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Road to recovery: when the practitioner becomes the patient

Marina Williams
1 February 2017

A serious accident taught James McEwan, APAM, that restoring psychological function is as important as healing physically from injury. Not long into a bicycle ride, he was grappling in pain and rapidly losing blood from deep wounds to his shoulder and neck. His left arm, almost crushed, and knee had taken the full brunt of force of the collision with a road guardrail; the cuts caused from sliding along the railing’s edge. Immediately, James knew he was in serious trouble, and worried he may never again practise as a physiotherapist.

‘The crash is still vivid,’ James says. ‘It was December 29, 2013. I was cycling to our beach house to start two weeks’ holiday with my family. I was descending a hill and the front wheel went flat. I was going about 70 kilometres per hour. I tried to control it by braking on the back wheel, which locked up. The result was the bike and I went sideways. Although I managed to stand up, my left arm had 12 fractures, bone was protruding out, and I had a smashed knee and gashed shin.’

When help arrived, James was rushed to surgery. Doctors saved his arm, but regaining use would depend on post-surgical rehabilitation. Putting into practice his years of experience, rehabilitation started well and he returned to work four months later. However, setback followed.

‘Recovery was going to be long, but rehab began straightaway because I wanted to give myself the best chance of a good recovery,’ he says. ‘When I went back to work in July 2014, I re-broke my arm and needed another plate put in to reset the radius. I was devastated, as I needed my arms to do my work.’

With a passion for physical activities, the Adelaide-based practitioner was skilled in using a combination of manual therapy, exercise and education for healing an injured body. A keen surfer, skier and swimmer, he trained and treated elite athletes. However, the crash became a wake-up call as to how he would continue to approach his profession: treating and healing the mind and emotions was to be equally as important when ‘fixing the body’.

‘I found the emotional struggle was harder than the physical,’ James says. ‘As a manual therapist, who was quite active, I found rehab frustrating because I had a knee and an arm injury. As part of my rehab, I saw a psychologist, which opened my eyes up to what was happening to me and how I needed to work through recovery emotionally as well as physically. It has changed my approach with my clients—the dialogue we now have focuses more deeply on how they are feeling and if they are talking about how they are feeling.

‘Before my accident, I would describe it as driving in a car with the handbrake on—you are going around in circles. You are talking with a patient but you are not really picking up on their responses to get direction. It’s only when you are talking with a person who has a skill set that can manage a conversation that will enable you to then pick up on what people are actually saying that the handbrake is off and you are getting somewhere.’

Three years on since the life-changing event, James says he is a better practitioner post-accident, with improved communication skills at home and at work. He is also enjoying cycling again.

‘It made me walk in my patients’ shoes and realise that successful strength and conditioning training and rehabilitation needs a good understanding of what the patient is going through emotionally— do they realise that they are, or are not, coping with the physical change to their lives?

‘Good mental health is important and vital to patients seeking physical recovery from injuries. We shouldn’t be ashamed to say we need help if we are not coping emotionally. It’s OK to talk about it.’


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