I’ve been thinking about how I would like to see rehab and training integrated a lot over the past few years and I decided to put down some ideas.
Entry: as a patient or a training client. Unhealthy (ie people with pain) would come to see me for PT and we would work together to get these people moving with less pain and begin exercising regularly. Healthy people could come see me for training or one of my personal trainer / coach colleagues.
Baseline testing: everyone would go through a combination of FMS/SFMA/YBT and a few other objective tests. Not everyone would have to do all of the tests or the same tests, but we would try to get some baseline information. For example, I’d like to see some sort of test that identifies a baseline metabolic conditioning quality, a test or series of tests that would allow patients to subjectively rate their ability to participate in their regular lives and frequency of pain / discomfort.
Rehab vs. Training: I want people to start training ASAP. While injured people might need to limit some activities due to pain, they should be able to work hard at the activities / patterns that don’t cause pain. I visualize seeing someone for PT for 30 min and then moving them on to personal training for 30 min. I see this as a more ethical solution than trying to charge them for PT services for 60 min. PT services would include any number of the more specific PT skills that I have learned over the years: motor control assessment / training, Sahrmann / Comerford exercise prescription, manipulation, IASTM, trigger point, stretching, joint mobilization, (DNS, PRI, and dry needling in the future). Corrective exercise would initially fall into the PT realm for 2-3 visits and then would transition to personal training with a review function. Personal Training falls into the bigger movement categories: push, pull, hinge, squat, carry.
Nutrition: Through CrossFit, I’ve explored paleo a little bit, but I think I would need to learn more or have a team member dedicated to learning more here. I think that ideal nutrition, like exercise might be varied a little bit from person to person.
Programming: this is where things get hairy and fun at the same time. Here is my basic model (2x/week):
1) Push, Pull, Hinge, Squat both days
2) some of these movements are in more dedicated strength portion of the workout (think 5, 3, 1)
3) some of these movements could be in a WOD format – to incorporate the varied type of metabolic conditioning that makes CrossFit so addictive and fun
4) at least one power movement per week and make reps appropriate (jumps, KB Swings, Oly Lifts, throws)
5) carry at least 1x/week: farmer’s suitcase, rack, waiter’s
6) make sure clients understand what is appropriate for them and how to scale based on assessments
7) Stay basic and then throw in more complicated stuff when appropriate
Goals: set them and check on them frequently
Logs: figure out an online system for clients to add data to as much as possible