Assess to Progress

Client: Jim

Personal Trainer: Austin Gregory Johns, CCS, president, San Clemente Health & Fitness Network

Location: San Clemente, California

Quality Assessments. Austin Gregory Johns, CCS, president of San Clemente Health & Fitness Network, is an advocate for fitness assessments. They are necessary to uncover potential limitations, but they also serve to develop trust between client and trainer, he says.

“It is imperative that a personal trainer approach new clients with an exercise readiness or health history questionnaire,” Johns says. “By the end of the first evaluation, the client should feel comfortable trusting the fitness professional completely with any health-related topic—no matter how private the subject may be.”

An Eye for Dysfunction. Johns’s assessments and sharp eye proved invaluable to his new client, Jim, who originally began working with Johns to gain flexibility and strength. However, Jim also experienced pain and restriction in his left hip. “Jim’s physical asymmetries were immediately visually evident,” Johns says. “During the evaluation, I performed simple goniometric measurements of Jim’s bilateral passive hip flexion.”

Based on the results, Johns encouraged Jim to obtain an examination from an orthopedist. “Jim hadn’t planed on having his hip medically examined, but his movement was so significantly impaired that I suggested it early in our training.”

Accepting the Inevitable. “After my visit to the orthopedic surgeon, my hip problem was diagnosed as dysplasia, which required a total replacement,” Jim says. At that time, Johns altered Jim’s training program to focus on leg and core strength and neurological coordination. “In addition, I gave Jim some very basic recovery exercises so he could progress more quickly through his rehabilitation.” In all, Jim required a 3-month hiatus from training to ensure adequate recovery.

Lessons in Patience. According to Johns, Jim’s recovery and return to activity happened quickly. The surgery was a complete success, which gave Jim a false sense of security. “His hip was feeling so good so quickly that he became mentally—but not yet physically—ready to engage in more strenuous exercise,” Johns says. Eager to be active, Jim took a long walk which led to the development of symptoms associated with plantar fasciitis. The setback was not extensive, but it was enough to warrant further caution. “It probably served to convince Jim to take it a little easier, allowing the hip to heal properly,” Johns says.

Training Protocol. Despite the training hiccup, Jim’s physical capacity continues to improve and he now works primarily on maintenance once per week with Johns. He trains on his own the remainder of the week. A typical session begins with a dynamic warm-up that often includes basic myofascial release with a foam roll. Jim then progresses to movements that challenge major muscle groups—push-ups, squats, hopping, twisting and more.

Another of Jim’s goals is to improve his tennis-playing ability, so Johns has tailored the program to include performance enhancement and injury prevention tactics, as well. The workouts conclude with mild static stretching to lengthen surgically damaged tissues.

Progress and Improved Performance. “As his mobility improved, we were able to return to high-intensity exercise,” Johns notes. “I still pay careful attention to the mobility of the hip as well as to some distal implications such as thoracic spine mobilization.” Jim’s tennis game has also improved. “Jim’s movement on the tennis court is improving dramatically, and we have begun approaching more athletic applications like sprinting and cutting.”

Scope of Practice. Johns warns that fitness professionals must be wary when working with clients with special needs. “Too often personal trainers like to use rehabilitative techniques in some sort of pseudo-physical therapy routine,” he says. “Our job as trainers is not to examine or reconstruct localized portions of the body, but rather to improve the functionality of all bodily systems as a whole.” If that is not possible, due to a limitation such as an injury—or in this case, hip dysplasia—the professional must refer the client to someone qualified to help.

“While it is inappropriate for fitness specialists to delve into techniques and methods for which they are not trained, this doesn’t mean a good trainer can’t be one of the most important health practitioners sought out by the public,” he adds.

Calling All Trainers

Do you have a client who has overcome the odds to achieve new heights in health and fitness? Send your story to content@ideafit.com and you and your client may be featured in an upcoming issue of IDEA Fitness Journal.