Patient Motivation-A minimalist approach.

Imagine a cluttered room, furniture everywhere, books that could fill a library, enough dishes to start a restaurant. T.V.s, Radios and other electronics scattered throughout the room, all of these need wires so plenty of them too. All this leaves little room to negotiate, limits behavior and over time causes more stress.

Now imagine the same apartment or house with only the bare essentials or even nothing at all. Its like a breath of fresh air or the ability to even breath at all. Hence the saying, “Minimize to Maximize”.

I have two approaches when riding the McGill slope to improvement. When looked at from a distance they seem quite simple and minimalistic, perhaps that’s why they work for me.

  1. Stack and sway
  2. Running the option

The Stack and Sway approach is simply selecting the most relevant exercise to address the patients most current needs. Sometimes this maybe just one stretch and one exercise.

Often I will change the word exercise to something else: an example, Movement Therapy or even Movement.

This at times takes great will power but its important to do the minimum required for the maximum amount of change. After the patient begins this simple routine, I begin to add more to the list one at a time. After 2-4 weeks the patient should be into the swing of their routine. Moreover they didn’t have the cramped list that is often handed to them. If there is no room for slip ups and expectations are high, there will be little room for the patient to maneuver. It also leads to higher levels of disappointment between Doctor and patient if (God forbid) there is a slip up.

Running the option requires some preparation on the Doctors part. Just as running the option in football, the client will be able to do the same. The preparation required is to take a list of commonly used rehab exercises and find a suitable option for each. When you prescribe the patient their movements you also give them their option. This places the patient in the driver’s seat. To make or create more control, add in two or three options. This has been a favorite in the past and was developed through personal discussions with a clinical psychologist.

Anyway that you can change the dynamic, empower the patient, and have fun in the process will be a winner in the patients eyes. Rehab doesn’t need to be boring nor does it need to be overly strict. It should be precise, effective, and simple.


  1. Sound yet Minimal efforts help create breathing space for both doctor and Patient.
  2. If something isn’t working, it’s much easier to figure out what when your list is small and systematically built.
  3. Remember the stigma and emotion attached to words. What do you think when you hear words such as: Pain treatment, Illness, decay, degeneration, exam and problem?

More over what does your Patient think?


About doctoranthony
As a spinal rehabilitation specialist with over 7 years clinical experience in the areas of - Spinal Manipulative Therapy, Active & Passive Spinal Rehabilitation, Functional Movement and Orthopedic Assessment, Strength and Conditioning Coaching, Fitness Programming, Business Development, Cognitive Behavioral Therapy, Motivational Interviewing and Consultancy - you can feel safe knowing that I understand the worry and concern surrounding spinal pain. This is why self-efficacy lies at the heart of my practice. For more info:

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: