Staying in Your Lane

Having worked in sports, health, and fitness since starting my undergrad sports science degree in 1997, (when I remember not picking up my new University email address for a whole term thinking this interweb thing would never catch on...) its fair to say I've been around the block a few times when it comes to exercise and seen a fair few fads come and go

OK I wasn't around for this one, and also: WFT?

It has also given me plenty of time and experience to figure out what my 'niche' is.  For me that has been looking to bridge the gap between clinical rehab and performance.

Building a niche is, in my opinion, one of the most important things a health and fitness professional can do in ensuring longevity in an industry renowned for chewing up and spitting out willing and enthusiastic newbies.  Those have been led to believe that a world of instagram selfies is the key to the 'four hour working week' and being a 'six figure trainer' (spoiler alert, its not).

Which brings me on to the point of this post.






Staying in your lane, or rather, within your scope of practise is often overlooked as being one of the most effective ways to build credibility, integrity and a full client book.   Conversely many people feel the need to try to cover all bases for their clients.  No one, I repeat, no one is an expert at everything - to truly become an expert Malcolm Gladwell would have us believe that 10,000 hours of practise is required.  In coaching terms thats 100 sessions a month, every month, for over 8 years - and that would just make us an expert at 'coaching'  when you have found your niche, be that nutrition, hypertrophy, S&C, or in my case biomechanics, you're looking at 10,000 hours of practise in that field  to consider yourself an expert.


Keeping all of that in mind we can hopefully start to see the importance of building an effective referral network of other experts that compliment your own skill set.

This collaboration continuum illustration was borrowed from a Postural Restoration Insitute seminar, and is one I have incorporated into internal training at the facility in which I am based.
Unfortunately, due to either a lack of understanding, or just plain and simple egotism, the health and fitness industry tends to exist towards the left hand side of this diagram.  if we wish to encourage movement towards the right hand side - we need to have an appreciation (and therefore an understanding!) of our scopes of practise....

Now I will caveat this somewhat by clarifying that a 'greying of the edges' of an individuals scope of practise is in many ways inevitable when considering a long career of a lifelong learner - and that particular areas of focus and emphasis can tend to change over time.  However, even with such individuals, there must still be a commitment to actually learning their new skill!

Once we understand our own scope of practise - and where it ends - we can and should begin to build a professional network of individuals who excel in areas that we do not.  That way we can continue to do the right thing by our clients and refer them to people we know and trust to best help them - trust me on this one, if your client has an issue outside of your scope, and you refer them to someone who is better positioned to help - you have a client for life.

The flip side of the 'if in doubt refer it out' mantra - is of course 'if you are not trained, qualified, or insured to do it - find someone who is!'.

In my own area of dealing with a majority of post rehab clients,  both athletes and general population, I consider myself highly fortunate to have a solid working relationship with arguably the top sports physiotherapist in Europe.  The reason that it works well is because of mutual trust, and an understanding that we have skill sets that are complimentary, but different.  I do not put my hands on any clients or patients, I do not stretch or force range, I make no attempt to change any physical structure.  My job is to coach people to move well, and to get them stronger - and to select the most appropriate movement for that individual at that time.  In short, we stay out of each others lanes.

One thing I cannot stand is the trainer who thinks he's a physiotherapist because he's watched a few videos on youtube, or sat in on a treatment session or two.  Just as someone wouldn't trust me to fly a plane they were in because I've watched Top Gun a few times,  they shouldn't trust a person with their physical health who is not educated, qualified, and insured to look after it!


Of course this argument works two ways, and we also shouldn't  see manual therapists with no coaching experience taking people through loaded strength training protocols.  However,  as the barrier to entry to become a chartered physiotherapist is very high and requires several years of study and continual further education - we do tend to see a higher level of professional integrity in this field than in the world of personal training  - where the barrier to entry is essentially non existent.

If you are one of those professionals looking to expand your scope of practise - and get more hands on involvement with clarinets (patients), there are a whole heap of further education training resources and certifications out there that are available to personal trainers and strength coaches who want to get more hands on.  Sports Massage, ART, IASTM even acupuncture and dry needling are all available to non medically qualified individuals.  Personally I have been pursuing higher education through the Academy of Applied Movement Neurology and the Postural Restoration Insitute, and found both systems provided me with a great range of tools to help get people moving better.  However, NEITHER  qualify me to manually change the structure of a persons tissue, so I don't ever do that.  I reach out to a person in my network who I trust and collaborate with him to get that done.

In short:  Don't be a Cowboy  <-- unless you are, in fact, a cowboy (which is infinitely more cool than being a PT anyway)

Assessing Control In the Sagittal Plane

Last weekend I was fortunate enough to be able to attend a superb seminar in San Francisco to further my education in the science of the Postural Restoration Institute or PRI for short. It was such a huge pleasure to be surrounded by a group of high level thinkers, and reminded me of the expression: If you're the smartest person in the room, you're in the wrong room!

PRI science manages to be both simple and complex - it is highly technical and requires an advanced understanding of biomechanics and anatomy.  However, at the same time the principles just seem so obvious once they are explained.  It is safe to say that anyone attending a PRI educational event will experience several 'ah hah' moments - if not full on face palms.

It all seems so obvious now

At this latest event, which was very much focussed on bringing Postural Restoration science out of the clinical setting it is best known for, and applying it in the space of strength and conditioning, the presenters had simplified some of the more complicated orthopaedic based PRI assessment protocols into a series of movement 'screens'.

One of these screens has been designed to assess an individual's ability to fully exhale, and successfully inhibit their Posterior Exterior Chain (one of the various poly-articular chains that PRI science is based upon).  Now whilst this sounds complicated - in essence this was a very simple assessment that would demonstrate if a client / patient / athlete has control in the sagittal plane.

Those who know me, know that I place a great deal of emphasis on an A,B,C of movement coaching that was popularised by Evan Osur in his Integrated Corrective Exercise method.  Dr Osur explains the A,B,C principles as follows  "For a movement to be 'successful' it must optimise the individuals Alignment, Breathing, and Control in that position.  If they don't have control, then they don't fully own that position."

In order to 'clear' this very simple screen the individual must be able to come out of a gross extension pattern (alignment), fully exhale and retract the ribcage (breathing) and successfully inhibit their trunk extensors (control).




So, so simple and really was one of those 'why didn't I think of that!?' moments.  Well.... I didn't, and they did - so huge thank you to James Anderson and Julie Blandin for coming up with this.

What does it mean?

Well - in PRI speak we are looking at core organisation and restricted costal mobility, and therefore airflow on one or both sides of the thorax.

For those who aren't familiar with this terminology, or who don't wish to explore PRI science - if your client can't do this, they are not ready to train outside of the sagittal plane.  Nice and simple.  They need to work on core control in this plane first, master the sagittal plane, and then  be progressed to the more 3 dimensional movements.

So there we have it - a simple simple screen technique born out of a very advanced school of thought.  And one that has an application for all.

To round off - here we have the awesome group of people who attended this latest PRI event in San Francisco.  I'll finish how I started this post - if you're the smartest person in the room - you're in the wrong room!

PRI Integration, San Francisco CA, Oct 2015