Monday, December 12, 2011

How the 'Do-Nothing' Approach Does Nothing for No One

I am often asked, "why do so many personal trainers think they are physical therapists?" Scratching my head, I really wasn't aware that trainers were acting like physical therapists, although the two professions do sometimes meet in a gray area because both deal with human movement. One professional FIXES movement that is broken; whilst the other professional makes poor movement simply better. Two very distinguished roles in my opinion. Likewise, there are those in every profession that don't even do that...they actually do nothing.

 There seems to be a "do nothing" approach in the health and medical fields. Doctors and other medical professionals become complacent and do the least amount of work for a patient.

Their answer is usually prescribing a drug to basically to shut a patient up and send them on their way. 

In the fitness field, trainers tend to steer clear of looking deep into movement dysfunction and designing the proper progressive exercise program.  This is in part to simply not knowing enough about certain aspects of fitness; and avoiding them altogether.
Think about it: how many times has a client approached you or a trainer with an injury, ailment, or new pain that you were unclear on how to approach, answer, or work around? Plenty of times....

The do-nothing approach gets nobody nowhere quick. The professional doesn't learn something and gain new experience; and the client/patient goes home with no answers. In the medical community,  this is haphazardly controlled by big insurance companies that have a tight leash on doctors and strongly recommend a doctor funnel the amount of care they provide. Doctors have the schooling and knowledge to help patients. But sometimes,  they simply do-nothing because doing nothing is easier and cheaper than doing something. However,  in the fitness field, this is only funneled by ignorance. 

Some trainers are simply not skilled enough to provide the very best service that they can. Therefore, they lack the confidence to work with people with certain limitations and pigeon-hole their customer base to people that are similar to their fitness level. Is there anything wrong with that? Not necessarily, but why limit yourself? Why strive for mediocrity? Why be paid to simply "tire" people out? Between you and me...ANYONE can tire someone out. My dog (on a good day) can tire me out. 

So how do we develop the necessary skills to do-something; rather do nothing? Trainers are not held back by huge insurance companies peering over our shoulders; so we can provide optimal service with  great care.

1.) Learn how to perform assessments. I know this is probably stressed upon alot lately; but it is true. Learn how to look at human movement with a keen eye for what doesn't flow right. Gray Cook's Functional Movement Screen is the most popular and helpful for trainers. It takes 7 key movements and helps the trainers score them based on a a pattern of efficiency. This is  a vital tool for a trainer's business. Cook's newest book "Movement" digs deep into this topic and I won't be surprised if it becomes a standard text in collegiate bio-mechanics courses.
Movement: Functional Movement Systems: Screening, Assessment, Corrective Strategies

2.) Review human anatomy again and again. Remember the old song, "My hip bone is connected to my thigh bone..."? It is 100% true. Everything is connected and everything affects everything. Anatomy is something that most trainers learn in the beginning of their education or certification process; but then it is lost along the way because it is simply not used in their daily vocabulary. Bad mistake. Use it or lose it, bucko. And most trainers, have lost it along with their confidence. Whatever is needed to learn anatomy I strongly suggest you choose continuing education courses that emphasize human anatomy repeatedly so that you use it in your daily life.

3.) Learn from others. We tend to put ourselves on islands. I'm not sure if it is a "pride" thing or if it a lack of transparency, but some trainers do not like to reveal what their weakness are to peers. This is sadly a hole in your water bucket.

As professionals, we should really expand our knowledge base--not only through books, DVDs, and lectures--but also through interactive and communicate means. Learning from one another is still by far the best way to grow as a professional.  On a personal note, I have been putting out educational workshop DVDs for about 5 years now. I don't think I came away from any workshop I have instructed without learning something new from one of the attendees.

The understanding that lack of exercise is the single most common denominator in the manifestation of diseases and most conditions is the driving force of all personal trainers. However, this understanding is not quite accepted by most trainers because they lack the knowledge to support it. Most are "too afraid" to explain to someone that a possible lack of stability in the scapula may contribute to their shoulder pain, or that simply mobilizing the hip joint can decrease lower back discomfort and possibly eliminate the pain altogether. We sometimes tend to not try things because we are not sure of ourselves because we lack some of the pieces to "make the picture".

Take this study for instance done in 1996:

A 20-yr-old female college basketball player suffered from a 7-month history of debilitating low back and left leg pain. Four previous independent physicians expressed diagnostic and therapeutic uncertainty. Bone scan, MRI, nerve conduction study, electromyography, CT, discogram and laboratory evaluation had all failed to identify the etiology of the problem. The patient was forced to discontinue basketball and drop out of college as a result of her spinal problem. Treatment by her prior physicians consisted of analgesics and prolonged bedrest.

BED REST....can you believe that? A do-nothing approach! This is the mindset of alot of trainers (and most doctors!) that lack the confidence in exercise programming because they lack knowledge in the human muscular system. The study goes on:

The patient underwent a functional restoration program consisting of isolated lumbar extensor progressive resistance exercise (PRE) on a MedX lumbar instrument, PRE to ancillary musculature, progressive aerobic exercise, static stretching and proprioceptive exercises. She showed a 368% increase in average lumbar isometric strength, 41% increase in isolated lumbar sagittal plane range of motion and decrease in pain. The patient returned to school after 8 wk of care; at 18-month check-up, she remained asymptomatic.

So what is the result of this study?

Functional restoration, even with uncertain diagnosis, can be effective in the resolution of chronic low back pain.

1 comment:

  1. Good post, john. Ive been thinking about buying Gray Cook's: Movement book. But I heard it was a bit dry and a little difficult to read. Is that right?


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