Do you have any set of exercises to use with individuals who have osteoporosis (this person also has arthritis and cervical spinal stenosis, and according to her Physical Therapist, should do weight bearing exercises, but keep her spine in neutral position, and not lift anything above her shoulders.
I looked at your profile and saw that you are a group exercise instructor. As such, you are working with apparently healthy individuals who have pretty much responsibility for the exercises they do if they choose to be in a class setting.
I generally have an issue with group weight training because I have witnessed too often that people have a difficult time following instructions, no matter how properly given. Consider this last comment a side bar.
Even in a personal training setting, I do not have ‘a set of exercises to use for people with osteoporosis’ because my exercise selection is dependent on the individual assessment. It would also take into account the arthritis and the spinal stenosis. I would also require a physician’s okay and would personally talk to the physical therapist. Obviously, the person went to the PT for some reason.
Frankly, with this person in a group exercise class, you are taking on an awful lot of responsibility, and I believe that you are going beyond your scope of practice. If this is part of a program at a health club, I would refer this to my supervisor.
Osteoporosis, arthritis and central stenosis. Wow.
I can’t believe a licensed physical therapist okayed group fitness.
Although this is not going to answer your question, here is my position.
If you can’t explain the pathophysiology of the disease/condition in question, if you don’t have a good grasp of the arthrokinematics of the involved joints, then you are taking a great risk.
Even if you have written clearance, as a fitness professionals we all must recognize where our area of expertise begins and where it ends. Too, even it if is within your scope, it doesn’t mean that a fitness professional is prepared to train an individual presenting with so many clinical conditions.
Cervical spinal stenosis can be a serious condition. I agree with all of the previous answers. Perhaps the best recommendation is that you consult with the client’s physical therapist and see if you can bring the individual in as one of your personal training clients. Modest ROM and some loaded exercises can perhaps be helpful, but not in a group exercise setting.
Take care, Daniel
WOW! The fitness goal for such a person is to increase joint strength and stability, and improve functional capacity. Do some cervical stabilization exercises and strengthen the posterior shoulder girdle.MORE IMPORTANTLY, stay away from HIGH IMPACT ACTIVITIES, avoid exercises and/or stretches in the painful portions of ROM. Ask whether or not the joints are swollen or painful .when that person shows for your class. If the answer is yes, she/he doesn’t work out that day. Aquatic exercises would be best the best thing.
While I agree with many of the previous suggestions regarding liability and discussions with this person’s doctor/physical therapist, there are several exercises appropriate for someone who’s been cleared for exercise with these movement restrictions. 1) weight bearing exercises can be performed in a chair to improve spinal stability as well as isolation of the targeted muscles or kinetic chain. For instance, chair stomps (just stomping flat feet on the floor while seated) are one of the exercises I use with my senior clients to improve bone density issues. 2) Many upper body exercises are highly effective at or below shoulder height, like Lateral Raises (with bent arms or straight), Front Raises, Biceps Curl, etc. Just make sure to start with either no weights or very small weights until her technique is perfect. Since this is a client participating in group exercise, I recommend taking plenty of time before & after class to discuss the specific movements she should modify during the class, as well as demonstrating some options during the class when it’s feasible. Because of the cervical spinal stenosis, make sure her range of motion is small enough that her neck & back remain neutral (especially when she’s getting tired!). Keep in mind, too that while an alternative aquatic exercise is effective at building & maintaining muscular strength & joint mobility, it is not considered weight-bearing exercise. Hope that helps!