The CPT’s Guide to Training Clients With Arthritis

Pain is one of the most difficult subjects to tackle for personal trainers. Ideally, your clients will never experience pain. In fact, if the client is experiencing sharp pain while working out, stop! This is when it’s time for a client to see a medical professional to ensure that they are still safe to train.

However, there are other types of pain that aren’t necessarily from an injury, and might just be the result of a condition such as arthritis.

For this, it’s still essential that your client get permission from their doctor to train with you, and to get specific instructions on what to avoid for their situation. Assuming that this has been done, what, then, do you need to keep an eye out for when it comes to arthritis?

What is Arthritis?

First and foremost, arthritis is a general term that refers to several diagnoses associated with joint pain and joint disease. Let’s talk about a couple of them, and what the Arthritis Foundation has to say.

Degenerative Arthritis (Osteoarthritis)

The most common degenerative arthritis is osteoarthritis. This is where the cartilage surrounding your joints has worn away, and bones start rubbing against one another. This causes pain, swelling, and stiffness.

This might sound painful—and it is! But, that being said, regular exercise is highly recommended for this condition. At this point, you, the personal trainer, are becoming a part of their treatment of the condition. In fact, the Arthritis Foundation states that the best way to prevent osteoarthritis is by staying active and maintaining a healthy weight.

Inflammatory Arthritis (Rheumatoid Arthritis, or RA)

In this version of arthritis, your own immune system is attacking the tissue in the joints, causing inflammation. Make sure your clients who suffer from this disease get permission to train.

RA patients can often have pain in the joints that impede function and quality of life. Compassion and encouragement are going to be the order of the day for arthritis sufferers of all types. Just remember that sometimes there’s very little they can do to prevent the pain. Some will choose to train anyway. Provided they have approval from a doctor or rheumatologist, make sure to be their biggest supporter in whatever physical activity they choose to do. Some days, RA symptoms will be more extreme than others. Keep this in mind with any arthritic client, especially when disease activity is high.

So, What Can You Do to Help?

First of all, find out what your client wants to do. There are so many different ways to get results, the first thing your clients should do is enjoy it if possible. If they won’t enjoy any exercise, then find another motivator. Maybe total body exercises hit the spots they need to focus on in less time, so they prefer that. Or, maybe they really enjoy isometric exercises that give them a sense of being thorough. They’re already dealing with joint pain—don’t add to their suffering with things they don’t like. Try to find something they’ll enjoy, or at the least, something they can most tolerate.

Exercise is going to be a great course of treatment for most arthritic people. This includes aerobic exercise, resistance training, stretching, and recovery. With that in mind, let’s talk about the facets of your exercise program that you should pay close attention to when training people with painful joints.

If they have a physical therapist, or are doing physical therapy, those exercises can be incorporated into their program to help.

When Doing Resistance Exercise

When it comes to arthritis, resistance workouts—like weight training or strength training in general—are going to serve a very important purpose for your clients because they increase muscle mass. Muscles wrap your skeleton and work with your skeletal system to keep up the structure of your whole body.

So, with arthritis, let’s say you have a client suffering from knee osteoarthritis, or knee arthritis for short. The joint is compromised. So, to increase functional mobility, strengthening the supporting tissue of that knee can, in some instances, help to relieve pressure on the knee. This won’t stop all the pain, but it can mean a reduction in pain, as the joint isn’t having to do as much work.

So, in this case, focusing on muscle strengthening around the knee is going to help. Now take this and apply it to the other joints. Arthritis pain can be tricky to deal with, but the stronger your clients’ muscles are, the better off they’ll be.

When Doing Aerobic Activity

In this, one of the most important things for you to look for is stiffness in the joints, pain, and discomfort. Low impact is probably going to be the most successful strategy here. This means that aquatic exercise, or water exercise, is a great way to get in aerobic activity without making their problems worse.

An aquatic environment gives you the opportunity to train with barely any impact at all on the joints.

For those who don’t want to get in the water, consider a rowing machine, an elliptical, or something along this line of thought. The key is to make it low impact.

If they’re already running on their own, just ask them frequently about how they’re feeling and how their joints are performing.

Building Rapport is Key

Personal training is a service industry. So it shouldn’t surprise you to learn that how you interact with people is just as important to your professional success as your ability to program and teach exercises.

This is even more important when it comes to any client you have suffering from a chronic condition in which there is no clinical fix. They are rockstars for even making it out to the session. Treat them well. Encourage them. Support them.

They will need to feel safe with you in order to ensure they are actually reporting their pain and activity levels.

Take the time to check in with them. Even if it seems redundant, it also communicates that you care. But when you check in, just remember, listen! Part of what they are paying for is your ability to do what they might not be able to do themselves—motivate them to exercise! So be the great motivator they need.

Compassion Should Be Your Guide

When training someone with arthritis, sometimes your entire plan will have to change in an instant. They walk in, you’ve had your plan together for them, but they just don’t have the energy, or they have been having an arthritic episode all morning and just don’t want to train hard.

This is totally fine! In these circumstances, this is when listening is critical. Hear what they’re feeling. Then, come up with something that they can do that day. Remember that the ultimate goal is not your programming for them, the ultimate goal is to get them moving as often as possible. They could spend the entire session doing stretches, and this would be a major success!

Just make sure that you acknowledge that they’re feeling terrible, and see what their body will say yes to in that moment. Do not force a workout on them or push them to their limits when they are in chronic pain or having an episode. This is where your adaptability really matters.

Weight Management Over Weight Loss

People who suffer from arthritis tend to have even worse cases when they are overweight. But there shouldn’t be a “weight loss” mentality with these clients. Rather, keep “weight management” in mind. When people get into thought patterns of always losing weight, eventually they can develop unhealthy habits by losing too much weight.

But when you think of it as weight management and body acceptance, you can make it less about the number on the scale and more about what they need to be healthy and live well.

If you are interested in learning about how diet can affect arthritis, check out more here!

Remember, the benefits of exercise for arthritic clients can include:

1. Increased and improved mobility

2. Better quality of life

3. Decrease in chronic pain

4. Greater independence in most things

5. Improved fitness and wellness

Help clients achieve their fitness goals and a better quality of life by getting certified as a personal trainer! You’ll learn the science behind exercise, how to work with special populations (such as arthritic clients), and how to build a successful business. With ISSA’s Personal Trainer course, you can learn online, from the comfort of your own home—get started today!