The role of empathy in the personal trainer's bag of skills is often underutilized and undervalued. A trainer without this skill is much like the physician or surgeon who has no bedside manner, clients just don't want to come see someone who doesn't "get" them or who doesn't take the time to try. Everybody knows the trainer who has had the same clients for 5, 6 even 10 years and some with little visible changes. Most likely this trainer has the ability to empathize with his/her clients. This article will take a look at the purpose for empathy in the training relationship as well as some key methods increase your empathy skills.

Let's start by saying what empathy is not. Empathy is often confused with sympathy which is feeling for someone. An example is when a client talks about their struggle with weight and the trainer says that sad or sorry. Caring is important but is not empathy. Empathy isn't commiseration either. I sometimes watch young trainers who have had their own issues and successfully worked through be too eager to share their own story. It sometimes feels like a competition, oh you're 30 lbs overweight; well I used to be 60 and look at me now. That is the best way to tell a client you aren't listening!!!! 

Empathy is a form of verbal and non-verbal communication used to portrait the message that you can feel what they're feeling. It is communicated by attentive, active listening. A key here is being able to read what someone is saying with their non-verbal cueing and placing you in their shoes. It is really important to not necessarily use experiences that mimic most the clients, but to call upon emotions that the client's is emitting. We all have similar experiences, but please understand that each individual brings a different history with them so the same experience will be different to each person. One person might feel angry where another might feel loss or fear. If you draw too much from your experience and not your emotional history you can get it all wrong.

Things to watch out for:

1.         Your own experiences: This can be a killer. Your experiences aren't your clients!

2.         Skipping to teaching: I understand you do your research and read all the articles on PTont he net, but acting the part of the rabbit often leaves the client behind.

3.         ASSUME you know what they feel or are going through: we all know the adage but it is one of the biggest killers in displaying empathy, clarify!

4.         Butting in: let the client talk, sit through silence when you're trying to get the "super why"

5.         Ask closed questions: This is ok for the ParQ, but not for history taking and goal development

6.         Letting the client off: When you get the feeling you are not getting the whole story, you probably aren't.

7.         Avoiding uncomfortable questions: Do you have the support of your family with this endeavor?

8.         Missing the check in: pre-programming too much based on where a client was the last time you met with them emotionally or not taking the time build repore on a session by session basis. Clients need to know you care!

9.         Non-verbal give-aways: just like in sports turnovers cost you the game. Rolling your eyes, squinting, shoulder movements, arm positioning, head tilts all send a message, practice and use a mirror.

10.       Failure to mirror: Leaning in or leaning out is a simple postural spacing that send a message, make sure it is the right message

In my opinion empathy is one of the most important keys to motivation. It is really difficult to motivate your client if you don't know their fears, their reasons for specific goals, and their general emotional state. Pushing someone who has no self confidence or is emotionally fatigued is a great way to undermine one's goals before even starting.  At the same time babying a client because you feel sorry for them may breed contempt. No one wants to be treated like a child and especially someone who may be treated that way often.  Some clients need to be wowed with your style or experience and some can feel overwhelmed by it. Knowing a clients frame of mind and their emotional positioning can give you the clues. Even the same client may need a different approach from one session to the next.

Empathy's biggest benefit is in maintaining clients. Who doesn't want to go spend regular time with someone who just seems to be there for there physical betterment and also for their mental and emotional release? We in the fitness profession spend tons of hours trying to understand human movement and how to improve on it, but little time on meeting the mental and emotional needs of our clients. I not advocating personal trainers becoming psychotherapist, absolutely not, but I am advocating tapping into the abilities we all have to be truly human and caring. Many people have far too few in their lives who are, becoming a part of their lives in this way enhances your ability to maintain the client/trainer relationship for a longer time.

Last but not least, be sure to refer out when you feel like you are in over your head! Going deeper into a client's emotional and mental make-up will sometimes uncover issues you are not trained to deal with. Add a psychotherapist to your list of referrals for this situation. You don't have to lose a client considering exercise will likely be the first thing a psychologist or psychotherapist will prescribe and your sending the message to your client that you truly do care.

Introduction:

The impact of stretching, ROM and strength training on neurology based conditions can be profound. Inactivity has a dramatic impact on future muscle function and coordination. Decreased ROM and muscle tightness impacts total movement and leads to overstressing the body and poor movement patterns. Many current and future problems come from these poor movement patterns.

The initial phase of corrective exercises is to increase general joint range of motion. It is essential to increase range of motion in a bilateral sense. ROM should be roughly equal bilaterally. Be sure to not work in any range where pain is felt. Make sure the ROM is smooth. Be sure to start with small ranges and work until maximal ROM is attained. Initially the speed of the exercises should be comfortable. Slowing down will increase strength and speeding up will increase more explosive capability. Focus on the exercise and be as precise as possible. Make sure the rest of the body is stable and supported so that only the joint being exercised moves.

Corrective exercise list and basic instructions:

Ankle- The ankle and foot can be the leading cause to many movement concerns, injuries and poor patterns.

Drags: (these can be done sitting or standing) hook your big toe top side down on the floor or behind something; drag your foot forward. This should stretch the top of the foot, in line with the ankle. This can be done with the foot being pulled straight forward or angled inward and outward.

Circles: This one is easy, complete perfect circles

Abduction/adduction: move your foot at the toes to the right then left.

Knee- The knee has very little range of motion so the focus is on circles. Try to keep the ankles and hips quiet.

Hip- The hips has significant ROM so there are many movements to be done here.

Circles: Hip circles should be done with the straight leg forward, to the side and posterior.

Hip raises: keeping one leg straight, lift the other upwards off the ground.

Hip clocks: sit at the end of a bench with your knee bent; swing the leg laterally like a pendulum back and forth.

Hip rotations: Stand and internally and externally rotate (straight leg and turn at the foot) your leg.

Pelvic circles:  Think Hula Hoop. Rotate at the pelvis.

Pelvic tilts: tilt the hip girdle forward and back. Tuck under the tailbone and then pelvic thrust.

Spine- The spine is made up of the lumbar, thoracic and cervical sections. Each of these sections should be worked in linear fashion and circular fashion.

Circles: start small here and remember to not move into pain. Try to stabilize both above and below the area you are working.

Flexion/extension/adduction/abduction: focus on each vertebrae and try to move just above it front/back/side/side.

Glides: We typically do glides on the cervical spine (neck). Holding everything else still, slide your head forward and back, as well as side to side. The top of your head should not raise or lower. Many people find the glide backwards very difficult.

Egyptian: Keep your head level and slide it in a circle. Remember not to lift your chin or drop it.

Rotations: Rotations should be done in each of the three sections. Try to rotate just above the area you are working.

Shoulder-The shoulder is often affected by the neck and can be affected by the elbow and wrist.

Flexion/extension/abduction: Stabilize the shoulder at the scapula and keep the neck straight. Move the arm forward, backward and sideways to the end of the ROM.

Rotations: Straighter your arm, rotate inward from the shoulder then extend from the shoulder.

Circles: Just like the hip, do circles starting forward, to the side and backward.

Scapula-The scapula or shoulder blade has the capacity for movement in all directions, so it is essential to move it upwards, downward, outward and inward. Keep the arm straight when you move the shoulder blade. What happens at the arm is happening at the shoulder blade.

Scapula circles:  Take one arm (horizontal to the shoulder) forward. Create a circle at the shoulder starting forward and moving down back up and forward again.

Elbow-The elbow has very little range of motion and rarely does anybody struggle with flexion and extension.

Rotations: Flex the elbows and move the hands in a circular pattern. Be sure to rotate both ways.

Wrist- The wrist flexes, extends, moves medially and laterally as well as circles.

Circles: Flex the wrist toward the ceiling with palms facing your. Leading with your thumbs rotate the hand inward and down then completing the circle.

Fingers- Flex/extend/ and circles are needed to maximize the finger ROM.

Balance exercises are a key in maintaining appropriate movement patterns. Proper balance requires core strength and endurance. The core’s function is to hold posture at rest and during function. Balance and core exercises go hand and hand and can be easily combined.

Try these exercises, make sure you are in a safe place and use a chair or bed to provide safety.

Close eye stand: Use a chair or something for stability, stand tall and close your eyes.

Small step lunge: Step forward with one leg and lower straight down. Adjust the depth as needed. To add difficulty angle the front step then close your eyes.

Single leg lift: Lift one leg while maintaining level hips. Increase difficulty by closing your eyes.

Single leg squat: Use a bench, step or table to add support. Bring one leg backwards and in the air, then squat on the remaining leg. Increase the depth to increase difficulty.

Horizontal axe chop: Place both hands in front of your body just above the belly button. Rotate at the waist as if you were swinging an axe. Add weight to make it more difficult.

Diagonal axe chop: Same as the above exercise but angle upward and downward.

Bent knee crunch: lie down on the floor with feet flat and knees bent. Lift your shoulders upward towards the ceiling. You can also lift your knees and keep your back and head flat on the floor.

Bicycles: Lie on the floor with your back flat on the ground. Bend knees and begin to air peddle the legs. Focus on keeping your back flat.