He should not get in trouble for a medical condition he cannot control, but he needs to handle it through the right channel rather than simply not participating. The way to protect himself is to go through the facility's medical process and get the issue formally documented.
Inmates at any facility can request medical attention for any ailment. If his foot condition is genuine and limits his mobility, he needs to submit a sick call request and get seen by health services. Once examined, if the condition is significant enough to affect his ability to participate in physical activities, medical staff can issue a restriction or waiver that officially excuses him from those requirements. That documentation is what protects him from being written up for non-participation.
Specialists are typically available on a monthly or quarterly basis at drug treatment facilities, so depending on the nature of the problem, he may need to be seen initially by a general practitioner or nurse at the facility first before a referral is made.
The worst thing he can do is skip exercises without any medical documentation in place. That will look like non-compliance rather than a health issue and could jeopardize his standing in the program. Getting it on paper with medical backing is the move.
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