Managing Complex Conditions Through Exercise Therapy: A Guide for Exercise Professionals

Jun 04, 2024

Last month I went live to a bunch of inspired paediatric practitioners and talked about managing complex conditions and exercise and health professionals. I got the most amazing feedback so decided to share it with you on here. You can also grab my free masterclass replay here.


As an exercise professional, working with clients who have complex health conditions can be challenging but highly rewarding. To ensure you provide the best possible care, it’s crucial to ask yourself three key questions:

  1. Are They Diagnosed? And What Are the Details Around Their Diagnosis?

  2. What Are Their Presentations and Preferences?

  3. What Health Professionals Are They Working With?

Let’s unpack these to understand why we are asking them, why it is so important to understand and explore how they can guide you in managing complex conditions through exercise therapy.

1. Are They Diagnosed? And What Are the Details Around Their Diagnosis?

Understanding the details of the child's diagnosis is the foundation of effective exercise therapy. Here’s how you can approach this:

  • Understand the Diagnosis: Ensure you thoroughly understand the details of the diagnosis. This includes knowing the symptoms, progression, and common complications associated with the condition.

  • Associated Co-Morbidities: Be aware of any co-morbidities that are commonly associated with the primary diagnosis. This knowledge helps in anticipating additional challenges, needs your client might face and can set you and your child up for success.

  • Assessment Methods: Familiarize yourself with how the condition is assessed and monitored. This understanding can help you interpret medical reports and communicate more effectively with other healthcare providers.

  • Undiagnosed Clients: If a client does not have a formal diagnosis but presents with symptoms, concerns and difficulties, focus on understanding these presentations. Make recommendations based on observed symptoms and any provisional referrals for diagnoses from healthcare professionals.

2. What Are Their Presentations and Preferences?

Each child's experience with their condition is unique. Understanding their specific presentations and preferences is crucial:

  • Sub-Categories of Presentation: Identify and understand sub-categories related to the condition, such as muscle tone variations, sensory profiling, or behavioural differences and things like demand avoidance. Knowing these can help you tailor your approach.

  • Client Preferences: Engage your child's carer in pre session conversations about their child's likes and dislikes from activities, tv shows, through to environment and sensory preferences. We can use this to set up our space, have what we need available and increase their motivation. All crucial for a successful intervention.

  • Behavioral Considerations: Be aware of any behaviors that might affect their participation in exercise. For example, some clients might have sensory sensitivities or behavioral triggers that need to be managed. It also helps align your expectations with the session.

  • Environmental Setup: Create a conducive environment that supports their needs and preferences. This might involve how you set up the space, the other people sharing the space, through to time of day, number of activities out and even how you project your voice and the lighting you have on.

3. What Health Professionals Are They Working With?

Collaboration with other healthcare professionals can enhance the effectiveness of your exercise program:

  • Connect with Providers: Establish connections with other professionals involved in your child's care. This collaboration can lead to better outcomes, save time, and provide comprehensive support for the client.

  • Review Assessments: Review any assessments and reports provided by these professionals. These documents offer valuable insights into the child's condition and progress.

  • Feedback and Insights: Gather information on what strategies and interventions have been successful or unsuccessful. This feedback can help you refine your approach and avoid potential pitfalls.

Finding Opportunities Through Connection

For children with complex conditions, connection is always the first priority:

  • Build Connection: Establish a strong, trusting relationship with the child. Have fun, play games and listen to them. Connection lays the groundwork for effective therapeutic interventions.

  • Follow Their Lead: Let the child’s interests and responses guide your sessions. You can easily be led by them and find numerous opportunities to layer in therapy. Being responsive to their cues can create more meaningful and engaging experiences.

  • Educate and Communicate: Continuously communicate with parents, carers, and educators about the therapeutic outcomes of your sessions. Explain how activities like playful Pilates can benefit the child, making it easier for them to support the exercise program at home and school.


Managing complex conditions through exercise therapy requires a holistic and collaborative approach. By understanding a child's diagnosis, recognizing their unique presentations and preferences, and working closely with other healthcare professionals, you can create effective, personalized exercise programs.

Remember, the foundation of success is connection—building relationships with the children and their support networks to find the best opportunities for therapeutic intervention. Through this approach, you can help kids achieve their health and wellbeing goals, enhancing their overall quality of life and fulfilling experience for you as a paediatric practitioner!