The Phobias of Training Older Adults

SCW FitnessSCW Blog

Upon entering the profession, most personal trainers have desires to work with highly competitive and aspiring athletes. They open their schedule and start taking on clients, however, most of their new clients tend to come from the demographic of general health and fitness-based populations (not competitive athletes). A large portion of the general health and fitness demographic is a special population called “older adults.”

The older adult (50-80 years of age) demographic is in desperate need of professional guidance and direction as they tend to suffer from physical limitations and pain management issues. As it is, most personal trainers do not pursue working with older adults for three reasons.

1. They Don’t Know How to Assess Their Movement
In an industry full of different assessment strategies, tools and protocols the uneducated and/or inexperienced personal trainer may not possess the skill set to safely assess the older adult. Typical assessments can include exercises like the push-up, the overhead squat or the in-line lunge and when implemented safely and correctly they are perfectly fine for the healthy older adult client to perform. However, for the older adult dealing with one or more physical limitations (sciatica, shoulder impingement, torn meniscus, etc.) or pain management issues, these exercises can be unsafe and/or difficult for the untrained or undertrained older adult to perform.

A large majority of older adults do have at least one physical limitation and that limitation is often the reason for them seeking out the assistance of a fitness professional. It’s the personal trainer’s professional responsibility to “do no harm” with every client in which they have the pleasure of working with and the older adult is no different. If the client indicates the presence of a physical limitation that will not allow them to safely perform movement assessment exercises, then a movement observation assessment may be a more appropriate option.

The Online Movement Observation Form (see image 1) can include rating or scoring a client’s ability to perform basic daily life movements like reaching overhead, sit-to-stand, stepping down and up or getting up and down off the floor. These daily life movements are typically performed by all clients on a regular basis however, the skill to perform these movements may vary from person to person. Based on these basic daily life movements and the client’s ability to perform them efficiently, the personal trainer can build an appropriate program design to address their needs. Eventually, improved efforts in their programing may result in the client being able to perform some or all of the more common exercise-based movement assessments.

2. They are Afraid of Hurting Them
A common misconception is that the older or aging adult is fragile and incapable of performing moderate to advance exercises or highly challenging workouts. This misconception comes from the idea that most people over 50 years of age have some sort of physical limitation that the personal trainer needs to “fix or workaround”. Common limitations could include a lower back, hip, knee or shoulder issue or a physical disease like arthritis, neuropathy or cancer.

Contrary to this belief, the majority of older adults are very capable of training hard and pushing themselves to higher levels even with a physical limitation, however, they may simply need to progress through a training program to reach these levels. A large portion of physical limitations that older adults may have can be improved with the introduction of a basic strength and conditioning program implemented two to three days per week.

With limited or no experience training clients with physical limitations, some personal trainers will attempt to “workaround” the client’s issue.

This creates two issues: first, it does not improve the client’s physical limitation and second, they will improve in all other areas creating a bigger gap between the physical limitation and the rest of the body’s ability to operate. The client’s body will learn to compensate with other musculatures, often leading to more injury. Although improvements have been made, the goal of improving the entire body has become even more difficult as one operating component has been left behind.

To the uneducated and/or inexperienced fitness professionals the aforementioned limitations may be outside their knowledge base. Though the scope of practice for the personal trainer does not include prescribing physical therapy (PT) they are capable and able to implement exercises prescribed by a physical therapist that are specific to the client and their limitations. Clients with a limitation may be asked to go to physical therapy first to help correct their limitation, as this issue is not in an area of expertise for the personal trainer.

In some cases, the limitation can be rehabilitated at the same time as the pursuit of regular health and fitness-based goals. The personal trainer can partner with a physical therapist or coordinate with the client’s current physical therapist as to what exercises they could implement, progress and/or avoid in their daily programming.

Developing a partnership or coordinating with a physical therapist accomplishes a few goals. It provides the personal trainer direction on how to progress their client toward improving their physical limitations correctly. It also provides the trainer the knowledge and experience moving forward with future clients. This does NOT mean that the personal trainer will be capable or able to prescribe physical therapy to future clients. It can provide the trainer with the confidence to use this type of programming again since it was used successfully with a previous client who had the same or similar limitations.

3. They Don’t Know How to Progress Them Appropriately
Many older adults have yet to find their way into a weight room or participate in any form of physical activity, as the baby boomer generation did not have the information on the importance of physical fitness that today’s generations have. Due to this inexperience, the older adult my not have the neuromuscular facilitation (ability to coordinate muscle movement smoothly or efficiently) required to perform even the most basic strength and conditioning movements. This does NOT mean the older adult cannot perform these movements. However, it does mean they will need a safe, progressive and efficient program design with proper cueing to teach them.

Personal trainers can develop a training philosophy that outlines their programming components (push, pull, press, squat, carry, etc.) and the exercise progressions of each. This progression would start with the most-simple (basic) movements like a bridge, strict press, plank and step up to the most complex (advanced) movements like a clean, snatch, get up or box jump. Due to the average older adult’s lack of physical activity and/or strength and conditioning experience, the uneducated and/or inexperienced personal trainer may be intimidated or find it very difficult to work with older adults. However, a training philosophy and exercise progression could drastically help keep the client on track.

The obstacle of teaching from such a basic level provides two valuable opportunities for the personal trainer. First, it provides a wonderful learning experience to truly have a positive effect on a client’s life. Assisting and helping them improve their ability to move more efficiently, safely and athletically can greatly improve the client’s quality of living. For those suffering from major physical limitations, disease or pain management, this achievement should not be taken lightly as this can be a life-changing experience for some clients. Second, it allows the personal trainer to work on their ability to progress and teach their programming. This is an opportunity to practice and work toward mastering the skills needed to work with individuals of all levels. Those who struggle to perform even the most-simple movements are the ones who need the personal trainer’s assistance, guidance and direction the most.

In an industry that produces the majority of their new business generation from referrals (estimated at 90+%,) personal success stories and experiences will do wonders for future client recruitment. The more efficient a personal trainer can be teaching proper movement mechanics and improving a client’s quality of life by achieving their fitness-based goals, the more successful they will be in this industry.

When it comes to training goals, the older adult typically wants to focus on improving their quality of life through better movement patterns and decreased pain. Often this is not the most challenging component for the personal trainer to program, however the stakes are high and the results are extremely rewarding. There is a great sense of accomplishment and pride for the personal trainer when they see the program that they created come to fruition and as a result observe their client walk for the first time in a decade without the use of their cane or successfully get up and down off the floor post hip replacement. Learning to properly assess, progress and cue the older adult client will help them achieve their goals, reduce their risk of injury and improve their overall quality of life.

For more information about Training the Older Adult and education from Robert Linkul, take advantage of the upcoming SCW Active Aging Summit July 24-25. He will be presenting sessions and offering chat time in the sponsor showcase.