The Personal Trainer’s Guide To Injury Prevention
How To Keep Your Clients Healthy, Happy & Achieving Results

Keeping Your Clients Healthy Needs To Be Top Priority

As a coach, the last thing that should ever happen under your watch is your client or athlete hurting themselves. Some injuries, unfortunately, happen and are unpreventable. But as a coach you must injury prevention must first be prioritized over performance in order to unlock their full potential to achieve physical longevity and maximize performance.

The fitness industry is filled with new coaches and trainers. And being new to the industry can be an overwhelming experience. However, having the right tools and strategies in place can help insure your success as an up and coming coach is pivotal.

As a new coach or personal trainer, do not fall into the black hole of trying to look good or sound smart to impress your clients. More often than not, they don’t care about the scientific terms, fancy words, and cool training techniques you’ve just learned. They care about getting results and not getting hurt. Results are king, and that is a fact. And delivering results while seamlessly keeping your clients pain and injury free is an essential component to being a great coach.

Maximizing your clients’ physical autonomy is what’s going to keep them coming back. If you can instill self-sufficiency and deliver results while keeping them pain free, you will have a long, fruitful career. A good trainer can help clients lose 20 pounds or up their bench press, a great trainer can change a client’s life through results that far surpass superficial focuses.

In order to keep our clients healthy, happy and achieving their goals, a basic foundation of knowledge and skills needs to be established. The following guide to injury prevention is here for you to use at your disposal and put into practice as needed to keep your clients safe and injury free.  Here are 7 steps that every personal trainer should be taking to help keep their clients injury free.

#1 Learn More To Build Your Knowledge Base

One of the very first things you can do to continue to improve your knowledge and sharpen your skills is to further invest in your education. I know what you’re thinking… you just finished school, received your degree, and passed your certification. You’re ready to jump right in and start training clients, not sit down and read even more books and articles.

Although the actual application and real life practice is obviously a necessity to learning and becoming a better coach, it is imperative that you are always continuing your education regardless of how long you have been in the field. Actively practicing and learning will keep you ahead of the curve to give you the most success in your career.

When beginning your permanent journey of learning, there are hundreds of topics, methods, philosophies, programs, and other variables to study and comprehend.  The best approach when developing your abilities, is to acknowledge all of the concepts presented to you, then take a useful piece from each one. Learn as much as you can, and become a “generalist”. This means you will be proficient in several aspects of coaching, and understand how to apply various tactics to a widespread client population. Developing these diverse skillsets will be invaluable to you in choosing the appropriate means to keep your clients injury free.

A good base to start with when continuing your education to help prevent injuries with your clients would include the following topics and resources:

Further your understanding of anatomy and physiology. “Trail Guide To The Human Body” is a great book to further educate yourself on how to properly locate muscles and various parts of the human body to help assess or treat a certain area.

Prioritizing the foundational human movement patterns, and how to screen them for dysfunction. The book “Movement”, by Gray Cook is an excellent resource to learn an efficient approach to evaluate human movement as well as understand how to correct dysfunction to optimize your clients movement and exercise program.

Learning different progressions and regressions for all movement patterns to best fit them to your client and their needs. Furthermore, taking these variations and learning how to correctly integrate them into a training program. Attending Dr. John Rusin’s 2-Day Pain Free Performance Training System will teach you actionable systems to instantly implement with your clientele and clean up weak links in your program design and coaching from the ground up.

Read and study articles on injury prevention methodologies. Reading the tons of free articles available on the web are excellent resources to study from and improve your knowledge. Some of the best websites with quality content include (but of course aren’t limited to):

• EliteFTS.com
• T-Nation.com
• Dr.JohnRusin.com
• AdvancedHumanPerformance.com
• ChadWaterbury.com
• StrongFirst.com
• And MANY More…

#2 Assess and Evaluate

You can’t measure what you don’t assess. One of the most vital aspects to injury prevention is conducting an evaluation and screening process for every single client you work with. This will create the framework for intelligent program design and guide you to the areas in need of intervention.

After consulting with your client to examine their subjective history, the next part of your injury prevention protocol needs to be some sort of movement screen and/or assessment.

Evaluations and screening processes should be an ongoing practice for the entire training career of a client.These procedures help identify negative lifestyle habits, health concerns, risk stratification, orthopedic sensitivities, dysfunction, movement and performance discrepancies, as well as serve as a “checkpoint” to test for improved function. Having a system in place that you can consistently replicate will create a solid foundation and give credibility to your coaching and training. More importantly, you will be greatly lowering the risk of injury for your clients.

One of the absolute best screening systems is the Functional Movement Screen. It provides a simple grading system to assess client/athlete movement. Once the screen is completed and if dysfunction is recognized, specific exercises can be prescribed based on those test results to correct weaknesses or imbalances. Having this screen in place will also help remove any confusion about what movements/exercises need to be removed or added to provide the best possible outcome for the client at hand.

The best programs in the world are the ones that focus on weaknesses. Real progress never happens if focus is only placed on strengths, leaving the underlying problems unresolved. By taking the time to screen and evaluate every client you work with, you create a safe training experience and intelligent exercise program that allows for the opportunity for increased strength, balance and function that is typically pain free.

#3 Remove Bad Habits And Poor Movements

“Addition by subtraction” is personally one of my favorite principals to apply in the initial part of coaching. This can be one of the most helpful pieces used to assist in building strength, improving movement quality, reducing pain and/or preventing injury.

This can be as simple as instructing your client to take breaks from their desk job throughout the day, get up and move around, stand when talking on the phone, etc. For instance, if you are working with an individual who has poor thoracic spine mobility due to sedentary work habits, there is no way you are going to make quality progress by focusing on mobility work in the training sessions alone. There needs to be an adjustment in their routine outside of the gym to make a significant overall difference for quality movement during training. Limitingtime of a bad habit from a client’s routine at work, or removing the habit all together, will have a profound effect on movement proficiency and thus quality of life.

Another common orthopedic sensitivity is lower back pain. Structuring in time blocks of purposeful walking with proper form/posture throughout the day can work wonders for the lower back. Adding in reciprocal movement will engage the musculature required to support and strengthen the low back thus, reducing back pain. In this situation, you are removing a sedentary habit by adding in a physical activity. This is another alternative to negate an undesirable habit by replacing it with a new positive practice.  To learn more about this topic, check out “The Cure For Lower Back Pain” for additional information.

Upon completion of a movement screening, your client may display a dysfunctional movement pattern (ex. Squat). One optimal way to help correct the pattern is easier than you think. DO NOT let them squat! Instead, concentrate on areas that need to be improved as a prerequisite to introducing the squat pattern into their training. Removing the flawed pattern and rebuilding a solid foundation to reintegrate it back into daily practice is a key component to injury prevention and intelligent coaching.

Depending on your client’s psychological preferences and learning style, you can determine what coaching methods, practices, and cues to use when applying this tactic. But don’t make the situation any harder than it needs to be. Identify the problem, remove the problem, create a better workout.

#4 Pay Better Attention To The Little Details

This is something that needs to be an ongoing priority. Don’t be looking at your phone, watching other areas of the facility, or contemplating what you are going to be doing in the next few hours. Give 100% of your undivided attention to your client and their training session.

Being able to read non-verbal behavior (body language, facial expressions, and certain stress responses) are a huge component to measuring and judging training intensity, movement integrity, and recognizing pain reflexes. Non-verbal behavior consists of positions, gestures, and total body movements that can clearly display how a person is feeling during that time. Identifying those subtle cues and movements are a great tool you can use to your advantage to adjust exercise variations and intensity to ensure client safety.

You would be very surprised how often a client will lie to you about how they feel.  While moving through an exercise they may convey it felt good and there is no pain, but their body language is telling you a completely different story. It is your responsibility to make the appropriate adjustments according to the cues and signals their body is giving you. Blatantly disregarding this is jeopardizing their results, orthopedic health and longevity.

Things to look for to identify exercise/movement discomfort or stress:

1. Distressed facial expressions (grimace face, eyes tight, brow positions, etc.)
2. Posture position (forward rounded or elevated shoulders)
3. Movement apprehension (body tension, limited movement, shaking, etc.)
4. A clenched jaw
5. Elevated respiration

These are some of the more common non-verbal stress signals, but there are many other indicators that can be identified to detect pain or stress. Being able to make adjustments on the fly by paying close attention to what your clients body is telling you can streamline their progress and keep them pain free. Plus, it makes you look like an even better coach!

#5 Use Appropriate Exercises And Variations

The belief that when a client can’t safely execute a certain exercise, and they just need to keep doing it until they get it, has to come to an end. This is an approach that unfortunately is seen every day in gyms across the world. The lack of understanding on how to apply exercise variations, and just the pure laziness of subpar coaches is leaving people hurt and in pain. Do NOT force feed a movement/exercise to a client who does display the ability to do it! Period.

Designing a safe and effective training program is an art. It doesn’t have to be extravagant and filled with the latest exercises. But what is most important, is that it suits your client appropriately in regards to their movement capacity and capabilities. Modifying certain movements based on your clients’ needs, and having a “why” behind every exercise programmed is pivotal to their orthopedic health and success.

Following the completion of the clients’ movement screen, the next phase is choosing intelligent exercise variations and training methods to meet their current requirements. This may come in the form of corrective exercises to improve motor control and movement integrity, mobility drills, exercise variations that alter range of motion, specific coaching cues, removing or adding movement patterns, etc.

Listed below are a few examples to help understand the possible approaches that can be made to improve a particular movement:

Movement Example: Squat

Corrective Exercise:

• RNT Method Back Squat to assist client in proper engagement of the required stabilizing musculature to correctly squat.

Mobility:

• Ankle mobility emphasis drills to improve pattern movement throughout the kinetic chain.
  • Foam Rolling For Soft Tissue Restriction
  • Joint Restriction Drill
• Range Of Motion Variation: Implementing the box squat to limit the clients range of motion due to orthopedic sensitivities and/or limitations.

Specific Coaching Cue: There are countless cues that can be used for fine tuning the squat, but a few examples are listed below:

• “Stay on the heels.”
• “Spread the floor.”
• “Knees out.”
• “Sit Back.”
• “Keep your back tight.”
• Etc…

Removal Of Pattern: Depending on your screening results and what is currently best for your client, sometimes the removal of a movement pattern completely (whether that’s temporary or permanent) is the most advantageous thing you can do for them. This may be due to lack of movement proficiency or even a severe injury that permanently limits them from a specific movement. But remember, if it is a temporary removal, it is your job as a coach to help rebuild that pattern and reintegrate it back into their daily practice.

Making adjustments to an exercise program is an ongoing process. There are endless possibilities and creative ways to modify movement patterns and exercises. Developing those skillsets requires experience and always remaining a student of your craft. Take the time learn new variations as well as other coaching tactics and use them on yourself first. Don’t forget that you are always your “first client.”  When you learn something new, try it on yourself first, assess the outcome, and then use that information when applying it to your clients.

#6 Always Apply The Minimal Effective Dose

The concept of applying “the minimal effective dose” is extremely important when working with any training population. To explain this notion a little better, think of it like this: Water boils at 212º F (100º C) at standard air pressure. Water is not considered “more boiled” if you apply additional heat. So you would be saving time and resources by turning off your stove when your water reached its boiling point. Then those extra resources (ex. money towards your electric bill) can be used else ware, or saved for the next time you have to pay a bill.

The same goes for when you are training a client. You are not going to produce a better training response by continually adding more training volume (time, intensity, etc.) during a session. There is going to be a point of diminished return. Making your client train until pure exhaustion where they can barely walk back to their car does not mean you gave them a great workout. It means you surpassed their appropriate limitations and left them at a high risk of injury with poor recoverability.

When designing an intelligent exercise program, multiple factors need to be taken into account: orthopedic health/history, systemic health, training experience, movement capability, goals, clients emotional state, as well as other variables. Taking these factors into account will help structure and monitor the correct “minimal effect dose” to prioritize injury prevention each training session.

The purpose to any type of training is to stimulate a change within the body. Structuring workouts that can consistently fuel a positive difference for the long term is where success lies. Think about the concept, “stimulate and recover,” every time a client steps foot in your facility. As a coach, ask yourself how you can provide the best training stimulus in the amount of time you are given, where your client can still recover optimally. Too often, some coaches keep pushing their clients beyond their limits resulting in lost effort and loss of proper form, jeopardizing their safety. Training your clients this way can lead to a multitude of injuries and chronic pain.

Focus on getting your clients to master the foundational movement patterns to create total body strength and symmetry within the body. From there, find other ways to challenge them without just adding more sets, reps, or time to the workout.  Using different loading tools (kettlebells, steel maces, clubs, barbells, dumbbells, chains, bands, etc.), changing rep tempos, using intensity techniques, and altering rest periods are some methods to impose additional challenges for your clientele.

Your clients should be leaving their training session feeling empowered and better than they did before they came in. Programming training sessions that allow them to consistently train hard and feel great every time they step foot in the gym creates training longevity and better quality of life. Remember…more isn’t better, BETTER is BETTER!

#7 Evaluate Every Training Session

An essential component to being a great coach and expediting your clients development is taking the time to evaluate every training session. Doing this will allow you to review and determine what worked well, what did not work, what can be improved upon, as well as make necessary adjustments to movements or the program itself.

Regularly going through this process will fine tune your clients training program keeping them on the path to achieve their utmost potential while keeping them safe and pain free. During your review, move through the criteria listed below to assist in making the correct modifications for future training:

1. Did the workout itself and/or a specific movement cause any pain?
2. Are there any exercises or patterns that need to be removed?
3. What movements need to be developed?
4. Is there emphasis placed on improving weak links?
5. Did the correctives or drills I applied have a positive or negative outcome?
6. Does a modification need to be made to an exercise to make it more suitable for the client?
7. How was the clients’ intensity from the beginning, to the end of the training session?
8. Should intensity be increased or decreased at any point during training?
9. Is this workout sustainable to repeatedly train on for weeks at a time?
10. Has there been notable improvement since last training session?
11. How did the client feel at the end of the workout?
12. How did the client feel coming into to today’s training session after recovering from the last workout?

Injury prevention should always be a coach’s number one priority at all times.  Developing your skills and knowledge is a lifelong process and your clients success depends on it. Regardless of your time in the industry, always remain a student of your craft and do everything you can do produce the best, and safest training experience for your client.

About The Author

Tim Danchak, BS, ACSM-CPT, FTS

Tim is a strength coach, wellness instructor, and functional training specialist in North Carolina. His primary focus is working with general and special populations to regain proper movement mechanics and improving total body strength. Tim’s passion is focused on enhancing overall quality of life and pain free performance for his clients.