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The Fitness Zone

How to Train a Client with Bad Knees
March 12, 2013 | by Josh Pullman

A client with bad knees' presents a number of opportunities for a new Personal Trainer who has not encountered an issue like this before, says Australian Institute of Fitness QLD Master Coach Josh Pullman.

By bad knees', we'll assume we're talking about knee pain that restricts correct execution of a common lower body exercise like the squat, or running.

Opportunity #1

Engage with an Allied Health Professional (AHP); namely, the client's physiotherapist. With injuries (or any contraindication to exercise), knowledge is power, for example a doctor wouldn't proceed with surgery for a broken arm until he got an X-ray for guidance.

A Personal Trainer shouldn't start to train a physically impaired client without guidance from an AHP, so write a precise and professional referral and use the AHP's response to provide yourself with the clarity and confidence your client deserves from you.

Opportunity #2

Learn more about the human body! There are plenty of common causes of bad knees' arthritis, tendonopathies, ligament damage, meniscus damage, tear to muscle within the knee joint itself etc. and it could be any number of things causing knee pain.

Aim to get your knowledge base to a level where you understand how exercises can impact your clients, whether they should avoid them or should engage in them to help manage their condition.

What Now?

Contact with AHPs like physios can really help with this area of your game, as can doing additional professional development such as the Rehab Trainer Course.Once you have been provided with guidance and have found out whether 1.) the knee is permanently disabled and is in a state of decline, or 2.) its function can be improved with some smart exercise selection, you can often incorporate the recommended rehab guidelines into your client's sessions.

This may include, but is not limited to:

  • reducing range of movement during compound leg exercises (quarter range squats)

  • sticking to light/bodyweight lower body exercises

  • using low-impact cardio equipment such as the cross trainer and the bike for cardio instead of the treadmill

  • a variety of priming/rehab/stretching exercises prescribed by the physio to improve knee function at the start of the session.

Usually the exercises to avoid are ones that involve excessive knee flexion under load (e.g. deep squats), or any high-impact exercise such as jumping or bounding.

The key when treating any client who is coming back from an injury, is to keep the communication between you and your client so they can keep you aware of how they are feeling physically and mentally. In addition, you want to keep the means of communication open with your clients physio and or doctor, so you can keep them updated with what they are doing in their personal training sessions and how their progress is coming along.

Enjoy this new experience of getting to know your clients' aches and pains, and never stop learning!

If you want to further your fitness knowledge and be able to train those with chronic conditions, then become an Exercise Therapist with the Diploma of Fitness program.

About Josh Pullman

With over 12 years' of coaching experience, Josh is a Personal Trainer, certified Strength and Conditioning Coach, and a semi-professional footballer. He is also the Master Coach at the Australian Institute of Fitness WA.

This content is not intended to be used as individual health or fitness advice divorced from that imparted by medical, health or fitness professionals. Medical clearance should always be sought before commencing an exercise regime. The Institute and the authors do no take any responsibility for accident or injury caused as a result of this information.

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