PNF Philosophy #3: A Positive Approach

A “Can do” Approach.

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The 3rd philosophy of PNF states that in order to access someone’s potential, the treatment should begin with positives, “small wins” or should begin with what the individual can do. 

This is way easier said than done because in most of our education, whether it be rehab, strength and conditioning, or personal training, we are trained to find dysfunction or weakness and highlight these weaknesses to the client/patient as well as anyone else observing.

As clinicians in the insurance world, we have to find an outcome measure that highlights a poor functional score to convince the insurance company that the client’s visits are “medically justifiable”.

Not much room for positivity there, huh?

So someone comes to us and our job is to highlight a bunch of things they can’t do, as if life isn’t negative enough… talk about an ego boost.

During the PNF residency, our PNF mentors always trained us to FIRST comment on what the patient was doing well and find the positives before saying anything about dysfunction.

That was standard routine in Vallejo, CA.

If you have experienced working with individuals with strokes, brain injuries, or spinal cord injuries, you know that highlighting positives can be very difficult given how profound their paralysis and dysfunctions can be.

But if we step out of our professional world and into that person’s world for just one minute, imagine how demoralizing it would be to suddenly be paralyzed, unable to walk, unable to perform bowel and bladder care, unable to remember anything about the last day, month, year or unable to do ‘every day things’  for yourself independently.

Basically your whole world has just been flipped upside down, your identity has been taken from you, and now you have a bunch of professionals standing there watching you try to do your best to move well and all the clinicians say out loud is everything you’re doing poorly and all the things they would like you to change.

Imagine being assessed in that situation and how that would affect your emotional state (to relate back to PNF philosophy #2: a whole person approach) and your motivation to move or “exercise”.

Why should this be any different in the orthopedic/sports medicine and fitness world?

Are we not still treating humans that are trying to regain a sense of their identity?

Don’t we all like genuine positivity and compliments, before we are bombarded with criticism?

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A great read about a positive approach is Dale Carnegie’s book How to Win Friends and Influence People.

As PNF clinicians, we are trained to always first articulate positives before mentioning what movement(s) we would like to address for our pre / post-test.

In addition to the motivational benefits of stating the positives about the client, as clinicians, highlighting positives also helps in treatment planning.

We can utilize the person’s strengths to begin the treatment with a physical task the patient can perform easily and progress to more challenging tasks relating to the patient’s weaknesses and dysfunctions. Basically start off with small wins.

We can also use a client’s strengths in order to influence their weaknesses, a concept recognized by some as irradiation.  More to come on this topic, as it is both a PNF philosophy and a basic principle.

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This week, try to first articulate the positives you see when working with a few of your clients/patients before discussing their dysfunctions. To take it a step further, try to begin treatment/training with something they do well and progress to something more challenging.  Maybe a boost in your clients’ confidence will affect their performance and will surprise you.  

Next post I will discuss PNF Philosophy #4: Movement must be specific, purposeful, and directed towards a functional goal. 

Ramez Antoun