I’m going to state the obvious but bear with me; you’ll see where I’m heading with this:
Injuries happen. It’s a fact of life that no matter how well you train, try to avoid being sick or eat like a boss, you’re still gonna ‘break’ at some point. It doesn’t mean you’ve done anything wrong. It’s ignorant, even dangerous, to claim that all pain states are due to errors.
I’d go so far to say that injuries and pain are necessary to your continued human development.
This means that as practitioners we will constantly be confronted with clients at less-desirable points of their lifelong Health Journey. And often the client is looking for you to agree with their false assumption that lying on the couch watching reruns of Star Trek or the Oprah Show is the best way of dealing with their condition… which is a load of bollocks.
The challenge is to find gentle, insistent ways to remind them that they are more than a sore knee or a painful back. With rare exceptions, no matter how uncomfortable or painful our situation is, there is always ALWAYS something we can improve on as well as foundations to build for our recovery.
I’m a perfect example of that approach, having gone through two shoulder recons the past 12 months. It was a tough time that deflated my ego as much as it made me look deeper at what I was willing to do to be the best I could be.
It reaffirmed my own approach to body movement that I’ve had for over 25 years : THERE’S MORE YOU CAN DO THAN WHAT YOU CAN’T DO.
This approach is founded in sound rehabilitative principles and it’s inherent in the Pilates Method. Pilates is a perfect framework from which to train almost anyone with any injury or condition. If you know the Method and it’s approach, and have a grounding in how to modify it, there will always be more that your clients can enjoy than the few things they need to avoid.
Here are my top ten tips to help you and your clients stay on track during an injury or pain journey.
TIP 1. WEAK BODY = POOR PAIN TOLERANCE
Pain Avoidance leads to poor fitness and a weaker body can’t deal with injury and stress as well as a strong one. Staying away from exercise and movement will make you worse, in your body and in your spirit.
TIP 2. COMMUNITY AS MEDICINE
Pilates is also about relationships: clients and practitioners talking, learning, laughing, grumbling. Pain and injury can lead to doing less, spending less time with friends and family, creating a disconnection from community. All of these connections are important distractions and supports that help you get through the pain journey.
TIP 3. LEARN. UNDERSTAND. REFER.
Obviously we need to be prepared to refer folks to the proper AHP if necessary. This is not the same as fobbing off a client because of laziness or frustration. It means determining your role on their Health Team. Also, understanding the ‘red flags’ (ie pain, movement compensations, changes in sleep patterns) is very important in dealing with any recovery process. It enables us to refer with accuracy and without taking too long. So keep current with your continuing education.
TIP 4. IT TAKES THE TIME IT TAKES
The Pain Journey is personal and has no artificial deadline to meet. Teach patience and also keep that in your own mind when you get frustrated at a process that’s slower than you “think” it should be.
TIP 5. YOU DO NOT KNOW IT ALL
Be prepared to say “I don’t know…but I will do some research and see what I can find out.” Learn with someone and be humble enough to accept that you do not have all the answers. And admit that to them; I trust a practitioner more that admits to being human than I do when I’m told what an amazing expert they are.
TIP 6. BE DISAGREEABLE
It’ll take time, sometimes months or even years to come through a painful time. But clients can improve on so many areas during that time. Agreeing that they stay in their pain cave won’t help. Tell them to get off their butts and into your lovely, air-conditioned, supportive studio to start improving their situation.
You could be making their situation worse and persist for a longer term if you simply take their tendency to be “slack” at face value. It’s called Enabling Behaviour and is sometimes used so the Enabler isn’t seen as the “baddie”. If you were asking them to go bungee jumping after a vaginal prolapse or train while having a migraine episode then yes, you ARE a baddie. I’m not suggesting we be that extreme. But most client objections can be countered by reminding you both that a) Pilates freaking works and b) you both will figure out the new game plan that can avoid the injury site or complications of the condition.
TIP 7. PILATES PRINCIPLES DO WORK
Breathing and rhythmic movement will regulate a ramped-up nervous system, helping to calm the mind and lower the pain. Remember your Pilates basics…6 Principles…they actually work!
Because of it’s ability to be infinitely modified by a qualified trainer (you), Pilates is the perfect system to get and keep people working safely.
TIP 8. BE CREATIVE
If you can’t put weight in the ankle because of a break or ankle strain, work at the hip joint instead. If they are dealing with RSI in the wrists, work their shoulders by putting straps below the wrist. APMA practitioners are highly trained to break down a Pilates exercise, giving us the capacity to work with clientele accurately and clearly. Move past the standard choreography and focus on the clients’ need and the tools at hand. Trust your training and voila, the answer will appear.
TIP 9. USE THE SIDE DOOR
Effort in any part of the body will cause growth hormone and endorphin release, both important to tissue growth and lowering pain. As well, improving the nervous system and coordination in one part of the body creates improvement systemically.
TIP 10. DON’T CHASE THE PAIN
It’s important to keep your client moving and focusing on things other than the pain they are in. Stop asking how they feel every 2 minutes. Don’t spend your entire time working the region of their soreness; it will keep their minds’ laser-beam of awareness overly sensitive to their discomfort. Give them permission to tell you how they are feeling but then work all parts their body.
It’s just one of Joseph Pilate’s many important contributions: The recognition that the entire body is affected by any one part. Working the body’s other weakness’ DOES help the pain site.
So…what are you going to say the next time a client says “My back is sore from a marathon gardening session this weekend. I’m going to cancel today’s session. I think I just need to lay on the couch, eat crap food and watch bad scifi movies…”?
I know what my response will be: Put down the TV remote and the Peanut Butter Tim Tams, come down to the studio and let’s discover what we can do to help you get moving again!