You are reading a blog written in two parts; most people will want to read part 1 I hope, part 2 is for the information geek. I want to thank Sam from our FTE course for prompting me to write this too.
Since I entered the industry as a wet behind the ears Fitness Instructor in 1994, I have watched people try and show how good they are as a Personal Trainer by how well they can fix people. Often through guess-work and using their clients to experiment on, driven by a guru, a course or a product. The intention of the trainer is almost always great, but the outcome is often random (and in the long term not great).
Fixing someone seems to mean to get people out of pain, so they can carry on their normal lives. Injury, re-hab, pre-hab, injury prevention, movement correction and much more is confused in our industry. I think I can help.
Fixing ourselves first
To start with we have to disassociate with the great feeling of instance gratification from ourselves and our clients when a client reduces the amount of pain, they are in, during a session. Also, we need to define our role in the industry as one of improving fitness, specifically to help our clients reach their goals.
As a trainer, strength coach, sports coach, etc., you really should be movement and skill development obsessed. These two aspects of training will set you aside from any other trainer in the industry. Additionally if you add in fatigue management, then you will be ready to lead the industry in your area.
Pain and Injury, however, are components of training, which some educators jump on as instant experts. Educators that are looking to jump on the new thing then leads to trainers making bad choices for clients and having too much confidence in what they can do. Using techniques based on the short term in session results that they see from Central Nervous System tricks can often lead to problems down the line for the client.
Pain and Injury
Pain and Injury need separating, as much as the role of a trainer and the medical expert. Pain is an output of the sensory input and the brains interpretation of the scenario. Based on danger, pain can be cyclical as in being in pain can cause more sensitivity to the signals that caused that pain. It means you can become more sensitive to pain the more times it happens and the more you focus on it.
The injury is either Acute or Chronic. Acute Injuries are ones that have just happened and are within the recovery time; chronic are injuries that are causing pain but are outside the recovery time.
Treatments for Injuries are pretty simple; they either do one of the following things –
1 – They ensure an environment that will allow the injury to recover within the usual recovery time, with the least amount of further impact on the client
2 – Rarely, but occasionally, they speed up the recovery from an injury. Very lucrative if you can find one of these, I would not suggest looking unless you are in a University lab though
3 – They interrupt the input or the perception of the input to alter the feeling of pain. To allow the client to recover with the least impact on their life.
Pain is a whole new issue though. When a treatment or recovery for an injury has not gone well, or when someone has started feeling pain without an injury at all, then they have a problem out of our scope. A client in pain does not make the trainer less able to make a positive impact. However without an understanding of the process to a certain level, it does mean the trainer can negatively impact the client too.
As with skill development, a lot of the tricks that work in session, work against a client in the long term. For example, for many years I would teach hands-on techniques to help people move better (and sometimes telling them this would help them out of pain).
In the session these hands-on techniques were amazing, I could see a clear improvement in movement and often my client said their pain had reduced. However what I did not know was this –
1 – If you confirm reasons for your client to be feeling pain, then they may become susceptible to feeling that pain more intensely and quicker. The hands on is a temporary change to the input and so immediately they will feel better, in association with this new way of moving.
2 – To develop a new way of moving that sticks (which could be a great way to help someone feel less pain), and then you need to help them develop a skill. Hands on development of skills, work in a similar way to a directive and intrinsic coaching of skills. Using either hands-on or intrinsic descriptions provide an immediate improved look to a motion, but take away from learning and long-term development of a skill.
A Possible Process to Follow
With Pain, as with Skill development the key is creating learning environments and positive feedback. If you follow this formula, then you will be covered and help the client in the best way you can. Unfortunately by sharing this, I am also sharing why there are no techniques I can direct you to by injury.
1 – Get the injury/pain medically diagnosed
2 – Make sure you have that plan to tackle the injury and pain, in place for you to follow with your client
3 – Assess the skills that the clients need to develop or re-develop, pain-free, which will help them have a less painful life.
4 – Develop a Skill Development / Performance coaching plan that will address the movement side of their goals
5 – If it is within the remit of the rehabilitation offered in the medical diagnosis, then setting some movement challenges and skill development could be great. By focusing on showing off how capable the clients body is, then you can have a positive effect on the client’s self-perception. Improving self-esteem and movement confidence can be key in reducing pain.
If you have been following all of my blog posts before this, you will know this! I expect you to not believe any of the above, I also expect you to want to challenge it.
On my FTE course, I shall be sharing all of the studies and other research behind my above conclusions. I will not let them off the hook either though, and I will be asking them to look into Injury and pain research too. Below though are some of the outstanding authors of pain and injury papers and videos. These Authors will link you to research if you want to keep diving down into this subject.
I will warn you now though, there are a lot of people in our industry, who are trainers, not neurologists, who are trying to own this niche. They have no medical qualification (some do not even have a research background). Try to avoid them and go to source!
Part 2 – The Experts I* have found so far
(*thank you, Michael Haley and Ryan Crandall, mainly for showing me these)
I have only added one video and two blog’s here, I deleted about 30 of each because I think you will find your own way to the research and the lectures from these. This is not to pass the buck, but instead to show that we all have to research and read. Unlike other “experts” I would like the people who actually know, to be able to provide you the information.
Although it is another plug (sorry), my group on the FTE course share a lot of papers on all these topics too. So join in for next year! At least click the link and see what we do!
A Great Video to get you started (wait until you get going through related videos)
A great blog on the whole, I love this post specifically though
(Plus the research in this will start you on a whole track of reading!)