You’re all pumped up for your new client. You spoke with her on the phone and she really needs help. She is in her late 40s and 25 years a lawyer—hunched over law books and computers. After 3 bouts of physical therapy for her neck and shoulder pain in the past year, she is ready to get on an exercise program. In fact, she has sought medical help multiple times for her neck and shoulders over the past 5 years. Although still in a lot of pain, she has been cleared for exercise.
She knows she isn’t moving well and doesn’t want to get “hurt” working with a trainer who pushes her too much, so she has sought you out. You explained to her about posture and tight and weak muscles, and how after you assess her you’re sure you’ll find “lots” to work on.
Before she arrives, you are already anticipating the kyphosis, forward head posture, tight hip flexors, and internally rotated shoulders. This will be a piece of cake.
Uh-oh. After greeting her, you can immediately see she is not the structural train wreck you anticipated. In fact, after your assessment, you find her posture is fine and she moves pretty well. This doesn’t make sense. Nothing is fitting cleanly into your corrective exercise recipe.
Now what?
First, you have to understand what chronic pain means to the body and brain. And although biomechanics are a definite factor in mechanical stress, with chronic pain it’s not so easy.
At Function First we say that we are “guided by biomechanics but not ruled by it,” which means we must first thoroughly understand how the body moves – period. And it is our opinion that you have to start here first. No sense in jumping right into working with the chronic pain client if you have an empty toolbox.
There are many modulators to chronic pain, and exercise is one of them when programmed properly. And the beauty of an exercise intervention is the positive cascading effects it can have on the individual physically, mentally and emotionally.
Sure, by the process of elimination you can find things that do not hurt your client. But that’s not the best approach, because if you do reproduce their pain, you can’t un-ring the bell. You have excited the neurotag associated with their pain and may have lost the client forever. And perhaps worse, you may have scared them away from exercise for good.
Have you seen the statistics on chronic pain?
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