There is much more to the term function than physical functioning and physical task perfomance. The fact that the PT is referencing the occupation of marathon running is good as they are giving the reason they will be doing their intervention. It doesn't lead me to say that every person in health care is working on function. Most are fixing structures and hoping you go off and have no more problems.
As a rule OTs incorporate many more aspects into their thought process. The idea that motivational, cognitive abilities, and social needs could be playing into the marathoner's impaired function is not discussed. I have many more questions even about this person's barriers to his physical functioning. The ability barriers to the functional task are often complex and interwoven. Is his running causing ongoing damage to the shoulder or is he guarding his shoulder and throwing off his whole stride. Would a pain management solution help him normalize his movement to allow everything to correct (could we slap an interferrential machine over his scapula and retrain movement?) Does he need to incorporate a recovery period into his training or does he refuse crosstraining for motivational reasons? Does he perform his shoulder stabilizing exercises on his own or is he just going to grind through the pain? Is his workplace set up to accomodate his shoulder injury? Do the other aspects of his personal abilities contibute to these issues? For instance, how does he handle stress and what are its physical manifestations if any? These are functional questions. A holistic approach is essential to finding why a person does what they do and how they do it. That is the leadership that OT can provide when they are involved with these types of cases. How much more effective could a PT be if they had license to dicuss these other issues? As of now we could help this runner and many others but it is unlikely that any OT will be invited to be involved. To use Joan's terms, what are the real "mismatches" for this guy? What can we do to get him back in the (arm) "swing" of things? The more we can incorporate in terms of approaches the better. Yours, Ed Kaine, OTR/L, RFT President of the American League of Functional Therapists www.FunctionalTherapist.org <http://www.functionaltherapist.org/> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
