#24. Exercise for "Special" Populations Monday, July 26, 2021 Everyone is special. To a degree. And our specialness manifests in a number of ways. Sometimes abstractly ("she has a certain je ne sais quoi about her"), but also bodily, cognitively, developmentally, emotionally... I could go through the alphabet. Probably twice. But won't. Instead, I'll say this: in health and fitness, your individuality matters. And you have more of it than you know. How about blood pressure? Is that something you care about? What commonly gets reported is that exercise reduces one's mean pressure by 4 to 9 mmHg (Kruk et al., 2018). But people are special, remember? The reality is more than 10% of people will experience an increase in systolic pressure of at least 10 mmHg after exercise training (see figure 6 and the corresponding commentary in: Ash et al., 2013). And blood pressure is just one domain in which we express our uniqueness. There are some fundamentals to keep in mind (you are a human, after all), but we're well past the age of one-prescription-fits-all exercise advice. What are some other areas to consider? Definitely anything that presents a limitation. And we all have them. You, me, everybody. It could be an acute injury. Maybe a sprained ankle. Or it could be an injury that's overstayed its welcome: a sensitive shoulder or bad back, a trick knee or bum hip. We have common expressions for our most common ailments. But no matter how common or uncommon your circumstances are, they warrant modifications to your exercise prescription. Perhaps balance problems present a fall risk. Perhaps diabetes unsteadies one's blood sugar. Perhaps you track time on a trimester calendar these days. Age is another consideration: are you ten? A hundred? History of diagnosis matters a great deal, too. Maybe it's asthma or arthritis, bronchitis or a blood disorder, cancer, depression, epilepsy, fibromyalgia, gout, heart disease... Again, I could do the alphabet (twice). And again, I won't. Instead, I'll say this: nobody escapes every letter completely. Nobody goes through life devoid of any limitation at all. Everyone battles something. And now it's time for some very special tips: Tip 1) Yesterday's taboos were money, religion, and politics. Those were the topics that prickled our sensitivities. Today's topics are too sensitive and prickly to mention here. But I can safely guess what tomorrow's might be: our limitations. At the moment, we're too frightened of this subject to treat it as indelicately as an ordinary taboo. I understand the discomfort in plumbing our vulnerabilities, but I think life and health are so much livelier and healthier when we're open and honest. Everybody reading (and writing) this blog has a challenge of some kind. So take stock of your health -- the full gamut of human functioning -- and accept yourself. As is. And honor your individuality. Strategizing to overcome a unique challenge is part of what makes exercise rewarding. Just remember: no matter what your obstacle course looks like, moving your body (in some way or another) is vital to goal attainment (King et al., 2019). Tip 2) Pre-exercise health screenings offer a checklist to get you started. It doesn't cover everything, but it gets you reflecting in the right direction. Depending on how you fare here, it may be prudent to inform your physician of your exercise plans, and the extremely ambitious nature of your goals. Similarly, if you have a professional trainer or health coach, let that person know about any risks and limitations you have (including medications with possible adverse effects). At the same time, nurture your wariness about "gurus" and "influencers" whose claims are not supported by education or citation. In this field, there is a long (and sometimes legal) history of tragedy befalling the trusting (Ciccolella et al., 2008). Tip 3) If you are a fitness specialist, then you should absolutely-certainly-definitely be apprised of any limitations or risk factors in your clients before providing instruction or recommendations. Because this is such a sensitive topic, your clients are unlikely to volunteer this information. So your first session together should involve a lot more conversation than exercise. And every word in that conversation should promote respect and dignity (for example, no one is "a diabetic"; rather, we are all people who have a condition). Whenever your client reports (or otherwise reveals) any such area of individuality (e.g., a condition or medication), if you are unfamiliar with it, you must put exercise prescription on hold until you've read enough to do it safely and effectively. Conversely, if you're a client and your health coach or trainer skips this step, it's time to find a different one.