Physical therapist it kinda pushy...
July 14, 2015 11:49 AM   Subscribe

So, I tore my rotator cuff a while ago, and I'm going to a physical therapist for that, and she's really pushing for me to go to the local swimming pool and take the aqua-aerobics class there. I really don't want to, but she won't shut up about it.

(Please excuse my grammar errors, I'm on new meds) I've been seeing this PT for a little over a month now and my shoulder is improving. All in all, I enjoy her sessions. But nearly every session she asks me if I'd consider going to the local rec center and sign up for the aqua aerobics class. I don't really want to because I don't like classes in general and dislike aerobics classes even moreso. I'm an extroverted introvert so the thought of getting into a bathing suit (of any kind) and getting into a pool with a bunch of strangers just makes me twitch. Just writing about it is making me twitch.

Hell, it took me nearly six months to work up enough guts to go to physical therapy. I mean they've gotta touch me and talk to me the whole time I'm there. *blah* But I go with a smile on my face and engage in friendly conversation with not only my PT but the receptionist (who also encourages me nearly every session to "get into the pool") and any other PT and/or patient who happens to be there because I can be social when I have to be. I go home and de-stress afterwards, but I can be social. And I'm pretty good at it. So it's difficult to explain to her that I'm actually very introverted and don't want to get into the pool with a bunch of strangers until I'm good and ready to.

I'm not a confrontational person. I tried deflecting with, "I don't have a swimsuit" "I have body issues." "I haven't been in a pool in decades." blah blah blah But she keeps pushing. She's countered all of the above and started negotiating with me to go. Like, if I go one day a week, we can swap one of our sessions. It's really very annoying! And now (as I mentioned before) the receptionist is pushing too. This is the only physical therapist in our small town. The next one is over an hour drive away. I might could start doing the exercises I've learned at home and just say, "Screw it!" But I don't know if I've learned enough to get my shoulder completely better.

I guess what I'm asking is... How do I tell my PT, nicely, to stop pushing this idea of a aqua-aerobics? That I'll go when I get the nerve and not a moment before? I told her I would go to this afternoon's class because she really pushed me into a corner, but I'm not ready. It's stressing me out. But if I don't go, that'll stress me out too because then I'll have to explain why I didn't go. I don't know what to do. Any ideas?
posted by patheral to Human Relations (36 answers total)
 
"I'm not going to do that right now, and I really need this to be the last time we discuss it until I bring it up. I'm prepared for us to stop working together over this."

Alternately you just say no. "No." Silence. Yeahbut blah blah blah. "No."
posted by Lyn Never at 11:55 AM on July 14, 2015 [18 favorites]


Maybe this is a bit of the ask vs. guess thing. Be direct, tell her you are not going to do it. It might be good for your body, but your mind is just as important. The stress is not good for you, or your health.
posted by annsunny at 11:55 AM on July 14, 2015


Alternately: "How do I get you to respect my no on this?"
posted by Lyn Never at 11:55 AM on July 14, 2015 [30 favorites]


Just say no! You don't have to give her excuses. Excuses can be countered with alternate ideas or attempts at convincing. Just say no. If she asks why, you say, "I don't want to and I'm not going to change my mind. Can you please stop asking me about it?" Or, if you really want to go all out, replace "asking" with with "bullying." I'm not a huge fan of that word as it's used in popular culture these days, but in this instance that's what she's doing to you. It's not cool.
posted by something something at 11:55 AM on July 14, 2015 [3 favorites]


Just tell them that you gave it very careful consideration and that your final decision is no pool. Period. You won't be discussing it any longer and you'd appreciate it if they stopped bringing it up. No further explanation is necessary. Repeat as necessary. If they continue pushing, call them out on it, "Please stop pushing me to do this. I've told you what my decision is and when you continue to disrespect my choice and push, it makes me feel harassed. "
posted by quince at 11:57 AM on July 14, 2015


Best answer: Seconding Lyn Never. What you're saying now? Making excuses? Those all sound like fixable things, and your PT is making suggestions to fix them. What you need to do is be firm and put your foot down about it. It's not a negotiation for you right now, it's you're not going to go do it, full stop.

Stop making excuses, just say no.
posted by phunniemee at 11:57 AM on July 14, 2015 [7 favorites]


Best answer: I know it's hard to be direct about this, but as someone from more of the direct (and yes sometimes brusque or pushy) side of things, I suspect it's that she hasn't heard you say "No." yet and until there's a no, the answer is maybe. So I know this is not your style, but I think you have to, one time, not deflect but just say "That's not on the table right now for personal reasons. I need us to find another way to work on my shoulder stuff or I'm going to need to find another PT. What do you suggest?" and then do the thing people on AskMe suggest which is stonewalling in a really dull repetitive way. "That's not on the table right now for personal reasons. What ELSE do you suggest?"

At that point if she's being pushy about it, it's overstepping your boundaries, not cool and grounds for finding a new PT. Right now, I can see it from both of your perspectives and I think there's a conversation culture clash over it. You don't want to go, that is your prerogative. It's very unlikely that the only way to work through this issue is with you in the pool with a bunch of people. You've done the good work of going to the appointments (I can appreciate it even if she can't) but you may need to step outside of your comfort zone in the short term to fix this for the longer term.
posted by jessamyn at 11:59 AM on July 14, 2015 [4 favorites]


Best answer: I agree with everyone else that this sounds like a case of Ask Culture meets Guess Culture.

However, I'd like to offer a counterpoint as someone who has spent a good bit of time in PT and has friends who are PTs. Often times it is their job to push you a little bit out of your comfort zone. Her job is to help you rehab your shoulder, and it's possible this aqua-aerobics class is just what your shoulder needs. Nobody wants to go to PT. Nobody wants to do the exercises. They're accustomed to people having excuses for why they don't want to follow the therapy, and they persist with their recommendations through it. It's their job.

Given that, deflection is unlikely to get them to stop. Be very clear and explicit that aqua-aerobics is off the table, but you are willing to do the other work necessary to rehab your shoulder. If they persist, broken record it. Write it down or send them an email if it will be easier for you, but make sure you leave absolutely no room for misinterpretation.

FWIW, I'm "Ask Culture", and I would push through all the deflections you mentioned in your post.
posted by AaRdVarK at 12:20 PM on July 14, 2015 [12 favorites]


Best answer: Look at it from the other side for a moment.

From a purely PT point of view the aqua-aerobics may well be an excellent idea, and therefor not suggesting it would be a failure on her part (the fact that you say "rec center” implies that she’s not pushing some something inappropriately expensive). If what she’s hearing in response are vague excuses like "I don't have a swimsuit,” then it may well seem to her that a little more gentle pushing will get you over the hump and get you to take part in physical activity she sees as beneficial… Some healthcare professionals might pick up on your heavy hints, but it’s not entirely surprising that she hasn’t.

From your side, even though she may be right on a purely PT basis, there are other reasons why this is not for you. So, as everyone else is suggesting, you need to communicate that effectively and not just use deflecting and delaying tactics hoping she will forget. There’s no need to be rude, and no need to explain unless you want to, but until you clearly communicate the “No!” you cannot expect her to stop recommending what she believes to be best for you.

If, after a clear no, she persists, then you are in different territory, and if she won’t respect that, you probably need to find someone else.
posted by Quinbus Flestrin at 12:20 PM on July 14, 2015 [11 favorites]


Why haven't you explained to her WHY you don't want to go?
posted by showbiz_liz at 12:30 PM on July 14, 2015 [2 favorites]


I would say no, and ask what her suggestion is in the alternative to swimming/pool aerobics classes. Instead of giving her reasons to make you say Yes to the Pool, it puts the onus on her to come up with another idea that may work for you. And shows that you're willing to work to get better outside of PT - just not in the pool. Sometimes people getting PT don't want to "do their homework" and work on exercises/stretches at home, and there is only so much that can be accomplished during individual sessions. So by asking for new options, it shows you are not just being stubborn, and are willing to do something non-pool related.

And if she still pushes the pool workout - then time to use the stone cold No's and answers above.
posted by Suffocating Kitty at 12:30 PM on July 14, 2015 [2 favorites]


Like if someone came to me for help and said "oh, I can't do [thing you know would help me] for [really inconsequential reason like not owning a swimsuit]" I would not somehow intuit that you have massive pool anxiety and would consider dropping me over this pool issue. I would think "she just needs a reminder to buy a swimsuit!"
posted by showbiz_liz at 12:31 PM on July 14, 2015 [2 favorites]


Response by poster: Why haven't you explained to her WHY you don't want to go?

Because I'm an extroverted introvert (I don't act introverted), people just flat out don't believe me when I tell them that I have difficulties with groups. Because I can interact socially with, for example, my PT and the people in her office, I'm afraid that she just won't believe me if I tell her how much it's stressing me to think about going to the pool. It's happened in the past, "But you're doing so well here... how is that different?" blah blah blah. That's why I've been deflecting. But I can see deflecting isn't the way. It's time to just own up and say that I just don't want to do it.

As for working outside of the sessions, I've already shown her my kit for home exercises that's very much like the stuff we use in sessions so she knows I'm working my shoulder at home -- because I'm tired of my shoulder hurting. She knows I'm gardening too when I have the energy, and that I'm being mindful of my shoulder. So it's not like I'm just going to the PT sessions and that's it. I think she's just got it in her mind that water aerobics is the thing that will be good for me overall (I have comorbid issues). And I know she's being helpful, but... I just can't bring myself to do it. Not just yet.
posted by patheral at 12:42 PM on July 14, 2015 [1 favorite]


This doesn't get to the root of the problem, but could you redirect her into advising you on exercises you could do in the pool alone? Or ask her if the two of you could do an in-pool session and then you could continue on your own. If the issue with the pool is the other people in it, surely she could get you set up to do whatever pool-based PT would be best for your shoulder without your having to take a group class.
posted by snaw at 12:46 PM on July 14, 2015 [1 favorite]


Best answer: You are currently giving reasons/excuses, not saying no. I'm seeing a clash of ask/guess culture. Funnily I too am an introvert that people mistake for an extrovert but I'm an an ask kind of person I would assume these were problems to solve & not you say no. A simple "No thanks, they're not for me, are there any exercises I could do at home that would have the same effect?" should end the matter.
posted by wwax at 12:47 PM on July 14, 2015 [1 favorite]


Best answer: It's time to just own up and say that I just don't want to do it.

I'd be even more specific: you are not going to do it. Your desires are not up for debate at this point, you've made a decision.

I know to you this may feel like saying the same thing "I don't want to" versus "I am not going to" but in the interests of helping you communicate clearly and not beat yourself up about not going to the pool (seriously, if you've made a decision, it's an okay decision for you, you can revisit it later if you want to, but be kind to yourself that now is not pool time for you) I'd stick to "I am not going to do that right now, we can revisit it in X amount of time, but for now let's focus elsewhere"

No need to turn this into a shame spiral opportunity since you are doing good with just getting there in the first place. I have this problem too, people just make a ton of assumptions that I don't have social issues or concerns and so they sort of laugh it off when I'm like "Seriously I will quit this job if you make me call strangers on the phone." so I've learned to be a lot more clear about my own boundaries and shrug off their amazement at this. "Yep, I am weird like that, but that's how it's going to work" and move on.
posted by jessamyn at 12:48 PM on July 14, 2015 [9 favorites]


I don't see why you have to give her any explanation at all, frankly, or explain that you're an introvert or what have you. As others have noted above, just tell her that it's not something you're going to do right now, that's that, you'll let her now if and when you change your mind, and please stop bringing it up now thanks, full stop. If you give reasons, that's just giving her an opening to argue with you about it.

Or, what wwax said.
posted by holborne at 12:49 PM on July 14, 2015 [1 favorite]


Response by poster: You know what's funny? I'm totally an Ask person and if I remember correctly the first time she suggested it, I said that I didn't want to do the pool thing. But then she asked "Why?" and "Because I don't want to." seemed to be a churlish answer so I started to deflect because I didn't want to be churlish and abrupt. And that's when it started to spiral. Now I know, "Because I just don't want to." is probably the better answer. It's too late for that now, I think. But yeah...
posted by patheral at 1:02 PM on July 14, 2015 [1 favorite]


"I'm certain you respect my decision."

What is she gonna say to that, that she doesn't respect it? If she doesn't, fire her ass.
posted by Ironmouth at 1:29 PM on July 14, 2015 [1 favorite]


Best answer: Or even: "You know, for just a variety of my own personal reasons, the pool thing is not something I'm comfortable doing. I'm really sure about that." Or "Really, you've brought this up before, I hear you, but that particular route is not for me. I'm hoping the health of my rotator cuff is not contingent on my getting in a pool." I think there's a tone you can use that has an edge of finality to it. Just sound certain. Convey the fact that you've thought it over, and you welcome her help and ideas, but that particular one is just not for you.
posted by swheatie at 1:41 PM on July 14, 2015 [3 favorites]


Now I know, "Because I just don't want to." is probably the better answer. It's too late for that now, I think. But yeah...

"I've thought about your recommendations for that, but I'm just not interested in doing classes. Are there exercises you can show me that I can do on my own [in the pool/not in the pool] that would help?"

Any further prodding on her part can be answered with, "I'm just not interested in doing those classes" until she accepts your answer or gets bored.
posted by jaguar at 1:52 PM on July 14, 2015


"Oh, not for me!" could work for answering the receptionist.
posted by jaguar at 1:53 PM on July 14, 2015


I think at this point I would just flatly say, "That's not gong to happen" or soften it as "Sorry, nice PT person, but that is not going to happen." Than ask her for alternative but you need to ask for something that works better for you. This will depend on what the essence of your issue with the group aerobic is "Can you suggest something that I can do at home, instead?" or "Do you know of anything similar that I can do on my own? Groups classes just don't work for me."
posted by metahawk at 3:22 PM on July 14, 2015


Look, you don't need to convince anyone that you really are an introvert. Saying anything other than, "No, thank you but I have made a decision that I do not want to do that. Please stop asking." is giving them a problem to solve. They'll say "Oh, you're an introvert? Well there's a class with less people..." But what you're really trying to say is NO.

So, just say no. This goes for future things to. It doesn't matter WHY. If you give someone a why, they will just try to work around it to try to change your mind. It seems like you've tried the "I'm an introvert." approach in other situations, and I encourage you not to. Again, your reason doesn't matter, the only thing you need to communicate is that you don't want to. Period. Also "That's not for me." is a good response too in more social situations.
posted by Crystalinne at 3:43 PM on July 14, 2015 [3 favorites]


Best answer: I have a bad back and had been told and cajoled for years by various professionals that I needed to do Pilates. But, much like you, being an introvert, the idea of a group of people staring at me and having a trainer adjusting my body freaked me out. So I refused. Finally, during pregnancy, my body basically collapsed to the point I couldn't move and I no longer had the option to refuse. Lo and behold, after fifteen years of therapy, Pilates was the only thing that actually worked. I wish I'd done it earlier.

Now, I don't tell you this to get you to do it, if you really don't want to. But your PTs repeat insistence makes me think that she thinks that this is a major component to your healing and something you really need to do, otherwise she wouldn't harp on about it. She probably thinks that's she isn't doing the right thing by you as a patient by not getting you onto it.

I would explain your extreme aversion and ask if there was another way of achieving the same objectives. Can she give you exercises you can do yourself? Can you get a one on one session with an instructor by yourself? What is another way to get the same results? I'd just hate for you to potentially ignore the one thing that will make the difference to you getting better and it's worth having a conversation with her to find out if water aerobics is a 'nice to have' or 'critically important' in your situation.
posted by Jubey at 4:46 PM on July 14, 2015 [11 favorites]


If it helps identifying her motivation: I had a similar experience at my PT's place when I was having my sciatica/L4 worked on, and they suggested swapping out one session per week with aquatherapy. I realized pretty quickly that they could have one PT person at the pool and have 10 patients all being worked on (and being billed). Instead of one-on-one therapy I got one out of 10. I went for a couple of sessions because I enjoyed it, but then I wanted the return to one-on-one and just stopped going and made more in-office appointments. They were fine with it because I just said I couldn't make that time anymore.

If being direct is too hard, tell your PT person that you absolutely can't make any of the scheduled classes, and gosh isn't that too bad. If they bring it up, deflect again "Oh, remember? My schedule doesn't work for that. Maybe next season they'll have different classes."
posted by clone boulevard at 5:18 PM on July 14, 2015 [1 favorite]


Best answer: Normally I'm all for "Geez, I'M NOT GOING TO DO IT, OKAY? I DO NOT WANT TO SWIM WITH STRANGERS" because pushy people piss me off. But....I think Jubey might have a point:

"But your PTs repeat insistence makes me think that she thinks that this is a major component to your healing and something you really need to do, otherwise she wouldn't harp on about it. She probably thinks that's she isn't doing the right thing by you as a patient by not getting you onto it.
I would explain your extreme aversion and ask if there was another way of achieving the same objectives. Can she give you exercises you can do yourself? Can you get a one on one session with an instructor by yourself? What is another way to get the same results? I'd just hate for you to potentially ignore the one thing that will make the difference to you getting better and it's worth having a conversation with her to find out if water aerobics is a 'nice to have' or 'critically important' in your situation."


I think given that they nag you about it every time, with multiple people nagging you every time, and water exercise generally being considered good yet gentle on the body as well...this may not exactly be something you can say no to and have it respected. It may be more mandatory than you think it is. It might be good to ask something like "On a scale from 1-10, how necessary/mandatory IS a swim class, anyway?"

I think you should say straight up, "I'm not going to do it in a group pool with strangers judging me in my bathing suit" (or whatever), "can you possibly think of a more PRIVATE way for me to do something similar that I'd actually not hate doing?"
posted by jenfullmoon at 10:33 PM on July 14, 2015 [2 favorites]


Best answer: Same position as Jubey - I had a debilitating spinal injury, and I kept being told by my PT to swim, or do aqua aerobics. I was a crappy swimmer, and hated the idea of group classes, like you. Solution was to call my local pool, and ask them what they thought I should do. They recommended a one-on-one session plan with one of their swimming coaches, and then quieter times that I could go in and use the pool to practice by myself. It was a fantastic solution, and lo and behold, it was the only thing that fixed my back in a LONG list of things I tried, from pilates to acupuncture to PT.

Now whenever someone tells me they have an injury that requires aqua-movement but doesn't like pools/aqua-aerobics/whatever, I ask them one question: Do you want to get better?

If you ask your PT how necessary this is, AND they say incredibly so, then find your options that will suit you. Perhaps it would be as simple as attending ONE aqua aerobics class, then finding a quiet pool to practice in.
posted by shazzam! at 6:25 AM on July 15, 2015 [1 favorite]


Response by poster: Okay, I have an appointment with her in about a half an hour (our regularly scheduled appointment). I'm still stressing about the whole thing, but I'm armed with y'all's insight, so it's a bit better. I'll talk with her and see why she's so insistent and see if we can come to a compromise. The aqua aerobic classes are out, but surely there's a compromise somewhere. Thanks for your help y'all
posted by patheral at 2:26 PM on July 15, 2015 [1 favorite]


Response by poster: One last closing comment as a follow up. I did talk to my physical therapist yesterday, and while she thinks that aqua-aerobics would be the best thing (because of the buoyancy of the water), she really just thinks that any aerobic exercise would be beneficial. I suggested walking because walking has always been my go-to exercise of choice. I've had difficulties with it because of the breathing thing (which I mentioned in previous posts). We agreed that I'll work on getting my walking game on again, and that she'll not mention aqua-aerobics anymore.

Thanks again, y'all for giving me the courage to just... talk with her instead of avoiding it altogether. I think I needed the moral boost.
posted by patheral at 9:16 AM on July 16, 2015 [5 favorites]


Yay! I'm so glad it worked out well.
posted by showbiz_liz at 12:56 PM on July 16, 2015


Congrats! I don't know if this is an option for you but at my pool there are these nifty flotation belts that people put on and ... walk around the pool. No classes, no real interaction with other people. I'm aware this may not be a thing you'd like but it's another possible compromise position if it turns out that walking outside is challenging for breathing reasons.
posted by jessamyn at 1:20 PM on July 16, 2015 [1 favorite]


Oh that's great, good for you! I hope you get better soon.
posted by Jubey at 11:05 PM on July 16, 2015


Response by poster: I dunno if I should start another askme or just continue this one, but I went to my PT today and all was not as well as it was on Wednesday. On Wednesday, the receptionist wasn't there. But she was there today and she would not shut up about going to the pool. I kept saying, "It's not going to happen" and she just kept going on and on about it. I told her that my PT and I talked it over and we decided on something else, but she kept singing the praises of the pool. Argh! I was working with an intern today rather than my PT, so I didn't get to talk with her directly about this, but honestly, it stresses me out.
posted by patheral at 5:03 PM on July 17, 2015


Response by poster: I meant to ask, should I confront the receptionist directly? I mean I have to talk with her nearly every time, or should I talk with my physical therapist about the receptionist's harping? Or should I just let it go?
posted by patheral at 5:04 PM on July 17, 2015


I'd get the PT to handle it, since you already told her your reasons for not doing it and she accepted them.
posted by showbiz_liz at 5:27 PM on July 17, 2015


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