Physical Therapy treatments are suppose to be goal oriented. Goals can be based on physical limitations such as strength or range of motion; pain level; job demands; and even recreational activities. Sometimes, it is hard to put the goal into words appropriate for the medical documentation.
One individual I treated had neck pain, head aches and some jaw pain. I was thinking she had a TMJ (temporomandibular joint) * issue but I needed a bit more history to be sure. So I asked, "When does your jaw hurt?" and she replied in an even toned voice, with a matter of fact expression on her face, "when I have oral sex".
Now, my dilemma, do I set a goal that reads "pt will be able to have oral sex without pain"?
After setting goals for another patient, I realized I had set the wrong goals. This 21 year old female had a different goal in mind and I was not aware of it until after it was accomplished.
She came to see me with right shoulder pain. She had been in a fight and when she threw a punch she dislocated her shoulder. Appearing to be a nice young lady, I felt this was probably an isolated incident and she was provoked in some way. She had difficulty sleeping and dressing, therefore the goals I set for her were;
1. Pt will be able to sleep through the night without pain.
2. Pt will be able to reach behind her back to fasten bra and tuck in her shirt.
After 6 weeks of treatment her symptoms were decreasing and she was sleeping and dressing much better. Then one day she arrived for her therapy session smiling and extremely happy.
I address her saying "You are happy today. Your shoulder must be feeling better."
Her reply was "Yes I feel great. Last night, I was in a bar and got into another fight. I threw a punch with my right arm and my shoulder did not hurt at all. Thank you so much."
Obviously, my goals were not her goal. Her goal was met.
