How important is it? Who needs it? How to use it?
As a professional trainer, I cannot over emphasize the value of the health assessment.
The unique aspect of the health assessment is that it allows trainers to get to know their client from the inside out. In this business, it’s often the things you can’t see that can seriously injure clients and ruin careers.
Despite having a significant client safety role, health assessments are surprisingly simple to do. They entail a series of health questions with a yes or no answer. Unless there are some serious health issues to be address, health assessments generally last 5 to 10 minutes. Health assessments are only as good as the accuracy of the client information which is why I stress to clients to respond to questions as accurately as possible.
Another important function of health assessments is to establish client rapor. Many trainers will have the client fill out the health assessment form then review it. I prefer to read the questions to the client to establish the interaction we will carry on to the training floor.
Health assessments are valuable tools for trainers but they can be used rather effectively by individuals. The trick is to know the proper action to take in case we get a yes on one of the health questions. The health assessment form is like most medical forms in which the answer yes acknowledges a health issue.
The following is my health assessment and the proper action to take in case of a yes answer.
Q: Are you taking any medication? Yes
A: Make sure medication or combination of medications, have no adverse affect during training. This can be done by reading labels and consulting with a physician or pharmacist.
Q: Have you had any heart problems? Yes
A: The problem can be as minor as a heart murmur or as serious as sudden death. Determine the degree of the problem and whether weight training can make matters better or worse. If weight training is encouraged, stay within safe training limits.
Q: Do you have difficulty with physical activity? Yes
A: This can range from just being out of shape to a muscular condition called fybromiyalgia. The trick here is to train within your limits
Q: Has a physician ever told you not to exercise? Yes
A: Physicians aren’t always right. If you feel you must train, get a second opinion from an equally qualified physician.
Q: Do you have any muscle or joint disorder that may be aggravated by exercise? Yes
A: Perform a ROM and load test on affected muscle or joint. This will determine the proper exercise for the affected area. It will also determine an action of either conventional training or post rehabilitative training.
Q: Have you had surgery within the past year? Yes
A: Make sure you’ve gone thru the complete recovery time or try to get clearance from the physician who performed the surgery. Any training mishaps to surgical area while training within the recovery time, even if you’re feeling great, can absolve the surgeon of any and all liability.
Q: Do you have diabetes? Yes
A: This is an article itself. Make sure all testing equipment is available when training since multiple glucose tests will be taken. Make sure a high glycemic carbohydrate is available. A juice or other liquid is ideal.
Q: Are you hypoglycemic? Yes
A: Many people don’t realize they are hypoglycemic. A good indicator is lightheadedness or dizziness from prolonged exertion or long periods without food. What I find effective with clients is to have them sip a juice or other high glycemic fluid between sets. A hit is just enough to wet the tongue with the juice placed under the tongue for quick absorption. An 8oz bottle of juice should easily last two weeks.
Q: Is there any history of heart problems in your family under the age of 55? Yes
A: Exercise, especially weight training, has a way of exploiting latent health conditions. If a person is physically active and has a good grasp on their health and fitness then by all means proceed. If a person is out of shape and doesn’t have a clue on the status of their health then they are highly advised to get a physical prior to starting a program.
Q: Do you have High Blood pressure? Yes
A: Weight training in many cases can actually lower blood pressure. The key is to be patient with training progress and stay within training limits.
Q: Do you have low blood pressure? Yes
A: Stay within training limits and stay hydrated since dehydration will lower blood pressure. Heavy sweaters need to pay special attention to hydrating.
Q: Do you consider yourself a heavy sweater? Yes
A: During training, heavy sweaters are prone to dehydration. Heavy sweaters will also be thirsty more often than others who don’t sweat as much so a practical solution is to obey your thirst.
Q: Do you consider yourself a non sweater? Yes
A: Sometimes in this business, what’s down is up and what’s black is white. This is the case for the non sweater. During training, non sweaters are prone to overheating because sweating is the primary way the body cools itself. The big mistake by most non sweaters is that they take in too much fluid during training thinking by hydrating they are cooling themselves. If the training is intense enough, the non sweater will get sick or crash from having too much fluid in their stomach. The proper action for the non sweater is when the heat is on the water goes on the head, neck and shoulders. This mimics sweating and will cool down the body.
Q: have you ever been diagnosed with osteoporosis? Yes
A: A mild case or the pre stage of osteoporosis is ideal for conventional weight training. In advanced cases of osteoporosis, conventional weight training can do more harm than good. My knee jerk reaction in this case would be to recommend physical therapy since the condition is more medical than fitness.
Q: Is there any other condition not covered by the health assessment? Yes
A: This is the catch all. I’ve performed tens of thousands of health assessments over the years and have seen a yes no more than five times. This question determines and addresses anything not mentioned in the health assessment that may have a significant impact on the training or client.
Q: What physical activity has been done within the last 3 months?
A: This is not a yes or no answer but is just as important. Typically when performing an assessment, trainers, me included, tend to visually size up a new client to determine their fitness level and subsequently their initial training loads and training tempo. A new client, in many instances, can appear to have a high fitness level but then the trainer discovers the client has done little to nothing outside of pressing a TV remote for the last three months. On the other hand, a new client may appear to have an average to below average fitness level but for the past three months has been training daily for a 10 K run. This forces the trainer to adjust his or her training approach because sometimes in this business, what’s up is down and what’s black is white.
This covers my health assessment questions. It is based on years of common conditions I’ve encountered on the training floor. Despite its training value, health assessments only provide limited legal protection for trainers. Poor standard of client care trumps a health assessment 100% of the time in legal cases. Use of the health assessment is highly instrumental to trainers and individuals in designing and implementing training programs that are both safe and productive.