Forum / Let's Discuss! / Advice%20needed:%20Shoulder%20injury

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On: July 07, 2015 21:38 PM
Greetings! I have a relatively new client, only worked with her 4 times. She is mid-50's, over-weight, with an pretty major shoulder injury that was recently discovered in an MRI. Her results are: "Supraspinatus tendon- full thickness tear of the anterior supra spinets measuring 8mm in anteroposterior dimension propagating posteriorly undersurface partial tear of the mid and posterior fibers of auroras piñata 8mm tenuous retraction but no muscle atrophy. " This is what she texted me after leaning her doctors office. I called her and explained that this was beyond my scope of knowledge and that I wasn't really sure how to proceed. She responded that she has been really impressed with what I have done so far and that I have already made a difference in how she is feeling and would like to continue working with me. Shoe that is really nice, I want to make use I keep this woman safe and I'm not completely sure I fully understand the extent of her injury. Can you help me with this and perhaps provide some suggestions on how to proceed?? Thank you, Claire
Casey H
On: July 09, 2015 17:41 PM
Hi Claire, Great to hear from you. Because this has just been diagnosed and it is an acute injury I would consult with her doctor before trying to teach her. I am assuming her doctor has given her the option of physical therapy and/or surgery and then physical therapy? It is a very individual decision on what people choose for repairing the rotator cuffs. I have known many people repair injuries similar to what your client has with really good physical therapy and then really good Pilates ( And the PT and Pilates instructor communicated a lot) But I have also had clients with this situation that went right for the surgery. The surgery is rough and a lot of people end up with the same or more problems a few years after the surgery. However, they are making great strides in orthopedic surgery and new techniques are used every day with great success for some. Either way ( the PT/Pilates or the Surgery) will be long with lots of ups , downs and soul searching for your client. Bottom line....You should not work with this client until you get the ok from the doctor and/or PT. It will cover you and you will have more information and guidance on exactly what to do instead of just guessing. Let us know how it progresses. Love, Jen

On: July 15, 2015 10:03 AM
Jen, thank you so much! My client's doctor has recommended surgery, not even mentioned PT. She is against surgery because she has had a bad experience. I told her that it is out of my scope of practice to diagnose or treat any type od injury, however it would seem natural to seek a second opinion if she felt uncomfortable with his recommendations. We have taken our work VERY SLOWLY, lots of pre-pilates work. We meet again later this afternoon. I will let you know how this progresses. I have been laying the ground work to release she as a client unless she commits to meeting regularly with a PT. She seems to think I can do the same as a PT for her, but I am very clear with her that is not my role and while I am happy to work with her PT, I am NOT a PT.
Casey H
On: July 16, 2015 07:59 AM
Hi Claire, This sounds really good. She obviously trusts only you and is relying on you a great deal. You will know if and when you hit a wall with her and may have to refer her out. Right now all sounds well. And I love you are already laying the ground work to have her see a PT. That is probably the best idea. Please keep us up to date on how it goes. This will be very interesting to follow. Love and miss you Jen

On: July 23, 2015 07:41 AM
Thanks Jen! After talking with a few local sources, I have found a highly recommended PT that I have referred my client too. I was very honest with her that I would love to continue to work with her, but only after she had received medical attention for her shoulder, and that if she was adamant in refusing surgery that needed meet with a PT before our work could continue. She truly appreciated my honesty and my referral to a local PT. I told her I would be happy to work with her PT but that I was not a doctor and that she needed a medical professional before continuing with any type of fitness/health routine could continue. Thanks for your guidance, Jen. XOXO, Claire
Casey H
On: August 24, 2015 08:48 AM
Hi Claire, This is the best way to go. Ultimately she will get the care she needs and you will keep a loyal client. You are doing great work. Love Jen
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