Hi Glynis. In my opinion whenever I have a client with exercise restrictions such as those given your client by her physician, I’m not sure that I would have them in a ‘group’ training environment. Whether or not a client has signed a waiver, and although their physician has ‘cleared them for exercise,’ the physician’s clearance was NOT without some restrictions. It’s difficult to truly monitor each participant’s participation in a group setting, and so monitoring someone with exercise restrictions would make them a one-on-on training candidate in my mind; particularly given the type of condition or injury that the client has, and the potential for a bad outcome if they are not properly monitored.
I hope that this helps.
I agree with LaRue
Make sure you are working closely with her Doctor and PT if she has one.
Everyone is different and we must make sure we are accommodating them as best as possible.
Even though she has been cleared for exercise it would be great to review the motions that cause her the greatest harm so that she can anticipate and be careful.
DJD is a common but serious problem many Americans face. However when returning to exercise individuals need to focus on stability (control) before they implement speed based training methods. Once control of ROM has been achieved in all planes of movement, Mobility (accelerated movement) should be introduced and progressed appropriately. Have them avoid cardio-based exercises (running, elliptical, rowing to name a few) the reason for this is because of the high volume of repetitions and the general disregard for control often associated with these activities. In a simple cardio session an individual may cover off a 1000+ repetitions in as little as 15 minutes.
As for stretching I’d recommend avoiding it all together with this and most populations. Looseness or laxity decreases the ability of a muscle to structurally support the joint leaving it more vulnerable to repeated and more often excessive injuries. Another reason to consider not stretching: according to the American Academy of Orthopedic Surgeons a grade one ligament sprain is stretching of the ligament. Now asked yourself – with stretching at what point does a ligament injury occur?
We generally relate ligament injuries to sports where they occurs rapidly under an extreme amount of force. But have we considered the possibility that once we loosen the muscle we may cause long term structural failure (orthopedic injury) of the ligament which could lead to the erosion of the materials of the spine.
Hope this helps.
First, this is not a marketing response, I am not employed or paid by the following training system.
I would highly, highly recommend you look into Foundation Training (www.foundationtraining.com). The focus of the work is on decompression of the spine through musculature integration therefor reducing inflammation of the discs and protecting the spine during movement.
The work focuses on the integration of the adductor muscles to anchor the pelvis and hip complex which allows the spine to be protected. It emphasizes the importance of head position for the spine and of the extreme importance the posterior line plays in hinging and all human movements.
They have designed a very few practical movements that integrate all of that. The concept mixed with easy to perform movements (not exercises) produce an amazing effect.
I have been using it in group format and in privates for over a year and I can go on forever about the results I’ve seen when taking those in pain out and those who want to increase performance to another level.
Its very well documented among athletes (Lakers, Garmin Cycling, Dogers, Surfers, etc.) and medically supported by Mercola etc.
Again take a moment to look at the site or feel free to contact me with more questions.
Hope this finds you well,
I was diagnosed with degenerative discs between S1/L5, L5/L4 over 25 years ago. I was very big on jumping/bounding sports and had suffered several falls from heights over 10 feet (including landing on the edge of a swimming pool in a seated position from a fall from a ten foot pool slide which I think started the whole degenerative process). I was given no restirctions other than avoiding any activity that caused me to spasm or produced pain. I found that I could still do a lot of things I liked, but the amount of concentration it took not to aggravate the low back muscles led me to give up jumping and jumping sports (jumping down when hiking, basketball, spring board diving, etc.). I have learned and now habitually maintain proper posture and stability. There is a possibility that some of my other discs have degenerated as I notice similar symptoms at other sections of my spine, but they are not debilitating as I know how to deal with the issues. And I have not persued diagnosis further as there is nothing to be done about them that I am not doing.
I have also worked with numerous clients with significant degenerative disc progression. Everyone will eventually have some degree of disc degeneration, but their history will also determine the level of degeneration they now have.
I work with such clients within their physician, surgeon, and therapist recommendations and under those guidelines within the clients tolerances. There are a number of stretches and exercises that have been pretty much standard recommendations. I progress clients to the limit of the recommendations and if the client desires continued progress (rarely as most are content with getting back to their previous level of ability without pain or managed pain), I send them back to their health provider to get further clearance for what they wish to do.
As each individual can have other contributing issues and individual compression areas affecting them differently. I do not make any exercise recommendations to other trainers. You need to follow their doctor or therapists recommendations and contraindications. If you are not comfortable working with such clients, you should do your best to find an appropriate trainer to refer them to contact.