How to set strong goals for your rehabilitation plan

It’s important to set strong goals for your rehabilitation plan to help you in your ongoing recovery from a serious health issue. Strong goals are the foundation of your plan. They provide a destination to work towards and even the direction to take to that destination. They become your road map to the best recovery you can get for yourself.

But what does a strong goal look like? How do you know if you are setting yourself up to succeed? To help you set strong goals for your rehabilitation plan, this blog takes you through a six-step plan to do just that.

This blog is part of a series on rehabilitation planning and you can read the first blog here on the principles of a good rehabilitation plan and the second blog here on what you need to include in your plan.

This blog (and the first two) will help you whether you are looking to create a full-on rehabilitation plan or you are further on — months, a year or years even — but want to tweak something you are doing or try something new.

As I’ve said before, rehabilitation is a life-long activity. Sometimes you may not make great gains in your rehabilitation several years after the health issue arrived into your life. But your rehabilitation can keep you from regressing, which is important. Also, rehabilitation is about self-care. And self-care is for life.

So let’s go through this six-step plan.

How to set strong goals for your rehabilitation plan

1. Identify what’s important to you

What is most important to you in your life? Now and what you want to be doing in the foreseeable future? How far you look into the future is entirely up to you.

Is it your family, your physical and mental health, your work, enjoyment you get from your hobbies and leisure activities, financial wellbeing, feeling calm and at peace, having a coffee first thing in the morning before everyone else gets up, or having a life purpose? Do you want to return to studying? Change careers? Retire? Doing more things independently? Something else? Make a list.

It doesn’t matter whether these activities are small or big, bring in money or not, involve other people or not, are mundane, are behavioural or just an internal feeling. It may be something you have to do or want to do. They can be from many parts of your life as I wrote about in the second blog in this series of rehabilitation planning. What matters is that they are important to you.

I will use myself as an example with a real-life issue.

What is important to me is maintaining my ability to move as freely as I can, to maintain my physical fitness (so I have to be able to exercise), and to push off having a knee replacement for as long as possible.

2. Have you been able to make whatever is important to you happen yet?

Are you able to do what is most important to you? Have you made it happen yet? If there is anything getting in the way of doing what is most important to you, add that to your list.

If there is nothing that is an obstacle to working towards your goal, and it is something you have started or can get started on, write down what is enabling you to do that. This could be something about yourself, a characteristic, strength, skills and/or a passion you have. It may be support from other people. It could be anything.

The importance of this is it reminds you of what is going well for you, your strengths, and what and who are around you that are a form of support.

An example

I live with progressive osteoarthritis in my knees. My right hip is in pain and I am worried it may be starting there. Moving as freely as I can is a bit hit and miss. By the end of the day when my legs are tired, my mobility isn’t great and I can end up waddling from side-to-side. I feel down and sometimes frustrated about the pain in my hip. I feel I need to look at how I am thinking about this issue too. Not sure why, but feel I need to. I have made exercise happen. Finally! (You can read that story here and here.) And I’ve maintained doing the exercise nearly every day and only took breaks over the Christmas holiday and when I had a light injury to my knee. Being part of a group of people who had the same goal to make exercise a daily part of their lives has helped. So has my self-discipline, which I’m really proud of. I am seeing a physiotherapist for my knees and hips. The exercises have helped my mobility. I waddle less. But I still have pain.

IMPORTANT TANGENT: It’s important to recognise yourself for your accomplishments and pat yourself on the back when you’ve done something well, or something you are proud of. Because there may be times when others won’t do that and you don’t want to constantly be in a place of waiting for praise from others to feed your sense of self-worth.

3. Now it’s time to set some goals. But first, inspire yourself

Look at what is important to you and what is getting in the way of you doing/feeling what is important to you. What is getting in the way can sign post you towards goals you can be setting.

The pain in my hip and from an old groin injury is getting in my way. This inhibits that feeling of moving as freely as I can.

Now ask yourself this question. If there was something you could do to work with whatever was getting in the way, to work around that obstacle or even work with the obstacle, what would it be?

I think the physiotherapist was a little perplexed I was still feeling pain given my mobility was better and she said the exercises helped to build the required muscle mass I needed. Need to get a scan to find out exactly what is going on in my hip.* I’m wondering about doing a meditation on my hip pain. Use the tennis ball more to massage my hip. I need to sit with my mental state around all this and figure that out.

Don’t judge your ideas now as good, do-able, bad, or not feasible. You’re aiming for as many ideas as possible. Write them down. It may be that the ideas spark another idea.

Do I need a walking stick for days when it’s really bad?

You could do this exercise with someone, in a group, or on your own. If you want, have someone read over your work as they may have ideas to contribute and thought of something you haven’t.

You can also share this with someone who has been in the same place as you but a bit further down the road. They can share what worked for them and others.

4. Craft your goals

Remember, goals don’t have to be of the Big Hairy Audacious Goal type. But they can be if that motivates you. If your goals are big, break them down into smaller goals. These smaller goals are like milestones you can work towards. You are more likely to achieve these smaller goals and this feeds your motivation to continue. Important.

For example, maybe you’ve had a health issue like Transverse Myelitis, Multiple Sclerosis, Cauda Equina Syndrome or a stroke which has greatly impacted your mobility. You want to be able to walk again preferably without a mobility aid within a year. That is your Big Hairy Audacious Goal.

Let’s break that BHAG down into smaller goals.

• Your first goal may be to go on a course to develop your skills of using a wheelchair so you can get out and about and maintain some independence.
• You then practice your new wheelchair skills.
• Your next few goals may focus on strengthening the muscles needed to walk through physiotherapy.
• Once you have the strength, then you try standing.
• Then take a few steps with a zimmer frame, then walk 25 meters, 50, 100, etc.
• You progress to walking with a stick.
• You then try walking without a stick.

5. Whatever the size of your goals, make sure they are specific

This is key. Because when a goal is specific, it’s more tangible in that a specific goal gives you direction on what you can be doing. Specific-ness ensures your goals are strong.

Here are some examples of unspecific, vague goals that don’t give much direction on next steps.

Get out more

• Get out more where? Doing what? With whom? When? Where?

Be more independent

• Independent from whom, from what? What activities do you want to be doing independently?

Feel calm

• What do you want to feel calm about? When do you want to feel calm? What gets in the way of you feeling calm? Is it intrusive thoughts? What other people say and do (or don’t)? Something else?

Do more things that make me happy

• What things specifically do you want to be doing? With whom? When? Where?

Return to work

• To the same job? If yes, do you need adjustments to your job so you can actually do it? If no, what kind of job do you want? When ideally? How will you know your body is ready? Or are finances dictating your return?

Using me as an example, an unspecific goal would be

Walk more freely.

Unspecific goals can feel large and they don’t provide direction on next steps. Whereas with the walking goal provided above, there was a clear progression of steps the person had set themselves to take towards their goal of walking again. They also knew they would need to attend a course and get outside help in the form of physiotherapy to help them meet their goal.

Answer these questions to ensure your goals are specific

I’ll continue using myself as an example.

What specifically do I want to be doing, thinking or feeling? How will this be different from what I am doing, thinking or feeling now?

I want to be able to get up from a chair with minimal pain and hobbling. Hopefully there will be less pain. I will feel more free in my body because it is moving more as it is meant to. That feeling of freedom will be me getting up from a chair and walking a little more quickly and ideally no hobbling which I do now.

Notice how goals can be something you see someone do or say. These are behavioural goals. Or goals can be about changing how you feel or think and these may not always be readily visible to others (which is fine).

How often do I need or want to do, think or feel this? Is it something I will be doing all the time? Like walking and/or using a wheelchair for example. Or is it only in certain situations. If in certain situations, what are they? Where and when do they happen?

I get up from chairs and walk daily. I exercise and do my physiotherapy daily. If I can’t, at a minimum 5–6 times a week.

When would I like to make this change by?

ASAP ideally! But I need a scan. And the results of that scan may determine what happens after that. If I could be walking more freely in six months time, that would be good. It feels like a realistic timeframe. I’ll book an appointment with the GP on Monday.

Who will I be doing this activity with? Or is it one I do on my own? Or both?

I walk every day with people like my husband, friends or colleagues.

Do I need specialist expertise to help me do what I want to be doing? If yes, what kind and who can provide it? Or do I need to learn how to do something?

I need the following specialist expertise: GP to get the referral for a scan; orthopaedic doctor regarding the scan and its results, physiotherapist for ongoing physiotherapy.

Who else can support me as I make this change?

Husband for moral support. He can also give me feedback on how I am walking. Coach and therapist for support on how I am thinking and feeling about changes in my mobility.

Notice how these forms of support are non-medical.

How can I hold myself accountable for making this change?

This is SUPER IMPORTANT. I see a lot of people rely on others for accountability and when the other person/people don’t provide it, the person never achieves their goals. You want to strike a balance between support from others in helping you to achieve your goals and support from within yourself.

I have just entered the task of making the appointment into my calendar. If it’s in there, it gets done. Including this issue in a blog is a form of group accountability for me. When I get up in the morning, put on my exercise clothes and do my physiotherapy first thing. I can lay my exercise clothes out the night before. Every day after finishing my exercise and physio, I will continue posting in the online boot camp’s Facebook group that I’ve done it.

What other questions do I have about making the change I want for myself?

How will I know when a using walking stick would be a good idea? Ask the physiotherapist. And can the physiotherapist do anything to improve how I am affected by the groin injury?

By answering these questions, you give yourself much more direction on what you do next. You have defined a route so you know where to go.

6. You need large doses of willingness to adapt, be flexible, be persistent and practice self-compassion

Some of your goals are going to require a lot of work on your part. You’ll sweat — physically and mentally. You may feel frustrated at times. You’ve got to stay with. People can support you and contribute to you feeling motivated, but at the end of the day, you’ve got to do this. Because no one can do it for you.

You may find that your end goal of walking without a stick isn’t achievable in a year. It may take longer than you thought. Or it may not be possible at all. You may have realised you were over-ambitious. (Being ambitious is not a bad thing. Sometimes ambition can get you further than you or others expected even if you don’t meet your original goal.)

In these moments, it is ok to be upset. And as I always say, you don’t have to unpack and live forever and ever in the upset-ness. This is when you need those doses of adaptability and flexibility, the persistence and self-compassion to adapt or even change your goal and continue striving towards it.

I get frustrated on some days with my hip and groin. It gets so painful and the pain can be random. I’ll have a good day and then several bad days. I walk more slowly sometimes. It’s frustrating. It’s ok to yell. And cry. (I do!) It’s a good discharge for me. I can then move on.

Remember, sometimes you may not know what the end goal is or can be

Sometimes you just don’t know what the end result will be. Or you may prefer not to set an end goal. You just want to get started and figure out the next step as you go along. That is ok.

In either case, what Martin Luther King Jr. said is applicable.

“Take the first step in faith. You don’t have to see the whole staircase, just take the first step,” having to see the whole staircase, just take the first step.”

Martin Luther King Jr.

Taking that first step with faith in yourself and the people supporting you is key. That first step is a goal in itself.

What’s it like for you?

Do you like to make a detailed plan of your goals or do you prefer to take one step at a time? What other approaches to goal setting have you tried which worked for you? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).

If you are living with a serious health issue or are caring for someone who is, and would like support to set strong goals for your rehabilitation plan, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2019

Originally published at https://returntowellness.co.uk on April 18, 2019.