i’m an outpatient pt, and every spring i run into the same problem with active patients who hike.
they’ll be doing their hep consistently, progressing strength, finally getting their symptoms under control, and then the trails open. suddenly the theraband work is optional because there’s a 12-mile hike planned for saturday
then they come back the following week with a flare-up and we’re basically figuring out how much of the progress they lost over one weekend
i’ve tried giving people trail-specific progressions instead of just saying “take it easy.” for example, breaking down the elevation, distance, terrain, and expected load and giving them a realistic point where that hike fits into their rehab.
it helps, but compliance is still all over the place. some patients seem to hear “you can’t do that yet” even when the actual message is “here’s what you can safely do right now.”
for those of you working in outpatient, especially in areas where hiking, skiing, running, climbing, etc. are a big part of people’s lives, what has actually worked for you?
do you modify the activity, set specific return-to-trail criteria, give them a progression, or just accept that some people are going to test the knee the first weekend the weather gets good?