Last month, I did another in-service at a studio gym. Movement 108 is similar to Innovative Fitness in that they have a great culture but they differentiate themselves by offering specialized classes. They offer kettlebell, TRX, MovNat, and strength training classes. They do a little 1 on 1 training, but classes are their bread and butter. I am always happy to refer people to their classes!
For myself, one of the biggest lessons from the in-service was that although research is moving us away from a bio-medical model to a bio-psychosocial model it does mean we have to change our practice radically. What is changing is the language around the treatments and assessments we use.
In my mind the language is shifting from a negative, therapist knows all approach, to a more positive client centred approach. It is easy to pick out faults in movement because everyone’s view of ideal is different! When you start viewing the client in a more broad context and focus on load capacity we start to give the client a lot more control over the situation. Instead of telling them they have to change their mechanics because their’s is somehow dysfunctional, we tell them in the short term it may be beneficial to alter loads through bio-mechanical change. As mentioned in a previous post, at tops speeds, in certain sports the bio-mechanics can play a larger role but in many cases they do not explain the pain we are experiencing (reference). When we alter biomechanics through coaching and alter the experience, it is often transient and can be very difficult for a client to keep long term (reference).
Again the language shifts from, “your hip is in the wrong place and dysfunctional, and until we get it in the right place you wont be able to train” to “in an effort to offload your painful hip we are going to try to alter your mechanics. This will offload the hip in the short term and allow you train back gradually to full strength.” The treatment, “change the movement,” is the same in both but one can instill fear (especially if you don’t know a lot about the body) and the other instills confidence that we can move as long as it is gradual.
When discussing the mechanisms of treatment I believe it is time we move away from terms like releasing, alinging, and putting back to reducing sensitivity, altering inputs, and proving the mind with some novels. Our treatments are meant to help reduce the minds perception of threat (remember pain is the body’s alarm for threat) and to allow for greater movement with less pain.
The skilled therapist knows that not every ankle (or any body part) should be treated with the same techniques. By choosing the appropriate treatment, empowering the client with self treatments, and educating on load management we can save everyone time and money. It’s my business to see clients but if I can empower clients with the tools and know how to help themselves I have really made a difference!
Maybe it’s corny even in treatment I think there is some truth to the saying, “give a man a fish, feed him for a day; teach a man to fish, feed him for life.