Quote:
Originally Posted by Kaisa
Hola,
I have a dilemma. When working in the states as a trainer and receiving clients from physical therapy or from the athletic trainer, I was always given very explicit instructions for what the client should focus on and what they should avoid. They had also pretty much always already received home exercises in the earlier phases of their rehab.
Now I live in Spain and run a personal training studio in a little town of 16,000 people. At least in my town (perhaps Barcelona and other places with more "wordly" influence things are better), the physical therapists are pretty much just masseuse. They do not precribe any exercises.
So my problem is that I get clients post ACL surgery or with disk herniations, etc. that have not done a proper (at least in my opinion) recovery and are not ready for a personal trainer. I have connected with local sports medicine doctors to give me some guidance but most of the time I am left on my own. Most people are just told to walk and swim. 
The clients come to me because they are released from therapy but given no further instructions (besides the swimming) and instinctually they know they are missing a step in the recovery.
This problem will not go away and I see an opportunity to fill this gap. Currently I turn away clients when I feel that I would be breaching my duty and take on the ones I feel comfortable with.
So I have three questions:
-What further education can you suggest for me?
-Online I found a course called "Medical Exercise Specialist". Do any of you have experience with it? The website is Welcome to PostRehab Online.
-Do you know any physical therapists who would like to come and work here with me? UConnJulie, you want to do a few month stint here in sunny Catalunya?
Thanks for your advice. I appreciate any insight you might have.
Salut,
Kaisa |
Kaisa,
I just saw this ... sorry!! As much as I would LOVE a several month stint in sunny Catalunya ... I could never leave my family for any length of time!!
Rehab is not difficult ... educate yourself about the surgery (ies) and then the deficits that the surgery creates. And then address those deficits. If you have taken Gray's FMS course, you already know how to do that! Follow his movement screen and the exercises to address it. But knowing info about the surgery is crucial. Ask the doctors for any post-op rehab protocols they may have.
Some basic things ...
ACL: if not immediate post-op, but rather 3+ months out, generally focus on ... posterior chain strengthening (hamstring and calf/gastroc esp), unilateral balance, quad and gluteal and hamstring flexibility ... etc.
Total Hip: ask surgeon about hip precautions. Some lift them and some do not. In general, they are ... 1. No crossing midline of the body (adduction); 2. No flexion past 90 degrees (no knee to chest or bending over while seated); and 3. No internal rotation (pivoting on it or positionally). For treatment needs lots and lots of gluteal strengthening/activation.
Non-surgical Disk Herniation: find out what reduced their symptoms. If it was extension exercises (get and read Robin McKenzie's book Treat Your Own Back) focus on things like stretching hamstrings, strengthening the core in NEUTRAL, etc. For many of these folks, if their initial injury was not traumatic, but rather a gradual progressive onset, then it is postural. So work on things to fix their specific postural dysfunction (ie flat lower back, no butt, etc).
I have Gray's Secrets of Primitive Patterns DVD but haven't finished watching it yet (just replaced my broken DVD player) and it is excellent. I am sure his other "Secrets" series DVDs are excellent as well.
I have not heard of the course you posted ... but it looks legit. Perhaps you could contact some of the people who provided testimonials (google them)? Who is your training certification through? Maybe they offer something similar?
I am happy to help you any way I can ... just PM me!! Otherwise, dive right in!!