As a fitness instructor at a big box gym, I encounter folks from all walks of life and in various stages of their life’s journey. It’s one of the things I love most about teaching there.
As such, I regularly have people check in with me to inform me of recent diagnoses or injuries that they have encountered.
(Yay! Do this. Don’t think it doesn’t matter or that the instructor doesn’t need to know. We do. Not because we are nosy, but because there could be contraindicated movements or we just need to give you extra attention that day to prevent injury.)
My standard line is, “Please follow your doctor’s or physical therapist’s advice about what you can and can’t be doing.” Sometimes I will dive a bit deeper if we have the chance and the injury or illness is significant.
Trouble is, what doctors tend to tell their patients about their post-injury, post-surgery, or post-diagnosis limitations doesn’t tend to be very helpful.
Some docs won’t tell patients anything at all, leaving me to either inquire pretty comprehensively into the nature of the problem, or risk a client getting injured on my watch.
More often, a doc will offer up generic advice that seems divorced from the reality of what happens in the group exercise context.
Case-in-point: A client recently disclosed some pretty major surgery to her abdominal region. I asked whether the doctors advised her on exercise, and she replied, “I’m not allowed to do squats.”
I literally scratched my head.
“What is it about the squats that your doctor wants you to avoid?” I prodded. My mind raced with the different possibilities. Is he worried that she will overexert in general? Is he worried about the hip flexion? Is he worried about pressure in her abdominal cavity? On her pelvic floor?
She didn’t know and I had no way of ferreting out the information that I needed to provide her with a safe exercise environment.
Similarly, an octogenarian with an artificial hip has been told by her doctor, “You can do whatever you feel like doing.” Accordingly, she takes me to task whenever I tell her a movement is contraindicated for folks with hip replacements, namely very deep squats.
“But my doctor said I could do anything I wanted,” she says.
“I don’t think you doctor had in mind that you would be doing this,” I explain and assure her that I would rather be safe than sorry with her very expensive hip.
Ideally, anyone who sees a doctor for an injury or chronic condition would be able to walk into my classroom and discuss general issues of load, force and exertion that their M.D. or P.T. wants them to avoid. I need to hear things like:
“I’m not supposed to rotate through my spine for six weeks.”
“I don’t need to add any extra pressure to my pelvic floor until I heal.”
“I shouldn’t be doing anything weight-bearing beyond my own weight until this heals.”
“No moves requiring me to balance on one leg.”
Normally, I can make judgments about what a client shouldn’t be doing based on general explanations of their condition. But if I want to be really safe, I have to ask a lot of intrusive questions and I’d rather not have to delve that deeply.
What can you do? Next time you hurt yourself, are diagnosed with an illness, see a P.T., or are told to limit your activity by a healthcare professional, whip out your notepad and ask some specifics. Ask where you shouldn’t bear weight. Ask whether any joints need to remain immobile and for how long. Ask whether you can jump, run, and lift weights and tell the provider how much weight you usually lift. Give the doc or P.T. sufficient information about your fitness routine so she can make educated suggestions on how to modify your activities.
Then come to class and we can work together to find alternatives to the things you can’t be doing for a spell. Because, as I tell my clients all the time, the worst possible outcome is that you leave my class more injured than you were when you came into the room.