Expertise: Do you already have it? If not, how do we get it? Part 2…

 In Pilates Therapy Concepts

Welcome back…

I’m grateful you’re back and are interested in how to develop expertise. Let’s get straight into it…

Clinical expertise has two components. 

  1. Acquisition of skills = do the right thing.

Learning the Pilates choreography ticks this box. Here is where we study the method, deconstruct and analyse the exercises so we can understand them inside and out. We learn how to share this knowledge with others – teaching from a place of knowing how to do it ourselves. Understanding the subtleties that differentiate the exercise called the hundreds from any other exercise where you are making a shape with your legs up in the air, head curled forward and pumping our arms up and down. We know there is more to the hundreds than this. It is the attention to ‘how’ which transforms the hundreds into a Pilates exercise.

  1. Clinical reasoning = do things at the right time. 

This is the part that’s not always included in the education of Pilates Teachers. How do we as Pilates Teachers acquire this part of expertise? It’s a process Jones & Rivett (2004) credit Higgs & Jones (2000) have called clinical reasoning. It involves the therapist [Pilates teacher] interacting with the patient (client) and others (family, medical practitioners) structuring meaning, setting goals and using professional judgement and knowledge during their work. 

How does this apply to Pilates Teaching?

We work closely with our clients, especially when working in a one to one or a studio setting. Our ongoing professional development helps to develop our understanding of the Pilates Method through weekly sessions as students ourselves, and on courses, we attend taught by other Pilates teachers. What I haven’t come across are courses open to Pilates Teachers offering them skills to improve their clinical reasoning, the critical component in being able to know how to do the right thing at the right time.

Thinking + Decision making + Practice = Wise Action

Research into this process has been done. It is intended to inform practitioners of physiotherapy in how to best care for their patients. I am well aware we are not physiotherapists but unless you teach only unicorns – people who have never had any pain, injury or trauma – it can equally be applied to any of us who work with others teaching them how to move. Movement has the power to heal but only when it is the right movement for that individual at the right time.

A personal story from my early days as a teacher:

Many years ago, in a group class, I thought I was careful and responsible in offering several versions of exercises to my clients. I shortened the levers, reduced the range of movement or increased their base of support to allow for the differences in the capabilities in the group. Why is it that those who aren’t strong enough don’t recognise when they are out of their depth and insist on going for the harder option? Why does the ego get involved? Let’s leave that for another blog. This same client then tells you their back was sore after the session and Pilates gets blamed. Pilates done correctly should never hurt your back! Fundamentally the responsibility was mine as the teacher – but in a group setting with clients with mixed histories and abilities – this responsibility needs to be shared with the client as well as the teacher (again, a subject for another blog). Let’s just say back in the early 2000’s one client not having a positive experience in their group class freaked me out. The obsessive compulsive perfectionist in me was not happy. I love Pilates and want others to share that love, it should never leave anyone in pain. But I learned a valuable lesson and realised I still had a lot to learn – birth of a course whore (I’ve also chilled out alot since then).

Have you ever stopped to think about why you choose to do what you do during your Pilates classes?

Group sessions tend to have a class plan or theme, but what about your private and semi-private sessions? How do you decide what to teach? Often we are taught that specific exercises are particularly useful for different populations – spinal extension exercises for kyphotic clients exercises focusing on hip differentiation for tight hips, work with a pelvic imprint for those with lordosis. It’s based on the experience of other teachers and their observations. It’s logical, right? But, is it appropriate or even useful with our more complex clients? Most of my clients fall into this category even if they arrive thinking it’s just their disc, or they need to strengthen their core. This strategy evolves from pattern recognition – and it works in some cases (those unicorns perhaps), but not all of our clients, especially the complex ones. Pattern recognition is useful for simple cases but there is a high risk for error. It’s purely based on experience and observation, this is what good Pilates educators are trying to help students develop but this has limitations when we are workig with clients with more complex histories.

Join me in part three to answer this question: How do you deal with more complex Pilates clients?

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