How to Train A 98-Year-Old PT client

A 98-year-old walks into your gym. Do you panic and reach for a stability ball, or do you coach what actually keeps them independent?

We take you inside a real coaching moment from our Show Up Fitness class and lay out how we think about program design for older adults and senior fitness. The big shift is simple but powerful: stop collecting exercises and start coaching movement patterns. We talk through what we look for the moment a client arrives, how we “assess” without forcing uncomfortable screens, and how we choose squat, hinge, push, pull, carry, and transitional work that maps directly to activities of daily living (ADLs) like standing up from a couch or getting off the toilet.

From there, we get practical. How do you build a safe 30-minute personal training session that still drives results? We share examples like supported squats, bar presses or machine presses for stable loading, light medicine ball throws for power and fun, and balance games that make clients light up and come back. We also cover progressions, regressions, and why a grounded goblet squat is often smarter than unstable “functional” gadgets for fall-prone clients.

Recovery is a make-or-break variable at this age, so we dig into volume, frequency, soreness management, and nutrition for older adults, including a clear protein target to support muscle building despite sarcopenia and dynopenia. We finish with the coaching mindset that keeps people safe: plan for worst-case scenarios, keep the space clean, and earn the right to progress.

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Transcript

Welcome And Trainer Resources

SPEAKER_00 0:01

Welcome to the Show Up Fitness Podcast, where great personal trainers are made. 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 showufffitness.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.

The 98-Year-Old Client Challenge

SPEAKER_00 0:28

Haddy all. Welcome back to the Show Up Fitness Podcast. Today we're going to help you design a program for a 98-year young client. And here's an excerpt from today's class where we help trainers level up their skills. We have Mr. Paul, and this was a client case example that he had. Listen up.

Real Client Wins And Uncertainty

SPEAKER_01 0:45

Yesterday I had Tesla Sid squats. He does seven. That's all. He was taxed. We had to rest. Really good though. Really driving through uh through the through the legs. And then um did some TRX uh sit squats by just kind of really controlling it. And then uh I hand him the med ball and I said, Why don't you just throw this over the shoulder that I can't? He sat there all day, like throwing that pipe. I went up to him. I said, This is the ball you told me you couldn't throw last week. So yeah, it was uh I'm gonna be really sore tomorrow, I can tell. It's fun. It's fun, it's fun for me. I do it, I do CAs with him. So I'll I'll typically do like some kind of like a TRX six watts, and then I'll do, I'll have him do like pulls, you know, against a rail. Like just kind of instead of I'm just not comfortable on the TRX man, you know, with him. He's not he's not super stable. So I've been having push-ups on a bar, things like that. So I'll just have him do a set and then I'll do a balance. Like, okay, let's stand on one leg and balance. Or he loves when I play catch with him. Like I'll put him on the chest press machine. It's about the only real heavy resistance I've done with him so far is put him on the chest press machine. And in between sets, I'll you know, play catch with him. And he just he lights up. He he likes when I when I don't catch it. So uh all my guys were they're fun, they're fun to train and they're they're they're getting better and they're getting stronger. And uh I I don't know. I don't know how these guys train without kind of the the depth of because I I'm still and truth be told, to everybody like I'm still like uncertain of of most of what I'm doing, you know. But I tell you, I'm super attentive. I can switch on to fly if I gotta, just because of what I've learned here. Uh if I want to do like yesterday, I was looking for something, but wasn't there, you know, like I could like I can change up and keep my, you know, just stay focused on the movement patterns I want to work on. You know, just trainers that have no training education, training people. And I just I couldn't imagine, you know, myself doing that because I just just feel like I know enough to give somebody a decent workout. But I have a team, like you guys, like when I get stuck or whatever, hey man, you know, you know, Tyson, whatever, you know, all you guys would like when I jump on the calls, like here's what I'm dealing with. And I get, you know, I take a bunch of notes and I take them to work and I put it to work.

SPEAKER_00 2:57

That's that's the beauty of it.

Why Cookie Cutter Plans Fail

SPEAKER_00 2:58

Where you know, compare you to as I was talking earlier with uh the lady who spent 15 months reading NASA, you know, she puts in one of those programs for this 98-year-old, the first thing she's gonna do is foam roll with them, static stretch. She's gonna do some balanced stuff, and then it's a giant circuit. You do a stability ball squat, which he can't do. No, does she have the competency to be able to go, okay? Well, maybe we should just not do that and do a squat because she's looking at the pattern, or is she looking at the exercise? And then doing a stability ball press. Like, are you fucking kidding me? That's not gonna work. He's gonna fall off that thing. Stability ball row, and then you got to do a single leg scaption, and then you're doing a leg press, and it's like, oh, next thing you know, it's like, oh, 30 minutes has gone by, and every time you're doing one of these exercises, you're so uncertain because he's not moving well, you have to keep on modifying it, and then he's gonna be like, I don't really see the value in this. And it's it's scary because that's how you hurt people. The beauty with the CCA programming is you're gonna learn how to regress it, and in this case, you can make it a CA or even a C, which would just be a straight set, to your more advanced populations where you can do a CCC, more athletic populations, whoever it may be, you can regress it and progress it.

Assess First Then Pick Patterns

SPEAKER_00 4:12

When we think of a 98-year-old, we're thinking fragile, can't do much. And for a lot of times, that may be the case. In class, I talked about an example with coaching fourth-grade basketball players. You may have an assumption on what the programming, the drills, the scrimmages are going to look like, but the very first thing that you're gonna do is watch them play. You're gonna have them scrimmage so you can gather data points on how to progress. The foundation as a coach, strength coach, or an actual coach in this regard, you have that element. You know the drills, shoot, pass, dribble, fireman's drill, whatever it's going to be. The defense, man, zone, two, three, box and one, whatever it is. You know when to implement it based on the team who you're playing, but also what your capabilities are of that team. It's the same with programming. Qualified trainers understand the human body. I'm not freaking out when a 98-year-old submits an application to work with me. I show up on time, I'm professional, I look depart, have a great handshake, and I learn about what they're capable of. The first assessment I do is watching them come in. How do they move? How do they sit down? Are they catering to one side? I'm not gonna have him put his hands overhead and do an overhead squat. He's never done that before. Why would I make him feel uncomfortable and expose all these things when we're not even gonna do that in the workout? Take blood pressure, maybe grip strength. And then I go out there and I do what the sport requires. As I said with basketball, shoot past dribble, you implement the offense and the defense. For life, it's a squat, it's a hinge, it's unilateral, transitional, carrying, pushing, pulling, pressing. Those are the core movement patterns. I'm going to incorporate exercises that are appropriate for this individual. Now, he told Paul that he's not great at getting onto the ground. So we're not going to do a lot of floor bridges and hip thrusts in the beginning. We got to work our way up to it. Just like in the case with the basketball team, if they suck and they can't even dribble, we're not going to spend all this time doing complex dribbling drills. You start with the basics. But there's going to be times when you have clients who come in and they're 98 and you have this perception, like, oh, they're not that capable, but they're skipping in and they got giant biceps. You're like, damn, that's awesome. You're going to apply the appropriate exercises, which may be an RDL or a hip thrust for that individual. So I think where trainers get frustrated and overwhelmed is we have a hypothetical case example, and then we write out this crazy program. It takes you a couple hours, and then your client comes in and you can't think on the fly. Pending

Building A 30 Minute Session

SPEAKER_00 6:51

on how long you have to train this individual, in the case for Paul, 30 minutes because he trains at ELIS. So you're going to have to do a CA variation. You're not going to spend 10, 15 minutes warming up because you only have a 30-minute workout. As he said, he did some squats for time. Then he gave him a five-pound med ball to throw over his shoulder, re-rest, rinse and repeat for two to three rounds. He did some TRX squats. And then he would sit down and have him do some balance games. And then we did some pressing on a bar. And then he'd have him do a little game where he would knock something out of the air. He'd throw him a ball and he would knock it down. And when he throws it back to Paul, he would chuckle because anytime that Paul would drop it, he would get the biggest smile on his face. And then he would walk him out to his car. You may be thinking, what only three circuits with a CA? That's for a 30-minute session. For a 60-minute session, you may do four. Have a little bit more of a warm-up. Yeah, let's do some soft tissue stuff to work on the mobility. You get into a CA, do that for three rounds, another CA, let's do some unilateral stuff, maybe five to six step-ups per side, really focusing on the eccentric. Because in life, as a 98-year young individual, you need to sit down on the couch. You need to stand up and get off the toilet. I want to look at the deacceleration. Can you control that? Or are you just dropping like a bag of rocks? You can hold his hand and really focus on that control. You can give him a med ball of three pounds and have him throw it back to you. That's a press pattern. What about pulling some band rows? I'm big into doing things and what we call ADL activities of daily life. That's what we should be doing. And as you progress, you can do little side steps to side hops to side jumps. You could get into depth jumps, not right now. Let's just own the transitional pattern. Loading the arms up behind the body, jumping over a penny, as I like to say. Land nice and soft. Have his back close to a wall. Worst case scenario, if he were to fall, he's just going to sit down onto a bench. You have your hand on his back or around for support at all times, in case of worst case scenarios. So

Volume Recovery And Protein Needs

SPEAKER_00 9:07

you're going to do an appropriate amount of volume, because at the end of the day, progressive overload, volume, frequency, and intensity. How many days are you training, Mr. Frank? Let's pretend his name is Frank. Hasn't trained at all. Let's start with two days. Because especially as we age, we lose a lot of that muscle mass, sarcopenia, dynopenia. If you do a full body workout, three rounds under load, really focusing on eccentric, he's going to be crazy sore. And there's nothing more discouraging for an individual who's at the latter end of their life to be so sore from a workout. Why are you going to show back up again? Train them on Monday, maybe on Friday, see how their body responds. We can put a tentative workout on there on Wednesday, but I want to see how you do. Most older folk are not getting enough protein. The sensitivity to muscle protein synthesis increases as we age. So we should be getting about 30 grams per meal. Most people are having two eggs and a piece of bacon, maybe 10 grams, 15 max, a couple times. So we're not giving them enough nutrients for optimal repair. So we got to talk about nutrition. We want to make sure that we're supplementing to get up to that amount so we can build muscle because even though we're 98, doesn't mean we can't build muscle. We want to make sure we have enough aminos for optimal repair, getting our sleep. But soreness can definitely play a huge role in the recovery process. That delayed onset muscle soreness is really taxing for people who don't have that much muscle tone. So we hit all the core patterns within the week. It doesn't have to be every single workout. You do what you can do within the time that you're given. 30 minutes isn't optimal, but it's better than nothing. If you have an hour, maybe you're going to throw another CA. You want to do some cardio throwing in at the end. A couple rounds of some ski or rowing if you can get down in that position. Modified jumping jacks. Maybe he used to like the jump rope back in the day. Give him a jump rope. Work on some dexterity. That coordination with the mind is really important because that goes into balance. Proprio reception. Where are we at in space? Can you stand on one leg? I'll tell you right now, if you did a program from a lot of these entry-level certs, stability ball squat, curl press, I always laugh because that's the foundation for NASA. If you were to do that on a 98-year-old, the likelihood of him falling off and potentially breaking a hip is going to be exponentially higher than a grounded, stable body weight squat or a goblet squat. That's significantly more appropriate. Can't get on the ground or do a push-up, do a bar press. Meaning you go to a bench press and you just do a push on the bar. Overhead pressing, maybe he doesn't have 160 degrees of flexion. We need to do a band press because a landmine would be too aggressive, too much. If we can't own the overhead mechanics and we get that rib flare and anterior tilt, we need to regress it back. Maybe he doesn't even have the mechanics to get overhead and you just have to do horizontal pushing and horizontal pulling. That's fine. You meet the client where they're at with their capabilities.

Make It Fun While Staying Safe

SPEAKER_00 12:04

And then you progress. You make it fun. He was cracking up, throwing the ball overhead. He liked doing that. I'm going to do that every single time he comes in, but I'm going to use my creativity to make it fun. Meaning, one time we do it seated, he throws the ball overhead. The next time we do it standing. The next time I'm going to be at his back and I'm going to hand him the ball for like some rotations. Then there's another time when I'm going to have him stand up and his eyes are going to be closed. And then we're going to do auditory cueing where I'm going to say right shoulder, left shoulder. Then he's going to drop it over that side. The next time he comes in, I'm going to touch his right shoulder and he has to go over the right side. I'll touch his right shoulder again. So we're working on reactiveness. Maybe we do the same thing with just leg lifts and hip flexion. Do you think he's getting into the frontal plane very much? Hold his hands, do some side shovels, like we're doing some square dancing, back and forth, forward, backwards. We don't walk backwards very much. So do that. Be safe. Have your hand behind him. At any point you didn't feel comfortable, you could get like a back harness. So then you put the back brace on him and then you're holding on, just like you were with a dog. I laugh because you may think, that's stupid. I would never do that. But if your clients are more prone to falling, as it happens when we age, you want to take that in consideration. That's what I call that final destination game. Worst case scenario, client trips on a freaking mousetrap, and all of a sudden, bam, they hit their head on the side of a plyo box and it pierces their eye and their eyes now on the floor, and all of a sudden electricity goes out. So someone's walking over him and they trip over him and they crush his head. It's like worst case scenarios. Awesome movies, by the way. I look at my training like that. What is the worst thing that could happen here? I want to make sure I'm safe. Is my environment clean? Could he potentially trip over a weight or his water bottle or my phone if it's on the ground? Be aware of your surroundings. The goal isn't to crush them, the goal is to teach him the patterns that are going to help with his activities of daily life and then progress. Throw in some fun things that are going to improve his balance and coordination as the accessory and have open conversations with him. Were there things that you like to do in the past that you want to get back into? Are we moving a decent amount of lightweight? That's why we do some machines. Because it's not that much load for him doing a push on a bar. But if you go to the machine and he does a press now, well, now he's getting load. One day could be more quote unquote functional stuff. The next day we do more machine-based stuff so we can move load. There's no 100% right way to train someone. It's looking at the individual and applying systems, the progressive overload, specific adaptation to oppose demands. These principles are the foundation. Most trainers lack them. Over time, he will progress into a CCA. You can do games where he gets on the ground, he has to get back up. You can do floor bridges and RDLs. But in the beginning, for this specific case example, he wasn't ready for it. But that's the beauty of overload as you will get stronger. And he's going to be doing dead hangs and single leg pistol squats, eccentric. Wow, it's pretty crazy how effective and efficient the body is. Because when you stop training it, you stop giving it a stimulus to adapt, that's when decay happens. Do things based off the principles that are going to make this individual's life better. It doesn't need to be a circus act. It needs to be fundamentals, whether overload, rinse and repeat. Always make sure it's safe.

Think On The Fly And Get Help

SPEAKER_00 15:38

And if you're struggling with any type of programming, get into our live calls. You can ask instructors how to incorporate the CCA, appropriate regressions, progressions, whether if it's metabolic disease, pulmonary disease, cardiac disease, if it's an athlete, if they're 98, if they're 15. But as I was saying earlier, qualified coaches understand the human body. Entry-level trainers barely understand their own. I feel for those 20-year-old, 22-year-olds who read a book, pass it, and they're like, okay, here's your first client, Frank, who's 98. And you're like, oh my God, what the hell do I do? And then after that, then you got a 17-year-old who wants to get a bigger bench. Okay, well, you got to be able to think on the fly and adapt from a 98-year-old to a 17-year-old, and your next client has shoulder pain. How do you incorporate soft tissue mobilizations to help them get out of pain? So then you can program via progressive overload. Programming around pain is really important. Most trainers lack that. And if that's something that you're struggling with, that's exactly why we have our soft tissue mobilization course. We have our nutrition course. We provide solutions for trainers who are struggling, the foundation so you can make this into a career. Throw this into your story. Shoot us over any case examples that you have. Comment, leave that five star review. And remember, living to 100 is way better than not living to be 100 and keep showing up.