S.M.A.R.T. GOALS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

S.M.A.R.T. GOALS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

SMART is an acronym that can help evaluate and add structure to your goals.

Specific

SMART begins with asking yourself the degree to which a goal is specific. This is the most important part to establish in order to evaluate expectations. The less specific a goal, the more difficult it is to determine how long the goal should take to complete or how to measure success. Consider the goals like “Return to the desired level of sports participation or function” vs. “Just live a healthy life without restrictions and with a minimum risk of subsequent injuries.”

Measurable

Measurable: How is the goal measured? What determines success? Some goals are YES/NO. “Do you feel better today than one month ago?” Other goals can be measured with questionnaires, strength testing, force plate, and other technology. Other goals are measured by the action. “Have you returned to running, climbing a mountain, or playing football again?” No matter how a goal is measured, it should accurately reflect individual success. For example, a measure of strength should only be tested if the test is used in the intervention. We can test many things, but we not to select what is important. Having a battery of different measurements could, for example, allowing the person to start running. Without access in a reliable way we are more guessing than assessing.

Actionable

Actionable:

How do we achieve the goal? What is your action plan? Your physiotherapist should have a specific action plan for your rehab with specific criteria and solutions in case of flare-ups or being behind the plan. Does your physiotherapist have the resources (equipment and time) or capabilities required to achieve the goals? If not, where can you find help create an action plan? If you have measured that you have asymmetry in countermovement jump, how do you then change it? There should be an action plan for every step of the rehab process. If the actions required to achieve a goal are unclear or there is a large number of actions, we should consider breaking down the main goal into manageable actionable sub-goals.
(I can help you make this action plan. Check out my patient ACL handbook)

Relevant

Relevant: In isolation, every single goal is relevant, but in real life, there are priorities. A common mistake is to chase too many goals at the same time or pursue the wrong goals. Isolate your training session to a specific goal. That could be strength, plyometrics, sports-specific, or something else. We need a monitoring system to help us ensure we are pursuing the right goals. That is where assessment comes in. Assessments are not exams. Assessments are a tool to show us where we are in our rehab and where we should prioritize the next training block and what measurable outcome we would like to increase. Most of the time, we want to focus our energy on low-effort, high-value goals. Said another way, we want a return on our investment. A good quote to remember in investment comes from Warren Buffett: “The first rule of an investment is don’t lose. And the second rule of an investment is don’t forget the first rule.” Therefore, let us not waste time on ineffective rehabilitation or, in case you have private insurance, let’s maximize the time you are using to work toward your goal.

Time bound

Time-bound: We want to make sure that goals are time-bound. By including a specific date or time frame by which a goal should be accomplished, it helps provide incentive and allows us to monitor progress. By adding time, we can also compare our outcomes to expectations to see if we are behind or ahead of a goal. If we are behind, maybe we can revisit our action plan. Goal setting is not an event. It is an ongoing process of actions, evaluations, and revisions. It is not about lowering goals or standardizing goals to ensure success, it is about recognizing that goals are dynamic and life happens. But when real-world events occur, how prepared are we to intervene?

When using SMART, we can stay flexible by setting aside time to re-evaluate your goals on a regular basis. In a busy schedule, this can be difficult to do. Therefore, online rehab may provide that extra time to stop and reflect on where we are on our journey to achieve your goal. If you need any supervision or mentoring regarding ACL rehabilitation, please do not hesitate to contact me. I am always happy to collaborate on any other physio or assist with your rehabilitation.

I would love to hear how you are using SMART goals in your rehabilitation.

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