5 Key Elements in Treating Clients after Motor Vehicle Accidents

5 Key Elements in Treating Clients after MVA’s: A Physical Therapist Approach

1. Communication: First and foremost, the absolutely most important element is communication. On initial visit, spending the time to listen to the client’s concerns and questions is extremely valuable. Remember, many of these clients have suffered a traumatic event, and many times have been rushed to the ER room, passed off to different medical doctors, and are seeking litigation. On day one, the client and therapist must absolutely be on the same page.
2. Time: Unfortunately, most of the clients that see after MVA’s, are months after the initial incident. Of course, we understand that this will change our outcomes. However, by re-establishing a set time-frame for improvement (for example 6 visits), we are able to establish a framework for improvement.
3. Ownership: It is so important, especially for those seeking litigation, the client most take ownership of his/her current condition. Such as with worker related injuries, when “I can blame someone for my condition,” and “because of you, I am in this condition,” the overall progression of those clients will be compromised. Therefore, from the onset of treatment, the client must decide that he/she is in control of the outcome. The accident occurred, and is in the past, and from this moment forward, only “I can be in control of my outcomes.”
4. Objectivity: As the clinician, it is so important to take an objective view point. Generally speaking, many of our MVA clients, will demonstrate fear avoidance behaviors. The fear of performing a tasks or activity, becomes the primary focus. So, by establishing, clear objective data, we can begin to formulate an outline for improvement.
5. Goals: Setting achievable and realistic goals. For example, “I can’t raise my arm above my head.” Well, ok, let’s begin by, “Setting a goal to be able to raise your arm above your head without pain.” Of course, gathering, ROM/strength/joint mobility/nerve involvement/ligamentous integrity, are fundamental, as these elements will guide your treatment plan. Also, it provides you with key information to relay to your client. In the example above, by assessing joint play, there may very well be decreased mobility of the AC joint, and decreased posterior glide of the glenohumeral joint. There also may be median nerve involvement with adverse neural tension. So, in discussing these findings with the client, there is often a sense of relief by the client, when you as the clinician, finally provides information of the “Why, am I still hurting.” By doing so, the client many times begins to overcome fear avoidance and can begin to work towards goals and overall improvement.