If you run high-intensity trainings in your classes — and I”™m guessing most of us do — you may have had a participant experience extreme difficulty during or just after a hard bout of work. In such cases, I”™ve seen the skin turn absolutely white or ashen — or, alternatively, bright red and tinged with blue around the cheeks. Either way, the student doesn”™t feel well and may be lightheaded, nauseated, shaky, and extremely fatigued.
It”™s likely you”™ve seen these signs, along with a variety of treatments offered: walking slowly around the room, sitting with the head between the knees, or just lying flat on the floor. These methods often don”™t seem to help and may even make things worse.
Keeping in mind something I learned from my major professor in grad school, I developed a “trick” that has proven helpful in such circumstances. It can bring someone back to feeling better quickly and can frequently eliminate the need for stronger emergency measures.
As soon as possible, get the person off the bike and onto the floor. For the sake of comfort, an exercise mat is ideal. If no mat is available, fold a towel to cushion the head. DO NOT elevate the head — we all know from CPR classes that will close off the airway. Speed is more important than comfort, though, so if a towel or a mat isn”™t available, just get your student on the floor.
Start the student on his back, with knees bent and feet on the floor. Instruct the student to keep the legs relaxed as she gently lifts one knee toward the chest for a moment and returns the leg to the starting position. Do the same on the other side. If the student is too confused to understand and follow your instructions, just ask him to relax and tell him that you”™ll be lifting his legs.
This process typically needs to continue for several minutes. Keep watching the student and giving instructions. Most of them will stop after only one or two repetitions. Be prepared to move the legs manually if the student stops due to fatigue.
A few things not to let the student do:
- Don”™t let her grab the knee and hold the leg up. What makes this procedure work is the rhythmic up-and-down action.
- Don”™t let him do this quickly and turn it into a forceful exercise. Again, the gentle, rhythmic action of the leg moving up and down is the key.
- Don”™t let her lift the second leg while the first one is still in the air. At least one foot should be flat on the floor during the entire procedure.
Like the rest of you, I”™ve taken many CPR re-certs. They don”™t cover anything like this, but it”™s highly effective. The color of the face returns to normal fairly quickly, and the nausea tends to go away quickly, as well.
For better or worse, I”™ve had many occasions to use this. When Jim Karanas was teaching his Performance Max program, more than a few participants experienced severe symptoms after max efforts (especially when rowing). Fortunately, the procedure was quite effective, as mentioned above.
Yet long before PMax existed, the “seal of approval” came from Dr. Campbell, my major professor, himself. In our exercise physiology lab one day, a student experienced exactly the symptoms described above — she was sick to her stomach, shaky and white as a sheet. I immediately asked if she”™d be willing to do something that I thought would help her. From the floor, her color came back after several knee “pumps” and she was fine.
Tough as he was to impress, Dr. Campbell said nothing, watched closely, and finally made eye contact with me and nodded his approval. This expert in cardiovascular dynamics apparently saw it as an appropriate treatment method.
You might want to practice the technique so you”™ll remember it. Then let”™s hope we never have to use it.
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I had my very first medical emergency in class yesterday. This article could not have been posted at a more valuable time. This woman had an internal defibulator/pacemaker and her heart was out of rhythm. Luckily, I had a firefighter in the room and he was there to help assist her..although he was shocked by the device that was trying to shock her heart back into its normal rhythm. As the instructor, I pride myself on warning people to listen to their bodies, wear HR monitors, ride at their own pace–but I can’t help but feel responsible. She was OK, but the transported her to the hospital to check her out. I have never felt so scared. From now on I will ask that my participants let me know if they have some sort of medical issue that may affect their workout. I pray this situation makes me a stronger instructor, and more aware of how people are feeling and what they need from me and my workouts. I also pray this never happens again! Thanks for the great article…I LOVE ICI!!! 😉
Thanks for reading and commenting on my post. How fortunate that you had a firefighter in the room. Many of my CPR courses have been taught by firefighters. They’re all trained EMTs and absolutely amazing at always knowing what to do, but of course it was scary for you. Good job at holding things together. I hope along with you that such a thing never happens again.