Personal Training Clients With Arthritis: Tips & Exercises

As a fitness professional, you are likely to work with a range of different people, so it’s not unlikely that you’ll find yourself personal training clients with arthritis.

In this article, we’re going to go over tips and exercises for clients that will help you feel more confident in your practice.

Before we get started, one of the best ways to help clients improve their health & fitness is through a combination of diet and exercise. You can do this with our Level 4 Sports Nutrition Course, offering expert nutrition advice alongside tailored workout programmes.

You can find more about this course and many others in our downloadable course prospectus here.

Personal Training for Clients with Arthritis 

You may have heard of the term arthritis, but do you know enough about each type to help those who suffer from it? 

Before we jump into our tips and exercises for personal training clients with arthritis, though there are over 100 types, let’s take a quick look at the two most common types of arthritis first.

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It affects millions of people all over the world and typically comes with age, but not always. 

Osteoarthritis occurs when the protective cartilage that acts as a cushion on either end of our bones wears down. This kind of arthritis can affect any joints in the body, however it is commonly spotted in the:

• Hands
• Knees
• Hips
• Spine

Osteoarthritis cannot be cured however it can be managed successfully. Symptoms can typically be managed through regular activity and maintaining a healthy weight; this is of course alongside medicinal treatments. 

The development of osteoarthritis is usually slow and progressively the symptoms will become more predominant. The most common symptoms that occur in the aforementioned areas are:

• Pain in the joints 
• Stiffness
• Tenderness
• ‘Grating’ sensation
• Swelling
• Bone spurs
• Restricted range of motion

There are many different risk factors for osteoarthritis, in fact you may find that more women than men are your clients that suffer from this though the reason behind this isn’t clear.

Things like obesity, older age and even genetics are all common risk factors too. You should keep all of these symptoms and limitations in mind when working with clients who suffer from osteoarthritis and take care and show compassion with what you’re asking of them.

Rheumatoid Arthritis

Another common type is rheumatoid arthritis.

This type of arthritis is actually an autoimmune and inflammatory disease, meaning that your immune system begins attacking healthy cells in your body unintentionally. This in turn causes inflammation which can present itself as painful swelling of the joints.

The lining of the joint becomes inflamed, which leads to tissue damage of the joint and can have more serious implications as time goes on. This is because this tissue damage can leave the sufferer with chronic pain in the affected areas while also inducing a lack of balance and even deformity.

Plus, rheumatoid arthritis can even affect other tissues of the body which can impact the lungs, heart and eyes.

The typical symptoms are:

• Weakness
• Swelling 
• Tenderness
• Pain in the joints
• Weight Loss
• Tiredness 

The actual cause of rheumatoid arthritis is unknown and though there are potential risk factors like your age, gender, and even genetics – there is no definitive cause. 

That being said, there are indications that alongside medications prescribed, self-management strategies like getting physically active for approximately 150 minutes a week. 

Simple exercises like swimming, walking, or cycling can also help. You should take this into consideration when designing your exercises for your personal training plans for arthritis.

5 Tips For Working with Clients with Arthritis

#1 – Approach your Client with Care and Compassion

Firstly, arthritis can range in severity dramatically. It can present itself in young people, middle aged people and old people. 

Therefore, you need to approach with caution and find out how advanced the arthritis is in each case as an individual subject.

You won’t make money as a personal trainer and gain clients if you don’t respect their condition. This should be approached with sensitivity as it is difficult to live with arthritis and you don’t want to invalidate their feelings around their condition. 

You can do this by making sure that you approach all of the questions you ask as open ended and leave room for them to say their piece. This means that you should never assume that you know what they feel like, you shouldn’t assume just because they’re young that it will be less severe than an older client.

Yes, there are cases that are more common among elderly, but this doesn’t take away from the fact that younger clients may suffer from RA, an autoimmune variation of arthritis as we mentioned.

Thus, if you’re wondering what is an important coaching tip for someone with arthritis? This should be at the top of your list, but how do you ensure that you do this?

You should approach every session by having a brief conversation about how their arthritis is that day. Arthritis is temperamental, sufferers experience ‘flare ups’ which means some days are good and some days are bad.

With this in mind, you should ask considerately at the start of every session if they’re suffering from a flare up and adjust your programme for them accordingly.

Compassion is very important, you need to ensure that you make the client feel comfortable enough to tell you when they’re having a flare up, as if you don’t create a trusting relationship where they feel like they can share this they could end up getting injured.

If your client gets injured, it is only going to set their progress back which is the last thing you want when on a journey to help their arthritis.

This is a tip that you need to ensure is always a common practice during every session and for every client.

#2 – Make Equipment Choices Wisely During Exercise for Arthritis

There is no single answer in terms of what equipment or machinery to use when personal training for arthritis suffering clients, as each client will be able to use different machines and lift different weights depending on:

• The type of arthritis they have
• The severity of their condition 
• Whether they’re experiencing a flare up

This tip goes hand in hand with what we just mentioned when it comes to finding out how their arthritis is feeling at that current moment. This will help determine what they will be capable of using, equipment wise, on that specific day.

For example, if your client doesn’t feel as though they’re able to use a barbell that day for their leg exercises, you could switch this out for a combination of many of the leg machines that offer isolation exercises.

In this example, say you had intended to dedicate the session to a leg day to improve the clients arthritic knees, you should adjust your barbell squats for a machine leg press for example. 

This way, the resistance can be adjusted to their limitations and range of motion on that day while also using the safety brakes necessary.

This way, you won’t be compromising their results or their safety during training. 

#3 – Celebrate Small Progress Accomplishments when Personal Training Clients with Arthritis 

Personal training for arthritis sufferers can improve an individual’s quality of life and make their condition more manageable, but this is a slow process. 

This is why you should be celebrating the small victories along the way on your clients exercise journey so they know they are making progress no matter the speed. 

A good way to do this is through client progress reports where you can set a meeting and talk through their progress every month, quarterly and annually or whatever suits their schedule and the length of time they’re with you.

Small and big accomplishments could be things like:

• Jumping up a weight in an exercise
• Increasing their 1 rep max
• Consistency
• Increased range of movement
• Showing up on difficult days
• Overcoming fears of exercises 

There are plenty of different achievements that can be unique to each client, you should pay attention to what they hope to achieve and make them aware of how they’re improving in this area.

#4 – Be Thorough With Your Consultation Process when Designing a Personal Training Program for Clients with Arthritis

The personal training consultation process is always important and should be thorough; however, there are some extra questions and information that you may want to retrieve from a client who suffers from arthritis. 

There is a specific question on the consultation form worded as:

Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise?

This question for those with arthritis will likely be answered as yes so this leads to the client usually needing to get some guidance or authority from their GP to be taking part in physical exercise. 

As well as this, your PAR-Q form will be the same, you should ask them to go into as much detail as their comfort level when it comes to their arthritis diagnosis and seek a GP note if necessary. 

You should explain to them that to conduct a personal training program for clients with arthritis you must have the doctors permission to keep them as safe as possible and also yourself protected. 

If you want to get some more information about their arthritis, the consultation meeting is a good time to do this. You can write in your notes section things like:

• What aggravates their arthritis
• What kind of arthritis do they suffer from
• If they have flare ups often
• Where their arthritis is most problematic e.g: the knee, shoulder etc.
• What exercises they have tried in the past & what works/ doesn’t work

This additional information will help you retrieve some helpful knowledge into their arthritis type and how you can help them manage the symptoms effectively.

#5 – Be Consistent with Check Ups

Check ups are incredibly important for those who take part in exercise for arthritis, they are more prone to accidents and chronic pain so you need to make sure you’re helping improve the problem not worsen it.

We aren’t talking about progress reports and monthly check ups, we’re talking about how you should be checking in throughout the session. 

Ask them during an exercise questions like:

• Is this too intense?
• Do you think you would benefit from some more resistance?
• Do you need to take a short interval from training?

They might not feel confident enough to tell you if their wrist or knee is hurting if that is what you have centred the session around but you should encourage them to feel comfortable enough to tell you that you can change the sessions no matter how far in you are.

For some useful information on personal training particular populations, read our articles below:

• 7 Tips for Training Clients with High Blood Pressure
• How To Make Money As A Personal Trainer
• 9 Tips to Put in Place When Personal Training Overweight Clients

5 Best Exercises for Clients With Arthritis

Here, we have specified 5 exercises that target each of the most common problematic areas of arthritis: the knees, wrists, feet, hips and shoulders. 

Personal training clients with arthritis will often include some walking and general low intensity exercises, but we here have some more specific examples that you could incorporate into your programme.

#1 – Partner Facing Side Plank with Band Row

Resistance exercises may seem counterintuitive, as you don’t want to put pressure on joints and aggravate them but, strengthening muscles can make you stronger and thus, put less strain on the joints during exercise and everyday life. Ultimately, improving symptoms. 

For this reason, the side facing plank is a great exercise to incorporate into personal training plans for arthritis.

This exercise is great for those who want to adjust the amount of resistance put on the body, it is versatile which is good for those with arthritis but this exercise is especially targeting the posterior deltoids among other upper body muscles too.

Thus, with the shoulder joint being one of the most commonly affected areas of arthritis, strengthening this muscle can help in contributing to some pain relief.

Starting Position

Start this exercise with you and your client facing one another on two comfortable mats. Ensure that your client’s mat is padded and is comfortable for their elbow to rest on, then, allow your client to take one end of a light resistance and long band and you take the other.

Execution:

• Begin by lifting the body onto one side by using the forearm to stabilise yourself
• Engage the core for heightened stability.
• Legs should be extended with feet stacked ontop of one another
• Ensure the band is being held with a neutral grip and there is slack before you begin.
• You and the client should be approximately 2 metres apart.
• Pull back on the band simultaneously in a rowing motion until the hand reaches your own rib cage – be sure to check your client is doing the same.
• Reverse to the starting position and repeat.

Duration: 4-6 reps / 3 sets.

Muscles Targeted:

• Trapezius
• Latissimus Dorsi
• Posterior Deltoids
• Serratus Anterior 
• Rhomboids
• Biceps
• Forearms
• Obliques
• Abdominals
• Glutes

Common Mistakes to Avoid:

• Placing the feet in the wrong position: You should ensure that your clients feet are stacked comfortably and that their core is strong enough to stabilise themselves. If it is not, help them and ask if they would like a yoga cushion or block to help stabilise their core instead of placing one foot in front of the other. 

#2 – Dumbbell Wrist Flexion 

Arthritic wrists are extremely common among sufferers, particularly the elderly. Wrist and hand exercises can be helpful in controlling the pain that comes along with this kind of arthritis, it can help to strengthen the muscles that support the joints.

This in turn, is going to contribute to the pain reduction alongside the likes of splints and medication. As well as this, exercise can increase the production of synovial fluid which acts as a sort of lubricant in order to improve proper joint function.

So let’s see how this is performed.

Starting Position

Begin with a mat under the knees, ensure it is padded well for your client, use two mats if you don’t have a thicker one to hand. Then, using a bench or some stacked steps, place the forearms on the surface with palms facing upwards.

Once comfortable, place two dumbbells of a light weight or whatever the client is comfortable with into their hands and the grasp should be in a supinated grip.

Execution:

• Once comfortable in the starting position, begin to roll the wrists downward until the back of the hand meets the side of the bench or steps – whichever surface you opted for.
• Slowly roll the wrists back up to the starting position, flexing the wrists upward until you reach the range of motion.
• Roll back down and repeat.

Duration: 6-8 reps, 3 sets.

Muscles Targeted:

• Flexor Carpi
• Brachioradialis
• Palmaris Longus
• Pronator 
• Flexor Digitorum
• Supinator 

Common Mistakes to Avoid:

Using the biceps: This exercise is good for arthritis sufferers when done correctly, so ensure that you watch their execution and make sure the power behind this movement doesn’t come from the biceps. This is to improve the muscles surrounding the wrist to put less strain on the joint, so to make it worthwhile, the power must be coming from the wrist.

If your client tends to use their biceps after 3 or 4 reps, lower the reps and sets and increase rest time in between as they are probably using their biceps because they can’t get the power behind their wrist after a few reps and reassure them that it is completely fine!

#3 – Machine Leg Extensions

The useful thing about working with machines when it comes to finding an exercise for knee arthritis is that the weight load can range dramatically and can be adjusted easily, meaning it is ultimately safer.

The leg extension machine typically has a starting weight of a couple of lbs, so typically your client will be able to lift this without putting pressure on the joint. These machines also make assistance from you as the personal trainer much easier.

You can lift the pad to help your client if necessary and set the brakes to a comfortable range of movement. 

Starting Position

Set up this exercise by adjusting the seat for the client ensuring that the pad is just above the ankle and their back is firmly pressed against the seat.

Check that their lower back is against the back of the seat and there is no gap. If there is, adjust the positioning accordingly.

Execution:

• With one leg at a time, lift the leg using the quadriceps for power until the leg is straight. 
• Then, lower the leg slowly with control back to the starting position.
• Switch legs and repeat on the other side.
• Adjust the weight if it is too heavy or too light, there should be complete control from start to finish. 

Duration: 6-8 reps per leg / 3 sets

Muscles Targeted:

• Quadriceps

Common Mistakes to Avoid

Incorrect Pad Placement: It is really important that when personal training clients with arthritis that you pay attention to the joint that has the potential to be put under pressure, in this case, the knee.

The pad being too far down the leg and below the ankle can put pressure on the joint so you want to ensure that the power behind this movement is coming from the quadriceps. You should ask them where they feel the pressure and check in regularly with them for safety.

#4 – Frog Pose 

Yoga in general is beneficial for mobility as a whole, but this exercise is dedicated to those suffering from arthritis in their hips, another common problematic area. 

This stretch, pose, exercise or whatever you want to refer to it as is very versatile. It is a solely body weight exercise that can open up the hips, strengthen their muscles and even the core helping things like balance and coordination.

Starting Position

Begin this pose with a comfortable mat, preferably padded, placed horizontally and on the hands and knees facing toward the long side of the mat.

Execution:

• With the hands underneath the shoulders slowly walk out the knees to either side, keeping them bent.
• Allow the feet to point outwards and keep separating the legs until they reach full range of motion and feel as though the hips are being stretched and are open.
• Then, lower carefully onto the forearms lowering until the stretch is felt in the hips and the back is straight.

Duration: 30 second intervals / 2 sets

Muscles Targeted:

• Adductors
• Hips 
• Core

Common Mistakes to Avoid: Straining: This is a difficult stretch if you have limited range of motion which your personal training clients with arthritis will likely have. Thus, ensure that they enter the stretch with caution and spot them the entire time, start off comfortably and if they can’t reach the floor, use yoga blocks to assist them.

#5 – Seated Calf Stretch with Resistance Band

The 5th most problematic and common place that suffers from arthritis is the feet. 

Stretches are among the best approaches to combat these issues and additional resources like resistance bands can be super helpful in intensifying or relaxing the stretch.

Starting Position

Begin with a resistance band or a yoga strap and a mat. Sit with the legs out in front and back up straight.

Execution:

• Once in a comfortable starting position, wrap the band around the top of the foot holding the band at either side.
• When it is in a secure position, slowly pull the back up into the starting position. 
• Pull back on the band using the biceps and keeping the arm at a 90 degree angle slowly.
• Pull just enough to feel a stretch but not a strain.
• Hold for the recommended duration or with what your client is comfortable with.

Duration: 30 seconds / 2-3 sets.

Muscles Targeted: 

• Gastrocnemius
• Soleus

Common Mistakes to Avoid: Ensure the band isn’t too heavy duty: The band should have enough slack in it for you to control the amount of stretch behind it. If it is too strong, it could come off the foot or put way too much pressure on the joints. 

Before You Go…

It’s challenging but incredibly rewarding to help those with specific conditions dramatically improve their quality of life through diet and exercise. And one of the best ways to expand your knowledge in these areas is through specialist Level 4 courses, starting with our Sports Nutrition Course.

Find more about this course and plenty others in our downloadable course prospectus here.