We have seen this scenario many times. Your client gets injured and spends time in rehab. They have worked with their physio and are ready for more, now what? Many clients are in that limbo of finishing rehab but not ready for running, strength training, and circuits. They have tried running five kilometers, attended a cross fit class, or attempted their usual sets and reps and it’s just not working. They are in pain, feel frustrated, and not sure how to bridge that gap and return to their usual activities. As fitness professionals, we play a key role in helping our clients return to doing what they love, and more! Here are some tips to help ease your clients back to their daily fitness routines safely and effectively.
1. Establish a baseline.
Find out what your client can do asymptomatically, if possible. Can they run two kilometers before the pain kicks in? Is it five reps of squats instead of 10? What is their threshold before symptoms kick in, if any? Use this baseline to work off and return to your established baseline if symptoms flare up or if progressions may not have been successful on a given day.
2. Decide on small, progressive, weekly increases in time/volume/intensity/ load.
Once a baseline is established, work on small progressions clearly outlined. Is it an increase of 10 per cent of running volume weekly? Adding 20 per cent of weight per week? Less? Stick to the progressions. Your client will be tempted to go back to what they did before but stress the importance of adapting to the load and challenge progressively. The body needs time to adapt to the new demands.
3. Provide modifications, tweaks, and form suggestions if your client becomes symptomatic.
Have a backup plan for when things get uncomfortable. If running at a 5:30/kilometer pace causes symptoms, can they switch to a 6:00/kilometer pace? If a certain weight flares symptoms, can they lower it by 10 per cent? What about form adaptations? Try optimizing alignment, adding breathing strategies, and core connecting cues to potentially reduce symptoms. Give your clients permission to regress in order to progress.
4. Collaborate with health care practitioners.
This tip is often underutilized but has great outcomes! Connect with your client’s sports medicine doctor, physiotherapist, athletic therapist, chiropractor, RMT and/or osteopath. Request to connect with them and share your findings and objectives. Connecting and collaborating as a team can give you valuable insights from both perspectives (and may also lead to more referrals!).
5. Know when to refer out and get help.
If your client is hitting a plateau, if symptoms are worsening, or if you find you are overwhelmed and unsure of what to do, refer out. It’s difficult to send a client away in the short term but they often return and are grateful for the knowledge, respecting your scope, and for putting them first.
Having a plan to help restore function and capacity takes time and patience but often pays off. When we take a step back to look at the big picture and help guide our clients with small, decisive steps, we can help them return to their activities with a solid plan for multiple scenarios and with less pain and greater function. Keep the lines of communication open with your client and their health care team and work together to get them doing what they love. It’s a win-win for all!