How to Train a 67 Year Old Pickleball Player With Frozen Shoulder and Tennis Elbow

Pickleball is the fastest growing sport among adults over 60, but injuries like frozen shoulder and tennis elbow can sideline even the most competitive players.In this episode of the Show Up Fitness Podcast, we break down how to safely and effectively design a strength training program for a 67 year old pickleball athlete dealing with shoulder stiffness and lateral elbow pain.Learn how personal trainers can assess movement, train around pain, improve performance, and help older clients stay competitive without surgery.Topics covered:• Frozen shoulder exercises for older adults:
 • Tennis elbow strength training
 • Pickleball injury prevention
 • Programming for clients over 60
 • Biopsychosocial model of pain
 • Training around shoulder and elbow pain
 • Full body programming for general populationIf you're a personal trainer working with aging athletes, this episode will help you confidently program for clients with pain while improving retention and results.Subscribe for weekly episodes on assessments, programming, and becoming an elite personal trainer.
• How to network with pickleball professionals and pickleball gyms to offer your services to bring in more clients so you can charge more and make over $100,000 as a qualified personal trainer.

If you want to become a personal trainer, SUF-CPT is the fastest growing personal training certification which helps you understand programming so you can design workouts for clients who play pickleball and all general population clients, especially when it comes to programming around pain. 

pickleball training for seniors
 strength training over 60
 frozen shoulder exercises
 tennis elbow rehab
 personal trainer programming for older adults
 training clients with shoulder pain
 training clients with elbow pain
 pickleball injury prevention
 workouts for seniors with injuries
 how to train older athletes

#pickleballtraining
 #frozenshoulder
 #tenniselbow
 #seniorfitness
 #over60fitness
 #personaltrainer
 #showupfitness
 #shoulderpain
 #elbowpain
 #strengthtrainingforseniors

Want to become a SUCCESSFUL personal trainer? SUF-CPT is the FASTEST growing personal training certification in the world!

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Transcript

Welcome And Big ROI Mindset

SPEAKER_00 0:00

That's the fun in this. You go out there, you meet people, you go to one of their tournaments, you offer to sponsor it, you pay 500 bucks. Oh my God, Chris, that's so much money. Three people sign up for $1,000 each. Your ROI is $2,500. How would you like to make an extra $2,500 a month?

Show Up Fitness Mission And CTA

SPEAKER_00 0:18

Welcome to the Show Up Fitness Podcast, where great personal trainers are me. We are changing the fitness industry one qualified trainer at a time with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showupfitness.com. Also make sure to check out my book, How to Become a Successful Personal Trainer. Don't forget to subscribe, rate, and review. Have a great day and keep showing up. Howdy all, welcome back to the Show of Fitness podcast.

Client Case: Pickleball With Multiple Injuries

SPEAKER_00 0:48

Today we're going to help you design a program for a 67-year young hunket who is playing pickleball, but also has tennis elbow on the right side, left frozen shoulder, and also an OCD lesion of the left ankle. Now, this is some fun stuff, but my question goes the critical thinking behind this, how many trainers out there are presented with a situation and they don't have the resources to go to? They go to Reddit, type in, how would you train this person? And you have 50 knuckleheads that are keyboard warriors, have no idea what to do because they're actually not even training. They're at home in grandma's basement and they're giving advice. Reading a textbook does not set you up for success when it comes to programming, thinking on the fly. And what I'm going to do today is I'm going to help you navigate, depending on which gym you're at, if you're at home, if you're at a hotel, wherever it may be, and go through some CCA programming to set you up for success, but also to help you think bigger and how you can use this as an opportunity to build your network.

Why Textbooks Fail Real Programming

SPEAKER_00 1:50

So let's start off with the low-hanging fruit, lateral epicondalija. I've done some stuff on tennis elbow. We should probably be calling it picklebell elbow because it's coming up a lot more common within that sport. And I love it. We have a 67-year young who's has some irritation, but she's still going out there and kicking ass. So she shows up today and she wants to feel better. So what we need to do is get into that soft tissue. We don't go to the bone. You can, it's just going to get some blood flow in there because that's where it's going to be irritated. But it's the tissue that's going to be distally moving away with that extension. Tennis elbow is going to be the extensors, golfers

Tennis Elbow: Soft Tissue And Loading

SPEAKER_00 2:30

is going to be the flexors. So I want to work down into those muscles, do a soft tissue technique. You're going to hold, and then work with flexion and extension. It doesn't feel great. And it's very common for your clients to say, well, it doesn't hurt there. It hurts at the elbow. Just like if I were to take your hand and shake it like you were a battle rope, your shoulder is going to get wrecked. But it's not your shoulder. That's just the byproduct of all the force that's happening at your hand. Same thing with tennis elbow, pickleball elbow. You have that irritation because it's a tissue capacity thing. Now, if there was any type of numbness that's shooting down into the fingers, you'd want to refer out to your team physical therapist. But in this case, it's specific to the work capacity and overuse with the sport. So you want to get in there, do some soft tissue. You can either do a mobility drill next or some type of corrective. Doesn't matter, corrective mobility or mobility into corrective. I like putting my hands into a prayer position, point forward, come back, do five to eight reps of those. And then let's get into some extensions and some flexions with a dumbbell, five, seven and a half, 10 pounds. And we're doing eight to 12 reps super, super slow. Three to five seconds with time under tension for the concentric and eccentric. And then the last rep hold for 15 to 30 seconds. It may get a little dull on the outside. Have your client rub that lateral part and it's going to feel better. Two sets of that. And then you'd want to get into the workout.

Red Flags And When To Refer

SPEAKER_00 3:53

But she also has some adhesive capsulitis, aka frozen shoulder, which is usually no issue. We just want to see what that range of motion looks like. So think of ice. It's frozen. Well, we want to get it to water. You're going to thought, it's the same thought process behind when you have this frozen shoulder. We got to work through that range of motion, and then maybe even a little bit

Frozen Shoulder Range Strategies

SPEAKER_00 4:15

more so. As a physical therapy tech, it was very common. I'd watch patients climb their fingers up a wall, hold where it's very discomforting, and you're going to hold for about a minute. And then you're going to want to go up a little bit more. You're working into that range of motion. Lots of drills that you can do. You can hinge back and put your arm in front of you, like on a barbell, and just elevate it to a position that has slight discomfort. Your client needs to make that decision. You're not working into pain where it feels so unstable like something's going to snap. Or obviously, if there's any type of numbness or dullness or irradiating pain, refer out to your team DPT. And you can also get like a PVC pipe if you're going to do a military press and then pull on one side at an angle and then work your way up into that higher position and then hold. As trainers, we are not manipulating joints. I'm not going to be moving that glenohumeral joint passively myself. That's for physical therapists, athletic trainers, but we can do soft tissue, but with frozen shoulder, it's not going to do too much because it's a capsule issue. Adhesive capsulitis. So that capsule has inflammation. So

Ankle OLT Explained And Teaming With DPTs

SPEAKER_00 5:21

we just want to work into that new range of motion. And then the last issue we had was OCD lesion on the left ankle. But really, what that is, it's referred to as OLT, which is an ankle chondrile lesion specific to the talus bone. You go back to your textbook certification, you should know the eight carpal bones, the seven tarsal bones, but you probably didn't get quizzed on that. So you just swept it under the carpet. But a talus is one of the seven tarsal bones. Remember, tarsals are on the feet, carpals are in the hands. More than 50% of our bones are in the hands and the feet. As we move distally, we then have the metatarsals and then the phalanges, lots of bones in there. You just have a little lesion on that condyle. A condyle is just a little protrusion in the bone. It could be a stress fracture. I want to learn more about that, which will then lead you into that conversation. I'm really excited to help you, Gertrude. Are you currently working with a physical therapist? After today's session, if you feel comfortable, I would love to take the opportunity to either go to your next session or if you could connect me with them, I would love to reach out to see how I could better program and to make sure everything I'm doing within is appropriate for your long-term success. How does

Network With Therapists And Build Trust

SPEAKER_00 6:31

that sound? And then when you reach out to the physical therapist and let them know you have a mutual client, ask them who their trainer is. You don't have a trainer. Why don't you come to my gym? I will comp you a session. If you're in a beautiful lifetime, get them a free pass, take them through a workout, let them know you charge $150. Explain DPT is upper's decision, not yours, because you are a dynamic personal trainer. It could piss the therapist off, but have fun with it. Take them through a great workout. And they're gonna be like, holy shit, dude, you're a qualified trainer. You really know what you're doing. In the future, if something pops up, why don't you send me a client? Because I'm gonna be sending you a lot of my clients when stuff like this comes up. How does that sound? And then you take them out to happy hours and coffees and lunches on a regular basis and you build your team. That's what success looks

PAR-Q, Scope, And Trainer Confidence

SPEAKER_00 7:19

like. So you have these issues that you found and discovered during the park. Physical activity readiness questionnaire. When in doubt, refer out. If you don't feel comfortable with these, let your client know. I don't feel comfortable. I may have to refer you out, but qualified SUF CPTs know that this is in your wheelhouse. This is a client who you can help. You don't need to avoid upper body and just focus on lower body because they had that discomfort. You've been given the tools to screen within the STM certification, one of the three that we offer.

Warm-Up And 10-Checkpoint Assessment

SPEAKER_00 7:51

That's why our trainers are making 100 plus thousand because they're qualified and they build great teams. So you can implement a workout within the CCA, which we'll go over here in a second. So within the warm-up, you're gonna do your soft tissue. You're gonna do those 10 checkpoints of human movement at the ankle, knee, hip, lumbar, thoracic, spine, your shoulder, your elbow, your wrist, do some breathing drills, check out their balance, see how they move. This is gonna be about 15 to 20 minutes into the workout and assessment. But from that, you're going to pivot. Great trainers do not train the program, they train the individual. That's why I'm not gonna spend an hour writing out this program. I'm gonna discover a lot within those first 15 to 20 minutes, and I may have to pivot. But in my mind, I'm going pickleball. What are we doing? It's gonna be more unilateral. We're gonna be rotating to the side. There's transitional components involved. She is active. I want to see what active means to her.

Needs Analysis For Pickleball Demands

SPEAKER_00 8:47

Because in my mind, active is different than her mind. Has she lifted weights? What's my rep range going to look like? My exercise selection is based off the core movement patterns for her sport. What are the common injuries? Well, she has most of them. So I don't have to worry about that. The bioenergetics, that's gonna be more phosphogen, that's zero to 30 seconds of high-intense work, which is type two recruitment, breaking down ATP, producing adenosin diphosphate, which can then bind with some creatin phosphate to create more ATP, but I'm not gonna get into bioenergetics right now. That's just a little example of how you assess based off of a needs analysis. If you want to throw in some METCON at the end, but I'm really just gonna focus on overloading the patterns.

CCA Template And First Circuit

SPEAKER_00 9:30

So within the CCA, the first one I'm gonna do is a unilateral. Then I'm gonna follow it up with a push, a pull, or a press, what I would call PPP right here. And then we would do an accessory. We would rest and do that circuit for three rounds. I would start with a unilateral step up, see how the control is, step down nice and controlled. How's that stability in the frontal plane? If she has a little bit of knee valgus, it's not the end of the world. I'm gonna put my hand on the lateral part of her knee, keeping her big toe, little toe, and heel on the ground and driving into my hand. We're gonna do like six to eight reps per leg. I don't want to do so many reps, especially because the eccentrics, where I wreck her and it then affects her sport. Because that's the last thing you want to do is take her through a workout on a Monday, and then she can't train for four days because she's so damn sore. So keep the volume low and then make sure that the intensity is appropriate for her being. And then I'm gonna go into a barbell push, which would be a push up. If I felt like it was appropriate to go on the ground, maybe she's a rock star and she said she can do 15 push-ups. Awesome, Gertrude.

Volume, Intensity, And Progression

SPEAKER_00 10:34

How about you show me? I may feel like it's appropriate to do push variations. I'm not gonna get her on her knees. There's no such thing as a girl push-up. Let's not get sexist in the fitness world. It's a push-up. So if she can do it, control it eccentric, I would do maybe three to five of those. Add a band. It depends on her capabilities. Then I'm gonna do a plank to get some anterior core stability and strengthening involved. When I go into the second round for the step ups, I'm gonna keep the load the same. Progressive overload doesn't mean you always have to add weight. The neuromuscular efficiency from doing it again, if that improves, that's also overload. So keep it the same. Then when we do the push-ups on the bar, maybe I have her lift the leg out for a couple of the reps. And then the same with the planks. Round three, same thing, same thing for the push-ups and planks. And then we move into the second CCA. Because of her age and her condition, between that step up into the push, I'm gonna see how she's responding.

Second Circuit: Hinge, Row, Side Plank

SPEAKER_00 11:30

If she's huffing and puffing, I need to rest longer between that circuit. So I would do a step up, learn about her life. What is her profession? How did she get into pickleball? Use the rest to your and your client's advantage. The second circuit, I'm gonna do a hinge and a single leg bridge. Moving into the opposite, if I did a push, I'm gonna do a pull. So I'm gonna do a TRX row. And then I'm gonna do a side plank with abductions to strengthen the glute mead, upper fibers of the glute max, TFL, sartorius, important muscles for stability going back and forth for pickleball. I'll do that for three rounds.

Squat, Press Mods For Shoulder Limits

SPEAKER_00 12:06

And then I'm gonna move into some goblet squats with the side, almost like a variation of a Q-sack to load that hip and to get some stability. And I'm gonna rock back and forth. We've already done a push, we've done a pull. Now let's do a press overhead. But because of the frozen shoulder, I have to modify it based on what her range of motion is like. It may be you wanted to do some thoracic stuff to see if it opens up her humeral flexion. She does not have to go and she probably can't even come close to getting to 160 degrees of flexion. So I'm gonna modify it. I'm assuming 67. A landmine press would be appropriate, but not for her because of the load. Probably can't move that barbell, even though it technically is 45 pounds because of the biomechanics and the leverage. It's gonna be less than that. But maybe you have to regress it to a half-kneeling banded press where you're gonna anchor it by her ankle. You're gonna hold it, and then she's gonna press up to the range of motion that's comfortable. And then maybe she

Sport-Specific Rotations And Stability

SPEAKER_00 13:01

holds at the end and you try to have her come up a couple more inches just to create that stability, which she's lacking. And then we're gonna do an airplane. That's where you bend your knee and you're gonna take away the sartorius, the TFL, and the gracillus, because those are all bi-articulate hip and knee muscles. So when you flex the knee and you put it down on a bench, you're just challenging the glute meat in that frontal plane. Maybe you feel like it's appropriate to bring a pickleball or some type of ball that you could toss to her. After that, she gets up, you give her a med ball, and she does some rotations or she's passing it to you, or you do a payload. So you're complementing the sport requirements and what she needs to have that force. She's going out there and she's probably doing lunge variation. She's probably rotating into a plane or a range of motion that she can't really own. So she's gonna be more prone to future injuries. We got to get her stronger. And the beautiful thing about the CCA is we're gonna do it the next time she comes in.

Rotating Patterns Across Sessions

SPEAKER_00 13:57

But what I'm gonna do on that second workout is I could take that third CCA. So bring the goblets up to the first one. And then instead of doing a push, which I did first, I'm gonna do a pull. So you still use the same template and think of it like this. I was talking about this in class today for our level two mentorship, getting people to think critically. Think of having a plate in front of you. You have your protein, your fruits and vegetables, and your carb. So you eat your protein first, and then the fruits and vegetables, and then your carb. The next time you eat, have the carb first and then the protein and then the fruits and vegetables. Same thing with the next time. It's the same with this programming. You're just changing up the rotation of the patterns, but you're overloading appropriate for the client's goals.

Homework, Apps, And Resources

SPEAKER_00 14:38

As I said earlier, I'm not gonna get down to a six rep max going to volitional fatigue because she's probably not ready for it. Work within her capacity, implement the soft tissue stuff, that's gonna help her feel significantly better. The homework is gonna be doing those wrist curls and those drills. I would send them stuff from the prehab guys because we work closely with them. If you do not have their exercise library app, it is amazing. Use the code SHOWUP and you will get a discount. It is amazing because you can send that to your client for homework to do. That's the program, and I would implement that regularly.

Sales Conversation And Packaging

SPEAKER_00 15:13

How sales works, and we have these calls on Friday where we do role playing. You talk to her at the end. How do you feel, Gertrude? And she says, Oh my God, my elbow feels fucking amazing. It's always great when you get someone who's a little older to start dropping some F bombs. But you sit her down. How are you feeling? My elbow feels great. My shoulder feels awesome. I really like those exercises. Awesome, Gertrude. How many times do you want to train with me? Well, Chris, I'm playing pickleball 38 times a week, so I'm thinking one or two times. Awesome, Gertrude. Eight sessions cost X and 48 cost X minus 10%. In my head, I took two plus two plus two plus two. That's eight in a month, times that by six months. That's 48 sessions. Within the session, that assessment process in the beginning, I like that question. Gertrude, what does success look like six months from now working with me? So you're planting that seed. So during that sales process, she imagines success with you. Then she decides you shut up and you don't talk as fast as I am right now. You smile. Which would you like? I would like the 48 Chris. Awesome. Here's how much

Courtside Networking And Workshops

SPEAKER_00 16:18

it costs. How do you want to pay for it? She throws down her black Amex and then you charge the card and then you help her get a results. But you don't stop there. You ask her, when's your next day? You're going to go and play pickleball. I would love to come and watch sometime. And then when you're there, you link up with some of the professionals and say, no, I really want to buy Gertrude a session and let her know that you bought her a private pickleball instructor session. You invested into her. And this is not in contingency of if she signed up. If she said no, I would still do this because I'm now getting into that environment. I'm going to be networking with that professional, other potential clients who need my help. I'm going to talk to the manager. How would you like it if I came in once a week or once a month and offered a free workshop to help with pickleball elbow? Oh my God, our members would love that. You would do it? Absolutely. You line up 20 old folk and you start doing some soft tissue on the lateral, the medial side. You have them do some wrist extensions and flexions, some mobility drills, and you just help 20 people. But more importantly, 20 people in your community know that you are a qualified coach. Hell, you could bring your therapist in because great trainers have a therapist on their team. Hell, you can go to one pickleball spot and the therapist goes to another pickleball spot and you're killing two birds with one stone. When trainers say things like that's

Invest Locally, Sponsor, And ROI

SPEAKER_00 17:39

so hard to get clients, are you investing into your growth? I'm not talking about some fucking bundle with your corrective exercise specialists and wellness specialists and your social media specialists that you just paid $1,500 for with NASA. I'm talking about being in the trenches, networking with actual people and showcasing your skills. That's the fun in this. You go out there, you meet people, you go to one of their tournaments, you offer to sponsor it, you pay 500 bucks. Oh my God, Chris, that's so much money. Three people sign up for $1,000 each. Your ROI is $2,500. How would you like to make an extra $2,500 a month? That's big thinking. Pickleball is hot

Final CTA: 30-Day Pickleball Program

SPEAKER_00 18:22

right now. If you want to get a full 30-day pickleball workout, which we have designed within the SUF CPT and the avatars, we will send that to you. Leave a five star review. Email info at showupfinist.com. We will send that to you so you have that confidence to better serve your community. Remember, big pickleball smashes are better than small ones and keep showing up.