Training a client with a chronic injury is no small task. This is especially true if a client is injured and the injury has gone undiagnosed and, as a result, untreated. It is generally outside the scope of practice for a personal trainer to diagnose or treat an injury. Personal trainers are not, by education and license, diagnosticians or physical therapists. Rather, personal trainers are “suspect-itians.” In other words, personal trainers might have an inkling or idea of what could be causing some discomfort based on a client’s description (e.g., tendonitis, shin splints), but health and fitness professionals are not (as a general rule) qualified to say: “You have X and you need to do Y.” (Note: The exception to this rule is a personal trainer who possesses the requisite skills and licensure, such as an athletic trainer license or other acceptable certification, to operate outside of this generalization.)
It is generally considered best practice for personal trainers to refer a client with a suspected chronic injury to a treating physician who can make a second referral to an orthopedic professional, physical therapist or athletic trainer. To remain within your identified scope of practice, do not try to diagnose or treat the suspected injury yourself. It is recommended to obtain medical clearance so that any exercise recommendation you make or program you design will not aggravate an existing condition. Use the prescribed exercises provided by the medical professional and incorporate other appropriate activities to balance the program (e.g., flexibility, mind-body exercises).
When it comes to working with clients who have had a previous injury and/or suffer from continuous complications from an unhealed or recurring injury, there are considerations to keep in mind while staying within your scope of practice. A few of the most common injuries you may encounter include:
General Signs of a Chronic Injury
According to the National Institutes of Health (NIH), common signs of chronic injuries include pain during activity, pain or an aching sensation when at rest, and swelling at the site of injury. While there are “at-home” remedies and treatment options for acute injuries, it is advised to seek medical treatment under the following circumstances (National Institutes of Health, 2016):
Severe pain, swelling or numbness Inability to place weight on the area Pain accompanied by increased swelling, instability or joint abnormality Bursitis
What is it? Bursitis is an inflammation or irritation of the bursa sacs,