Managing the 'Clinical' Client
- Help define the ‘Clinical Client’;
- Discuss our role in their management as Pilates Teachers;
- Discuss the importance of GOOD Communication and;
- Offer advice on how to achieve better results.
- Been referred to you by a Healthcare clinicians for specific rehabilitation OR;
- Been advised to try Pilates by a Healthcare clinicians and found you themselves OR;
- Has simply contacted you themselves but then explained their main aim for doing Pilates is to achieve an improvement in a physical or mental dysfunction that is affecting their lifestyle.
- You have ‘SOLD’ your skills well to the Clinician and your Pilates qualification is from a credible, trustworthy organisation;
- You have achieved a good working rapport with that Clinician, gaining their trust and achieving good results;
- The Clinician has reached the appropriate stage of treatment to suggest your services;
- The referring Clinician is at a loose end, the client is no longer responding to treatment and its time to try something else;
- The Clinician has the ‘Manual Skills’ but not the rehabilitation exercise knowledge base.
- The clinical diagnosis (what is THE problem)
- The mechanism of injury (how did it happen)
- The prognosis (what potential recovery does the client have)
- How long have they had it
- What THEY (the clinician) would like YOU (the Pilates teacher) to specifically work on
- What NOT to do
- What to look out for (any alarming signs & symptoms)
Seeing as the aim of this section of Pilates Union UK is to aid its members with the management of the ‘Clinical Client’, what better place to start than actually defining the ‘Clinical Client’ and our role in their management!
This article will:
The ‘Clinical Client’
Clinical Pilates refers to the application of original Pilates methods for use in the management of the injured client. Most commonly researched and applied by Physiotherapists around the world, clinical Pilates typically involves working with clients on a 1-2-1 basis to assess and prescribe exercises specific for their ailment. In some circumstances this may eventually involve working with a small group of clients suffering similar dysfunctions.
The term ‘Clinical Client’ could be used to define any client that you teach Pilates to who has either:
So the ‘Clinical Client’ isn’t just the client referred by a Healthcare clinicians, be it a Doctor, Physiotherapist, Osteopath, Chiropractor, etc. It could be someone that has read an article in the Sunday paper praising the benefits of Pilates for say ... Back Pain ... sympathises with it, and decides to search for a teacher straight away.
Our Role
Why treat this person any different to any other client that you come into contact with?
Well... look at this way... Unlike the healthy client who is simply after a new challenge, wants a taste of this ‘new trend’ or just keen to improve their body awareness & strength...
The ‘Clinical Client’ will ultimately be hoping and anticipating that Pilates and in particular, their Pilates teacher (YOU!) is going to alleviate their back pain, improve their posture, help resolve their weaknesses, prevent future injuries, help facilitate a return to work, get them back to their sport, restore their desired body shape after pregnancy, slow down their arthritic disease, improve their breathing capacity, etc, etc ... The list could go on and on ... NO PRESSURE THEN!!
I would hope ALL of you who have read this far are thinking...
No problems here, before I start teaching ANYONE Pilates I insist that they have completed one of my detailed enrolment forms including a brief medical history, contact details of any Healthcare clinician they have been to regarding any physical ailment AND I get them to sign the disclaimer which outlines that THEY are responsible for their actions and should not ignore pain if experienced during a session.
Of course, these are the basics that ALL Pilates teachers are taught to do with ALL clients, if not simply just to cover their own backs. Detailed enrolment forms and asking a client’s background information also helps the client to realise that THEY too are responsible for the management of their problem, NOT that the onus is on you to sort it!
The next step is to KNOW YOUR LIMITATIONS!
Not all clients seeking Pilates tuition will be able to find someone nearby who is also a fully qualified Healthcare clinician with the expert knowledge required to deal with their ailment. Presumably, NOT all the Pilates teachers reading this article are qualified Healthcare clinicians! So it is inevitable that sooner or later these types of clients will be knocking on your door and rather than turn them away, consider what you may actually be able to do for them.
Our Pilates training teaches us the basics of Pilates itself but also, in most curriculums, the basics of managing these types of client groups. Where the skills of their management can be learnt, the application of these skills is arguably acquired with experience. Therefore, I believe the most important thing to retain when working with the ‘Clinical Client’ is to remain honest with yourself and your client... KNOW YOUR LIMITATIONS!
DON’T jump in out of your depth in the fear that you’ll lose your client to a nearby competitor.
DON’T promise to solve the client’s problems when really you’re not even sure where to start.
And perhaps most importantly...
DON’T lie to your client. Tell them if you’re not sure what the answer to their question or problem is... but ASSURE them you’ll do everything in your power to find out!
So our role as Pilates teachers (NOT Healthcare clinicians trained in Pilates) is fundamentally to be honest with our clients, those referring clients to us and most importantly ourselves. I believe if you follow these basic principles you’ll achieve better results.
It’s now worth looking at why a referred ‘Clinical Client’ has been sent to you by a Healthcare clinician;
Any one or a combination of these could be the reason but the latter in particular speaks volumes about the SKILLS you as a Pilates teacher possess. It is a common misconception that Healthcare clinicians educated in the diagnosis, treatment and management of physical dysfunctions (Physiotherapy, Osteopathy, Chiropractic, etc) are also equipped with the knowledge on how and what exercise to prescribe. Very few academic courses in these disciplines contain modules on exercise prescription and rehabilitation. This is presumably why so many practicing clinicians would look to seek the help of a qualified Pilates teacher.
Where we as the Pilates teacher should know our limitations regarding adequate clinical knowledge and injury management, many Healthcare clinicians need to be aware of their limitations in prescribing suitable, progressive exercises.
Therefore, the perfect management of the ‘Clinical Client’ is going to be the result of EXCELLENT COMMUNICATION between Healthcare clinician and Pilates teacher!
Communication
Quite frankly in dealing with the ‘Clinical Client’ and assuming that you are NOT a qualified healthcare clinician, it is imperative that you maintain good communication with the client’s healthcare clinician. Whether they are the source of the client referral, the name of the last clinician to have dealt with ‘their problem’, the client’s registered GP or the client’s medical advisor, maintaining communication is the answer to helping you achieve better results.
Having gained written consent from the client, I would contact their healthcare clinician to discuss the details of the ailment and ask in particular for:
This is by no means a definitive list of questions to cover BEFORE starting with the ‘Clinical client’ and hopefully in most cases, this information may have already been provided. However, if you as a Pilates teacher have any doubts or queries ahead of starting work with the client you should strongly consider contacting the clinician and asking any questions. I believe the Healthcare clinician will be grateful for your honesty and in order to help the mutual client achieve the best possible results, offer the information required.
Of course, the communication with the clinician shouldn’t stop after the introduction. Try and maintain it throughout the course of working with the client, offering regular updates on progress or quizzing when a plateau in the progress is reached. A mutual trust will slowly be gained and worse case scenario is that it keeps your name fresh in the clinician’s mind possibly leading to even more referrals!
How to achieve better results
Once you have communicated effectively with the suitable healthcare professional and discussed the clinical details with your client, it is vital with the ‘Clinical’ population that you start with the basics. In some cases this may have already been covered by the referring clinician but in order for you and your client’s working relationship to be more productive, it is worthwhile re-capping on the basics, thereby avoiding any future confusion.
The basics form the foundations for development of the client’s CORE strength and, when taught correctly, command the client to be more body aware. With appropriate emphasis, this new found awareness can spill over into other areas of everyday life which, for this population, is often where most progression is made. By encouraging the client to be conscious of their own body and the basics of Pilates outside of their dedicated Pilates sessions, you will find they improve quicker and become more receptive to the benefits of Pilates.
Finally, don’t progress too quickly.
If you are not satisfied with the client’s abilities to perform basic Pilates exercises following the correct principles, then don’t advance them onwards. This would be no different to building a house on top of concrete foundations that hadn’t set!
(by Robert White MSc MCSP, May 2009)
PLEASE NOTE: The content of this article is written merely as an opinion by the author and is by no means to be received as a clinical guideline. Opinions written are solely those of the author and as such Pilates Union UK does not accept any responsibility for actions taken as a result of reading this content.
NEED HELP WITH THE BASICS?
Why not check out ‘The Complete Pilates Technique’ by Emma Newham.
