Laurie's Blogs.


Aug 2022

Proper Dosing of Your Therapies

Laurie Edge-Hughes, BScPT, MAnimSt, CAFCI, CCRT

I came across an interesting blog – Great Outcomes Require Proper Dosing, by John Woolf MS, PT, ATC of WebPT.

I’ll give you the synopsis of the article…


The concept of dosing is commonly understood when it comes to medication.  However, the same holds true when it comes to physical therapies as well.  Unfortunately, we don’t often explain this concept well enough to our patients, but doing so can be a useful tool in helping to achieve successful outcomes.


Dosing when it comes to physical therapy.  


Physical Therapists are trained to identify the systems that need to adapt for a successful functional outcome.   


Early in the plan of care, the treatment dose may be directed at one system, such as muscle activation, or pain control. As the plan of care progresses, the treatment will include additional systems, such as balance . All phases of the treatment plan may include some form of behavioral modification. Each of these systems are “dosed” with an intervention, an exercise, manual technique, or conversation that enhances the patient’s healing journey.


If you overdose the treatment, there are side effects. If you underdose the treatment you may not see the necessary changes.  Helping patients understand why a proper dose of your treatment is important to success is critical to patient success.  


When possible, create a therapy roadmap at the first visit.  Outlining this process at the start of their journey is can help patients better understand their role in recovery and what to expect. In doing so, patients are more likely to follow you when you describe to them the road ahead. Co-creating a vision of their future and describing the phases and interventions will help to calm anxieties, build trust, and instill enthusiasm for actively engaging in the treatment plan.


When co-creating the treatment plan, consider framing each visit and your interventions as “doses” of treatment.  It might sound something like this: “OK, you want to get back to playing golf, and you are concerned about this back pain. From our examination today, you have tight hips, poor core muscle control, and some balance issues. Getting you back on the course and feeling better is going to require addressing each of these things in small doses so that your body adapts to the changes you want. Each time you come to the clinic, we will address each of these areas. If we get the proper dose of treatment on each, you are likely to get back to playing and less likely for it to recur.”  


Bottom line: The patient needs the proper dose of treatment to achieve an optimal outcome. As such, they need to understand that skipping a treatment session with you is like skipping a dose of important medication. When patients understand that their body needs a dose of your interventions to improve, they will place a higher value on the experience, make the conscious choice to attend therapy, and be more likely to reach their goals.



Tell me your thoughts on this one.  I like the idea of our therapies as doses.  Doses of education. Doses of manual therapy.  Doses of exercise, and so on.  I also like the reminder to give the patient (or client) some idea of the road map ahead.


Have a great week everyone!


Cheers,  Laurie