–   NOVEMBER 2020   –

Creating a physiotherapy plan with a complex disability


As neurological physiotherapists and specialists in treating clients with brain or spinal cord injuries or diseases, we understand how challenging the journey to recovery or robust maintenance of your condition can be. You want to feel like your condition is under control and you’re doing everything you can to alleviate the symptoms or reach those big goals. Some days, feeling great again may seem impossible, others you may celebrate small wins or gains with those you love.

Setting goals when you have a complex injury or disability can seem like a difficult task. It’s hard to know what’s realistic, either after a traumatic event or with a degenerative disease where recovery paths can be so different from person to person. One day you may be walking fine, the next you may fall or struggle with your balance. You might find yourself struggling to complete daily tasks – dressing yourself, making a cup of tea but yet have managed perfectly well last week.

We understand you may be frustrated that progress isn’t going as fast as you’d expect, or that mentally, you’re finding the nature of your illness hard to cope with. With injuries or diseases of the Central Nervous System (CNS), it can be hard to predict or map an exact pathway, as there will be ups and downs, but it’s critically important that you work with a specialist like one of our team, to set goals and chart your progress.

The first step is to outline your goals – what do you want to achieve? Is this realistic or not? What are the steps you need to take to get there?

There are many factors to consider when creating your recovery or maintenance plan and critically, it depends on your condition and on your expected outcome. Our brains have a fantastic ability to adapt following alterations to our environment, and it’s this plasticity which enables us as neurological physiotherapists, to tap into the brain’s neuropathways and teach your body new ways to move.

We work with all our clients on a step by step plan – celebrating every small win along the way. It’s important for clients not to compare themselves to others in their situation, even with the same disease, as there are so many variables from person to person, that it can provide false hope, or indicate a more challenging path ahead than might be necessary.

While in life before injury or disease, an activity might have been insignificant, it might now be a major achievement and should be celebrated! We actively encourage all our clients to take baby steps, to see the positivity in small gains and recognise that a mountain cannot be metaphorically climbed in a day. Recovery might take weeks, even months or years and for clients with a degenerative disease, those extra weeks or months of quality life with small wins, can make all the difference mentally and physically.

Any robust recovery plan must include not only managing pain and symptoms but how clients share the heavy burden that can come from a brain or spinal cord injury or disease.


It’s not uncommon to be in shock from a recent diagnosis or be overwhelmed and a strong support bubble is one of the most important aspects to maintaining your health as best we can. Family, friends and experts are all likely to play a role in helping to hold you accountable to your own recovery, support you mentally and provide the medical expertise to enable those small wins and celebrations.