I've actually lost out on a couple of clients because I refused to train them until they seen a physio. I don't regret it, it's actually helped me as I get a lot of people with pain and i'll tell new people this so they take it as a warning of sorts - If I say they need a physio, they know I really mean it.stuward wrote:I don't disagree with you and I'm sure that lots of trainers put their short term monetary gains over their client's long term health, but in the long term, you would both be better off if you correct the pain first. That doesn't mean you can't work on other aspects at the same time.
Pain is something I mull over, too. In an idea world i wouldn't need to deal with any pain but, can you imagine going to a physio and saying, "my shoulder hurts, but only when I bench over 100KG". Technically, their remit is to get you out of pain and back to daily life. Not bench X amount of weight, or run X amount of miles.
I recently had this conversation, with a recreational runner,
Me: Do you have any injuries, aches, or pains?
Runner: No... Although, my knee hurts when I run.
Me: At what point does it hurt? just in general? a certain distance?
Runner: Actually, it only seems to happen after I hit 3 miles.
Me: Oh, well that's easy - don't run any more than 2.5 miles
I was joking, obviously.
I was always a "if it hurts, refer out", thinking it was a black or white issue but it's not really.
I do have principles, though. I never train someone through or in the presence of pain. However, I will train people with "pain". If I can train them how they need to be trained PAIN FREE, then i'll do it. This pretty much involves working only with "non-painful dysfunction" whilst completely avoiding anything that hurts. Normally, it results in the pain magically disappearing.
Something I've said a lot before, "I can't do anything with your knee, i'm not a physio. I can fix your hips, strengthen your glutes, and improve your movement, though". So, if I can do this without ever having any pain, then I'll do it. If not, I refer out. Of course, I always do a screen etc, and if there's blatant "red flags", I'll refer out anyway. Sometimes people who think they aren't in pain present some real red flags when you screen them. "no pain but, this leg feels very heavy and sometimes kind of numb"...... Um, ok, go see this guy *hands over number for physio*.
As a result, I actually get the respect of a good physio who is known for hating personal trainers. He invites me to the consultations, I send him the programs, call him to discuss the client, etc. It works well.
Also, I don't think trainers should put their hands on clients. That really irritates me. I don't mean light touching to help with coaching i.e. placing fingers between shoulder blades and saying, "break my fingers", I mean trainers who manually stretch their clients. Hamstrings are a popular one. Even if the client needed the hamstrings stretched, which is a big "if", then why not just teach them how to do it themselves? That's what we're supposed to do!!
I recently got a new client with a history of sciatica. She seen another trainer and it didn't go well. He had done a course, which was a weekend course over about 3 months which means he can call himself a "lower back specialist". What an insult to the clinical realm, who, in order to work with patients like that need to study for years, yet can be seen in the same light as a "Lower back specialists" who got qualified via a weekend course. It disgusts me.
Anyway, the other trainer made her worse. I assessed her, got her moving etc. Had to tell her, "look, you clearly have a nerve issue and, i'm not comfortable working with you. As a personal trainer this is completely over my head. I know I can help you but, initially, you need some physiotherapy. You don't need a trainer right now". I told her how I can work in conjunction with him, etc but, right now I can't work with her. I was (and am) very positive about helping her but, she needs MEDICAL intervention first. She had already signed up to do one session per week with me, possibly more. I advised her to hold off on the money she is going to spend on me and direct that to the physio. Honestly, she looked overwhelmed when I said that. She asked if she can book sessions anyway, and she'll see us both. I told her to hold off until she's had the initial consultation. I'm sure it will be fine, but the physio needs to be in charge. I got a heartfelt text message afterwards about how in 20 years of suffering from this, she's never felt like anyone actually cared and, although nothing is happened yet, she has a very good feeling about working with me.
Honestly, that alone is priceless and why I'm trying to do this. I don't think you should ever forget your bottom line. Mine is that I want to help people, first and foremost. It's easy to over look it but clients like that remind me of it. Plus, the alternative would most likely be taking one session for a few weeks and making things worse, imagine what she would say about me then? Right now she talks about me like i'm a genius, even though i've not actually done anything, yet lol.