Training Adults with Cerebral Palsy: What WE've Learned After Years on the Gym Floor

Too often, when an adult with cerebral palsy walks into a gym, the expectations are lowered before they ever touch a weight. They’re given a resistance band. They’re told to focus on stretching. Or they’re referred somewhere else because the trainer simply doesn’t know what to do. After more than 14 years of working with individuals with disabilities, we’ve learned something very different: The diagnosis doesn’t write the program. The athlete in front of you does.

CEREBRAL PALSY IS NOT ONE THING

Cerebral palsy can affect muscle tone, coordination, balance, posture, and motor control, but how those characteristics show up varies significantly from person to person. Some athletes may have greater involvement on one side of the body. Others may have more involvement in their lower body. Some may use a wheelchair or another mobility device. Some may have a co-occurring intellectual disability, while others do not. That variability matters.

You cannot see “cerebral palsy” on an intake form and know how someone should squat, hinge, push, pull, or carry. You have to observe. That is why our starting point looks much like the approach we use with any athlete with an intellectual or developmental disability: identify their goals, understand relevant medical and health considerations, observe how they move, and determine what they can successfully do today.

The assessment isn’t about creating a list of limitations. It’s about finding the starting point.

START WITH MOVEMENT PATTERNS

We don't need an entirely different strength and conditioning system because someone has cerebral palsy. We still want to develop foundational movement patterns such as the squat, hinge, push, pull, and core stability. The exercise used to develop those patterns may simply look different depending on the athlete.

For the hinge, that might mean starting with an elevated kettlebell deadlift before progressing to a trap bar. For the squat, it could mean using a box to provide a consistent target before adding external load. For upper-body pulling, a seated cable row may provide the stability an athlete needs to produce meaningful force.

The exercise is the tool. The movement pattern and the athlete's goals determine how we use it.

STRENGTH DOESN'T REQUIRE PERFECT SYMMETRY

This is especially important when working with athletes with cerebral palsy. We don't wait for perfect movement before allowing someone to get stronger. An athlete with greater involvement on one side may not perform a deadlift that looks exactly like the person next to them. That doesn't automatically make the movement unsafe or ineffective.

Our job is to determine what is appropriate for that individual. Can they control the movement? Can they perform it consistently? Can they tolerate the load? Can we progressively increase the challenge while maintaining an acceptable movement pattern?

If the answer is yes, we have something to build from.

Trap bar deadlifts have been a useful option for many of the adults with CP we've coached. The elevated, neutral handles can make the starting position more accessible while still letting the athlete meaningfully load the hinge pattern. We've watched athletes progress from relatively light trap bar deadlifts to loads they never imagined themselves lifting.

Not because cerebral palsy disappeared. Because they got stronger.

USE THE ENVIRONMENT TO YOUR ADVANTAGE

Sled pushes are another tool we use frequently. They allow athletes to produce force without requiring the same movement strategy as a traditional bilateral lift. The load is easy to adjust, the task is relatively simple to understand, and athletes can work on leg drive and trunk stability while moving through space.

Carries can serve a similar purpose. Depending on grip ability, farmer carries can challenge grip strength, trunk stability, posture, and overall work capacity. For an athlete with greater involvement on one side, the loads do not always need to be identical.

Again, symmetry isn't automatically the goal. Creating an appropriate challenge is.

COMMUNICATION IS PART OF COACHING

One of the biggest mistakes a coach can make is assuming that a person's communication style reflects their ability to understand, work hard, or make decisions about their own body.
Some athletes with cerebral palsy have speech differences. A response may take longer. Verbal communication may require more effort. Give them the time.

We often combine verbal cues with demonstrations and simple forms of feedback. A thumbs up. A head nod. Pointing to the weight they want. Showing the movement instead of adding another paragraph of coaching cues. And then we pay attention.

Over time, you learn how an athlete communicates fatigue, frustration, excitement, discomfort, or that the weight you just gave them was way too easy. That isn't separate from coaching. That is coaching.

PROGRESS BASED ON WHAT YOU SEE

Progression should not be determined by a diagnosis. It should be determined by performance. If an athlete demonstrates consistent movement quality, tolerates the current workload, and is ready for a greater challenge, we progress them. That might mean adding five pounds. It might mean another repetition. It might mean increasing range of motion, changing the exercise variation, reducing assistance, or introducing a more complex movement. Progressive overload still applies. We just have to coach the athlete well enough to know what progression should look like for them.

THE GOAL ISN'T TO MAKE DISABILITY DISAPPEAR

We aren't trying to make an adult with cerebral palsy move like someone without cerebral palsy. We're trying to help them become stronger, more capable, and more confident within their own body.

Sometimes progress is easy to measure. A 20-pound goblet squat becomes 30 pounds, then 40, then 55. Sometimes it looks different. An athlete walks into the gym more confidently. They need less assistance with a movement. They carry something independently that they previously needed help with. Or they finish a set, look at their coach, and ask for more weight.

Those moments matter.

For too long, the fitness industry has treated adults with cerebral palsy and other disabilities as though strength training is either too complicated or too risky. Our experience has shown the opposite.

They don't need lower expectations. They need coaches willing to observe, adapt, communicate, and progress.

​Coach the athlete, not the diagnosis.