Unfortunately, back problems are a common issue these days. As an ACE certified professional, it is important to remember the ACE Integrated Fitness Training model for exercise programing as well as your scope of practice. If you feel, at any time, that the issues your client is suffering from are outside of your knowledge and skill base, it is best to refer him/her to another professional. When in doubt, refer out! This may be a case of needing to see an orthopedist and/or physical therapist for a bit more clarification on this client’s contraindications. If this client has been cleared by a physician/physical therapist, it is best to start by helping to improve the client’s stability and mobility. Here is a link to the free IFT online course to review the programming: https://www.acefitness.org/continuingeducation/course/4a5x86y2/ace-integrated-f
itness-training-ace-ift-model-for-exercise-program-design-free-online-course. You may also find this webinar on clients with low back pain helpful: https://www.acefitness.org/continuingeducation/course/4a52yv2v/catering-to-clie
You may need to start with exercises as simple as core engagement like the hollowing exercise found here: https://www.acefitness.org/acefit/exercise-library-details/1/121/. Or the supine dead bug exercise found here: https://www.acefitness.org/acefit/exercise-library-details/1/147/. Other exercises like these can be found in the ACE Exercise Library and are recommended for clients who need to focus on their stability and mobility. Remember, it is important to focus on stabilizing the trunk before moving on to exercises that involve greater movement or load the spine with weights such as medicine balls or dumb bells.
If you do have access to a facility with a pool the water will help increase cardiovascular effort while also decreasing the impact on the spine and other joints. Keep in mind that the temperature of the water is very important, as water that is too cool may not allow the muscle to warm up and be accepting of the exercises, where water that is too warm may cause light headedness and undo fatigue. The Aquatic Alliance of the Arthritis Foundation recommends a pool temperature of between 83 and 88 degrees Fahrenheit for aquatic exercise (not lap swimming).
If the pool is not feasible then arm ergometers, leg only ellipticals, or recumbent bikes may be good options depending on the positions that your client is able to tolerate. Be sure to keep checking in with your client before, during and after each session to monitor pain and narrow down exercises and modes that will be helpful in their training process.