Soldier with some issues

I recently completed my rural placement at an army barracks physiotherapy department. One of my patients was an army mechanic who presented with knee pain and a history of ITB friction/impingement syndrome. On clinical assessment, it turned out his main problem was now meniscal damage. The patient was quiet and vague during subjective assessment, and anxious and highly irritable during objective assessment. His nervousness and anxiety continued as myself and a senior physio explained that it was likely he would need surgery. The patient was opposed to this idea and wanted to learn more about other options. I prescribed gentle ROM exercises and booked an appointment with him for the next day.

I spoke with the senior physio afterwards and he explained to me the importance of developing a good rapport with patients like this because there were obviously other factors contributing to this patient’s anxiety that we were yet to find out.

So the next day I was with the patient by myself and had a treatment plan prepared to work through with the patient. But when I sat down with him in the treatment room, the patient appeared much more relaxed than the day before and more prepared to chat. So I dug a little deeper, and found out that the patient’s partner was pregnant and due and any moment, and that his mother had a history of multiple surgeries which had resulted in many complications… This explained a lot about why he was so apprehensive about having surgery and had wanted to know specific timeframes for recovery because he was worried about how he would look after his family. My treatment plan went out the window and I just spent the whole session just chatting with him and explaining the simplicity of the surgery and although he was still hesitant, he seemed to relax a lot and appeared a lot more comfortable about the situation.

I thought this was a good example of the importance of developing a good rapport with your patient and getting their complete social history!