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"I Don't Know"




“So, do you think you can help me?” he asked after telling me his story. Following 5 years of persistent pain with visits to various medical practitioners including multiple attempts at PT, he felt hesitant but wanted to try again.

At one time a competitive cyclist, he hadn’t been on his bike in over 3 years. His goals weren’t lofty. Really he just wanted to be out of constant pain. He yearned to do simple things like sit for more than 10 minutes without having to shift positions.

I gave him an honest answer.

“I don’t know”

I actually didn’t remember that detail when several months later we were celebrating his progress and he mentioned it. He was in less pain, stronger and much to his surprise back on the bike.

My patient explained that the moment I responded “I don’t know”, despite the expected discomfort of uncertainty, he felt this attempt at PT would be different.

I’m not writing to advocate saying “I don’t know if I can help you” to all your patients. However there are times when your patients need your AUTHENTICITY more than they want your CONFIDENCE.

“I don’t know” certainly didn’t mean I don’t want to try. It meant that given the information I had learned in our short time together:


I didn’t have enough information.

As much as I emphasize the importance of a detailed initial evaluation, there are meaningful details that will never be revealed that first visit (or second or third).

If someone comes to see me after failed visits elsewhere I get curious BUT try not to jump the gun with unfair assumptions like the other practitioners weren’t “good” or the patient was non-compliant.


And the truth is I don't really know why I was able to help him when others weren't.

Saying you don’t know can be perceived as many things including uncertain but also sincere. For some it may open the door to healing.

Holding space for uncertainty and all the possibilities it brings is a lesson that extends way beyond PT.

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