Yani Fish is a PT with a specific focus – coaching cancer patients and contributing to clinical research. She told us what it’s like to have such an emotionally challenging niche, and why she chooses to balance it with training general population clients.
Issy Striive: Yani, can you tell us about your route to becoming a PT?
Yani: I’ve been training clients full time since 2018, I was an athletics coach for a short time, but I trained to become a PT while I was running a digital marketing agency.
Issy Striive: What prompted the change of career?
Yani: I've been in competitive sports since I was small - gymnastics, then U18 GB track and field but injured my spine and hips. It seemed like the obvious thing to do was to become an athletics coach. If I couldn't run, I wanted to help people run. But it turned out that I really struggled not being on the track competing myself!
Issy Striive: I can see why that would be difficult. So what did you do?
Yani: I went to Uni to study advertising - I didn't know what I wanted to do.. I don't know why I didn't think about studying sports science. But working in PR wasn’t bad, until the recession. I also ran a blog about being a female sneaker collector, which was fun!
Issy Striive: Was that a boost to your PR career?
Yani: The blog was a casual thing, but then girls from around the world who also collected trainers were getting in touch with me. It suddenly became a sneaker collective and brands started working with us! We even started consulting for Nike, it was crazy.
I had a light bulb moment - ‘I know how to market a brand, I work in PR, I'll start my own social media digital media agency.’ So that’s what I did. I was looking after social media for brands like Reebok Classics and food spots like GAIL’s Bakery.
Issy Striive: When did training come back into the picture?
Yani: About nine years ago, I realised I’d worked for about 700 days without a break. I was burnt out completely and got really sick. When you're freelance and riding high, it's super exciting. Then you realise you haven’t eaten or slept properly for ages. It hit me hard.
I shut the agency and took some time for myself. And during that time I started training in the gym and felt more fulfilled than I had in a long time. My old back injury still gives me grief, so I was teaching myself to train around that. A few years in I realised I wanted to help people to find enjoyment in moving - so the obvious choice was to study to become a PT.
Issy Striive: Seems like a blessing in disguise in some ways.
Yani: Totally, and from the start I knew I wanted to specialise in something as a PT. I enjoy knowing a lot about something specific. Specialising has its ups and downs, but I knew it would suit me best.
Issy Striive: What lead you to oncology?
Yani: My best mate got cancer when we were 29 - Hodgkin's Lymphoma. I’d sit with her while she was having her chemo. It was absolutely brutal. She asked her oncologist, ‘what exercise can I do’? And he'd say, Oh, go for a walk. But she wanted more than that.
So I found Anna Campbell who is now part of the World Health Organisation. Her charity, Can Rehab qualifies you to become a cancer & exercise rehab specialist. To this day I think of her as my mentor.
‘One of my main objectives is to create space where people don't feel like 'Jane the cancer patient’, they feel like 'Jane the badass’.’
Issy Striive: What is the qualifying process like? There are so many types of cancer, I can imagine it being an intense syllabus.
Yani: You look at cancer broadly and understand most of the different general types of cancer, stages, and grades. If a client says 'I've got squamous cell carcinoma', I understand what that is, the medication they're on, the side effects of that medication, the treatment and how to safely train someone based on all of these things.
For a non-qualified PT, it would be incredibly difficult to understand exactly what is about to happen to someone in treatment, how to treat them during and afterwards. These people need someone with specific knowledge, and after seeing my friend struggle to find someone, I knew this was the route I needed to take.
Issy Striive: How does the emotional side of specialising in training cancer patients affect you? I think this is something PTs don’t talk about enough when considering a niche demographic.
Yani: Let’s start with the lows so we can end on the highs! Obviously there’s the sad news from clients, them turning up to sessions saying their cancer has progressed and it's spreading, or their treatment’s suddenly not working. In this field, you have sad conversations every day. Maybe they can't have babies because of medication, or their kids asked them why they had no hair. They're hard conversations to have.
Issy Striive: And in those moments your role is so much more than a PT.
Yani: People think I must be desensitised to those conversations, and to clients passing. “You've been doing it for years now”. But it never gets easier to hear. And I don't ever want to be desensitised to it, because then I don't care anymore. I knew what I was getting into, you have to fully understand that you're taking that on.
Issy Striive: It shows that you’re human and I’m sure it makes you a better PT. Let’s hear some highlights.
Yani: Recently, a woman I was training was strict pressing the 15kg bar. She did three sets of 12, put the bar down, and said 'Before I was diagnosed, I couldn't even lift three kilos over my head. I thought training during treatment would be hard enough, I never thought I would actually build strength'.
I was so pleased with what she said, but then she added 'I'm a badass'. and I thought YES. That's it, that's how you should feel.
From the moment of diagnosis it can feel like cancer is your life and it controls you. One of my main objectives is to create space where people don't feel like 'Jane the cancer patient’, they feel like 'Jane the badass’.
Issy Striive: When you get the fantastic news of a client being in remission, do you bitter-sweetly lose that client?
Yani: Not necessarily, because I also train people who don't have cancer. My client base is probably 80% clients with cancer and 20% not. I find it helps on an emotional level to have that balance. And of course it means I can sometimes stay working with people when they are in remission.
To any PT who is considering specialising in something emotionally intense, I would recommend considering a split of clients. We're not trained therapists, it's OK to not be able to handle it all the time.
Issy Striive: Good advice, a trainer needs to be honest about handling the difficult aspects of a specialty. Also remembering it's OK not to know something.
Yani: 100% that makes you a better PT. If someone came to me 6 months pregnant, I wouldn't accept her as a client. I probably could train her but I'm not qualified to do so, and I know great pre and post-natal trainers that I would refer her to. In turn she is more likely to trust me because I referred her out to someone awesome. It’s never worth risking hurting someone for a few more sessions in the bank each month.
'In advertising I experienced some different treatment due to being female. I’ve never had that in the slightest in the fitness industry.'
Issy Striive: Speaking of money, you own your business, Strong in Surrey, and have recently started working in a clinical setting. Did you decide to add that as an income stream? It's not easy going it solo, so it's quite common for PTs to have their own business and add some fixed hours with a gym.
Yani: I was working in studio with other PTs before lockdown, and picked up a bunch of clients from there. That footfall was my best lead strategy, although I also got clients through social media, word of mouth and covering the odd bootcamp.
Before Covid I was earning more than enough, then lockdown hit and I lost 70% of my client base overnight. I needed to do something about it!
The rent on my studio now is much cheaper than the shared space I was renting prior to lockdown, so that was part of the decision to move there. I opened as soon as we were allowed to open studios again after lockdown. I had people coming back, but with the cost of living issues, a lot of people just couldn't afford to continue training while on treatment etc. So I needed an additional income stream, and wanted it to be something I felt passionate about. I was already volunteering as PT at the Royal Surrey hospital so made a connection at the University and started working at the University of Surrey as a research assistant in exercise oncology. I’m helping run a trial hopefully creating a pathway and programme so that every person with a cancer diagnosis has access to safe exercise from day 1.
Issy Striive: Do you see yourself ever returning to a commercial gym?
Yani: No, I don't want to work in a commercial gym, mostly because I train patients who are vulnerable. They don't want to be in a commercial gym for confidence reasons, so that they can have the space to themselves and it just be about their time and also so they don’t pick up infection etc. Having my own private space is perfect. In fact, part of the research we're doing is to encourage the NHS to create a referral pathway from diagnosis to a trainer within a clinical setting, to help maintain and hopefully improve strength and mobility during treatment.
Issy Striive: You said your own space is cheaper than renting a shared space. A newly-qualified PT may hear that and consider going private. What would be your advice on choosing a training space?
Yani: As a new PT, I wouldn't rent my own space just yet. If you've never had gym floor experience or coaching experience, go and work in a commercial gym for a year. Pick up a client base and start talking to people, that shoves you right in at the deep end. You're in the middle of a busy place, fighting other PTs to get clients, with so many different types of people coming through the door. The wages might not be great, but at least you have income and you can build a client base quite fast. If you're in a private studio you're paying rent regardless of how many clients you’ve got (or not) – you can quickly find yourself in the red.
Issy Striive: Great advice. Before we finish, what do you enjoy about the fitness industry? And what do you wish was different?
Yani: When I worked in advertising I experienced some different treatment due to being female. I’ve never had that in the slightest in the fitness industry. In my experience, men and women are treated equally in terms of charging rates and respect, and I really love that.
Issy Striive: Awesome. What do you wish would change?
Yani: I wish there was more regulation around who can give advice. There are a lot of unqualified people on social media giving guidance that's often off. It’s a shame because things like Instagram could be amazing if educated advice was always being given.
We hope you’ve enjoyed this glimpse into what it’s like to train cancer patients and work in a clinical setting. You can see more of Yani’s work in @stronginsurrey on Insta.