Information for Referring Clinicians

At a glance

What we are

A private barbell gym, not a clinic and not a franchise circuit. Everything below is one-to-one unless a member specifically asks otherwise.

Setting

Free-weight training facility — lifting platforms, squat racks, trap bars, dumbbells, kettlebells, rowers and stationary bikes. No selectorised machine circuit.

Supervision

One-on-one. A coach is within arm's reach for every working set and calls the set off when position degrades, rather than when the rep count is met.

Who coaches

Stanislav Babenko, owner and head coach — USA Weightlifting Level 2, CrossFit Level 2 Trainer, CPR certified. He coaches these sessions personally.

Session format

About 60 minutes: warm-up and balance work, one or two primary strength movements, accessory work, then low-impact conditioning. Typically two to three sessions a week.

Intensity model

Progressive load with technique as the gate. Beginners spend weeks below anything demanding. Members are not tested to failure or to a one-rep maximum as a matter of routine.

First visit

Free, roughly an hour, and includes a seated history-taking conversation before anything is lifted. No obligation, and no working sets if clearance is still pending.

Scope

What we do — and what we don't

The second list matters more than the first, and it's the reason this sheet exists.

What we do

Coach progressive resistance training — hinge, squat, press, row, carry — with load individualised to the person
Train balance, single-leg stance and gait-related strength in every session
Train floor transfer as an explicit skill, progressed from bench height to low box to floor over months
Program around written restrictions and post-operative protocols supplied by you or by the member's surgeon
Substitute movements rather than pushing through pain, and document what we swapped and why
Provide a member's current program on request, at any time, to the member or to their clinician with their consent

What we don't do

Diagnose. We don't name a pathology, interpret imaging, or offer an opinion on what is causing a symptom
Treat pain. Active undiagnosed pain goes to evaluation before it goes under load
Manual therapy, dry needling, modalities, taping, or anything else inside a licensed scope of practice
Rehabilitation in place of physical therapy, or work inside an active post-operative protocol without the protocol in hand
Balance rehabilitation, vestibular work, or care for a neurological condition — that's a clinical setting, not a barbell gym
Override you. If your restriction and our programming conflict, your restriction wins and we call you

Precaution handling

The constraint we work to, condition by condition

This is the same table our members see, written plainly so you can check whether it matches what you'd want for your patient. Where your instruction differs, we follow yours.

Presentation	Constraint we work to	What the training becomes
Established osteoporosisespecially with prior vertebral fracture	No loaded spinal flexion, no loaded rotation. Neutral, braced spine cued on every repetition.	Trap-bar and block deadlifts, goblet and box squats, loaded carries, hip thrusts, step-ups, overhead and landmine pressing. Progressive load rather than indefinite light work.
Osteopenia	Same restriction applied by default, but we treat it as erring safe rather than as a hard limit, and we'll relax it on your instruction.	As above. We'd rather teach a neutral braced spine from day one regardless of T-score.
Total hip arthroplastyapproach-specific	We ask which approach was used and when precautions lift. Posterior: avoid deep flexion, adduction past midline, and flexion with internal rotation. Direct anterior: avoid extension with external rotation. Conservative default if the member doesn't know.	Trap-bar deadlifts, box squats to a permitted depth, hip thrusts, banded abduction, carries, single-leg balance. Depth and stance limits are removed on your timeline, not kept indefinitely.
Total knee arthroplasty	Available range sets the depth; symptoms set the load. Kneeling removed. Next-day effusion treated as a volume signal.	Box or pin-limited squatting at a symptom-free depth, step-ups, hinge patterns, carries, hip thrusts. Half-kneeling drills done standing or seated.
Knee osteoarthritis	Bias hinge over deep squat, controlled tempo, no deep lunging, no impact. Cycle before lifting to warm the joint.	Trap-bar and Romanian deadlifts, partial-range squatting, step-ups to tolerance, leg curls and extensions within a comfortable arc, bike and rower for conditioning.
Lumbar fusion, discectomy or laminectomy	Protect the operated segment, load everything around it. No loaded end-range flexion, no loaded rotation, no good mornings early. Bracing taught before load.	Deadlifts started from blocks or a rack and lowered over months, dead bugs, planks, Pallof presses, and loaded carries as the primary trunk work.
Subacromial pain / rotator-cuff-related shoulder pain	Overhead is optional. Avoid the painful arc rather than training through it.	Landmine press instead of strict overhead press, floor press instead of bench, pull-downs instead of pull-ups, neutral-grip and chest-supported rowing, scapular and cuff work first.
Unable to get to or from the floor	Nothing on the program requires floor position until floor transfer is trained as its own progression.	Standing and bench-supported substitutions for every floor exercise, plus a separate, deliberate floor-transfer progression with a rack to hold.

What we need

What helps us most from you

Four lines on a prescription pad is plenty. What we can't do is guess.

The restriction in writing, in movement terms. "No loaded lumbar flexion" is something we can program to. "Be careful with the back" isn't.
An expiry date, or a review date. Precautions are usually time-limited, and members frequently carry them for years after discharge because nobody told them the clock had run out. Tell us when it lifts and we'll lift it.
For a replaced hip, the surgical approach. Posterior and anterior hips have different at-risk positions, and members often don't know which they had.
Anything you want us to watch for and call you about. We see these people two or three times a week for years, which makes us a decent early-warning system if you tell us what to look for.

Where we stop

When we refer out or require clearance

Our own limits, stated up front

Active, undiagnosed pain goes to evaluation first. We don't push through it and we don't try to work out what it is. We'd rather lose the intro session than load an undiagnosed problem.

We require written clearance before the first working set for a cardiac condition under active management — recent event, stent, arrhythmia, uncontrolled hypertension — and for uncontrolled diabetes, recent stroke, or active cancer treatment. The form below is all we need.

An active post-operative protocol takes precedence over anything we would program. We'll train around it or wait, whichever you prefer.

We decline what we're not equipped for. Balance rehabilitation, vestibular disorders, and neurological conditions belong in a clinical setting. We'd rather send someone to the right place than keep a client we can't serve well.

You're welcome to verify any of this in person. Call the gym, come and watch a session, or ask for a copy of a member's written program. If something in this sheet reads wrong to you, we would genuinely rather hear it than not — (603) 501-9572.

Printable

Medical clearance for supervised strength training

Complete, sign and return by any route that suits you — the member can carry it, or you can email it to grizzlywlinfo@gmail.com. This is not a request for a diagnosis or a treatment plan.

Grizzly Weightlifting LLC — clearance form

33 Emery St #001, Portsmouth, NH 03801 · (603) 501-9572 · grizzlywlinfo@gmail.com

Patient / member name

Date of birth

Clearance

Cleared for supervised, progressive resistance training as described in this sheet, with no additional restrictions.

Cleared with the restrictions written below.

Not cleared at this time. Reassess on or after: __________________

Restrictions, in movement terms

These restrictions expire or should be reviewed on

For a replaced hip — surgical approach

Anything you'd like us to monitor and report back to you

Clinician name & credentials

Practice & phone

Signature & date

By signing, you're confirming that supervised resistance training within any restrictions noted above is appropriate for this patient at this time. You are not accepting responsibility for the programming, which remains ours. We'll contact you before changing anything that touches a restriction you've written.

Sources

What the constraints above are based on

We're coaches, not researchers, and we're not going to pretend a reading list is clinical judgement. But you should be able to see where our rules come from.

Watson SL, et al. High-intensity resistance and impact training in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial, J Bone Miner Res 2018;33(2):211–220 — the basis for loading rather than indefinitely restricting low bone mass, with the caveats that participants were otherwise healthy and supervision was close.
Sinaki M, Mikkelsen BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises, Arch Phys Med Rehabil 1984;65(10):593–596 — the basis for the loaded-flexion restriction.
Crompton J, Osagie-Clouard L, Patel A. Do hip precautions after posterior-approach total hip arthroplasty affect dislocation rates? A systematic review of 7 studies with 6,900 patients, Acta Orthop 2020;91(6):687–692 — why we ask about approach and expiry rather than applying one precaution set to every hip.
Fiatarone MA, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people, NEJM 1994;330(25):1769–1775.
Fiatarone MA, et al. High-intensity strength training in nonagenarians, JAMA 1990;263(22):3029–3034.

The member-facing version of this material, with the full programming detail, is at strength training for adults over 50. Nothing on either page is medical advice or a substitute for your assessment.