To Be A Better Trainer, You Have To Be A Better Detective With Mark Toomey
As exercise and fitness professionals, we all know how vital it is to have a new client complete a personal history and profile prior to starting an exercise program.
Most profile forms ask the basic questions; weight, height, fitness goals, as well as a list of previous and current injuries and conditions.
In an earlier article, I mentioned how vital it is to have any client provide you with a list of all medical and therapeutic professionals he or she may is seeing or has seen in the past.
Now, let’s add another component to that list:
What medications are they taking?
Most of us are not medical doctors, so don’t assume a quick Google search or a posted question on Facebook to other trainers will accurately tell you what impact a prescribed medication may have on a client’s fitness goals.
More importantly, that type of amateur sleuthing won’t give you a real understanding of what kind of reaction may manifest when that medication is added into any exercise or conditioning program.
Always call the prescribing physician and make sure that their client can exercise while taking the medication.
It’s what professionals do.
By all means, use the release form we made available in one of my earlier articles to contact the client’s healthcare provider.
Let’s not stop at prescription medications, though.
How you deal with clients and their use of non-prescription or Over-The-Counter (OTC) medications is a potentially bigger issue.
Well, in a 2011 survey, over 50% of patients with muscle, joint or arthritis pain and 70% of patients with a headache and migraines relied solely on self-treatment using only OTC medications.
A recent issue of Practical Pain Management (April 2014) posed the challenge that understanding the type, amount and consumption pattern of OTC medications is more akin to detective work than any of us would think.
Let’s start with knowing what we don’t know; according to a recent study of 500 patients, over 85% reported that they thought their doctor knew of all the OTC medications they were taking.
Sadly, only 46% of those patients ever recalled telling their doctor which OTC medications they were taking, and only one-third of the patients surveyed had ever discussed their use of herbal or vitamin use with their doctor.
We all can recall someone who started an herbal supplement program and either initially or over the course of time experienced anxiety, increased heart rate, hot/cold flashes or some form of gastric distress.
Think for a moment how any of these symptomatic experiences could impact how a new or existing client would perceive your performance as an exercise professional.
“Oh, I went to Trainer X, but his program made me sick to my stomach and dizzy.”
Remember, if you can’t give them an answer, they make it up themselves.
Apart from what your client is taking, your detective work needs to determine whether or not your client is taking their OTC medication as directed and has accurately told you which version of the medication they’re consuming.
Never assume that any non-prescription medication is being taken properly.
A 2003 survey revealed that one-third of all patients taking OTC medications had taken more than the recommended dosage either carelessly or intentionally.
Patient self-medication is at best an inexact practice and could have a material impact on your business.
Here’s a simple example of how complicated this can be:
One of your female clients suffers from menstrual pains.
She has a violent reaction after one of your group classes and while she’s in the bathroom with a line of people forming outside, you inquire as to how she’s feeling.
Her reply, “I’m just having really bad cramps and I took some Midol.”
How many of us would ask “which Midol?”
Well, Midol Liquid Gels contain ibuprofen; Midol Extended Relief has naproxen and Midol Complete/PM/Teen all contain acetaminophen.
Is this client taking any other OTC medications that contain any of the aforementioned drugs?
Are you aware of the FDA maximum daily dose of ibuprofen or acetaminophen?
(Currently for ibuprofen, it’s 800 mg per dose or a total of 3200 mg per day and recently, the FDA has recommended the discontinuance of prescribing combination drug products with more than 325 mg of acetaminophen per dosage unit.)
Do you understand how ibuprofen or naproxen might affect someone involved in a significant strength or conditioning program?
Let’s look at another example:
One of your male clients is training for an upcoming triathlon.
His overall times are not improving and you ask if he’s feeling well.
“It’s just my allergies, I guess. I’m taking Sudafed.”
How many of us would ask to see the Sudafed?
Probably not many, but in this case, he’s taking Sudafed P&P (Pain and Pressure), a version of Sudafed that contains acetaminophen.
You’re aware he takes Tylenol to deal with the normal aches and pains of a triathlete.
Your endurance-training client is double-dosing acetaminophen.
What does the literature say about the use of acetaminophen by endurance athletes, and is there any danger in him taking twice the recommended dosage?
Your ability to position yourself as a professional in all aspects of your client’s training depends on the amount of time you’re willing to invest in your business and more importantly in those who entrust their health to you.
Pushing a little harder to get information that you can use to monitor your clients’ progression within the training program you created for them can also be handed off to the medical professionals those same clients see.
You can be that all-important hub of information and in becoming so, increase your value as a service provider.
As our industry becomes crowded with more trainers chasing a relatively static number of customers, your ability to differentiate yourself becomes more important.
Time spent in learning how to become that indispensable hub is more valuable than another weekend spent at another certification.
Becoming a better exercise professional requires extra work; in some cases, learning how to play detective.