In May, I became a certified personal trainer. I did this mainly to add value to my teaching and the SMRT video streaming service. I also did this because several states have prohibited bodyworkers from giving clients stretches or exercises and I think more will follow suit. I feel like the exercise piece is the complement to the bodywork piece and I did not want to stop talking to clients about it.
I also believe SMRT training provides benefit to personal trainers and adds another skill they can use with clients. While SMRT classes are usually taken by massage therapists and other bodyworkers, the classes work well as continuing education for personal trainers.
I just worked on a client who I have not seen in awhile. His left knee was swollen and he limped into my home office. I used SMRT, which allows for quick release of tissues. His semitendinosus tendon was solidly adhered to his medial gastroc head. Neither moved and the area was wildly painful. I started there, worked that out, then got rid of congestion along the calcaneal tendon so that it moved freely, worked the hamstrings and into the glutes.
When I had him flip over, his left knee had a fair amount of inflammation. I was working on the inflammation (which was dissipating nicely) when I began looking at his feet. I noticed that his left foot was pulled toward dorsiflexion while his right foot was in more than its share of plantar flexion. I knew then what the issue was.
I explained to him that I believed that the dorsiflexion/plantar flexion imbalance in his ankles was causing him to have dormant butt syndrome on the left. So, his left glute max muscle had turned off. I believed that this was causing two issues that were in conflict with each other and the conflict was causing the knee pain and inflammation.
The glute max not operating optimally will cause hamstring dominance. This can make the hamstrings at the posterior knee overly tight and cause cramping in that area when the knee moves into flexion (which happened even when I passively flexed his knee). This weakens the distal end of the quads. But, because the glute max is weakened, the corresponding (in this case, left) hip flexors become overly tight.
This pattern alone can cause irritation, but rarely this degree of pain and inflammation. But couple this pattern with the dorsiflexion/plantar flexion pattern and the distal quads did not know what to do. Should they be weak because of the tension in the distal hamstrings? Should they be tight because of the tension along the anterior line of the leg and thigh? What to do, what to do? Then something happens and they just freeze up and no longer let you move.
I told him that, while the session was necessary and he would likely need a few more, I did not think the treatment had any chance of holding if we did not fix the muscle imbalance. Then I coached him in how to do a straight leg wall stretch for the hip flexors (because a flexed knee hip flexor stretch would cause cramping at the posterior knee).
He did it before he left the room and said it was incredible and had really stabilized everything we did with the bodywork. It is thrilling when it all comes together perfectly!!!
There are numerous courses for continuing education for personal trainers available, but SMRT familiarizes them with the body’s anatomy and gives them tools that can be combined with stretches and workout programs to optimize performance and minimize injury and dysfunction.