Bridging the Medical/Fitness Gap

Transcript taken from Fitness Candor Podcast episode 136

00:03 Eric:Record. Hey everybody, welcome back to Fitness Candor podcast. Simon Shawcross from joined us again today, and we’re gonna talk a little bit more shop geared towards the fitness professional again, but hopefully maybe if you’re not a fitness professional, you’re working with a trainer, maybe this can be of some benefit to you. But I’ve spoken on the podcast a couple times to other people about, there’s a gap that needs to be bridged between the fitness professional and the health professional, health professionals being a general practitioner, doctor, any kind of physician, chiropractor, physical therapist, you name it. Because I don’t know, Simon, about you, but… Well first of all, welcome to the show, before I keep rambling on.


00:54 Simon Shawcross:[00:54] ____. [laughter] But yeah, I was happy to just jump straight in, it’s fantastic. Always a pleasure to catch up, Eric.


00:58 Eric:Awesome. So anyway, my experiences have been, I would say 70/30, to the point where it’s like, someone who’s working with a trainer, specifically me, either they won’t bring up to their physician, let’s say if they have a nagging back injury or maybe they’re just coming off of surgery, they won’t bring up that they’re working with a personal trainer, because either they don’t find it relevant, or if they do say they’re working with a trainer, the person that they’re talking to, the health professional in the medical field, they get kind of like this weird, they do the eye roll like, “Oh, you’re working with a trainer. Great, whoop-de-doo.” So I don’t know if you’ve… What kind of experiences you’ve had with your clients in relationship to health professionals, but if you do I’d like to hear some of that.


01:53 Simon Shawcross:By and large I’ve had really positive experiences. One of the challenges as a personal trainer is sometimes the way in broader society how a personal trainer can be perceived, unfortunately, sometimes is as a little bit dumb, or not necessarily somebody who understands health concerns and issues. Now, I think, for a start, that’s quite an unfair perspective in general. There are great fantastic trainers who really know their stuff, even into the health realm of the spectrum, but people who I would say could probably rehabilitate an injury or musculotendonal issue as well as a physical therapist, or maybe even better in some circumstances. So it’s a little bit of an unfair label, but sometimes that’s a label you might have to deal with from a health professional. Their perception in their mind of what a personal trainer is might be something… A career or an individual that they would typically look down upon, which then puts you in a challenging position, because you’re looking to do good work with your client and to help them on their road to recovery.


03:07 Simon Shawcross:So one thing I found just super beneficial from the outset is to create an open and frank dialogue with that individual’s medical professional, and I would look to get the client on board with giving you their GP, or whatever the medical practitioner is, their specialist, giving you their contact details so you make first contact with the doctor, with the osteopath. One of the things when I first started out that I found pretty quickly is that doctors would… If a client mentioned their personal training to a doctor, almost the default position would be “Oh, that’s a bad thing, the trainer’s probably not gonna know what they’re doing and could make something worse for you.”


03:54 Simon Shawcross:And what I found was that’s sort of the health professional’s defensive position. You can blast that preconceived notion of who and what you are away by making the effort to make first contact. A lot of the times, the health practitioner is gonna just drop their preconceived notion of you the moment they realize they’re speaking to an intelligent individual. So if you make the effort… ‘Cause trainers who don’t really care about their clients are not gonna bother to make that effort. So if you’re the one who picks up the phone, fires off the first email, whatever it is, whichever mode of contact you’re gonna use, and gets in touch with that person to say, “Look, I really value your opinion. I’m working with Mrs. X, and I wanna make sure it’s the best possible journey towards health she can have. What advice do you have for me as a trainer? And this is what I intend to do with the client.”


04:49 Simon Shawcross:And then you’re creating this open, frank and honest dialog from the outset. And you might actually find you end up with a doctor or a health practitioner who completely ends up respecting you, and maybe even as your relationship grows, starts to forward clients to you down the road, and that’s happened to me in many circumstances with osteopaths and doctors. Once they’ve become comfortable and confident in who I am and what I do, and that Mrs. X is fine, she’s okay; in fact, she’s getting better coming to see me, and he’s seeing that during their appointments, then you can open up a great referral networking chain as well.


05:25 Eric:Yeah, that’s big, that’s really important. I think a lot of people don’t realize that that is an avenue, if you’re getting started in the fitness industry, to use doctors and people in the health profession or the medical profession as reliable sources, because that only creates a better system for you, and you become more respected and you’re looked at as not just like a… Not just like someone who, like we talked about right before we pressed record, just runs somebody through a workout willy-nilly, who cares. You’re in, you’re out, go do your PT on your own. So I like what you said about if you make first contact, you reach the person and let them know that you’re on board with what their outcomes should be, I think that’s really important what you said about, obviously creating the dialogue, make the first contact and ask them what advice do they have for you, instead of saying, “Hey doc, here’s my plan. How do you fit into it?”


06:31 Simon Shawcross:A doctor is rarely gonna be liked to be talked down to like that.


06:34 Eric:Right. [chuckle]


06:34 Simon Shawcross:They’re gonna be used to be in the position of power and talking down to the patient. And in your situation as a personal trainer, it’s wise to listen to what they have to say first. And look, doctors usually are not great at exercise prescription. They don’t know this stuff like a great personal trainer does. So ultimately you are the expert in this position, but you need to get them on board with you, and to get their professional medical opinion on the situation that that particular client is currently facing.


07:12 Eric:Right. Do you have a… What’s your most recent story of somebody going into… Maybe a coming out of the doctor’s office, or maybe post-surgery that you’ve had to deal with that you… Anything pop into your head right away?


07:27 Simon Shawcross:One of the super beneficial ones which tracks the whole sort of process was somebody who’s having cruciate ligament surgery. And before the surgery, they knew… It was something that happened from a tennis injury during their youth as a tennis player, and they knew that they were gonna need this operation, or decided that they wanted to for the upshot or the upside, potential upside of the surgery. And so I was in a really lucky position to be told that this surgery was coming. So let’s take 12 weeks to make this joint as strong and resilient as possible. You’re gonna have a period of time post-operation and post-op where training is not gonna be recommended. And then you’re gonna have post-rehabilitation. So really, that chain followed that whole gamut of from rehabilitation to a couple of weeks off to full rehabilitation. And I was using a really good device which has medical grade cams on it so that the knee extension and knee flexion exercises were possible and were safe to do.


08:53 Simon Shawcross:And we got that joint and the muscles and tendons and cartilage of that joint as strong as we possibly could during that 12 weeks pre the surgery. My client then went and had the surgery, and this was all with the agreement of the doctor. It’s like, “Yeah, you need to be doing this stuff.” We had the surgery. Within I think it was a week and a half of it, ten days after the surgery, he was back doing the exercises with me again. And for the sake of safety, I lopped off at probably about, I don’t know, 30% of the load first session back, but we were back up to full strength within three or four weeks post-surgery, and then began exceeding the levels of strength that had been pre-surgery within five, six weeks afterwards. And therefore, you have a situation there where what we did really supported the surgery and the physical issue that client was going through at that time. And the value that I was able to add as personal trainer meant that this guy was strong going into surgery, recovered quickly because he was metabolically was super active in those tissues, and then we could pick up almost where we left off and get him back up and back to full health and full strength really quickly. And that stuff is really practical and can be done if you’re prescribing exercise appropriately around surgery.


10:48 Eric:Yeah, and then…


10:49 Simon Shawcross:And then if we just… Sorry, yeah, go on.


10:51 Eric:I was just gonna say then you have data and feedback that you can send to the physician if they’re open to that kind of information, and that also creates that feedback loop.


11:04 Simon Shawcross:Yeah, yeah. And an absolute favorite of mine, just to touch on this while we are on the subject, was, and I may well have mentioned this before on the podcast, but I had a client that I worked with for about 10 years who had Parkinson’s disease. Year on year he had to go in every… He saw a specialist every couple of months, but then year on year he’d go in for a full medical testing of his strength and cardiovascular ability at a hospital. And when I worked with him for the first seven years of that, year on year we increased his strength in his… His quadricep strength, which was the main measure of strength that they took, and I emailed back and forth with his doctor during that process. And they were blown away by that progress over the first seven years. So it’s always worth having that open channel of communication. And what you’ll find is, if you’re doing a good job or a great job with the client, is the medical staff can be blown away by what is possible, because you need to remember that most of their clients do not take this proactive stance on their health to that degree. They don’t necessarily hire a personal trainer. They may consider, “I go for a walk around the block every day for half an hour, and so therefore, I’m looking after my health.”


12:31 Eric:Good point.


12:31 Simon Shawcross:But far fewer people really look to strengthen their muscle tissue and keep themselves strong during that kind of disease process. So you can seriously impress medical professionals by the work you can do with clients across a whole range of conditions.


12:49 Eric:And that kind of brings me to my next concern about this whole situation, is that I think being a personal trainer is not the same as being like a physical therapist, or someone with that skill set. Is it hard for a PT to learn physical therapy, or maybe some prehab moves for people? No, absolutely not. I don’t think that should be a strict standard. I think that’s why we have people that we can refer out to. We build our network and if somebody does need physical therapy, then we can have people we trust to send people to, and I…


13:27 Simon Shawcross:Yeah, a physical therapist plays a really important role, yeah.


13:31 Eric:A huge, huge role. Good physical therapist, just like a good trainer, ’cause there’s different levels in the whole spectrum of the profession. But what I was gonna… What I was trying to get to is that I have been looked at by clients as a physical therapist. They come off of a surgery, and they’ll say, “Well, I don’t need to go to physical therapy ’cause I work with a trainer.” And I have to sit, seriously, sit down with them and have a conversation and say, “You do need to go to physical therapy because this is not in my wheelhouse, and here’s why, X, Y and Z.” A lot of trainers out there might completely disagree with that. I don’t. I think it’s very wise to stay in your lane. So if I’m a strength training specialist, I’m going to stick in that lane. I’m not gonna veer out and claim to know how to appropriately rehab someone, at the same time try to strength train them also. I think there’s a fine line that we have to walk, as…


14:36 Simon Shawcross:I think… Yeah.


14:37 Eric:As trainers.


14:38 Simon Shawcross:One of the first things I think you need to do when you’ve got anybody coming to you as a new… Let’s say, for example, as a new client, and they say, “I’ve got this issue, and I want you to help me work around it, or fix it, or help me with this issue that I have.” First thing that I think you need to consider is, is it within your capabilities to help that individual with that particular issue? Do you have the knowledge, do you have the skillset, and are you confident to do that? If you’re not, you have to back away. You have to recommend somebody else straight away. If you are capable, and it falls within your remit, and it falls within legally in your jurisdiction, what you’re capable of doing and are allowed to promote and sell and teach, and you feel completely confident at that, great. If not, always best to refer out. Refer them back even to their GP so they can get a referral onwards to a specialist, or to a physical therapist that you trust. Always better to do that than to plough on thinking, “Well, I kind of know how to work with this. I worked with Mrs. Jones two years ago and kind of resolved that for her.” It may not be the same scenario at all. And you’re far better, both from your own conscience perspective, [chuckle] and for helping the individual in front of you to make sure that they get treated appropriately. So, yeah, I thoroughly agree with what you were saying there.


16:11 Eric:And it’s tough on our part, at least I want to be that person that can be, I can be the accountability partner for my client, especially if they’re during PT, during that process, and set a reminder for me to remind that person, “Hey, make sure you do your PT today because X, Y, and Z. Not just because you’re being told to, but because it’s gonna help you.” And I’ve done PT on my own shoulder. I’ve gone to physical therapy for my shoulder, and then was able to maintain that. And I’ve worked with a physical therapist to rehab myself. I didn’t wanna do those exercises. It was hard enough for me, even having the knowledge, “Alright, I know why I need to do this, because six months from now, I don’t wanna have frozen shoulder, or my labrum to go even further into a tear.” But people get the little piece of paper with stick figures on it, and they look at this thing, they’re like, “Well, I’ll do this like once or twice a week and I should be fine.” But those things need to be done as prescribed, two to three times a day. And we, as trainers, if we want to maintain that client-trainer relationship, we need to make sure that they are doing everything outside of the gym, in that case, in that case.


17:35 Simon Shawcross:Yeah, yeah.


17:36 Eric:Everything outside of the gym that they need to be doing.


17:39 Simon Shawcross:And that’s the difference, because what they’re doing with the exercises that are prescribed by their PT, and that they’re required to be done multiple times a day, is they’re not specifically looking to build strength back up, per se. They’re looking to build mobility back up, and that has to precede the real strengthening process. So there is a path that it is beneficial to follow, but you’re absolutely spot-on. Most people get those sheets of paper with the stick man on and they might have a go day one, maybe day two, but then that’s pretty much it. And as you say, it is important to do, and it is an essential part of the recovery process. So if we can, as personal trainers, be there to support, encourage, and help foster that habit that the PT has prescribed, then we’re really, really assisting that client.


18:34 Eric:Yeah, I think you’re ahead of the game. So how do you go about finding the person that you’re going to refer to or to make the connection to? Have you ever shadowed physical therapists in your area? Or maybe spent some time with physicians and really tried to sit down with them and describe what you do? Or is this like on a case-by-case as it comes to you scenario?


19:01 Simon Shawcross:The way I did it as a personal trainer when I started out was pretty much on a case-by-case basis. I suppose when I first started I had… And this may be something common that happens with trainers who are new, when people know that you’ve only been doing this for a year or two, they tend to be more insecure about your ability to work with them around those type of issues. So what I noticed at the start of my career, I would have far more people saying, “Oh, my doctor says I shouldn’t do X or I shouldn’t do Y,” or, “My osteopath says I need you to get in touch with them.” So then for me what happened was there is this very organic process of what I found was I wanted to do the best for these people, they’re telling me this information, the best way for me to move forward is, like I said at the start of this, is to get in touch with that health professional directly, so I can start a conversation, start a two-way dialogue with that health professional, and then organically that just grew a network.


20:03 Eric:Yeah.


20:04 Simon Shawcross:And then by the end, I was getting so many referrals from health professional… People who weren’t personal trainers, so other health professionals, sending me clients, that I couldn’t take on all the clients that I was being sent by health professionals, because they knew that they were sending their client to a safe pair of hands. And that’s really valuable as a personal trainer, to have that as health professionals’ perspective of you. If you can become a relied on, trusted individual to help people, then you’re gonna find you’re gonna have no shortage of clients. Now, whether you wanna work with people who have higher levels of dysfunction is another question.


20:46 Eric:Sure, yeah.


20:46 Simon Shawcross:Maybe you wanna train studs and that’s what you wanna do.




20:50 Simon Shawcross:But what I’ve found is there’s a lot more people who need a lot more specialist help out there, and it can be very rewarding indeed to work with those types of clients.


21:01 Eric:Yeah, absolutely. I’ve gone into places where I know that some of my clients maybe have been to physical therapists specifically, and asked if I could just shadow for a day.


21:15 Simon Shawcross:Yeah.


21:15 Eric:I actually haven’t done that in quite some time. And now that we’re talking about it it might be a good idea to do that.


21:20 Simon Shawcross:Was the response you got good in general? Were they happy for that to happen?


21:24 Eric:They were extremely surprised, and I think if you get a hold of… If you just talk to… And I don’t know all the terms, I know they have interns and things like that. Obviously, you’re gonna bypass that person, but if you’re talking to someone at the front desk, like the manager of the facility, they might not be as adept to say, “Yeah, come on in, let’s do this.” But if you can get them to really talk to the head therapist, the leading person in charge, that person is usually very open to having someone come in. I’m not sure it happens very often, so it brings a level of excitement as well, but also shows respect. And again, to your point, you’re building that network, that relationship. And I know I said I’m all about staying in my lane, but there’s nothing wrong with learning how to do different things for external and internal rotation and shoulder mobility and things like that because they do those things so often, which I think in turn can benefit your clients moving forward.


22:37 Simon Shawcross:And there’s gonna come a point during the rehabilitation where there is this handing off, where they’re ending their physical therapy and going to be with you from now on. So using some of that stuff through the transitional period and to keep them strong in, for example, the rotator cuffs, is pretty valuable.


23:00 Eric:Yeah, very much. But for the most part, yeah, I’ve gotten some very good feedback from it. As long as you talk to the right person, don’t give up. If you leave a message for somebody and you don’t hear back in a week, then you need to call again because you will get lost. If you’re not bringing in income for them, you will get lost in the shuffle, because it’s such a high demanding… They’re dealing with insurance and everything else, which is thankfully something that we don’t have to do, at least in the States, but that’s a whole other topic we could get into. I’ve had people ask me, “Well, how come trainers don’t deal with them?” Well, there’s a lot of different reasons. And maybe we’ll just leave that in the pocket for now.


23:41 Eric:But yeah, Simon, I think this is very valuable conversation, and especially if you are a trainer that is in a position where you’re not really sure how to handle somebody either coming to you as a first-time client, or if you’re getting ready to deal with somebody who might be having surgery, then it’s very valuable to, like you said, make the first contact, create the dialogue right away, take notes, and give feedback. I think that’s all very very important.


24:14 Simon Shawcross:And what was interesting was that was both of our experiences. We’ve both been proactive in that stepping out to meet the health professionals and being the ones who’ve made the initial step in that direction. And I think that speaks as to how valuable that process can be for a trainer who really wants to forward their career and excel with working with a wide variety of clients.


24:43 Eric:Agreed, absolutely. And this benefits you as a professional, and it solidifies you as a professional in the industry, where right now we are in dire need of more professionalism, and this is definitely one way, by working with other high-level professionals.


24:57 Simon Shawcross:Yeah.


25:00 Eric:Simon, I gotta jump off here, sir, but let everybody know where they can find you and what you have going on right now.


25:07 Simon Shawcross:So they can come and find about certification programs at The other thing is we just released a… I just wanted to say this one thing, we’ve just released this fantastic blog post on, which is written by a really well respected business writer, and it’s got their 25 top resources they recommend for a fitness professional to become an entrepreneur and forward their business. And it’s just a very exciting blog post that I just wanna just put out for people to go and take a look at it, because if you’re serious about your career, this has got some great free tools in there for you to start moving forward.


25:46 Eric:Cool, yeah. I’ll grab that and link it to the show notes for sure.


25:49 Simon Shawcross:Fantastic.


25:52 Eric:Well. As always, this has been great, and we’ll talk to you very soon.


25:56 Simon Shawcross:Fantastic, Eric. Bye for now.