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What to do When Your Client has a Pain Flare Up
Good coaches take responsibility almost to a fault. We feel like we should make every decision correctly, never cause a flare-up, never produce pain. And when a client does experience increased symptoms, it can shake our confidence hard — which then shakes theirs. In Episode 7, Dr. David Skolnik answers a question from Steph, a physical therapist and coach, on exactly this: what to do when a client flares up, so neither of you spirals.
Big THANK YOU to our sponsors:
- CoachRX - Hands down, the best platform for coaches. From building your intake & assessment processes to individual program design, invoicing and education, CoachRX has you covered. Get your first 30 days FREE - Try CoachRX
- Performance Supplements - go to www.performance-supp.com & use the code smarterstrength at checkout to save 15% on your entire order (I'm a big fan of their Krea-Grow - everything you need to support high quality training sessions!)
- AbMat - go to www.abmat.com & use the code drdavid at checkout to save 10% of your entire order (get a Zercher Pad - your elbows will thank you!)
BEFORE THE FLARE-UP: SET THE STAGE
Starting from day one of any coaching or rehab relationship where pain is part of the picture, normalize what's coming. Progress is not linear. Pain management is not linear. There is no straight line from "pain" to "no pain" — and if you frame the work that way, any deviation from that straight line becomes a crisis.
DURING THE FLARE-UP:
Credit to Dr. Katie Dobrowski, whose presentation at the Coach'em Up conference gave David this framework — which he's already used with multiple clients and shared with a coaching client who applied it with one of her own clients within 10 days.
When a flare-up happens: remove as much emotion as possible, and collect objective data. A training environment is uniquely controlled — load, range of motion, volume, intensity, duration. All of it is scripted. That means you have a rich data set to work with. What was different from last week? What was most novel? What did you expose this client to that their system hadn't seen before?
The goal: identify, as objectively as possible, what may have contributed to the likelihood of a flare-up — and share that process with your client so they can see that this isn't a mystery, and it isn't a catastrophe.
YOUR ACTION: REFRAME THE FLARE-UP AS A BENCHMARK
Here's what to say — to yourself first, then to your client: "We just found the current limit of your tolerance. And in a few weeks, we're going to replicate this exact session — same effort, same intensity, same duration — and it's not going to flare you up. That's a win we wouldn't have had if we hadn't found your limit today."
LEAVE A REVIEW
Thousands of listeners — and only a handful of five-star reviews on Spotify. If this show is helping you coach better, five stars takes 10 seconds and makes a real difference for discovery. Thank you.
NEXT WEEK — EPISODE 8
My client squats wrong. Should I fix it? Is it actually a problem? How do I know? And what do I do about it?
View all episodes
By David Skolnik
4.9
4949 ratings
Good coaches take responsibility almost to a fault. We feel like we should make every decision correctly, never cause a flare-up, never produce pain. And when a client does experience increased symptoms, it can shake our confidence hard — which then shakes theirs. In Episode 7, Dr. David Skolnik answers a question from Steph, a physical therapist and coach, on exactly this: what to do when a client flares up, so neither of you spirals.
Big THANK YOU to our sponsors:
- CoachRX - Hands down, the best platform for coaches. From building your intake & assessment processes to individual program design, invoicing and education, CoachRX has you covered. Get your first 30 days FREE - Try CoachRX
- Performance Supplements - go to www.performance-supp.com & use the code smarterstrength at checkout to save 15% on your entire order (I'm a big fan of their Krea-Grow - everything you need to support high quality training sessions!)
- AbMat - go to www.abmat.com & use the code drdavid at checkout to save 10% of your entire order (get a Zercher Pad - your elbows will thank you!)
BEFORE THE FLARE-UP: SET THE STAGE
Starting from day one of any coaching or rehab relationship where pain is part of the picture, normalize what's coming. Progress is not linear. Pain management is not linear. There is no straight line from "pain" to "no pain" — and if you frame the work that way, any deviation from that straight line becomes a crisis.
DURING THE FLARE-UP:
Credit to Dr. Katie Dobrowski, whose presentation at the Coach'em Up conference gave David this framework — which he's already used with multiple clients and shared with a coaching client who applied it with one of her own clients within 10 days.
When a flare-up happens: remove as much emotion as possible, and collect objective data. A training environment is uniquely controlled — load, range of motion, volume, intensity, duration. All of it is scripted. That means you have a rich data set to work with. What was different from last week? What was most novel? What did you expose this client to that their system hadn't seen before?
The goal: identify, as objectively as possible, what may have contributed to the likelihood of a flare-up — and share that process with your client so they can see that this isn't a mystery, and it isn't a catastrophe.
YOUR ACTION: REFRAME THE FLARE-UP AS A BENCHMARK
Here's what to say — to yourself first, then to your client: "We just found the current limit of your tolerance. And in a few weeks, we're going to replicate this exact session — same effort, same intensity, same duration — and it's not going to flare you up. That's a win we wouldn't have had if we hadn't found your limit today."
LEAVE A REVIEW
Thousands of listeners — and only a handful of five-star reviews on Spotify. If this show is helping you coach better, five stars takes 10 seconds and makes a real difference for discovery. Thank you.
NEXT WEEK — EPISODE 8
My client squats wrong. Should I fix it? Is it actually a problem? How do I know? And what do I do about it?