Personal Training Clients with Arthritis
We all know arthritis is a common musculoskeletal condition affecting the mobility and strength of the joints and is often experienced by the elderly. As fitness professionals, we’re taught to be aware of the physiological changes occurring with age and secondary conditions, such as arthritis, commonly associated with the aging process. This awareness allows us to adequately accommodate and appropriately supervise clients with these limitations.
Typically we would encourage an arthritic client to participate in low impact activities such as:
- Warm water exercise or swimming
- Chair based exercises
- Low impact resistance training
- Tai Chi
But what would you do if you came across a young client in their early 20’s, suffering from arthritis? How would you accommodate their physical limitations whilst still aiming to achieve their individual training goals, such as weight loss, hypertrophy or improved sport performance?
Unlike older adults, who are generally participating in physical activity for social reasons and to maintain a good quality of life, younger clients are more likely to have additional individual, performance related training goals. These goals can be difficult to achieve when the symptoms of arthritis are present. For example, how can you improve a basketballer’s jumping power with training methods like plyometrics if their arthritic knees are constantly painful, stiff, swollen or limited in range? This type of scenario is not something we would typically be prepared to encounter.
A report released in May 2014 by the Australian Institute of Health and Welfare (AIHW) indicated that as expected, the prevalence of arthritis increases steadily across the life stages (<1% in 0-15 year olds, 19% in 35-64 year olds and 51% in those aged over 80). However, this means there are still around 160,000 young Australian adults aged 16-34 years who suffer from various forms of arthritis. What if one of those 160,000 approached you to help alleviate their symptoms through regular physical activity, would you know how to accommodate them?
The physical limitation is not the only challenging factor to consider when working with young sufferers. Emotions experienced with a debilitating disease such as arthritis can have a strong psychological impact on a client’s mental state, motivation and self-esteem. Can you imagine how a 20-year old would feel among a grey army of participants in an aqua aerobics class? Or the frustration they must feel when they’re only able to perform body weight squats after having just spotted for a training partner on their 100kg lift?
A lot of planning needs to go into developing a foolproof program and providing a comfortable exercise environment to assist a young arthritic client to achieve their goals. Here are some helpful points to consider in your planning:
- Set small, realistic targets on each exercise: Psychologically this promotes a sense of achievement rather than the feeling of failure.
- Collaborate with a network of allied health professionals: Regularly liaise with your client’s specialist doctor and other health professionals such as physiotherapists, osteopaths, occupational therapists and myotherapists to form a holistic management plan.
- Exercise in an appropriate environment: Consider training clients in a group where everyone is encouraged to work at their own pace and ability, or in a private one on one session.
- Use a variety of techniques to promote mobility: Use dynamic pre-stretches or self myofacial release before engaging in each strength exercise to allow the joints to move through their full range of motion.
- Always have a variation or alternative exercise in mind: To enable physical activity to continue in the case of flare ups/bad days.
- Include an extended warm up: But not just the standard, boring 15-minutes on a stationary bike. Make it fun by including activities that use the whole body, like a game of one on one basketball etc.
- Develop your tool box: Non-traditional equipment such as the VIPR, strength bags, medicine balls, combat ropes, etc can add load, intensity and variation to your programming and provide some alternative grip solutions for upper extremity sufferers.
Research has found that regular physical exercise is one of the most effective treatments for managing arthritis, regardless of age. It can help to improve joint mobility and flexibility, muscle strength, posture and balance as well as decrease pain, fatigue, muscle tension and stress. For people suffering from arthritis, exercise can assist to lessen the impact of the condition and improve quality of life. Whilst working with arthritic clients brings inherent challenges for the fitness professional, we should see it as a fortunate opportunity to support these clients and assist them to reach their desired training goals, despite any limitations.
References: Arthritis and other musculoskeletal conditions across the life stage, Australian Institute of Health and Welfare, Released 16 May 2014, http://www.aihw.gov.au/publication-detail/?id=60129547059
New report shows kids and young people get arthritis too, Arthritis Australia Media release, 16 May 2014, http://www.arthritisaustralia.com.au/images/stories/documents/news/2014/140516_New_report_shows_kid_and_young_people_get_arthritis_too.pdf
Arthritis Information Sheet – Physical Activity, Arthritis Australia 2007 (Reviewed June 2014) http://www.arthritisaustralia.com.au/images/stories/documents/info_sheets/2014/General/Physicalactivity.pdf
Written by Lauren Coyle, AFA Education Manager
If you are looking for an activity program in a safe and social environment contact Life Fitness Academy who run programs in Caulfield, Victoria.