Showing posts with label prehab. Show all posts
Showing posts with label prehab. Show all posts

Friday, 1 April 2016

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)




Saturday, 23 November 2013

Don't forget the little guys

One of the most common training mistakes we see people making is letting the mirror or their ego be their guide – as opposed to a logical, thought out and planned training session.

Training only what you can see in the mirror, or falling into the trap of needing a testosterone fuelled answer to ‘how much do you bench?’ can lead to an unbalanced program. Unbalanced programming leads to an unbalanced body. An unbalanced body can, and in the majority of cases, will, lead to injury or pain – not cool.

In this day and age of limited time, anything that seems like a quick fix or giving instant results will have its appeal. However, taking a few minutes at the start of every workout on some of the vastly overlook smaller stabilising muscles will pay off tenfold when it comes to training the bigger muscle groups.

One of the smaller areas that almost everyone can benefit from paying some attention to is the stabilising musculature of the scapular. The scapular, or shoulder blade, has two quite different but interdependent functions in upper limb mechanics. It both provides stability, and assists with movement at our most mobile joint – the shoulder.

FACT – Did you know that the humorous, or upper arm, can only abduct (raise outwards) by 30 degrees? The rest of the movement is provided by the scapular.

We all know that people interested in weight training, whether its for sports performance, health, or simple aesthetics all get a kick out of lifting heavy things.

However, how many times do you stop and think about what must happen within the body to provide that force? A bench press, overhead press, or the humble push-up all require an expression of force during shoulder flexion (driving the upper arm away from the body). If the upper arm can only abduct by 30 degrees without needing assistance from the shoulder blade then we can start to see how important healthy and functional scapulae are during international bench press hour (that’s Monday at 6pm to the uninitiated).

So what does this all mean? Well – did you ever hear the expression ‘you can’t shoot a canon from a canoe’? Most often quoted when talking about core training – but equally important in shoulder function.

There is no way that 100kg bench press is going anywhere in a hurry without being propelled from a stable base – and that stability comes from the shoulder blade. If there is no stability in the scapular then the body will find it some place else. All that shrugging and wriggling around that you see during a bench press or a push up is not so much people trying to hoist up a weight – but more the body looking for a stable platform from which to exert a force. The body will find stability somewhere – it doesn’t want a 100kg barbell crashing down on it any more than it wants to go face first into the matt during a push up. Another way to look at this is trying to exert a force with your arms without stable scapulae is a bit like trying to sprint on sand – its possible, but it isn’t half hard work!

How do we achieve this?

You can ‘set’ your scapulae by going through some very simple activation drills for the surrounding musculature. Try running through the following before performing any kind of upper body push (or pull) and you should be able to feel the effect of having a stable platform.

*Prone ‘scaptions’ or flying Ys

*Scapular push ups (also known as serratus punch)

*Hanging scapular retractions (hand from a chin up bar, and simply try to pinch your shoulder blades together)

*Scapular wall slides

Each of these movements will help you to be aware of where your shoulder blades are sitting, but also to innervate the smaller muscles that hold the scapulae in place. The shoulder blades should feel as though they are sucked down and back and are flat against the back of the rib cage.

It may go against your instincts in a time pressured lunchtime training session, but if you want to train the big muscle groups effectively then invest 10 mins at the start of every workout on some of the small ones.