Now You’re Really Pushing It

| SC, USA | Right | December 7, 2016

(I’m a physical therapist assistant and am finishing up my last clinical rotation. I’m treating a patient with a shoulder repair that follows the same protocols as a rotator cuff repair. He’s recently progressed to active assistive range of motion but per doctor’s orders is not allowed to take off his sling nor allowed to do active range of motion. This particular treatment session he reports that he is in a lot of pain, so I go through the usual questions to figure out what’s up.)

Me: “Have you done anything new?”

Patient: “No, I’ve been doing my usual routine.”

Me: “Have you been following the home exercise plan the way we taught you to?”

Patient: “Yes. I do my arm swings and my push-ups.”

Me: “PUSH-UPS?! [Instructor], could you come over and listen to this. [Patient], could you repeat what you said?”

Patient: “Yep. I’ve been doing my arm swings and push-ups everyday.”

Clinical Instructor: “What?! Do you mean your step-backs?”

Patient: “Well, yeah. But when I come back up I do a push-up. It’s only from the table.”

Clinical Instructor: “When have we ever told you to do push-ups? What made you think to do that?!”

Patient: “It just felt like the right thing to do.”

(I also found out the patient had been doing active range of motion at home, standing up, because his reasoning was that it would speed up the healing process. Thankfully it didn’t seem like there was any permanent damage or re-tears from this. We corrected him and he (hopefully) knew better than to do any of that.)

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