When Injury Walks In

Working with an injured client can be intimidating, especially as a new Pilates or yoga teacher. Suddenly, every exercise you know can feel like a question mark hanging above it. Can they perform this? Is this going to hurt them? Am I making this worse? My biggest advice is to stop thinking you need the answer right away. You do, however, need to pay attention, document what you learn, and come prepared.

Pre-Session Prep

If possible, start before the client ever walks through the door. A pre-screen can give you valuable information about previous or current injuries, surgeries, limitations, and areas of pain. Sometimes clients will reach out before their first session to explain what is going on, allowing you to research and prepare ahead of time.

Once you begin working together, start a client file. Take notes on the symptoms they report, what movements cause discomfort, what modifications help, and, over time, which exercises you have already given them. Over several sessions, these notes can begin to reveal patterns that give you something to return to when planning future sessions instead of starting from scratch each time.

Then, ask questions. Does it hurt when they reach forward and bend at the hips, but not when their spine is in extension? Does changing the rotation of their upper thigh change the sensation? What happens when you decrease the range of motion, remove resistance, or add support? Think almost like a movement experiment: if we change this, then what happens here? The classic x=y. You are not trying to diagnose their injury. You are gathering information about how this particular person responds to movement so you can make better decisions about what you ask them to do in the studio.

Remember, you are not their doctor or physical therapist. Knowing the boundaries of your expertise is part of being a responsible movement professional.

Build an Exercise Bank

One of the most valuable resources you can create as a new teacher is your own exercise bank. Rather than organizing it only by Pilates exercise, apparatus, or sequence, start categorizing movement by what it actually asks of the body.

For each exercise, ask yourself: What does this strengthen? What does it mobilize? Is it primarily a coordination, stability, or muscle-firing challenge? What movement pattern does it ask the client to perform? An exercise may belong to more than one category, and that is useful information too.

Then start adding variations. How could you make it smaller? More supported? Less loaded? Could you change the client's orientation? Remove one component? What other exercise could accomplish a similar goal without asking the client to enter the range or position that is currently bothering them?

This gives you options. If the exercise you originally planned is no longer appropriate, you do not have to abandon the purpose behind it. You can choose another route to have them perform that shape and movement.

I also like asking myself: What positions and movement strategies does this person's body constantly return to, and what movement options do they use less often? If someone spends a significant amount of time flexed, rotated, guarded, shifted to one side, or avoiding a particular position, what other movement options can you safely introduce? What could oppose, support, or provide another expression of that movement? The goal is not necessarily to “correct” the person or assume that their postural habits are directly causing their injury. It is to understand what movement options they already live with, and where you may be able to gradually find the balance.

Research What You Don't Know

Your yoga or Pilates certification is the beginning of your education, not the end of it. If a client tells you about an injury, surgery, or condition you do not understand, write it down and research it. Learn the relevant anatomy, understand what you can about the condition, and become familiar with any recommendations or restrictions the client has been given. If they are currently working with a physician, physical therapist, or other healthcare professional, encourage communication and work within those recommendations.

An important skill to develop is recognizing the difference between something you can modify and something you should refer out.

If a client has a known injury, has been cleared to exercise, and you can find movements that are comfortable and appropriate for them, modification may be enough. Change the range, resistance, position, support, or exercise entirely. You do not need to force your original plan to work.

Referral is different. If a client has new or unexplained pain, their symptoms are worsening, they have not been evaluated or cleared following a significant injury or surgery, or their symptoms make you question whether exercise is appropriate, that is no longer a problem you need to solve through creative modification. Pause the movement that concerns you and recommend that they seek guidance from an appropriate healthcare professional. Knowing when to refer is not a failure to teach; it is part of teaching responsibly.

And do not be afraid to not know something. Not knowing does not mean you have to guess, and it does not mean the entire session needs to stop.

You can tell your client: “Since there are still some question marks around this area or range of movement, I’m going to focus over here for now until we have more information. I want to make sure we are moving in a way that feels good for your body while still giving you a great workout.”

There is almost always somewhere else to go when continuing exercise is appropriate. Work on another area of the body. Train a movement pattern they tolerate well. Explore and deepen on a theme of breath, mobility, strength, stability, or coordination somewhere that both you and the client feel confident. Better yet, find a way to connect that work back to one of their personal goals.

Then go home, look up the parts of their story with a question mark, and come back to the next session prepared.

Working with injuries does not require you to become the client's diagnostician. It requires you to become a better observer, question-asker, researcher, and teacher. Modify when you have enough information to work safely within your scope, and refer when you need more information before you can confidently do so.

Your job is not to figure out what is wrong. Your job is to understand the information you have, recognize what you do not know, and make responsible movement choices within that boundary.