Recognising the limits of my abilities

A 36 y.o. female, mother of 2, injured while working as a care aid in January sits in the exam room with me for a discharge assessment. She has run her course in our active rehabilitation program. For a while, she was improving and making slow but steady progress; however, suddenly her pain is back the same as before with seemingly no reason. She is in tears as she tells me about her frustration with her pain as well as her family issues at home, including a custody battle for her kids and her worries that she won't be able to work to provide for them. As a fellow sister in Christ, she tells me about her prayers for healing and trying to stay positive that God will work everything out for the good for those who love him.

Unfortunately, the course I took on the pelvis this past weekend is a bit too late. I can now assess her and diagnose her as having an unlocking left sacroiliac joint with a right intrapelvic torsion caused by a mobility disorder with associated tightness in her right adductors and weak transverse abdominals and deep multifidus; however, how does this help her now with her discharge 2 days away? As a last resort, I'll suggest to her case manager that she be referred to the physio who taught my course with her 20 years of experience in this area. It is at times like this where I recognise the limits of my abilities. Perhaps if I knew more I could have given her a more specific exercise program so that she would have made greater gains. I know I can't fix everyone and everything, but it's still frustrating and these are the moments where I wish I had more clinical expertise.

I review some exercises to activate her transverse abdominals and teach her how to release her adductor muscles at home. At the end of the session, I sit feeling helpless as she thanks me for listening and for my help. We talk about prayer and healing and she tells me about trying to stay strong in her faith as I try to encourage her by reminding her that God's always there even though it doesn't always seem like it. I suppose all I can do now is pray...