How rapidly the year has flown by and as we head into the New Year, I took a moment to review the year that has passed and plan for the year ahead. I set goals for what I would like to achieve and then break it down into steps of what I need to do to achieve those goals. This is the same process I take my clients through, especially with teenagers whom I see. Often parents will report that trying to make their teenage child comply with home exercise programs is a challenge. As parents we want to see our child achieve their best potential, and when that child has physical impairments, the need to ensure that they maintain and improve their physical function and capacity is vital for them to be able to participate fully in their community. However, as a teenager with special needs, after over 10 years of being in and out of medical appointments, being told what they have to do, it just gets to a point where puberty hits and autonomy kicks in, and they just don’t see a point in it all! As with all teenagers, negotiations, taking responsibility, being accountable and finding a middle ground for compromise is part and parcel of growing up.

So how do we get a teenager to comply with their home exercise program?  This is what I do usually with teenagers who have the cognitive ability to rationalize and set goals for themselves. During my session with them and their parents, I assess their physical impairments, and what needs to be done to improve their physical function.  For example, the teenager complains of pain in the knee, and parents complain that they are having trouble participating in sports, refusing to join activities, and gaining weight with inactivity.  The physical impairment is muscle tightness and reduced joint range of motion.  The aim is to have a stretching and strengthening program to improve muscle length, joint range of motion, core strength and balance in order to improve function and participation in sports without experiencing pain.

In order to move from problem (the knee pain and lack of participation) to solution (exercise program for stretching and strengthening) – I like to ask the What, Why, When, How questions.

What – The first thing I like to encourage is for the teenager to dream dreams. What would they like to do when they grow up? For example travel the world.

Why – We then establish the motivation for the dreams. Why do you want to be that or do that?  For example, because I would like to see the world.

When – We then explore when would we achieve the dream.  When do you think you would like to be living your dream/doing that dream activity? For example, when I finish school.

How – We then explore how do we achieve that dream. How do you think you are going to be able to do that? For example, traveling requires independence, physical fitness, self management when your knee hurts.

By the time we get to the How, we already know our What, Why and When. Then we relate the How to the Now. What are you doing Now, and How it affects your What in your future.  This inevitability leads to the problem we are facing now and the solution we have to manage the problem. As we go through the process of thinking and dreaming, we end up gaining a purpose and clarity of why we need to do the home exercise program that we design together.

Often by the end of the session, the teenager themselves would be able to see the relevance and importance of their home exercise program, compliance becomes a necessary means to an end that they want to achieve for themselves.

If your teenager is struggling to follow their home exercise program, and would like help with setting specific and relevant goals and activities, contact our Paediatric Physiotherapist on 9557 8521 for an appointment today.