T Nation

help me with my client!


#1

Ok, so I'm a personal trainer now, soon to be bonded. Last night I had my first big scare and would like the forums advice. I've been training and giving advice for free in order to gain experiance and test out the business. One of my friends is also my first full-time client. He is a former college basketball player who just wants to get back in shape and put on some serious mass for the first time in his life. He's been making some big gains training with me and is beginning to understand how to manage his nutrition correctly and the importance of the post workout shake etc. I've been focusing on bringing his power and strength back up for basketball while priming him for mass gains. Last night we decided to have some fun and drop the workout to play some ball. My friend, another former player, and myself struck up a street game with some young sloppy kids and a street baller. Right off the bat my training brought my friend and myself into the game blazing. Our energy reserves were beyond exceptional and his game was explosive and fresh. The other team was immediately blown away and began to show signs of fatigue way too early as well as being frustrated because of all the lost opportunities. We were up by two and on another point run when his man decides to get real rough. I was playing the point and had to pass to our other guy for fear it was going to get dirty real quick if I passed to my client. It didn't matter when seconds later this asshole locks up and jerks my friends shoulder out of socket. Game over. I wanted to beat the living shit out of this street ball punk but had the pressence of mind to focus all my energies on my friend. We didn't want to set it as I am only a personal trainer and not a sports medicine specialist. We got him 1000 mg ibuprofen and an ice pack immeadiately. He wouldn't go to the ER right away so I had him sit in a hot tub with the ice pack on his shoulder to relax, calm down, and possibly allow the muscle to loosen up enough to let it slide back in. It didn't happen. I then made him go to the ER after we called some friends, who we do know that have training setting shoulders, and they suggested we get him in, the sooner the better. We got him in quickly, they drugged him up so much he almost passed out and is shoulder then relaxed and slid back into place. This is when I found out it has happened 27 times before! Yeah thats right he did tell me he had a bum shoulder that had been dislocated, but not 27 times! I was so suprised and kinda irratated! Me and the resident there were talking in total disbelief thinking this was beyond excessive. We got him back together and I took him home, bought him something to eat making sure he was ok since he couldn't drive. He then asked me when we were going to do the next workout. I told him that workout was done. We were going to avoid his shoulder all together until he had surgery on it. The RN referred him to a good doc in town and I told him our next goal was to get him into that doc and make sure this was going to happen within the next year. He was pissed with me but understanding since I bascially told him I wasn't going to train him for at least one month and that we weren't going to be doing anything hardcore when I decided I could train him again. Did I do the right thing? Can he even do lateral raises to strengthen the shoulder until he is able to get surgery? Should I even bother with him? Is there anyone here who has had orthoscopic surgery done on thier shoulder? What can he expect? What can I do to help him after the physical therapist is done with him?


#2

personally consult with both his pt and his main doctor. dont let HIS pride get in the way of YOUR common sense.but, dont let their lack of information corrupt his training career.
peace, flash


#3

Okay, we go through stuff like this all the time where I work since we have a PT clinic in the building and they refer a lot of people our way.

First thing you need is to get a letter from his doctor detailing what exactly is wrong with his shoulder. Ask what muscles specificially need to be strengthened, while you probably already have a good guess this is definetly a CYA situation. Then ensure that the doctor provides you with written instructions for what movements you are prohibited and which ones should be avoided. Then ask which shoulder movements are safe or recommended. Ask for these descriptions in anatomical terminology so there are no mix-ups. Then, follow the doctor's instructions.

Provided this is all in writing from the doctor and provided you follow his instructions to the T your butt should be covered legally. That having been said if you don't feel comfortable working with this person any more don't! As a trainer you have the right to decline clients when you feel the need. IF a client fails to inform me of medical problems they're immediately out the door, afterall you don't know what else they're holding back. . .

STU


#4

Not sure if it's legal for a physician to discuss patient care with a personal trainer. You might want to ok it with your client first.

You did the right thing by recommending that your friend see a doc, but if your friend wants to get the best possible treatment, he needs to be honest with his doc. They will surely ask him if it has happened before, and if he lies, that's his choice. If I were in your shoes I would just strongly urge your friend to be completely honest with the docs. If you go over his head, even though you have his best interests at heart, he may see it as a betrayal. In his mind, dislocating his shoulder another 27 times may be a better option than surgery. It might not be what you would do, but you have to respect his wishes.


#5

I had my shoulder scoped years ago. I feel a lot of physical therapists are a joke, they"re just going through the motions. Anyway, Wk one was recovery, wk 2 I did my own rehab at home w/ db's normal training w/ weight and movements that were not painful, wk 3 was back to the gym and back wk 4 I was lifting pre surgery weight. Now It all depends on the amount of damage of course, But it also matters how much effort is put in to rehab.


#6

You've done the right thing in my opinion. You could probably go on training him in some capacity but you have to look at the ethics of that.

I've clients that I've stopped seeing for similar reasons, it sucks having to give up X amount of money a month from them but word will spread that actually care about your clients.


#7

Does he have that condition that he was born with small joints that pop out easily?

Or maybe the stretchy tendon condition?


#8

In order for the you and your client's doctor to discuss your client you both need his permission. Just get him to write down that he grants both you and the doctor to discuss any and all physical and medical conditions that may relate to his training in the gym.

STU


#9

I've had a dislocated shoulder for about 15 years. The last time it came out of socket was about 5 years ago. Over the years it probably has come out of socket about 30 times. This occurs only during basketball. I also throw a softball like a girl in fear of dislocating it. It does not effect me when I lift weights. Will this hamper me down the road for strength or mass gains? Do I need to get it fixed or is there any specific exercises to strenghten surrounding muscles?


#10

my clients all fill all out a medical history before training commences--part of that form is the name of their doctor--their signature at the end authorizes me to discuss any conditions listed that might be an issue in their training--it's for their protection and mine

I think you've done the right thing--but your friend should have been up front about a condition as serious as that

get his permission to talk to his doctor before continuing the training

--Bill