Expertise: Do you already have it? If not, how do we get it? Part 1…

 In Pilates Therapy Concepts
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Expertise – Yes, I’d like some of that, please!

I have now completed the ISM course with Diane Lee a world-renowned expert in her field. Parts 2 and 3 of the ISM series were within 4 weeks of each other so there wasn’t time to put together anything to share, but there is plenty to come! I was the only Pilates person in the group of 25 attendees, and there have only been four Pilates Teachers attend the series worldwide, so I felt very fortunate to be there learning from Diane. My previous blog explored evidence-based practice, research and what that all has to do with Pilates. This one looks into the idea of expertise, what it is and how do we acquire it.

How do we best help our clients?

How do we in the Pilates community ensure we are teaching and practising in the most effective way we can when working with our clients, in the safest way we can? A good start is to continuously study, learning all we can learn about Pilates as a system but then what? Is that enough? How do we develop the expertise to know when our clients may need to do less or more? How can we ensure we are safely progressing clients through the choreography? How do we develop the expertise to answer these questions?

Why should we strive to develop expertise?

If you work with clients who have never had any experience of pain (the unicorns) lucky you! Most of us see clients who have histories of illness, injury or disability. Since I first started out as a Pilates Teacher, I seemed to attract what I now refer to as complex clients. These are the ones who found their way to my door when their medical practitioners ran out of tools to help them. At that time Pilates in the UK was gaining attention as the go-to exercise system. It was being recommended for those with histories of injury, back issues, and who were unable to exercise in more traditional ways such as gym or group fitness classes. I quickly realised I needed more skills than I had acquired during my matwork training. It never occurred to me to send these clients away. I’ve been striving to develop skills to help as many people as I can ever since.

Is following a sequence of choreography the best way to go with all of our clients?

When you work with the unicorns, you can follow the classical choreography relatively safely. Paying attention to technique, form and ensuring they master each exercise before progressing to the next will work like a charm. I would have struggled to teach many of my clients if I solely relied on the classical choreography, so the contemporary approach I had learnt with Body Control was very beneficial. There is a but here, this worked, but, how do I teach people who don’t have the pelvic stability to lie semi-supine and slide a leg without pain? I decided to learn as much as I could to help the people who sought me out. My quest to develop expertise started then and is still ongoing now.

Do we do the right thing at the right time when teaching?

How do we decide what the right exercise for our clients is and when is the right time to introduce something new? I will confess to having progressed clients on too fast in the past, giving them choreography that was too difficult for them. I’ve found it hard sometimes to know when they are ready to progress. Flashing forward to the ISM course I just completed, and I was amongst experienced physiotherapists who were having their minds challenged with alternative ways of assessing the treating their patients. I had it easy as I didn’t have any existing paradigms that needed amending. I was just looking forward to improving my effectiveness with my clients in a safe way. It was reassuring to realise these medically trained practitioners also struggled with the same challenges with their patients. A vital part of the ISM approach is working out what the right thing to do is, as well as, when is the right time to increase the challenge for the client/patient from a movement perspective.

So how do you know if you’re already an expert?

Ericson and Smith (1991)have defined expertise as having the ability to do the right thing at the right time. This made me take a minute to consider the approach taken by some Pilates educators that the order of exercises we teach is the way they should be taught – to all clients. Hmm, I’ve seen discussions on social media around this concept, and usually, some classical teachers share their experiences that the elders adapted and tweaked these orders depending on the client in front of them. This, to me, suggests the elders would meet the requirements outlined by Ericson & Smith – they did the right thing at the right time. So how did they know how to do this? If we aspire to follow in their footsteps, how do we get there?

How do I become an expert?

During the ISM series, there was a discussion about clinical expertise and how it can fill in the gap between science and practical knowledge (more about these in part 2) and how this is necessary when working with clients with pain or disability. When you attend a course taught by a world-renowned physiotherapist – research matters and so there is no surprise to find that there has been research done defining expertise – really – people research all sorts of stuff! More of this in a bit but if you can put your hand on your heart and say you consider yourself an expert, then thank you for reading this far, off you go, and by the way, lucky you. If you’re still with me, let’s crack on.

Come back and join me for part two, where I share what the research says regarding how we become experts…

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