When I had developed the initial version of my run clinic, I wanted to test it with a few willing volunteers from the triathlon club. The club's board of directors (BoD) put up a brick wall because I had no certifications of any kind.
I initially thought this was some form of elitism, since my research revealed NO other run coaching or training programs that would help convert ex-runners and uncomfortable runners to comfortable endurance runners. There was no certified program that taught anything close to my clinic! Why did the board want me to have some alphabet soup after my name?
After looking into the matter, I found it's not about a piece of paper: It's about professionalism, which really means its about liability. Every professional practitioner of any kind, from MD to chiropractor to massage therapist, is certified by a recognized and accepted authority, is a member of a professional organization, and has liability insurance to ensure any harm they may inadvertently cause will be remedied.
The status of being a professional means you can't hide behind a liability waiver. The waiver only protects you against things the client does against your instructions (such as "Stop if you feel any pain!"). If the client is harmed while acting according to your instructions, you may be liable.
A run clinic for "broken" runners is certainly not a minimal-risk environment! The club BoD was absolutely right: It would be very wrong for the club to permit me to offer a clinic to its members without professional certification and liability insurance.
So I looked at all the professional certifications I could realistically pursue, including Physical Therapist, USAT Level 1 Triathlon Coach, Certified Personal Trainer (CPT), and a few others. The one most relevant to my run clinic is CPT, though the USAT Level 1 Coaching cert may be more useful in the long run.
The USAT Level 1 coaching certification is relatively simple to acquire: It takes only money to travel to and attend a certification clinic. Total cost, about $1000. Unfortunately, the next clinic I could reasonably attend isn't until September. Plus, the cost is an obstacle right now, though it may not be in September.
For the near term, becoming a CPT seems to be the way to go. A quick online search reveals literally a dozen or more different Personal Trainer certification programs out there, several of which have national-level recognition and acceptance. Most of them are either online programs, or DVD-based, or both. Only a very few are in-class hands-on programs.
I've been working with a personal trainer 2-3 times a week for a decade. Over those years I've often "traded up", and I now believe I'm working with one of the very best personal trainers in all of San Diego. I think I'm getting as good or better "hands-on" training than any classroom course could provide.
So I decided to restrict my search to the DVD and online certification programs. Several of these also had good national acceptance. Unfortunately, the total certification costs of those programs tend to start at $1000 and go up from there. And each program has different recertification costs and insurance rates.
I decided to restrict my focus to the cost of insurance, which is where the rubber hits the road: If I want at least $2 million in coverage, which program gets me certified with the lowest total cost when insurance is included?
The result surprised me. No, it shocked me! The ACT Certification program has a FREE certification available, though it has an annual insurance cost that happens to be $5 HIGHER than the paid program + the discounted insurance. The total cost for a 2 year ACT certification + 2 years of insurance? The annual costs are the $65 program fee + the $105 insurance premium, or $170/year. Which, for two years is $340. That's less than what some programs charge just to take their exam!
While ACT has not yet been accredited by a national agency, they are absolutely committed to obtaining NCCA approval, and it looks like they will acquire it before the end of this summer.
What amazes me is that their insurance company sells insurance to ACT-certified personal trainers at such a reasonable rate. Someone has done the risk assessment, and has found the ACT approach worthy. I wonder why other certification programs have much higher insurance rates? Perhaps they are padding the total to obtain maximum profit. If that's the case, then ACT has gained even more of my respect.
ACT claims one of their goals is to turn the economics of the fitness certification industry on its head. Their low program costs and low insurance rates seem to back this ideology to the hilt.
After all, I am the one doing all the work to get certified! What does the certification program itself do? Once the course is designed, implemented and approved, everything else is either stamping out copies or computer-based. Basically, minimal per-student costs, even allowing for ongoing program development and improvement. You can get a high-volume web server from GoDaddy that can support millions of users for a total cost of under $10/month: The recurring costs to present an existing online program truly are minimal, even trivial.
I can't judge the quality of the ACT content. But then, I don't feel I need to: Their insurance provider has done their own due diligence. Then again, I haven't read the insurance policy itself yet, so I don't really know what it does and does not cover.
I do get it all for only $14.66/month: Training, certification, CEU (Continuing Education Unit) classes, recertification, and insurance.
At this price, it seems silly to pay more now, since I'm planning to get the USAT cert eventually. At the very least, the ACT program is a minimal investment that is worth trying, just for the hell of it.
ACT, here I come!
Tuesday, June 28, 2011
Friday, June 17, 2011
Interviewing and Assessing
Sorry for going so long without a post!
I've been spending the past several weeks talking to folks who are ex-runners or have problems running, and trying to form accurate assessments of their current condition and the likelihood I'll be able to help them.
It seems everyone has their own personal horror stories related to running. When the stories are told in the present tense, I want to understand if the problem is transient or continual, and if it is due to poor running form, inadequate strength, or a deeper medical issue.
Turning stories into assessments is tough! After the story, I ask questions to learn more, generally to separate emotional pain and frustration from physical pain, and to separate physical causes from physical effects.
An example: I had one friend going on about minor annoying knee pain that became agony when running. I asked about his warmups, asked if he had changed anything (such as shoes, route, or duration), and asked if anything else aggravated his knee. It wasn't until well into our discussion I asked "When did you knee start to hurt?" His answer was informative: "Right after I slipped and fell in my kitchen."
The problem had nothing to do with running, and everything to do with letting a damaged knee heel. He didn't need any developmental running help from me: I told him to go to his doctor to ensure no soft tissue was damaged and no bones where chipped or cracked.
Doing a good interview isn't trivial. I've seen many folks (help desks, doctors, physical therapists, car mechanics, etc.) ask questions until they find something "interesting", then take off on a tangent instead of completing the interview process.
To ensure I stay on track until the interview process is completed, I'm building a list of things I want to know about a problem runner, and good questions to ask to get than information.
Even with the best interview in the world, I'm still only getting the person's subjective observations. Objective information is critical not only to establish facts independently of the person's story, but also to learn what is subjectively most important to that person, and as a chance to identify missed items for additional discussion.
So along with each subjective story, I must also ask the person to perform objective tests. It is important these tests don't aggravate any condition: The fundamental premise in providing any kind of training or care must be: "First, Do No Harm."
If the person can't walk without difficulty, then clearly there's nothing I can do for them related to running. If they can walk comfortably, then a wide range of tests are possible. Going from simplest to most difficult, the list includes:
The list goes on. The key thing is to sequence the tests in order of increasing difficulty, to learn as much as possible from each test, and then to stop when things become too difficult.
But the list of tests should not grow without end: It is important for me to employ only those tests that provide information I can do something with, and avoid tests that may reveal limitations that have nothing to do with running. Not only do I want to avoid wasting time and effort, but I also don't want to go into information overload!
The assessment process doesn't end after the initial interview: When run training starts, it is important to continue to perform assessments with each new exercise and drill. With repetition, the exercises and drills will stop providing new information concerning symptoms, and will start indicating progress toward the goal of creating a comfortable runner.
I've done many online searches looking for good interview and assessment guidelines and techniques, and there are surprisingly few that not only describe what an interview and assessment should achieve, but also provide meaningful guidance toward developing interview and assessment procedures, and designing the individual steps required.
The best I've found come from the medicine and psychology fields, but they are way too technical and academic for me to gain knowledge I can apply to my own run clinic. Training and coaching guides provide lots of examples, but little pedagogy. Or perhaps what I was searching for is just "common knowledge" in those in various fields, and not needing much in the way of discussion.
The one thing that has helped me most in developing my interview and assessment has been my experience with interviewing potential new hires, and also with being interviewed for new positions. It is vital to get the greatest amount of relevant information in the limited time available, and to use that information to make the best decision possible.
In this case, I'm interviewing potential members of my run clinic, and hopefully they are simultaneously interviewing me as well. I need to get the information I need to determine if they should seek medical advice instead of joining my clinic. If I think I can help, I need to communicate that in a manner that will gain agreement and commitment from the person: I have no reason work with an unwilling or unhopeful client!
I initially thought the target and method of my clinic was what made it unique and worthy. I'm now beginning to suspect that the interview and assessment process will be at least as important in determining successful outcomes as the clinic itself.
I've been spending the past several weeks talking to folks who are ex-runners or have problems running, and trying to form accurate assessments of their current condition and the likelihood I'll be able to help them.
It seems everyone has their own personal horror stories related to running. When the stories are told in the present tense, I want to understand if the problem is transient or continual, and if it is due to poor running form, inadequate strength, or a deeper medical issue.
Turning stories into assessments is tough! After the story, I ask questions to learn more, generally to separate emotional pain and frustration from physical pain, and to separate physical causes from physical effects.
An example: I had one friend going on about minor annoying knee pain that became agony when running. I asked about his warmups, asked if he had changed anything (such as shoes, route, or duration), and asked if anything else aggravated his knee. It wasn't until well into our discussion I asked "When did you knee start to hurt?" His answer was informative: "Right after I slipped and fell in my kitchen."
The problem had nothing to do with running, and everything to do with letting a damaged knee heel. He didn't need any developmental running help from me: I told him to go to his doctor to ensure no soft tissue was damaged and no bones where chipped or cracked.
Doing a good interview isn't trivial. I've seen many folks (help desks, doctors, physical therapists, car mechanics, etc.) ask questions until they find something "interesting", then take off on a tangent instead of completing the interview process.
To ensure I stay on track until the interview process is completed, I'm building a list of things I want to know about a problem runner, and good questions to ask to get than information.
Even with the best interview in the world, I'm still only getting the person's subjective observations. Objective information is critical not only to establish facts independently of the person's story, but also to learn what is subjectively most important to that person, and as a chance to identify missed items for additional discussion.
So along with each subjective story, I must also ask the person to perform objective tests. It is important these tests don't aggravate any condition: The fundamental premise in providing any kind of training or care must be: "First, Do No Harm."
If the person can't walk without difficulty, then clearly there's nothing I can do for them related to running. If they can walk comfortably, then a wide range of tests are possible. Going from simplest to most difficult, the list includes:
- Monitor the walking gait. Is it smooth and symmetric?
- Watch how the person gets out of a chair. Can they stand up directly, or do they need to push themselves up?
- Can the person balance on one foot? With eyes closed?
- How difficult is it to do squats? Squat-and-hold? How many are possible? Is one leg favored over the other?
- ...
The list goes on. The key thing is to sequence the tests in order of increasing difficulty, to learn as much as possible from each test, and then to stop when things become too difficult.
But the list of tests should not grow without end: It is important for me to employ only those tests that provide information I can do something with, and avoid tests that may reveal limitations that have nothing to do with running. Not only do I want to avoid wasting time and effort, but I also don't want to go into information overload!
The assessment process doesn't end after the initial interview: When run training starts, it is important to continue to perform assessments with each new exercise and drill. With repetition, the exercises and drills will stop providing new information concerning symptoms, and will start indicating progress toward the goal of creating a comfortable runner.
I've done many online searches looking for good interview and assessment guidelines and techniques, and there are surprisingly few that not only describe what an interview and assessment should achieve, but also provide meaningful guidance toward developing interview and assessment procedures, and designing the individual steps required.
The best I've found come from the medicine and psychology fields, but they are way too technical and academic for me to gain knowledge I can apply to my own run clinic. Training and coaching guides provide lots of examples, but little pedagogy. Or perhaps what I was searching for is just "common knowledge" in those in various fields, and not needing much in the way of discussion.
The one thing that has helped me most in developing my interview and assessment has been my experience with interviewing potential new hires, and also with being interviewed for new positions. It is vital to get the greatest amount of relevant information in the limited time available, and to use that information to make the best decision possible.
In this case, I'm interviewing potential members of my run clinic, and hopefully they are simultaneously interviewing me as well. I need to get the information I need to determine if they should seek medical advice instead of joining my clinic. If I think I can help, I need to communicate that in a manner that will gain agreement and commitment from the person: I have no reason work with an unwilling or unhopeful client!
I initially thought the target and method of my clinic was what made it unique and worthy. I'm now beginning to suspect that the interview and assessment process will be at least as important in determining successful outcomes as the clinic itself.
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