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Always Ace Your Patient Interview

Table of Contents

Key Takeaways:
  • Getting the right information is the key to writing a good program and being an effective coach and physical therapist
  • Establishing a goal is paramount when designing any sort of plan, including a training plan
  • Finding out where your patient/client has been and where they are at now allows you to take the goal and apply it to the current context
  • Making a list of the time availability and equipment availability lets you bring the goal and current content into reality with guidelines for application
  • Use our free printout that has all of this information in one place, today!

Information Is All You Need

There is only one thing that you need when you are putting together an intelligently periodized program for a patient or athlete: information. But not just any information, you need the right information. Lets go over a 3 step framework that is easy to implement, remember and repeat. This is the exact same interview framework that we teach our strength coaching mentees in our 6 Week Clinical Coach Challenge

Step 1: Figure out their goal

The first step of any good physical therapy plan or action is to keep an end point in mind. Asking the patient “where are we going” will illuminate a lot of things that can be helpful along not only the clinical journey, but the training one as well. A goal give you an idea of where to put your effort, as well as a destination that you can point your vehicle at. The goal will also allude to the expectations and beliefs of the patient. Depending on where they are now, a goal can look very reasonable, or very unreasonable. If the goal is unreasonable, like improving their low back pain so they can win a national olympic lifting championship, but they’ve never lifted weights before, this is good information.

It says to you the coach and physical therapist, we might need to spend some time figuring out other smaller, more attainable goals first as well as there may be very high expectations that we might not be able to hit. Despite the goal not illuminating any roadblocks or speed bumps along the way, its still absolutely necessary to pin down.  If they give a vague goal, it’s your job to try and pull more information out of them. How quickly do they expect to get there? By what means do they think it will happen? What do they believe the road to get there will look like? Straight or a lot of bends and curves?

Step 2: What is their experience, both past and present. 

There are few nuances to this step to go over, but in general you want to know what they have already been through up to this point. Have they exercised in the past? If so, what did that look like? They may have been powerlifters or professional skiers, but they also may have been totally sedentary without any training experience at all. Both scenarios, experienced or inexperienced, help build a better picture for the program design. You also want to know what their current activity level is. 

If you had them follow a program right now, what is an “appropriate” amount of training? If you give them a 5 day per week, 1 hour per day training program and they haven’t done any exercise in the last 10 years, that would likely result in an unenjoyable experience that they may even become symptomatic from it. On the other hand, if they are a regular 5 day per week exerciser, a 2 day per week, 20 minute theraband session would really only decondition them from their current activity tolerance.

Additionally, have they been coached before? The athlete coach relationship looks different with different people are involved, but the give and take is something that can tough to get used to if not experienced in the past. Coaches and physical therapists alike have a rough picture of what they feel things will loook like in their mind, and if the athlete isn’t experienced when it comes to following that path, they can deviate secondary to their own ideas and opinions on the matter. To be clear, their ideas and opinions are vitally important when it comes to shaping the plan, but many changes implemented frequently can convolute the picture for both parties.

Feedback is another aspect of being an athlete that needs to be learned from time under tension. Some athletes don’t like to give any feedback whatsoever because they either aren’t used to it or don’t want to think while working out. Other athletes will tell you every little minute detail about their experience during the session, from what they ate this morning to the butterfly they saw on the way to the gym. Those athletes who have run the gamut of coaching previously are usually more “coachable” in that they know the dance steps that are involved in the coach-athlete relationship.

Finally, you want to know if they have any aches or pains to take into account. As a physical therapist, this is likely going to apply to all of your patients you are writing programs for and coaching, but lets be real, almost everyone on the planet will have some sort of ache or pain to take into consideration. Knowing this information will allow you to make any modifications to movements they want to include as well as design a program around any sensitivities they have to help move them in the right direction. 

If you’re managing someone with some issues in the squat, check out our article on Clinical Squat Modifications for applicable tips you can use today!

Step 3: What do they have access to, both time and equipment wise.

Now that you know where they want to go and where they have been and are, you need to know by what means can you move them towards their goal. Knowing things like how many days per week they want to workout or how long each session during those days can be will help immensely with program design. Someone who has been working out 5 days per week can likely tolerate and would benefit from something like a 4-6 day per week plan.

Conversely, someone who is brand new to training will likely only tolerate a couple days a week to start, but can likely be given more than that. You just don’t want to overdo it. This step also takes into consideration their schedule. If they have a family or a busy work schedule, their program will look very different from someone who is single and works PRN. Knowing and having a list of all of the equipment they have available is a must. A program for them can’t include work with a barbell if they don’t have a barbell available. Their program will look very different if they have an entire commercial gym vs no equipment at all. That’s not to say you can’t design a program without equipment, but more equipment affords more opportunity when it comes to training.

If you put all of these steps together, finding their goal, figuring out where they’ve come from and where they are, as well as knowing what time and equipment availability they have, you can write an individualized program for anyone. 

To help you while you’re in the clinic, I put together these steps in a document that you can fill out in real time while sitting with your patients that you can find right here!