What sets a Medical Exercise Specialist apart from a Personal Trainer?
Exercise is not one-size-fits-all. Especially when you’re living with a medical condition, recovering from surgery, or dealing with physical limitations.
For someone managing diabetes, cardiovascular disease, an autoimmune disorder, a neurological condition, or a joint replacement, the way an exercise program is designed and monitored can be very different from traditional personal training.
As a Medical Exercise Specialist, Rivak Hoffmann works with individuals whose health histories require a more specialized approach to exercise. He also works closely with members of the medical community when appropriate to help bridge the gap between healthcare and ongoing physical activity.
The question to consider is:
What Sets a Medical Exercise Specialist Apart?
What Does a Medical Exercise Specialist Do?
Quite simply stated, a Medical Exercise Specialist is a fitness specialist who typically has a medical background and designs and implements safe programs for people with specific medical conditions or disabilities.
In many cases, they act as intermediaries between fitness and health professionals.
Rather than approaching every client with a traditional personal training program, medical exercise considers how an individual’s diagnosed medical conditions, medications, previous surgeries, physical limitations and healthcare recommendations may affect the way that person should exercise.
How Is a Medical Exercise Specialist Different From a Personal Trainer?
A professional with a Medical Exercise credential often has a long history of working in the healthcare industry and a strong understanding of internal medicine and how diseases or syndromes affect different systems of the human body. This is coupled with extensive training in Medical Exercise programming and implementation.
This is what sets the Medical Exercise Specialist apart from the standard certified personal fitness trainer.
That is not to underestimate the skill set of a certified personal trainer. Rather, Medical Exercise Specialists and traditional personal trainers often serve clients with very different needs.
General personal training clients are frequently interested in goals such as weight loss, general strength and conditioning, flexibility and improved overall fitness.
Medical Exercise clients, on the other hand, may be exercising while managing chronic inflammation, joint pain, blood sugar regulation, heart disease, joint replacements, autoimmune disorders or degenerative neuromuscular conditions.
For these individuals, understanding the underlying medical condition and how it may affect exercise can be an important part of program design.
What does that look like in practice? We’ll review that below by covering several examples of medical conditions that can require a more specialized approach to exercise.
How Is Exercise Approached for Diabetes and Cardiovascular Conditions?
Type 1 and Type 2 Diabetes Mellitus
Monitoring and adjusting exercise modalities can be critical for blood sugar control and for reducing the risk of serious complications during a training session.
Individuals with Type 1 or Type 2 diabetes can respond differently to exercise depending upon factors such as blood glucose levels, medications, exercise intensity and duration.
A traditional personal trainer may not have the specialized background required to address these considerations. A Medical Exercise Specialist with the appropriate training and background may measure and chart blood sugar levels and blood pressure during a specific training session.
Understanding these physiological responses can help the Medical Exercise Specialist appropriately adjust exercise modalities around the individual’s medical condition and established healthcare plan.
Hypertension and Coronary Artery Disease
Many individuals with hypertension are taking ACE inhibitors, calcium channel blockers and beta blockers to help keep blood pressure within safe ranges.
Uncontrolled hypertension can lead to serious health consequences, including vascular complications, cerebrovascular events, kidney damage and vision problems.
Having an experienced Medical Exercise Specialist who understands the effects of hypertension during exercise can therefore be particularly important for a client’s ability to complete an appropriate exercise session.
Blood pressure vitals and oximetry may also be performed during exercise sessions when appropriate.
Medication use is another important consideration. Because certain medications can influence heart rate, blood pressure and an individual’s response to physical exertion, the exercise program needs to consider more than simply whether the client feels capable of completing an exercise.
What Exercise Considerations Are Important for MS, ALS and Autoimmune Disorders?
Multiple Sclerosis and Amyotrophic Lateral Sclerosis
Multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) are serious neurological diseases that can affect voluntary muscle control and physical function.
Muscles can weaken as these conditions progress, making the selection and progression of exercise particularly important.
Having an appropriate exercise program that considers neuromuscular function can play an important role in supporting an individual’s physical abilities and quality of life.
For someone living with MS, ALS or another neurological condition, exercise programming should account for the individual’s diagnosis, abilities, limitations and recommendations from members of the healthcare team.
The objective is not to treat the underlying neurological disease through exercise. Rather, Medical Exercise Training can provide appropriately selected physical activity that supports function and quality of life within the parameters established for that individual.
Autoimmune Disorders
Autoimmune disorders can present an entirely different set of exercise considerations.
These conditions include Myasthenia Gravis, myopathies, lupus, rheumatoid arthritis, Graves’ disease and Hashimoto’s thyroiditis, among others.
Individuals with these medical conditions may experience chronic inflammation, muscular weakness, joint deterioration, thyroid dysfunction, extreme fatigue or muscular inhibition.
Understanding these conditions is integral to making appropriate choices in exercise design.
For some individuals, that may mean using alternative gentle activities or shorter “micro sessions” rather than continually challenging the individual with longer or increasingly strenuous workouts.
Understanding an individual’s rate of perceived exertion (RPE) can also be critical for success. Exercise that is appropriate for one person may be excessive for another person managing fatigue, inflammation or muscular limitations associated with an autoimmune condition.
The goal is to appropriately challenge the individual without ignoring the medical condition that may influence his or her response to exercise.
How Can Medical Exercise Support Individuals After Knee or Hip Replacement?
Post-operative knee arthroplasties and total hip arthroplasties are another situation in which understanding anatomy, biomechanics and joint limitations is particularly important.
The majority of prosthesis materials used today consist of titanium, cobalt chromium, ceramic or plastic.
Normal range of motion can be inhibited post-operatively because of post-operative tissue fibrosis and limitations associated with the specific prosthesis, which does not precisely duplicate the normal range of motion of a natural joint.
Understanding range of motion and a joint’s limitations under the influence of axial load is critical when developing an exercise program intended to protect the prosthetic joint from unnecessary stress, fracture or dislocation.
It is also important to understand that prosthetics have a specific lifespan.
For someone returning to regular physical activity after a knee or hip replacement, exercise programming should therefore consider more than simply rebuilding strength. Range of motion, loading, exercise selection, progression and the limitations of the prosthetic joint all need to be considered.
Medical Exercise Training can help bridge the transition from the medical and rehabilitation phases of recovery into appropriate ongoing physical activity once the individual has been cleared to progress.
Why Is Communication With Your Healthcare Team Important?
For Rivak Hoffmann, Medical Exercise Training is not simply another form of personal training.
His experience working with individuals who have complex medical histories allows him to look beyond repetitions, sets and calories burned and consider the physiological factors that can influence how an individual responds to exercise.
At Scottsdale Active Aging, Rivak works individually with clients to understand their medical history, diagnosed conditions, medications, previous surgeries, physical limitations, current abilities and personal goals.
When appropriate, he also works closely with members of the client’s medical team.
This individualized approach can be particularly valuable for older adults who may be managing several health considerations simultaneously.
A client, for example, may not simply be an older adult looking to improve strength. That individual may also have a previous joint replacement, hypertension, medications that affect his or her response to exercise, or an autoimmune condition that influences energy and recovery.
Those factors can change how an exercise program should be approached.
The goal is to determine the type of exercise, intensity and progression that are appropriate for the individual while helping that person improve strength, mobility, function and overall quality of life.
For Rivak, successful Medical Exercise Training is ultimately about understanding the person behind the medical history and designing exercise accordingly.
