11.2. Other medical problems
In addition to musculoskeletal injuries, personal trainers may encounter other medical issues in fitness, such as osteoporosis and exercise-related heat exhaustion. Additionally, trainers may encounter clients with cardiovascular conditions, diabetes, or respiratory issues (please refer to section 11.3.3 below). Adapting exercise programs to accommodate these health concerns, emphasizing safety, and promoting overall health and wellness is crucial.
11.2.1. Osteoporosis
Beginning at around the age of 35 in both men and women, calcium is lost, causing bones to become less dense and more fragile. Osteopenia is a condition in which bone mineral density is lower than normal. It is considered a precursor to osteoporosis, a disease of bones in which bone mineral density is reduced, the bone microstructure is disrupted, and the bone microstructure is disrupted the actual proteins in the bone are altered. Besides age, inactivity also leads to these changes in the skeletal system (National Institutes of Health 2007).
Regular physical activity has specific effects on bone health. Strong evidence suggests that early physical activity can maintain or increase bone mineral density (National Institutes of Health 2007). In older age, exercise has a modest effect on slowing the decline in bone mineral density.
In general, the treatment of osteoporosis includes exercise and calcium, vitamin D supplementation forms (Srivastava, 2002), and bisphosphonate therapy (Ettinger, 2003).
Women in postmenopause are at greater risk for osteoporosis. Major risk factors for postmenopausal osteoporosis include advanced age, genetics, lifestyle factors, thinness, and menopause status. To reduce the risk of osteoporosis, all postmenopausal women should be encouraged to maintain a healthy lifestyle, which includes physical activity and a balanced diet (Baccaro, 2015).
11.2.2. Exercise-Related Heat Exhaustion
Exercise-related heat exhaustion is an illness caused by getting too hot during exercise. During heat exhaustion, body temperature rises above normal, which is within a degree or two of 37°C. This temperature control is vital because many processes in the human body only work well within a specific range of temperatures.
The body has several ways to lower body temperature when it gets too high. Firstly, by sweating. When sweat evaporates, it lowers body temperature. Secondly, the body can lower the temperature by sending more blood to the skin and the arms, legs, and head. This lets more heat escape. The body temperature will rise if the body cannot get rid of the extra heat. In heat exhaustion, body temperature may rise from 38.3°C to 40°C. When this happens, a person feels weak and dizzy. If the heart cannot pump enough blood, a person can collapse.
Besides exercise, heat exhaustion can also be caused by not drinking enough fluids (dehydration), exercising outdoors on a hot day and also high humidity (the body cannot use sweat to cool itself), being in poor physical shape, having an infection, taking certain medicines such as stimulants, antihistamines, and medicines for epilepsy, having certain medical conditions, like sickle cell disease or conditions that decrease sweat and having a chronic illness (Hopkinsmedicine, 2023).
The main symptom of heat exhaustion is a body temperature of 38.3°C to 40°C. Signs and symptoms may include rapid heartbeat, fast breathing, heavy sweating, dizziness, fainting, nausea, vomiting, diarrhea, headache, muscle cramps, dehydration, and problems coordinating movement.
Unlike heat stroke, heat exhaustion does not cause significant brain or thinking problems, such as delirium, agitation, unconsciousness, or coma.
Heat exhaustion can be treated in fitness by stopping the activity and moving to a cooler area. A person should raise his or her legs to a level above her head and take off any extra clothing and equipment. It is recommended to drink water or a sports drink. Many people will get better within an hour or two of treatment; if not, a person should be checked by a doctor for more serious problems.