Should We Train People in Pain?
I came across an interesting fitness blog post recently. It is a great point of thought, I make it a point, regardless of the program design for my client to ask how do they feel. Asking and listening to a client is very important and should determine how you proceed before training. How do you all address this subject with clients.
There are many types of pain. Pain from over exertion requires recovery and may require medical intervention. Pain from injury definitely needs to be assessed and return to exercise needs to be approved by a physician. Regardless of the cause, pain is a contraindication to strenuous exercise, and perhaps any activity, until the pain is at least reduced and/or the cause is uncovered. Some forms of pain and discomfort are due to sedentary lifestyle and respond well to slow progression of activity.
If you want a more specific answer, you will need to tell me what type of pain you are referring to and the cause if you know it.
I agree with you. I always make sure my clients are pain free before any of their workouts, because the last thing I want for them is to start training them and not knowing they have some type of injury or other issues. If they tell me that they have some type of pain, I have to make a quick assessment to determine if it’s something that can be dealt with or if they will need to talk to a physician. Better safe than sorry.
Kurt
Great question. The first thing we have to ask is what type of pain are they in.
Fitness professionals should train within their scope of practice.
Since their is no regulation on personal trainers it falls back on your education and your national certification. ACSM is the only medical national certified agency that while completing and showing competency as a health fitness instructor for example allows you to train certain clientele based again on the competency that one has completed.
All of the other 100+ certification agencies are not comprehensive nearly as is ACSM.
As a physical therapist, I am trained to assess and manage pain. Now with advanced knowedge and taken two classes in chronic pain, I won’t train clients in chronic pain, because it will only exacerbate and foster the pain cycle.
However a person with mental pain(ie depression, anxiety, sadness) is pain. Will exercise hurt them? No, based on the science, research and recent studies, exercise will do just the opposite, increase a release of natural endorphins, blood flow, lower heart rate and blood pressure, change mood and decrease stress which we all know.
However a client with a given pathology, knowing the pathology, your distinct scope, education, training, and skillet should be the guide.
Therefore, if someone is in pain, is it really safe and logical to train them?
No it is not..
I posit that most older adults have some chronic or reaccuring pain.
I never work with acute pain, but chronic pain, of course..
Chronic pain or long lasting pain can be a symptom of tight muscles (muscle knots), weak muscles (causing tendonitis) or misalignment or improper biomechanics (causing kinetic chain symptoms), it can be disease related, (such as arthritis, fibromyalgia), or a symptom or something more severe. The pain of arthritis can be measured on an arthritis pain scale to determine exercise acceptability, and we all know the best thing for arthritis is movement, same for fibromyagia.
Additionally, lower back pain is a common chronic pain that may be managed with the right stretches and strengthening exercises. In my health history screen I address and explore pain, discomfort and limitations.
It can often be difficult as trainers to know whether our clients are experiencing “pain” or muscle soreness. Often clients who are new to exercise or new to pushing themselves to new levels of fitness, do not know what they are supposed to be feeling. Like others, I often coach my clients of what they should be feeling and what they should not be feeling. Then we talk about the difference between fatique and pain. I go by the rule that if a certain area is experiencing true pain and its a new pain that they haven’t experienced before or sought medical treatment for in the past or is a pain that has reimmerged in an area where they’ve had a previous injury and that pain continues for more than a week after it has been rested, then they need to be referred. Once a client is experiencing pain, we rest that area, no longer work it, although I will work other areas of the body that do not affect that particular site of injury.
I think its important, as others have stated, to talk about the difference between fatigue and pain with clients. Its also important to perform a proper medical history prior to training so you can be aware of any previous injuries or medical conditions that may make them prone to pain or reinjury. Always err on the side of caution and client safety.