Answers (8)
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In March 2006, pain began radiating down my left leg and throughout my lower back. It all started when I bent forward to pick up something off the floor. I had experienced acute back pain before, so I started a course of ibuprofen and RICE (rest, ice, compression and elevation). Nothing really helped, but I continued to plug away at work for about 2 more weeks before deciding not to be a knucklehead and instead to get some help. By then I was walking with a limp, with pain down into my calf. After a visit to a physiatrist and an MRI, I discovered I had a herniated disk at L5-S1. The news was difficult to swallow: I, who had prided myself on maintaining good health and had never even broken a bone, now had an in- jury that could impact the rest of my life. A cortisone/steroid injection into the L5-S1 region gave me almost immediate relief. I was also prescribed a bout of physical therapy. I could still train clients but was unable to lift their weights for a month. I told my clients this, because I needed them to understand that I wasn’t a slacker, that I was under doctor’s orders not to lift anything heavier than 5 pounds. My clients were sympathetic to my injury and helped out as much as they could. Those who couldn’t unrack their own weights had to be subbed out to an- other trainer.From my experience, I learned not to be a knucklehead, to treat each injury (no matter how small) with care and not to avoid getting help. I also realized the importance (especially for personal trainers) of taking the time to do a well-de- signed prevention program, including flexibility exercises and work on the trans- verse abdominals and core muscles. Seventy percent of my current workouts are based around flexibility and deep core muscles to try and prevent reinjury. Most days my back reminds me that I am not 25 years old anymore (I am only 37), but I can manage my condition. The best result of all this is that I now have a much better understanding of lower-back in- juries, scope of practice and how pain can truly impact one’s daily activities. I also learned not to “guard” an injury. When I was guarding too much, my lower back would get very fatigued by the end of the day and I felt I’d almost taken a step back- ward in my recovery.
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I am currently fighting a nagging ham- string/gluteo strain and have been do- ing so on and off for 3 months. I have used myself as an “example” to show clients the importance of listening to your body when in pain and of not taking the healing process for granted if you are injured. Also, I have used my situation to reinforce the concept that it is okay if you have to stop your favorite activity (or whatever activity has caused the injury) or to modify it temporarily until the injury has completely healed. In my case, I canceled all my races for the fall of 2006 because of this injury. Clients appreciated the fact that if I, as their personal trainer, was willing to sacrifice my favorite activity for a speedy recovery, so could they.
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The best advice I can give trainers comes from my experience of not listening to my body. During my younger years, I would push through any injuries and keep on training clients. I ran on knees that were swollen, jumped with feet that were in pain, demonstrated strength exercises with low-back pain and even taught step classes with a cast on. Now at 50, I have arthritis in my neck, low back, knee, hands and hips. I am far too young for these conditions, and I wish someone had given me this advice 30 years ago: pain is your body sending you a message. It’s telling you to back off, rest or modify your activity. Listen to these messages. Anytime you push through pain, you lay down permanent scar tissue that will affect you the rest of your life. More important, when you—as a trainer—work out injured, you send the message to clients that they, too, should push through pain. Each time I train my clients, I ask them how they are feeling and if they have pain or restrictions anywhere. After a careful assessment, we decide how to train that day, incorporating modifications or completely eliminating strenuous training as appropriate. We may opt for a stretch, balance or relaxation session if an injury is present. If all activity is contraindicated, we opt for a meditative type of session. My clients know they will not work out as usual when injured, so they expect no different from me in the same situation. If I am having an issue, I tell them and explain that I will be modifying my work with them that day. I may do more coaching and less participating. I will not introduce any new exercises if demonstrating them could further irritate my injury; instead, I opt for moves that clients are already familiar with and that require only coaching tips from me. I approach each session with a positive attitude, knowing that I can still run a great session with motivating coaching cues and the underlying message to the client always to heal what is hurt. My osteopath professor had an interesting philosophy on “pushing ourselves,” which I feel we can apply to our client training as well. He said we should not step out of our comfort zone but rather nudge our comfort zone gradually wider. When we step past our comfort zone, we push the body too much, which is how illness and injury happen. So, gently and gradually nudge your comfort zone to improve your performance. Follow your body’s messages, and they will tell you when to nudge, when to back off and when to stay the course.
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I used my ruptured plantar fascia as an educational tool for my clients: after ignoring persistent plantar fasciitis, I ruptured the fascia while playing tennis. Luckily, my clients were happy to work with me even though I needed to spend as little time in weight- bearing positions as possible. I became very adept at verbally describing exercises, and all of my clients were happy to go into a lighter- weight/increased-repetition training cycle to minimize my need to spot them. Therefore, the injury did not really interfere with my training business, but it did provide me with many good teaching examples. The first and biggest lesson was, of course, not to ignore an injury. Now, when clients try to train through pain, I am able to remind them of what happened to me. They seem more willing to work around an injury and to seek help when I suggest it. Another lesson my clients were able to take away was the importance of stretching. While I had to spend as much time as possible off my feet, I did actually do calf and hamstring stretches with clients as part of my own recovery. I have known most of my clients for many years, so I was very comfortable stretching alongside them. Clients also heard about my frustrations in achieving my own workout. I had been using a stair climber and doing step aerobics for my cardio workout, but I had to switch to riding a recumbent bike. This different workout turned out to be a nice break for both my mind and my muscles, and I shared that experience with clients, teaching them that change can be a positive thing.
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I am currently going through an injury to my thoracic spine (dr are unsure yet what it is). It doesn't affect how I program, I just have to be very clear verbally.
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I have a new comment to this question. I recently broke my ankle and have begun to realize that with some injuries, you just can't train a client PROPERLY. No matter how skillful you are at program design, you just can't spot heavy lifts safely; and when your client's goal is strength.. well, its been a nightmare. Also, some clients need your participation and demonstration to motivate and inspire them. I have had to recommend these persons to other trainers for now, or have supplied them with programs they 'should' be doing on their own. The rest of my clientele has me burning through the dry erase markers like a mad scientist. Good thing Costco sells them in bulk!
