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Conditions and constraints

Each condition carries what to prescribe, what to avoid and why, and the guideline it came from. Tagging a client with a condition changes what the generator will produce for them.

Hypertension

Cardio-metabolic Clearance required

Elevated blood pressure. Exercise is beneficial but the screening threshold and the Valsalva caution both matter.

Canadian Society for Exercise Physiology (2021) · American College of Sports Medicine (Garber et al.) (2011)

Overweight or obesity, weight loss goal

Cardio-metabolic

The evidence here mostly corrects an expectation. The volume needed for clinically meaningful weight loss is much higher than what most clients expect, and resistance training alone will not do it.

American College of Sports Medicine (Garber et al.) (2011) · American College of Sports Medicine (Donnelly et al.) (2009)

Type 2 diabetes

Cardio-metabolic Clearance required

Exercise is a first-line treatment, not a caution. The two things that actually change management are the gap between sessions and hypoglycaemia risk in clients on insulin or sulfonylureas.

Canadian Society for Exercise Physiology (2021) · American Diabetes Association (Colberg et al.) (2016)

First year postpartum

Life stage Clearance required

Return to activity is graded by healing and symptoms, not by a fixed number of weeks. The weekly target is lower than the general adult one.

CSEP (Davenport et al., BJSM) (2025) · Canadian Society for Exercise Physiology (2021)

Older adult (65+)

Life stage Balance work

Adults 65 and over have an explicit balance requirement in the Canadian guidelines that younger adults do not.

Canadian Society for Exercise Physiology (2020) · American College of Sports Medicine (Garber et al.) (2011)

Pregnancy

Life stage Clearance required

Physical activity is recommended throughout an uncomplicated pregnancy. Screening uses the Get Active Questionnaire for Pregnancy, and there are absolute contraindications a trainer must not train through.

Canadian Society for Exercise Physiology (2021) · CSEP and SOGC (Mottola et al., BJSM) (2019)

Achilles tendinopathy

Musculoskeletal

Midportion Achilles tendon pain and stiffness, usually worst in the morning and at the start of activity. Loading is the treatment; rest alone is not.

Martin et al., JOSPT (2018)

Chronic low back pain

Musculoskeletal

Persistent non-specific low back pain. Guidelines recommend exercise but do not specify dose, so individualise and progress by response.

American College of Sports Medicine (Garber et al.) (2011)

Knee osteoarthritis

Musculoskeletal

Degenerative joint change at the knee. Structured land-based exercise is a core treatment, not a risk.

Arthritis Society Canada (2024) · Bannuru et al., Osteoarthritis and Cartilage (2019)

Osteoporosis or low bone density

Musculoskeletal Balance work

Reduced bone mineral density with elevated fracture risk. Exercise is protective, but loaded spinal flexion and rotation are the movements associated with vertebral fracture.

Osteoporosis Canada (Morin et al., CMAJ) (2023) · Giangregorio et al., Osteoporosis International (2014)

Patellofemoral pain

Musculoskeletal

Pain around or behind the kneecap, typically with squatting, stairs and prolonged sitting. Exercise therapy is the strongest recommendation, and the hip matters as much as the knee.

Arthritis Society Canada (2024) · Willy et al., JOSPT (2019)

Rotator cuff tendinopathy

Musculoskeletal

Shoulder pain from rotator cuff tendon irritation. The term 'impingement' is outdated. Active, progressive exercise is the first-line treatment.

Desmeules et al., JOSPT (2025)