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Programming for Special Populations

a tailored approach to Exercise

July/August 2014 - The best fitness professionals know that exercise program development can't be treated with a one-size-fits-all approach. As a fitness professional you are very likely to encounter clients with special needs or health concerns. Pursuing continuing education through post-rehab workshops or courses that work with special populations such as the STOTT PILATES® Injuries & Special Populations (ISP) course can open up the door to a world of new clients, all of whom are looking to have a unique focus that caters to any conditions they may be individually experiencing. Special populations groups are persons with various conditions that are often under the care of physicians or other health care personnel. Specialized training is beneficial for both personal training specialists as well as group fitness instructors, depending on the type of population being instructed.

Some growing special populations groups include:

  • Pre/Post-Natal
  • Active Aging
  • Injuries/Rehabilitation
  • Obesity
  • Osteoporosis
  • Diabetes

In conjunction with the appropriate health practitioner, training to work with these diverse groups gives you, as a fitness professional, access to more clients who would otherwise overlook training with a fitness generalist. As noted, there are a variety of special populations to consider working with, some of the largest categories including rehabilitation, pregnancy, obesity and active aging.


Many post-rehab clients are looking to restore function and return to normal, daily activities and previous levels of functionality. After these clients have worked with a licensed health care practitioner, with post-rehab training under your belt, you have the potential to help these clients:

  • Minimize the extent of the initial damage
  • Reduce associated pain and inflammation
  • Promote healing
  • Maintain/restore flexibility, strength, muscle balance and proprioception and overall fitness

Especially for this specific group of clients, medical rehabilitative treatment is usually only available for a short period of time, whereas through mindfully-based movement, not only can you cater to those who do and do not have medical coverage, but you also have the opportunity to retain these clients well beyond the post-rehab phase with mind-body exercise.


With pre/post-natal clients, if exercise has been a part of a woman's regular routine, she is generally encouraged to continue exercising at a mild to moderate level during her pregnancy, barring any complications and keep in mind to continually modify programming to accommodate hormone and body changes.

If you work with any clients in the pre-natal category, the benefits of staying active through pregnancy include:

  • Less maternal weight gain
  • A stronger likelihood of coping with labour better and getting
    back into shape quicker postpartum
  • Aiding in the prevention of gestational diabetes
  • Improved psychological well-being

After delivering a baby, one of the first considerations for new moms from a fitness perspective is to redevelop the strength of the pelvic floor, a fundamental practice in mind-body modalities.


According to the IHRSA Canadian Health Club Report, 18.4% of Canadian adults are obese with another 41.3% of men and 26.9% of women being classified as overweight. Developing concentrated skills to serve this population will serve personal trainers and group instructors well as demand on the fitness professional community to be able to serve this group grows. With many obese clients, their joints are being compromised from additional stress placed on them and their range of motion tends to be reduced.

Work with them to assess their goals and develop programming and equipment use based on their ability.

Active Aging

The physiological and psychological benefits of exercise for the older person are considerable. Exercise intervention has shown decreased morbidity and mortality symptoms, decreased anxiety and reduced hospitalizations.

This demographic also tends to have a higher level of disposable income and often seek out private one-on-one training making them an appealing audience, especially to the personal training specialist.

While there are some risks associated with exercise for the senior client, many can be minimized with appropriate medical screening and by awareness and appropriate response to warning symptoms.

When working with this population some key concepts to keep in mind include:

  • Start slowly
  • Improve core strength
  • Strengthen stabilizers of all joints
  • Improve balance
  • Work with props to improve proprioceptive feedback
  • Keep an eye on energy levels during workouts

While there are various classifications for this varied group of clients, there are some overall considerations and tips to keep top of mind:

Questions to Consider When Working with Special Populations:

  • What is the severity, irritability and nature of the condition?
  • What is the diagnosis of the injury or special need?
  • At what stage of healing is the injury?
  • If chronic, what is the behaviour of the condition and the client's usual functional level?
  • Is pain involved? What kind? How much? Where?

General Tips for Working with Special Populations:

  • Be respectful of their unique needs
  • Be confidential
  • Do not give out medical advice, refer all questions back to
    the appropriate medical personnel
  • Obtain medical clearance to work with these patients
  • Apply correct exercise techniques, including exercise
    regression and progressions
  • Incorporate all components of rehabilitation: muscle
    conditioning, flexibility, proprioception, functional exercises, sports skills, correction of biomechanics and maintenance of cardiovascular fitness

Always keep in mind that as fitness professionals it's not our role to diagnose, but ideally we work as part of a team of professionals helping clients return to their original state.

The future of exercise with injuries and special populations is gaining momentum – ensure that you stay on top of this trend and ahead of the crowd by adding this in-demand skill set to your fitness professional toolkit.