Prescribing Exercise for Different Client Stages

Notionally we can put clients into one of three groups for exercise prescription purposes.  These groups will give you some guidelines as to the general focus of your prescription.  Note that although we suggest you are aware of the three possible groups by no means should these groupings over-ride each client’s individual circumstances and personality.  We simply present them here as a model to help you understand that prescription is about meeting the needs of the client at any given time, and that each client’s needs will change over time.

The low tolerance (beginner) client

The low tolerance exerciser is someone who doesn’t have an exercise habit, is attempting exercise, but has limited capacity to tolerate the effects of exercise.  These are usually your long-term inactive population who might become a new member at your club. 

The following criteria relate to this group

1. They haven’t taken part in moderate to vigorous exercise at least three times per week every week for the last six months
2. They have limited physical capacity to tolerate exercise of moderate to high intensity without experiencing significant discomfort and fatigue during the workout, and soreness/discomfort for a day or more afterward
3. They don’t have established usage patterns (attendance times, behaviours, rituals) and/or strong social connections with any staff member and/or club member

Low tolerance exercisers are going through significant behavioural change at the same time and trying to cope with exercise.  They need to establish convenient and pleasurable routines, become comfortable with the workout environment (people, setting, equipment, times, rules, culture), and also enjoy as much as possible their exercise experience. 

When prescribing for these people you will usually write a programme that:

• Ensures they do not experience pain or significant discomfort when exercising
• Ensures they do not experience embarrassment, hassle, confusion or failure within the setting
• Ensures they get the opportunity to interact with staff and members in a positive manner
• Ensures they have clearly defined objectives that relate to them ‘settling in’ and ‘mastering’ some of the elements of their programme

Every extra moment that a low tolerance exerciser spends in a club, having a positive experience allows them to reinforce the ‘pros’ side of their personal balance sheet. 

You may read the above and think – logical.  We hope you do.  Now we’d like to point out that the most common complaints of new exercisers are;

• My programme is too long
• My programme is too complicated
• I hurt too much after completing my programme
• I don’t receive help to complete my programme
• The staff / club doesn’t care
• I look foolish when doing my programme

You wouldn’t have to go far in the ‘drop out’ population of a club to get these statements.  Yet the most prescribed workout we see is the same for the ‘low tolerance’ group as it is for any other group within a club.  It’s understandable that when a keen new club member is talking about their dreams and ambitions that you get prescriptoritis (inflammation of your prescription talents) – but what they really need is a cool head and a calm (and gentle!) writing hand.  Give them a break, it usually took them a lot of courage to join, do your best to ease them in to it.

The habitual exerciser (intermediate) client

The habitual exerciser is someone who has an exercise habit, has a base of fitness, but doesn’t yet adhere to all elements of their prescription and/or isn’t getting the results they desire. 

The following criteria relate to this group

1. They have taken part in moderate to vigorous exercise at least three times per week every week for the last six months
2. They have moderate physical capacity to tolerate exercise of moderate to high intensity and don’t experience significant discomfort and fatigue during the workout, and soreness/discomfort for a day or more afterward
3. They have established usage patterns (attendance times, behaviours, rituals) and/or strong social connections with staff members and/or club members

Habitual exercisers are usually your active club members, (i.e. they visit a few times a week) who do most of what is required but don’t do all that is required to progress.  Often they are a little frustrated with progress and can’t understand why they are not making more headway.  They might train but avoid exercises they don’t like, or cut short more intense parts of the programme.  They might train too often or not enough or they might not recover (sleep/eat/hydrate/rest) well enough to help them adapt. 

Because this group already have a programme that they're doing and a set of behaviours, your role is one of investigation and correction.  You need to go on a fact finding mission and work out what isn’t working.  Then, you work closely with the person to plan and execute changes in their training and recovery behaviour in order to get them the results they are seeking.

When prescribing for these people you will usually write a programme that:

• Ensures they are very clear on what has to be done to make progress
• Has them record what they are doing accurately so you can monitor their adherence to the programme (not just their attendance) and provide support where required
• Ensures you are very positive about the progress they have made and clearly define training targets for them to work on as further evidence of progress
• Ensures they have clearly defined objectives that relate to them ‘achieving X training target by Y date’ and ‘perfecting the exercises they complete’ within their programme.

Every extra gain that a habitual exerciser makes is validation of their long-term training effort and is a great way for them to stay in maintenance (see the stages of behavioural change model) and become an advocate for the club and you!

Now we’d like to point out that the most common complaints of habitual exercisers are;

• I train a lot but it doesn’t really work that much
• Some people are so lucky, it comes so easily for them
• I can’t seem to get X to happen no matter what I try

The compliant exerciser (advanced) client

The compliant exerciser is someone who has an exercise habit, has a good base of fitness, adheres to all elements of their prescription and is getting the results they desire.  These people actually make up a very small minority of fitness club members.

The following criteria relate to this group

1. They have taken part in moderate to vigorous exercise at least three times per week every week for the last six months and complete their programme and progress their programme in a consistent and logical manner
2. They have moderate to high physical capacity and can tolerate exercise of moderate to high intensity without experiencing significant discomfort and fatigue during the workout, and soreness/discomfort for a day or more afterward
3. They have established usage patterns (attendance times, behaviours, rituals), understand their training clearly and have strong social connections with staff members and/or club members

Compliant exercisers are usually your highly active club members (i.e. they visit three or more times a week) who do all of what is required to progress.  Often they are advocates of exercise and have additional exercise habits outside of the club (mountain biking, running etc).  They can’t understand why anyone wouldn’t love exercise and working out in the club.  They do all of their training all of the time and if something comes up, have a plan to ‘make up’ or ‘substitute’ activities so their goals are achieved.  They will train, warm down, eat well, hydrate, rest, and follow a balanced approach to their well-being.

Because this group already has a programme they are doing and a set of behaviours your role is one of guidance and improvements.  They are usually quite pro-active in finding out more about how to improve their approach and if they think you are knowledgeable will open up their sacred training philosophy to you.  You can then work closely with them to get every ounce of benefit out of their training knowing it will be done, every-time, just as planned.  They do have a tendency to over-train because they sometimes think more is better.  Their over-training can either be caused by training too often, or not cycling easy, moderate and hard days.

When prescribing for these people you will usually write a programme and plan that:

• Has a very clear focus and parameters including what is in maintenance and what fitness component is to be extended
• Includes a monthly cycle or three monthly cycle of training (i.e. is periodised)
• Includes a plan B for things that come up
• Captures the volume of outside training and includes it within the overall plan (e.g. if they run twice a week and Sunday is a long run – your plan considers that)
• Includes tips on recovery, and when to regress or progress the programme to gain adaptation
• Includes information on how to monitor over-training including using a training diary if they wish