PE Natalie Wilson - What To Do When You Don't Know What To Do

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[00:00:00] Raphael: Hey Natalie.

[00:00:09] Natalie: Hi Raph. How are you?

[00:00:11] Raphael: I'm pretty awesome. How are you?

[00:00:14] Natalie: I'm good, thank you. Are you jet lagged?

[00:00:17] Raphael: My dad doesn't believe in jet lag. And, um,

[00:00:22] Natalie: he comes from a, a more powerful generation than we do.

[00:00:27] Raphael: And, uh, I'm kind of coming around to his way of thinking. A little while ago, I, I talked to Russell Gilbert on this podcast.

[00:00:32] Raphael: He's a sleep medicine, uh, physician. And, uh, we talk, we talked about strategies to improve sleep, especially for people with chronic pain, where sleep's also an issue a lot of the time. Uh. You know, a lot of the, uh, basically the biggest takeaway that I got from Russell is like, yeah, there's like 10 or 15 things you can do in terms of daily routine, like how much caffeine you have, blue light exposure, temperature in your bedroom, darkness, you know, stuff like, you know, bedtime at the same time every night.

[00:01:04] Raphael: But all of those things collectively have like a 5% impact compared to feeling anxious about not getting enough sleep or doing a bedtime routine correctly. 95% impact. And so what actually stops people getting to sleep is they're freaking out about the fact that they're not gonna get to sleep. So, you know, to a certain extent, I think when you get into that whole kind of like blue light blocking glasses, must get to bed at exactly the same time, no caffeine after 9:00 AM all of that stuff, it's kind of.

[00:01:36] Raphael: Exacerbating the pRaphlem is 'cause it can just make you more anxious about sleeping. It's like, okay, you save your 5%, but then you like make the 95% worse.

[00:01:46] Speaker 3: Yeah. And

[00:01:46] Raphael: so I kind of think jet lags kind of the same, like I think so anyway, when I talk to Russell, you know, I said to him, look, I really love my coffee, but I just, you know, if I have a coffee after like, you know, 9:00 AM or whatever, I.

[00:02:05] Raphael: I can't sleep. And he's like, oh, I think that's just all in your head. And I was like, huh, okay. Maybe it is. And so I just started drinking more coffee. It hasn't, I haven't, I'm not aware of any effect that it has on my sleep, so

[00:02:19] Natalie: Wow. What a great medical consult for free. Yeah. Yeah. He

[00:02:23] Raphael: cured me. So I kind of think it's the same with jet lag, um, where I.

[00:02:33] Raphael: A bunch of caffeine first thing in the morning when at the new destination take a bunch of creatine because creatine's got good, uh, efficacy. It's what emerging research, I would say, showing that it improves mental alertness, especially when you are undersleep. And uh, then I just go on and bet my day.

[00:02:55] Natalie: That's awesome. I think anxiety pRaphably fucks with a lot of things. Right?

[00:03:01] Raphael: It's like the universal amplifier of bad shit.

[00:03:05] Natalie: Yeah. Yeah.

[00:03:06] Raphael: Um, anyway, we got sidetracked. So, um, the purpose of our conversation today is, uh, what to do when you don't know what to do.

[00:03:17] Natalie: I was so excited about that title. I wasn't expecting you to come up with a title when I proposed the topic and when I saw the title, I just got really excited.

[00:03:25] Natalie: 'cause then it really just kind of gives me a bullseye, a target to look for.

[00:03:30] Raphael: Yeah. Alright, so let's narrow it down a little bit. 'cause like there's a lot of situations where you might not know what to do. So let's, let's contextualize this. What are we talking about?

[00:03:39] Natalie: All right, lemme set the scene. So you are a Pilates instructor, whether you're a baby Pilates instructor or not.

[00:03:47] Natalie: You are a seasoned Pilates instructor and you are at the studio getting ready for your class and five minutes to your class. You have a client who comes in, client, could be new client, could be a seasoned client, but the client tells you, Hey, by the way, I wanted to let you know that I've been diagnosed with.

[00:04:10] Natalie: Name something. Uh, ACL tear, uh, some kind of spon de scary things, right? Like I wrote some stuff down. Uh, plantar fasciitis sounds so serious. Uh, carpal tunnel syndrome for me, the two that I encountered, not as a Pilates teacher, but as a Pilate Pilates educator here at Breathe is, um, we had a student who said.

[00:04:38] Natalie: I have muscular dystrophy. I've never worked with somebody with muscular dystrophy before. Um, and EDS like I know what, um, LER Danlos is. I just have never worked with anybody with that. Uh, so that's the scenario. Client walks in, you're about to teach class, they say some scary name, and you, you don't have any knowledge or experience about it.

[00:05:04] Natalie: What do you do?

[00:05:06] Raphael: Or, or even worse, it's not five minutes before the class. It's right at the start of class and you're going, Hey, anybody got anything wanted? Let me know. And one person sticks their hands up and goes, yes, I just had a hip replacement three weeks ago. I used to hate it when that happened. Um, okay, so I, I mean, how do you want go about this?

[00:05:28] Raphael: I've got a, I've pRaphably got one framework and one kinda life hack that I'd like to. What, what, what have you, what, what are your, what are your thoughts on the topic? What do you do?

[00:05:41] Natalie: I love when we don't plan for these things and we have different ways to approach the pRaphlem. I really love that. Like I a a lot of people ask me, you know, how do you and RAF go about podcasting?

[00:05:52] Natalie: And really we just kind of show up Yeah. And make it happen. Um, I structured my thought process around what to do before the class, during the class, and after the class.

[00:06:04] Raphael: Oh, you're, you're way more structured than me already.

[00:06:06] Natalie: I think I usually am way more structured than you, but I think it works out. I think we, we can make it work based on you.

[00:06:13] Natalie: You tend to have more, um, broad overall frameworks that work well in general. Um, and then we can detail get into the nitty with structuring the class.

[00:06:27] Raphael: Hmm. Well let's go. What do you before class. Okay. What? Walk us through, walk us through the whole process.

[00:06:37] Natalie: The whole process. Before, during,

[00:06:38] Raphael: you want all of it?

[00:06:39] Raphael: Yeah. Before, during, and after.

[00:06:40] Natalie: Okay. Well, before, before. Like before the Before. The first thing I wanna say is we are not expert fixers. I think that's your term, RAF, that you used in strengthen the person, not just the body part. I just read it, reread that book about two weeks ago. It's good. It's good. I highly recommend.

[00:07:01] Natalie: I

[00:07:01] Raphael: was using

[00:07:02] Natalie: it.

[00:07:02] Raphael: Has it dated much?

[00:07:05] Natalie: Um, well, some of the things that are dated have to do with the products that we sell.

[00:07:10] Raphael: Oh,

[00:07:11] Natalie: yeah. Yeah. But beyond that, no, no, no. It's, the content hasn't dated.

[00:07:15] Raphael: It's still current. No, no. The content

[00:07:16] Natalie: is really good. And actually the reason why I was reading it is because we are trying to, the studio that I, I work at, you know, just trying to upskill and up level the private lessons that we have.

[00:07:30] Natalie: Not even clinical, just private lessons. It's, it's a really great book for giving better private lessons. Anyway, commercial aside, I'm not getting any profits from the sale of this book, but you should read it.

[00:07:41] Raphael: We sell it for $4 99. I know

[00:07:44] Natalie: know if you, if I had a cut of that, you'd get nothing. Uh, but I, I think the very first.

[00:07:54] Natalie: Tip is to let go of the idea that you're ever an expert fixer period. Also, a second idea is that, uh, humans are anti-fragile. Uh, so that's, that's before the before.

[00:08:05] Raphael: Alright, well hold on. Just, let's just double click on those just for a second. So, I think the letting go of the expert fixer thing, I think that's pRaphably like, we could just end the episode after that, which is like, okay, you don't know everything.

[00:08:18] Raphael: It's not your job, everything.

[00:08:22] Raphael: What to do for someone with muscular dystrophy, eds, or hip replacement or whatever, that's not your job. Okay, great. Yeah, I I'm not supposed to know that.

[00:08:34] Natalie: It is really liberating to, to embrace that idea that you don't have to, no, you're not obligated to know everything. That really, truly solved 99% of my pRaphlems when I finally learned that.

[00:08:50] Raphael: Well, in that case, can I then dovetail in, and maybe this is what you're about to say anyway, but once you release that need to have the answer, you can just ask the client. Oh, muscular. Muscular dystrophy. Okay. So how does that limit you in, in ways that are relevant to, to exercise class today? Yeah. Oh, you've got carpal tunnel syndrome.

[00:09:17] Raphael: Are there any movements that you need to avoid? Yeah. Great. Okay. I'll make sure we don't do any of those. Thanks for letting me know. Yeah,

[00:09:27] Natalie: yeah. No, that's, those are really good questions. That was on my list. I think the first, the first question that I have when somebody tells me that they have a medical condition that I'm not aware of or I might be aware of, but I realize that it could.

[00:09:43] Natalie: Inhibit some of their movements or participation? The first question I asked, not if, not always, but do you have, do you have medical clearance to participate in this class? Sometimes it's worth asking that question. If they say, I'm just coming back off of a broken bone or a surgery, it's good to, you know, for for you to ask, does your doctor know that you're coming back to group Pilates?

[00:10:08] Natalie: And, uh, hopefully they say yes or, oh, yeah, I've been, I've been working out for quite a bit now. You just wanna be able to elicit some kind of response that makes you feel confident that they're gonna be all right. And then the second question I would ask is exactly what you said. Oh, tell me about it.

[00:10:23] Natalie: Tell me, is there anything that really bothers you? Are there things that you avoid? Are there certain movements or positions that you avoid? Um, I'm very honest with people if I don't know what it is.

[00:10:35] Raphael: Well, here's the thing, like if, if I've been dealing with carpal tunnel syndrome or muscular dystrophy or hip replacement or whatever for five years, I know which positions I don't like being in.

[00:10:47] Raphael: Right? That's a very simple question for me to answer, so you just ask me. Okay. Which positions do, do you avoid? Oh, I don't like this one, this one and this one. Okay, great. Well, let's not do those then.

[00:10:57] Natalie: Yeah. Yeah. So that's the before there's, there are a few things that I also wrote down in my before list.

[00:11:07] Natalie: One is staying calm and curious, which just again, is exactly what we're talking about is. If you remember that people can't be broken very easily. And also that you don't have to know all the answers, you just ask questions. And I get really excited when I meet people who have weird medical conditions I've never worked with before.

[00:11:27] Natalie: 'cause then I can say I've worked with somebody with muscular dystrophy and it was awesome. Um, so staying calm and curious is another tip that I have. And then finally, um, I'm really big about self-regulation in my classes. And, and really what that just means for me is reminding them that they can work within their tolerance.

[00:11:46] Natalie: They pick the option that works best for them. Take breaks. If you need to reach out to me during class, if there's something that doesn't make sense or doesn't feel good, but leaving it up to the client to know that this is your workout and I'm definitely here to help you. But you know, like you can call the shots and you have veto power and you can do what you want and be curious and explore as well.

[00:12:10] Natalie: So that's before.

[00:12:11] Raphael: I like that. Yeah. What about during?

[00:12:14] Natalie: During, okay. Um, exercise selection, which by the way is a topic that I think is relevant across the board, not just working with people who might come in with a scary medical condition. Um, have you ever been to Inn Out Burger?

[00:12:37] Raphael: Oh, love Inn Out Burger.

[00:12:40] Natalie: Yeah.

[00:12:40] Raphael: Every time I'm in California I'm like, where's the Dearest Inn Out Burger? In fact, I was in Vegas a few months back. I was like, oh, they've got Inn Out Burger in Vegas. That's awesome. So Jules and I, my wife, we had Inn Out Burger like multiple times. Love it.

[00:12:53] Natalie: What's your order?

[00:12:55] Raphael: Just whatever the basic, I can't remember what the menu's called, but it's like just this one standard burger meal, please.

[00:13:01] Raphael: Okay. Please.

[00:13:03] Natalie: Uh, I, I, I live with three other Wilsons who love In-N-Out Burger. Um, I'm okay with it. I love all burgers and fries, but it's, it's not my favorite burger joint, but whenever there's an In-N-Out burger, we have to go. But the reason why I bring up In-N-Out burgers, because I was reading something online about.

[00:13:22] Natalie: How in an out burger is different than other burger joints. And one of the things that this post talked about is their menu and their, I wrote it down. Their menu is simple to execute. Easy to scale, hard to screw up. Isn't that great? Yeah. Doesn't that remind you of Heath's philosophy? Totally. Sim, simple to execute, easy to scale, hard to screw up.

[00:13:49] Raphael: Heath is the In-N-Out Burger of Pilates.

[00:13:51] Natalie: Yes. Yes, he is. I don't think he's ever been to In-N-Out Burger. We're gonna have to,

[00:13:56] Raphael: I'm gonna, I'm gonna take him there one day.

[00:13:58] Natalie: Yeah, yeah, yeah. You're gonna have to do that. But I wrote that down because I thought that was so key to. Just life in general. But when it comes to programming Pilates, I feel like as I continue to evolve as a teacher and I'm getting better at being a teacher, one of the things I'm doing is just really focusing on how I can make things simpler for myself.

[00:14:21] Natalie: So looking at all of the programs I've written and how do I use this pro, how do I simplify the programs that I already have? Not creating new programs, not creating new creative sequences, but. Making things even more simple. So that's my first tip.

[00:14:40] Raphael: Yeah, and for those of you outside California who've had the misfortune of never going to In-N-Out Burger, their menu is unbelievably simple.

[00:14:49] Raphael: I mean, I can't remember the exact details, but it's like you got a, a burger or the jumbo burger, you've got a small, medium, large fries, and then you've got different flavor soft drinks. That's about it. They don't have McNuggets or Happy Meals or apple pies, or it's just like, what kind of plain burger would you like?

[00:15:11] Natalie: Yeah. Mm-hmm. So, yeah. So that's my first tip is in general, one of the ways that you can. Really solve a lot of your pRaphlems in the studio is to select exercises that are simple to execute, easy to scale, hard to screw up.

[00:15:32] Raphael: Amen.

[00:15:33] Natalie: Yeah. Another tip. Teach in layers

[00:15:38] Raphael: start easy. I, I would like to just add to that.

[00:15:41] Raphael: Sorry. Okay. I think exercise selection, I, I entirely agree with what you just said, but I think overall exercise selection is something that is. We focus on too much in Pilates. I think like often, you know, I see posts, you know, the best exercise for blank insert, you know, condition or whatever. You know, the best exercise for back pain, the best exercise for, you know, building core strength or the best exercise for whatever.

[00:16:11] Raphael: It's like there's pRaphably a a hundred exercises that would be good for people with back pain or building core strength or whatever. It's like the difference between the best and the worst exercise is pRaphably like 10%, you know? Yeah. And the, so like spending all of your time agonizing about should we do this or that variation of an exercise is like you, you're obsessing over something that does, doesn't make much difference.

[00:16:36] Natalie: No, no. It's a waste of time and energy for sure. And like I said, for me personally, as I continue to evolve as a teacher, my programs are becoming even more simple. It's just 'cause I need to remember them. That's the thing is I need to remember them and I'm having a hard time if I, there's too much, if there're too many bells and whistles.

[00:16:59] Natalie: So yeah. Gotta be the in and out burger. Can you.

[00:17:08] Natalie: So second tip, teach in layers, progressions. Start easy and give people a few options and see if you can get them moving right? Moving right away in something that's simple and easy. And then build and challenge. One of the things that I have learned from working with people with medical conditions, I mostly work with people who have Parkinson's and multiple sclerosis is.

[00:17:36] Natalie: They'll, they'll tell you, they'll tell you when they need to stop or you know, what layer they need to stop at. And so just let them, let them move and let them figure things out, give them choices.

[00:17:51] Raphael: And, um, I, I think there's, there are different definitions of the term layers or layered that they using Pilates.

[00:17:59] Raphael: And so what's, what's you. Your definition, which I know is my definition as well. And Heath's definition. What, what do you mean when you say layers?

[00:18:08] Natalie: What I mean by layers is that you break up an exercise into progressions, starting with your easiest version of the exercise or a, an uh, a simple step, simple and easy step of an exercise.

[00:18:24] Natalie: So, for example, if we were going to teach the hundred on the mat. Depending on who's in the room, I might start off with just doing a curl up. If I'm working with an advanced class, even people who are advanced, quote unquote advanced, might need an easier layer. So maybe it is legs. Skin tabletop or knees into your chest, starting in a tucked position, keeping the knees tucked as you beat the arms, right?

[00:18:56] Natalie: I don't think there are hard and fast rules about how you layer or progress and exercise, but it, it should be for the people in front of you. The bet that you're making is that whatever, uh, I don't wanna use the word layer. Whatever variation of the exercise you choose to do is one that you think everybody's gonna be able to execute.

[00:19:18] Natalie: And do about, you know, 10 to 20 reps if they, if they needed to.

[00:19:22] Raphael: And then, then you basically just add a. Not so slightly harder version. So, but it, the, the, the key thing is that it's the same exercise.

[00:19:34] Speaker 3: Yes. Just

[00:19:34] Raphael: a harder versions. It's not like, and now let's do it on a football or something. It's like, no, no, let's just straighten your legs a bit more or lower your legs to the floor a little bit, or whatever it might be.

[00:19:45] Natalie: The transition should always be easy. And that's a really good point we have, we have this. Activity in the course and the course that we teach where we ask people to take an exercise and we break it up into layers, and we have had some students interpret that to mean. We'll do an easy version, say on the long box, and then you take the long box off and do the harder version on the bed.

[00:20:07] Natalie: It's like, no, no, no, no, no. Keep them on the bed or keep them on the on the box. We want the transitions to be fast.

[00:20:13] Raphael: Well, I would say there should be no change to body position or equipment settings. Really. Yeah, within, that's right. Those layers. It should just be literally, lift your knees up, drop your knees down, straighten your legs, bend your legs, relax your head down, you know, move your arms through a larger range of motion, whatever it might be.

[00:20:28] Raphael: Right?

[00:20:29] Natalie: Yeah.

[00:20:32] Natalie: Another way that you can think about it. So I don't know if you were taught this way in your initial training, but when I was taught in my initial training, I spent one week learning the beginner version of the a hundred, and then two weeks later the moderate version and so on and so forth. Yeah. I think if that's, if that's the way that you were taught exercises, my suggestion would be go find all those versions of.

[00:20:57] Natalie: Go find the hundred, find the beginner version, find the moderate version, and find the advanced version and, and just put them side by side. And if it's an easy transition, teach it like that. Start off with your beginner version and then if you see that they're nailing it, move on to your moderate version and then try the harder version.

[00:21:14] Natalie: Yeah.

[00:21:14] Raphael: When I learned stop Pilates, I'll call the prep version or whatever. And so I would say like for most exercises it's like you got the intermediate advanced. There are usually like five other versions in between those that you can add in, and it's literally just teaching all of those in exercises from easiest to hardest as a sequence.

[00:21:35] Raphael: Mm-hmm. That's literally what layers is. Yeah. Yeah. So you say, Hey, hey everyone. We're gonna do the hundreds. So lay down your back knees, bent feet on the floor by your butt, hands behind your head, curl up, and then you progress it to, okay, now we're gonna bring the knees, tuck your knees into your chest. Go again.

[00:21:54] Raphael: Okay, now we're gonna straighten one leg towards the ceiling. Okay. Now both legs. Okay. Now keep, now bend your knees, go to tabletop. And like we just gradually, gradually, gradually. And people, like you say, get off the bus at the stop that suits them today.

[00:22:10] Natalie: Right. But at the beginning, everybody rides the bus.

[00:22:13] Natalie: But at ev

[00:22:14] Raphael: at the beginning, every, you choose an exercise where everyone can ride the bus together.

[00:22:18] Speaker 3: Mm-hmm.

[00:22:19] Raphael: And, but depending on your group, you might choose. Easy peasy, peasy version. Or you might go, Hey, I know everyone in the room. I'm pretty sure everyone can do tabletop. So we'll start there.

[00:22:32] Natalie: Yeah,

[00:22:36] Natalie: yeah. Shall I move on?

[00:22:38] Speaker 3: Yeah.

[00:22:39] Natalie: Okay. Um, oh, here's a good one. Avoid diagnosing and assuming limitations, right? So they tell you a scary thing. Again, you're not the expert fixer. Let people try things out. And one of the things that I learned from working with people with disabilities is actually not just people with disabilities and anybody give people space and time to troubleshoot on their own.

[00:23:06] Natalie: Give them a moment, you know, like let them try it because I think most of the time people underestimate. Their own abilities. And sometimes if you're a teacher who's scared to teach people with specific disabilities or medical conditions, you might be writing off somebody who could actually do quite a bit more.

[00:23:27] Natalie: And I get surprised all the time by my own clients who have huge medical conditions. They surprise me all the time and they surprised themselves, which is the funniest part, to watch them nail something they didn't think that they could be able, you know, that they would be able to do. Just by saying something like, I'm gonna set this timer for 60 seconds.

[00:23:45] Natalie: I know that's a lot. We've been practicing 45 seconds for the last 20 years. I think we can try 60. Do what? You can take a break if you need one. I'm gonna be counting down and then I'll give you some time marks and. It's so motivating for them to know. It's just like, okay, you have 15 seconds left. And a lot of them will pull, will pull through.

[00:24:07] Natalie: Yeah. And they're so happy.

[00:24:09] Raphael: And that's, that goes, that's in line with the literature on chronic pain where, uh, the support of someone's spouse or workmates, particularly the spouse. Is a factor in chronic pain. And so if the, if the spouse is unsupportive, like as in like, oh, stop complaining and you know, just, you know, I'm sick of you whinging sort of thing, and you know, not, you know, acknowledging the person's distress or whatever, like just ignoring their distress essentially.

[00:24:43] Raphael: That can unsurprisingly. Make people more distressed.

[00:24:46] Speaker 3: Yeah.

[00:24:47] Raphael: Whereas on the other end, if the spouse is overly coddling, it's like, oh, don't you get up? You know, I'll do it for you. You know? Oh, don't you dare wash the dishes, you know, you stay on the sofa, I'll make you a cup of tea. And if like 10 years later they're still saying that, you know, it's like you're essentially disabling that person.

[00:25:05] Raphael: Yeah. And so neither of those is ideal. And what you want is something in the middle where like what you said, it's like, okay, look, I know you've got a bit of a sore back today, but I'm gonna set the timer for 60 seconds and let's see if you can make it now. If you need to stop, that's fine, right? But let's see how far you can go.

[00:25:21] Raphael: Right? Because it, it gives that person agency and challenges 'em to push.

[00:25:26] Natalie: Yeah, I think. Sometimes we underestimate the power that we have over our clients in motivating them just by simply in the way that we speak, right? So I say this to our students all the time when we're working on their charisma. I.

[00:25:43] Natalie: And you know, like when you get to the end of the exercise and you know that you're pushing them, give them the kind of energy that you think you're gonna need to get to the finish line. Like there's a, uh, a reel that I love watching on Instagram. It's this like, she has to be 102 years old running a marathon and her running coach is at the finish line and somebody's in the crowd videotaping her.

[00:26:08] Natalie: And you know, she's like 90. She is. A hundred years old and she's like plotting along and her coach is screaming so loud like, Miriam, don't stop, keep going. And it's just, it's so good because that's the kind of thing that we're trying to encourage. Our students to do as well. It's just like when you're, when you get them to the end and you want them to push a little harder, there's a big difference between like, nice job, keep going.

[00:26:36] Natalie: As opposed to, you know, like giving them energy, giving them motivation.

[00:26:40] Raphael: I, I wanna double come back in another episode and double click on what you said before. It's like when we are teaching them charisma, right? Oh yeah. So let's book that now, but that's another episode.

[00:26:50] Natalie: Okay. Alright. I love that topic.

[00:26:53] Natalie: Okay. Um, and then, oh, here's one of my favorites. When you have a client who comes in saying that they have pain or injury, please let them come to you if they need it, and don't remind them about their pain and injury, or if you see that they're really, really struggling, maybe go over there and just check in and say, Hey, how can I help you?

[00:27:21] Natalie: But one of the things that I see a lot. With our students when they're trying to be kind and compassionate and empathetic is when we're practicing working with people who come in with pain and injury. And during their session they say, Hey, Ralph, how's your back? How's it going? Stop if the other's pain

[00:27:43] Raphael: mom does this, love your mom.

[00:27:44] Raphael: But, um, you know, if she's, if I, if I go I, if I like, I don't know.

[00:27:59] Raphael: She's like, oh, you look a bit tired today. I was like, yeah, I had a late night last night. Oh, you poor thing. You must be so tired. And it's like, for the rest of the visit, it's like, oh, you poor thing. You must be so tired. You're so tired. You must be so tired. It must be hard for you. It's like, no, I'm fine.

[00:28:10] Raphael: I'm fine. Yeah, just have one late night. You know, don't make it a thing. Don't, don't, don't speak that into me that I'm this poor victim who's tired and distressed and I can't think straight and it must be so hard. No, I. Just have one late night. And so I, I mean, I, you know, that doesn't make me feel empowered, you know?

[00:28:36] Raphael: And so I think that's really, really important. What, what you say there.

[00:28:40] Natalie: Well, and it also reminds you that you feel like shit, I. When you could just be having a good time having frequent cookies with your mom. Right? Sorry mom. No diss. But yeah. Yeah. I was, I, I explain this to our students all the time because they are, it comes from a really good place that they wanna be em empathetic and they wanna be kind and compassionate.

[00:29:00] Natalie: But I was saying to them, you know, a lot of times people who have chronic pain, and if you have chronic pain, you understand this completely. There are specific activities and moments in life that distract you from pain and your Pilates class. Those are a gift, can be one of, yes. Those are a gift.

[00:29:16] Raphael: Like what you want is to be distracted from the pain, not reminded of it.

[00:29:19] Raphael: Right. Right. And, and and also, I know when you are, you know, for, for many people who have some kind of disability or injury or you know, something that's kinda holding them back in life in, in one, some area. It's like you don't want everybody to give you special consideration. You just wanna be one of the gang.

[00:29:38] Raphael: Right? You just wanna be a normal person. You don't want the people to stand up on the train and give you a seat. You just wanna just be blend in, you know? Yeah. And so it's like you just don't mention it. Don't mention the war. Yeah.

[00:29:50] Natalie: No. No, don't mention it. Wait for them to come to you because oftentimes if they're uncomfortable enough, they will flag you down and say, this is really not gonna work for me.

[00:29:59] Natalie: Yeah. Or obviously if you see them, you know, some of my clients will be, uh, just bear it and you can, I can see it in their face that they're just dying, and I might just go up to them and say, Hey. Take a break if you need it, check in if you need something.

[00:30:13] Raphael: And I think it's, that's fine to say that at the start of class as well.

[00:30:16] Raphael: Hey, look, if you need to take a break anytime, totally fine. Or if you need help, just wave, you know, on, you know, wink at me and I'll come over and whatever, you know? But then just after that, leave it in there. Court, don't mention, yep, 100%.

[00:30:30] Natalie: Yep. Uh, that's, that was my last item for during class. I have just a couple for after.

[00:30:39] Natalie: Do you wanna hear him?

[00:30:39] Raphael: Yeah. Yeah.

[00:30:40] Natalie: Okay. Um, the first is do your homework. So, you know, you didn't have time during class to learn about carpal tunnel syndrome or muscular dystrophy, but if this client is gonna be a regular client of yours, or in my case it was regular students of mine, I wanted to learn more about it.

[00:31:00] Natalie: So doing some Google Scholar research going to the A CSM guidelines to see if there was anything I needed to know. Um, looking up national guidelines. It is kind of tricky and this might be an episode that you could do as well about how to filter out the good stuff from the shitty stuff.

[00:31:19] Raphael: I think the one, I'm so glad you said those things.

[00:31:22] Raphael: I think the one line. Or you know, memory trick for this is literally yourself a copy. The guidelines Amazon. 30, 40 bucks and it's like, it's got just about every freaking condition in there. Do not please for the love of God, just randomly Google muscular dystrophy. 'cause you'll get someone telling you colonic irrigation and reiki are the, you know, best treatments for it.

[00:31:53] Raphael: So like, you just can't trust everything on Google. So go, you go read the A CSM guidelines. They're not a hundred percent perfect, but they're about 95%. Perfect. You know, it's a very reputable source. And if you're a little bit more, um, scientifically literate, you can use a Google Scholar. You can look up national guidelines and stuff, and that's all great.

[00:32:14] Raphael: But like, if you just wanna spend 40 bucks and get the A CSM guidelines, it's got everything you need for 90% of Yeah. The people gonna walk through the door.

[00:32:22] Natalie: Yeah. The other thing that I like to do is there are certain physical therapists, physiotherapists that. I follow that, have podcasts and I'll go check out their podcasts and see if I can find a topic.

[00:32:37] Natalie: I, I do that a lot. That's actually my favorite thing to do is to shout out Adam

[00:32:41] Raphael: Mackins.

[00:32:42] Natalie: Adam Kins, um, E three rehab. Do you ever listen to E three rehab? Yeah, yeah. Yeah. They have some really good topics, so, so I have a handful just at my disposal in my Spotify and I, if I have, if I come across a condition, I'll see if the, if they have anything to talk about.

[00:32:57] Natalie: I learned some really cool stuff about osteoporosis and frozen shoulder in the last month. Yeah, good stuff.

[00:33:08] Raphael: Is there anything else for after.

[00:33:10] Natalie: Uh, the last one I have is if you work in a studio setting or, you know, for, for me, working on a team at Pilate School is I just reach out to other instructors and just say, Hey, have you had this person?

[00:33:22] Natalie: You know what works? Tell me, are there any tips to make it better? I just like to reach out to other people and see if, if they have any. Special tips, and I find that oftentimes it's not even, it's not even the medical stuff that I want information on, it's just, you know, how do I approach this person, uh, and work better with them?

[00:33:41] Raphael: I would, pretty much, I would, I would approach that one with more caution. That's like, I guess I'm, I mean, I would ask you. Or Heath or you know, someone on our team, like if you'd been working with a client and I, I, and I was taking over that client, I'd be like, Hey, Nat, you know, tell me about Sally. What's going on with her?

[00:33:59] Raphael: How do you work with her? Whatever. But I guess I'd be very skeptical of most people in the world, physios included. Because there's just a rampant lack of understanding of current guidelines. And they might say like, yeah, make sure you do colonic irrigation with them, or, you know.

[00:34:20] Natalie: Yeah, that's fair. I'm totally using my own lens around this because I only hang out with Pilates instructors and educators who I trust and know, know their shit.

[00:34:33] Raphael: Yeah. Yeah. And there's, there's a few people outside of the. Sphere who are in that bucket for me, like Adam mct for example.

[00:34:44] Natalie: Shout out Adam. Yeah.

[00:34:47] Raphael: Uh, but very few, like less than one hand's worth of fingers in my, yeah. In my mind. And not that they're all, that, all the people in the world, but it's like those are all the people I know.

[00:34:58] Raphael: Mm-hmm. Um, yeah,

[00:35:01] Natalie: me too.

[00:35:02] Raphael: Me too.

[00:35:04] Natalie: Good. That's my list. What do you think, boss? Pretty good, eh?

[00:35:07] Raphael: Yeah. Pretty awesome. Uh, I had, I had a couple of those things. Um, I've got a, uh, I've got a framework actually you reminded me of. I've got two frameworks actually. So, and, uh. I'm gonna share them fairly quickly 'cause I've got about 12 minutes left.

[00:35:24] Raphael: And dear listener, you can look at the podcast and see how much time's remaining. See how we did. Um, so the first thing is, you reminded me of this at the start. Now when you asked, when you said ask 'em questions about it and, and I think really there are two questions you can ask when someone comes in.

[00:35:40] Raphael: And says, I've got a, A, B, or C diagnosis. And you're like, what the heck is that? I've never heard of it. You dunno. Is it some kind of exotic tropical disease or is it an autoimmune condition? Is is it an injury? Is it like, you dunno. What it is, is ask them two questions. When did it start and how did it happen?

[00:36:00] Raphael: How did it start? When does start? How start? And that will tell you if it's. An acute injury or if it's not an acute injury, and if it is an acute injury, that's when you should ask, have you got medical clearance? You know, has your doctor slash physical therapist or whoever approved you to do go to group exercise?

[00:36:20] Raphael: And so really like super, you know, zoomed out. If it happened less than three months ago, they pRaphably should get medical clearance, like if it's significant enough for them to mention it. Asterisk, there's some nuance to that, and if we'd wanted to double click on it, we could say, for some things it's three weeks, and for other things it's, you know, 3, 6, 12 months.

[00:36:47] Raphael: But if you just wanted like a really good rule, rule of thumb that in 80% of the cases is gonna be about right. It's like, okay, when I've got this blah, blah thing in my. Insert body part here, and you've got no freaking clue what that is. Okay. How long ago did that start? Oh, four years ago. Okay, great. Well, it's not an, it's not an acute injury then, whatever it is, it's not an acute injury.

[00:37:09] Raphael: Oh, it started two days ago. Oh, well how did it happen? Well, I, I was riding my bicycle to work and I got hit by a car and that's when the pain started. Oh. It sounds like it might be an acute injury. Maybe should see a physical therapist or a doctor about that. Before you come to class. So it's just a really quick, rough and ready rule of thumb, which is gonna be right about 80% of the time.

[00:37:29] Raphael: And it's just when did it happen and how did it happen? And if it sounds like it could be an injury, when you ask 'em those things, like if it's less than three months old and there's some kind of impact or trauma or something that could cause an injury. Might be an injury they should get medical clearance.

[00:37:43] Raphael: Yeah. And if it's not, it's almost certainly not an injury and they don't need medical clearance. Because dear listener, if you, you might even have a very, very serious medical conditions like cancer. Guess what? You should still exercise. Yep. But just still, you don't need medical clearance. You just need to go exercise.

[00:38:03] Raphael: Now, there are some considerations when you exercise with cancer or osteoporosis or muscular dystrophy or carpal tunnel syndrome or whatever, but the recommendation if you go by the A CSM guidelines is always gonna be. Yep. So you don't need medical clearance for any of those conditions. You just need to be, uh, you just need to be aware of what the considerations are and that person's almost certainly gonna know if they've been living with the condition.

[00:38:36] Raphael: Yep. So the only time you need medical clearance is if someone has an acute injury, like a broken bone muscle tear, herniated disc that recently through trauma. Something like that.

[00:38:50] Natalie: Yep. Blown it. Or if they've come back from a surgery recently. Right,

[00:38:53] Raphael: right.

[00:38:54] Natalie: Yeah.

[00:38:56] Raphael: Uh, so when and how, and then the second one, second framework is really any, like, we've talked about this on the podcast before, that any human movement can, and I think should be broken down into the three components of strength, range of motion and control.

[00:39:13] Raphael: And we can describe every movement in terms of. To what extent it challenges each of those things. And so you might have a movement that's very challenging for strength, but not challenging for range of motion like a plank. Or you might have a movement that's very challenging for range of motion, but not very challenging to strength like a front splits.

[00:39:34] Raphael: Or you might have movements that are challenging to both, right? Like front, front splits on a very low spring and you know, controlled, likewise. Uh, and so when you have an injury or a medical condition or some other kind of situation like pregnancy, you are going to need to modify certain moves because of either tissue vulnerability or pain or stiffness, or just lack of control of your body part.

[00:40:08] Raphael: It's all going to boil down to you lack some amount of strength, range of motion and control in that movement. Like if you have had breast cancer surgery and maybe radiotherapy and you've had lymph nodes removed, like you're gonna have lost strength in the shoulder. You're gonna have lost range of motion in the shoulder.

[00:40:29] Raphael: You're gonna have lost control in the shoulder, right? And the reason for that is obviously the surgery and then all of that stuff. But the result is you're weak, you're stiff, and you're uncoordinated. And so now, even if you just have like shoulder pain, right? Well guess what happens Because of pain. You can't exert as much force and you can't move your shoulder through full range of motion and you don't have full coordination of the shoulder.

[00:40:54] Raphael: So guess what? You've reduced strength, range of motion control. If you've got frozen shoulder, guess what? You've lost strength. You've lost range. You've lost control to some extent. And so for any movement, regardless of whether someone has muscular dystrophy or osteoporosis or Parkinson's or carpal tunnel or you know, surgery or whatever, it's like.

[00:41:17] Raphael: You're gonna need to adjust the strength, the range, and the control of any given movement based on their current capacities, because it's not a fixed amount if you've got cancer reduced strength by 40%, because like, well, how long ago was their surgery? And what sort of rehab have they been doing? And what baseline did they start from in terms of their strength and mm-hmm.

[00:41:37] Raphael: All of that. So it's like, it's just a matter of like, well, what are you capable of today in terms of strength, in terms of range, in terms of control? Let's start you there, right? Yeah. And so doesn't matter what itis or s or apathy the person has, it's just like, okay, what are your current limitations or abilities in strength, in range, in control in that body part, right?

[00:42:02] Raphael: So it's It's just a matter. And how do you find that? Well start them with the easiest possible version. See what they can do. If they can do it. Go a bit harder, keep going until they go, wow, that's, that's a bit too much. And then go, okay, great. Let's back it off. And that's your version.

[00:42:18] Natalie: That was such a game changer for me when I learned how to teach in layers.

[00:42:21] Natalie: And Keith always says this, that the first layer of the exercise, your 90-year-old grandma can do it. If you start there, whatever that means for you, and especially if you don't know the people in front of you and you're having to make a guess. It's always better, I think to go easier because you can always scale up.

[00:42:40] Natalie: Right? So it goes back to the in and out menu is easy, simple to execute, easy to scale, hard to screw up. Yeah, really like it just boils down to that. Like if you can think about exercises in that way and then pick those exercises and pro program them in, it really is hard to screw up.

[00:43:01] Raphael: Yeah.

[00:43:02] Natalie: Yeah.

[00:43:03] Raphael: So if I could sum up my takeaways from this.

[00:43:06] Raphael: You tell me if I'm, what I've missed, because I pRaphably have missed some, is like, number one, just let go of the idea that you have to know the answers. Yeah. And just ask the client, right? Hey, are there any move? Oh, are there any movements that are painful for you There any, you know, is there any positions you'd like to avoid?

[00:43:22] Raphael: You know, um, and then ask them when and how it happened and if it was less than three months ago and. That there was some kind of trauma, a physical trauma, asking if they've got medical clearance and if it wasn't and they don't, don't worry about it, ask them, and then just, you just got work on their strength, range of motion and control.

[00:43:46] Raphael: And that's again, we ask the client, you know, are there positions, et cetera that you. Tend to avoid or that are painful for you or you know, that you struggle with. Okay, great. And so that doesn't mean that you completely eliminate necessarily those things. Like if someone's got a sore back and they say, oh, flexion hurts, or bending forward hurts.

[00:44:07] Raphael: It's like, okay, let's see if we can bend you forward just a little bit, you know, so that it hurts just a teeny bit. You know, so that you, rather than putting you in a position where it's an eight out of 10 pain, let's put you in a position where it's like a three or four outta 10 and you can tolerate it.

[00:44:20] Raphael: It's not gonna blow you up. And you can start to build up a tolerance to that, you know? So it's like, yeah, whatever you can do, let's do that. Right?

[00:44:30] Natalie: Yeah, I think it's really important to focus on that and to keep reminding the client to focus on that. Just do what you can

[00:44:38] Raphael: and, and if I could then reach to where

[00:44:39] Natalie: you can

[00:44:40] Raphael: then sum up like kind of.

[00:44:42] Raphael: What I took away from the rest of what you shared is like, don't make it a thing. Yeah. Just let them, let them give them the option to, you know, take a break or ask for help and then just treat 'em like everyone else.

[00:44:57] Natalie: Treat 'em like everybody else. Yeah. And

[00:45:01] Raphael: teach in layers. We already mentioned that, but

[00:45:04] Natalie: yeah.

[00:45:05] Natalie: Teaching layers and program like In-N-Out Burger

[00:45:09] Raphael: program. Like In-N-Out Burger. Good talk. Good talk.