Gluteal Amnesia.
Compensation Patterns.
Dysfunctional Breathing.
These are three phrases I wish fitness and wellness professionals could banish. On their own, they’re just words, but my problem is that each of them frames the client as deficient. Sometimes deficiency is worth noting, but in a clinical or general fitness setting, each of these cases our clients “compensation” or “dysfunction” is done completely under the radar. What’s the point in telling someone they’re wrong about something they didn’t know they were even doing? What if, instead, we could take the stance that our clients are capable, that they have strengths, and that they have strategies to use those strengths? By simply shifting our framing, would our outcomes be different? My stance on this is a firm yes.
Today, I’m going to describe how our words choice can influence the outcomes we see, detail why deficit-based language flies in the face of good practice, and propose alternatives that get our point across without the same baggage.
If you’re a healthcare, fitness, or wellness professional, I hope you’ll come away considering your choice of language. If you’re a client, patient, or athlete, I hope you’ll come away from this with new words to apply to yourself and a new filter that you can apply to the words your coaches or practitioners use.
The Power Of Words
The words we choose as practitioners have immediate and direct impacts on our clients. You can see this for yourself with one of my favorite examples. I want you to find a partner and do a general nervous system response test. You’ll do the same test with three different scripts.
- The first one is just like in the video: “I’m going to press on 3-2-1-Go and I want you to hold here.”
- On the second one: “I’m going to press on 3-2-1-Go and I want you to resist me.”
- On the third one: “I’m going to press on 3-2-1-Go and I want you to try and resist me.”
“Do or do not, there is no try.” – Yoda
If you’ve had the same result I’ve had every time I did this, the first test was the strongest, the second test was worse, the third test was worse still. Pretty odd, considering that nothing else has changed. We’ve applied no interventions aside from the prompts, yet our outcomes are different.
So what’s happening here? Our word choice is subtlety influencing the outcome of the test. While “hold” is a pretty neutral word, “resist” and “try” both seed our client’s mind with the idea of failure.
When a couple words like this can make a difference, what can we expect when we tell someone they’ve got a compensation pattern in their hips? And more to the point, if we know that our words can have a negative impact on our client, why wouldn’t we choose words that could have a positive impact?
Bad Medicine
I agree that we need to use words to draw awareness to the things we want to change. I also know there is real empowerment that happens for folks who receive a diagnosis when they’re working through chronic conditions. Fitness professionals, and many healthcare and wellness professionals are not qualified to diagnose anything. We are qualified to identify, theorize, and create interventions. None of those require us to tell our client that something is wrong with them.
So if we don’t need to tell our client that something’s wrong with them, why do we choose to do so?
First, there’s an element of ignorance. If we don’t know the effect our words have on our clients, we can’t know to choose them wisely.
Second, there’s our point of focus. It is very easy for us to be focused on our method, rather than who we are applying our method to. This makes a lot of sense given our education model which is built around comparing someone to an ideal. If we are looking for 120* of range of motion in a test and we find 90* – we will (rightly) focus on the gap that we are looking to fill. Unfortunately, we may also project that gap onto the person. We do not see a person, we see a lack of range of motion.
Third, is the worst. It’s laziness. We can so easily reduce our client to a collection of symptoms and attributes. In a course I’m currently taking, we build a lot of our work out from the angle of someone’s ribs (a narrow or wide infra-sternal angle or ISA). When we review case studies, oftentimes other participants in the class will say that “My client is a narrow ISA.” Not true. That person is a fully-formed, functional, and independent human being who has a narrow ISA.
The Body Reading courses from Anatomy Trains do a great job of drilling this with participants. In each review, we start with a statement of strengths. Even something as simple as “your posture looks very confident.” Almost ten years after my first experience, that sticks so strongly in my mind. By leading with what’s right for the person, rather than what’s “wrong” we reinforce their humanity.
Strategy, Not Compensation
If we start by acknowledging that our clients are fully-formed, functional, and independent human beings whose agency in their lives brought them to our practice, how would we choose words differently?
This is where I think we have a lot of easy growth that’s possible and ready for us to take advantage of.
Here’s the way I phrase it with my clients: we do not have amnesia, compensation, or dysfunction. We have strategies. Here’s why I like that word so much more.
- It’s accurate. Words like “amnesia” and “not firing” are misnomers. If you don’t have a spinal cord injury, your glutes are there and they know how to fire. However, the strategy that your body has for the task of hip extension may not take full advantage of them. That’s cool, let’s see if we can give your body awareness of a different strategy!
- It’s neutral. Strategy does not have judgment built-in like compensation or dysfunction do. Calling someone’s breathing “dysfunctional” neglects the truth that this person in front of you is … well … breathing. The function of breathing is respiration and if they’re not on a ventilator, it’s functional. Could a new strategy for breathing be applied to help them find more efficiency?
- It’s not reductive. It acknowledges them as more than the problem they have. As far as I’m concerned, this is the most important part.
People come to us because some part of their life isn’t going the way they want it to. Maybe they’re dealing with stress, anxiety, or depression. Maybe they’re dealing with chronic pain. Maybe they’re trying to get an invite to the Olympic trials and they’re looking for a 1% improvement. While maintaining our scope of practice, it’s important to acknowledge that the person in front of us is so much more than the reason they came in.
I would love to hear from you. What words or phrases do you find helpful? What words do you want to never hear again?
