It's generally accepted that 80 percent of the adult population will experience spinal issues at some point in their lives. This means most personal trainers must eventually decide if they're willing to work with a client who has lower back pain (LBP). While it is certainly doable, you should take a series of steps to avoid further injuring your client. Yes, business insurance for fitness professionals will help if it happens. But it's better to avoid the situation in the first place.
Before you begin, determine whether you're dealing with a low-risk issue or a situation requiring a doctor's attention. If the client is experiencing severe or constant pain, send them to see a physician right away. If there is no apparent cause for the pain, they should also visit their primary care physician. Other red flags include a history of cancer or anything you feel uncomfortable judging as a fitness professional. In those instances, stop talking and recommend they see someone qualified to provide an accurate diagnosis.
LBP can be a manifestation of a number of different maladies. As a personal trainer, you're in no informed position to diagnose them, treat them, or work with acute symptoms. (That is, unless you're also an MD who specializes in skeletal issues.) Before agreeing to work with such a client, have them get a note from a doctor saying it's OK. Once you have that in hand, you can then proceed to develop a regimen capable of working around the problem.
In most cases, you'll want to focus on muscle groups capable of supporting themselves without leveraging that region of the body. In other words, avoid anything that would require the client to use their lower back for leverage, or as a hinge. While some trainers might be tempted to “stretch and strengthen” the lower back, consider the potential for exacerbating the condition. This is why most experts recommend working on the body as a whole, rather than targeting that area.
Often, when clients try to accomplish more than their musculatures can handle, the spine is called into play. This means you'll need to monitor your charge more closely to ensure they are well within their range of capability. Working with an LBP often means retraining the body's movement patterns to reduce spinal stress. Ultimately, you want to work toward strengthening their core, without making the injury worse.
Yes, you can train clients who have lower back pain, as long you keep all the foregoing in mind. Assess the situation, confirm they're OK to be working, and avoid stressing the traumatized area. While it's a rare occurrence, keep in mind it's very easy for a client to say you made their problem worse. To avoid this, carefully document all your efforts on their behalf.
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