"I can lift 100 pounds but I will pay for it for the next 3 days."
Fri, 09/18/2009 - 5:52pm
I did an FCE yesterday where the gentleman stated that he can lift 100 pounds but will "pay for it" for 3 days. Anybody else have the same experience before? How do you handle a statement like that?
What I did was reassure him that he was not going to have another injury and that we needed to find his "safe maximum" lift amount and that I was looking for subtle clues to tell me when your body is saying enough is enough. He was not very forthcoming with his pain/symptoms at all during the evaluation either. I would ask multiple questions and they would all get blown off so I think there might be other issues.
Any thoughts are greatly appreciated,
Jon
This is a common response by both people that are genuinly conveying information to us, and also as a means to dismiss the validity of the testing we do. This has been identified in the litterature as a failure to negociate symptoms-or "yes, but" statements. I think we have two options here-base our determinations about function (assess material handling abilities) keeping in mind the reliability of reports of pain and limitation (did what he/she said match up with what they demonstrated), and/or see the person the next day (or over three weeks) to see if thier function was appropriately affected. But, if the client's reports of pain and limitation were not accurate on day one, two and three-what good does it do us to see them the next day? Some other things you can weigh in your mind-RMS testing results of the affected and unaffected body parts, whether or not you "discounted" some weight from the max safe lift, and of course whether or not the person provided high levels of physical effort with tesitng. I think your assessment of RPDR and "blowing you off" when trying to seek more information tells you a lot. Hope this helps.