The Critical Period

Although this short post isn't necessarily directly related to sport health, I do believe its principles often apply.

It's a short one (as many have been lately), but an important one I believe.

The first few weeks in acute injury management is what I would call "the critical period". In this period, your goals (unless the individual disagrees, of which I doubt) are simple.

• Get them better.
• Get them moving.

This "reactivation", as some would call it, essentially gets them back to their normal activities of daily living (and sport if applicable) and hopefully, out of the clinic. Not a good business model, I know.

Easier said than done? I don't believe so.

With effective quality care, I believe you are providing the most appropriate and sincerest form of clinical care. Because far too often, I come across patients who have traditionally received less than optimal care from the get go, the "critical period", resulting in a deconditioned state and likely in a chronic diseased state.

In my opinion, this was  iatrogenic.

While I do think one-to-one clinical intervention is ideal, I do believe it isn't absolutely necessary. As Mike Reinold mentioned, it can be done. Additionally, I'm going to go out on a limb and say that even the most cutting-edge clinical interventions aren't required, however, I do believe that the most appropriate ones certainly are.Communication is key. And listening is even more paramount. In fact, I think they go hand in hand.  And for that, I believe that what you say is very important. Fostering fear avoidance behavior and overly tissufying may be problematic.

Because inappropriate clinical care in this critical period often leads to a frustrated, deconditioned, and chronically suffering individual.
So if you're still managing patients 6 months post-onset of acute low back pain, please do your patients a favor and reassess your approach to care.