As Pilates teachers, we encounter clients with various injuries and conditions, and it’s important to be well-informed about how to manage these within the scope of our practice. One condition that may come up is an occult fracture -a type of fracture that is not immediately visible on standard X-rays. Understanding this condition is crucial, especially when a client informs you that they’ve been diagnosed with one.
What is an Occult Fracture?
An occult fracture is essentially a hidden fracture that doesn't show up on initial X-rays. This can make it challenging to diagnose, even though the fracture can cause significant pain, swelling, and tenderness. Occult fractures are most commonly found in areas like the scaphoid bone in the wrist, ribs, and the femoral neck in the hip. Due to their subtle nature, they often require advanced imaging techniques, such as MRI or CT scans, for accurate diagnosis.
When a Pilates Client Mentions an Occult Fracture
If a client tells you they have an occult fracture, it's important to recognise that this condition needs to be managed carefully, often in close collaboration with a medical professional. Here’s what you should consider:
Emphasise Medical Guidance: Ensure your client is working with a healthcare provider, such as a physiotherapist, osteopath, or doctor, who is managing their fracture. This is crucial, as occult fractures can worsen if not properly treated.
Understand the Treatment Process: Treatment for an occult fracture typically involves rest and immobilisation to allow the bone to heal. In some cases, surgery may be required. Your client should not be engaging in any Pilates activities until they have been cleared by their medical provider.
Modifications and Rest: If the client has been cleared to return to gentle exercise, focus on movements that do not put stress on the injured area. For example, if the occult fracture is in the wrist, avoid exercises that require weight-bearing through the hands.
Communication is Key: Regularly check in with your client about their symptoms. Encourage them to communicate openly with both you and their healthcare provider about any pain or discomfort they experience during or after sessions.
When to Expect Clients Back in the Pilates Studio
The timeline for a client’s return to Pilates will vary depending on the location and severity of the fracture, as well as how well it is healing. Here’s a general outline of what to expect:
Initial Healing Phase: During this phase, which may last several weeks, the client should be focused on rest and should avoid Pilates altogether. Encourage them to follow their medical professional’s advice and avoid pushing themselves too soon.
Reintroduction to Movement: Once a healthcare provider confirms that the fracture is healing well, clients may begin to reintroduce gentle, non-weight-bearing exercises. This might include breathing exercises, gentle core engagement, and other movements that do not involve the injured area.
Gradual Increase in Activity: As healing progresses, and with their healthcare provider’s approval, clients can gradually return to more of their regular Pilates routine. However, this should be done cautiously, with attention to any signs of discomfort or pain.
Full Return to Practice: Full participation in Pilates classes or sessions should only resume once the client’s healthcare provider has confirmed that the fracture has fully healed and the client is no longer at risk of re-injury.
Final Thoughts
As Pilates teachers, our role is to support our clients' health and well-being while respecting the boundaries of our expertise. When it comes to conditions like occult fractures, it’s vital to ensure that clients are working closely with a medical professional and that any exercise modifications are made with their safety in mind. By staying informed and maintaining open communication, you can help your clients navigate their recovery and safely return to their Pilates practice when the time is right.
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