My client experiences pain in his shoulder sometimes it actually locks up when we’re doing exercises such as overhead press, push ups even a bicep a curl or tricep dip’s. He doesn’t want to see a physical therapist which would help me figure out what exercises would be contradictory. He literally will hit it and says that he feels that that unlocks the shoulder this is been going on with him for over 10 years. I worked on mobility with TRX and no wait over 5 pounds. I’m trying to determine what exercises I should not do with him and what exercises I could do with him that would increase his strength without exacerbating the situation. I feel very limited in my knowledge in this area and try to attend appointments with my other clients to actually do you see physical therapist but each client is an individual and age for their situations are individual. What class or CERT could I take to help me increase my knowledge of exercises that would be indicated in contraindicated and what would you do if this was your client? I know we should not diagnosed as personal trainers.
As a trainer there really is no class or certification that will help you deal with such an undiagnosed problem. I am a Registered Nurse and CES, but would feel this is out of my domain. If you cannot get him to see a doctor or physical therapist I feel you need to avoid any type of exercise that aggravates this, or you are putting yourself at liability. I would especially avoid shoulder presses and pushups. Trying to work the area without really knowing what is wrong or what may aggravate it may only make it worse. It is certainly possible that he dislocates his shoulder easily, which is actually a pretty minor problem, but if he has something like frozen shoulder than no trainer is qualified to treat it unless under the direct instruction of a physician and/or physical therapist. If you really cannot get him to budge, I would only work cardio (and no swimming, elliptical, rowing, etc) lower body and core with him. Maybe if you tell him that he would agree to get it diagnosed.
I also hold several corrective exercise certifications but your scenario is beyond the scope of practice of any one of them. Janet put it well enough: only work on the body parts far removed from the shoulder and impress on him the importance on having it checked out. He may be afraid to hear what he does not want to hear but he cannot put this responsibility on your shoulders.
Try to refer him to a Muscle Activation Therapist in your area. These guys can really work on issues like the one your client has. You and your client has nothing to lose by trying it out:
I hope this helps.
Quite frankly, I would not begin working with this client without a physicians clearance. If I was already working with a client and this situation arose, I would suspend training until the client got clearance. The potential harm to the shoulder must be evaluated. Even for doing exercises that don’t involve this shoulder, continuing without clearance could result in unintended use and injury of the shoulder.
In the meantime, there are courses available for learning more about shoulder injury and shoulder stabiity. But even with this knowledge, personal trainers must require that the client is cleared to work with us.
I agree with Martin that he needs to have a physician/ortho look at his shoulder. There’s no guessing here, he needs a doctor who can diagnose the situation–not just treat the symptoms.
There are just too many issues that can affect the shoulder. Continuing to train him without knowing exactly what his injuries are could lead to further damage.
It’s always best to get a definitive answer.