Your client may have uterine fibroids that can become very large and push against the abdominal wall. This is very common among women, especially women with darker skin and those living at higher latitudes. I live in Wisconsin and had this problem. I was prescribed a high dosage of vitamin D (& iron) following a blood test that found my levels of vitamin D and iron were very low. It was amazing how quickly my abdominal distention was relieved. Heavy bleeding during my periods was also greatly diminished. I continue to take Vitamin D and try to get 10-20 minutes of sunshine when I can. For more info on Vitamin D, please do an internet search of Dr. Michael Holick’s reports or videos on the subject.
Thank you everyone for your feedback. Elizabeth and Tim, I was thinking the same thing-visceral fat based on our conversation. The exercise training I was thinking of setting up was HITT in between the strength training. I did explain how important the nutrition part is and I do not advise on the nutrition and explain that I am not a dietician, but do tell my clients that the gym alone is not the answer.
If her stomach is distended and hard, chances are good that she has too much visceral fat, (that is the fat that develops and forms around internal organs usually either from a sedentary lifestyle or chronic stress). This fat is different from the fat that we typically see in clients who have “soft” stomachs. Although both fats are not good in excess, visceral fat is especially not healthy. Great way to reduce both if she has been cleared by her doctor for exercise, is to do HIIT type training, cardio, and a good diet. Hope that helps!