Safety / Injuries | Special Population

People with Seizures Can Train: Here’s How to Do it Safely

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We trainers need to be prepared to work with all kinds of clients. We have to be able to safely and effectively train people, no matter what physical limitations they have.

So, how do you work with a client who has epilepsy?

What special accommodations do you need to make?

What do you need to know about seizures before they happen?

These are important questions to ask and to answer to be prepared to help all your clients.

Last week on March 26th was Epilepsy Awareness Day, also known as Purple Day. Let’s celebrate what makes each of us unique and as trainers, learn more about this condition that may affect some of our clients.  

What is Epilepsy?

First, let’s talk about what this medical condition is. According to the Epilepsy Foundation, epilepsy is a condition characterized by re-occurring seizures that are unprovoked—in other words, they are not caused by anything in particular and could happen at any time.

Not everything about epilepsy is fully understood, but here are some facts about it that we do know:

  • Epilepsy is also known as a seizure disorder.
  • It can affect anyone at any age.
  • There are many different types of seizures and degrees of severity.
  • Seizures can cause other health complications.
  • A seizure is a neurological event, which means it happens in the brain—a surge of electrical activity in the brain.

There are two main types of seizures:

  • Primary generalized seizures. These seizures affect both sides of the brain and are often linked to hereditary conditions or genetics.
  • Partial seizures. These affect just one side of the brain. They are sometimes triggered by an injury to the brain, like a traumatic brain injury or a stroke.

These types of seizures can further be broken down into other types, like an absence seizure during which a person simply seems to be daydreaming, to the more dramatic tonic-clonic seizure, which causes uncontrollable, often severe spasms and loss of consciousness. These are the most potentially dangerous types of seizures, especially in a gym, because a person can get hurt from falling, hitting objects, and hitting their head on something hard.

So what causes epilepsy and seizures? Sometimes there are known causes, like a brain injury or an inherited genetic condition, but often there is no way to know what causes epilepsy, or even what will trigger a seizure.

Some people are more aware and are better able to control their seizures. They may know what is likely to trigger a seizure, like flashing lights, stress, or being sick or on certain medications.

Many people can control epilepsy with medications, diet, or other treatments. These don’t usually eliminate seizures, but they can minimize them or make them less frequent.

Should People with Seizures Work Out?

ISSA, International Sports Sciences Association, Certified Personal Trainer, ISSAonline, How to Train safely with Seizures, Getting fit at the gym and working with a trainer should not be limited to people who have no health issues

As trainers, we know that exercise is good for everyone, right? That includes people with limitations, and it includes people with epilepsy.1

Some studies1 show that people with epilepsy can reduce seizures with exercise. Aerobic exercises have been shown to:

“induce beneficial structural and functional changes and reduces the number of seizures."

Resistance training has also been found to have benefits for people with epilepsy. In a study, rats who submitted to resistance exercise had fewer seizures and experienced many other benefits such as better memory and decreased brain-derived neurotrophic factor levels.

Other studies show that men who exercise vigorously when they are younger have a reduced risk of developing epilepsy in the future. A Swedish study shows that in a large group of males, lower amounts of cardiovascular exercise in their early life is associated with an increased risk of epilepsy when they are older (Nyberg et al, 2015).

How to Handle a Seizure at the Gym

Click to view full infographic or here to download PDF and print for your clients.

ISSA, International Sports Sciences Association, Certified Personal Trainer, ISSAonline, How to Train safely with Seizures, How to Handle a Seizure at the Gym

Most experts would agree that the benefits of exercising outweigh the risks for people with epilepsy. But it is still important to look after your client's overall safety and to take steps to minimize risks and injuries.

First, be sure that your client has gotten the ok from a doctor to be working out.

As long as you have a go ahead to train, the best way to keep your client safe is to know what to do when they are having a seizure. Talk with your client in advance and find out what some of the signs are that you should look out for when a seizure begins. And, make sure that the other staff members in the gym are aware as well.

The gym can be a dangerous place to have a seizure. If you see the signs that a seizure is imminent, there are some important things to do and not to do:

  • Most importantly, clear away anything your client can hit his head on or bang into if he falls and experiences spasms.
  • If you have enough warning, you can also help get your client to the ground to avoid a fall.
  • Never hold down a person having a seizure.
  • Also very important to NOT do is put anything in your client’s mouth. Do not give water or medications until the seizure is over and your client is fully alert again.
  • Stay by your client for the duration of the seizure to help keep objects and people out of the way.
  • If a seizure lasts longer than five minutes, call for medical help.
  • Watch your client’s breathing.
  • Look for a medical identification tag, and follow any directions you read on it.
  • Stay calm, and keep others calm around you.

As your client starts to come around, explain what is happening—post-seizure, a person may be confused or agitated.

Do You Need to Make Training Modifications?

Some people with epilepsy are prone to more severe seizures, and if this is the case with your client, you may need to modify some of your workouts. For example:

  • Instead of lifting with free weights use body weight exercises. Use only the weight machines that can be easily adjusted and stopped, so that the weights will not drop on your client as a seizure takes hold.
  • If you will be working in a pool make sure you don’t leave your client alone. If you have to leave, first find someone else that can keep watch and call for help if needed.
  • For walking and running, take your client outside. Falling on a treadmill may pose more risks than falling outside or on a track.

It’s also important when just beginning to work with an epileptic client that you start out slow and small with your training exercises. This will allow you to figure out if any exercises are going to pose a problem or trigger a seizure.

Never start with something potentially dangerous that could lead to a big fall, like rock wall climbing. Get to know your client first and what his limitations are.

Although a client to have a seizure while training is uncommon, epilepsy is a pretty common disorder. Knowing what your client’s medical issues are, what dangers they may face when working out, and knowing what to do in the event of a seizure will allow you to train your client safely.

Lastly, we would love if you could comment below if you have trained a person with epilepsy or if you have epilepsy and share some tips you have as well as some of the precautions you take when you exercise?   

Dominique Groom and Christina Estrada


1. Almeida, Alexandre Aparecido De, Sérgio Gomes Da Silva, Glauber Menezes Lopim, Diego Vannucci Campos, Jansen Fernandes, Francisco Romero Cabral, and Ricardo Mario Arida. "Resistance Exercise Reduces Seizure Occurrence, Attenuates Memory Deficits and Restores BDNF Signaling in Rats with Chronic Epilepsy." Neurochemical Research (2017): n. pag. Web.

2. Epilepsy Foundation. N.p., n.d. Web. 01 Feb. 2017.

3. "Safety with Exercise and Sports." Epilepsy Foundation. N.p., n.d. Web. 01 Feb. 2017.

4. Nyberg, J., M. A. I. Aberg, K. Toren, M. Nilsson, E. Ben-Menachem, and H. G. Kuhn. "Cardiovascular fitness and later risk of epilepsy: A Swedish population-based cohort study." Neurology 81.12 (2013): 1051-057. Web.

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