Age is 42, non-smoker, blood pressure is 139/92, glucose level is 93, and her total cholesterol is 200. She has not exercised consistently for 2 years and would like to lose 20lbs. She is not a fan of running, but can do it, and she has never done resistance training besides in a group exercise class. She would like to run a 5k in the next year with friends. She does not know her current body fat, but had it checked a year ago when she wanted to start a plan and it was 26% (she didn’t follow through with plan). She does not have any known cardiovascular diseases or family history of them. Should a fitness trainer require physician clearance, before starting an exercise program?
I would not require a physician’s approval but I would take her blood pressure repeatedly and ask her to do the same at different times of day. There is a good change that her blood pressure will get lower when she starts exercising. I assume that you were the one who took her blood pressure. I often find that people are nervous during the screening and follow up.
However, if this continues with the diastolic BP number being above 90, I would urge her to discuss this with her doctor.
I would have a few more questions for you before I would make a decision on medical clearance. She has not worked out on a regular basis and I would want additional readings on the blood pressure. Chances are, she could most likely begin a program without medical clearance, but some additional questions would be the following:
–Did you take her blood pressure or are they numbers from her last doctor’s appointment? If you did it, perhaps take it again.
–Did you take her resting heartrate?
–Is she on any medication?
–Did you have her complete at least a PAR-Q?
That is what I would go by to start…
Great advice so far. I especially like Christine’s suggestion of getting a PAR-Q and current data. Data from a year ago (BMI) could be way off. Also, what is her current weight?
And finally, what is her commitment level towards training, and potentially changing her eating habits to contribute to weight loss.
I would add to the above recommendations/suggestions that since her goal is to run a 5k next year, doing outdoor activities/exercising might be good place to start at. She doesn’t look like she will need a physician’s clearance from the information you have provided and incorporating a program that cardio is the main theme would be an excellent way to go .