Roughly 1/3 of my work involves assessing movement and creating programs for clients who have encountered some type of discomfort in regards to physical activity, sport, or training. Some have been injured and are now in a post-rehab phase and have or are currently also working with a Physical Therapist. Others are just trying to reduce chronic issues they’ve been dealing with making their activity uncomfortable for them. Some have had no symptoms but from basic assessments they need to improve at certain areas to move and perform well.
Since I am Personal Trainer first and foremost I do not treat pain directly. My background in assessment and corrective exercise does give me the opportunity to help a lot of individuals by reducing compensations, imbalances, and gaps in mobility, stability and strength. Doing this, in turn, often relieves them of the pain and discomfort they had.
If someone has been very active like a gym rat, daily runner, or athlete. Reducing the training that they love due to movement dysfunction, pain, injury, mobility issues or whatever it is that has inhibited them from those activities can become extremely stressful and mental.
Keeping them engaged in the process of fixing the issue is crucial. Lack of adherence to a corrective program is never because the person doesn’t want to get better, it’s often because they lose faith in the program or lack discipline and patience. Sometimes it’s just a lack of appreciation for the process.
I wanted to share some strategies that I found helped in keeping the individual engaged.
Make them OWN their issue. If you want a client to adopt YOUR corrective program than make them adopt THEIR issue. This is where the tremendous value in SELF-assessments come in. While I assess the individual I like to think out loud and give them insight in to what I’m doing and how their body is doing. I’ll be open in telling them what is/isn’t working, what is strong/ weak, and what range of motions are restricted or ideal. Then I will be sure to have the individual identify what they are lacking and have an understanding of how that is effecting them.
I’ll give you an example. I’m not just going to tell them they have tight hamstrings. If I perform the Active Straight Leg Raise with them and they score poorly I’ll be sure to explain why. If I tell them that the straight leg should be close to perpendicular with the floor and they cant get past 45 degrees they can physically see, realize, and own an issue they have developed. While our corrective program might be highly developed you should create ways for your client to assess themselves and receive instant feedback on if the intervention is working. Improvement is motivating and that will motivate them to adhere to the program. If the client walks in and tells you they can’t tell if the program is working, why would they stick with it?
Keep it simple. This person would rather be doing whatever it is they were doing before having to see your face for an appointment. They’re bummed and if we prescribe an endless amount of mobility drills, SMR, banded activation, breathing exercises, you name it, they will be more discouraged by the tediousness of the program than the discomfort they walked in with. The Pre/Post Rehab, Correctice Exercise, Mobility world has blossomed over the last decade. There are copious amounts of resources to improve movement quality and fix dysfunctions available to trainers, coaches, and other practitioners. This has also created a bit of a “rabbit hole” for those professionals to fall in to. Be aware of your own programming for them. Keep it simple. Prescribe the activities that will have the most bang for their buck. Think of it as the 80/20 principle to rehab. Give them the game changers and leave them with some time in the gym to do their own thing, which brings me to my next tip.
Don’t steal their baby. What if you had to rehab but could excel at something else at the same time. That’s what good corrective programming should provide. This is even more important if you are working with an athlete who is accustom to hard work and who might even express or identify themselves by their physicality. They need something to chew on. They want to still feel like an athlete. Don’t steal their baby.
My advice is to find at least one movement or exercise that can still be trained at full capacity without diminishing your corrective work and create a program around improving it. This will also give the individual a focus that runs parallel with their less exciting programming. If the athlete’s issues are hip related design a pull-up or bench press program. If they are a long distance runner with a toe injury give them a program to improve their 2k time on the Ski Erg. I love to end my sessions with this type of work. It’s like a negotiation.
“If you don’t what I want you to do first, week can do the fun stuff after”.
It also provides a training effect for the client which can be vital to their psyche and adherence to your program.
– Josh Gould
Boston Personal Trainer