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Training with a chronic condition or a disability: where we start

CrossFit Wilanów

This piece is not medical advice. It describes what reliable sources say, how training is scaled when your body sets different conditions than usual, and how starting works at our box. If you have a chronic condition or a disability, agree your exercise plan with a doctor or physiotherapist who knows your case.

Scaling is more than a lighter barbell

In class, scaling usually means weight and reps. That is only the first layer. You can also adapt the surroundings: the colour and placement of equipment, your spot in the room, the way the coach talks to you. You can match the movement to the time of day if a condition has its own rhythm. Two stories published by CrossFit show how wide that range is. They are accounts of particular people, not research, so treat them as examples, not a template for yourself.

A visual impairment: contrast, a fixed spot, clear communication

Carl Arredondo, a former TV meteorologist from New Orleans, has retinitis pigmentosa, a genetic disease of the retina. He sees well only what he looks at directly. He keeps training and works as an orientation and mobility instructor and an adaptive coach.

His solutions are simple. A white medicine ball and jump rope that stand out against the floor. Velcro strips on the barbell so he can feel where to grip. A kettlebell dusted with chalk, because a black weight on a black floor disappears. A fixed training spot, and a rule that equipment goes back where it came from, so nothing lies where it should not. Dark glasses even on cloudy days, because light tires him.

The second half is movement. You squat, deadlift and row in one place. Running in a group, jumping from spot to spot or working at someone else’s station needs a plan, so the coach replaces the run with rowing or a bike, and puts any exercise where you have to hit a target in a fixed, marked position. The goal stays the same; the route to it changes.

The third thing is talking. Carl explains to people around him that he will not see someone coming from the side, and on runs others call out to him when a car is coming. During a demonstration he stands close to the coach. The coach and the group cannot guess what you need until you tell them.

Parkinson’s disease: scaling depends on the medication

In 2024 Cochrane published a review of more than 150 randomised trials of exercise in Parkinson’s disease. Its conclusion is cautious: most types of exercise were associated with benefits for motor symptoms and quality of life in people with mild to moderate disease, compared with no exercise. Certainty of evidence was often low, there is no evidence that one type of exercise is clearly better than the others, and much less is known about people with advanced disease. The Parkinson’s Foundation recommends at least 2.5 hours of activity a week across four areas: aerobic exercise, strength, balance with tasks that need attention, and stretching. The World Health Organization lists strength training and gait and balance training among physiotherapy methods.

These sources do not say exercise cures the disease or will help any particular person in a particular way. They say movement is a sensible addition to treatment, and that regularity matters more than the type of exercise.

What this looks like in practice is shown by the story of Jules King, a British CrossFitter with advanced Parkinson’s. In her account, levodopa works for her only for a short time, so which movements she can do depends on when she took her last dose. Box jumps were possible when the drug was working strongly. As it wore off, step-ups replaced them. Training began with unweighted squats, load was added gradually, and her coach stood close during movements where a fall or a freeze could happen, and asked her directly whether she could manage today.

The lesson is not only about Parkinson’s. With many chronic conditions, a good day and a bad day differ more than they do for a healthy person. Scaling therefore has to take into account not just fitness, but also the time of day, medication and what you tell the coach before class.

How starting works at our box

We do not run a separate adaptive programme, and we do not promise that we can coach every case. What we do have are a few things that count in this situation.

  • You start with a conversation, not a class. Write or call before your first visit and describe what affects you, what you can or cannot see, when you take medication. The coach will prepare a spot and versions of the movements before you walk into the room.
  • Your doctor first. With a chronic condition, after surgery or with an eye condition, ask the doctor treating you what effort is acceptable and what to avoid. Some movements, for example jumps, inverted positions or overhead work, may need limits. The coach does not treat or diagnose. What the coach can do is build training around limits they know about.
  • Personal training as a way in. With greater limitations it is best to start one to one, where the coach’s whole session is yours, and join the group afterwards. It begins with a free phone conversation.
  • There are at most 12 people in a group, so the coach sees everyone and can change the version of a movement during class, not only afterwards.
  • One of our coaches has CrossFit Adaptive training. Małgorzata Sławińska completed the CrossFit Adaptive course and works with people with different needs. If this is your situation, ask for her when you arrange the conversation.

Classes are in Polish, and if anyone in the room does not speak Polish, the coach runs the class in English.

What to do before you come

  • Write down what your bad moment looks like: freezing, tremor, a cramp, dizziness, losing your bearings. The coach needs to know what to do if it happens.
  • Agree where you stand during the demonstration and how you want to be spoken to. Close to the coach, at a fixed station, with the movement named rather than shown, if a demonstration does nothing for you.
  • Keep a simple log: time of medication, how you feel, what went well and what did not. After a few weeks you will see a pattern that helps set the time and type of training.
  • You have the right to shorten or stop a session. You are the only person who knows how you feel today.

Answers to common questions are also in the FAQ.

Sources

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