Most individuals seeking the guidance of a personal trainer want to improve their general fitness, reduce pain, improve their athletic performance or lose weight. But what if your client had very different goals? What if their goal was simply to stand or walk? That is exactly what Stephen Sims does in his role as a personal trainer with Neurokinex, a not-for-profit organisation dedicated to providing rehabilitation for people living with various forms of paralysis. We sat down with Stephen to talk about five lessons he’s learned working with people living with spinal cord injuries.
Lesson 1: Look past the wheelchair
Regardless of a person’s situation, it’s important to see them as an athlete. In this situation, the client has gone through a traumatic experience and they are looking for someone to help them have some faith to improve their situation. So, when someone comes to Neurokinex, we don’t treat them as someone in a wheelchair. We treat them the same way any trainer would treat someone coming in off the street. We look at their strengths and weaknesses and map out a plan to help them achieve their goals.
And just like any client, it’s about setting realistic goals. For many people I see, the goal is to walk again. But sometimes we need to start with different goals like stabilising movement around the spine or picking something up off the floor. These small goals are steps toward the larger goal of walking again. The programmes we develop are very individualised. We see training someone with a disability as just a bit different from how we would train anyone.
Lesson 2: Focus on abilities, not limitations
Most people come to us wanting to walk again. While this is often the ultimate goal, there are other aspects of the body that we need to work on before getting to walking. For a higher-level injury, we would need to improve trunk stability and control first before they can attempt to stand or walk again. We would look at the severity of their injury. Can they move their arms? Can they sustain a seated position? These are the building blocks to standing. Our founder and CEO Harvey Sihota is very up-to-date on all the latest training techniques and neurological rehabilitation science and that really underpins what we do.
Lesson 3: The environment matters
We have learned that people feel better and perform better when they are not in a clinical setting. We try to build a positive, friendly and open environment that feels more like your local gym. It’s about community and connection. Clients who come at the same time get to know each other and share their experiences. It becomes a bit of an open forum where everyone understands each other. This can be immensely helpful from a psychological perspective, especially for people who have just come out of hospital. That nervousness they feel just goes away.
We don’t treat our facility as a clinical environment. When you enter our gym, there are similar machines and kit to what you would see in an ordinary gym. We just use these machines in a different way. We’re aware that some people have never entered a gym in their life and that amount of kit can seem scary. For others, it is really exciting.
Our approach to training is very different in that we focus on neuroplasticity. This is the ability of the neural networks in the brain to change through growth and reorganisation. For many, the sessions focus on gentle movements and rehabilitation, but we can also do high intensity training for clients who are able. We are currently training a number of Team GB hopefuls and clients already in the GB squad for sports such as wheelchair rugby, triathlon and shot put.
Lesson 4: Adapting skills and knowledge to each unique person / situation
As a trainer, it is a real challenge to adapt our training for each individual. There is no one-size-fits-all approach. I am routinely put into different situations among people with varying abilities and different perspectives about training. It’s all about trying to find some common ground. Agree on the goals and agree on a plan. Talk to your client about the type of equipment they like and don’t like and adapt your plan to that individual person. This is true in any personal training situation, but it’s especially important when you’re working with people with disabilities. The harder they work, they better gains they will get so it’s important to keep them engaged and motivated. The saying, “if you don’t use it, you lose it,” is very relevant for us. We try to use as many muscle groups as we can in our sessions and challenge people in many different ways to create gains. Even a small gain is enough to keep someone coming back.
Lesson 5: Exceeding expectation while managing hopes
We never make promises. When clients first come to us and tell us their goals, we know right away whether those goals are realistic or not. While standing may be the ultimate goal, we know the steps that need to be taken to get there. Everybody is different. But we need to get our clients to trust the process.
In order to maintain motivation, we set small challenges. This takes their eye off the big goal and changes their focus to other things. For example, can they beat their personal best on the hand cycle? Can they pick up this cup off the floor in less than 10 seconds? If a person is able to walk but is unsteady, we won’t just walk and walk and walk. We’ll instead put people on a Bosu ball and see how long they can balance. We try to divert our clients to accomplish things that can help in daily life. This helps them start building toward their ultimate goal, while enjoying ‘small wins’ where they can improve more quickly.
The way we view disability and the way we train is different from anywhere else. That’s what sets us apart. Our environment and approach help people psychologically. Here, people don’t feel out-of-place or as if everyone is looking at them. We set out to build their confidence as much as their strength and abilities. Many people come to us with their head down, but they always leave with their head up.
For more information on Neurokinex, go to https://neurokinex.org/