Different strokes for different folks

I vividly remember the training sessions on inclusion in my previous job. I particularly enjoyed debating what terms were now accepted and rejected to discuss ethnic groups, disabilities, and facilities like “access toilets” (as opposed to “disabled toilets”).

To be honest though, I can’t remember much of the conclusions. I just remember thinking that it would be a full-time job to stay abreast of the trends, and that frankly, if you discuss matters in a sensitive and open-minded way it doesn’t really matter what words you use.

With that said, I do think it’s important that we begin to see what we term “disabilities” more like “different abilities”. And with that, accept that when people have different strengths and weaknesses, it doesn’t translate to being better or worse as a human being.

I say this because I have recently looked into dyspraxia and, specifically, how it affects movement and development. What I found was a scarcity of resources related to strength and fitness – and, indeed, any aspect of healthy everyday living – for adults with dyspraxia, and a wealth of shocking personal stories across support forums. I was therefore left with my own knowledge and initiative – always a terrifying position to be in – to come up with a safe, effective, and motivating training programme for an adult with dyspraxia.

The Dyspraxia Foundation describes the condition as a “developmental coordination disorder” which “fine and/or gross motor coordination in children and adults“. As well as affecting movements involved in everyday life like getting dressed (doing up buttons or laces, for example) and writing, it can affect speech, memory, and planning and organisation.

The difficulty that many sufferers face is that their condition is virtually undetectable, making them appear stupid, slow, or uncoordinated to people unaware of dyspraxia and its symptoms. Children suffering from dyspraxia may not be able to take part in games with their peers, causing them to miss out on key opportunities to practice social skills. You can imagine the implications this has on self-esteem.

On a physical level, both children and adults with dyspraxia show lower muscle tone than average, with particular weaknesses in the wrists and hands, as their muscles get left out of the small movements most of us perform multiple times a day. Think about how tired your hands get if you write a lot after not having hand-written anything in a long time; if you have difficulty writing and therefore avoid it, you miss out on precious hand and wrist conditioning.

So what does this mean for the fitness professional training a client with dyspraxia? I am by no means an expert, but based on my research and experience, these are the first items I would recommend taking into consideration (as well as the standard discussion of health and exercise history and goals):

  • Initially, focus on exercises which involve a simple position and a single movement. For example:
    • bodyweight squats rather than weighted squats, so attention can be paid to the motion of the lower body rather than worrying about an external weight playing havoc with centres of gravity;
    • static lunges rather than travelling lunges;
    • strict shoulder press rather than Arnold press;
    • T-bar tricep pushdowns rather than rope tricep pushdowns or skull-crushers.
  • Work on balance and flexibility to help tone and condition lower-limb and core muscles and teach good posture. Start small, for example:
    • trying to stand on one leg;
    • standing on a Bosu;
    • walking on tip-toes or walking on heels.
  • Use easier or familiar exercises to build confidence. These are great during the warm-up or at the end of a session when fatigue has set in.
  • Isometric holds and tempo work can add intensity without increasing difficulty. For example:
    • 10 squats with a 10-second hold on the last one;
    • hold each lunge for a count of 2 at the bottom;
    • shoulder press up for 1 and down for 3.
  • Prepare for longer times spent explaining and demonstrating exercises, using multiple methods if necessary, and make a mental note of what method works best for your client. For example:
    • explain the entire movement first, then perform it, holding in each phase of the movement to point out key positions;
    • mirror the movement as your client performs it;
    • perform the movement exactly as your client does, side by side.
  • Use exercises and weights with which multiple sets can be performed. This will allow for plenty of practice without fatiguing too quickly. If good technique is achieved early on, add in isometrics and tempo work for subsequent sets rather than jumping to new and more complex exercises.
  • Prepare to scale exercises back if necessary, breaking them into phases or abandon them entirely. Don’t persevere if you or your client are getting frustrated. Simply explain that you’ll build back up to it. Remember everyone has certain movements that we find more difficult to grasp than others.
  • Keep upper body weights light to avoid stressing weak wrists and hands. Use more focussed, more intense exercises – like straight-arm lateral or front raises – as a chance to use lighter weights and condition smaller joints safely.
  • Be mindful of other gym users and your client’s personal space. Dyspraxia can affect spatial awareness, and as well as leading to bumps and scratches, less empathetic gym users or members of the public may take issue with clumsiness.

As always, of course, a good rapport and open dialogue are paramount. You should never have to tiptoe around a client’s needs, and should be comfortable discussing progress and difficulties.

Below are some of the resources I found useful; if you have any experience or useful tips and links, please share in the comments or drop me an email and I will update this post. Knowledge is power!

Resources

Dore

Dyspraxia Ireland – Tips for Teachers

Dyspraxic Adults

Physiotherapy and Dyspraxia for Professionals

Skills For Action

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