PTSD & physiotherapy

ptsdflo

New Here
Hi, I'm new to here & would really appreciate some advice (sorry for long post). I am currently seeing a physiotherapist for some chronic health conditions. However found some of the aspects of physio triggering. On the 2nd session I was honest with the physio & explained I had PTSD & some parts of physio were causing me anxiety. Initially she seemed understanding & tried to ask me what the cause of PTSD was to have an understanding of how she could help. As I was not yet ready to answer such a difficult question I couldn't answer her so she left it at that. By the 3rd session I realised I would have to explain a little more but as I was worried of it being shared with just any other health professional I asked her if it was confidential just to physio. She responded that it was however if she was concerned she had a duty to report her concern etc but what then threw me was she finished her sentence with "don't tell me, It's ok I don't really need to know". This made me feel so uncomfortable & like she wasn't interested to take the time to understand how It was making me feel. We then proceeded with the physio session & she did not change any aspect (still asked me to do an exercise I found triggering & said "just don't think about it"). Clearly she has never dealt with a trauma patient before & is inexperienced in how to handle it but expected a little more understanding. I'm not able to change physios ( it would also mean explaining everything again causing more distress) & she is otherwise very good physio side of things. My question is how do I now approach her to explain she needs to adapt some things & explain a little more about the cause for her to understand? Should I just be more blunt?
 

Sideways

Moderator
Welcome to the forum!

My question is how do I now approach her to explain she needs to adapt some things & explain a little more about the cause for her to understand? Should I just be more blunt?
I was recently working with a physio (and separately, a hydrotherapist) and had a similar issue. Some of the work he wanted to do was eek, nope, back away slowly and put your hands where I can see them!!

The 2 things I kept in mind was (1) explaining what didn't help/would help didn't require any kind of discussion about my trauma history; and (2) people get ptsd from all sorts of different experiences, so it's not obvious on the face of it what will be a problem for me just because I have ptsd.

That's totally okay. So I told him I have ptsd, and some things may be too uncomfortable for me to do. And from there, we played it by ear - when something wasn't okay, I simply told him I wasn't okay with that, could we do it differently?

He had a different way to approach things each time I spoke up, because physios typically deal with all sorts of physical disabilities and disorders and people who can't do a particular thing because of physiological issues. Me personally, I couldn't do anything that required lying face down - he always had a work around for that.

Apart from that? We had a general rule that he would make sure I knew before he touched me. That was reassuring.
 

ptsdflo

New Here
Welcome to the forum!


I was recently working with a physio (and separately, a hydrotherapist) and had a similar issue. Some of the work he wanted to do was eek, nope, back away slowly and put your hands where I can see them!!

The 2 things I kept in mind was (1) explaining what didn't help/would help didn't require any kind of discussion about my trauma history; and (2) people get ptsd from all sorts of different experiences, so it's not obvious on the face of it what will be a problem for me just because I have ptsd.

That's totally okay. So I told him I have ptsd, and some things may be too uncomfortable for me to do. And from there, we played it by ear - when something wasn't okay, I simply told him I wasn't okay with that, could we do it differently?

He had a different way to approach things each time I spoke up, because physios typically deal with all sorts of physical disabilities and disorders and people who can't do a particular thing because of physiological issues. Me personally, I couldn't do anything that required lying face down - he always had a work around for that.

Apart from that? We had a general rule that he would make sure I knew before he touched me. That was reassuring.
Thank you for your reply, that has been helpful advice which I will try bring up with the physio & also weirdly reassuring that someone has experienced a similar situation.
 

joeylittle

Administrator
She responded that it was however if she was concerned she had a duty to report her concern etc but what then threw me was she finished her sentence with "don't tell me, It's ok I don't really need to know". This made me feel so uncomfortable & like she wasn't interested to take the time to understand how It was making me feel.
If you are currently being abused in any way, she'd be legally obligated to report that. And, in some countries, even if the trauma event was in the past - if someone committed a crime against you, and that was what caused your trauma? She might be obligated by law to report that, too.

I understand how this made you feel - I'd probably feel the same way. But looking at it from the outside, I honestly think she was trying her best to support you. She backed off very quickly when she realized that she didn't know for sure if she could keep it confidential. This doesn't mean that she's not interested, it just means she's worried about pushing you to tell her things you aren't comfortable telling her.

In other words - just because she's not experienced with trauma, it doesn't mean she can't adapt and learn.

It would help you out to really think about what you want her to know, and how in-depth you want to get. It sounds like you have a good sense of the movements that are problematic for you - so, if you can spend a little time thinking about how to give her details on what aspect of that movement is hard, she'll have a better chance of coming up with a way to approach it differently. Saying "moving my arm like that triggers me" isn't always enough info - but, saying "rotating my arm is alright, but bringing it over my head is what's hard. It might be easier with me standing, instead of laying down. Or, with less range of motion. Do you have ideas of how we could modify this?"

She doesn't need to know the specifics of what happened in the past, in order to help you in the present. And you don't need to get too deep into it out loud with her, either. Just see if you can break down which specific aspects of the movement are trigging to you, and which aspects are NOT triggering to you. That'll help her, help you.
 

barefoot

Sponsor
I’ve had this too - don’t really have anything to add to the above responses, which I would echo strongly.

Completely agree that you don’t need to share content about your trauma history - she is right when she says that she doesn’t need to know.

As @Sideways and @joeylittle have said, trying to identify specifics around what is ok for you/not ok for you, and either suggesting alternatives that would suit you better or asking her if she could adapt something would be key.

And like @Sideways it’s always really crucial for me (in any medical examination or procedure including physio appointments) that I ask them to let me know in advance when/where they’re going to touch me. This means it won’t take me by surprise and spook me. And also gives me an opportunity to say that I need to pause for a moment, or to say I don’t want them to do that etc (ie boundary setting!)

I can understand how her telling you ‘just don’t think about it’ didn’t land brilliantly. And perhaps you’re right and that she is not hugely trauma informed. But, for what it’s worth, I do think it sounds like she is trying to be supportive. You asked us if you need to be more blunt. I think it would help her (to help you) if you were very clear and direct with her about what would help (or not) and what’s challenging and what’s ok. That will give her something to go on, I think, so that hopefully she can make the experience easier for you while still giving you effective physio treatment. But that doesn’t mean you have to share details of your traumatic experience(s)

Good luck - and well done for keep turning up for physio sessions, which are proving triggering. Things like this, avoidance can easily kicked in (I’ve been there!) So, I’m really glad that you’re able to prioritise your health and make it to sessions, even though they are hard to navigate.
 

ptsdflo

New Here
Thank you they are good points you have raised & will think of what I need to do to approach it in this way.

I’ve had this too - don’t really have anything to add to the above responses, which I would echo strongly.

Completely agree that you don’t need to share content about your trauma history - she is right when she says that she doesn’t need to know.

As @Sideways and @joeylittle have said, trying to identify specifics around what is ok for you/not ok for you, and either suggesting alternatives that would suit you better or asking her if she could adapt something would be key.

And like @Sideways it’s always really crucial for me (in any medical examination or procedure including physio appointments) that I ask them to let me know in advance when/where they’re going to touch me. This means it won’t take me by surprise and spook me. And also gives me an opportunity to say that I need to pause for a moment, or to say I don’t want them to do that etc (ie boundary setting!)

I can understand how her telling you ‘just don’t think about it’ didn’t land brilliantly. And perhaps you’re right and that she is not hugely trauma informed. But, for what it’s worth, I do think it sounds like she is trying to be supportive. You asked us if you need to be more blunt. I think it would help her (to help you) if you were very clear and direct with her about what would help (or not) and what’s challenging and what’s ok. That will give her something to go on, I think, so that hopefully she can make the experience easier for you while still giving you effective physio treatment. But that doesn’t mean you have to share details of your traumatic experience(s)

Good luck - and well done for keep turning up for physio sessions, which are proving triggering. Things like this, avoidance can easily kicked in (I’ve been there!) So, I’m really glad that you’re able to prioritise your health and make it to sessions, even though they are hard to navigate.
I think part of the problem was time constraint of the session. When she could see I was upset she just carried on & didn't give me a moment to recover. When I explained what movement I was not happy doing she still asked me to do the same thing rather than adapt.
 

barefoot

Sponsor
I think part of the problem was time constraint of the session. When she could see I was upset she just carried on & didn't give me a moment to recover. When I explained what movement I was not happy doing she still asked me to do the same thing rather than adapt.
Yeah, that’s not ideal.

Could you email her ahead of your next appointment? Or discuss it at the start next time, before you start the physical activity?
 

joeylittle

Administrator
Could you email her ahead of your next appointment? Or discuss it at the start next time, before you start the physical activity?
Agree with this.

@ptsdflo - how many of the exercises are triggering for you? If it's just one, it's probably possible to discuss it in-session. If more than one, you may need to ask her to carve out a little time to make sure you've got a chance to discuss.
 
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