Is there a doctor in the house? What is your job and what is not your job?

February 23, 2016 at 12:47 pm 11 comments

What's Your Tool?

What’s Your Job?

Well, I thought I’d be writing an article on something completely different today, but I will share that with you next time. It has become more and more obvious to me that we need to discuss Scope of Practice. I know, I know…it sounds boring…but, as usual, I will attempt to make it a non-boring subject! Let’s go!

What is your job? Really. As a Pilates teacher, what is your job? What are you?
You are a personal fitness trainer.
A personal trainer of an extremely refined “phylum” of exercise.
You are not a physiotherapist (unless you’re trained as one).
You are not a massage therapist (unless you’re trained as one).
You are not a psychotherapist (unless you’re trained as one).
You are an exercise trainer in the modality of Pilates. Whatever style of Pilates.
You are extremely valuable in that role. Pilates proves itself over and over to be a very good form of exercise, especially when applying a quality education in functional anatomy/kinesiology to the movements/actions/exercises.
Physical activity/exercise is essential to the health of any human being.
You are valuable by encouraging healthy physical activity.

(Why is Shari saying this like that? What’s she getting at?)

It seems that both clients and Pilates teachers are starting to think that a Pilates teacher is something other than a high-end and very specialized exercise trainer. Just because we craft our sessions for the person in front of us; just because we can work around nearly all injuries and ailments; just because Pilates can often support a person’s system so well that healing occurs when nothing else seems to work…this does not mean that you bear the responsibility for fixing anyone.

Let’s make that clear: Your job is to exercise people working around their injury or ailment. Not into it. You do not fix or heal anyone. Hopefully, the work you do creates an environment (simply by providing a safe place for movement) that allows this person to be more healthy as an organism and that supports the opportunity for healing in an ailing area or system. You do not fix or heal people.

Why Pilates (and other movement modalities) seems to make this possible…?
That’s another article all together and the focus of my life’s work. (Join me in The Vertical Workshop Pilates Teacher Intensives or stay tuned for many more things…)
For the moment, let’s stick to this.

It seems as though Pilates teachers are feeling a lot of pressure to cure ailments. Your client has osteonecrosis in her knee. I see people all of social media forums asking what to do. I get emails asking what to do. I’ll tell you what to do: Work around that knee. Only do movements, exercises, ranges of motion (ROM) that will not even spark a bit of pain. Strengthen the rest of the body and work around that knee. Pick what exercises, versions of exercises, physical set ups and settings on apparatus to make sure that poor knee doesn’t have a negative experience at all. Choose wisely what to do and what not to do.
And that means you do not tell your client that you can “fix” her knee. You will not use Pilates to help heal that knee. You might say “Because in Pilates we work around your ailing joint, avoiding it at all costs, and strengthen the rest of your body so well, it appears that your body will have a better chance at healing itself.” You see…your client will heal herself. Or she’ll get an operation or go to physiotherapy or get an injection or live with the pain. But you cannot claim that Pilates is going to fix her.
Let’s play out another scenario:
Your client comes to you with a rotator cuff tear. Whether this is a new client or a client you’ve been working with for some time what do you do?
Right. You avoid that shoulder girdle and shoulder joint in the workout. You find out what  ROM of the arm this client has where there is no pain and work within the parameters of…no pain. Indeed, you ask if he has gone to the doctor, physio, etc. You ask if he is getting any treatment and doing any other exercise. Then you create a workout that works around that area. Is it going to be a lot of legs and lower torso exercises? Sure. Not ideal and imbalanced? Sure. And that has to be OK. Do you go in and try to teach this person good shoulder girdle mechanics? Not if the shoulder is injured and in pain. When this person is healed up enough to mobilize his shoulder girdle, then you can address the shoulder girdle mechanics, but…just avoid the area at first. Your job is to give this person a workout working around the area of injury.

It’s tempting, I know it is! It’s tempting to try to heal this person. However, you simply do not have the qualifications for it AND AND AND…it appears that very often just working around a joint really does help a person heal! I mean it! It’s holistic.

Now, the thing is, the Pilates teacher community is one of the most wonderfully giving groups around. We just want to help! We feel so deeply for our clients and want people to feel good…but the pressure that I see building up in the community is unnecessary and damaging. Release yourself from this pressure. It’s not your job to fix people. It’s your job to give them amazing exercise around their ailment so that they can perhaps heal themselves…which is better than you trying to fix them.

I will strongly encourage you to learn about each ailment your clients come to you with. You must educate yourself on whatever they bring your way. Why? So that you can figure out how to work around it. One way to learn? Google. Yes, our good friend Google. Then you have to be wise about what you’re reading when you search an ailment. Please just learn about the pathology. The anatomy of the ailment. Great websites for lay-people webmd.com: http//www.webmd.com
National Library of Medicine: https://www.nlm.nih.gov/medlineplus/medlineplus.html
Mayo Clinic: http://www.mayoclinic.org/patient-care-and-health-information

Learn about the ailment or injury, take the pressure off of yourself and work around ailments.

Your job as a Pilates teacher is amazing! You are good enough and great enough doing what you do as a very high-end specialized personal trainer. You train people’s bodies to strengthen and heal themselves! Goodness! Pilates teachers are great!

***Do you need help figuring out how to work around different parts of the body or ailments? Reach out to me! I will teach you! I’ll share my tried and true, well-worked guidelines of how to educate yourself and work around anything! (That’s what my Injuries, Ailments and Imbalances  as well as my Mysterious Aches and Pains workshops are all about.) We can work in workshops or private workshops on Skype or video conference. I’m glad to help.

Any questions? Just ask!
Enjoy teaching!
– Shari

****Thank you for having taken he time to read this article and I hope it encourages you to move forward in your teaching and practice in this stunning way!

If you have any questions at all or want to share your thoughts in the comment section, please do!

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Your Favorite Client Finish It Strongly!

11 Comments Add your own

  • 1. Anna Satterfield  |  February 23, 2016 at 1:16 pm

    Thank you so much for posting this article, it really is on point, and a perfect reminder of what our responsibilities as instructors truly are.

    Reply
  • 2. Viviana Romanazzi  |  February 23, 2016 at 3:22 pm

    Great!! As always. I do feel that pressure on me! And not because I feel I can fix people! Not at all! Just because people think they can be fixed by you, most of times.

    This article helped me. And I’ll definitely have a look at those websites. And, of course, I’m looking forward to learning with you!!!

    Thank you, Shari 🌼

    >

    Reply
  • 3. ritamatraia  |  February 24, 2016 at 7:50 am

    Excellent Shari! I will pass on to my instructors and I thank you for these reminders!

    Reply
  • 4. Cait Lyddy  |  February 24, 2016 at 2:21 pm

    What a wonderfully succinct and uplifting article. Thank you!

    Reply
  • 5. theverticalworkshop  |  February 25, 2016 at 6:36 pm

    I’d like to share Anastasiya Goers comment she shared with me. WordPress (this platform) wouldn’t seem to let it post. Ahhh modern technology!

    “Thank you Shari for this profound article. You are so correct saying that being a Pilates teacher means simply being a trainer in this fitness modality. We can approach conditions with more understanding than probably a lot of other fitness trainers would but that’s the end of our scope of practice. And I feel that we provide a very unique and personalized approach to exercise but we don’t have to feel pressured to “cure” our clients. That’s what doctors are for. We are here to help our clients connect with their bodies so that they can heal themselves (brilliant thought, by the way!)”

    Thank you, Anastasiya!

    – Shari

    Reply
  • 6. Beth Mastin  |  February 25, 2016 at 6:38 pm

    Hi Shari,

    Thank you for your most recent post. It was a great reminder of what I know but don’t always remember!

    I have been referred by a client to one of her friends that presents an interesting set of challenges for me.

    She is An equestrian who fractured her pelvis and broke her shoulder a while back. Not sure how long ago though. She also has Osteoporosis and has fractured 28 bones. It takes her 30 minutes in the am to get vertical as she put it. She lies on the edge of the bed and let’s her leg hang over on the spasming side to stretch the Soas. It spasms regularly.

    She is planning a summer trip in Ireland to ride across the country. She says she is looking for stretching and strengthening to help her achieve that goal. She wants Pilates to be a part of that training. She is also doing some sort of cross training as she put it.

    She has admitted she is always on the move. Walks 3 to 5 miles 3x a week currently.

    She works with people and horses and runs a very interesting program to help people de stress with horses.

    I need some help with this one especially with the pelvis. Any help would be much appreciated.

    Thank you,

    Beth

    On Tuesday, February 23, 2016, The Vertical Workshops Pilates Teacher Blog < comment-reply@wordpress.com > wrote:

    > theverticalworkshop posted: ” Well, I thought I’d be writing an article on > something completely different today, but I will share that with you next > time. It has become more and more obvious to me that we need to discuss > Scope of Practice. I know, I know…it sounds boring…but, ” >

    Reply
    • 7. theverticalworkshop  |  February 25, 2016 at 7:05 pm

      Hello, Beth,
      Thank you for taking the time to read this article and comment on it.
      Indeed, we must remember what it is that we can do so well for our clients…and what we must refrain from attempting. We must realize that what we do is not only good enough…but great! It actually does do great things for people!

      Now, osteoporosis is another ailment that is important to work around. Work Around. That means…nothing that is going to risk fracture. And she already has 28 fractured bones. That’s a lot of bones fractured. Is that all in her spine and pelvis? Or did you mean 28 fractures in her bones. And, again…where are these fractures? Where is her osteoporosis.

      For osteoporosis, though this isn’t what I was originally taught, I realize now that it is VITAL to eliminate all spinal flexion. ELIMINATE it. You must work around the possibility of fracturing her more. That means you modify an exercise that usually has full or partial spinal flexion into natural curves…or omit the exercise. Also, with that number of fractures, she sounds like she is at risk of cracking her ribs or thoracic vertebrae in prone exercises. That means nothing where she is lying down on her stomach. She can do spinal extension, but only upright. There are some good exercises for this. I will be glad to share them with you if you would like. Just email me at info@TheVerticalWorkshop.com And perhaps you might want to do a Skype session on osteoporosis.

      Also, beware of rotation of the spine.
      And any transition where she must kneel down. You must make sure she doesn’t crash on her knees if she has osteoporosis in her hip (neck of the femur).
      Any balance challenge exercise must either be eliminated or turned into a balance assistance exercise where she has full support with her hands and there is no risk of falling.
      Then, there is making sure you adjust your spring settings for appropriate load on the reformer.
      And there are “bone building” exercises you can inject into the workout. Again, I’ll be glad to teach them to you.
      Let me know your thoughts. Let’s continue to discuss.

      – Shari

      Reply
  • 8. Rachel Greene  |  March 7, 2016 at 3:12 am

    Thank you so much for this article. I live in Bali where there are not a lot of physical therapists so I have many people expecting me to heal. I can breathe easier and let go of some of that responsibility. 🙂

    Reply
    • 9. theverticalworkshop  |  March 7, 2016 at 11:15 am

      Breathe easily, indeed. Educate the community on how Pilates helps support its own healing. This is vital to true healing…self-healing.
      Thank you for having read this article and for reaching out to me!
      All the best!
      – Shari

      Reply
  • 10. cheryl turnquist  |  May 23, 2016 at 9:38 pm

    For some reason I’m just seeing this blog post…. LOVE IT! love, love, love the clear and specific points….. soooo valuable and necessary to hear… I wish that every instructor would read this!!!

    Reply

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