I would start by making sure he is medically cleared. Make sure you have a note or a PARMedX from his doctor. Has he gone through physiotherapy? If he has, then he should have some exercises from that. I would start with those. Sit/stand is a good functional exercise to improve leg strength, but you may want to include some unilateral exercises like hip abduction or leg extensions as well. Does his doctor have any recommendations for cardio? This may be difficult to accommodate with the knee replacements, but probably start with walking if he is able. I would also include some upper body strengthening exercises like tubing rows or wall pushups.
Hello Janice DeMille,
You want to do a consultation, get the doctor clearance, and figure out how to balance the body. Work on balance as in reducing the fall risk and strength to be able to get off the floor. Make sure to work on total body flexibility; because, a strong muscle is a flexible muscle and we cannot move around with stiff joints.
Don’t do anything that causes pain and keep open communication throughout the process. Sometimes people like to push too hard without telling you; keep your eyes and ears open. Nothing is written in stone, you will have weak and strong days, just go with the flow.
I like Sherry’s ideas of wall push ups and rear rows. Those are usually enjoyable and help the person feel good about themselves; since, the chest and back muscles are large.
Start slowly; you will progress. Find out what the person did in physical therapy and proceed from there.
Natalie aka NAPS 2 B Fit.
I have trained a client with similar limitations, even though it was her right side that was weaker. I started training her when she was 80 years old.
I did as many unilateral exercises as possible to try to bring the weaker side ‘up to speed’ to the degree possible. I also worked on balance using equipment such as balls (as in wall squats), balance boards and dyna discs. I also included some playful exercises such as catching a ball to improve hand/eye coordination.
With my client, we made quite good progress for a number of years. After a while, it was a matter of maintaining what we had, and then I gradually needed to yield to the realities of her getting older. I trained her for 10 years; she then suffered another stroke and had to go to a nursing home where I was not allowed to train her.
If you train your client for that length of time, be prepared for a decline that you can only delay but not prevent. It can be emotionally quite difficult.
I’m happy for you and your client that you accepted a challenge even when a little uncertain. I have been working with a man who’s 78 and had a stroke three years ago, and by far, it’s one of the most rewarding jobs I’ve experienced in a very long time.
I will preface this by saying that I was fortunate enough to be at his last two sessions with the physical therapist. We both got bored pretty quickly, so I had to get creative, I began bringing pieces from my home gym that included different resistance bands, a few body bars, and my open mind. I keep experimenting very conservatively, so we’ve built confidence and trust together. Communication has been essential, and I’m lucky that Jerry is really good natured. 🙂
All advice above is great! Because my client has to use a walker and is very balance-challenged, a lot of his core and upper body work is sitting. Although we work biceps and chest (he beamed the day I could point out his “strong guns”), we spend a lot of time with the posterior muscles; seated, he does unilateral reverse flys and low rows, and lying down, lat pulldowns. I’m holding the other end of the figure 8 band. He does have a good hip hinge and can intentionally contract his abs, so he is doing a mini deadlift- hands tap chair seat and return to standing. Lots of bridges lying on the bed too- best cue to get a smile is reminding him to “pinch a quarter! 🙂 (bridges may not be great because of degree of knee flexion after TKR?)
Wishing you great success (and joy!)