Nearly three years ago, I had an accident which saw me rupture two out of the three ligaments in my left ankle. I knew it was bad when I couldn’t stand up on my own and didn’t push back when ushered to ER.
Anyway, post-accident I saw a string of physios to help my ankle get back to normal. And because it was significantly weaker, I would have recurring sprains every few months. It sucked. It hurt. It annoyed the heck out of me. I should mention I have a less than stellar track record with physios and listening / acting on their advice.
Why? I get bored standing on one leg, and I often believe I’ve healed faster than what is actually occurring. Oh, and I’m stubborn. I don’t ice and elevate as much as I should and I certainly don’t rest.
My ankle is not as strong as it used to be. Nowhere near it. I’ve been advised to get reconstructive surgery, but I like to swim upstream. I have accepted a lifetime of being extra careful walking on cobblestone paths, never being a regular pavement pounder (I liken long distance running to torture anyway) and a shoe collection free of 12” stilettos.
Most physios I’ve seen: Friska, I can tell you’re not icing and elevating every 2 hours. You need to do this. If you don’t, your ankle will remain puffy, you’ll struggle to go about your daily life. I can’t start the rehab exercises while it’s still swollen. Are you taping it like I told you? You have to do this. I will know the difference next time you come in. There’s no point making another appointment if you don’t do what I say.
Me: I know. I know. I know. I’ll do better.
And then I leave. And nothing changes. I do a Houdini and disappear, never returning to the same physio. When I was being ‘good’, I iced and elevated maybe twice a day vs the prescribed every 2-3 hours.
Anyway, I moved interstate for my career. I found a new physio called Matt. My first appointment began like they always do… But then, everything changed.
Matt: Friska, you have strong muscles. I can tell by your right leg. And great balance too! Maybe you run or do yoga? That’s more than the average person. This will make recovery much quicker for you.
Me: Oh, really? Yes, I’ve been practicing yoga consistently for years. And run.. not as much now because of the ankle but I try to get out for a short one weekly.
Matt: I can tell, good habits to get into, well done. Now, I see your left ankle is still swollen and much weaker than the other. But since you are so careful with your health, we will be able to help regain its strength and definitely prevent recurring sprains. But we will have to persist and battle through together.
Me: Yes! Let’s partner together! How?
Matt: Here’s what I am thinking. First, I want you to see your progress. I am going to measure the extent of the resistance you can push against, and your ankle’s flexibility.
When you come back for your next appointment, we can check your progress to see how we are doing. What do you think?
Me: Sounds good. Do you think I can be back to stilettos without a reconstructive op?
Matt: Yes definitely! Scar tissue takes time, you’ll need patience, but eventually it will subside.
Firstly, we’ll have an array of strengthening exercises for you to do each day. Just 10 minutes while you’re watching tv, brushing your teeth, working at your desk.. that will really help.
Secondly, I’m going to leave you untaped so you can get used to getting around unassisted.
Thirdly, I’ll use the therapeutic ultrasound machine each time you come in to help with the swelling.
Lastly, I am going to give you some tape, so when you are going hiking or feeling a bit wobbly, you can get used to taping it yourself. You won’t need me all the time.
Me: Ok, I can do 10 minutes. I could do more if I consciously focus on it.
Matt: Absolutely! I have no doubt. When you come back we will compare measurements and see how we did. And if you’re pushed for time, just focus on the first two exercises I give you. They have the most impact. I understand life gets busy.
Me: Ok! I hope every week I will make progress.
Matt: I know you can!
I did my exercises almost religiously since that fateful first appointment.
Matt did something powerful with me that day in his office. I have reflected on why I chose to listen to him, why he cut through when no one else had.
We always want to change people.
We want to help. To fix. To improve. We advise, problem-solve, suggest, try to change someone for their own good. Our heart is in the right place.
But unless they want to change, nothing you say or do will influence their behaviour.
Learning from Matt, here’s some ideas on how to positively change someone’s behaviour….
Step #1: Pride
Matt started out by invoking feelings of pride. He noticed the strength and flexibility of my right ankle, and mentioned it was better than most. This immediately made me feel proud of what I had done, instead of guilty about what I had not. This is a major difference. Pride makes us want to do more, it makes us feel powerful and we want to live up to it. How do you make others feel proud of themselves?
- Point out the positives
- Praise them for what they are doing right
- Illustrate a self-fulfilling prophecy
Step #2: Engagement
Matt also uses “we” more than “you.” His approach was to involve me, not to tell me. The outcome was that I felt it was truly a team effort. In a professional context, involvement and adopting a collaborative approach is a sure-fire way to generate engagement, commitment and buy-in. It can be a painful process, and is definitely more effort-intensive and slow, but the dividends it pays will help you in the long run.
- Say ‘we’ not ‘you’
- Involve, don’t instruct
- Buddy up with other people to change with
Step #3: Progress
The next thing Matt did was catalogue my progress. He took measurements of my ankle and also how far I could bend and flex. This gave me a benchmark—it’s like seeing how much you have in your savings account or weighing yourself. Specific, measurable goals are always easier to achieve. I could see my measurements each week—I competed only with myself and wanted to improve on them each visit. He defined the goal posts. Previous physios would just give me exercises and I had no way of tracking whether they made any difference!
Small wins, visibly and regularly celebrated, is a powerful motivator.
- Define a measurable benchmark
- Track progress
- Make it easy to visualise change
Step #4: Tools
The last thing Matt did was give me specific tools and steps. I had heard all of these before, but not in such a direct, prescriptive way. When I heard them before they felt like orders. But after Matt’s first 3 steps, they felt like weapons. He broke them down into manageable actions and promised a measurable outcome. He empathised with the busyness of modern life and provided a ‘short cut’ option without making me feel like I was copping out if I took it. I was hooked.
- Give steps
- Provide helpful tools
- Make a clear path to change
This is a different approach to ‘traditional’ behavioural change strategies such as exerting pressure and guilt tripping. It goes against our instincts, but actually gets results without making people feel bad in the process. Heard of positive psychology and appreciative inquiry? More carrot, less stick. We all have bad behaviour we know we should change, it’s refreshing to receive a bit of compassionate help sometimes.
Help someone break free of their bad habits and use these four steps.
As long as I maintain my ankle strength, be super careful on soft or declining ground and continue to have no interest in becoming an elite runner… I can get by quite happily sans reconstructive surgery. Oh, and I’ve settled for 10″ heels.