Special Populations?

Most qualified trainers already have some education and experience with clients who live with specific issues; but what constitutes deeming someone as being part of "special populations"? In the fitness industry, we think of these as diabetics, children, elderly, or physically disabled...but is that it? According to US Legal, " Special population is a term that is generally used to refer to a disadvantaged group". Furthermore, disabilities are definitely a sub section of SP, but we in the fitness indusrty, tend to assume that disabilities are largely physical ailments. With the rise of mental impairments also comes the challenge of knowing how to properly train as well as recommend treatment to other qualified professionals. I know, through personal experience that training is somewhat therapy. Clients feel comfortable and free enough to divulge situations, action and thoughts that they normally wouldn't tell their partner, parents, friends, and even doctors.....so what exactly is our role? How do we responsibly train people suffering from depression, anxiety, and even TBI? Many people who need professional medical/psychiatric help do not seek treatment, and the trainer is left to fill in the gaps. As much as we do like to help clients, we all need to understand our scope of practice and stay in our lane. Keeping up with education for certain populations is key in growing and maintaining business. Much education is offered concerning obesity, elderly, youth, diabetics....but rarely do we find classes instructing on how to train the mentally impaired or disabled; the reason for this? It is a fine line between being a good trainer, and stepping into the role of a qualified psychiatrist. What we as trainers prescribe/recommend may be legitament for many healthy people, but when we add the mental status......we can do more harm than good. If you suspect depression, anxiety or self harm with clients, we must remember that this is not our area to attack, we must be responisible, professional, and most of all put the clients' needs above our bank accounts. 

Tools of the trade or liability?

There seems to be a bit of confusion going on when it comes to the scope of practice for personal trainers. Yes, we know our job is to demonstrate, assist and motivate clients according to their fitness needs....but is that all? Well, yes...and no. Depending on education/certification, SOME trainers are not only qualified but licensed/certified to go "above and beyond". They, themselves have taken it upon themselves to study, complete or graduate from programs that can very well make them experts.  This is called duel hybrid training. This means that in ADDITION to being a certified personal trainer....he/she may ALSO have a degree in massage therapy, accupunture, or chiropractic works. This is when training moves out of just the gym and possibly into the medical world; and it can be dangerous when unqualified people go beyond their scope of practice. I see too many trainers just copying what other trainers are doing......and without knowing why. In MI, as long as we have proven education in advanced services, then we are serving within our scope. It is clear in other industries where the lines are drawn but not so much in personal training.

This topic came about during what I like to call a "gym war". When a place has only indie trainers contracted to work, required to have their own insurance and liability waivers...then things get confusing. Nobody except the owner knows each individual's qualifications. Clients get confused on what services they can ask for or legally recieve.

A client recently gifted me a wonderful tool. It is a popular purcussion and massage "gun" with "thera" right in the name. So, it is a theraputic gun for muscles and soft tissue. Ok, so who knows what I'm getting at? TO USE OR NOT TO USE on clients? This is an actual question, because in the state I live in, the waters on this topic are murkey.

On one hand, trainers work with muscles...yet, without further certifications, we are not to even really stretch our clients; so where does this thing fit in? I love this tool, it's awesome BUT when  I got down to the legalities.....the question was, could I possibly hurt someone with this? Answer= yes. If one is not familiar with a client's medical conditions, that intense massage could loosen a blood clot, increase BP and cause a huge mess not only for the client, but for trainers and gym owners. It's about liability. If you really want to look at it, this tool is geared towards physical therapists, and athletic trainers mostly. This makes sense, they are most qualified to use it! Yes, anyone can buy one...but if they use it on themselves then the liability is on them. If a "professional" uses it on them, then liability is on the professional. If it's used in a public gym...then the gym owner also becomes liable. So is this tool for THERAPY? Or is it for massage? That brings up another issue. If this tool is used as a massage device and is applied by a trainer, then are they not acting within the scope of a massage therapist?  If money is exchanged for this service...then absolutely, I say yes.

In my opinion, trainers should be able to use such tools as these ONLY with proper instruction and education....as well as only on cleints where health history and medications are known.

Since I personally have racked up a ton of certs/continuing ed.....I feel I would be covered to use tools as these BUT I don't. My first job is to help my clients, and I would be doing a disservice to them if I did not make myself very much aware of the possible effects of everything I do with them. I am choosing to go back to school for my massage license, not because I want to do that for a living, but because I want to feel free and confident enough to not only use this tool, but also dive into dry needle, graston among other things. Just as well.....if I ever intend to write nutrition prescriptions and charge for them, I would need to be a licensed nutritionist. Don't get me wrong, I know we all want to serve our clients the best we can, but we have to realize our responsibilities to our clients. If we want to do certain things and provide certain services......we must be accountable to our profession and further our education in order to legally and responsibly help our clients properly. Please feel free to weigh in on this. I am very curious to your thoughts. God bless!

Tools of the trade or liability?

There seems to be a bit of confusion going on when it comes to the scope of practice for personal trainers. Yes, we know our job is to demonstrate, assist and motivate clients according to their fitness needs....but is that all? Well, yes...and no. Depending on education/certification, SOME trainers are not only qualified but licensed/certified to go "above and beyond". They, themselves have taken it upon themselves to study, complete or graduate from programs that can very well make them experts.  This is called duel hybrid training. This means that in ADDITION to being a certified personal trainer....he/she may ALSO have a degree in massage therapy, accupunture, or chiropractic works. This is when training moves out of just the gym and possibly into the medical world; and it can be dangerous when unqualified people go beyond their scope of practice. I see too many trainers just copying what other trainers are doing......and without knowing why. In MI, as long as we have proven education in advanced services, then we are serving within our scope. It is clear in other industries where the lines are drawn but not so much in personal training.

This topic came about during what I like to call a "gym war". When a place has only indie trainers contracted to work, required to have their own insurance and liability waivers...then things get confusing. Nobody except the owner knows each individual's qualifications. Clients get confused on what services they can ask for or legally recieve.

A client recently gifted me a wonderful tool. It is a popular purcussion and massage "gun" with "thera" right in the name. So, it is a theraputic gun for muscles and soft tissue. Ok, so who knows what I'm getting at? TO USE OR NOT TO USE on clients? This is an actual question, because in the state I live in, the waters on this topic are murkey.

On one hand, trainers work with muscles...yet, without further certifications, we are not to even really stretch our clients; so where does this thing fit in? I love this tool, it's awesome BUT when  I got down to the legalities.....the question was, could I possibly hurt someone with this? Answer= yes. If one is not familiar with a client's medical conditions, that intense massage could loosen a blood clot, increase BP and cause a huge mess not only for the client, but for trainers and gym owners. It's about liability. If you really want to look at it, this tool is geared towards physical therapists, and athletic trainers mostly. This makes sense, they are most qualified to use it! Yes, anyone can buy one...but if they use it on themselves then the liability is on them. If a "professional" uses it on them, then liability is on the professional. If it's used in a public gym...then the gym owner also becomes liable. So is this tool for THERAPY? Or is it for massage? That brings up another issue. If this tool is used as a massage device and is applied by a trainer, then are they not acting within the scope of a massage therapist?  If money is exchanged for this service...then absolutely, I say yes.

In my opinion, trainers should be able to use such tools as these ONLY with proper instruction and education....as well as only on cleints where health history and medications are known.

Since I personally have racked up a ton of certs/continuing ed.....I feel I would be covered to use tools as these BUT I don't. My first job is to help my clients, and I would be doing a disservice to them if I did not make myself very much aware of the possible effects of everything I do with them. I am choosing to go back to school for my massage license, not because I want to do that for a living, but because I want to feel free and confident enough to not only use this tool, but also dive into dry needle, graston among other things. Just as well.....if I ever intend to write nutrition prescriptions and charge for them, I would need to be a licensed nutritionist. Don't get me wrong, I know we all want to serve our clients the best we can, but we have to realize our responsibilities to our clients. If we want to do certain things and provide certain services......we must be accountable to our profession and further our education in order to legally and responsibly help our clients properly. Please feel free to weigh in on this. I am very curious to your thoughts. God bless!

Pelvic Floor and Health

The pelvic floor muscles are greatly ingnored yet their function are an intergal part of health. Simply put, these muscles support the bladder and bowels; in woman, also the uterus. So why are they so important and what is their relevance in relation to exercise? One would guess correctly that childbirth, chronic constipation and obesity can weaken these important muscles due to the pressure or stress inflicted on the pelvic region, that may lead to pelvic floor dysfunction.  This occurs because those muscles are designed to contract and relax at specific times for specific reasons...when dysfunction happens....the muscles "forget" to relax and stay in a state of contraction. Symptoms for PFD can range from lower body pain including genitals/ back to problems and discomfort in visits to the bathroom.  Exercise can help strengthen these muscles, helping them to perfom properly, but in more severe cases, physical therapy and even surgery may be needed to rectify this problem. As a trainer, and having PFD myself, drove me to research not only fitness and in depth anatomy on this subject, but I also picked the brain and shared health and fitness information with my own physical therapist. What I found in studies and conversations, is that though there are many documented and researched causes of PFD....I had not had any of them. This begs the question..."why did I have this and how did it happen"?  What I found was that some weightlifting form and styles of exercise done repeatedly can in fact aid in the development of PFD. Clients may want rounder glutes, ab definition, or to increase their dead lifts...but some of the most basic, well known, commonly used exercises (with proper form via personal training) may not bode well for some client populations. I also found that I hold all of my mental/physical stress and natural pain management in my pelvic region. There is a rise of people, both men and women, being diagnosed and treated for PFD and it is finally being linked to forms of sport and exercise. If clients have unexplained pain, continuing digestive issues, posture problems, or even a very high stress tolerance.......and have been seen by their doctor without getting any diagnosis, I would suggest referring them back to their primary care doctor for an evaluation on PFD. Finding the root of the problems should come before any corrective exercise is attempted. In cases with clients that indeed do have PFD, what you may be prescribing as a typical harmless exercise routine could be doing more harm than good in the long run.

Eating Disorder Awareness Week

February 26th launches Eating Disorder Awareness Week. In honor of this, I would like to encourage all in the health and fitness industry to research on this topic. I know first hand, the devastating effects of this illness and have been victim of the ignorance that surrounds this issue. Smashing the stigma of disordered eating, warning signs.....and informing non- certified nutritionist trainers on the dangers of prescribing diets to clients is my personal mission this week. #1- Eating disorders very rarely are just about "weight". - Though generally weight and food are the main focus....it is more about the ability to control something....anything....it just so happens that the concentration of control is the number on the scale and calorie counting. #2- Eating disorders are considered a mental illness. - Yes, it definitely starts as a mental illness, such as the likes of OCD, ADD, Bipolar disorder, and Depression/anxiety; however, the mental aspect of the disease quickly manifests itself physically. Many of the effects of severe eating disorders are not reversible and even in remission, the health issues can last a lifetime. #3- Eating Disorders go largely undiagnosed. - This used to be considered to be more of a female illness. Nothing is further than the truth. Men suffer in silence due to the stigma and shame attached to the label of eating disorders. The gym hosts many men, (some in competition), that are body dysmorphic, make it a practice to binge on high calorie food for a season followed by starving themselves of necessary macronutrients in the name of "shredding". #4- Eating disorders have the highest mortality rate of any mental illness. - Many think you only die if you literally starve yourself to death, but the truth is, suicide, ruptured gut/esophagus, low blood pressure/electrolyte imbalances that affect the heart are the biggest reasons of death. Many lose their life while recovering. This brings up the very serious subject of refeeding syndrome. WARNING SIGNS!!!!!!!! - obsession with calorie counting (yes, even the count- my- macros line of thinking) -baggier clothes with dwindling body size -the constant "am I fat", or "I'm too small" comments -hair loss - low sex drive - dry mouth/bad breath -over supplementation -digestive complaints - insomnia - people pleasing personalities -perfectionism -high stressed/high strung -gray or yellowing/dry skin -ridged fingernails Now, I'm not saying that any of these things singularly point to someone in, or at risk for developing an eating disorder, but if you notice many of these issues, then keep an eye out. Pay attention. Clients and trainers have a rare relationship. People are much more likely to divulge their eating issues with you because of the nature of the trusting relationship. How does this apply in a fitness professional's scope of practice? It comes down to responsibility. If you are not a medical professional, it is your duty to know the scope of your practice and act appropriately. Direct any client that has disordered eating to their doctor and/or therapist. Too many trainers are selling "food prep" programs when they are not certified nutritionists. The mentality of clients needs to be taken into consideration. Yes, a trainer may know how to get a client to lose 20 pounds....but is it always appropriate to give them what they want versus what they need? Trainers are to be encouragers and teachers. Our choices in training and food guidelines can shape how clients view health. So stay informed, continue education and be responsible. Metabolic backlash, food intolerances, and other ailments can arise with an inappropriate food/training program, if the entire clients health...including mental is not fully investigated. We need to remember that first and foremost, fitness is about health....not just the "body". If we treat clients' body only...without considering their total well being, then we are feeding into disordered thinking....as well as eating.

HAES.....really?

I'm sure by now we have all heard of HAES, or Health At Every Size; though this is a "feel good" theme, is it the messege we want to send to people? Children? I may catch a bit of flack for this, but I'm going to share my views and hopefully open up a healthy discussion on this issue.

I do not believe that thin is necessarily beautiful, nor do I think fat is. For me it is not about the size, it is about the healthy glow, the optimal physique for each body type. Simply stated, it is about being the best and HEALTHIEST version of oneself. That statement may seem cliche, but I personally find it to be true. The HAES movement was made popular in light of the "Fat Shaming" movement. No, I did not come up with that title...it's really a thing! As a fitness professional, I do my best to continue eduaction in form of classes, seminars, relationships, discussions, even using myself as my own guinea pig; when I stumbled upon an entire rabbit hole of YouTube videos on fat shaming and HAES. The debates were endless, and honestly, I could see both points of view UNTIL.....I heard one particular statement. "If we embrace obesity and celebrate it...then why aren't we embracing anorexia"? Taking clean eating (and the amount) and exercise (and the amount) at either end of the spectrum out of arguement. THAT got me. Saying that a severely obese individual does not suffer any consequences due to the excess weight would be ludicrous. I am not arguing the reasons for obesity. Yes, there are metabolic issues, hormonal dysfunction, etc... that can contribute to weight gain, but with 190 billion dollars in the U.S. being spent on research and treatments of obesity and obesity related illnesses each year, I think we have to examine our messeges. Do I believe you can be beautiful at any size? Absolutely! Do I believe you can be healthy at every size...mmmm.....I'm not really buying into that. As a former severe anorexic/bulimic....I know that at times in our lives we feel invincible. We are not quite aware of future illnesses and complications we may suffer through the decisions and actions we make today concerning our nutrition/exercise AND their amounts. I personally suffer several permanent effects from my eating disorder past that didn't surface until after recovery. It would be a disservice to send the messege to the public, that obesity is not harmful. If health issues are not apparent now, I will assure you that difficulties in health will appear sooner or later. I feel that education on obesity and eating disorders is more fruitful than shaming anyone, but I also believe that "Healthy At Every Size" is a myth and should not be encouraged. Please feel free to share your opinions...just please...keep it clean and respectful! God Bless!