A client asked today “Are we fixing the source of the problem or simply chasing symptoms?”
What a fucking great question!
He had trained with me intermittently for a while, but started coming in with regularity when the physio at his local gym ran out of ideas. He’s a keen amateur runner, so would rather be pounding the pavement than hitting the iron.
I’m not a physio, but a huge part of my service falls under the banner of Injury Management. That is what he trains here for.
So we very quickly got the pain he came in with under control, as far as I know, it’s never returned. But several other “issues” have since arisen, most we’ve dealt with as they rise.
Often following a period of running.
So are we simply watching symptoms flare up and treating them, or are we fixing his root cause?
As much as I wanted to simply tell him that we were of course treating the root cause, that would have been a lie. And you simply can’t lie to clients, especially if you want your business to remain a business.
So what are we doing?
Clients come to me in pain for numerous reasons. We can very loosely categorise them into:
Acute injury – ie there was a definite incident that resulted in the injury. Forgotten injury – ie they hurt, often in wired places for seemingly no reason, but they forgot about the time they fell off that wall aged 7 and cracked their head open…. No injury – ie they hurt, movements X, Y and Z make them hurt more, please help me hurt less!!
And I mean these are LOOSE categories, if you take these literally and call me out on them, it’s your failing, not mine.
Lets look in turn at each:
The first two are almost the same. There is/was an injury. I am an example.
Several years ago I had to quit lifting in Kettlebell Sport as it was destroying my back. No amount of physio on my back seemed to help, general training kept it good to the point I could operate, ie run the hills, practice martial arts, I was still doing Doorwork back then and it never held me back. But it was generally painful. Then after taking the Anatomy in Motion courses under Gary Ward and the Srith Lord, it started to fall into place that that time in the Lake District that I rolled my ankle so badly it instantly swelled and turned a nice purple colour, but due to the terrain I HAD TO keep running down the rocks because a fall would have been very, very bad.
Gary Ward (left) and Chris Sritharan, the brains behind AiM
That injury caused me to limp. That limp lessened and became a subtle weight shift onto the other leg. That subtle weight shift loaded my tissues differently. When I lifted, especially with the load at or above shoulder height, then that poorly distributed line of force put some tissues under excess pressure and BANG. Dave was crippled by a back injury nearly 10 years post ankle injury.
The “fix” is to re balance the weight distribution and convince the central nervous system that it’s OK to load into the damaged ankle.
Look at that right leg…. If this was a front on shot, you’d see the centre line between the 2 ketlebells run down the left side of my spine with more weight shifted into my left leg. Think of how the tissues are being stressed under that load.
Once you know, it’s simple. It was many years post “bang” that I was shown.
Which is why the last category, the “No injury” folk can be such a puzzle to solve.
The pain they present with, a bit like with my back, could be triggered by something seemingly unrelated. Maybe it’s just the top layer of compensation with many other layers beneath it.
When there isn’t a clear line to follow, or the line that we think is right turns out to be a a fix for the immediate symptoms yet leaves the path open for other symptoms to arise, then we have to become a detective.
Not saying I’m Batman, just that Batman and I have never been seen in the same room together,,,,
And a detective asks questions, tests theories and follows clues.
Some questions have unhelpful answers. Some theories don’t pan out. Some clues turn out to red herrings.
But the investigation goes on.
And as long as we keep an open and inquiring mind, as long as we refer out when we need to, and as long as the relationship with the client is open and built of trust. We get there.
The best part about being a Coach rather than a therapist, as has been noted by a therapist buddy of mine many times over, is that people expect me to work them hard. So even if I’m flummoxed and can’t get THE fix, we can still train you in a manner that develops strength, mobility, endurance and confidence in being able to use the body and use every session as an opportunity to collect further clues.
So, long story short, we may well be treating symptoms, but only so we can peel away the layers and find the root of the problem.
Dave Hedges www.WG-Fit.com