A new client has approached me who wishes to train but has indicated she has severe Delayed Pressure Uticaria. When I further probed this they have demonstrated with pictures that activities as simple as sitting cross-legged, or sitting on a foot, sleeping wrong, will result in severe swelling, and rash. They have confirmed this is the diagnosis by their physician, and not self diagnosed. They have already asked their physician if they can train, to which she indicated there was a general response of “Not without inflammation,” as the physician is convinced there is no mechanism by which they could be subjected to this pressure without persistent flair ups. However he did not see a specific harm in the activity provided she tolerated the resulting swelling.
She is insistent on training, which I respect and I do not want to simply turn her away, however with a clinician actively stating the individual should be cautious in any weight training which contacts the body, I am reticent to get her started without second opinion as I am not a very experienced trainer.
What would be your recommendations for if/how this individual can be constructively trained using barbell techniques, and general guidance for doing more good than harm in guiding them though this. As I am aware of the broad nature of this question several thought I had were as follows:
- Pressure uticaria would pose no impediments to deadlifting, as she has indicated the swelling does not occur on the hands. Therefore deadlifting could be used as an effective training mechanism.
- Overhead press, and bench press could also be trained with care, but minimal change to the routine, as the contact points are not substantial or prolonged. Though receiving the bar on the return to the rack on OHP may need to be performed with care. This woudl be watched but without bringing it overly to her attention so as not to cause fear response.
- Squat movements can be dosed slowly. As this is an inflammation response, something as light as a PVC or training bar, may be able to provide an entry into the sport, without triggering of symptoms for the majority of working sets, with slow control increase in dose to control the response.
Thank you.