Measuring Progress in Rehabilitation & Pain Management – SMART Goals

Injuries and chronic pain can interfere with movement, general tasks, social activities, sleep, sports, hobbies and mood. Therefore an important part of rehabilitation is to reduce the impact an injury or pain has on daily functioning.

Whilst most injuries heal well, they generally need time to do so. Other conditions may be permanent or have limited healing potential. This can make returning to a high level of function more difficult, though not impossible. It is still possible to achieve functional gains despite ongoing pain or pathology.

Regardless of the condition or prognosis, effective management requires the setting of SMART goals.

What are SMART goals?

SMART goals are goals that are:

Specific

 Measurable

 Achievable

 Relevant

 Timed

They are goals that are important to you to achieve. This may include returning to an activity that has been affected by your pain / injury, or being able to do an activity you need to get done despite pain. It can also include exercising, losing weight, becoming more social or starting a new activity/hobby. By setting SMART goals you aim for and find ways to achieve the things you would like to, and also measure your progress with recovery.

How to set SMART goals:

Goals associated with emotions, or goals that are unrealistic or non-specific, are not effective as they generally cannot be achieved. Goals need to be important to you, or you will lack motivation to work towards achieving them.

Emotions are often fluctuating and depend on life’s circumstances, with many of these situations being beyond our control. Setting goals like “I want to be happy” may be successful temporarily, but will fail when something in life happens that counteracts this emotion.

Goals that aren’t realistic, for example “I want to become an Astronaut and travel to other solar systems”, also will not happen.

Any goal that you plan to achieve ‘one day’ or ‘someday’ or ‘later on’ probably also won’t happen as they don’t sound like a top priority.

An example of a goal that isn’t SMART is “I want to increase how much I can lift”.

  • This is not specific. How much do you want to lift?
  • It is not relevant. What level of weight is important to you? How much do you need to lift?
  • It is not measurable. How do you know when you are lifting enough?
  • Without setting limits – How do you know that this goal is achievable?
  • This goal is not timed – By when do you want to lift this weight?

To make this goal a SMART goal you can change it to, “To be able to lift a washing basket full of wet sheets from the ground to waist level in four weeks”. This is:

  • Specific – because the weight / object and height are noted.
  • Measurable – because the weight and height is specified and measurable, you know whether you are doing it or not.
  • Achievable – it is likely this goal can be achieved in four weeks.
  • Relevant – it is important to you because it is an activity you need to be able to do in your daily life.
  • Timed – four weeks time.

How to achieve SMART goals:

Once you have set your SMART goals you then have to work out how to achieve them. What do you need to do to achieve this goal? How can you make it successful? What things may prevent the success of these goals, and how can these be overcome?

Once you have planned your goal all that is left to do is keep taking steps to work towards it. Goals require action and motivation.

I am achieving my SMART goals – what now?

If you have achieved all of your SMART goals, then well done but keep going. There are always more goals to set and achieve. You can either choose to maintain or improve on what you have already achieved, or set different goals and achieve something new. Just follow the steps you have already done with every goal you set.

I am not achieving my SMART goal:

Don’t give up. There are many reasons for not achieving goals, therefore it is important to investigate why the goal wasn’t achieved. Once you have learnt what didn’t work the first time you can try again with the same goal, a modified goal or a different goal. Common reasons for not being able to achieve goals include:

  • Setting goals that are unrealistic.
  • Setting goals that lack importance – this often leads to lack of motivation.
  • Your situation changed and the goal wasn’t important anymore.
  • Experiencing a setback (e.g. increased pain, another injury, something else interfering with achieving the goal).
  • Competing goals that were more important (had to move house that week).
  • Lack of confidence to achieve the goal.
  • Lack of resources to achieve the goal.
  • Procrastination
  • Time management.

If you are not achieving goals due to reasons of procrastination or time, then it may be that the goal isn’t important enough at the moment to make a high priority. Sometimes people procrastinate because they are worried about not achieving what they set out to do, and eventually this becomes a self-fulfilling prophecy. Back yourself and give it a go. If it doesn’t work then evaluate why and reset. It is that easy!

So start setting some goals with your physiotherapist that you want to, and can, achieve.

“A journey of a thousand miles starts with a single step.”

–         Chinese Proverb

About the Author:

Megan Clark is a Physiotherapist at Physiotas on the North West Coast.

Megan has 12 years experience working in musculoskeletal physiotherapy since completing her Bachelor of Physiotherapy with honours in 2005.

She has a keen interest in the field of Pain Management (acute and chronic) which she developed whilst working as a physiotherapist in the United Kingdom in an occupational pain management rehabilitation setting.

Megan has recently completed her Master’s in Pain Management at Sydney University and has worked in pain management programs. Her other main interests include occupational rehabilitation and clinical pilates.