Pivot, pivot pivot said rose

When my mom asked me to bring a brimming bucket of water into the house, she cautioned, "Be careful” do not to spill it. Naturally, I promptly managed to spill it inside the house, earning myself not just a mouthful but also a good thrashing. Perhaps she thought after saying “be careful” he spilled- may be did it on purpose. I guess everyone has had a similar experience, whether or not it came with a beating.

We often find ourselves saying "be careful" in various situations—whether it's someone scaling a wall, riding a bike in the rain, or a kid lighting a Deepavali cracker. Deep down, we recognize that uttering those words doesn't necessarily translate into heightened caution. It's more of a ritual, a verbal token that makes us feel like we've contributed to risk management, even though we understand that the level of care someone takes isn't likely to change based on whether we say those words or not.

Verbal tokens in clinical practice:

As we know feedback is usually provided to “correct” movement abnormalities. We believe, this correction can help patients achieve the goal with minimal error. Unfortunately, echoes of seemingly well-intentioned but repetitive advice, like the ubiquitous "be careful," pervade the landscape of rehabilitation. “Keep the right foot forward”, and now “the left foot forward” is so common in stroke rehab clinics is a common vocal ritual. There are many such feedback, which serves no purpose.

Why are these kind of feedback don’t work?

Well, there are many reasons for it. I don’t want to get into all the details- that’s for the reader to seek and clarify. But i will just say what our patients will feel like if we keep on giving “obvious” feedback.

In a Friends (TV show) episode, a determined Rose keep on saying, "Pivot! Pivot! Pivot!" as they transport a large couch in a tricky stairway. Despite earnest efforts, the repeated guidance becomes a frustrating, leaving Chandler (the great late Matthew perry) exasperated outburst, "Shut up! Shut up! Shut up!" The humor of Friends serves as a poignant reminder to know when to shut up and when to give a feedback.

Learn to give proper feedback from evidence not just verbal token. Probably i will write about them next.