What Do You Want Fitness Instructors/Personal Trainers to Know?

NatsFan

Carol and I are working on a hand out for SUSO that those of us with LE can hand out to fitness class instructors and personal trainers so they are aware of LE issues. 

The idea is to do something similar to the What We Want Our Healthcare Providers to Know about Lymphedema handout on SUSO.  The idea is to give them a brief explanation of LE, and tell them that we may not do certain moves such as downward dog or push ups, why we may prefer not to use exercise bands, etc. 

When I take a new fitness class, I always get to the first class early to talk with the instructor and let them know that I won't be doing certain things that stress the arm, but that I'd like alternate moves.  Most have been pretty good, but I had one yoga instructor who kept singling me out during class because I wasn't doing a full sun salutation complete with cobra and downward dog - this despite the fact that I'd met with her before class and was clearly wearing compression.  A professional-looking handout with facts and specific suggestions would be very useful for both those of us with LE and fitness instructors or personal trainers who may not be aware of LE, and I think would reinforce the seriousness of it for instructors who may think we're just dogging it in class. 

I'm thinking maybe a simple "DOs and DON'Ts" format might be good.  For instance:

• DON'T single out a participant who doesn't do moves that stress the arm and tell them to do it right or make them feel as if they're not "getting with the program"
• DO provide alternate moves - and if possible provide those moves in a general way rather than singling out the participant, such as "For those who may have some upper body or shoulder issues, here's an alternate you can do"

Also, any of you who do yoga or other fitness classes, what do you do as alternates?  For instance, I don't do downward dog on the floor, but will do a wall version or even just a simple forward fold.  Same with pushups - I won't do floor pushups, but I will do wall pushups.  Any other ideas?

 

purple32

Nats and Carol- what a great idea !

When I was looking into the LIVESTRONG program at my YMCA I suspected at that time that I might have breast truncal LE and knew very little ( even less than I do now  :>)  about LE.  I was afarid to go there because although they worked with cancer pts ., When I called, I asked if they worked  specifically with ppl. with LE and they said no.  I actually think it is irresponsible of them to promote their free exercise programs to women who have had BC surgeries and treat them as if they are at no risk for LE ( when in fact they may be creating a risk!)  All this to say, I would also love to see this in the hands of all YMCAs.

The top of my list would be :

" Don't ask BC/ LE pts. to do moves with repetetive arm movements as it may pose a health risk or induce swelling"

"Don't expect BC/LE pts  to participate in weightlifting without clearance from a DR or LE therapist. "

"DO encourage women who have had BC to consult their medical team and see it is is advisable to wear a compression sleeve/ glove during exercise."

DO look into safe weight lifting programs for women who have or are at risk for LE - be sure to consult physicians and LE therapists before proceeding.

DO encourage  women who are exercising to take several water breaks.

DO ask women who may have arm fatigue to stop their exercise  rather than to subscribe to the  'no pain/ no gain' theory.

That's it for now - hope it helps some.

Thanks for doing this !

SpecialK

I participate in Livestrong at my YMCA and they are very accomodating about my LE.  Livestrong has now revamped how they assess and all the personal trainers at my Y are familiar with LE.  If we do an exercise that is a no-no for me, I just substitute an approved one from my LE PT.  They did want to look over the exercises my LE PT provided, and I always wear bi-lat sleeves-gauntlets to the class.  They also have a gentle chair-bases yoga class twice a week, no body weight on the arms.  I substitute a lighter handweight if needed, and also bring my resistance bands provided by my LE PT and will use them if the exercise station (we do circuits in a group class) is one I shouldn't do.  Actually, most of the people in my class do LESS than I do.

mdg

I am a bcc survivor and a fitness professional. I teach aerobics and use to be a personal trainer. I don't have LE but if I can help in my way let me know. Feel free to PM me with any questions. I do also take yoga. Quite honestly I have not had to modify my workouts too much except chest exercises. I do realize that not everyone is that fortunate. I also plan to start teaching some fitness classes in January at my local cancer center so if you have any LE resources you could share with me I would really appreciate it.

carol57

Purple and SpecialK, thank you!

mdg, we're practically neighbors (kinda sorta...I'm in SW Michigan)!  NatsFan and I will happily take you up on your offer to help, and I'm going to PM you now so I can get you a working draft of part 1 of our project, which is designed for personal trainers and has a heavy dose of weightlifting precautionary notes. 

What NatsFan and I are hoping will surface from this thread, is suggestions for the part of our piece that is aimed at all the folks who teach classes, such as step and other cardio routines, yoga, etc.--people who may not be personal trainers but who include lots of exercise elements that may pose LE risks.

Any other personal trainers, yoga instructors or exercise class leaders seeing this thread: we want to make this a very positive and helpful set of guidelines, so please let us know if you'd like to help!

Carol

purple32

That is great to know, specialk .

Perhaps a " Do's and Don't " list such as the one being proposed would be soemthing the LIVESTRONG program at my local Y would welcome.

Thanks to any personal trainers who are willing to help with this project !

PersonalTrainer

I'd be happy to help.  I'm both a personal trainer and an exercise instructor.  I teach many types of classes.  Actually - reading this thread, I was thinking a fact sheet on LE would be nice to have to give to my class participants - I spend a lot of time explaining my sleeve and glove every day!  Just this morning in between classes I spend a good five minutes I really didn't have (time is tight between classes) explaining the lymphatic system.  When it's so obvious you're wearing a sleeve - teaching about LE becomes part of the job.

First - I wouldn't put "don't single out the participant" on the sheet.  You don't want the instructor to be intimidated into not giving you correction during class.  A professional instructor should know how to properly correct your form subtily - without making you feel like a dunce.  Many people who take my classes have a injuries or issues where they can't do some of the moves - it's a bad instructor who would insist on them doing something they aren't supposed to.  We do appriciate when people let us know ahead of time the issues they have - that way we won't try and get you to do something you've told us you can't.  I also make alternative sugestions for people on moves I'm going to do in class when they come to me and tell me they can't do something ahead of time. One of the things I generally say when I'm making my introductions at the beginning of a class is "Please modify the class as you need to." 

That said - you can't always expect us to be able to give you individual instuctions all the time.  Things like taking an extra water break to stay hydrated - you just need to do that on your own.  We can't slow the pace of the class to take a long time demonstrating an alternative exercise for you - or by calling extra water breaks.  But a good instructor will understand and not make an issue when you're doing something slightly different from the class - and we often can give you a different exercise - just not always as we're teaching a lot of people.  For example, I have a woman who has Erb palsy who takes my bootcamp class.  When we're doing something overhead - I'll often catch her eye and quickly demonstrate a rep of an alternative for her.  But you have to remember that classes aren't personal training.

With LE being such an individual thing - I might focus the fact sheet on what LE is and some general things you might not be able to do, like putting weight on an arm, or using bands.  I'm fortunate - or I'd be out of a job - that my arm likes when I lift heavy weights and do things like pushups or planks.  That said - as an instrutor I have to demonstrate perfect form so, while I do lift heavy, I don't lift so much that I'm over my limit to finish the last rep. 

As a personal trainer - when I agree to take on a client with health issues or an injury - I make it my business to learn what to do and not do for that person before I make a program for them.  For example, I had a client with MS who had real problems with heat - I found a spot in our building to work with her that was well air-conditioned and we only scheduled sessions for times that room was avalible.  I've had many clients with issues - in fact most of my clients have something wrong with them  - but as part of our certifications, we know never to take on any client who has issues beyond our scope of practice.  It would be helpful to get a fact sheet from potential clients if they have an issue.  Just because a personal trainer has never worked with someone with LE (or whatever issue) doesn't mean they can't - what they need to be is willing to listen to you and willing to do the research to learn what exercises will help you and what will hurt you.  I wouldn't hire any personal trainer who isn't interested in listening and learning. 

carol57

PersonalTrainer, thank you! What a wonderful, detailed post.  I'll be PMing you to see if we can get you a copy of our working draft of the document, for your comments and suggestions.  A handout for people taking classes, or even who begin a personal training session, is a wonderful idea! When we're done, these documents will be available on stepup-speakout.org for download, so free to anyone who needs them or knows someone else who could benefit.

Anonymous

Carol and Mary, I have comments but will get them to you tomorrow. Still laying low with back pain. I am so pleased you guys are working on this kind of handout!

PersonalTrainer

Sure - send them over when you have a rough draft.  I think it's a great idea and I'd be happy to help

LuvLulu07

I'm happy to help also.  I'm a pilates instructor and Pink Ribbon Program certified.