How do I train this guy!?

[Saif291]

Hey all,

I started my second personal trainer job in a gym about 3 days ago, I already have 10 clients and today I got promoted to head trainier for the evening shift, now I have one client who I will be seeing 3x a week he is overweight, high blood pressure, and diabetes, Now I am not concerned with those since I have worked with clients who've had those before, what I never experienced though was a empty knee socket. I know its not actually physicall possible to have no knee, but this client is 38 and has had 16 knee surgeries. He can literally pull his knee cap away from his leg in a sense. he has had surgery on pretty much every aspect of his knee, ligiements,tendons ect. His goal is to lose 60lbs in about 4 months... That is a long shot I know but he wants to really focus on cardio... With his knees as bad as it is Im obviously not going to put him on a treadmill, I was thinking elliptical and bike. I also had him hitting some punching mitts and such to get his heart pumping. Do you guys have any other suggestions I could do to get his heart pumping but without making him move on his knee too much ( at least until I help him strengthen it). thanks folks.

[WoopItsKevin]

First thing that comes to my mind would be a pool...swimming is a great form of cardio with little-no impact on the knees. Other than that the hand bike if you have access to one, or like you said elliptical/bike. Make sure his diets on point obviously. 15lbs/month is definitely do-able but you will have to make sure is calorie intake is on point, not just the cardio.

[PeteratCastle]

I'm with Kevin, swimming is the way to go. (though I wouldn't use a hand bike)

Look into pha type training maybe. You could do this with the bike and lat pull down machine. I quite like PHA as a form of CV training. But you can only do this if his knee can take it. He should know what he can do and how much strain he can put on it, tbh. You could have him walk with a steep incline on the treadmill, maybe?

Just some quick thoughts.

WD on having 10 clients already, how did you go about getting them? Just asking as I remember you saying you might struggle with that

[Achilles00]

I think the punch bag and mitts would be a great alternative to what these guys have already said, swimming, which is always going to be the best option

[big_easy]

I would suggest a rowing machine. Rowing is a full body exercise. Rowing is strength based cardio and allows the knees to loosen and move without impact and stress.

[PeteratCastle]

I would suggest a rowing machine. Rowing is a full body exercise. Rowing is strength based cardio and allows the knees to loosen and move without impact and stress.

I agree, it depends on the ROM of the client though. His knee might go flying all over the place if he rows as the bending and straightening of the legs happens quite rapidly.
I would probably do a full stress test on the knee before starting any program, deffo see if he can take rowing and cycling

[WoofieNugget]

Don't they have any other more experienced trainers that can train this client? Judging from your previous post about sales you're barely experienced at all and suddenly the fact you're "head trainer" at 21 and brand new to the gym tells me of the quality of the place you're working. No offense, but a guy with these conditions is way beyond your experience level and you should probably refer him to another person.

[gabrielsyler]

Do lots of low weight high rep lifting, that'll get him into the cardio zone and allow you to focus specific physio work on his bad knee.

[JoeCannonMSCSCS]

Because of his high blood pressure, do circuit training. Also don't use Target heart rates as his medication will make that almost impossible for you to use. Instead use the RPE scale (0-10 scale).

Can he get into a pool? then do that. has he used an elliptical before? Id think its fine as long as no pain. the EFX elliptical might be best since you can adjust the incline.

Best of all though Id say would be a recumbent bike as its least knee stress.
Remember when it comes high blood pressure, less is more in terms of exercise intensity. keep intensity to 3-4 at most.

I hope you have a CPR cert. If not I HIGHLY recommend you get it now. Get the AED cert too.
Joe