Exercise Adherence: The Key to Getting Better Client Results

As personal trainers, we have the awesome privilege of helping people improve their lives by improving their health and fitness. We can help them change from an unhealthy lifestyle to one that will build great health, fitness, and longevity.

You can help, but your clients have to follow through for the rest of their lives.

We spend a great deal of time and effort helping our clients plan, prioritize and follow through with their commitment to better health. But still, they have the ultimate responsibility to make it part of their lives. 

Stick to a fitness program is known as "exercise adherence"​ - While it's ultimately up to the client to stay on track, there are many things we as personal trainers can do to help.

Are Your Clients Exercising?

Despite the best intentions from the client and your expertise, most of the people who start a regular exercise program, will be off it within a year. Helping a client adhere to regular exercise is one of the hardest things we do as personal trainers.

When asked, the reasons given for dropping out of a regular exercise program are: Lack of time, inconvenience, expense, physical discomfort, embarrassment, poor instruction, inadequate support, or loss of interest.

It is difficult to accurately determine physical activity rates among adults, but studies indicate that 20% - 45% of Americans exercise on a daily basis.

There are several reasons why this activity is hard to measure: The varied definition of exercise, for example walking to work, playing tennis or golf, a bike ride for fun or transportation, may or may not be included in the definition depending on the individual’s fitness and the exertion level.

Another discrepancy for this variable is that most of the studies use self-selected data - The individuals polled choose whether they exercise regularly or not. Studies have also shown that most people over-estimate how much physical activity they perform.

In contrast most will under-estimate (or under-report) how many calories they consume, leaving the research uncertain.

​So, there is a good chance that your clients think they are exercising more than they are (and that they are eating less than they really are!)

What is Exercise Adherence?

Exercise adherence has been defined in research literature both as exercise behaviour within a structured program and as exercise maintenance outside of a formal program.

This means that going to the gym and playing touch football in the front yard on Thanksgiving are both forms of exercise.

This definition is vague and does not include frequency, intensity, duration or time span. Most of the studies on adherence take place over a period of six months, however, adhering for six months is not the same as adhering for six years, or sixty years.

To truly adhere to exercise, a person would have to maintain a regular habit for a lifetime.

How You Can Help

Having a clearly defined definition of exercise adherence does not give us the tools we need to improve it with our clients. We need to help them “see the light” that exercise is worth the effort.

You can do this by helping with your clients' motivation, offering them rewards and accountability, building a support system, encouraging a positive mindset, and by providing a dose of reality.

1. Improve Your Clients' Motivation

The motivation to exercise regularly generally falls in two major categories: Intrinsic and extrinsic. In other words, a person’s motivation to exercise comes from either internal or external reasons.

Intrinsic motivation often comes in the form of challenges, enjoyment, or satisfaction, while external reasons are usually body-related issues (e.g., appearance) or social factors (e.g., participation in activities).

Most trainers know that a person’s motivation is highest, and intrinsic, when they participate in something that is interesting and challenging to them. For example, adherence rates for martial arts classes are much higher then they are for aerobics classes.

The reason for this is most people who participate in martial arts do so for the sport or competition – internal reasons such as self-satisfaction. While the majority of people who take an aerobics class, do so for external reasons – to lose weight or improve their health.

Even though a person might find this activity more enjoyable than another, does not mean they would continue to do it if their external motivator disappeared.

Body-related extrinsic motivation is not usually enough to maintain a regular and frequent exercise routine. A person will eventually lose interest and find reasons why they can no longer meet their plan of participation.

One study found that for a person to continue in an exercise program they would need to find enjoyment and/or growth of competencies in the physical activities. If this doesn’t happen within a reasonable amount of time for that person, they are very likely to drop out.

The researchers in this same study found that women are more prone to exercising for body-related, extrinsic reasons, than men because women are, in general, less satisfied with their bodies.

What does this mean?...

Men are more apt to exercise to build their competencies or for the enjoyment of the activity, equating a far better chance for exercise adherence. Men often choose sports as a form of exercise and the camaraderie and competition serve as their intrinsic motivator.

How To Create Intrinsic Motivation

One of the most remarkable studies involving exercise adherence resulted in a 94% adherence rate.

In this study, a group of women in an aerobic dance class for 16 ½ weeks. The researchers concluded that the reasons for the astounding adherence rate was attributed to many factors:

• The group was homogenous (they were roughly the same weight, age, female and they were only exercising with people from their same group)
• They carpooled to the classes together (thereby committing them to the class)
• They enjoyed the social networks
• They experienced pleasurable feelings associated with increased energy and fitness
• The leader was a nurse (and allowed the participants to ask her health-related questions)
• The study was for a finite period of time
• The participants were committed to an established goal
• They had a strong desire to change their body image and to change their physical status for improved health

There is no telling how long this group would have stayed together had the study been for an unlimited length of time, but it shows the possibilities for improved adherence to a program if certain factors are in line, namely homogeneity.

The Problem of False Hope

Some people drop out of a program is because they were never committed to it in the first place or their expectations were too high.

This phenomenon is called the false hope syndrome.

People are not likely to meet unrealistic expectations of exercise results and repeated attempts will often result in self-blame, guilt and frustration. This makes subsequent attempts even harder.

One study found that the participants predicted that they would be more satisfied at a later point in the program, but in fact, they were not; they were actually less satisfied. The most likely reason for this is they did not revise their predictions, even given the experience of past failures.

Knowing this, it may be possible to determine these attitudes in a client and either explain to them that they need to be 100% committed before beginning a program OR find a way to improve their commitment.

Studies show there are at least two good ways to improve a person’s commitment if they are not intrinsically motivated: Rewards and contracts.

2. Use Rewards and Contracts to Improve Adherence

We may not be able to make our clients’ external motivators shift to internal, as this has to come from them, but we may be able to help steer them. Giving rewards is often a useful tool in motivating a client at first, but its power will fade over time.

Rewards are especially useful in the beginning, because intrinsic motivators such as improved energy and strength will take some time to develop. As external rewards lose their value, encourage your clients to experience the positive feelings of satisfaction from progressing in their exercise program.

Holding a client accountable for their continued exercise can also be successful. The adherence rate of participants who signed a contract stating they would continue with the program for 6 month was 65%, whereas the non-signers were as low as 20%. You can use this strategy with clients by having them agree and sign the plan that you two develop together.

3. Build a Support System

One of the most important factors attributing to long-term adherence to exercise is social reinforcement from family or friends. This can have a powerful impact (perhaps the most influence) on a person’s adherence to exercise.

If a client’s family and friends are giving them encouragement and support, their chance of adopting exercise as a lifestyle is far greater.

For example; a working single parent could use their role and duties as a reason for not having the ‘time’ to exercise, but if their family and friends offer to help with certain tasks such as picking up a child from day care, it will be much easier to take the time out for their own health.

You can remind your client that if they take care of themselves, they will better be able to take care of their family.

4. Encourage a Positive Mindset

Another way you can help clients as they change from a sedentary lifestyle to an active one, is by guiding the conversations your clients have with others and with themselves.

Caution the client that the subconscious mind does not know the difference between fact and fiction: They should speak in positive terms about themselves when talking internally or to others. This can also be used as a powerful tool to maintain motivation.

For example, if your client speaks negatively and puts himself down, he will feel down. This negative self-talk may have been intended to create an adversarial attitude within the mind and cause a “fight back” response. But, most of the time negative self-talk picks away at the client’s confidence.

Saying such a phrase to oneself as “I’m fat and weak, I’ll never be able to do this” might seem like a way to fire them self up and work harder, but a little bit will seep into the subconscious mind and fester. The client, at a certain level, will believe it and not put as much effort into improving their health and will likely drop out.

Conversely, one can use positive language to bolster themselves and increase motivation and strength. Phrases like “I can do this”, “1 more minute”, or even “I’m doing great” can have a powerful impact on the individual.

As a trainer, you have the ability to put these powerful positive phrases into your clients’ head. Teach them that their mind is powerful. If it can bring a person down or make them quit, it can also bring them up and make them win. They have the power to succeed, and you have the power to help them.

5. Provide the Harsh Reality

There are plenty of studies, strategies, and tools that can help promote exercise adherence, but if all this doesn’t work, it may just come down to telling the client to stop acting like a baby, let go of Mommy’s hand, and do what needs to be done to be healthy. They may not like hearing this, but when the consequences of a sedentary lifestyle are truly understood, they just may get it, and get on with it.

Summary: How To Increase Your Clients' Adherence to Exercise

• Use external motivation to get buy-in from your clients
• Use suitable rewards
• Use a realistic plan that works with the client’s schedule and willingness
• Make a contract to hold clients accountable
• Make exercise fun, interesting, challenging, and/or enjoyable
• Help your clients establish a support system
• Train positive self-talk/attitude/mindset
• Build intrinsic motivation for life-long fitness