist or patient?
Have you seen our exercise handouts?
They look like very involved recipes. There are lots of ingredients (muscles and body parts to feel), lots of steps in a specific order, with the intention of getting a desired outcome (meal). Some are more involved than others. Some have lots of ingredients and steps, some don’t. Take for example one of our most “notorious” exercises: the 90/90 hip lift with balloon. There are 11 (!) steps written for that recipe… I mean exercise. 11 steps just to lie on your back and blow up a balloon? Yep 11.
This is a great exercise because it has so many great ingredients and it can be used for so many reasons/outcomes. That’s why there are 11 steps.
A novice PRI PT (or patient) will follow that recipe to the letter; and we know if you do it exactly as written we will get the outcome we want. But the better you get at teaching that exercise (cooking) and the more you know what your patient needs to get out of the exercise (what tastes good to them) the more creative you can be with your cooking. You can emphasize, (“hold that pause after the exhale a little longer”) or de-emphasize (“don’t worry about the placement of your tongue for now”) certain ingredients or steps if your patient doesn’t need them. Add ingredients (shift your hips, reach an arm, look to the left with your eyeballs etc.) if that makes the meal taste a little better. Don’t forget the main ingredients, otherwise you won’t have mac and cheese, but you can be creative.
As a patient, read the steps, know the ingredients, but make sure you aren’t getting stuck at step one because you don’t know how to measure exactly 6 cups of water. Ask your therapist what the main ingredients are and what makes the exercise taste better or worse depending on what you need. I see too many patients that have gotten caught up in the overwhelming details of an exercise (like using exactly 6 cups of water or ¼ teaspoon of salt) that they miss out on a great meal.
So next time you read a PRI recipe remember the mac and cheese box. The recipe will definitely give you a meal, but its not the only way to get mac and cheese.
Questions? Leave a comment!