There are several "eye-catchers" that a personal trainer should look for as you consider working with a client. Several of these would warrant examination and then permission from a doctor before the fitness assessment or training. All would require further conversation as a part of the trainer / client relationship.
After securing the medical history form, look for the following signs and / or symptoms that are suggestive of coronary artery disease or heart disease. These absolute contraindications to exercise testing are conditions that must be stabilized or adequately treated before testing. If any of these are evidenced, the client should be referred to appropriate medical personnel prior to assessment or training by you as a personal trainer.
– Pain or discomfort in the chest (angina pectoris), neck, jaw, arms, etc.
– Shortness of breath at rest or mild exertion
– Dizziness or reports of syncope (temporary loss of consciousness with full recovery)
– Paroxysmal nocturnal dyspnea or difficulty breathing appearing suddenly at night, usually waking the client after an hour or two of sleep; caused by pulmonary congestion that results from left-sided heart failure
– Orthopnea or difficulty breathing which is brought on by lying flat
– Ankle edema
– Cardiac arrhythmias, palpitations or irregular heart pulsation of the heart, usually only perceptible to the client
– Tachycardia or rapid beating of the heart (usually rates over 100 BPM)
– Intermittent claudication or limping
– Known heart murmur
– Unusual fatigue or shortness of breath with usual activities
– Acute infections
– Suspected or known dissecting aneurysm (weakening of a blood vessel wall)
– Severe symptomatic aortic stenosis (narrowing of a blood vessel wall)
– Recent significant change in an resting ECG (heart scan) that is indicative of ischemia (vessel blockage), MI (heart attack) or other acute cardiac event
– Acute myocarditis or pericarditis (inflammation of the heart muscle or sac around the heart)
– Acute pulmonary embolus or pulmonary infarction (blood clot)
Individuals exhibiting any condition in the preceding list would automatically be considered high risk or likely to suffer some coronary event with exercise.
High Risk Individuals should always have a medical exam or medical personnel involved in testing them BEFORE any tests or training from the personal trainer. It is HIGHLY recommended that these conditions be met BEFORE working with him / her.
Providing a safe environment for our clients is paramount to personal training. Completing and then discussing a person's medical history with them prior to fitness assessment or training exhibits that precautions have been taken to ensure a safe environment. In this age, when 2/3's of our population is overweight and / or so many individuals are taking some medication for a disease, disorder, or a condition, it is prudent on the trainer's part to know what s / he is "getting into . "
To learn more about "reading" a medical history, see the article, "BEFORE A Fitness Assessment or Personal Training a Client … Look at the MEDICAL HISTORY for Known Diseases."