How many times a year do you see your doctor? Maybe once for your physical or to renew medication. Sometimes more if you get sick. Maybe frequently because you have some type of illness. Maybe not even once a year. And when you do see your doctor, how comfortable do you feel around him or her? Do you confide in them about your work stresses, or the thing your kid said to you the night before? Do you talk to them about your relationship or tell them about the amazing dinner you had last night? You may, but most likely not.

Now how many times a week do people come in and work with their personal trainers? Probably at least once a week, maybe even four or five times a week. As a coach, I interact with my clients sometimes daily. We send messages back and forth, we see each other frequently, and I learn a lot about every single one. I know what foods they like and dislike, I know about their jobs, and their relationships, how many kids they have, their insecurities, the name of their dog. I have very strong relationships with all of my clients and I’m sure most personal trainers do as well.

This isn’t my way of saying that personal trainers are better than physicians because we know more about our clients than doctors do about their patients. That’s not true at all. What I am saying though, is that it’s our job to recognize when something is wrong. Here’s my anecdote to illustrate this point:

I’ve been seeing a client for a couple of months now. He has very high levels of stress. He’s a very sweet guy, very kind, works hard on his exercises he does independently, and his main goal is to gain some mobility. We’ve done some stretches and breathing (I had him do an entire session of just breathing and he gained over 15 degrees of shoulder flexion), but our most recent session he opened up a little bit further. I began to ask him questions about how he’s sleeping and he told me not very well. He said he’s stressed at work. Okay, that’s pretty normal for Silicon Valley. But, I asked some more questions. “How much sleep did you get last night?” he said he had about 9 hours. That’s a decent amount of sleep, so why isn’t he sleeping well? I inquired further and found out not only has he not felt rested after sleeping, but he doesn’t want to get out of bed in the morning. He’s been feeling incredibly depressed and doesn’t have the strength to get up in the morning. My heart sank. Here’s this awesome, happy, nice guy who can barely get up in the morning. From what it sounded like he also has not sought help or guidance for this yet. He hadn’t told his doctor because he doesn’t think he needs to make an appointment for this issue. Yet, his depression is so crippling that he is barely functioning. So what is my responsibility as his personal trainer? I’m not equipped to take him through a screening, or counsel him, I’m not a licensed therapist. But, he’s confided in me. I’m his first point of contact with this issue in his medical care team. He’s been working with an acupuncturist and a massage therapist, but his reason for treatment is stress, not depression. There’s a very good chance I’m the first person to receive this information just because I see him enough and I happened to ask the right questions.

So what did I do? I told him I was here to help him and to listen. I told him that everyone at our clinic cares about him and we are there to help improve his standard of living. And finally, I referred him. It’s not my job to treat depression, I am not trained on how to handle depression, but it is my job to recognize when there is a problem and to refer appropriately.
Which brings me full circle to the title of this article. Personal trainers are generally the first point of contact for people; we are on the front line of healthcare. This is something Brendon Rearick taught me. We generally have the most time with people throughout a year of sessions. We may not treat disease or do rehab, but we have the most reps with clients/patients. So while it’s not our jobs to do medical procedures or treat and diagnose, it is our job to recognize and refer accordingly for the best interest of our clients. We are part of their medical care. The services we supply are to improve performance and health for every type of client, whether you play professional basketball, or you’re a 65 year old woman who wants to walk up the stairs without holding on to the railing, my primary purpose in your life is to improve your life. So if I ignore or overlook things like depression or other medical issues, I’m failing at my job. Recognize, identify, and refer – it’s in your job description.