Your new client has lead a sedentary lifestyle for most of his or her life. What is your approach?

I employ a hybrid of both Iola and Catherine's suggestions. For my clients who have been sedentary for a great length of time. We discuss their goals and expectations when beginning a program. I also take some time to establish small goals for them to work toward. Moving around every 30 min after sitting, getting in and out of chairs properly, keeping an activity and positive thought journal daily and also paying a visit to their physician to receive an activity release. I also have made myself available in a few instances to discuss the concerns the physicians had regarding my clients. Very rewarding experience working hand in hand with their doctor, it's always nice to have reinforcement when helping clients make lifestyle changes.

Definitely start with simple things like walking, biking or a fun low impact class. But be sure that it as an activity that gives you time to encourage them or allows them to see fitness as being fun. Build their belief in themselves to continue their journey to healthier life. Don't be afraid to probe deeper into their 'reason' for choosing now to improve their health, connect them to their 'why' and they'll stick with the program and you for taking a true interest in them as a person, not just a client.

We'd start with a discussion about what types of activities they might enjoy, and how to begin incorporating that activity consistently, 3 or 4 days a week to start.

Something as simple as a 20 minute brisk walk, actively playing with their kids, going for a bike ride, or trying a new dvd or class. At first, my approach would be focused on creating a sense of success through consistency, building confidence through small, achievable goals that can be built upon incrementally.

Just as important as preparing the body is preparing the mind, improving self-efficacy and confidence that one can accomplish something that has likely been difficult in the past.

First I would refer them to a physician for physical activity release form. Proper health risks taken into consideration, I would start with low level activities like walking if capable, or swimming if obese. If they are not able to walk or legs are weak, possibly start with chair exercises. Increase leg strength with exerbands or leg weights. Upper cardio strength with arms movements, after a while use 3-5 lbs. free weights. Exercise would be 5-6 times per week at 30 minute intervals.

I have to assume that these people don't have medical conditions. If they do then you need to stop and address these concerns and conditions first.

So, if they just haven't moved they probably don't like to move. You need to make things easy and enjoyable. You will need to be the sunshine. Keep it simple, walking, stepping up and down, using a chair to stand up from and sit back on. Watch the sit and be fit videos.

The most important thing is to do things they like to do... play music they like, if they like being in a pool and have access get them in the pool. The goal is really simple get them to move without them being sore the next day. They need to "enjoy" movement. I find that people who don't like to move or haven't moved much need a lot of "mental" coaching.

My first reaction would be three-fold: one, what's happened in her life to cause this 180 degree action? Secondly, congratulate her on taking the first step toward a more active life. Lastly, I would ask her why her life, up until now, has been sedentary (are we talking about a lack of motivation and/or confidence, negative experiences, health conditions, etc..???).

Once we have had a discussion about why physical activity has NOT played a major role in her life, then it's time to move on to why now is the BEST time to do this!

A SMART goal-setting session would be part of our discussion; an honest chat about when she can do this, what she wants to try first, how often she'll be able to commit, what type of support does she have....

After all the initial info gathering and one-on-one discussions have taken place, I will be in a good position to create a basic fitness program for her that would include all the basic components, and the "look ahead" view in terms of progressions we can work toward.

Overall, my goal would be to gain her trust so that I can obtain as much info as possible to positively affect her life, while making her feel as though she's doing the lion's share of work (which, really, she is!). She needs to feel her confidence building right from that first meeting. It needs to be clear that we are a team: she's the expert on her body and I am the person who has to decipher what she probably should do, what she can do or will be able to do, and how to make the entire process as challenging and comfortable as possible.

No problem, right??

I do a thorough assessment first and foremost. As we spend our lives in a more sedentary fashion, each of us will end up with imbalances. I need to determine where your weak spots are, not just generalize. I don't want to just get you moving, I want to get you moving in a fashion that is not going to cause you injury, now or later, so you don't get sidetracked due to injury.

Part of the assessment is also to find out what the clients goals and motivations are. These are probably the 2 most important aspects of any program - the client's goals and motivations. We also cover what people enjoy doing or would dislike the least :).

I also begin with some basic nutrition education as nutrition is a large part of overall health.

I will initially give clients small goals to achieve on a daily basis - eat breakfast soon after waking, drink more water throughout the day, write down (or use an online journal) what you eat.

I then take time to design an outline for a 6 month program, breaking it down into what we will focus on every 4 weeks, as far as the weight training aspect and results we want to achieve. Then I plan the first workout or two and take the client through those. I also give clients specific homework to do (exercise, food log, change and eating habit, pat themselves on the back). I explain to clients why we are doing what we are doing, how we will know when it is time to progress to the next phase, and most importantly I ask if they understand why we are doing what we are doing. If they don't understand the why clients will tend to lose motivation.

As we progress through the different phases of training everything is customized for the client with their goals, abilities, motivations and limitations in mind. And I try to keep it fun!

After the client has been medically cleared I do an assessment to see if any corrective exercises need to be incorporated. From my experience most clients, especially those who have been mostly sedentary, have some form of correction that needs to be addressed. For instance they may have difficulty keeping their feet from turning out or their knees from turning in or going forward when performing a squat. That is just one example but I address those needs first as well as basic core and balance conditioning. I also focus on light cardiovascular exercise as others have mentioned above. My goal is to get them comfortable with moving and if they enjoy what they are doing they will continue to do it. I also want them to be successful at something which intially may be simply doing 20 minutes on the bike or treadmill a few days a week. That will make them more confident to try new things as I am simultaneously aiding them in strengthening their core and helping to build their stability and learn proper form for the challenges that I will present to them in the future sessions.

Thank you everyone for your responses. It's great to hear for the most part that your collective approach is to establishing rapport first with your clients before we assess.

Thanks for your comments.

Baby steps - literally! Following the principle of "overload," essentially any physical activity is going to overload your sedentary client, so slow walking to start. Also body weight exercises which will help in several ways (improve their strength, their coordination and perhaps most of all their confidence - which will hopefully spur them on to continue their quest). I hope this helps.

LaRue Cook
www.lecfitness.com
lecfitness@yahoo.com