Currently, I am training one client who is recovering from a double hamstring strain, and another recovering from double hip replacement surgery.While this may seem strange, it really is more common than you may think—injury rehabilitation that is. The chain of health care begins with the physician, usually followed by a physical therapist, and often ends with a personal trainer. A physical therapist’s sole focus is to rehab the injury in order to regain normal function, or as close to that as possible. However, insurance restrictions often cover therapy only for a minimal amount of time, leaving the patient to fend for himself and continue to work on his/ her own following therapy. Most of the time the rehabilitation ends there. So in my line of work, it is getting more and more common for people in this position to approach a personal trainer for post-rehab training.
As you may have imagined, training a client recovering from hip replacement surgery or a strained hamstring requires very special consideration in order to strengthen the areas in question, while not worsening the injury in the process. Each case is unique and should be handled as such. I usually begin by giving the client a form to pass on to the physician, asking for any limitations and recommendations as far as the client’s training is concerned. The physicians are usually more than happy to cooperate and pleased at the same time that the trainer is taking the time to ask for the physician’s professional advice. From there, I research the injury, and using the guidelines provided by the physician, design a training regime for the client.
In the case of the hip replacement, quite a few restrictions were in place: no bending over, no angles greater than 90 degrees, and no twisting, due to the increased chance of the hip dislocating. These types of restrictions require special exercises that are safe and within the recommended guidelines, as well as effective for the injury in question. The goal was to strengthen the hips and surrounding muscle groups, while at the same time increase flexibility and prevent any further injury. We began with compound exercises like partial wall squats with the help of a therapy ball, and simple standing exercises coupled with exercise tubing to improve balance and increase overall strength. I also incorporated some specific hip exercises that my client performed while lying on a bed in order not to exceed the 90-degree angle rule, as well as stretching exercises. My client quickly progressed, improving overall balance, strength, and flexibility. In the next phase we moved on to some dumbbell exercises along with additional stretching and exercises from the floor once we were given the okay to do so by her physician. Currently my client continues to improve on a regular basis, and her physician is very happy with progress.
The point to be noted in all of this is that personal training has a place in the healthcare system chain, and is becoming more and more commonplace following physical therapy. In part due to the minimal amount of time that a physical therapist is usually allowed to work with patients, and in part because it can be very confusing for a patient to continue on his/ her own without any guidance. However, if you are currently in this position or find yourself to be sometime in the near future, I highly suggest you research your candidates closely and ask your physician for referrals. Good lines of communications should remain open between the trainer and the physician throughout the course of training, most of which can be accomplished by communicating by fax and paper through the client. So if you find yourself in need of post-rehab training, I highly recommend you look into retaining the services of a personal trainer. Just do your research and be sure that the trainer you are considering is certified through a reputable organization.
Melissa Allen, BS, CPT, CES is a certified personal trainer, corrective exercise specialist and Medifast health coach, is the owner of the Optimum Condition Corrective Exercise & Performance Center, located in El Cajon, in the East County of San Diego. We specialize in customized fitness training and corrective exercise for both recreational athletes and post-rehab clients, as well as guaranteed weight loss programs or your money back. You can schedule a free consultation to help you get started. Please visit her website at OptimumCondition.org.
