Don't let PERFECT be the enemy of BETTER

There's a perspective most clinicians have that is false, and that can hurt your recovery. Bluntly, their perspective is: There is a right and a wrong way to move. And stroke survivors move wrong. 

Further, they'll say, if you move the wrong way, its bad for your body, and brain. 

"You'll hurt your brain."

They'll contend that since you're moving wrong, the brain will "ingrain" that movement. The brain will learn that bad movement, become satisfied with that movement, and that will become your movement strategy forevermore.

"You'll hurt your body."

They'll say that, because you're moving wrong, and the human body is designed to move right, you'll cause orthopedic (bone/ muscle/ ligament/ etc.) damage.

Both of the above are only true if you completely discount two fundamental aspects of human motor behavior:

a. For 250 thousand years humans have learned to move the same way: Move, self correct, move again better, self correct, move again better... but if you are discouraged from moving, where is the opportunity to self correct?

b. The injury to the brain makes the whole move, self correct process slower than clinicians can deal with for 2 reasons: 1. Therapy has limited amount time with the survivor. This is a bigger problem in the USA than many other countries, but everywhere its a problem. 2. Many therapists have a lot of experience with brain injured patients, to be sure. But the frustration, fatigue, depression, changes in the brain, emotional issues, etc., etc. is something therapists can attempt empathize with. But they don't really understand unless they've lived it. There are therapists who have lived in both worlds. I've met quite a few of them. They know. Here's one. 

The upshot of a and b is that the clinician— through word and deed— assumes that the survivor will never learn to move "right." And so, "you'll hurt your brain" and, "you'll hurt your body."

So the question clinicians are trying to answer is "How can I best coach them to move right?" Instead the question should be is, "How can I get them to move better?" Better is always achievable. (Clinicians, look at it this way: Chip away at their present AROMs. If the have 20° of elbow extension, go for 30°.)

In some ways, stroke survivors have the same dilemma as high level athletes. Both athletes and survivors are trying to push through a ceiling in their ability to move. And just like a an athlete, the survivor's progress will be slow and very (very) incremental. 

And that's OK, because its not about "right". 

Its about better.