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Massage Today
July, 2009, Vol. 09, Issue 07

Including Exercises as Part of a Treatment Plan

By Ben Benjamin, PhD

Question: When you teach a client exercises as part of a treatment plan, how do you ensure that they do them regularly?

Answer: It depends on the client. Each of your clients may be motivated by something different. It's important to remember that people have different learning styles, so an explanation or instruction that works for one person may not work for another. Some people learn visually -- they need to see something on paper or watch you demonstrate what you're talking about. In contrast, auditory learners learn best by hearing what you have to say, and kinesthetic learners need to have a direct experience, either physically or emotionally.

With any client, I tend to give a verbal explanation first. I might say, "Healing while you're doing these exercises means that you'll have a fuller range of movement when the the status of the injury has improved. If you heal without a full range of movement, there's a greater danger that you'll re-injure yourself when you become more active." Then, for a visually oriented client, I might show the person a drawing that illustrates how adhesive scar tissue contributes to re-injury.

Exercise - Copyright – Stock Photo / Register Mark For auditory or kinesthetic learners, I might tell a story about a client who healed more quickly once she started doing the exercises. I'd also have the kinesthetic learner practice the exercise as I explained it. In addition, I often bring up the financial benefits that come from healing more quickly. I explain that doing the exercises will make the treatment process much shorter, saving the client a good deal of money. This is often a strong motivator -- both for relatively wealthy people and for those whose financial situation is less secure.

Some people have a strong desire to do the exercises, but need some support to make that possible. For a person who is not very physically active, doing any kind of exercise daily may feel challenging and unnatural. Establishing a new routine takes a long time. Research has shown that it takes at least a month of doing something every day to create a new habit. I often work together with my clients to develop strategies that will help them take ownership of the exercise process. One client asked me to send her an email reminder every day for a week until she got the hang of it. Another client came up with a unique strategy. He said to his 10-year-old son, "Every time I do these exercises you get 50 cents. If I forget, I don't pay you." His son never forgot to remind him to do the exercises.

Of course, there are some people who will never do their exercises. Don't take it personally. We all have challenges in different areas and can be resistant to doing certain things even though we know they're good for us. For instance, I personally don't like exercising alone or taking vitamins, so I devise strategies to help me. All you can do is be patient and do the best you can to help your clients form healthier habits.

Author note (submitted after this article was published):

I neglected to mention an important fact: In some states, massage therapists are not allowed to teach exercises or stretches to their clients. According to my sources, it is permissible to mention exercises if you do so as a suggestion rather than a prescription. If you would like to offer your clients the option of doing particular exercises that you think might help them, I recommend saying something like "Some people find doing these exercises helpful. You may do them if you wish." Or "Some people recover more quickly when they do exercises like these."

My thanks to the thoughtful reader who brought this issue to my attention.


Click here for more information about Ben Benjamin, PhD.


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