Should We Train People in Pain?

Today I want to pose a philsophical question, and get your guys’ thoughts on it.

Should a personal trainer or strength coach train someone in pain?

Is it really black and white?

Is it as simple as if someone is in pain, they see a physical therapist, chiro or sports medicine professional?

Or is there gray area?

If you are a trainer or coach, what are your thoughts? If you train people in pain, do you have a certain set of rules that you follow to determine who you would (or wouldn’t) train?

To the sports med professional who read this – do you expect a referral from a trainer/coach any time someone is in pain? Or are there certain times and instances were you expect them to be able to handle it on their own? Or is it cut-and-dry: If someone is in pain, they need to see a sports med professional?

I have my own thoughts on this, but I want to hear yours first in the comments section below.

Please keep this open-minded and professional – if I get the impression someone is being condescending, rude, or openly combative, it’s not going to get posted.

I look forward to hearing what you guys think!

All the best



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  1. I actually have an interesting story for this one.

    Until recently I was involved in powerlifting and trained in a powerlifting club. Now training through pain is more or less what you get when you have a full time job, and you are deep in the strength phase of your program. However sometimes things are not business as normal.

    In the middle of last year I was training for a small comp. My numbers were looking good and things were going ok. At the time I started to get soreness in my shoulders and elbows. I started to see my physio again as a result of this, just to get some work done. I was planning on taking a bit of a break after the next comp too.

    On top of this I also started to get some wrist pain, which in hindsight was actually fairly intense. However I assumed that, seeing as I already had soft tissue issues with my arms, and I had a desk job using a computer, that it was probably related to that, something like RSI that was agrevated by training. So I trained through it, and never had it looked into.

    Now come the day of the comp, I got my first squat in, was looking pretty strong and was all set to PB on my second for the day. I set up under the bar, wedged it into my back, and stepped it out of the rack. That was when my arm broke. There were two distinct snaps as both my ulna and radius broke one after the other.

    Fast forward a couple of days after some surgery and some shiny new metal, and I was talking to one of the surgeons, and described the pain I was having in the lead up to the break. As my bones didn’t look brittle, and there was no other obvious cause that they could see, she said that given what I described there was a good chance I had a stress fracture going into the comp.

    So really, when it comes to training through pain, I guess one of the problems can often be the pain you have might not be what you think it is. Unknown unknowns are never a good thing.

    • Great story Anthony – even though I didn’t necessarily mean “train through pain” you still bring up a great point.

      Hope you’re healing well!

  2. I’m presuming we are talking here about joint pain and/or soft-tissue soreness, with no open wounds or obvious trauma, and that they otherwise appear healthy and fully functional outside of the affected joint/area.

    We’re lucky at our facility in that we have a good network of physio/chiro and massage therapists that we can feel confident referring clients out to, rather than sending them to their GP’s who would just tell them, “don’t exercise”. We usually get direct feedback from those medical professionals as to what they feel the clients can and can’t do while recovering from their injuries. Also, the owners of our facility are very experienced in post-rehab work and are a great resource when dealing with a potentially injured client.

    That said, in general, with regular clients I know well, I give them the choice. If they still want to train, we’ll do a lot more preparatory work (mobility, etc.) before proceeding to assess their ROM, degree of pain, etc., and then we’ll work around the affected area and/or significantly deload any movements that might affect it, and avoid any movements that would be contraindicated based on the site and nature of the pain. This is all done with the understanding that if there is any increase in pain, any locking or sharp pain in the affected area during any movements that we stop immediately. If I see any deviation from proper form on movements, we stop immediately. If their issue hasn’t resolved itself (or isn’t at least getting significantly better) by the next time I see the client, I advise them to seek help from a medical professional.

    If the client is relatively new, and/or I don’t know them well enough to judge their body language and other feedback when they are training, I advise them not to train and to seek help from a medical professional.

  3. I agree with Anthony. As physical therapist interested in training I am sometimes in a position to know what might cause the pain. If you know the severity of the pain and the underlying mechanisms your in a postion to do something about it. This could be everything from a tiny modification in your training program (or in some cases just train as normal) to a complete overhaul or rehab. As Mel Siff stated in his book supertraining ” pain inhibits performance”. Therefore I would allways try to find the course of pain, and if I can not figure it out my self, I would seek help. Training with pain is usually not a good thing.

    There is off course some times you can train throughout pain (painfull eccentric training for patellar tendinopathy has actually proven effect), but it is never a good thing to train through pain if you do not know what is causing it.

    As a general rule, pain is your body`s signal that something is not right. When something is not right, you should allways try to find out what that something is. This way you can address it early and decrease the risk of severe injury and increase the risk of becoming a more efficient athlete.

    • Halvor –

      Great comments about pain and performance. I always try and explain to people that no matter how hard they try, pain changes everything.

      Great stuff!

  4. As for Mike`s question, I guess we usually can. But in most cases we need to make modifications and train them somewhat differently.

  5. Great question Mike! I say the answer is the dreaded “it depends”. If we get someone in who has shoulder pain on a basic ROM test, we refer out to our PT (in our facility). That doesn’t mean that we don’t begin training them in other areas.

    Just because this individual has limited options fpr upper body doesn’t mean that we can’t help them begin a lower body training program or a fat loss strategy (that is what we deal with mostly).

    As soon as they ‘graduate” from therapy, we can transition them into a full blown program taking into consideration whatever restrictions they may have.

    So I say YES and NO!

    Take care and congrats on the new family!

    • I agree wholeheartedly – it depends it a great answer.

      And I think you’ll agree with my thoughts, which go up on Monday 🙂

  6. Tricky question..

    For me, there is no clear cut answer to this. It would depend on the degree and location of pain.
    Significant pain – Go see medical staff as soon as possible.
    Pain that can’t be explained through movement screens, muscle tests and/or palpation – Go see medical staff as soon as possible.
    Even if I can explain the persons pain, I would still advice them too see a PT or similar, but I would not refuse to train them.
    I would however, train around the pain and get to work on eventual deficiencies (Which we all have to some degree).
    Just because your knee hurts does not mean you can’t train the rest of your body. I’ve trained around several injuries myself (none of which I got during strength training), including a broken radius bone and partial tear in PCL.

    So don’t force someone through pain, work around it and strive to eliminate the pain (in combination with a PT).

    • Jacob –

      I love the fact that you at least have rules – if this, then that.

      I agree it’s not black and white. Good stuff man!

  7. I believe it all comes down to knowing your body. I have a bad habit of training through pain. When I was younger nagging pains just didn’t stick around long enough for me to be concerned but as I have got older they seem to persist. It seems all my bad habits have caught up with me.

    I am all for training through soreness but one has to learn the difference when your body is trying to tell you when something is wrong and when it’s just a little sore or just plain lazy! This is where getting knowledge, reading and not believing every tom, dick and harry (especially on the web) comes in.

    People like Mike Robertson and Eric Cressey read, teach and practice what they preach. The more you read and understand what they have to say, the more you understand about exercise, injury prevention and healthy movement. From what I have read (and I’ve read a lot over 10 years) – they appear to be most balanced in their outlook. They not only tell you what exercises to do, they tell how to tell if you have a problem (a kind of self-empowerment if you will).
    What they have learnt from them:
    1) Train better (technique) but address your weaknesses too – it’ll keep you injury free which means you’ll get to the gym more consistently and therefore you’re more likely to break those PBs.
    2) Variety – you can’t just bang out the same program for year upon year. Your body (and mind) adapts and so must you to challenge it.
    3) Rest and deloading (something I’ve been guilty of avoiding but I’ve learnt is just as important part of one’s program) – this is part and parcel of allowing your body to adapt to the new challenges you are throwing at it. This enables you to break through those plateaus and also you’re less likely to get injuries and make through to the end of whatever you are training for.
    4) Accepting that your body will have wear and tear – so work with it not against it!

    I have been playing racquet sports since I was knee high and weight training for the last 10 but the last 3 years have seem me play and train so much less because of injury. Had I listened to my body and had the resources of Mike and Eric available to me in my teens, I am confident I would not have the injury profile I have now. I’d be out there playing the sports I love to play and being all round stronger and injury free.

    In summary:
    – Know your body and you’ll know when there is something wrong – if in doubt see a specialist (a proper one).
    – Gain knowledge, there is no substitute to learning for yourself.
    – Have balance (training, diet, rest and corrective/injury prevention)
    – Always address your weaknesses because when you’re pushing yourself, your weakest muscle, tendon etc will be the one that lets you down first.

  8. There is certainly a gray area on this topic, and the question is where do you draw the line where it is okay for a personal trainer to work with a client with injury and when is it not. I think that a skilled personal trainer can educate the client to avoid pain, and use their creativity and knowledge to modify exercises or select different exercises that keep the person out of pain. If a personal trainer attempts to “treat” the client, I think that they are over stepping their boundary. For example, if a client has shoulder pain while performing a shoulder press behind the head, it is okay to tell them to modify and perform a shoulder press in front of the head. However, I feel that it is not okay to “prescribe” them exercises to specifically help the problem. I would not tell them to perform “prone Y, T, I” exercises to help with the pain. The simple reason is that a personal trainer does not have background in pathology and diagnosis. While these exercises may be helpful for some shoulder conditions, they may be harmful for others.

  9. Great post Mike!

    This really had me thinking this morning.

    As a practicing physiotherapist and fitness professional, I wear two hats, but have the luxury of having access to the knowledge specific to each realm and am able to base my decisions on careful analysis of aggravating and mitigating factors including vascular, neurological, anatomical, health status etc.

    That being said, if anything crops up that I feel is out of the norm (red flags, certain signs/symptoms, changes in status etc) I am the first to refer out for further medical investigation by those who are more qualified than me to make those judgments (e.g. MD/surgeons). I am always aware of the limitations of my skill, knowledge, experience and use those boundaries to define my own scope of practice within the larger “legal” scope of practice.

    The truth of the matter is that most fitness professionals do not have the background, training or scope to take into account all the potential causal or precipitating factors for pain onset/persistence or injury. In most cases, they are trained and insured to work with a generally healthy population, within the scope of their skills and abilities. This is not to say that there aren’t fitness pros out there who have done the requisite work, study, training to work with special populations with specific knowledge, but these individuals are few and far between.

    So, as a general rule, I would err on the side of caution and refer out.

    This just makes professional and legal sense: it mitigates risk and protects all parties involved. It is always wise to realize that liability issues do come into play, and a fitness professional would be remiss if he or she didn’t take these into consideration.

    Questions to think about:

    If someone comes in with calf pain, as a trainer does one “diagnose” it as a minor strain and then continue with a workout that doesn’t challenge that area? Or in the back of the fitness pros mind, does he or she consider the pain may be caused by a deep vein thrombosis that could dislodge and put the client at risk for a pulmonary embolism? Is the low back pain really just mechanical back pain? Or is that pain caused by vertebral compression fractures or even more frightening, bone cancer? Is that shin split pain really just shin splints or is that ankle injury just a simple sprain? Or is this a case of compartment syndrome requiring emergency intervention and an avulsion fracture, respectively?

    While these may seem far-fetched and extreme, these are real questions and situations.

    So what am I really saying?

    I guess my take away poinst would be to work within your skill level/scope of practice, and err on the side of caution.

    For fitness professionals, it would be wise to create networks with various sports med professionals so that if any situations do arise, you have people to work with and seek advice from.

  10. It would have to come down to how the trainer assesses the client, and whether they can tell if the type of pain is coming from a minor or major issue. If they suspect that it’s a simple biomechanical fault, put them through very mild corrective exercises, and the pain dissipates, then training could be beneficial, especially if there is no pain or swelling the following day. However, to simply train through pain is never a good philosophy, as it only leads to problams and a lack of understanding of the issues involved. When the trainer cannot say for certain that the pain is a simple issue that is within their scope to correct, it would be best to get a second opinion, as two heads are always better than one.

  11. Having been through the Rehab Trainer Essentials course with Australian Physios’s I now feel confident to assess a client presenting with pain and using the result to determine whether they are suitable for training or should be refferred. Highly recommend it to all fitness pro’s


  12. Since all the previous comments where so well thought out and detailed (“it depends”) 🙂 I will be more simple minded and simply say NO, NEVER!

    The reason being is that we as personal trainers/strength coaches, don’t have the formal training to diagnose the cause of the pain. Yes, in some cases (tendinopathies it may be okay to train with low-moderate pain). However, as a main rule (at least according to the training I have received -): Pain = inhibition and altered motor patterns = non productive training.

    I also don’t believe that we should let the client decide if they want to train through pain. STOP right there! If they don’t agree, the session is over. Yes, we can work on other areas if they are unrelated to the pain (but then again – body works as one unit – we might think that the alternative exercise we suggest don’t affect the injured area, but most often it does.

  13. would agree with Jacob . . . if someone’s knee hurts why shouldn’t you work upper body, and core for example ?

    just to take this line of thinking a little further . . . if a new client has some obvious (pain free) deficiencies do you just go ahead and program accordingly, give them some appropriate stretching and strength work, or do you refer it out . . . where do you draw the line between giving a client appropriate program and diagnosing and prescribing corrective exercise ?

  14. From a liability and safety standpoint, depending on your credentials, it is probably always better to be safe than sorry. As a physical therapist who has worked as both a therapist and a trainer, I have to say, I personally think it all depends. May seem like a contradiction, but I guess that is the point. I think it depends on the trainer, the client, and the circumstances surrounding the pain. When in doubt it is probably always good to refer, in that respect I agree with what Dev Chengkalath posted above as he gives some excellent examples.

    Fitness professionals should never practice beyond the scope of their training and therefore they must be able to police themselves. Because there is no defined set of skills trainers are required to master prior to representing themselves as trainers, this can be VERY difficult. The truth is today trainers are a diverse group with extremely varied backgrounds, experiences and qualifications.

    I also think we can over-react to pain. While pain is a signal that something is wrong, movement can sometimes be exactly what a particular person needs. The question a trainer needs to ask themselves is “Do I have the specialized training or experience needed to make good judgements for my client?” That will really depend on the trainer, the clinet and the circumstances. My experience hanging out in gyms is many trainers (but now all) probably are not qualified to make comprehensive judgements in cases where a pathology is indicated via pain. In that case, it is probably better to refer and/or for the trainer to simply consult with a health professional they know and who knows them.

    BUT there are always exceptions and therein lies the gray area. This is one of the big problems with a profession that doesn’t really have a well-defined scope of practice nor uniform credentialing process. My personal experience has been that trainers knowledge base and exerperiences are all over the board. How’s that for an ambiguous answer 🙂

    • Wow – AWESOME answer Shaun!

      Another simple question we have to ask ourselves – is it truly an issue with the joints/muscles/whatever, or is it just the clients’ execution of an exercise that could be exacerbating things?

      Like the kid who squats on his toes with knees caved together, and claims squats will hurt yours as well?

  15. Great discussion so far! I agree with so many points. I’ll add this …

    As a chiropractor, A.R.T. provider, CSCS, and Crossfit Coach, I practice strictly out of the gym.

    1. With many who exercise, exercise is their drug, meaning instead of alcohol, cocaine, cigarettes, binging on food, television, or video games, certain individuals use exercise to activate the same dopamine-serotonin pathways that drug addicts use. Given that, it is difficult for someone in pain to completely give it up.

    That’s why I’ve learned to modify an individual’s program so the injured tissue is not being loaded.

    Injured low back? Stick to single-leg training (learned this from the MR).

    Impingement in the shoulder? Stick to pulling exercises.

    Weak ankle? No jumping or heavy power work.

    In this way, people keep the relatively healthier drug of exercise and avoid loading the injured tissue.

    2. My only other comment includes understanding when the nervous system is “Red-lighting” a tissue (I learned this concept from Dr. Brady at If an individual goes to touch their toes, can do it, but it is very labored … or if glenohumoral abduction is very labored … sometimes the body “red-light’s” the muscles. In Standing lumbo-pelvic flexion, the brain essentially says, “I don’t know lumbar multifidi, let him go slowly. Hey psoas, you there? You got him? Ok good. Oh shit. Be careful. Please … easy does it.”

    Understanding this “red-light” concept tells me when I should hold an individual back from their program.

  16. It depends if it’s good pain or bad pain. General muscle soreness from previous exercise is perfectly fine in my books. Bad pain is that which has the potential to become an injury and I wont train anyone through that.

    I will always refer clients to a physio and make sure they get a set of rehab exercises plus a list of contraindicated exercises. Clients will usually want to continue training with me so I work around the injury, obeying the physio’s instructions. There is always some way to work around it and the client will often end up better for it.

  17. I’ll throw my 2 cents in here real quick…

    I totally agree with pretty much everything that has been posted thus far.

    Another aspect that I have run into is people who have pain, have been to doctors or physios and have been told ‘I don’t know…just rest’. Obviously, rest is not going to magically cure them. And if I can determine through assessment that their mechanics are totally off and that is contributing to their problem I will go after that.

    Of course I will work around the pain as much as possible. However, I have noticed in some cases (especially with shoulders) that anything you do can cause a bit of discomfort (even basic mobility drills)…but the alternative of doing nothing at all is surely not going to get them moving better.

    So, depending on the individual I have done a few things that I knew would be a solution in the long run even though it caused temporary discomfort…and the fact that they got better leads me to feel I made the right call.

    Now maybe someone as awesome with shoulders like Eric Cressey can always avoid pain 100%, but I am not there yet. However, I look at it a bit similarly to manual therapy work like ART and Rolfing…it is definitely hurts when you are getting the treatment, BUT you feel so much better afterward. And of course you have to really think through what you are doing and why: it is one thing to do some side-lying extension rotation with a little discomfort versus ignoring their pain and doing OL snatches.

  18. Some very good comments already, and not much to add to what’s already been written by my fellow physiotherapists.

    One variation though, is with chronic pain issues. The injuries that will never heal. I for one have a number of injuries stemming from an RTA resulting in mis-aligned fractures that result in regular pain. Luckily as a physio I’m able to manage the vast majority of my problems and still compete in Triathlon. But I do so with regular pain from those fractures and resulting problems. After my last major operation (to re-break my femur, and reset it) the surgeon simply gave me a choice- “do sport and suffer in pain, or don’t do sport and you’ll be pain free, who knows if there’ll be any long term damage as there’s no guarantees either way, so it’s just up to you”.

    So yes, I train in pain. my choice. I know the risks, but I know how to manage it.

    As a S&C coach / personal trainer / anyone really- as already said it is always best to refer out or gain a detailed assessment to ensure you’re working with an accurate diagnosis so all parties are fully informed.

  19. I spent a year in physical therapy school before leaving, and from what I got out of it, I realized that there is nothing special about physical therapists… only SOME physical therapists. Likewise, there is nothing special about personal trainers and strength coaches… only SOME personal trainers and strength coaches. The problem with putting people in boxes is that you either miss out on their full capabilities OR you grossly overestimate their abilities because they hold a degree. There are plenty of personal trainers I know that would be amazingly qualified (and far more qualified than many physical therapists) at training someone in pain. More often than not, however, a personal trainer is not at all qualified to do such a thing. On the other hand, I have seen what goes on in a lot of PT clinics around the country… and on occasion, I have been greatly disturbed. Some PTs have no business being PTs. Of course, more often than not, I would consider PTs in general to be far better than personal trainers at working with people in pain (it is, after all, a big part of what they were specifically trained to do). But anyway, it is always an individual judgment, never a generalization.

    Summary: If you can, you can. If you can’t, you can’t. Do what you can. Don’t do what you can’t.

    • While Tim may have a point that there are some physical therapists who who are good and some who are inadequately trained/educated/experienced, the difference between almost any physical therapist and trainer is the base level of training. That PT degree and licensure is a testament to having completed specific study requirements covering a wide range information and being tested against it.

      There is NO such requirement for the field of personal training.

      There is no standardization, no base level of physiological or anatomical knowledge, no study of disease process/pathology, and there is no governing body that defines the legal scope of practice to protect the public (State Board, Regulatory College etc). An individual could take a weekend or online course and become “certified” practically overnight. This can’t take place for physical therapists.

      The above is not to say that a trainer can’t acquire these skills, abilities or knowledge. Far from it, there are plenty of resources out there, including Mike’s blog, that offer incredible and vast amounts of knowledge to be reviewed, questioned, integrated and applied in the appropriate context.

  20. Where I work I see two different realities in this regard.

    1st, when we get our new class of athletes many times in certain sports the athletes dont understand the difference in pain and soreness. that distinction becomes first.

    generally i believe that the SC coach has more tools to work around pain while its being addressed by sports medicine than we often think. especially more so than just “go to the leg press”. whether or not SM or sport coaches will allow you to is another matter.

    for pro athletes managing issues that they have becomes a constant reality. In my observations there are very very few true professional athletes without issues that require low levels of constant attention to manage and mitigate. If those athletes were to only train on the days they felt 100%, they would get left behind in their training and by their coaches. its shoulders with swimmers and hips for track ect…

    it doesnt take a lot of work to keep these things under control once you figure out what works for the individual.

  21. I am a new personal trainer. What about clients who want to start training, have not exercised for some time due to history of disc problems? They say they are now find and doctor allows them to exercise. What exercises would be contraindicated? My scope of practice based on my certification is a generally healthy population but it seems so many people have some history of back problems so if they now feel well are they considered part of the generally healthy population? Surely they have special needs when it comes to exercise. And many have gained weight because they were unable to exercise but now feel better and want to get back in shape so if trainers decline them where are they to go? Would a PT with a degree in kinesiology serve them better/have better knowledge?. Suggestions?

    • I think a good PT is like Pizza Supreme – lots of ingredients not just all meat or all pizza base or paste. PT cirriculum tends to say be like the tomato paste. Without a base background relative or toppings of further varried relative over the paste – it just aint pizza its just tomato paste.

      Also knowing in depth biomechanics & ways of manipulating them via old school tried & true & evolving methods is crucial & I wish was the requirement for anyone to be a trainer (Or that it was mandatory for pass in all courses).

      When I was 11 I starting training wih an equestrian coach almost daily & spent most waking hours outside of school/work with the horses. I was training active at least 5 hours a day then & now getting to 40s still do, I believe those second eyes see movement patterns you dont see & help you understand & practice. Over a multiude of sports & weekly coaching sessions for all not to mention lots of mulah I feel Ive gained insight to text taught in biomechanics manipulation.

      Therefore best background for PT is Master a sport/s & some – pay for good coaching (best usually are old, battered, tough as nails & are like the encyclopedia for their sport) study the science behind all movement. Go back to trianing origins in athens to chariots to yoga pathways – later resulting pilates – body building – so forth.. Doing so gives direction to what you apply or dont apply with your clients – for serious PTs are over seeing the flood of rep counters flooding through.

      I will say study of Clinical pilates is amazing & dance opens the gates wide for movement understanding more than kinesiology alone.

      It takes time to be a learned PT & I will be honest in saying it took at least a decade to get a level where I follow my gut or intuition in almost all sessions after establishing a repore/connection with clients.

      Anyways, give new clients a Medical Release to be filled by a doctor/specialist before training them/again. If thier GP or Sports Physician is a bit of a ahhhmm….. Monkey? Always have a swag of allied health profesionals including good GPs (I personally have an amzing sports one) you can work with to refer clients to & work together.

      If the client dosnt see a GP & get the appropriate referal ie Physio FROM a GP, then they’re being lazy hoping youl be the 1 ticket answer or are self diagnosing by going to an allied health professional without referal per condition/s. The amount of times Ive heard weekend warriors, fun runners or Do It Yourself style Fitness enthusiasts with no biomechanical knowledge running to a chiropractor for a sore back without seeing a GP first. How do they know the pain isnt refered or linked to cancer as mentioned earlier. ARGGG! Dont encourage this behaviour.

      When screening a clients background & physique I always note general posture & test its alignment with the wall etc & any flags give them a medical release form to signed their GP with their diognosis & or clearance with precautions.

      As a PT for 25 years now, Im obsessed with the perfection & growth/potential of every single movement. True co-ordination takes practice practice practice with the heart laying in the self mastery required to do it well or better. My obession for what I do helps me skill up others (Not count thier reps)

      If a problem is present we need our health allies to call onto medical imaging & testing so forth to see & sometimes treat what the naked eye cant see. Without knowing degree or depth of anything – problem or stength – You/they wont master SQUAT!!!!!!!!!!!!

      You cant spread your expertise wide & expect to be up to date with it all at all times (believe me – Ive tried:) I mean you dont see a podiatrist to see about your heart for good reason mainly the science depth & scope of the human body being like its own universe in motion.

      If You/they dont want to master anything theres no point, even a banging bod even requires it/mastery to some degree & practice, witthout this attention to detail if results are attained they are usually only short term & non lasting.

      Welcome newbe 🙂 & hope you love this craft as much as I do.

  22. I might have a slight different train of thought. A lot of deconditioned clients don’t have a concept of pain. IE: Most will say this hurts or that hurts but they confuse it for lactic acid buildup etc.. Most people are not in tune with their bodies. I always ask for more details. A client telling me her knee hurts doesn’t tell me anything. Where does your knee hurt? What movements cause the issue to happen. How long has this been causing you pain? What is the Scale of pain? I really think it’s a loaded question but IMO I would work around the issue correcting it and always reassesing. If the issue is not getting better I would send them to a Physical Therapist that I was confident in.

  23. I do not know a personal training certification that allows for one to diagnosis anything… none. We critisize our MD’s and DO’s about being too conservative in their treatment or call for MRI’s, CT scans, X-rays etc but our society has become so litigious that our MD’s/DO’s are forced to operate within these guidelines.
    While I understand it’s tempting to want to advise someone about pain and make the call to press on, if you were the trainer of Anthony and made that call, you would have been slapped with a lawsuit.
    Pain is easy to dismiss but there’s so many underlying conditions that one must not ignore our bodies signals; cancer, blood clots etc. A trainer will get more clients and be more respected if they refer out a client to their medical physician who happens to catch a more serious problem.

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