This blog is a follow up to my previous one about the Peter O’Sullivan workshop I attended a couple of weeks ago now. I had a few responses and comments on twitter that compelled me to clarify a few things.
The first point I want to make is that I am a strength and conditioning coach with a strong biomechanics leaning. This is my skill set and it is the set of glasses through which I view patients/athletes with low back pain. I am yet to see someone I have looked at and thought, ‘this person is perfect, they are strong, mobile and there isn’t anything in the way this person moves that they can change in order alter loading through their back’. And by loading I don’t mean lifting with a flexed spine, I’m looking more for movement habits and the amount of work that goes through the back day to day. Seated and standing positions, sit to stand, standing to floor, gait and squat patterns. The vast majority of people I see will end up deadlifting, squatting and split squatting along with mobility and accessory work where appropriate, essentially they follow some basic S&C work.
After a day watching Peter work, I have not all of a sudden “joined you”, whatever that means. Like any workshop I attend, if I can take a couple of things that I can use in my coaching, then it’s been a useful day, and it was definitely a useful day. It helped me to understand a little better the complexities that sometimes lie behind people’s back pain, their perceptions of it and how to communicate with them. But I don’t like to focus on it too much, people already think about it all day, it rules their lives. Adding some understanding around why they feel it helps but I prefer most of their focus goes on the task rather than the outcome (their pain and reducing it). The task is to try and move in a particular way, when they’re in the gym that movement is under load. I like to use the words of a rugby coach I had when I was a teenager, look after the performance and the scoreboard looks after itself.
In the more complex cases, getting to that stage can take longer, and developing trust in the training, their backs and in me takes more time. But that’s the cool bit about being a coach, everyone is different, and working out how to make that connection is all part of the job.