Now then, corrective exercise, pre-hab or performance training?
So currently I see a lot of Personal Trainers offering assessments with treatments, corrective training and pre-habilitation training and I am starting to wonder if their terminology is going to be causing their clients more problems in the long run.
This is how I want to be training people!
For a start, unless you are medically trained to diagnose and treat, then how would you know what to treat and why to treat it? Also why would anyone hire a Personal Trainer for treatment, when they could use a Physiotherapist? It seems to me, that the role of the Personal Trainer, Strength and Conditioning Coach and other ‘fitness’ specialist, is to improve performance. Nothing more than that. The ‘treatment’ side or the Pre-hab (a term used by some to suggest they are preparing you to avoid injury, but could also read as the opposite of re-hab which is the training immediately after an injury, therefore making pre-hab the training directly before an injury!!) is something that is encompassed within a good performance programme, as at some point you will need to make your client great at injury avoidance, which from all accounts will come from training the client in the skill of avoiding travelling into a position that will cause injury. This makes symmetry an ideal place to look for a potential lack of skill, but a terrible place to look afterwards to see if you have improved the client.
Maybe by training a client well in performance, then the end result will be that the client also gets to enjoy some extra movements pain-free, and so you feel like a medically trained therapist, but in reality if you take this route, ignoring the complexity of diagnosis and the causes of pain, then you may be setting yourself up to lose regularly. I mention this, because on the back of this route, I see many trainers then look at fascia and other areas of treatment that are not proven scientifically and that give a grey area for people to ‘suggest results, and suggest science’ without accountability, to help them get ‘results’ with pain clients that they cannot get from performance training. This is a trap I have fallen into previously during my career and something that I have to try and avoid every time I help a client feel less pain in everyday life.
My Kind of Injury Avoidance Training
Look at the motions that the vulnerable joints have to go through under fatigue, where the focus is not on prevention, but getting the work done!!
The point of this blog / rant, is to say that maybe sometimes by staying as a performance trainer, you will get and give better referrals (where people are qualified to take a guess on fascia and may be using it for non-structural reasons can help your client), and you will gain a respect with your clients for knowing your boundaries.
In training a client in the skill of injury avoidance (something that is never going to be 100% just because of the vast array of different scenarios that could lead to each injury), you are already setting yourself up for a great journey of learning. Getting great at seeing and creating all of the motions of joints, all the possibilities of them occurring and more importantly working out how you can best get your client to train in these areas without injury in the training, is something you may never reach the end of. Who has time to then learn to be a specialist in all the other areas that will help your client? I would suggest you build a big network of specialists to help your client if required, stop focussing on re-hab, pre-hab, treatments and start focussing on performance, doing, skills, coaching, movement and the aspects of life people really want…being able to move better, look better and be healthier (think that covers them all!)
In conclusion if you are a Trainer that has been taught to ‘Treat’ then try and start thinking ‘Perform’. If you are being taught about what fascia does and how to apply this, then think about its relevance and the science first. The very best Therapists I have met do not treat, they create environments for healing (the type that occurs through time and the body’s own re-generation systems) and if they are saying that, then as a Performance Coach and Personal Trainer, I would not insult them by saying I treat.
Thank you for participating in my rant!