Tuesday 17 April 2018

Do No Harm - Treatment Intensity And Consent

"This other therapist I saw just beat the crap out of me."

People seldom expect to see an Athletic Therapist, physiotherapist, RMT, or chiropractor without experiencing some level of discomfort during the treatment. After all, we, as the clinicians, are applying manual pressure into your body to exert some kind of physiological change. Things could get tender!

However, I hear, time and time again, stories of individuals who see practitioners that seem to have a particular level of sadism for making their treatments as excruciating as possible.

As I've covered before, pain tolerance is a very individualized factor when it comes to any treatment. Some people will be able to handle more pressure and discomfort than others, and as a result, those few may actually require a more intense treatment in order to attain the desired desensitization effect from it.

Inversely, if someone has a much lower tolerance to pain, they do not need to - nor should they - receive any treatment method that is more intense than they can handle. Remember, any therapeutic treatment is targeting the nervous system only, rather than causing any true physical change to the tissue. That being said, a client should only need to be taken to their personal threshold for the intensity of a technique to have an effect. What's more, exceeding that threshold may actually result in heightening that person's pain sensitivity.

With that in mind, I cringe when I see these photos - from both clients and clinicians - who are proudly showing off their treatment bruises. "More pain, more gain," is not a principle that applies to healthcare, and taking these extremes is unnecessary at the best and damaging at the worst!

In my view, these mistakes are being made both intentionally and unintentionally. While even the professionals may be prone to forgetting that higher intensity may not be necessary, there are definitely those cases out there where the clinician is trying to use that "more pain, more gain" belief as a placebo or a means of creating some sort of dependency for return-visits. (What can I say? Workers with shady ethics can be found in every field.)

So as a message to other clinicians, be mindful of your treatment and make sure to follow the first rule of your field by doing no harm! To clients, you have a right to tell your therapist to ease off, and if they're too insistent that, no, they need to go that hard, then you also have the right to leave their office. No one has a right to cause you pain without your consent.


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