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The Fitness Zone

Training Clients with Back Pain
September 12, 2013 | by Josh Pullman

Back pain is one of the most common physical ailments clients will present to their Personal Trainers, so you need to know what to do says Josh Pullman, Australian Institute of Fitness QLD Master Coach.

Most people take for granted how great it is to have a healthy back, until they become injured! This type of pain is not an injury to be taken lightly, and referral to a physio is a smart move if the problem persists.

However, there are a few things a great Personal Trainer can do to minimise the risk of back pain in their clients, and be of most assistance to them. These include:

1. Have a great system for screening your clients. Always conduct a postural evaluation to identify any potential tight, weak or unstable areas, then follow up with a flexibility assessment to help confirm your findings. This will give you guidance as to how best program for your client's needs.

2. Prevent rather than cure. Muscle activation exercises and trigger point work at the start of a workout can go a long way to ensuring most of the load during strength training is accounted for by the correct target muscles, rather than smaller muscles that we have for stabilising or supplementary actions. The specific muscles you focus on will depend on what you learn in the postural evaluation and flexibility assessment.

3. Do your research. The brightest minds in biomechanics identified trunk flexion-rotation movements as being by far the greatest cause of back injury in the general population up to 80% of lower back injuries are linked to this movement, particularly when under load. Be vigilant in ensuring the exercises you choose are safe. Train your clients as smart as you do hard, and remember to ensure your clients earn the right to progress onto more advanced exercises. Just because it looks complex and flashy, doesn't mean it's conducive to a safe and effective workout.

4. Develop a strong, stable platform in your clients. Investigate and become proficient in exercises that help to take the stress off your back by developing the muscles that are supposed to support it.

5. Improve your own learning. Attend specialised courses on screening, rehabilitation and pre-habilitation so you are confident in training clients with lower back challenges, and know how to best prevent future back pain. We highly recommend the Rehab Trainer course.

In summary, your client only has one back, so we need to help them protect it. Screen your client's posture and movement patterns thoroughly, and then invest some time in some pre-habilitation exercises to ensure your client has great technique when it counts. Make the effort to understand the basics about back issues, and choose trunk-strengthening exercises that build a great platform for safe, effective movement.


Josh is a past Master Coach from 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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