John Hanc is a long-time contributor to the New York Times and Newsday and a former Contributing Editor to Runner's World magazine. His articles have also appeared in numerous publications including Smithsonian, Family Circle, the Boston Globe and Columbia Journalism Review. In the past year, two books co-written by Hanc have garnered a total of five major literary awards. Your Heart, My Hands: An Immigrant's Remarkable Journey to Becoming One of America's Preeminent Cardiac Surgeons (Center Street Books), which Hanc wrote with Arun Singh, M.D., won four awards, including Gold Medals in both the 2020 Nautilus Book Awards the and American Society of Journalists and Authors annual writing competitions. Fighting for My Life: Living in the Shadow of Alzheimer's Disease (Thomas Nelson), which he wrote with Jamie Tyrone and Marwan Sabbagh, M.D., also won a Gold Medal in the Nautilus Awards.
Do Your Clients Need a Social Prescription?
What am I going to do now?
In March 2020, that was the question Bob Phillips asked himself—the same question just about every other health and exercise professional was grappling with.
“My business was nearly decimated overnight,” says the Melville, Long Island-based trainer. “I had to do something.”
While many health and exercise professionals responded by pivoting to virtual, “I never really made that transition,” says Phillips. A full-time trainer for nearly 30 years, Phillips likes old-school training. Meaning, training done by people, working together in a gym. Not as some disembodied faced on a screen.
Now, no gym. No people. Only the faces on the screen.
A student of bodybuilding and fitness history, Phillips thought back to things he’d read about the early fitness culture. “The old-time strongmen did a lot of their training outside,” he said.
But where outside? Muscle Beach was a long way off—and many parks were closed or severely limited. Driving around Long Island’s Suffolk County, he finally found one.
“It was called Nelson Park,” he says. “But it really should be called Nelson’s Parking Lot.” The field, named after Peter A. Nelson, a New York City firefighter who died in the 9-11 terrorist attacks, was essentially a series of baseball diamonds and tennis courts. Great for Little League, but maybe not for a high-intensity exercise class.
But Phillips got inventive: He could hang his TRX suspension trainer off a pole on the batter’s box and hook up his NT loops on the support pillars of the bleachers. BOSU balance trainers and kettlebells could be positioned on the strips of grass between the field and the bleachers.
He put the word out to clients, and even created hand-painted signs that he posted locally: Twice weekly, small-group conditioning classes in Nelson Park. Socially distanced, equipment wiped down between sets.
Immediately, a few of his clients were in. “They were like ‘Bob, I had nowhere else to work out,’” he says.
With two to three sessions per week and a total of about 10 to 12 clients participating, Phillips led the groups through the depths of New York’s COVID-19 spring, into the summer and fall of 2020. What developed, however, was more than a stopgap, temporary revenue-generator for Phillips. Much more.
“It was a lifeline,” he explains. “It became an oasis of hard work, camaraderie, laughs, mutual support. Some people who’d never met before they started doing these outdoor sessions became friends. I ended up getting a new client.”
“Tremendous,” is how Gerry Martire, one of the participants in the outdoor workouts, describes the outdoor sessions. “You looked forward to it.” And not only because of the creative, challenging workouts. “It was everything about being on a team that you missed,” Martire says. “And yeah, it was about being with other people, with your friends.”
Certainly, new business is always a nice outcome. And Phillips’s quick but successful pivot—in a distinct direction from many of his colleagues— is a good lesson in adaptability. But the success of his outdoor group workouts was rooted in an aspect of the fitness business that many health and exercise professionals might often overlook—or never even consider.
You’re selling something even more fundamental than your knowledge of exercise—something that, as those classes revealed, was in short supply for many during the pandemic.
“The personal connections you make with your clients are an important part of what you do as a fitness professional,” says Dr. Indu Subramanian, a neurologist at UCLA Medical Center who is also a yoga instructor.
We’re not talking about you and your client going out for drinks or becoming BFFs. This is connection at a more basic level. “It’s that vital sense of human connection…and touch,” she says. (And yes, she means touch literally, as in when you're just assisting or spotting clients during an exercise. “That might be the only touch they get in the whole week,” says Dr Subramanian. “And we know that’s huge in terms of health benefits.”)
The Way of the Future
The medical world’s understanding of the value of socialization is undergoing a major reappraisal right now. More physicians, like Dr. Subramanian, are calling for “social prescribing.” This is not just a case of doctors encouraging their patients to get out and see friends a little bit more. Social, as opposed to socialized, medicine is more systematic and often involves the use of structured group interactions.
Making Yourself Part of the Social Prescription
When it comes to exercise, says Dr. Sherry Pagoto, “social support is super important.”
Not only because, as many medical professionals are now arguing, socialization or human connection has a more critical role in our overall health than was previously thought. But also because making positive changes to one’s health and lifestyle is not easy.
Who can help? You can.
“I know with my patients, we very much encourage them to build a social world around their activity,” says Dr. Pagoto, who is a licensed clinical psychologist and a professor in the Department of Allied Health Sciences at the University of Connecticut.
These support structures “will further cement the habit by bringing it accountability, social contact and just making it more fun.” Health coaches and exercise professionals, she says, “have a role to play in that.”
Part of that, she says, is helping to assess the level of social support in a client’s life—by asking whether they have family or friends who will exercise with them when they’re not training with you. And even if your client's family isn’t exercising with them—are they at least supportive of their efforts?
“You need to learn if this person is fighting against the current with their social life,” Pagoto urges. “Many may have partners or spouses who don’t share that interest and might even find your client’s exercise a bit of an inconvenience. It might interfere with taking care of kids or other aspects of life.”
If that support or mutual interest is wanting, either at home or among their friends, “I'd say ‘Let’s talk about how to build in some support. Maybe some group classes or finding an online community.’”
Pagoto references a study she conducted that involved people who chatted about their weight loss on Twitter. “We asked them why they posted,” she says. “They said the support they got from the people they found online who were on the same journey was actually stronger than the support they got from family or friends.”
So, does this mean that you should be going online and hitting “Like” every time a client posts about a successful workout—with or without you?
Well…yes. Maybe it should be more than a thumbs up. “I think one thing trainers could do is create a Facebook group for their clients,” she says, “so that they can connect with each other and support each other.” And probably also say nice things about you. “From the trainer perspective, this keeps you on your client’s radar,” she says. “And you as a trainer can post reminders or tips on workouts.”
Pagoto also says that socialization might be a reason to consider offering more small-group trainings. “Small-group training is another way to get clients to meet other people, whether face to face or virtually.”
Finally, recognize the role you play with clients. “You don’t have to be a therapist or their best friend,” says Pagoto. But you do need to ask questions—about their training and the challenges they may have in adhering to it. The most important thing you can do “is listen and empathize,” she says. “What everybody wants is validation: ‘I just want to know that I'm not crazy!’ Don’t feel like you should have all the answers. Because some of what they’re talking about might not be a problem you’re prepared to solve.”
Besides, adds Dr. Pagoto, very often “people are looking for support, not solutions.”
“I think it’s the way of the future,” says Dr. Subramanian, who is also director of the U.S. Department of Veteran’s Affairs Southwest Parkinson's Disease Research, Education and Clinical Center. “Social prescribing meets people in the community where they are, and links them to social support structures.” Dr. Subramanian says she has seen the value for her patients with Parkinson’s disease. “Loneliness is a big issue for them,” she says. “Any way we can develop connections can help.”
Social prescriptions are already being written in the United Kingdom, where physicians can now direct patients to a so-called “link worker.” These trained specialists focus on connecting patients to community groups and services for practical and emotional support. Link workers not only connect patients with existing groups, but also help create new groups, working with local partners.
The British National Health Service calls social prescribing a “key component” of the country’s healthcare system and has set a goal to have nearly one million patients referred for social-prescription interventions by 2024.
“It’s now part of normal practice,” says Krishna Kasaraneni, MD, a general practitioner in the Yorkshire city of Sheffield, and a member of the British Medical Association executive committee that helped lead the effort to implement social prescribing in 2019. It’s used for, among other things, putting people with diabetes in touch with community groups “that can help get them outside and exercising,” explains Dr. Kasaraneni.
Exercise training and health coaching, of course, is where you fit into this picture. Specifically, the kind of one-on-one or semi-private, small-group training that you likely offer your clients. In that sense, you are a part of that socialization process.
Many savvy health and exercise professionals recognized this long before it became a current topic in medicine. “Yes, they love the exercise,” says industry veteran Leigh Anne Bolling Richards, who is currently a group fitness instructor at the Bell Road YMCA in Montgomery, Ala. “Yes, they’re benefitting from it, but it’s [also] the social connection. And the support they give each other.”
That, says Bolling Richards, who also teaches exercise physiology at Auburn University-Montgomery, is a key reason people hire trainers and coaches, join gyms and sign up for classes. Her own 8:30 a.m. Muscle Mix classes at the Y exemplify this. “We’re a group of ladies, many of us 50 and up, but also some younger people, and we just have a great time,” she says. “I call us a ‘little sorority.’”
Her “sorority” added a new member, whose story is illustrative of the way organized fitness activities can help strengthen social connection as well as connective tissue. The new class member is a 29-year-old woman from Great Britain, who had recently moved to Montgomery with her Trinidadian husband. “I saw her at the Y, working out alone, and I invited her to the class,” Bolling Richards says. “I told her, ‘I know it’s a bunch of old ladies, but you might enjoy it.’”
She did—and now, Bolling Richards says, this young woman is very much at home in the morning classes. “She didn’t have a lot of friends here when she first arrived in Montgomery,” she says. “Now she does.”
More Important Than Ever
Of course, the importance of socialization or human contact has taken on new urgency the past year, as most of the world has been deprived of it. Talia Walsh, owner of Quest Studio in Jessup, Pa., has made a point to reach out and connect with not only clients, but her staff as well. “I think a lot of people became used to being alone during COVID-19,” she says.
In part to help encourage what might be called a “healthy re-entry” into in-person instruction and classes with clients, Walsh has engineered various levels of connectivity with her staff. “We do a monthly team call to check in,” she explains. “I reach out to them all personally, and we try to do a quarterly get-together…a team dinner, or we go for a hike or just hang out.”
She also tries to involve her staff in the community relations activities that are a part of Quest’s outreach. “I do a lot with the community outside the studio, and try to incorporate our staff and our members in those as well.” These initiatives include periodic fund raisers for a wide range of causes, and often involve volunteering. “It’s another way for our members to get together,” says Walsh.
It’s also a reminder of what smart, savvy health and exercise professionals understand about human nature.
“This is part of your service,” says Bolling Richards. “It’s not just showing them proper form and coming up with a great program. It’s listening to them, connecting with them, showing them you care.”
As a working trainer, Phillips cares about his business—and he’s happy to say that he’s now back with his far-more-profitable, in-home clients. But he didn’t jettison the outdoor workouts. In fact, they’re still going strong—albeit at a different park that is better suited for his workouts.
Still, looking back at the dark days of spring 2020, Phillips acknowledges the important role his workouts played in the “parking lot-park.”
“All of us really needed it at the time,” he says.
And we probably still do.