Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that is triggered by experiencing or witnessing a traumatic event.
Symptoms
Intrusive memories or flashbacks
Emotional numbness
Anxiety
Over-thinking, worrisome thoughts
Feelings of helplessness, fatigue, restlessness, exhaustion
Depression
Avoidance of social settings
Nightmares
Things that trigger memories of the trauma usually lead to intense emotional and physical reactions - raised heart rate, sweating, and muscle tension
Triggers
Certain sights, sounds, smells, or feelings that reminds the PTSD patient of the event they experienced
For veterans, triggers may be sudden, loud noises; suspicious cars or packages; etc.
Modifications
Recognize the barriers in the PTSD client and adjust accordingly - is the gym filled with too many loud noises (e.g., weights dropping, children screaming)? Go train in a separate room, or earlier in the day when there are less people.
Fatigue is a common symptom in this population, particularly for those who take medications. Know which, if any, medications the client is taking, and adjust the intensity and duration of the workout to avoid overtiring the client.
For clients who have social barriers, start off with one-on-one training, or have them bring somebody close to them. Once they feel confident, transition them to a small-group setting.
Exercises
Exercise is beneficial for recovering and regaining confidence in those who have PTSD. It can elevate mood, reduce anxiety and depression, release stress, and address other health problems associated with PTSD, such as cardiovascular disease and high blood pressure. As long as the client has no physical limitations, he/she can participate in exercise based on the ACSM exercise guidelines.
Tips for trainers and those working with the PTSD client:
Use a "task list"
Show the person a safe place to unwind and decompress, before the session starts. If needed, provide scheduled breaks so they can go there.
Provide support when there is a sudden loud noise
Allow the person to have a longer cool-down time than usual, so that the body and mind are cooling down together.
Be on the watch for profuse sweating, watchfulness, shaking, and other signs that the person with PTSD is becoming anxious and upset. Provide access to the nearby safe place in which he or she can withdraw and get back in control in private. Supportive behaviors for the personal trainer can include: staying calm, being near, but not touching the person or asking them questions. (Never say, "Are you alright?") The personal trainer could say, "I am here if you need me." "Let me know if I can get you anything."
Later, help the person identify what may have set off the panic attack. Sometimes, noises or a specific odor can trigger a panic attack.
Allow the person to bring his or her support dog to the gym.
How to help a client who is having a PTSD episode:
Have the client take a comfortable position.
Encourage the client to breathe slowly and relax.
Tell the client that he or she is safe.
Let the client know you are there to help.
Address the client by name.
Slowly bring the client back to the present place.
If necessary, refer the client to a qualified health provider.