Last Friday morning I was driving to the airport to head to Hartford for the Amputee Rehabilitation Specialist Certification Course. It was really early, and I’ve made that drive enough times that I basically have the whole thing down to a science. I know almost exactly how long it takes me to go from pulling out of my garage to sitting at my gate.
The problem is I also tend to cut things pretty close. I don’t leave a ton of room for error. Especially when my flight is at the butt-crack of dawn and I’d rather be in my bed longer than sitting at my gate waiting.
So when I got to one of the main roads leading to the airport and saw that it was closed, my immediate thought was, “Oh farts (PG version of what I said). If this detour adds more than a few minutes, we might have a problem.”
I don’t know the back roads around that area very well, so now I’m following random detour signs through neighborhoods, hoping they eventually dump me back onto something I recognize.
They did. I made it to the airport just fine. No dramatic ending here.
Looking back, the stressful part wasn’t that I didn’t know where I was going. I knew exactly where I needed to end up. I just didn’t know the route anymore.
And there’s something really comfortable about having somebody tell you exactly how to get somewhere. Take this road. Turn here. Go this far. As long as nothing changes, you barely have to think.
That’s basically a protocol.
And protocols can be great. I’m not knocking them. There’s something really reassuring about being told, “Do A, then B, then C, and you should get this result.”
The problem is patients don’t always cooperate with the directions.
Their residual limb isn’t healing the way anyone hoped. Phantom pain is through the roof. They’re terrified of falling because they already went down once. An old knee or back injury starts dictating how they move. Maybe they’ve spent months hopping, offloading, guarding, or just doing whatever they had to do to get through the day, and now those habits are baked in.
Now the road is closed and the directions you got don’t get you to your destination.
That’s why I teach from a framework.
A protocol gives you turn-by-turn directions. A framework gives you the map.
The map may actually feel less helpful at first because it still makes you think. You might have to try something, see what happens, back up, and take another route. But that’s also where you start to learn and actually understand what you’re doing instead of just reproducing somebody else’s directions.
You already have a ton of skills as a rehab professional, and I don’t want anything I teach to get in the way of you using them. The framework is there to help organize those skills and give you a North Star when the obvious route stops working.
You still know where you’re trying to go. You just have more than one way to get there.
And honestly, I’d rather you understand the map than memorize one perfect route.
Because the human body is eventually going to close a road on you.
You still need to know how to get there.