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Principles for Modifying Corrective Exercises for those with Limited Mobility


Everybody is different, which means every body is different. When you’re instructing your clients through exercises, you have to cater to each individual’s body: their shape, their current state of fitness, and their range of motion to name a few. It’s especially important to consider your client’s mobility level if they have tricky knees, hips, ankles, or shoulders. Here are a few principles for modifying limited mobility clients using corrective exercise.

Important Note: As a personal trainer, you always want to practice inside the scope of your work. You should always perform a PAR-Q on every client to assess safety and to determine if they fall within the scope of your work.  If they answer “yes” to any question in the PAR-Q, they may need a doctor’s release to exercise.  Additionally, them may need other services that fall outside the scope of practice for a personal trainer, such as physical therapy for rehabilitation of an injury. 

Why Is Corrective Exercise Important for Clients with Limited Mobility?

Limited mobility can result from a variety of reasons: old age, obesity, joint pain, paralysis, and more. Besides pain relief and evasion, a few benefits of corrective exercise for limited mobility clients are: 

Decreased metabolic demands: In most gym settings, the emphasis is placed on pushing yourself to the limit. How much are you sweating? How hard are you breathing? How loud are you grunting? Corrective exercise can keep your client from getting overwhelmed at the gym and focus on what their own body needs.

Improve Confidence:
When you give a client a corrective exercise to perform, you’re giving them a task they can more easily fulfill. Your limited mobility clients won’t likely be able to perform squats with load on their shoulders, but they can do another exercise that will work their thighs, raise their heartrate, and boost their confidence while decreasing the risk of injury.

Improved motor control and muscle mass: For many clients, limited mobility is a result of not using certain muscles, causing them to be stiff. Corrective exercise enables clients to focus on what they can do, not what they can’t, and overtime, they’ll improve range of mobility and motor control on top of confidence. 

Importance of Warm-ups for the Limited Mobility Client

For most clients, joints, ligaments, and muscles will have some level of inflexibility at the start of a workout (Hall, 2017). Consider, then, just how much more important a warm-up is for clients who have been in physical therapy. Depending on your client’s healing progress and their physical capabilities will dictate what type of warm-up will be most appropriate for them. For some, it may be performing low intensity/low impact activity on a recumbent bike, while for others it may be walking on a treadmill or using an Elliptical trainer. 

After a cardio warm-up, static stretches will also be a key element from a corrective exercise standpoint for those with limited mobility. This will help increase joint mobility, allowing them to perform corrective exercises more effectively. The stretches chosen must be specific to the client’s needs, but areas such as the calves, hip flexors and chest to typically key areas that need to be addressed on most with limited mobility.

And after static stretching, depending on one’s capabilities, they can perform basic dynamic stretches as well, like hand-to-toe taps, leg marching, and arm swings to improve neuromuscular control.

Principles for Modifying Limited Mobility Exercises

Change the client’s mindset before you change the physical stance: Changing the client’s mindset can be hugely beneficial before any perceptible changes are made in the body. The first corrective exercise is getting the client to the exercise and see their body differently. Shift focus to overall health rather than visible results so that small changes can seem like big victories. This will be hugely empowering to your client.

Corrective exercise has focuses on form, not intensity: Does the activity targeted to the area you would like to impact on this client?  Can be movement be performed with form that will not result in injury or improper biomechanics? These are the things you want to look at. Check form over how hard they’re working. Your client could be really exerting themselves, pushing their Rate of Perceived Exertion (RPE) score, but if they have improper form, then they could really hurt themselves under your care.

Limiting phrases limit clients: Words have power.  The words that you use with your clients will either help them reach their goals and believe in themselves, or they will do the opposite.  When you are working with a client who has limited mobility, you must get them to focus on what they can do, not what they can’t do.  One of the best ways you can do this is to use positive and reaffirming words that compliment their strengths.  

Importance of Cool Downs for the Limited Mobility Client

Exercise is a stressor to the body that requires time for the body to repair itself before the next stressor. A cool down begins this process, making it especially important for those with limited mobility (Hall, 2017). From a corrective exercise standpoint, static stretches would be most appropriate for these individuals to continue to improve upon their mobility. 

Example Corrective Exercises for those with Limited Mobility

In a recent post, we detailed ways to modify exercises for those with age-related limited mobility [link to article]. Many of the tips and suggestions are worth repeating here as your elderly clients and other clients who need corrective exercise have a few things in common: trick knees and hips, and ailing joints.

Ball Squats and Knee Extensions: Depending on the client’s situation and capabilities, these exercises can help strengthen the thighs and hips in both a more isolated and complex (multiple joint involvement) environment, which can improve limitations that may have at the knee. 
Bridging: These may be appropriate for those who need corrective exercise for knee, hip and low back limitations.
Dumbbell Exercises: Building strength is incredibly important for those with limited upper and lower body mobility. Dumbbells provide flexibility on how exercises are performed (two-arms, alternating arms, one-arm) and limb independence. 
Hand Squeezes: Clients going through corrective exercise for their wrists will strength and alleviate pain doing this exercise.
Rows: If you have clients with limitations in the shoulders, this could be a good exercise to improve their situation. You may need to first teach the individual how to retract their scapulae properly and then progress them to the actual row with scapular retraction.

Specialized Personal Training for Limited Mobility

Whether you’re treating clients with long- or short-term limited mobility, you’re essentially helping clients with some type of physical disability. It’s important to be sensitive to each client’s needs, and you can do that by adding to your physical training education. Strong Education, a sister company for Special Strong (see below), offers personal training classes for individuals wanting to work with adults with disabilities. We’re happy to answer any questions you may have, but it’s always a good idea to broaden your clientele scope.

Special Strong provides adapted fitness for special needs children, adolescents, and adults with autism, Down Syndrome, and other disabilities. Through our online training platform, we also provide special needs certification courses for educators, professionals, and parents who want to learn how to adapt fitness to serve the special needs population.  Fitness franchise opportunities are available.

References
Hall, T. (2017). Warm up and cool down important part of exercise routine. Retrieved from: https://prowersmedical.com/warm-cool-important-part-exercise-routine/.