Effectively training clients requires us to listen to their needs. It’s equally important is the knowledge that they can hear you clearly. And then consider those whose hearing loss may make them feel excluded from the fitness world.

Tracy Markley, the IDEA 2021 Personal Trainer of the Year, has written extensively and published materials on the topic. Her work is especially meaningful, as Markley is partially deaf in one ear and almost totally deaf in the other. And it’s especially poignant, as the severity of her own hearing loss was not diagnosed and treated until several years after she graduated from college.

“The fact that I can teach and write books that pertain to the fitness industry is something I am especially proud of,” she says. “Coming from people telling me I talk funny—and often being treated as if I was not smart—to [accomplishing what I’ve achieved] the last several years is something that’s pretty cool.”

Here, Markley shares more information about hearing loss and how you can ensure you are creating an inclusive and effective environment for your hearing loss clients.

Hearing Loss and Your Client Base

According to the National Institute on Deafness and Other Communication Disorders, one in eight people in the United States ages 12 and older has hearing loss in both ears. That’s about 13% of the population, or 30 million people!

“Often people just assume it’s the older generation who has hearing loss, but that simply is not true,” says Markley. “Two to three out of every 1,000 children born in U.S. are born with a detectable level of hearing loss in one or both ears. About 15% of American adults ages 18 and over have trouble hearing. Half of all people over 80 suffer from hearing loss.”

The Physical Impacts of Hearing Loss

Markley notes that if a client can’t hear well, the ramifications go far beyond the ability to listen to trainer cues. “Hearing loss can also bring upon balance issues,” she explains. “Not wearing hearing aids when they are needed can lead to falls, dementia and other physical challenges. It also causes many to isolate away from people or groups.

“It’s intriguing how the senses work together,” she says. “I wear hearing aids, and when I don’t have them on, I sometimes literally sway to one side when I’m walking around the house. Many of us with hearing loss who also wear glasses notice that we also hear better when our glasses are on!”

This is important feedback for trainers who may need to make adjustments if clients show up without their hearing aids.

“Unfortunately, not all clients take responsibility for their self-care when it comes hearing loss,” Markley explains. “My clients who forget their hearing aids always have more balance challenges during their workouts than they do on the days when they wear them. It is important for us as professionals to know each case per client and monitor each session due to how they arrive.

Science offers confirmation. Recent research published in JAMA Network Open from the University of California, San Francisco, found that people with hearing loss have significantly poorer physical function—especially poorer balance. Other noted was slower gait, poorer walking endurance and faster declines in physical function over time when compared with those with good hearing.

How Trainers Can Help

Research further confirms that fitness pros play an important role in working with this special population. The UCSF study commented that a future treatment for those with hearing loss may be a “broad multidimensional and interprofessional intervention, including hearing health care as well as physical therapy and activities like tai chi.” Fitness professionals interested in working with this special population could make an important contribution to those challenged by related loss of functional abilities.

The first step is to create an accepting, knowledgeable environment. Then, there are practical considerations.

“While training a client with hearing loss—no matter the age—it is wise to be in front of them, while giving instructions,” Markley says. “Most people with hearing loss read lips to help fill in the words, tones and letters that they do not hear. It is important for their safety, as well as for them to feel comfortable exercising in the environment you provide for them. If they feel fearful or must remind you continually that they cannot hear you because you talk behind them or turn away from them while speaking, they will not continue to be your client. They do not want to feel like they are a burden to work with.”

Group classes provide special challenges. According to Markley, “You can only do so much. I encourage others to not talk in class, as there is probably a hearing loss student or students who cannot hear instructions.” She emphasizes that, “If you teach senior classes, this is very important to know.”

Hearing Loss Pandemic Challenges

Markley says that most people with hearing loss experience “listening fatigue,” also known as hearing fatigue. She adds: “It takes more concentration and energy to hear what others are speaking. This is especially challenging while we are all wearing face masks. Many read lips, and the lips cannot be read with masks on. This can leave clients very tired during and after their workouts. This can also leave some feeling like they don’t want to go to a session or a class because it is just too exhausting to try to hear the trainer and instructors.

“When there are people talking around them, music and background noise and they are trying to hear what is being said to them, it is very difficult.”

The key for these clients—as with all the people we are trying to help—is to be knowledgeable, empathic and caring. Know that hearing loss does not have to diminish wellness.

Learn more about Tracy Markley work with stroke survivors