What is your best resource for helping clients with specific injuries? Sometimes I feel inadequate to work with a client since I am only certified as a Pilates teacher and not as a physical therapist. I want to be confident that the movement patterns I’m giving them will be safe. I really appreciate your Pilates Protocols chapter in the library.
This is a beautiful question. One that comes up all the time for Pilates teachers.
I would like to share with you something a physical therapist once asked me when inquiring about my work: He asked "Are you working AROUND the problem or ON the problem?"
Whoa! Mind blown! 🤯
I don't remember how I answered his question in that moment, but I remember that it completely changed the way I thought about my teaching, and how I could help my clients.
Many Pilates teachers begin by teaching group classes, such as Reformer classes or mat classes. The good news is that the group format doesn't really allow the time and space to work on each individual's challenges. All you can really do is make sure they don't make things worse.
When teaching a group class, get to know your students. Ask each of them if they have any injuries or limitations you should know about. If you come across a pathology you have no experience with, make sure you do your research that night or after class to find out the movement contraindications or precautions for this specific injury.
To save you time, we list contraindications and precautions for every single exercise in the Pilates repertoire in the Pilates Encyclopedia membership.
Then you'll know what this client needs to avoid, the next time they come to your class. Think about movement variations or alternative exercises that keep the client safe.
You are now working around the problem, which is a great first step.
If you are a new instructor but are mostly teaching one-to-one sessions, don't despair. You can still begin by working around the problem.
The benefit of teaching one client at a time, is that you don't have to multitask and focus on several different body types and movement patterns at once. You can fully focus on the person in front of you.
After you've familiarized yourself with what NOT to do when suffering from a certain pathology, you can continue your research on the best ways to improve their condition.
If your client is being treated by another health or wellness professional, such as a physical therapist, medical doctor, chiropractor, or massage therapist, ask your client for permission to get in touch with them to find out how you can help. (Developing relationship with professionals in related fields is also a great way to get new clients. That's how I met the physical therapist who asked me that paradigm-shifting question.)
You could ask our client directly, but they often don't have the anatomical knowledge and language to accurately explain to you what their doctor recommended. An alternative is to ask your client to ask her physical therapist to write down which movements to avoid or practice more of. If your client hands you the paper, she immediately gives you permission to use this information (medical professionals are not allowed to share health-related information without the patient's permission.)
Your client might need more length in her hip flexors, or more core strength, or to avoid hip internal rotation or shoulder flexion of more than 90 degrees.
Now that you know which movement skills to improve, you can choose specific exercises for this goal.
In the Pilates Encyclopedia membership, we have lists of exercises for each movement skill that you can choose from, from mat to Reformer to all other apparatuses.
With this information at your fingertips, you can now choose exercises that avoid the DON'Ts and emphasize the DOs. You'll be able to teach a lesson that's completely tailored to your client's needs and goals.
The protocol explained in this blog post works well if your client has a diagnosis, which means they know what's wrong and why they hurt. If your client has pain that's undiagnosed, which is very very common with something like "back pain" or "neck pain", then you can still find a way to help them by asking the right questions and deconstructing the Pilates exercises. Keep an eye out for a blog post on this subject, coming soon.
Now I want to hear from you: What has helped you the most when it comes to building more confidence for your teaching? Tell me in the comments.