I’ve spent a year with a client that was morbidly obese, sedentary, diabetic, hypertensive, age 65.
After assessments and medical clearance we started training three times a week.
First with walking then on a treadmill then on an Eliptical. He worked out everyday in between our sessions, usually for 45 minutes.
Today we train twice a week: Strength training, he continues his “cardio”on his own.
I write up a workout for him to follow.
He is on my Success Story page.
He still needs to loose another 15 – 20 pounds but thus far he has lost 32 pounds, 6 inches off his waist, his blood sugar is normal along with his blood pressure.
Slow but Sure
Baby steps – literally! Following the principle of “overload,” essentially any physical activity is going to overload your sedentary client, so slow walking to start. Also body weight exercises which will help in several ways (improve their strength, their coordination and perhaps most of all their confidence – which will hopefully spur them on to continue their quest). I hope this helps.
After the client has been medically cleared I do an assessment to see if any corrective exercises need to be incorporated. From my experience most clients, especially those who have been mostly sedentary, have some form of correction that needs to be addressed. For instance they may have difficulty keeping their feet from turning out or their knees from turning in or going forward when performing a squat. That is just one example but I address those needs first as well as basic core and balance conditioning. I also focus on light cardiovascular exercise as others have mentioned above. My goal is to get them comfortable with moving and if they enjoy what they are doing they will continue to do it. I also want them to be successful at something which intially may be simply doing 20 minutes on the bike or treadmill a few days a week. That will make them more confident to try new things as I am simultaneously aiding them in strengthening their core and helping to build their stability and learn proper form for the challenges that I will present to them in the future sessions.
I do a thorough assessment first and foremost. As we spend our lives in a more sedentary fashion, each of us will end up with imbalances. I need to determine where your weak spots are, not just generalize. I don’t want to just get you moving, I want to get you moving in a fashion that is not going to cause you injury, now or later, so you don’t get sidetracked due to injury.
Part of the assessment is also to find out what the clients goals and motivations are. These are probably the 2 most important aspects of any program – the client’s goals and motivations. We also cover what people enjoy doing or would dislike the least :).
I also begin with some basic nutrition education as nutrition is a large part of overall health.
I will initially give clients small goals to achieve on a daily basis – eat breakfast soon after waking, drink more water throughout the day, write down (or use an online journal) what you eat.
I then take time to design an outline for a 6 month program, breaking it down into what we will focus on every 4 weeks, as far as the weight training aspect and results we want to achieve. Then I plan the first workout or two and take the client through those. I also give clients specific homework to do (exercise, food log, change and eating habit, pat themselves on the back). I explain to clients why we are doing what we are doing, how we will know when it is time to progress to the next phase, and most importantly I ask if they understand why we are doing what we are doing. If they don’t understand the why clients will tend to lose motivation.
As we progress through the different phases of training everything is customized for the client with their goals, abilities, motivations and limitations in mind. And I try to keep it fun!