This is a short collection of information I have learned about training high risk clients as a personal fitness trainer over the last 20 years.

The last thing you want is to hurt someone. People don’t pay you to injure them. You won’t just have your own self to deal with, but the person, their family, legal, etc. It just isn’t anything you want to deal with. If you take certain steps with every person you train, you will proof yourself up against a potentially bad situation.

Who is Considered a High-Risk Client?


Think of scenes from movies where people lose their minds and think that everyone is an FBI agent trying to get them. Then view all of your clientele as potentially high-risk clients who are trying to sneak chronic illnesses past you, hiding the massive pain they are in until their shoulder dislocates, or maybe they came to workout drunk.

Once you have that viewpoint, you’ll be fine. That’s because your clients hide things from you, no matter who you are. For reasons of pride, shame, embarrassment or simply stuff that’s none of your business.

I have had totally normal clients come in one day and turn into high-risk clients.


  • One fit mother who was a very fit regular in the gym had not had a thing to eat that day. She nearly passed out and it did cause a whole scene – bad for PR.
  • One younger guy had not slept but one hour the night before. He didn’t want to tell me he was with a girl and he was hiding the fact that he was tired. I had awesome goals for him that day to beat his personal record and he didn’t want to disappoint. He didn’t make it and eventually spit out the truth, but he really could have hurt himself.
  • One older guy was having pain in his back but kept on going way past when he should have stopped. He was out for a week or so and it was completely unnecessary.
  • One overweight guy came in with soaring high blood pressure. None of us knew about it until his nose started bleeding and I told him to lay down while I get the blood pressure monitor.
  • A young man was really upset one day and ready to just kill it in the gym. He wanted to lift more and more, and he was kind of angry, so I kept an eye on him. He had a bad day (some jealousy thing girl left him for a bigger guy) and he was ready to change his life. Total recipe for disaster…

So if you think “Oh, I’m fine. I don’t have any elderly clients.” You’re wrong. We are all high risk at some point.

As a Fitness Trainer, Know Your Trade

The first way to proof yourself up against unwanted scenarios like this is to be trained. Be educated. If you think you know everything there is to know, you’re wrong. None of us know everything about the body. Pick up everything you have ever read and read it again because you missed something.

Get several different personal fitness trainer certifications. Get specialty ones like training golfers, kettlebell training, Olympic weightlifting, running, and anything else you can think of. The weirder you get, the more you will learn. I promise that. If it is weird to you, then you don’t know anything about it.

Take a course on training high-risk clients. I took a class in college called “Special Populations.” It talked about how to train all sorts of special populations – mentally impaired individuals, people without arms, etc. I even went to the State Center and saw how the state takes care of mentally impaired citizens. They have a workout room and the physical therapist there took me through her exercise programs for the different groups.

Aside from this being a reality check on life, I actually got a ton of ideas from her. There were all of these different ways to keep someone from falling and safeguards against injury that I immediately applied to an elderly woman I was training.

Dedicate a certain amount of time each year to your own personal education. It is hard enough for fitness trainers to take time off for themselves, but maybe around the holidays when it is slow, have a trip paid for so that you can go do that new certification in a place you’ve never been. I’ve always just made time for it, and I totally mixed work and play.

Legal Forms for Personal Fitness Training

Get your legal forms in order. Your client release forms, physician’s okay to exercise, etc.

If I have someone with a very alarming situation come up and ask me to train them, I get interested. I don’t back off and take them reluctantly. I demand to work closely with their doctor on a full plan. This does two things:

  1. It keeps you covered in case something does go wrong, you can have the written instructions from the doctor and any correspondence between you and them.
  2. It weeds out the lazy clients who actually don’t want to get better. I love helping people, but there are people who don’t want to help themselves. You and I aren’t actually doing the work. We are setting people on a path and giving them the motivation to get there. We cut a path through the woods and say “Go!” They are the ones that do the work. Having someone around who doesn’t want to work is a drag on the whole atmosphere.

This doesn’t just mean for high-risk clients. I would suggest that if anyone has a massage therapist, physical therapist or any kind of doctor they see regularly, that you get their take on the person and see what you can do to help them back along. Physical therapists and chiropractors love me when I ask them for ways to back up their work. I have built some awesome relationships with professionals in various cities by doing this exact thing. Look at it as a chance to expand your network as a trainer. You will also get a peek into how they work.

All sorts of health and medical professionals have a level of frustration with their patients/customers who don’t make progress. They are usually in the mindset of “If I could only get this guy to get on a foam roller 3 times per week, he wouldn’t have to come limping to me all the time.” That’s when I just add the foam roller into the regimen and the dude’s hip gets handled. Everyone is happy and you look so innovative!

Various Risk Factors for Personal Training Clients

Here is a list of all sorts of risk factors. It is not complete, but I am putting these here to get your mind going:

High blood pressure

Whether they know it or not, the person may have high blood pressure. Fat or skinny, young or old. You can get to know their own medical history by having them write it down. You can also check their vitals when they first start out. Get in the routine of weighing, taking blood pressure, body fat, measurements (if their goal is size loss or gain).

Weak bones (Osteoporosis)

I saw a woman in her 40s with bad osteoporosis once. It was some odd situation compounded by the fact that she smoked. Yep, smoking significantly lowers your bone mass. I was talking to a surgeon recently, and he said that he could tell if a person was a smoker just by looking at their bones in surgery. This is something that is not obvious – like you can’t see someone walk into a room and tell that they have osteoporosis. But you can do your best to educate yourself on their medical history. Osteoporosis is easy enough to handle with even mild weight training.

Young Ones Who Think They Are Invincible

Some people just think that “Nothing will go wrong.” Even if it has many times. This is often seen in teenagers. They want to take on the world! I love the energy that these kids give off. Your job as a fitness trainer is to channel it. Teach them things like “Adding weight to poor form is like painting a dirty car.” Make them fitness snobs and form experts. Challenge not just their bodies but their minds. You will find no better student if you are able to harness these guys and girls. Rarely do they take to authoritarian control. They are rebels, but with a purpose. Fuel and guide their purpose.

Previous Injuries

God knows where these people have been and what they had done to them before they came to you. Have you ever seen a 50-year-old car or truck? Have you ever seen an 85-year-old truck still putting around town? Think of how many dents and dings these people have had over the years and 10X it.

Assume Nothing About Every Client You Train

There is nothing that you can assume with an elderly man or woman that walks into your gym.

  • Don’t assume they can do a step up on a six-inch platform.
  • Don’t assume they can walk on a treadmill.
  • Don’t assume they can hold their balance on a treadmill.
  • Don’t assume they can get up and down from the floor.

Any trainer will develop an art of observation. Just look at the person that is in front of you. Don’t say “Oh, I have this new guy and he’s just like this other 70-year-old I train.” Ohhhhhhhh no he’s not. He’s nothing like him. You screwed up already.

If Something Seems Off, It Is

I have saved more bad situations than I can remember by just looking at something being slightly off with a person. Even if I can’t put words on it, I’ll pay attention to it and act accordingly.

I remember reading a story about a Fire Chief who all of the sudden, right after sending more firefighters into a burning building, ordered everyone to get out. Many around him were confused. He didn’t know why he was doing it, but he had a gut feeling. The building exploded after the last firefighter got out. He looked like some wizard saint of fortune telling.

In reviewing photos after the incident, a certain white smoke was seen coming from an area of the building that was within his sight. I don’t remember exactly what this meant, but it meant that something bad had just happened and the Chief did the right thing.

You may not know everything about the body, but you do have your own powers of observation and can compare today’s Jill to yesterday’s Jill. Get in touch with your clients. You’ll start to hear about the guys doing stupid things on the weekend and when the girls are on their menstrual cycle.

Which brings me to my next point…

Nothing Is Sacred – Need-To-Know Information

Take the viewpoint that, for your client, privacy doesn’t exist.

However you do this, develop a “need to know information download” agreement with your client. If something is off, interrogate the person. Don’t stop until everything makes sense to you.

I had a woman with whom something was off, and she didn’t know what it was either. I could tell she was telling the truth (a skill you will develop), so I took it easy on her that day. The next day she was sick as a dog with strep throat. I could have easily made her pass out by pushing her harder that day and then I would have had a whole bag of other problems to deal with.

It is part of your job to know when to give a person an easy session. Categorize that into the types of workout sessions you deliver. Sometimes you deliver easy sessions and it is totally appropriate.

You will never know everything about a person, but you can try. Get into such good communication with them that they will tell you everything. Don’t gossip about others to anyone and they will spill their guts to you. Sometimes it gets awkward hearing things more fit for a confessional, but it is definitely much better than having a person not tell you when something is off.


Look, few of us are really in this profession for the money. We’re in it for the people. You can’t hate people and be a fitness instructor. It is necessary to get into people’s private lives. You are actually already there as soon as you start prescribing exercise.

It is only bad to get into someone’s private life if you intend to spread that information or use it for purposes other than getting them to reach their goals.

I have grown so much by getting a look into your average individual’s problems. I learn from them and avoid making their mistakes. Us trainers should consider ourselves privileged to have such good rapport with those we work with.

Once you start to know your clients, you’ll be able to really exercise them and prevent injury.

Leave A Reply