Podcast: Episode 33: Home Exercise Programs

I get asked a lot by health professionals and yoga teachers how I get my clients to do their homework or the exercises I give them to help them get better. They struggle to get their clients to do their part – so why do people not do things that they know will benefit them?

The truth is, this has never been a problem I’ve had to solve. I have no agenda with my clients regarding whether they do their home program or not, and there are three reasons why my approach to this is successful.

Join me this week as I show you how to cultivate a trusting relationship with your client and how you can work together to get the best results for them. Discover why it’s important for the client to understand their own purpose and how you can weave this into your teaching practice.

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What You'll Learn from this Episode:

  • How physicians can cultivate better relationships with their clients.
  • What I think about when creating a program.
  • How I use my skills and experience to help clients.
  • Some tips for creating a mutually beneficial relationship with your client.
  • Why I don’t have a set process to help my clients recover.

Featured on the Show:

  • If you want to dig further into this, you’ll love the course coming up in March about how the art of yoga can make the science of medicine so much more effective. Click here for more details.

Full Episode Transcript:

Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.

Susi: Hello and welcome. Thank you for listening. With this episode I want to dig into home exercise programs. I get this question a lot from health professionals and yoga teachers. How do you get your clients to do their homework? How do you get them to do the exercises that are going to help them? Why aren’t people doing the thing that’s going to help them get better?

And what I can say from the start is that I have not had that problem throughout my entire career. That has not been a problem that I’ve had to solve. And there are three key, key reasons as to why I think that is. So, I’ll go through those key reasons on this particular episode. And I’ll also, along the way, give some bullet points of things that you can start to integrate and explore in your relationship with your clients.

And if you are a client, you’re not the health professional, it’s something for you consider in your own relationship with the person you might be seeing for care and for recovery purposes. So, the first one is something that I’ve referred to on previous episodes, which is a quotation or something I read in a journal article or something of that sort 10, 15, maybe even 20 years ago. I don’t remember when. But it still remains very, very clear in my brain.

And that is that the rate at which a patient takes their prescription medication is proportional to the level of trust they have in their physician. And I remember reading that and being gobsmacked that it had nothing to do with whether the medication was helpful for them so much, or the stats on it being beneficial. It had to with the relationship that they had with their physician.

And even though back then I was already in that way of thinking, that it really was about relationship, that sentence emboldened me, in a sense, to build that relationship skill even more. To build that state of trust and to have that relationship be one that really was one of caring. And dare I say, one of love. Because, in my books that’s really what the healing energy actually is.

And I remember learning, years after that, this idea of how relationship can be power with or power over. And very typically in most medical relationships the physician is an authority figure, and there tends to be a power over. Physician says do something; patient is expected to do it. And there tends to be this power over.

Whereas I’ve always seen it as power with. I’ve always seen that the client has something to bring into the relationship. They’re the ones who’ve lived with their body, they’re the ones who have experienced their sensations and symptoms. They’re the ones who have been interpreting or trying to interpret what they all are about. So there is a vast amount of knowledge.

And then, I have a ton of experience in anatomy, and physiology, and how to put programs together, and looking at movement, and the various layers of the koshas, and integrating yoga into all of this. So I can bring that into the mix. I’m a really good problem solver, so I can bring that in. Especially when someone’s got a lot of puzzle pieces, I can help them pin some of those pieces together and then recognize where some of the gaps are and then we can start to close the gaps together.

But what’s inherent there is that they are an equal player. And sometimes in my relationships with my clients, particularly when they’ve been used to having more authority power over relationships it can be a bit shocking for them. Because I’m asking of them to come forth with the information so that I can, the more information that I have from them, the better.

And so sometimes it takes a little bit of working with them to actually say to them, “This is information that I would like to have. This is going to help.” And then what builds is this really trusting relationship where I can be a trusted advisor in addition to a teacher, and they are bringing the pieces that they’re uncertain of and I can help bring clarity.

Where this really gained steam for me was when I went through a phase where a number of new clients were coming to me, it was between like 2009 and 2011. And they would say to me, “If you can’t help me nobody can. I’ve been to everybody.” And I knew some of those everybodies, and I knew that they were good. And so it struck me. I’m like, “Well, A, that’s an interesting choice of words, like, if you can’t help me nobody can and this is my last stop.” I’m like, “I’m not sure what’s going to happen next.”

And the other piece of it is I wonder what it was about those relationships where the information just didn’t land. Or wasn’t absorbed, or, I mean, who knows, I wasn’t in the room. But it got me very curious because, again, I knew that those professionals were good. So there was something up within that relationship.

And so at that point I decided it wasn’t about me giving advice, that I really wanted them to bring in their feel and experience. Which as I’ve mentioned was sometimes challenging for people because they were expecting to be told what to do. And I was drawing information out of them, teaching them how to trust their own self, right? Because my relationship, which is built on this idea of trust, I’m actually teaching them how to trust themselves. And so I’m almost modeling for them what it is that I’m wanting them to do with their own self. So I’m asking them to bring that information in.

Which then leads to the next piece, or the next big principle here, which is to understand what their compelling reason is. Like why are they even here? For what purpose? What is it that if they were able to resolve whatever it is they’re wanting to resolve, what could that do for them? And what will help keep them on path?

People can show up at our doorstep and say, “I want your help.” And they might be inspired by somebody else, or something that maybe was posted on social, or something on the website. And they might be inspired and be hopeful and then things will go along and there’s some work to be done in the process of recovery and then they might lose interest for whatever reason.

So, I really want to find what that compelling reason is. Like, there’s a spark that’s been lit, now what happens? Like, how can I help nurture that spark? So that’s part of my job I think, is part of that trusting relationship, is part of that nurturing of that spark so that they are learning, and growing, and being pulled back to their mat each time to continue to do their practice.

And so inside of that is also their purpose. Which, one might say the compelling reason and purpose is the same thing, which could be true. I find that there are bits of nuances of each, right? And it’s really like what is it that someone will gain?

And I often say to my trainees that if a client says to me, you know, “I want to be able to walk pain free.” And then I ask them, “Are you walking?” And if they say yes, then in my mind that’s not compelling enough. Because they are already walking so there’s not a compelling reason to keep with the program when things might be getting challenging.

And so I ask more questions. And if I don’t learn what that reason is, then as I get into the session with them I just pay close attention. I listen for it, and I just listen to what’s being said, I listen to what’s not being said. And then out of that I can piece together really what is driving them. Said another way, like what gets them up out of bed in the morning? What makes them tick? And as I start to understand what that is, then I can weave that into my teaching. I can weave that into my relationship with them. And then we start to see that spark really begin to arise, and then I can support them in that nurturing of it and then move them forward.

The third part that might seem unrelated, but I think is really, really, really important is that whether a client does their program or not is not my problem. It’s not a reflection on me. Now, I paused there on purpose because I want you to really sit with that, particularly if you are a client, for one, and you’re listening to this podcast wondering if you want to become a client. Or whether you are a professional sort of pondering this yourself.

It’s not on me whether the person does their program or not. My job is how I show up. My job is how I meet them. My job is how I teach them. But whether they do their program or not is not a reflection on me, nor is it my job. So I have no agenda for whether they do their program or not.

And let me tell you, when I really, really understood that, it freed me up hugely. And I was, granted, already gaining really good results in having people do their programs anyway, but this just up-leveled the trust because I had no agenda in the background. Like “Oh, how am I going to make this person do their program?”

There was just no agenda, so it was way more free. And we can feel that, right? We can feel that quality with another person. And when there’s an agenda or when you can kind of get that they’re concocting something and there’s something a bit mischievous about it. Or maybe mischievous is a polite word for saying it. But when there’s really no agenda there’s just the freedom to be.

And that’s when I find clients really step up on their own. Because they’re just being who they are. I get to help them be who they are. Right? Like that’s it, because that’s really what the recovery process is, is someone becoming a greater version of who they already are and injury is an opportunity for that. I don’t want to digress too far down, that’s for another podcast episode coming up. But the whole program piece is just a reflection of the bigger picture.

So, with that let me go through a few things that are generally on my list when I’m thinking about creating a program, other than these big rocks that I just mentioned.

The first one is when I write up a program, so if I do it on a piece of paper, so this was particularly before the pandemic. When I would see people live and in person and they would leave with a piece of paper. On the piece of paper I always write the purpose of the program. I used to, years ago, when I first started, I used to write what was wrong about them. Like what they came in with, the symptoms and the medical scenario, and all that stuff that we typically would call wrong.

Then one day I just had this wave of insight, like, “If I’m reading what’s wrong with me all the time, then that’s what I’m paying attention to.” And I knew that where my attention goes energy grows, and awareness grows too. So it’s like, “Oh, I’m going to stop doing that and I’m just going to simply put the purpose for this.” Which is typically this is what I want to get to.

And so then that’s what I wrote the purpose down as, is this program is to help you walk further. Or, here is to walking further. Or, we’re up-leveling your strength. Or, it is time to chill out. Or something like that, something that has the energy and the vibe of the client.

So, sometimes the purposes are cute. And sometimes the purposes are direct. And sometimes the purposes are like, I start it off with, “You are not going to like the purpose of this.” And we joke about it because they realize that yes, they need to slow down. They don’t really want to slow down but they know they need to slow down and okay, I’m going to slow down, right?

So sometimes there’s a little bit of a humor around it. But I write the purposes to what the actually outcome, desire is going to be, And so then every time they look at that piece of paper they see, this is what the outcome is. And it’s really fascinating when one reads the outcome, how much quicker that outcome actually comes, yeah?

The other is, is that I write out all the things that worked in the session. And I don’t include anything else that wasn’t in the session. So, if I am doing things with the person in the session and I have ideas of like, “Oh, this would have been really good to add.” Then I just make a note of that, that maybe I’ll do that the next time. I don’t add anything that I know they can’t already do.

And so I will not choose movements or other techniques that they had a lot of trouble with and they couldn’t really get their hands around, so to speak. I do that which they already have success with, or they might not have had 100% success but they know what they need to work on. So then that’s the other piece of it, is I make sure that it’s things that they can already do that they can just build upon when they’re at home.

I also want to make sure that what’s being chosen is meaningful. So, that blends into what I just mentioned about what I’m choosing. But also when I write it up, I sometimes leave blanks in each one. So maybe they’re in shavasana and I start writing down what their program is. And maybe there’s four or there’s six pointers that I want them to focus in on.

And I’ll put enough space between them on the page so that when they come and look at the program and we’re sitting there talking about it, I say, “okay, here’s what the program is.” And then I’ll say, “So, remember with this one it’s like this point, this point, this point. And this is the purpose of it. And this point, this point, remember this, remember that. Is there anything that I’m forgetting?” And I’ll ask them, “Is there anything I’m forgetting?” And they might say, “Well, remember when you said this, this, and this?”

And there are times with some people when I will deliberately leave space. And I might put a few bullet points down, but I’ll deliberately leave things out so that they can fill it in. And then they’re contributing to the creation of that program. So it’s not just me designing something to give to them, they are in it as well.

Which is one of the reasons that I’ll write it up and then we sit there before they go, and actually talk about it. And that they get what it’s all about and they get their own input into it. And they might even say, “Well, what about these other exercises that I’m doing?” And I’ll say, “If they’re working for you then integrate them.” So then we make that program really, really meaningful.

The other is, is when it’s a first-time client, I typically do not give them any more than four. And I had read something, after I was doing this for a period of time, I remember reading something or other that when you give five or more it almost becomes too impossible of a task. Which was very validating for what I was already doing. Four was just a really simple and easy number and would take about five or ten minutes to do.

Inside of that, typically I don’t write down how many repetitions I want someone to do it or how many times a day I want them to do it. And invariably people ask me, “Well, how many times should I do it a day and how many repetitions should I do?” And I’ll say to them this, “In terms of repetitions I want you to feel what you’re feeling, and to stop when that feeling begins to shift.” and so then we’ll describe what that feeling is because we would have talked about it in the session.

But this is very different than say, “I want you to do five sets of seven, or three sets of ten.” Because then what they’re focusing on is the number, they’re not focusing on the quality of the movement necessarily. And so if I can direct and be deliberate about where I’m wanting their attention to be then that’s what they typically will focus on.

So when they come back, they’ll actually tell me, “Well, this is the number I did, and this is how I felt when I was doing them.” And I’m like, “Great. Prefect. Okay. So, now we know what your baseline is from after this session. Or we now know where your baseline has come to, now let’s build from there.” When they come back, I will take that program and I’ll ask them, “How did it go? What worked and what didn’t?” And oftentimes the person will say, “Well, I totally understood this. This one didn’t really make sense. This one really helped my back. This one really was awful.” And I’ll say, “Okay, let’s go through the program.”

And I mention that here because I want the program to be a continuity feature. So that when they leave, they have their program, they come back, we review the program, and then we build upon it from there. And then I might keep things in the program for their next go around, or I might take things out, or I might add in. It really just depends on how it builds.

I don’t create the second or third or fourth program to make things interesting, to not have it be boring, not at all. It’s all directed to build their function and where they want to grow to. So I don’t have any problems with trying to make things interesting or making good choreography, or any of that. To me, this might sound horrible, but I just find that’s a bit superficial and it’s not actually addressing the problem that is.

To answer the question around how many days a week a person should practice, this is how I typically answer. And this is probably going to be a bit funny to hear. What I say is, “You know what? I optimize for great success.” So, I mean, you could try to do it seven days a week but if you miss tomorrow you’ve already failed. And so why start off on that foot?

So you could go for six days a week, which would be great. And then I’d say if you did five days a week it would be awesome. If you did it four days a week, that would be like knocking it out of the park. If you did three days a week, woo-hoo, you are killing it. Two days a week, you are going to get out of pain so fast.”

So you see what I’m doing here? What I’m doing is I’m keeping the bar really low and I’m wanting them to not do it for me, I’m wanting them to do it for themselves. So, when someone comes back and says, “I did the program three days a week.” Or, “I didn’t really do it that much, I only did it three days a week.” I’m like, “Perfect. Great. Let’s see where you’re at, let’s see how that three days a week worked for you and let’s build from there.”

And so that might then mean we build from there in terms of the duration of the program in those three days a week. Or maybe we add in so they do more days a week. But that’s up to them. And so what I’ve found is that so many people have different unique experiences around their lives, how they do their lives, that I just want them to do it. And so how they figure it out is perfect for them.

I remember talking to one health professional who said, “People have to do their programs before they go to bed because of the impact of their sleep.” And, I don’t know, there’s some people who are wrestling with their kids trying to get them to bed at night, and the last thing they want to do is do their yoga practice before bed. Whereas, waking up in the morning, absolutely. So, I don’t have a set process round that, I just want to support them in getting better. So whatever that means from the unique perspective for them, is what I then focus on.

If you have questions about this episode, I would love to hear them. You can send me an email to [email protected].

If you want to dig into this further you are going to love the course coming up this March, www.functionalsynergy.com/integratingyogaandmedicine2021. You will love it because we dig into these concepts of really supporting clientele in getting better and how can we do that? How can the art of yoga really make the science of medicine so much more effective? Looking forward to seeing you there.

If what you’re hearing on this episode is really resonating with you and you want to dig into this further, whether you are a student or you are a professional wanting to integrate more yoga, you will love the therapeutic intensive, and we’ve got two of them coming up this spring, in March and in April. The April one is specifically for health professionals. You can read more at therapeuticyogaintensive.com.

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