If you’ve ever struggled to teach a client a particular exercise that they just aren’t getting, you know how frustrating it can feel—for both of you. Your job as a personal trainer is to help clients learn the exercise technique, but that process can get awkward if the client feels embarrassed or discouraged by their lack of mastery. You might also feel this way for missing the mark on how to teach it. Your best line of defense for diffusing these potentially high-pressure situations is to prepare multiple options for breaking down an exercise. Try using the suggestions below as a starting point to achieve success.

Save it until the end

As long as the client isn’t at risk of injury, sometimes it’s best to leave a detailed technique tutorial until the end of the set or better yet, the workout, especially if you’re dealing with a case of “learner’s block” that’s made worse when there’s pressure to perform.

Besides that, you might interrupt the flow of the workout when you spend too much time breaking down an exercise. If a client isn’t getting a particular move, regress it a bit and reserve a few minutes at the end of the session—once the client has cooled down—to “workshop” the exercise progression. With the workout over, there’s less pressure to accomplish the right technique asap.

Cater to multiple learning styles

As a personal trainer, you might have observed that people prefer to learn a new exercise in different ways, such as by watching, listening and/or doing. Usually a combination of all three works well, perhaps with an emphasis on one particular style.

Most personal trainers naturally notice which approach works best for which clients. Still, get in the habit of using a variety of teaching techniques when needed. For example: show the client what the exercise looks like by doing it yourself. As you visually demonstrate, explain what’s happening. Invite clients to perform the exercise with you. Remember that touch, when appropriate and with a client’s permission, can also provide feedback on what to focus on. Continue to demonstrate, explain and perhaps modify as needed.

Use props and tech tools

Trainers are known for using props such as a bar, band or dowel to help demonstrate proper movement angles with clients. Sometimes asking clients to look in the mirror is all it takes for them to see—and correct—what’s going wrong with their form. This might be especially true for people who are visual learners.

If that doesn’t work, or there are no mirrors for them to watch their form, turn to your phone for assistance. Take photos or video of clients in action to help them understand and correct technique problems (be sure to get their permission to do this first). Mobile apps like Coach’s Eye and Hudl Technique allow you to go in-depth with on-the-spot footage or video imported from your camera roll. For example, you can view slow-motion playback and draw lines, angles and arrows on a video or photo to review and analyze problematic or desired movement patterns.

Go back to the drawing board

If a client still hasn’t improved after a thorough tutorial, perhaps it’s time to re-evaluate the progression you’ve chosen. Re-start the exercise with something less advanced, temporarily eliminating or lightening the load. Remove any other equipment if appropriate and go back to bodyweight basics.

It might also be that the client needs more time to become aware of, and properly isolate, a muscle or muscle group involved in a given exercise before you can move on. Opt for foundational mastery before getting too complex.

Let it go

Finally, if a particular exercise seems to create a stumbling block for multiple clients, you might need to face the fact that it’s not the right exercise for right now. Perhaps some clients need to do more foundational work before they’re ready for this next step. If you can’t logically tweak the movement so it’s more user-friendly, consider ditching it (for the time being, at least).

Personal trainers are responsible for helping fitness clients improve and progress. To that end, carefully break down exercises and carry on from there, using the tips in this blog post.

Do you have additional tips for breaking down exercises with clients? Share your recommendations in the comments section below!

The post What to Do When a Training Client Can’t Get the Exercise Technique Right appeared first on NASM Blog.

Core training has become a staple of almost all conditioning programs. Whether it is for high-level athletes, the weekend warrior, or your average fitness enthusiast, “working the core” tends to get a lot of attention by fitness professionals, their clients, and the general public alike. Unfortunately, still to this day, there are many misconceptions on what the core truly is, how it functions, as well as how to properly design a progressive core training program.

Far too often fitness professionals are asked by their clients or prospective clients, “How do I get rid of this?” as they grab their midsection. Or, they will ask the fitness professional, “Can you show me the best ab exercise so I can lose this.” So clearly there is a misunderstanding in that many people believe if they do core exercises they will spot reduce the excess body fat in that particular region. This is a perfect opportunity for the fitness professional to educate on what truly makes up the core in regards to their physical anatomy, as well as how the core works as an integrated unit in functional activities in every day life, and that spot reducing a particular area by focusing on a few exercises isn’t the correct approach.

A common misconception many individuals make is that the core is simply the portion of the abdominal complex directly in and around the navel. The core is far more encompassing. There are 29 muscles that attach to the core and it is made up of the entire axial skeleton (cervical, thoracic, and lumbar spine), and the pelvis. Simply put, if you remove the arms and legs what is left is the core.

The body is made up of roughly 602 muscles that move 206 bones. These muscles can basically be split into one of two categories: movement muscles and stabilizing muscles. Clearly, all muscles have complex roles in regards to proper human movement and most will have multiple functions depending on what type of movement the body is doing. Other factors that contribute to how particular muscles respond and react will be body positioning, previous injury, physical make up, and movement compensations. However, with as complex as the human movement system is, understanding muscles and their roles as either primarily movement based or stabilization based in their function will help fitness professionals to design and implement sound conditioning programs.

LOCAL STABILIZATION MUSCLES OF THE CORE

Provide support from vertebra to vertebra

• Transverse abdominis
• Internal oblique
• Lumbar multifidus
• Pelvic floor muscles
• Diaphragm

GLOBAL STABILIZATION MUSCLES OF THE CORE

Transfer loads between upper and lower extremities

• Quadratus lumborum
• Psoas major
• External oblique
• Rectus abdominus
• Gluteus medius
• Adductor complex

MOVEMENT SYSTEM

Concentric force production and eccentric deceleration during dynamic activity.

• Latissimus dorsi
• Hip flexors
• Hamstring complex
• Quadriceps

Building the Core

Local stabilization system –> Global stabilization system –> Movement system

Research has shown (1) that the muscles responsible for stabilizing the spine when functioning optimally work as a feed forward mechanism. This means that the stabilizers of the spine should fire milliseconds prior to any extremity movement in order to create a rigid platform so that the movement based muscles of the body can more effectively and more efficiently produce optimum levels of force. Within individuals with chronic low back pain, research has demonstrated (1, 2) that the core stabilizers fire either at the same time, after, or not at all upon the extremities being engaged. For this very reason working through a well designed and properly executed core stabilization program is paramount for every and all individuals who are trying to eliminate low back pain, increase their fitness, or solely perform their activities of daily living.

The starting point for a sound core conditioning program should be establishing a solid base of core stabilization. Core stabilization exercises are defined as those that place stress upon the spine but there is little to no movement of the spine. The ability to find neutral spine and resist the effects of gravity will help protect the back while providing a solid base for the muscles that generate movement (force) to work more efficiently. Teach clients to use the drawing-in maneuver (pulling in the muscles below the navel, activating the local stabilization system) and bracing (“bearing down” and activating the global stabilization system) at this level of training. Core stabilization should be established in all three planes of motion before moving into core strengthening exercises.

• Sagittal – Planks/bridges
• Frontal – Side Planks with a hold
• Transverse – Pushup with rotation/press outs

Once the proper level of core stabilization has been established, which usually takes roughly 4-6 weeks depending on the individuals stating point, they can then progress to core strengthening exercises. Core strengthening exercises are defined as exercises that begin to add more dynamic eccentric and concentric motion of the spine. Core strengthening exercises will assist fitness enthusiasts in progressing their fitness programs by aiding in the ability to complete more load bearing exercises such as loaded squats, deadlifts, as well as other multi-joint strength based exercises. During this phase of training it is important to have individuals perform the activation techniques (drawing-in and bracing) as was learned in the core stabilization phase of training. Bracing, which is a co-contraction of the global muscles of the core, such as rectus abdominis, external obliques, and quadratus lumborum, focuses on global trunk stability, not on segmental vertebral stability, meaning that the global muscles, given the proper endurance training, will work to stabilize the spine. This will provide the most stable and rigid position for the spine as it begins to handle more load in the higher phases of training. Individuals should remain in this phase of training for roughly 4weeks (or potentially 12 weeks depending on how many phases of strength training is necessary for their fitness goals).

Just like with stabilization training, core strength should be established in all three planes of motion before progressing to the power level of training.

• Sagittal – Crunches, stability ball crunches
• Frontal – Side planks for repetitions
• Transverse – Band rotations, chops, lifts

After completion of progressive core stabilization and core strength programs, the next phase of training is power training. Core power exercises are used to improve the rate of force production by the core musculature, and to prepare an individual to dynamically stabilize and generate force at more functionally applicable speeds. In our activities of daily living we are required to move at various speeds so creating the adaption and benefits associated with power training should be a focus of a comprehensive core training program. Life is unpredictable and we may never know exactly when we may need to be able to accelerate or decelerate an object or our body weight explosively. Plus, many of the new fitness trends, such as HIIT, boxing or mixed martial arts conditioning, require high levels of power to properly participate in them. Additionally, when you look at some of the most popular fitness tools in use, such as battling ropes, kettlebells, and medicine balls, establishing proper core power would further aid in the successful use of these fitness implements. And don’t forget that many of the popular recreational activities adults participate in such as golf, tennis, softball, or any other weekend warrior activity, all have an element of power development associated with them. It is for these reasons that the development and implementation of a progressive core program is essential within any properly designed fitness program.

• Sagittal – Medicine ball (MB) pullover throw, soccer throw.
• Frontal – MB lateral throw
• Transverse – Rotational chest pass, front MB oblique throw.

References:

1.) Ferreira PH, Ferreira ML, Hodges PW. Changes in the recruitment of the abdominal muscles in people with low back pain: ultrasound measurements of muscle activity. Spine. 2004; 29: 2560-2566.

2.) Hodges PW, Richardson CA. Inefficient muscular stabilization the lumbar spine associated with low back pain. A motor control evaluation of the lumbar spine. Spine. 1996; 21: 2640-2650.

3.) NASM (National Association of Sports Medicine). 2017. NASM Essentials of Personal Fitness Training (6th ed.). Burlington, MA: Jones and Bartlett Learning.

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Ah yes, the “Why are they doing that?” remark. We’ve all seen it. Somewhere in “Training Land” a trainer is making a client do some movement that looks, well, rather ridiculous. It might even look so odd that the untrained eye or mind might wonder, “What the heck are they doing?” Please allow me to explain.

If we can agree that exercise is supposed to improve movement, then the purpose of any exercise should be to help the client move better and move more efficiently. Following the NASM OPT model, we know that proper progressions lead us from Stability to Strength to Power. But, if there is a weak link in the chain—and we ALL have weak links—improper programming can lead to injury and even a lack of trust. Thus, effective communication is a must for quality trainer/client relationships.

The best trainers are excellent teachers. Any muscle-bound dude in a tank top can shout instructions, but a more effective style is explaining what the exercise is trying to achieve. For example, there is an industry shift toward incorporating ground-based movements, especially during the warm-up. If a client breathes poorly, chances are they move poorly too. Starting them on the ground with diaphragmatic breathing–as odd as simple breathing exercises may appear to onlookers–is a great way to prep the body. After breathing, working contralateral patterns from a supine position (i.e., dead bug) can reinforce the body’s natural movement mechanics, while forcing the client’s brain to send the proper messages to the proper limbs at the proper times.

Which brings us back to teaching. As fitness professionals, our job is to educate clients about the “why” of what we’re doing. “We are relearning how to breathe to increase lung capacity and improve energy levels,” or “We are working on unilateral strength to improve coordination, correct imbalances, and make your brain focus longer.” Once we’ve established rapport with our clients, and we get a feel for what they can do well, we can add some flavor to their progressions. So, we might incorporate a bear crawl into a circuit.

As kids, we are bear-crawling and crab-walking phenoms. As grown-ups, we generally lose these skills. (Even activities like skipping seem a challenge for our grown-up abilities. To see this in action, ask adults to skip. Then ask them to skip backward. It’s somewhat hilarious to see how something so simple in our youth has become a drill of mind-bending coordination.) I incorporate these same exercises into my NINJA class warm-up. I explain that as NINJAS, we need to move well from every imaginable position. So, we train from the ground up with a combination of bridge and reaches, kick throughs, and multidirectional bear crawls/frogger/gorilla patterns. Does it look ridiculous? Probably. But, it also looks like the beginning of a judo or Brazilian jiujitsu martial arts class. Do I demonstrate the applicability? Yes. Do I teach the significance of moving better? Yes. Do my NINJAS struggle with it initially but improve with practice? Yes. Do they see how these animal-flow patterns improve their hip mobility, thus making their punching and kicking more powerful? Heck yeah!

Trainers should also be aware how their clients or classes look while doing these types of exercises. If my client is bear crawling, and their butt crack or belly is hanging out, I will shut the drill down and adjust to something else. Good coaches put their players in a position to succeed; and I want my clients thinking about their movements, not their butt cracks. It also improves our worth by showing the utmost care and respect for our clients.

Programming creativity is good, but specific exercises should have specific purposes, with the explanation following the NASM OPT model. If you communicate well, teach like a champion, and the client can execute your game plan—congrats, you have earned the right to get a bit ridiculous!

Train hard. Train smart. Train safe.

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The lunge is a versatile, simple and effective movement for lower body training. Various positions, planes of motion and speeds can all yield different training adaptations for the exerciser. Lunges are the gift that keeps on giving! We’ll discuss different tweaks, twists and turns that change the demand on the kinetic chain; and that keep your clients’ workouts interesting and effective.

Two Basic Lunge Positions

First, let’s review what a lunge is. A lunge is very much a “squat with a kickstand.” The best way to feel this idea is to take yourself to the bottom of your squat, hold, and take one foot and step back. There you have it.

There are a couple basic lunge positions that apply to most variations: one with an upright trunk and one with a slight forward lean of the trunk. Let’s look at how these positions differ in their demand on the lower body.

The Upright Lunge – An upright trunk tends to create what is often called a 90/90 lunge where both knees at the bottom of the move are 90° angles. With this positioning, the majority of a person’s upper body weight is situated directly over their hips. From what we know about biomechanics, the joint farthest away from load will receive a majority of the stress. So, in an upright lunge, the forward knee will experience more torque because it is the joint farthest from the load of the body. Therefore, the knee extensors will bear more responsibility. Bottom line: If the exerciser’s trunk is upright and performing a 90/90 lunge, it is a more quadriceps dominant movement.

The Forward Leaning Lunge – When an exerciser leans slightly forward with their upper body weight positioned over the mid-thigh, demand will be evenly distributed across the hip, knee and ankle. Again, using our biomechanical principles, if the primary load is positioned in between two joints (in this case the hip and knee), the muscles moving those joints through extension will both bear responsibility in the exercise. Bottom line: A slight forward lean increases glute involvement.

Further Increasing Glute Involvement

Twist to Open! We can further increase gluteus maximus involvement by adding trunk rotation. Remember that the gluteus maximus concentrically performs hip extension and external rotation. An exerciser can eccentrically load the gluteus maximus in the sagittal and transverse planes by leaning forward (hip flexion) and rotating the trunk toward the forward leg (hip internal rotation). By loading the glutes eccentrically in both of these planes, we increase the demand on them and therefore increase their response. For example, if performing a lunge with the left foot forward, you would rotate the right shoulder toward the left knee. To maximize glute involvement, be sure that you don’t lift your forward heel of the ground while decelerating toward the floor. Aim to have your weight distributed evenly across the forward foot.

Multiplanar Lunges

Multiplanar lunges are a great way to mix things up! From what we know about the training principle of specificity, our bodies respond very specifically to the stimulus presented in a workout. Research further supports that the directionality of forces applied to the kinetic chain impact how the body responds. For example, loading the body laterally (such as in a shuffle pattern or lateral lunge) selectively improves its proficiency in the frontal plane. The bottom line here is that we definitely want to work in multiple planes and multiple joint angles to maximize a client’s training.

Tips for executing multiplanar lunges:

1. Solid hip-knee-ankle mechanics apply here just like they do in squatting motions. Make sure that alignment is prioritized during multiplanar lunges.
2. Start a client in the plane they are most comfortable in. For many clients, this is the sagittal plane. Remember we want our clients to feel confident before we begin to push them into new directions as they improve.
3. Don’t take strides that are too long. People have a tendency to use momentum to propel themselves up if the step is too long. Start with a shorter step to ensure control is maintained throughout the entire range of motion.
4. Try reaching toward the ground with your hands as you step (usually applies to bodyweight or dumbbell lunges). This helps to soften the landing of each step and reinforce eccentric control. You can also use your client’s reach to efficiently guide them into different planes (e.g., have them reach for 12:00 or 9:00 as if they are standing in the center of an imaginary clock).

Bringing It All Together

No matter how you combine the variations discussed here, make sure technique and posture are maintained. Lunges are a great part of your client’s progressive and challenging program design; and can be modified for any fitness level. And importantly, the variations presented here can keep your client (and you) from getting bored!

References:

1. NASM (National Academy of Sports Medicine). 2017. NASM Essentials of Personal Fitness Training (6th ed.). Burlington, MA: Jones and Bartlett Learning.
2. McCormick BT, Hannon JC, Newton M, Shultz B, Detling N, Young WB. The Effects of Frontal- and Sagittal-Plane Plyometrics on Change-of-Direction Speed and Power in Adolescent Female Basketball Players. International Journal of Sports Physiology and Performance, 2016; 11(1), 102-107.

The post The Lunge – An Effective Lower Body Training Exercise appeared first on NASM Blog.

Despite growing popularity and adoption of programs incorporating heart rate (HR) zone methodology, the fitness industry in general appears to lack a solid understanding of the scientific facts and limitations to this programming concept. The goal therefore is to present relevant information so that fitness practitioners and fitness enthusiasts can better understand the pros and cons to using HR zones.

Maximal Heart Rate (MHR)

First and foremost, many models utilize a mathematical formula to determine maximal heart rate (MHR) based upon one’s age, assuming all people of the same age have the same MHR – this cannot be further from the truth (1). Maximal HR is determined primarily by genetics and individualized to each person rather than generalized by a formula – it is influenced by a myriad of events that include:

• Age – although humans do witness age-related decreases in MHR as we age, it does not necessarily decrease linearly, nor is it one beat per minute (bpm) per year. Data exists to demonstrate how fit individuals can maintain the same MHR for periods of 15-20 years – unfit individuals however, do show a more linear decrease over time (2).
• Conditioning level – as the cardiopulmonary system adapts to training (predominantly aerobic training), MHR may decrease as maximal cardiac output (Q) is attained by an increase in stroke volume (SV). Cardiac output represents the work capacity of the cardiovascular system (HR x SV) whereas SV represents the volume of blood pumped out of the left ventricle with each beat (3).
• Stress, stimulants, recovery status and blood volume (hydration) can all impact resting, exercising and MHR – as they can vary from day-to-day, so too can a person’s MHR change.

While more than 30 different MHR formulas exist, the Fox and Haskell model (220-age) is perhaps the most popular given its simplicity of use, although it also has one of the largest margins of error – this error is estimated to be approximately 12 bpm (one standard deviation) (4, 5). What this means as an example, is that for a group of 100, 20-year old individuals, 68% would have a true MHR ranging between 188-212 bpm (220-age ± 12 bpm) (Figure 1). Expanding to 2 standard deviations or approximately 95% of the group, the error doubles to 24 bpm (i.e., MHR = 176-224 bpm); 3 standard deviations represents approximately 99% of the group with the error expanding to 36 bpm on either side of the estimate (i.e., MHR = 164-236 bpm). Furthermore, this formula tends to over-estimate in younger individuals (e.g., a 25-year old may never attain 195 bpm) and tends to under-estimate in older adults (e.g., a 60-year old can exceed 160 bpm). You can now see the probability of error. A takeaway here is that if a MHR formula is to be used (which shouldn’t), consider one with smaller errors (e.g., Tanaka = 208 – {0.7 x age}).

Figure 1: Error example of the 220-age formula for estimating MHR in a 20-year old

Zone Methodology

Most models incorporate percentiles to distinguish their zones (e.g., 60-70% MHR), selecting values often based on arbitrary ideas, simplicity or mathematical convenience rather than evidence-based science, with some subscribing to an assumption that each zone range optimally evokes some specific metabolic response (e.g., 60-75% MHR = fat-burning zone). Unfortunately, no consistent evidence exits to support the notion that a specific intensity evokes that same adaptation in all people. For example, in some individuals their optimal fat-burning zone may occur at 55-60% of MHR, whereas in others, it may as high as 80-85% MHR. The truth is that our metabolism is as unique as our fingerprint and is influenced by gender (women typically burn more fat than men at rest and at sub-maximal intensities), hormonal levels (e.g., estrogen, human growth hormone), diet (very influential – high fat diets can increase fat utilization), adaptations to exercise specificity (e.g., high-intensity exercise can promote greater carbohydrate storage and utilization 24-7), genetics (e.g., ectomorphs – tall and slim favor carbohydrates over endomorphs – heavier who favor fats), medications and more. So then, how can we define a zone by some generic range? Take MyZone as an example which incorporates a 5-zone model – Grey, Blue, Green, Yellow and Red with each representing a specific intensity range (e.g., 50-59% MHR; 60-69% MHR, etc.). Does each zone represent a specific physiological or metabolic event? Doubtful when using a one-size fits all approach. Granted, they, like some others use percentile ranges for other purposes – while they do not represent physiological or metabolic zones, they can be used to represent intensities from which accomplishments, recognitions, badges or rewards are attained (i.e., gameification). Using this data, progress and adherence is supposed to be measured. Here to, we need to understand the limitations to exercising heart rate which also influenced by many events that include:

• Blood volume – a dehydrated body generally decreases blood volume, subsequently increasing HR responses above normal – does that mean you are rewarded with more points for being dehydrated?
• Simulants (e.g., caffeine) – they can activate the sympathetic nervous system which accelerates HR responses above normal – again, is one rewarded with more points for taking a stimulant?
• Stress and lack of recovery – a body not afforded adequate recovery from exercise or life stress may demonstrate elevated HR responses above normal.
• Fitness improvements – As mentioned previously, training adaptations lower HR responses due to improved cardiorespiratory efficiency – attaining pre-set intensity ranges can become more difficult over time (i.e., a person finds it harder to earn zone points due to improved fitness). Why should they be penalized for becoming more fit?

We should therefore ask – if tracking time or attainment in zones is so inconsistent when derived from %MHR, is it really a valid indicator of adherence, progress or improvement?

Anaerobic Training and HR

Any time exercise intensity changes, the body’s cardiopulmonary system adapts to meet the new demands, but unfortunately this take time – anywhere from 30-45 seconds up to several minutes, depending upon the intensity challenge (6,7). The ability of the body to meet current energy demands is known as attaining steady-state (SS), often referred to as getting the ‘second wind,’ – it essentially represents HR responses matching work demands. Why do we care about SS-intensity exercise? SS-HR responses during sub-maximal work (i.e., outside of resting HR or MHR) correlate decently with oxygen consumption (VO₂), from which calories can be estimated consistently. But, this correlation only applies to SS-HR responses during exercise and not to non-SS exercise (3,6). Considering the popularity of many of today’s workouts where work intervals are generally performed for less than 3-minutes (e.g., HIIT-type training, resistance training sets), they mostly involve non-SS HR response, rather than SS-HR responses. Subsequently, the HR response measured does not necessarily reflect the actual work performed by the body. As proof of concept of this HR-response lag or to demonstrate the non-SS nature of interval-type training, conduct the following simple test:

• Perform a SS, light-to-moderate intensity bout of exercise for 4-minutes while monitoring and recording HR response (by 4-min, you HR should ideally level off, attaining a SS-response). Next, perform an all-out 60-75 sec bout of high-intensity exercise before returning to an easy pace to recover – complete the following tasks:

1. How long did it take for the HR response to start climbing? Had it increased much by 10-sec? How about at the 30-sec mark? In fact, it may still be climbing by the end of the work interval.
2. Monitor HR response during the first 30-seconds of recovery. Did HR continue to climb higher during the early phase of recovery or did it being to drop immediately following the end of the exercise bout?

What this translates to is that HR measured during interval-type training cannot be used to estimate true work performed by the body or calories, given its delayed response time – therefore it is only a number. But, as a number it can still hold some value if the same work intensity becomes performed consistently at lower non-SS HR responses or if HR during the recovery phase decreases more rapidly (i.e., both imply improved cardiopulmonary efficiency).

What conclusions do we take from this? We agree that mathematical formulas, especially 220-age are flawed, as are zones using arbitrarily defined ranges. Aiming to score or aggregate time spent in zones based off exercising HR is too inconsistent and influenced by far too many variables unrelated to exercise effort. Additionally, some models fail to adjust their zones to accommodate for training adaptations. Furthermore, during non-SS, interval-type exercise, HR responses do not reflect actual physiological work performed by the body (i.e., time delay), nor do the HR responses accurately estimate calories.

So then, should we discard zone methodology? Absolutely not… Zone methodology offers the potential to systematically compartmentalize adaptions much like we witness in resistance training (i.e., endurance, hypertrophy, strength). However, we need to rely upon more accurate methodologies that impose the appropriate demands upon the body’s systems to evoke the desired adaptations (e.g., fat-burning efficiency, anaerobic capacity).

The most logical solution lies with utilizing more individualized zone methodology derived from a person’s unique metabolic markers (i.e., Ventilatory Threshold One – VT1; Ventilatory Threshold Two – VT2) rather than from generic formulas of MHR (3,7).

• VT1 is a metabolic marker of aerobic efficiency and provides great insight to what we burn as fuel (e.g., fats, carbohydrates) – aka caloric quality. Relevance here is that it will greatly influence what we burn during SS-exercise and more importantly, what we burn as fuels throughout the day.
• VT2 is a metabolic marker of anaerobic capacity and provides insight into caloric quantity (i.e., the number of calories which hold relevance in performance and perhaps with weight loss).

The beauty of using individualized zone programs derived from unique metabolic markers is that they can be continuously adjusted as the body undergoes adaptation, providing more realistic means to monitor progress and achievements. Keep in mind however, even with this model, there is no solution for accurately measuring non-SS HR responses – we need to simply accept that inevitable truth.

Fortunately, today’s technology and wearable devices are advancing very quickly and it is just a matter of time before the innovators within the fitness industry transition away from MHR-based zone methodology and adopt better models based upon metabolism (Ambiotex is one innovative tech company who has developed a wearable shirt that measures these metabolic biomarkers). Given the sheer size of the larger commercial users of HR Zones such as Orange Theory Fitness and MyZone, I believe they may be the catalyst to shift the entire fitness industry forward. In closing, if you’re one who thrives on being innovative and evidence-based, perhaps it is time for you to start considering how and when you’ll make the transition to these cutting-edge ideas and applications.

References

1. Robergs R, and Landwehr R, (2002). The surprising history of the HRmax= 220-age equation. Journal of Exercise Physiology Online, 5(2), ISSN 1097-9751.
2. Bryant CX, Merrill S, and Green DJ, (editors), (2014). Personal trainer manual (5^th edition). San Diego, CA. American Council on Exercise.
3. Kenney WL, Wilmore JH, and Costill DL, (2012). Physiology of sport and exercise (5^th edition). Champaign, Il., Human Kinetics.
4. Skinner JS, Bryant CX, Merrill S, and Green DJ, (editors), (2015). Medical exercise specialist manual. San Diego, CA. American Council on Exercise.
5. Riebe D (editor) (2018). ACSM’s guidelines for exercise testing and prescription (10^th edition). Riverwoods, Il, Wolters Kluwer Health.
6. Kraemer WJ, Fleck SJ and Deschenes MR (2012). Exercise Physiology: Integrating theory and application. Baltimore, MD. Lippincott Williams and Wilkins.
7. Pocari J, Bryant CX and Comana F, (2015). Exercise Phsyiology. Philadelphia, PA. F.A. Davis and Company.

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Before you grab a Halloween fun size candy out of the cauldron, here’s the creepy calorie count that will have you haunting the gym.

October is known for homecoming, pumpkins and pumpkin-flavored everything, postseason baseball, the Chicago Marathon, and Halloween. Always has been, always will be. With Halloween creeping up on the 31st, there is an excellent chance your teeth will find their way into some coveted Halloween candy. Whether you’re trick-or-treating or handing out candy, take pride in your decision-making. No one wants to waste their time–or their calories–eating bad candy.

If you choose to stay home and hand out candy, be a great candy-giver. Your candy selection reveals your true character. Have great candy at the ready? The Halloween ghouls will smile upon you. Knowingly have a horrible candy selection? Beware the wrath of angry trick-or-treaters. Just remember: under NO circumstances is it acceptable to hand out raisins.

But, how do we stay disciplined amidst such sweet temptation?

First, allow yourself a small treat. Staring down a bag of Snickers while testing your willpower to see how long you can NOT have one is a little extreme. It’s OK to eat one Snickers. But, if we lose self-control and shovel buckets of candy into our mouths, we will need a contingency plan. This plan starts by knowing how many candy calories we’re ingesting and what we need to do to burn them off.

According to the CDC, the average adult man (over the age of 20) weighs 195.7 pounds, while the average adult woman weighs 168.5 pounds, and for this article we’ve simplified by using a weight near the middle of 180 pounds. Using this number, we’ve balanced it against some popular Halloween candies, their calorie count, and what needs to be done to scare it off.

1. Snickers

Do you know anyone that hates Snickers? Neither do I. For instant neighborhood credibility, hand out Snickers on Halloween. Just know that each Snickers Fun Size candy bar has 160 calories, so each of those leftover Snicker Bars will require 15 minutes of pushups to burn off (that’s if you go hard since calorie burn ranges between 4 to 11 per minute!).¹

2. Reese’s Peanut Butter Cups

Does life offer any better combination than chocolate and peanut butter? Correct answer: no. Before you argue with me that the peanut butter in Reese’s Peanut Butter Cups has protein, and is therefore healthy, be aware that the Fun Size Cups are owners of 110 calories. You’ll be jumping rope for 27.5 minutes (or vigorously jumping for 8) to clear that cup.¹

3. Skittles

Rainbows are magical, and if we could take a bite out of one, it surely would taste like Skittles. Along with being visually appealing, these multicolored fruity candies are adding 60 calories per fun sized bag (though the serving size says 3 bags!). Taste the rainbow, then punch a heavy bag for 7.5 minutes (or 22.5 minutes if you eat the 3 bag serving,). ¹

4. Butterfinger

If your job is to catch footballs, having butterfingers is bad. If you’re a candy bar, that was once associated with The Simpsons, having Butterfingers is good. With only 85 calories packed into the Fun Sized version, you’ll need to swing the kettlebell for anywhere between 4 to 21 minutes to avoid a Homer Simpson belly.^1,2 (Make sure you don’t have butterfingers when swinging your kettlebell.)

5. Twix

While a chocolate/peanut butter combo is always right (see #2 above), Twix is close in the ranking with its own genius paring. Caramel and milk chocolate are classics, and handing out Twix means you have the “cool house” on the block. But, each Twix fun size bar that finds its way into your mouth is 80 calories. Get ready to do 8 minutes of box jumps to tweak the Twix.³

6. M&Ms

M&Ms are basically the chocolate version of Skittles. They are about the same size and have the same visual appeal. Some might think, “Since M&Ms are little, I’ll just eat the whole bag, and it’s OK because they’re little!” Bad idea, buddy. Those little bags of M&Ms are 73 glorious calories (serving size is 3 bags), so hit the treadmill for 7 minutes (whole 3 bag serving you’ll need to increase that to 21 minutes) at a 5% incline at 4 mph.²

7. Sour Patch Kids

Even though they are not my favorite, the Chicago Tribune recently listed Sour Patch Kids as the number one ranked Halloween candy in Illinois, so they made this list. Sour Patch Kids are a fantastic mix of chewy and sour. While a 5 oz. bag has 150 calories, consider the amount of work your jaw has to do just to chew them up before slamming battle ropes for 13 minutes.⁴

Enjoy the fun of the season, but remember these Halloween bullet points:

• If you’re going to eat candy, eat good candy, but know the calorie content and know how to burn it off
• Never, ever, ever give raisins to trick-or-treaters (and by the way, those little raisin boxes have about 129 calories)

Happy Halloween!

Calorie reference tools and sources:

1. MyFitnessPal.com
2. SparkPeople.com
3. FitClick.com
4. DailyBurn.com

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The act of breathing seems incredibly simple, but doing it properly can be surprisingly complex–and of vital importance to your clients’ performance.

HOW IT WORKS

The average person’s lungs move about 0.5 liters of air with each relaxed breath. That amount can jump to 3 liters during vigorous exercise.

When you inhale, air travels through your nose and mouth and on through the pharynx, larynx, trachea, bronchi, and smaller and smaller tubes called bronchioles (which are the thickness of a hair) to 600 million small sacs in the lungs called alveoli. Each alveolus is surrounded by a net of tiny capillaries, where red blood cells drop off carbon dioxide and pick up oxygen (a process called “gas exchange”).

When you exercise, the levels of carbon dioxide and hydrogen ions in your bloodstream increase. This leads to a drop in blood pH, which triggers an increase in breathing rate. In fact, the primary
 driving force behind almost all respiration (especially at sea level) is a need to remove carbon dioxide, not to take in oxygen. (At altitude, respiration increases because the blood is less saturated with oxygen.)

Exercise increases respiratory system efficiency, but it doesn’t significantly increase lung capacity

BREATHS BY THE NUMBERS

• 12-15   AVERAGE NUMBER OF BREATHS TAKEN PER MINUTE AT REST
• 17,000   APPROXIMATE NUMBER OF BREATHS TAKEN PER DAY
• 6 MILLION   APPROXIMATE NUMBER OF BREATHS TAKEN PER YEAR

SURPRISING OUTCOMES OF BAD BREATHING

The diaphragm is a dome-shaped muscle beneath the lungs. When you inhale, it flattens and moves downward, pressing against the abdominal organs so the lungs can expand. However, many adults don’t properly engage the diaphragm—poor posture, stress, and other factors lead people to breathe shallowly, moving the upper rib cage more than it should. It can also cause discomfort in the chest and back muscles, weaken the muscles in the pelvic floor and lower back, and disrupt proper movement of the shoulders and spine.

To help clients practice proper diaphragmatic breathing, have them place their hands on their lower ribs so they can feel them rise and fall as they breathe. The majority of the breathing motion should be felt here, not the upper chest, during everyday life and especially during exercise.

WHAT’S YOUR LUNG DISEASE IQ?

Lung disease refers to any condition that prevents the lungs from working properly. People with lung disease often experience shortness of breath and may fatigue sooner during exercise. Here’s a refresher on the guidelines for working with such clients (when their doctor has approved exercise).

Clients with lung disease generally tolerate aerobic exercise at 40% to 60% of peak capacity, three to five days a week for 20 to 45 minutes.

Consider circuit training in a Peripheral Heart Action (PHA) format of 8 to 10 exercises, with one set of 8 to 15 reps per exercise.

Emphasize breathing control; schedule frequent rest intervals.

Consider using a pulse oximeter during exercise to track oxygen saturation in the blood. Levels should be a minimum of 85% but preferably 90%. Below 85%, stop exercise.

HOW TO BREATHE DURING EXERCISE

The gold standard during strength training is to inhale on relaxation and exhale during exertion. For cardio, you generally breathe in and out through the nose or, when intensity ramps up, through the mouth. Here, a few breath-control tricks to try with your clients.

For clients who tend to hold their breath, encourage them to count each rep out loud.

If clients experience side-stitches while running, suggest exhaling during the left footfall (not the right).

If your client can’t catch his breath, have him stand tall with his hands behind his head to open the lungs and allow for deeper inhalations—don’t bend over with hands on knees.

To gauge exercise intensity, use the talk test: If the person can’t talk much, they’re in the high-intensity range. If they can carry on a conversation, the intensity is low to moderate.

When cooling down or stretching, deep, slow breathing helps calm the body and aid in recovery.

References:

NASM (National Academy of Sports Medicine). 2017. NASM Essentials of Personal Fitness Training (6th ed.). Burlington, MA: Jones and Bartlett Learning.

TTEMA15

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We know that weight loss or body fat reduction is largely based on a numbers game. And “working out” is a way of controlling the numbers (less calories in, more calories out and weight loss change can be achieved). Cardiovascular training and resistance training both have many desired benefits and we know that both should be done to achieve the best physical shape a person desires – but how can we get those “cardio” and “muscle building” clients to learn and embrace the benefits of both? One great way to get the most out of your program design is to combine cardiovascular work with resistance training using a method called Peripheral Heart Action (PHA) Training. This method is similar to a regular circuit training method that keeps your client moving from one exercise to another with minimal to no rest between exercises. However, with PHA training, while you are moving from one exercise to another, you are focusing on alternating upper and lower body exercises.(1)

In traditional circuit training techniques, clients are asked to move quickly from one body part to another in a “circuit” fashion that allows each body part enough time to recover before it is worked again. For example, NASM uses a vertical loading circuit training system that begins with working the chest, followed by working the back, shoulders, biceps, triceps, and legs. When starting with the chest, the following exercises allow the client ample time for the pectoralis muscles to recover before working them again. Using a PHA system, clients are performing a variation of circuit training; however, they are simply alternating upper and lower body exercises. For example, your client would perform a chest press exercise, followed immediately by ball squat, followed again by a back exercise, immediately moving on to a leg exercise like a step-up, etc. (See table 1 for an OPT programming example)

This method of training forces the blood to quickly circulate through the body, increasing caloric expenditure and theorized to decrease body fat and increase lean muscle mass.(2)

Overall, circuit training (in general) has been shown to increase caloric expenditure in comparison to similar traditional resistance training where a client may rest up to 90 seconds between sets.(3) Key benefits of using a circuit training system such as PHA include enhancing an aerobic base for clients while simultaneously challenging local muscle endurance. Many clients may not be familiar with PHA training and thus, may have concerns about whether they can sustain the activity or whether or not they will be able to build muscle using this type of program. We will address these questions for you.

Who can perform peripheral heart action training?

Most healthy individuals can perform this type of training. Whether your client wants to lose body fat or increase muscle tone–this system of training can work for them. With increased movement comes increased caloric burn. This form of training gives weight loss clients “more bang for their buck” and can even be used for bodybuilders or recreational exercisers looking to increase muscle size (hypertrophy). While the rest periods between exercises may be greatly reduced (or non existent) this meets the requirements for hypertrophy. In fact, most individuals seeking hypertrophy tend to rest too long between sets and lift too heavy to train appropriately for their desired goals. Recall that several factors are required for hypertrophy (high levels of volume with minimal rest periods force cellular changes that result in an overall increase in muscle size) – volume (3-5 sets; 6-12 repetitions; 2:0:2 repetition tempo), frequency (3-6 times a week), intensity (75-85 percent of 1 RM), rest (0-60 s), and proper nutrition. As you can see, the PHA system works well for hypertrophy clients, allowing the proper rest and volume to achieve the desired goal – while even adding in a time saving bonus!

Athletes may receive the best benefit from PHA training. While endurance athletes must still engage in aerobic activity that significantly increases their maximal oxygen consumption, circuit training (which includes PHA training) increases maximal oxygen consumption 4 to 8 % (significantly less than cardiovascular conditioning programs, but important in increasing local muscular endurance).(2,3)

Who should avoid peripheral heart action training?

Using the PHA system may put too much physiological stress on individuals who have blood pressure deviations (high/low blood pressure) and those who may be severely de-conditioned. Individuals with special conditions, such as pregnant clients in their second or third trimester, may require more rest between exercises and, dependent on the client, may want or need to avoid PHA training. Remember that each client is unique and while some may be able to perform PHA training, others may not be able to meet the cardiovascular and muscular demand. If individuals present with any condition listed above, proceed with caution and advise the client to seek medical advice. As with all physical conditioning programs, clients who might be at risk should consult their physician before initiating an exercise program.

There are several different forms of training that can benefit your clients and given each personal goal, you can become extremely creative with your programming. Be sure to incorporate a comprehensive health and fitness assessment process (which includes a preparticipation health screening and medical history), as well as a movement assessment to ensure that your client is structurally ready for the demands of your program.

References

(1) NASM Essentials of Personal Fitness Training.

(2) Gettman LR, Ayres JJ, Pollock ML, Durstine JC, and Grantham, W. Physiologic effects on adult men of circuit training and jogging. Arch Phys Med Rehabil 1979;60:115-20.

(3) Gettman LR, Ayres JJ, Pollock ML, and Jackson, A. The effects of circuit weight training on strength, Cardiorespiratory function and body composition of adult men. Med Sci Sport Fall 1978; 10(3): 171-6.

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There are four hormones that are critical to the success of your client’s weight loss program. Cortisol, insulin, thyroid, and the sex hormones (testosterone in men, and progesterone in women). When kept in balance, these hormones have the largest effect on metabolism. When out of balance, they can prevent your client from achieving the fitness results they desire.

Hormones could probably be one of the contributing reasons why your clients oftentimes don’t see continued results. Increasing caloric expenditure while decreasing caloric intake is a tried and true method for achieving weight loss, but many times that foolproof system fails.

Cortisol

Cortisol is a glucocorticoid produced in the adrenal glands in response to stress. Mental stress (work), emotional stress (divorce), physical stress (exercise), or environmental stress (toxins) are all forms of stress that cause your body to increase the production of cortisol.

When cortisol levels increase, it stimulates the sympathetic nervous system, aka the “fight or flight” system. This activation tells your body you are in some form of imminent danger and it immediately increases your blood pressure, elevates your heart rate, and releases glucose into the blood stream from your liver. If this happens for an extended period, it will start to affect other hormones and wreak havoc on your metabolism.

Some of the more important symptoms of elevated cortisol include increased insulin resistance, reduced production of thyroid stimulating hormone, blockage of T4 to T3 (thyroid), and depression of testosterone production in men and progesterone production in women². Left unchecked, chronically elevated cortisol creates an internal environment that becomes very difficult to allow for weight loss.

How exercise can improve cortisol balance:

High intensity exercise done when cortisol levels are elevated above healthy ranges can add more stress to an already stressed system. If you think your client may be in a state of chronically, or acutely, elevate cortisol, reducing the intensity of the training will not further increase cortisol. Reducing intensity helps the body to recover sooner, lowering cortisol.

Insulin

Insulin is produced in the beta cells of the pancreas in response to elevated glucose levels in the blood. In small doses, insulin is very anabolic, but when insulin is secreted over long periods of time, such as when someone is in a state of insulin resistance, then the metabolism does some interesting things.

First, since the muscles are not getting fed, they signal the brain telling it you are hungry, especially for sugar since it is the fastest thing to bring energy levels up. Next it increases inflammation systemically which then increases cortisol. Lastly, when glucose levels rise, your body tries really hard to do anything it can to lower it so it shifts fuel utilization away from fat-burning to carb-burning. Bye-bye fat loss.

How exercise can positively affect insulin:

Since insulin balance and blood glucose regulation go hand-in-hand, and elevated blood glucose has been shown to slow down fat utilization⁴, maintaining a healthy insulin balance is important for the metabolism. High intensity interval training has been shown to improve insulin sensitivity. However, if cortisol is also suspected as being elevated, HIIT can also increase cortisol, worsening insulin resistance. A proper balance of 1-2 HIIT sessions per week, mixed with lower intensity, and recovery-based activities is a good way to start to positively affect insulin sensitivity, while allowing for long periods of recovery between bouts.

Thyroid

Thyroid hormone is the main metabolic hormone in the body. It is produced by the thyroid gland, located in the throat, in response to thyroid stimulating hormone that comes from the pituitary gland. However, the initial hormone produced by the thyroid, thyroxine4 (T4), is metabolically inactive. It must be converted into T3 in order to affect your metabolism. As previously stated, elevated cortisol can inhibit this conversion.

Many people that have been “diagnosed” with hypothyroid have a functioning thyroid, but their T3 level are low due to other factors³. While many doctors will quickly prescribe synthetic thyroid drugs, it is important to identify what could be causing these decreased levels.

How exercise can improve thyroid balance:

Exercise intensity, especially in terms of cardiovascular exercise, has a profound effect on the thyroid hormones⁵. A study on exercise intensity and thyroid hormone levels found that at anaerobic threshold (~70% of MHR) all thyroid hormones were improved from baseline. As intensity continued to increased, TSH also continued to rise.

Sex Hormones

Testosterone and progesterone are the two main hormones in males and females, respectively. In males, if testosterone levels fall, it causes a loss of energy, limited ability to build and maintain muscle mass, and a loss in libido. In women, lowered progesterone production causes an imbalance in the estrogen to progesterone ratio resulting in irregular menstrual cycles, an increased risk for PCOS, pre-menopausal symptoms, and an increase of fat storage around the hips and triceps.

Ironically, elevated cortisol (i.e., chronic stress) can lower both testosterone and progesterone production through a phenomenon known as pregnenolone steal. In addition, there are several other causes to lowered sex hormones, including pesticides, xeno-estrogens, and nutrient deficiencies.

How exercise affects sex hormones:

High intensity resistance training has been shown to have the most beneficial effect on testosterone in men⁶, and cardio training and resistance training at a moderate intensity has shown similar results on the sex hormones in women⁷.

References

1. LaValle, James B. “Cracking the Metabolic Code.” 2004
2. Sapolsky, Robert M. “Why Zebras Don’t Get Ulcers.”1994
3. Ismail, Adel AA. “On the Diagnosis of Subclinical Hypothyroidism.”The British Journal of General Practice57.545 (2007): 1000–1001.
4. Gillen JB, Percival ME, Skelly LE, Martin BJ, Tan RB, Tarnopolsky MA, Gibala MJ. Three minutes of all-out intermittent exercise per week increases skeletal muscle oxidative capacity and improves markers of health in overweight adults. PLOS ONE. Nov 3;9(11):e111489, 2014.
5. Ciloglu, Figen, et al. “Exercise intensity and its effects on thyroid ormones.” Neuroendocrinology letters26.6 (2005): 830-834.
6. Raastad, Truls, Trine Bjøro, and Jostein Hallen. “Hormonal responses to high-and moderate-intensity strength exercise.” European journal of applied physiology82.1 (2000): 121-128.
7. Copeland, Jennifer L., Leslie A. Consitt, and Mark S. Tremblay. “Hormonal responses to endurance and resistance exercise in females aged 19–69 years.” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences57.4 (2002): B158-B165.

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Foot pain can be one of the most debilitating types of pain and discomfort for both the average individual and the athlete alike. To put it simply, when your feet hurt, everything hurts. The foot is essentially the foundation of the body; it is the first thing to touch the floor each morning and the last thing to leave the floor each night. Therefore, if the foot isn’t feeling or functioning its best, then the rest of the body is likely to suffer as well. Hawke and Burnes (2009) suggested that foot pain affects up to 42% of the population at any given time. They continue that foot pain is defined as an unpleasant sensory and emotional experience following perceived damage to any tissue below the ankle. One of the most common sites for foot pain is the arch or mid foot, followed closely by the ball of the foot, and then the heel. Furthermore, foot pain is associated with reduced functional ability, including self-care, increased risk of falls, depression, and reduced physical and mental aspects of quality of life (Hawke & Burnes, 2009).

Overuse Injury

Most foot pain is due to musculoskeletal overload or overuse. As Hawke and Burnes (2009) stated “many common types of foot pain are primarily attributed to stress that exceeds the maximal tissue threshold, which is frequently experienced in long duration, low magnitude stress or repetitive moderate-magnitude stress.” Thus, when the stresses on the foot exceed what they are accustomed to, then the chances of an overuse injury greatly increases. During the holidays many people begin traversing the shopping mall, strolling to view holiday lights, participating in holiday parties (think dancing in unforgiving shoes!), and many other activities that overload what the foot considers normal. The body is an adaptable organism that, if given time, will evolve to handle the new stress. However, given the rushed and progressive nature of the holidays, the tissues of the foot rarely have time to strengthen enough to handle the abuse.

Relationship to Weakness

Foot pain in itself is not inevitable and is not entirely due to spending a few more unexpected hours on your feet. Latey et al. (2017) identified a significant relationship between foot pain and foot muscle weakness. In a review of several studies, the authors found that plantar fasciitis and heel pain were associated with toe flexor weakness. These findings suggested that if muscle weakness is a precursor to foot pain, then more progressive resistance training and other foot exercises might be effective. It should be noted that foot pain is not isolated to foot muscle weakness; other muscles up the kinetic chain also play a powerful role in the stresses placed on the foot. Friel, McLean, Myers, and Caceres (2006) suggested that the gluteus medius functions to decelerate pronation at the subtalar joint upon heel strike when walking and running. In the cases of excessive pronation or pronation that occurs too quickly, overloading the plantar fascia, the glutes may be weak. In addition, Shirey et al. (2012) indicated that core muscle function is imperative for optimizing stabilization at the knee. We can infer from these findings that if a weak core is associated with knee pain then a weak core may also have a negative impact on the stresses placed on the foot. Furthermore, while foot muscle weakness is an important consideration and strengthening should be implemented, if the glutes and core are neglected then you can perform foot strengthening exercises until you’re blue in the face and it may not reduce the excessive tissue stress and chances of injuries. Therefore, a comprehensive foot pain prevention/reduction program would include flexibility, activation, and strengthening for the entire lower body and the core.

Prevention Process

Plantar fasciitis is one of the most common reported painful conditions of the foot. In a survey of more than 500 physical therapists, all said that plantar fasciitis was the most commonly treated painful foot condition (Martin, et al., 2014). There are more than 2 million new cases of the condition per year and at any given time it affects as much as 10% of the U.S. population. Martin et al. (2014) suggested that decreased dorsiflexion range of motion and high body mass index were the two leading risk factors for plantar fasciitis. The researchers also found that calve and hamstring tightness, as well as excessively pronated feet, were associated with the condition. Thus, a program should address these in an attempt to rectify plantar fasciitis. Clinicians suggest a multifaceted approach to treating plantar fasciitis:

1. Soft tissue massage to the soleus and gastrocnemius
2. Calf stretching to improve dorsiflexion range of motion
3. Joint mobilization to the talo-crurual and subtalar joints as necessary
4. Strengthening of the foot and hip muscles (Martin et al., 2014).

You may be thinking that the above approach looks very familiar as it follows almost the same progression as the NASM Corrective Exercise (CEx) model. NASM CEx uses the following four-step process when seeking to improve overall movement patterns or to prevent injuries:

1. Inhibit overactive musculature through self-myofascial release (foam rolling)
2. Lengthen shortened tissue through static stretching
3. Activate underactive musculature through isolated activation exercises (a form of low-threshold strengthening)
4. Integrate by using total body movement patterns to improve motor control and coordination (NASM, 2014).

As you can see, there are two distinct differences between the approaches. First, joint mobilization techniques are outside of the scope of a personal trainer. Thus, they are not included in NASM’s recommendations. However, clients can choose to perform joint mobilizations on themselves if they would like. Another difference is that Martin et al. did not list integrating total body movement patterns after the isolated strengthening. While many great physical therapists do perform this, it is often times overlooked. However, it is important to note that isolated strengthening alone rarely leads to improved performance. Thus, it is imperative to include total body movements to essentially re-teach the nervous system how to move properly, reducing the excessive stress on select tissues.

Identify Dysfunctional Movement

Before trying to fix a problem it’s important to identify the root cause of the problem. In many cases, movement is the key to identifying underlying causes of pain and dysfunction. This is indeed true for foot pain. The overhead squat is a great assessment that provides valid information about total body flexibility, coordination and strength. There are several movement impairments that may relate to foot dysfunction. Beginning at the foot and ankle complex, an individual may demonstrate feet flattening or feet externally rotating during the squat (figure 1). When either of these occur, it indicates that excessive and unnecessary stress may be placed on the supportive structures and tissues of the foot.

<Figure 1>

Many foot impairments are directly related to foot dysfunction, however, many are not. Knee adduction during the squat (figure 2) may also be related to foot pain. When the knees adduct, it can easily overload the medial structures of the foot, such as the plantar fascia that supports the medial longitudinal arch. Thus, if an individual is continuously demonstrating knee adduction during walking, climbing stairs, and squatting it can contribute to plantar fasciitis. Furthermore, knee adduction may indicate that the glutes are not firing quick enough or are not strong enough to stabilize the knee. As was mentioned above, non-optimal gluteus medius function could be a prime contributor to foot pain.

<Figure 2>

Programs

The above compensations may occur independently or simultaneously. It is not uncommon for an individual to demonstrate knee adduction solely because the feet flatten. Or the reverse, an individual may demonstrate feet flattening because the knees move in. Below are sample programs that may be utilized for individuals according to their compensations. Each program will include foam rolling, stretching, isolated activation exercises, followed by total body integration.

It is important to point out a few key factors. First, it is not recommended to use deep aggressive rolling on the bottom of the foot in cases of medically diagnosed plantar fasciitis. Plantar fasciitis indicates that the plantar fascia is irritated. Thus, there is no need to roll aggressively irritating it more. However, some light rolling on the bottom of the foot, with minimal pressure or a soft roller, is great to help encourage circulation and to simply massage the foot. In this case, roll slowly through the bottom of the foot for 60-90 seconds. In cases of foot pain not diagnosed as plantar fasciitis, it may be acceptable to roll on a harder or smaller roller or with more pressure. In this case, a smaller roller is great to massage the bottom of the foot and to encourage movement of the muscles (and even bones) of a foot that has been stuck in a shoe for hours. On this note, some rolling of the bottom of the foot can be great to perform several times per day when spending hours shopping/walking through a crowded mall, simply to keep things moving and to kindle the sensory environment of the foot.

From the programs below, choose what best fits the compensation and repeat it every day before activity (even if the activity is heading out to spend the day with family). If there are multiple compensations then choose the one that is most apparent to be the primary, then second most apparent to be the secondary, etc. With multiple compensations, the programs can be rotated throughout the week.

Program 1: Feet Flatten

SMR—hold tender spots for 30-60 seconds

1. Plantar fascia 
2. Peroneals 
3. Calves 

Static Stretching—hold first point of tension for 30-45 seconds

1. Standing calf stretch 
2. Peroneal stretch

Activation—perform 12-20 repetitions

1. Towel scrunch     
2. Posterior tibialis   

Integration—perform 12-20 repetitions with perfect form

1. Single-leg balance with reach 

Program 2: Feet Turn Out

SMR—hold tender spots for 30-60 seconds

1. Calves 
2. Short head of the biceps femoris 

Static Stretching—hold first point of tension for 30-45 seconds

1. Standing calve stretch 
2. Supine biceps femoris stretch

Activation—perform 12-20 repetitions

1. Calf raise with internal rotation
2. Tibial internal rotation with band

Integration—perform 12-20 repetitions with perfect form

1. Box step-up to balance 

Program 3: Knee Adduction

SMR—hold tender spots for 30-60 seconds

1. Adductors 
2. TFL 

Static Stretching—hold first point of tension for 30-45 seconds

1. Standing adductor stretch 
2. ½ kneeling hip flexor stretch  

Activation—perform 12-20 repetitions. Hold plank for 10 “reps” of 10 second holds.

1. Side-lying wall slide 
2. Stability glute bridge 
3. Prone Iso-ab/Plank  

Integration—perform 12-20 repetitions with perfect form

1. Lateral tube walking  

References

Clark, M. A., Lucett, S. C., & Sutton, B. G. (Eds.). (2014). NASM essentials of corrective exercise training (1st ed.). Burlington, MA: Jones & Barlett Learning.

Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral hip abductor weakness after inversion ankle sprain. Journal of Athletic Training, 41(1), 74-78.

Hawke, F., & Burns, J. (2009). Understanding the nature and mechanism of foot pain. Journal of Foot and Ankle Research, 14(2), 1-8.

Latey, P. J., Burns, J., Hiller, C. E., & Nightingale, E. J. (2017). Relationship between foot pain, muscle strength and size: A systematic review. Physiotherapy, 103, 13-20.

Martin, R. L., Davenport, T. E., Reischl, S. F., McPoil, T. G., Matheson, J. W., Wukich, D. K., & McDonough, C. M. (2014). Heel pain—plantar fasciitis: Revision. Journal of Orthopaedic & Sports Physical Therapy, 44(11), A1-33.

Shirey, M., Huributt, M., Johansen, N., King, G. W., Wilkinson, S. G., & Hoover, D. L. (2012). The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. International Journal of Sports Physical Therapy, 7(1), 1-12.

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A high school athlete walks through our doors and we can see their strength, stability and biomechanical control deficits from their gait pattern. We’ve also had collegiate and professional athletes come to our facility with the same issues. The only differences between that young, beginner athlete and the older, elite athlete is that the elite athlete has typically maximized and benefited from their gifts and masked or hidden the compensations and weak links much better. The result is that we often get athletes coming to us because they can’t figure out why they got injured.

It doesn’t sound sexy, but from this common scenario it can be stated that training to avoid injury should be a priority and training to maximize performance should be secondary (Kucera 2005). What’s one of the primary reasons successful teams are successful? Is it their athleticism? Power? Conditioning? According to a study done by Hägglund, et al. and presentations by Nelson, A. & Padua, D. 2016, it’s the teams that keep more of their players on the court or field through the majority of the season. Surprised? Granted, you have to have a fairly decent pool of talent, good coaches, etc., but even if you’ve got the best team in the nation but all your athletes are injured, the team’s not likely to win.

Two qualities lacking with many athletes are strength and motor or movement competency (said another way: movement quality).

Movement Quality + Movement Quantity = Performance² 

Therefore, if you put both the quality of proficient movement with the right muscles acting on the right joints at the right time together with a high degree of strength supporting that pattern, the outcome or whole is EXPONENTIALLY better than the individual pieces.

Great…if that’s true. So, which training exercises move to the forefront that addresses these issues of quality and quantity? It’s always hard to narrow it down when people ask, “If you had to give me your top six favorite exercises, what would they be.”

How can we pick six top patterns?

• High Value, Low Risk: Always opt for training exercises that afford a high degree of effort, a big bang for our buck, and are REALLY difficult to get hurt while doing. I tell my students and interns that any fool can make their client work hard. It takes a high quality, highly skilled and educated coach/trainer to get a client to work hard and do it safely.
• Train Movement Systems: Make sure to train the body from head to toe, and do so every training session if possible (while also allowing for adequate recovery). What does this mean? Some upper body patterns and lower body patterns (i.e., upper pushing and lower posterior chain or upper pulling and lower squatting). The exception would be only training upper or lower body, or training one body part such as when an athlete is injured, on a compressed time frame and has to prioritize lifts or patterns, or to avoid overtraining when an athlete is in season or is training 5-7 days/week.
• Train for Function. Case in point, it doesn’t matter how much you bench…unless your sport is power lifting. Beyond that, lying on your back pushing up has limitations to sport application.

Why I would recommend the following lifts (beyond the reasons listed above)?

• Anybody can do them (minimal equipment needed)
• Unilateral exercises have more application to most sports. Running, cutting, throwing, striking are most frequently done on one leg or with one arm (or with one arm pulling while the other is pushing).

Are these six lifts the end all answer? No, but let’s get great at some basics that incorporate as many good qualities as possible.

1. Single Leg Squat – Goblet or Suitcase:

Why:  Single leg squat strength has great implications for function in running, cutting, jumping, acceleration, deceleration and ACL injury reduction, especially since most athletes move on one leg at a time. This exercise works on balance, proprioception, foot strength and stability as well as triplanar hip stability.

Technique Points: (<–click to see how it’s done)

1. Spine position neutral throughout from cervical through lumbar spine (do not compensate for increased range).
2. Free foot off the side edge of a box. Brace the abdomen and spine.
3. Hands reach forward with light load initially (typically 2.5 – 5 lbs per hand will allow for a good counterbalance and actually make the exercise easier) while the free foot also reaches forward to assist with counterbalance.
4. Lower to a depth that the athlete can safely control while maintaining ideal posture. This will vary for each athlete depending on their capabilities.
5. Keep the load balance over the entire foot making sure heel, base of big toe and little toe are all engaged and knee tracks in line with 2^nd and 3^rd

Optional: Split Squat (<–click to see how it’s done)

If the athlete is not capable of true single leg squatting, a split squat is a wonderful way to progress into this pattern.

Do you want video links for these as well?

2. Single Leg Hip Extension Bent Leg

Why:  Staying on the theme of unilateral training, this exercise allows the athlete to train the posterior chain muscles of the gluteus max and adductors. These two groups are typically underdeveloped and play a large roll in leg and hip power for acceleration, max speed and deceleration patterns. Underdeveloped glutes can also cause injury situations stemming from synergistic dominance problems with hamstring overuse. (NASM PES)

Technique Points:

1. Spine position neutral throughout from cervical through lumbar spine (do not compensate for increased range).
2. Shoulder blades at the edge of the bench. Arms can be extended on bench to stabilize the torso.
3. Knee should approximate about 90˚ when in full hip extension (foot placement too far forward creates a larger than 90˚ knee angle and recruits the hamstring group excessively). The free leg can hold a 90/90 position with a dorsiflexed foot.
4. Utilize a small pad on the floor under the hips/glutes as a target for the athlete to touch ensuring maximum consistent range.
5. Brace the abdomen and spine, descend until the glute touches the pad and drive through the entire foot emphasizing glute contraction and a glute “squeeze” to finish the hip extension. (Minimize cues like “lift high” or “drive up” which tend to exacerbate lumbar extension or excessive hamstring recruitment in beginners.)
6. Load can be added in a variety of ways, but beginning with a load such as a kettlebell or plate on the abdomen often times helps athletes create a better brace as they receive more kinesthetic feedback.

Optional: Cable or Band Single Leg/Arm RDL

This is another option as it recruits the posterior chain muscles of the thigh allowing the glute to still work while also integrating the balance and contralateral motion components.

3. Push Up – Lateral Crawl

Why:  This integrated move allows the athlete to train from head to toe with unilateral positions within the exercise as well as scapular stability work. It’s also a closed chained pattern that typically allows for more natural shoulder movements (improved scapular rhythm) to occur and makes it less likely/more difficult to overload the pattern or shoulder (unlike barbell or even dumbbell pressing at times). Finally, it allows the athlete to integrate contralateral patterning, movement in the frontal plane, and extra work on anti-extension, anti-rotation spinal stability.

Technique Points:

1. Spine position neutral throughout from cervical through lumbar spine (do not compensate for increased range or load). Using external feedback (such as a Dyna Disc, foam roller or tennis ball) can help athletes to feel their spine’s position in space, especially as they begin the lateral walk.
2. Draw-in and brace the abdomen, contract the glutes and press the hands into the floor to create maximum body stability.
3. Descend to a depth where the shoulder is at or slightly past the elbow and return to starting position.
4. Once complete with the push up, move laterally while keeping the spine as level and neutral as possible.

Optional: Hands Elevated Push Up

Frequently athletes are unable to control their bodyweight in a push up If you are working with a beginner, elevating the hands (e.g., on a bench) allows the athlete to brace and utilize the glutes for stability.

4. Single Arm Row Anti-Rotation with Suspension Device

Why:  This exercise targets grip strength, unilateral and scapular stability, emphasis on mid/lower trapezius and rhomboids, and balancing pushing to pulling strength. Putting athletes in a position that requires focus on grip helps both scapular stability and decreases the risk of lifting weights that are too heavy. Simply stated, if the athlete can’t hold on, they will cease the exercise and not put themselves at risk. This is not always true with exercises like lat pulldowns or cable rows. Further, with load in only one hand the athlete will get more anti-rotation work and also allow them to feel and learn how to pull and stabilize their scapula and spine all the way through the posterior oblique sub system through the contralateral glute max to the ground. (NASM PES).

Technique Points:

1. Spine position neutral throughout from cervical through lumbar spine (do not compensate for increased range). Do not allow rotation.
2. Using a suspension device in single handle mode, use a closed grip for safety. Free arm can be abducted and externally rotated to 90˚ to create a packed shoulder position and some retraction. Often this gives newer athletes a sense of stability and symmetry when trying to create retraction in the working arm.
3. Feet flat with knees slightly flexed to maintain traction on the floor. Abdominals drawn-in and braced.
4. Pull until the body slightly passes the elbow of the working arm, keeping scapula relatively low and finishing in a retracted/depressed position.
5. Slowly return to starting position.

Optional: Single Arm Dumbbell Row or Bar Inverted Row

Either of these options can be utilized if a suspension device is not available. 

5. Full Body Explosive: Medicine Ball Squat, Throw, Drop, Jump, Land Single Leg. Hold, Jump, Land Single Leg and Hold

Why:  This is a simple whole body explosive pattern that allows the athlete to experience triple flexion, triple extension, load and decelerate in single leg support and then get a single leg jump and stability landing as well. The value here is getting both an upper body explosive action that translates into most overhead throwing or hitting sports and two unilateral decelerated landings with a one leg jump all in a low risk pattern.

Technique Points:

1. Spine position neutral throughout from cervical through lumbar spine (do not compensate).
2. Start on the balls of the feet with a medicine ball overhead.
3. Rapid triple flexion and ball slam followed immediately by a soft, quick “stick” landing on one leg.
4. Hip load, spine position, knee tracking over 2^nd and 3^rd toe and balance should be emphasized.
5. Once balanced (typically for at least 2-3 seconds to prove control), the athlete should explode into triple extension and then again land on the same foot as they did in step 4.
6. Repeat with other leg.

Optional: Drop Jump 1 Leg to 1 Leg Jump & Stick

If no medicine ball is present or the movement is too complex, it is always best to break it down, make it simple and get great first.

6. Integrated Core: Split Stance Anti-Rotation Chop to Rotational Chop

Why:  There is a fair amount of information coming from the physical therapy world discussing the importance of the core’s ability to resist unwanted lumbar extension as well as rotation and being able to control and create rotation when desired. (NASM PES, Boyle) Gaining the ability to avoid rotation and extension is a simple and safe precursor to redirecting and creating rotation, so emphasizing the anti-rotation component early in the set or phases is a great primary goal. The additional benefit of the split stance is that it allows the athlete to stabilize in an asymmetrical position similar to running, lunging, and cutting, as well as practice utilizing the trail leg gluteus max as a lumbar stabilizer.

Technique Points:

1. Spine position neutral throughout from cervical through lumbar spine. There should be no change in spine position until rotation comes into play, yet even then the spine should corkscrew from the thoracic spine down, maximizing motion in the thoracic spine and staying tall.
2. Leg position should be at the 90˚/90˚ position with the torso tall.
3. Abs braced and trailing gluteus max engaged.
4. Pull to the chest and press the belly button. A 2 phase down and 2 phase return works well to keep the movement clean.
5. Once (if) adding rotation, press down and across the lead leg thigh keeping the posture upright.

Optional: Anti Rotational Chop only (or from a kneeling or half kneeling position to limit the degrees of freedom).

A great option especially if there might be any compensations or questions about your athlete’s ability to control rotation.

Summary Statements:

Be a coach of change and forward thinking and cautious to embrace current trends. Be a coach that avoids the common mistake in performance enhancement of maximizing strength and power development without training and educating your athletes on how to control it.

*These recommendations do not preclude the need for a full movement assessment to identify quality of movement, range of motion, stability and compensations. This will help determine IF these exercises are appropriate or if there should be modifications made as well as what corrective exercise programming should be done to maximize the movement quality we have already discussed.

References:

Boyle New Functional Training for Sports (2^nd edition)

Nelson, A. & Padua, D. 2016. Fusionetics: Performance Healthcare from Lab to Court. NASM Optima Conference, Oct. 2016, The Scottsdale Resort at McCormick Ranch, AZ. Lecture.

Ambler-Wright, T. 2016. Assess & Correct: (R)Evolution in Movement Testing and Programming. NASM Optima Conference, Oct. 2016, The Scottsdale Resort at McCormick Ranch, AZ. Lecture.

Huang, P., et al. 2016. Return-to-play recommendations after cervical, thoracic, and lumbar spine injuries: A comprehensive review. Sports Health, (1), 19–25.

Kucera, K.L., et al. 2005. Injury history as a risk factor for incident injury in youth soccer. British Journal of Sports Medicine, 39 (7), 462–66, 680.

NASM (National Academy of Sports Medicine). 2012. NASM Youth Exercise Specialist Manual. Leawood, KS: Assessment Technologies Institute.

NASM. 2015. Clark, M.A., Lucett, S.C., & Sutton, B.G. (Eds.). NASM Essentials of Sports Performance Training (1st ed. rev.). Burlington, MA: Jones & Bartlett Learning.

NASM. 2014. Clark, M.A., Lucett, S.C., & Sutton, B.G. (Eds.), NASM Essentials of Corrective Exercise Training. Burlington, MA: Jones & Bartlett Learning.

NASM. 2017. McGill, E.A., & Montel, I.N. (Eds.), NASM Essentials of Personal Fitness Training (5th ed.). Burlington, MA: Jones & Bartlett Learning, 34-45, 136, 191-193 283–85.

Nelson, A. & Padua, D. 2016. Fusionetics: Performance Healthcare from Lab to Court. NASM Optima Conference, Oct. 2016, The Scottsdale Resort at McCormick Ranch, AZ. Lecture.

Hägglund, Martin et al. 2013. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British Journal of Sports Medicine, 47(12):738-42

Does using self-myofascial release (SMR), static stretching, or a combination of both, improve range of motion (ROM) for overhead athletes? See what the results were for these softball players.

Journal Article:

Fairall, R.R., Cabell, L, Boergers, R.J., & Battaglia, F. (2017). Acute effects of self-myofascial release and stretching in overhead athletes with gird. Journal of Bodywork & Movement Therapies, doi: 10.1016/j.jbmt.2017.04.001

Purpose of the Study:

The purpose of this study was to examine the acute effects of self-myofascial release (SMR), static stretching (SS), and SMR + SS on glenohumeral (GH) internal rotation (IR) range-of-motion (ROM) in overhead athletes exhibiting glenohumeral internal rotation deficit (GIRD).

Study Participants:

12 asymptomatic adult male amateur softball position players participated in the study. No participant had pain either at rest or while playing, had never been diagnosed with any specific shoulder injury, or had shoulder surgery. Position players were chosen because they throw over-hand at all times, which is the biomechanical shoulder movement most associated with GIRD.

Procedure or Methods:

GH IR ROM was measured with participants in a side-lying position on the side of the throwing shoulder with the throwing shoulder and elbow both flexed to 90°. The participants were told to allow gravity to pull them into passive IR. Here, the measurement was taken. Passive was taken as opposed to active to assist in maintaining the scapula in a stabilized position.

SMR was performed by the participants in a side-lying position on the side of the throwing shoulder, with shoulder and elbow flexed to 90° lacrosse ball was positioned in the area of the infraspinatus muscle on the posterior side of the shoulder blade. Participants were instructed to locate the “most tender area” and then were instructed keep constant pressure on that location for 60 seconds. Two sets of 60 second holds were performed with 30 seconds rest between.

Static stretching consisted of performing the sleeper stretch and the cross-body stretch on the throwing shoulder. The sleeper stretch was performed in a side-lying position with shoulder and elbow flexed to 90°. Then, the participants were instructed to let the throwing shoulder to naturally fall into internal rotation to the end ROM where resistance was felt. The non-throwing arm was then used to push the arm down, further increasing the stretch. The stretch was to be held at a point of “mild discomfort” for 3 sets of 30 seconds with 30 seconds rest between.

The cross body stretch was also performed in a side-lying position on the side of the throwing shoulder. The participants were told to wrap the non-throwing arm under the throwing arm just proximal to the elbow and pull the arm into horizontal shoulder adduction, across the body, to the point of “mild discomfort”. This stretch was held for 3 sets of 30 seconds with 30 seconds rest between.

Results:

All three methods produced significant increases in GH IR ROM.

• SMR + SS produced the greatest increase at 10.15°
• SS produced the second greatest at 8.58°
• SMR alone produced the least improvement at 3.84°

Discussion:

The results of this study demonstrate that all three methods significantly improve GH IR ROM in overhead athletes with GIRD. However, SMR + SS improved ROM significantly more than SMR alone. SS alone also improved GH IR ROM significantly. These authors conclude that if an athlete has enough time for warm-up, performing both SMR and SS will give them the greatest improvements in ROM and may provide additional injury prevention benefits. If limited on time, SS alone may also be adequate.

Take away for NASM CPTs:

The results of this study support the use of foam rolling with static stretching as part of an integrated warm-up for overhead athletes who exhibit ROM deficits in the glenohumeral joint. Glenohumeral internal rotation limitations are highly associated with shoulder injuries. The improvements measured in this study were seen immediately, after 1 intervention. Thus, the combination of SMR and SS can have a positive impact within the first session.

January is a good time to check in with clients and find out if they identify more with Mr. Heat Miser or Mr. Snow Miser. Those who “never want to know a day that’s over 40 degrees” may be spending their spare time conquering moguls, slicing up the ice at an outdoor rink or even seeking out more unique thrills such as snowkiting, ice climbing or ski biking. Whatever their sport of choice, these winter warriors can benefit from your services in a whole new way this season, says Tony Ambler-Wright, MS, NASM-CPT, CES, PES, CSCS, and a Master Instructor for NASM since 2005. But for you to help them succeed and stay safe, it’s important to know what they’ll be up to when they’re exercising outside–and what they hope to accomplish when they do. We asked Ambler-Wright to share his advice on doing that (and more).

Watch Them in Real Time

One of the easiest ways to see how your client is performing in their winter sport is to observe them in action. While a video analysis is of great benefit, don’t rule out joining them for a weekend workout. When I lived in Northern California and the snow was more accessible to me, I really enjoyed snowshoeing with clients for a unique weekend training session, as it aligned well with my endurance training at the time. It was a win-win situation for both of us. Getting a firsthand look at their participation (in person or in video pixels) offers you the opportunity to:

• Update their indoor training program to address breakdowns in form, technique and body alignment in their outdoor sport.
• Suggest they meet with a winter-sport coach or trainer to work on improving technical elements of the activity—skills that come only with proper teaching and cueing during the activity itself.
• Work with their coach or trainer to adapt their training program (with you) to support and advance their efforts in areas that need extra work.

Investigate Their Motivations

Here’s a good reason to bring up the subject of winter sports, even with clients who don’t normally participate: Any type of cross-training can offer myriad benefits for athletes at all levels. You can use these as a selling point if you feel someone’s motivation is flagging—or as a conversation starter if you worry that their outdoor activity may not live up to their expectations. Ambler-Wright says winter sport training can:

Bust boredom. The new and added challenge of trying something different from the norm may be enough to keep easily bored clients stimulated and motivated to stick with their program. It’s vital, however, that they choose something that’s enough of a reach to be intriguing but not so much that it puts them at risk for physical injury or a wounded ego.

Improve performance in their “regular” workout or sport. If a client wants to improve lower body strength and power, as well as their cardio performance, then suggesting they participate in a winter sport perfectly aligns with their goals. For example, if a client normally walks or hikes for cardio, snowshoeing could be a great alternative.

Shed pounds. If your client has specific weight loss or body composition goals, winter sports can be just as effective—if not more effective—at burning calories over a given period of time than more traditional forms of exercise, like indoor cycling or walking. For example, a 2.5 hour day on the slopes alpine skiing (which equates to about 44 minutes of active ski time) yields similar calorie burn to an hour of indoor cycling. ⁽¹⁾ Ice skating, for instance, can torch more than twice as many calories as walking at 2 miles per hour. The caloric burn return snowshoeing is equally as impressive. Studies show that snowshoeing on unpacked snow at a little under 3 miles per hour elicits a similar heart rate response and caloric expenditure as walking on a treadmill at 6 miles per hour! ⁽²⁾

Help Them Get Prepped Properly

Even if the sport isn’t “new” to them, a year may have passed since they participated. For those who are looking to try something different or those who haven’t engaged in the sport since they were a kid or teen, the learning curve will be larger. Some exercisers may benefit from having you act as the “voice of reason” by encouraging them to take lessons or, at the very least, schedule a review session with a professional in that mode of exercise.

The CPT should encourage (and ensure) that their client is learning how to properly perform the activity or sport, starting at the appropriate level, to build the necessary foundation to succeed and enjoy participating in it. I would suggest they also invest in the appropriate gear to keep them safe and make the experience as enjoyable as possible.

For example, snowboarding and skiing require agility, balance, coordination, and lower body strength and power—all of which can benefit and translate to improved performance in other sports. However, if the client never takes the time to learn to properly walk, stop, or turn in skis, or effectively get up off the ground from a seated position with a snowboard (very basic, foundational skills), it can very quickly escalate from a fun, exhilarating experience to one that is not enjoyable, and possibly even dangerous.

Address the Demands of the Sport

Ensure that you understand what the client will have to contend with physically, then compare that to what you’re addressing in their current program. For example, skiing requires great agility, coordination, hip mobility and stability, core stability, and lower body strength and power. If these things are not being addressed as part of the current program, CPTs should work on ensuring that clients have strong and stable hips, as well as dynamic core stability, balance, and the agility and coordination to react to unexpected stimulus and terrain. This can be addressed by training in multiple planes of motion, adding asymmetrical loading and balance demands into current exercises, incorporating progressive plyometrics, and utilizing unstable surface training where appropriate.

Reinforce the Importance of Recovery

You might suggest weekend winter-sports warriors meet with you on a Monday. Then flip the focus of your typical training session from strength training and conditioning to recovery. Do things like foam rolling, stretching and other lower-intensity mobility drills. This will help them recover from their weekend outing, and they’ll love you for it. This would also be an opportunity to promote and encourage use of other recovery modalities like percussion/vibration therapy, hands-on stretching, compression boots, or electric muscle stimulation, if available and within your scope of practice.

Remember: Not all clients will bring up their winter sport plans with you at their training session. By starting that discussion, you can reinforce your value as a resource and support to them in every area of fitness. And you may help keep them injury-free, so you can continue your work with them throughout the rest of the year.

1. Stöggl T, Schwarzl C, Müller EE, et al. A comparison between alpine skiing, cross-country skiing and indoor cycling on cardiorespiratory and metabolic response. J Sports Sci Med. 2016;15(1):184-195.
2. Connolly DA, The energy expenditure of snowshoeing in packed vs. unpacked snow at low-level walking speeds. J Strength Cond Res. 2002;16(4):606-10.

The demand for group fitness experiences is booming. Participants are expecting more, but how can you meet these expectations with less?

In a perfect group fitness world, we’d have all the best equipment, in every size, style, and weight, and we’d have enough to cover every participant who attends our classes or group trainings. But since we don’t live in a perfect group fitness world, we often have to make due with what we’ve got, and sometimes that means teaching a very packed class and not enough equipment to go around. In order to maximize the group fitness experience with minimal equipment, check out the following suggestions.

Body Weight Exercises

The easiest way to get around not having enough equipment is to not need as much of it. Plank variations, pull-ups, pushups, squat jumps, lunge jumps, wall sits, sprints, and shuttle runs are all great examples of moves that can be modified for multiple levels without needing any equipment. And never underestimate the power of the isometric hold! 

However, there are only so many pushups and squat jumps you can program until people start getting bored, which leads me to my next example:

Circuit Formats 

Setting up a circuit class is a great way to maximize the equipment you do have. You can alternate stations that need equipment with ones that don’t need equipment. If you’re really in a pinch, partnering up enables two people to utilize the same piece of equipment. For example, two people can share one medicine ball and hand/throw it back and forth.

Programming for Rest (And sharing!) 

Whether you’re doing a circuit format or not, programming for rest periods allows participants to share equipment during class. Using a 1:1 work rest ratio, one partner will be working with the equipment while the other is resting (and providing coaching or motivation) and then they switch. You can do this for several sets before rotating on to the next exercise. Depending on how successful their performance is, try sets of 30 – 40 seconds.

Things to remember: Make sure you program exercises that are difficult or intense enough that the participants will need rest after they’re done.

Examples include squat/lunge jumps, pull-ups, isometric holds at end range.

Partners & Groups

Put everybody in groups of 3. Give them 3 exercises to rotate through. Do this two to three times and then switch exercises. An example: Partner 1 does shuttle runs. Partner 2 does a plank variation. Partner 3 uses the equipment. 

Extra: Creative Alternatives

• Agility ladders are great, but another option is using masking tape on the floor to draw your own. It’ll save you time setting up and save you space on storage! You can even make one on each side of the room to have several small groups going at once, preventing traffic jams and leaving space in the middle for the other half of the class to do something else.
• Head outside to take advantage of natural and urban landscapes: Step-ups on park benches, pull-ups on tree limbs, and cat walks on railings are just a few examples. People love variety!

Even if you have enough equipment, challenge yourself to try some of these examples just to mix things up for your participants. Happy teaching!

Having a client with hip replacements may seem like a daunting prospect, but in most cases the new hips function just as well as biological hips. Research suggests that 25% of the population will get hip osteoarthritis by age 85 (Murphy et al., 2010). Further, Knight, Aujla, and Biswas (2011) stated that at the time of their article there were more than 75,000 successful hip replacement procedures per year. The odds of a fitness professional working with a total hip client are quite high.

Total hip replacement is one of the oldest and most successful replacement procedures in medicine. One of the first total hip replacement attempts occurred in Germany in 1891 (Knight et al., 2011). The materials and methods of hip replacements have evolved—thank goodness—yet the idea remains the same: a rigid femoral stem, a robust acetabular component, and bone cement or type of “grout” to improve fit. Due to the hip being a robust and stable joint, hip replacement hardware generally doesn’t have the same types of stress applied to it such as something like a knee replacement. Because of the high shear forces at the knee, knee replacement fits are trickier than a hip. Thus, after full recovery, which is said to take up to a year, the hip can withstand many forces and move through normal ranges of motion.

Limitation—Short-term Physical

While it is traumatic to have a steel-rod driven into the leg bone, much of the initial movement restrictions are due to the damage sustained by the joint capsule during the procedure. To access the proximal femur with a saw and get a new acetabulum glued in, the hip must be dislocated. Dislocating the hip causes significant damage to the joint capsule. The first several weeks post-surgery, surgeons and physical therapists try to limit hip extension, adduction, and external rotation to allow the joint capsule to heal. However, because of the nature of soft-tissue injuries and healing, this also means that it’s imperative to follow the rehabilitation protocol. Once someone has been released to begin moving the hip, it’s vital that selected movements also prevent dysfunctional scar tissue from developing.

Limitations—Long-term Physical

Long-term limitations are there to prevent having to repeat the surgery. The total hip procedure involves removing a significant portion of the femur. Bone does regenerate, but slowly. One of the worst scenarios is to have a hip replacement replaced too soon because even more bone will have to be removed. Stress is needed to provoke bone growth (see Wolf’s Law), but too much and too often can have a negative impact. For this reason, the exercise limitation most frequently prescribed is to stop running. I’ve found, with my two titanium hips, that running itself is not the devil. However, those with an unusually high-impact stride, such as heel strikers, need to consider either learning how to become a forefoot striker or cease the practice of running.

Limitations—Psychological

Psychological limitations are often more prevalent than physical limitations. A hip replacement is a major surgery requiring at least a two-night hospital stay in most cases. Surgeons use an injection into the spine to block all sensation to the affected side. Thus, immediately, and up to 24 hours after the surgery, pain is at a minimum. However, as the nerve block begins to wear off, the feeling of a metal rod that has just been hammered (literally, visit AAOS.com to see a video) into the femur is anything but comfortable. From my experience, the toughest trials were when it came to sleeping. I spent the first two weeks sleeping in a recliner, with the hip slightly flexed. Lying flat on my back made the pressure on my hip feel almost as though it was going to pop out of the socket. It of course never did, but this feeling lead to weeks of terrible sleep that was mentally draining. One of the most helpful things I found was to place a low-frequency vibration device (I used a vibrating foam roller) directly on the joint. The small yet continuous oscillation reduced the discomfort and allowed me to eventually get some much-needed sleep.

Total Hip Rehabilitation

As is the case with many orthopedic surgeries post-op, the initial goal is movement within safe ranges. This begins with most people up and walking around the hospital on the same day as the surgery. However, also note the previous mention of the nerve block because the first time around the hospital is by far the easiest. Once home, the rehab typically consists of normal daily activities, such as walking (with a walker), mini-squats with support, and isometric glute, quad, and hamstring contractions. The general recommendation is to move through motions that are comfortable, not causing too much pain. But, let’s face it, nothing is going to be that comfortable.

Once home rehab is completed, and physical therapy begins, the goal is using all available ranges of motion, but then also beginning to strengthen the hips. Biomechanical models suggest that the lever arm from the center of joint to center of body mass is approximately three times the length of the lever from the center of joint to abductor muscles (Houcke, Khanduja, Pattyn, & Audenaert, 2017). Thus, theoretically, the abductors must be able to generate a force that is three times greater than bodyweight. While this model serves a good purpose, and is still in use today, it is based on traditional views of anatomy and discount any notions of fascial loading principles. A common movement compensation seen with hip replacements is a hip hike during single-leg activities, such as walking. Preventing or correcting this movement dysfunction requires not only hip abductor strength but also a focus on core stabilization, coordination, and strength.

Home/Gym Programs

First things first, always follow the doctor’s recommendations, especially if you are not a physical therapist. I personally learned the hard way with my hip replacements that the prescribed exercises have an intended purpose, and they should be followed accordingly. The program sample below begins when the client has received permission from the surgeon or physical therapists to begin exercising on their own. Thus, many of the exercises below will be in conjunction with what the physical therapist is doing, and the goal is not to overdo anything.

Weeks 1-2: Perform each for 10-12 reps. Begin with 1 set and progress to 2 on the second week if able.

1. Soft-tissue Work:
   1. Roller massage may be used, but it should be done with a hand-held roller using upper-body strength and not body weight compression.Roll hip flexors, quadriceps, adductors, and hamstrings on both sides for up to 60-seconds.
2. Core Activation
   1. Breathing: Beginning supine, with one hand placed or small weight placed on the belly button, breath in and push the belly button into the hand. Breath out slowly as you draw your belly button towards the spine. Repeat the same process prone (if able), except the hand, doesn’t need to be placed on the belly button.
3. Hip Rocking 
   1. Begin in a quadruped position with hips under knees and hands slightly in and forward of shoulders. While maintaining a neutral pelvis and spine, use the arms to push gently back into hip flexion, going only as far as comfortable. Hold the end position for 2 breathes, then pull forward so hips move slightly past knees.
4. Tall Kneeling 
   1. Get on both knees if able near an open door and grab onto the doorknob and then place one hand on each side of the door (watch your fingers so you don’t pinch them! An alternate starting position can be kneeling inside a doorjamb with hands on each side of door frame.). Engage the core and set the hips back into in a slightly flexed position. Then, use the glutes to push the hips into a slightly extended position. Squeeze glutes but maintain a neutral pelvis and lumbar spine. Do not posteriorly tilt. (Picture shows the use of dowel rod to assist with alignment.)

Week 3-4: Perform each for 12-15 reps. Begin with 1 set and progress to 2 on the fourth week if able.

1. Soft-tissue Work 
   1. Roll hip flexors, quadriceps, adductors, and hamstrings on both sides for up to 60-seconds.
2. Core Activation 
   2. Wall Plank: Standing at arms distance away from a wall, place forearms on the wall and keep the body straight from ankle to ear. Can progress by either slowly stepping the feet away from the wall or performing on a bench or table. Focus on the same breathing techniques as week’s 1-2.
   3. Standing Y-T-A’s: Stand with feet hip-width apart, perform a slight hip hinge (~45 degrees). Hold this position, focusing on the neutral pelvis and spine, then perform Y-T-A’s with the arms.
   4. Tall Kneeling Chops: Same tall kneeling position. Chops with cable, tubing, or med ball. Positioned high and pull to low. Use light resistance.
3. Balance/Stability:
   1. Staggered Stance Cable/Tubing Row: Begin with feet hip-width Progress upper body by adding in alternating and single-arm rows. Then, progress lower body by narrowing base of support.
4. Hip Strength:
   1. Hip Hinge (bodyweight):Perform a modified deadlift. Focus on maintaining a neutral pelvis and spine. Squeeze glutes, but do not posteriorly tilt. (Picture below is using a dowel rod to show alignment.) 
   2. Weighted Carry: Begin with low-intensity weight on same-side as the new hip. Progress by moving to an overhead carry on the same side. Then move the weight back to a regular carry position on the opposite side. Finally, perform an overhead carry on the opposite side.

To conclude, treat hip replacement clients just like normal humans (while also following the doctor’s recommendations). There are structural changes, but in most cases, clients will be able to move and function almost as well as anyone else. Be cognizant of the initial and long-term limitations, as well as the psychological struggles that are present after any surgery. With time, effort, and attention paid to core and hip stability, along with overall movement quality, the hip replacement client will be back at it, feeling better than they’ve felt in a very long time.

Want to learn more about hip dysfunction? The author, Kyle Stull, will be presenting more on the topic at NASM Optima 2018! Register now for you seat at the session!

www.NASMOptima.com

References

Houcke, J. V., Khanduja, V., Pattyn, C., & Audenaert, E. (2017). The history of biomechanics in total hip athroplasty. Indian Journal of Orthopaedics, 51(4), 629.

Knight, S. R., Aujla, R., & Biswas, S. P. (2011, September 6). Total hip arthroplasty–over 100 years of operative history. Orthopedic Reviews, 6(2), e16.

Murphy, L. B., Helmick, C. G., Schwartz, T. A., Renner, J. B., Tudor, G., Koch, G. G., … Jordan, J. M. (2010). One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage, 18(11), 1372-1379. http://dx.doi.org/10.1016/j.joca.2010.08.005

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It’s time to take a turn for the better with rotational training plans. These 3 steps will show you how to apply this directional change with all of your clients.

Our ability to change direction is one of the most underappreciated capabilities we perform EVERYDAY and ALL day. It started when you first sat up in bed and rotated your leg off the mattress to place your foot on the floor. You may have turned towards the hook on the wall and reached for your keys. Your dog or cat may have nuzzled up to your leg as you turned and squatted in their direction. Multiple times a day we turn, we rotate. Like a clock face, we reached towards three for our cup of coffee, we reached toward seven thirty for that folder we just dropped. We did more things to move at off angles than we did straight ahead.

With this being the case, it only makes sense that we challenge our bodies with exercises and movements that we regularly do. Incorporating multidirectional or turning movements into the workout plan isn’t as difficult as some may think. No need to throw out the current workout plan. All you’ll have to do is use some imagination and patience as you gradually build out a comprehensive program that takes direction dominant workouts and gets you better at what you do everyday. Here are 3 simple steps you can take to create a multidirectional fitness plan.

Move off the machines

First, selectorized machines definitely have their place but also have limitations. If on a selectorized piece of equipment, such as a chest press, leg press or knee extension, you are usually seated with a supporting back pad. Most machine-based manufacturers create equipment that typically dictates the direction of resistance, with the exception of hybrid pieces that use cables and pulleys from the same seated positions.

Switching off of this type of machine equipment, you allow yourself more degrees of freedom by not letting the machine tell you where to go. Here are alternative movements for seated selectorized exercises.

Go West… and East

If looking at a compass, we’re usually doing things towards the north. In other words, we tend to go forward, north, or backwards, south. An example of this might be a forward lunge and a return to the starting standing position. Take that same lunge, but instead of going forward, make a simple change and take a side step to the west (or east) with both feet still pointing in the same forward direction (aka: lateral lunge). Another alternative is to rotate out and turn your step toward the west (or east) position, the stance leg still pointing forward with lunging foot turned towards the west (aka: multiplanar lunge). The change of direction is guaranteed to challenge the hips and torso more than it’s been challenged with sagittal plane moves for stability and postural control.

Resist from different directions

Direction of resistance doesn’t always have to be from behind, like standing in front of the cable machine to perform a cable chest press. You can bias your position relative to the cable machine by standing more towards one of the pulleys. Even though you may be performing the chest press with a forward motion the resistance is now coming from an off angle. With this approach you are performing an “anti-rotational” movement by not letting the resistance turn you towards the pulley. This difference of directed resistance can be applied to other moves, like in a standing dual cable low row, by offsetting the position relative to the pulleys. The use of cables is just one example of performing anti-rotational movements. 

Another example of performing this is by offsetting loads of resistance. Perform a “Farmer’s carry” where you walk a given distance holding two implements of choice, such as dumbbells, kettlebells, ViPRs or sandbags. Instead of carrying the traditional identical weights in both hands, have one hand holding a significantly greater weight than the other. For example, in the right hand you carry a 10 pound dumbbell while the other is holding 30 pounds. Take it one step further and carry differently weighted implements, dumbbell in the right hand with a sandbag in the left. Repeat the use of the same different loads, just change hands to balance the workload for that session. This asymmetrical load or implement technique now challenges the body from a vertical direction.

Training to incorporate rotational movements does not have to be as obvious as doing cable woodchops or a dumbbell PNF pattern Small subtle changes are enough to challenge the body to prepare the client for the loaded movement patterns we do everyday but don’t think about. No one thinks about training to lift a bag of pet food from the ground over the shoulder but these are the things we do and don’t think about. As fitness professionals we are classically trained to evaluate positions and demands of our clients lives. Let’s not forget that training is not just to counter the static positions or common postures they do throughout the day, but to prepare for the transitional movements from one posture to the next. I’ll guarantee you that your client had to turn to do it.

Want to learn more about rotational training? Author Ken Miller will be presenting more on the topic at NASM Optima 2018! Register now for your seat at the session!

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When I was young and thought about flexibility, it would conjure up images in my mind of Jean-Claude Van Damme doing center splits between two chairs. I was obsessed with that, so I practiced that version of flexibility until I was able to actually do the Van Damme splits between two chairs. That was long time ago. There is no way I can come close to that feat, or at least with the expectation of ever walking again. As I aged, not only did I lose my once impressive range of motion (ROM), I also learned that flexibility is so much more than the ability to be incredibly “bendy.” I also had my share of partners assisting me with my stretching. Between my brothers who would push me into the splits with me feet elevated on school textbooks and my martial arts brothers putting me into a stretch called the “row boat,” there is little I would recommend from my early experience in partner assisted stretching.

I often teach workshops on partner assisted stretching with no resemblance to the stretches I experienced growing up. In these workshops, we discuss muscles to stretch, legality, hand position, optimal ROM, common compensations, end feel, resistance barriers, and show the nuance of how to preferentially stretch specific muscles. We also practice three different versions of partner assisted stretching: static stretching, neuromuscular contract-relax, and neuromuscular contract-relax with antagonistic contraction.

The National Academy of Sports Medicine (NASM) defines flexibility as the ability of the human movement system (HMS) to have optimum ROM as well as neuromuscular control throughout ROM in order to prevent injury and enhance functional efficiency (efficient movement with minimal HMS stress). As a young martial artist, I was able to use my ROM to show off, but it did not necessarily have neuromuscular control throughout that ROM. Once you move beyond the ROM that you can control the joint is in a position for increased injury. For our clients, we use assessments to objectively identify tight muscles before implementing partner assisted static or neuromuscular stretching and I do not recommend stretching muscles that are not identified as short and tight.

I live in the state of New York, where stretching is considered exercise. So, as a personal trainer, I can legally stretch my clients here. I have not checked all states, but this seems to be the case for many. My suggestion is to find out if stretching falls under the category of exercise or therapy in your state. Anytime a trainer puts their hands on a client it can increase liability if the client gets injured. With that said, I rarely stretch the muscles of the upper body like the pecs, lats, and even more rarely the neck. As a general safety rule, I often only teach students how to stretch their clients’ legs.

Hand position is important for comfort of the client and how you portray yourself as a professional. The goal is not to spend time on what is right or wrong when it comes to misconduct. I want trainers to be aware that hand positions do not have to be inappropriate to be perceived as inappropriate. This may have less to do with how the client feels and more to do with how others see you. I can only suggest doing what needs to be done to get the best stretch while always being aware that misconduct is a liability even if there is no misconduct. Stretchers beware!

When we take a client’s joint through a ROM it is important to have an idea of what that joint’s ideal ROM is. I do not think it is necessary for trainers to pull out a goniometer and measure the exact degrees, but they should have an idea and a reference for what is actually tight. Once you take the joint to an end range there will be a resistance barrier. It does not need to even provide that much of a stretch for the client for it to be a halting point. Clients may often say, “Keep pushing, it can go farther,” yet there is a shift in the hips during an assisted hamstring stretch. It is important to keep the position strictly limited to the muscle being stretched and not focus on getting the foot farther away. It is also important to move slowly into the stretch as some people will be easy to move through ROM, but they will feel an intensity from the stretch that was unexcepted.

When I present the workshop, we explore how to perform partner assisted static stretching, which is taking the joint to its first resistance barrier without compensation and holding it there for a minimum of 30 seconds. For increasing ROM you would then move the joint passively into a new range and end feel. This can be done three times before a break may be needed (and appreciated by the client). This is a good form of corrective flexibility and is relatively simple to implement and still get positive outcomes. Another form of partner assisted stretching is a type of neuromuscular stretching called contract-relax. This is similar to static stretching in that you take the joint to the first resistance barrier without compensation and hold it. You would then ask the client to very gently (25% or less intensity) push against the stretch for 7 – 15 seconds. For instance, if you are stretching their calves you would have them use the calf muscle being stretched to gently push back against the stretch. Once they release the pressure, you will passively take them into a new ROM. The third type of partner assisted stretching we explore is contract-relax with antagonistic contraction. The only difference here is once the client pushes against you, instead of passively moving them into a new ROM, you would ask their assistance in actively moving into the new ROM.

It is very important to teach your clients how to stretch on their own, so they do not depend on you as their only means of flexibility. Partner assisted stretching is not necessary, but ultimately clients enjoy it and they can get benefit from it. It can be a nice and welcomed treat after a well-crafted and executed workout. There are not many quality courses on partner assisted stretching, so I encourage you to look for them to help you with the practical application. This way you can offer your clients a safe, effective, and enjoyable stretching routine.

Want to learn more about partner assisted stretching? Author Rick Richey will be presenting more on the topic at NASM Optima 2018! Register now for your seat at the session!

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Human movement is an amazing orchestra of muscle contractions controlled by the central nervous system to create joint actions to accomplish specific tasks. The motor tasks can be as simple as raising a glass of water or as dynamic as an explosive golf swing.

When you look at all the muscle and joint actions the body is capable of, there are countless movement patterns that can be created. In order to allow the body to have such a vast amount of movement possibilities, the 10 main joints (listed below) of the human movement system (HMS) have specific roles and responsibilities. Starting from the ground up the joints are:

• Foot
• Ankle
• Knee
• Hip
• Lumbar Spine
• Thoracic Spine
• Cervical Spine
• Shoulder
• Elbow
• Wrist

When evaluating the HMS, these joints can be categorized as either a stability- or mobility-based joint.

Mobility: The ability to move freely and easily.

Stability: The ability of the body to maintain postural equilibrium and support joints during movement.

When the joints are looked at individually, each joint can be classified by their main responsibility. Of course, every joint will have some overlap in roles, but each has a primary function. The stability joints are the foot, knee, lumbar spine, cervical spine and elbow. The mobility joints are the ankle, hip, thoracic spine, shoulder and wrist. A clear pattern emerges in that the kinetic chain is a series of joints stacked on top of each other in an alternating pattern of stability then mobility. This sequence creates the ideal platform for dynamic human movement.

Unfortunately, a disruption in this pattern can occur, creating movement dysfunctions. The most common causes of this alternating pattern disruption include previous injury, chronic pattern overload, muscle imbalances or bony malalignments. When issues like this occur, it can affect the normal function of the joint. If the dysfunction is severe enough, the joint, or in many cases joints, will then begin to lose the ability to maintain their primary stability or mobility function. Quite often the joints that are stability-based become more mobile, and the joints that are mobility-based become more stable.

When the joints within the kinetic chain lose their primary role due to dysfunction and change roles, human movement becomes compromised and the chance of injury increases significantly. Fitness professionals who understand how to properly assess human movement, understand the function of each joint, create programs that either restore or ensure human movement will not be compromised, are at an enormous advantage to help their clients move better.

Want to learn more about mobility and stability training? Author Marty Miller will be presenting more on the topic at NASM Optima 2018! Register now for your seat at the session!

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The use of motorized treadmills has become commonplace since their origination in the early 1950s. Originally designed to diagnose heart and lung disease, treadmills quickly became a standard in fitness centers after Dr. Kenneth Cooper coined the term “aerobics” in 1968. Motorized treadmills now provided the ability for fitness facilities to offer an indoor cardiovascular training option to those who liked to walk and to running enthusiasts.

The evolution of the motorized treadmill is extremely profound; originally they started with only the ability to change speeds, but eventually offered inclination options. While motorized treadmills remain relatively similar to their original design, there have been some amazing advancements in user connectivity, interactivity and the ability to analyze and capture performance data.

Clearly motorized treadmills will continue to evolve and remain a mainstay in the fitness world. However, there has been a recent trend toward using non-motorized treadmills, particularly in the performance, fitness and rehabilitative space.

When walking or running on a motorized treadmill, the belt will move at the speed set by the user, regardless of the user’s gate and movement efficiency. In essence, the user’s main objective is to be able to pick their feet up at the same speed the treadmill is moving at. This, unfortunately, does not require optimal biomechanics to accomplish the task. If anything, it is possible that if the user chooses the wrong training speed, their biomechanics have a significant chance of becoming incorrect as they “cheat” to maintain the predetermined speed. Compromises in form and technique that can be observed include:

• holding on to handrails, either consistently or sporadically,
• increased noise from heel strike impact,
• improper running mechanics.

When an individual uses a non-motorized treadmill, they are only able to walk or run at speeds they actually create. The belt will only move based on the speed applied, same as if walking or running outside. Other advantages of training on a non-motorized treadmill:

• greater activation of the posterior chain,
• assists in improving posture and core activation,
• burns calories at a higher rate,
• great way to work deceleration training as the belt will slow down in direct correlation to the rate at which the user decelerates.

So, next time you’re ready to use a treadmill for yourself or a client try adding in a non-motorized treadmill for an amazing overall workout experience.

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For as many ways as there are to challenge the body in a workout, how many ways do we think about approaching our warm-up routine? How well prepared are our bodies for the stresses of the approaching workout?

Stephen Covey, author of “7 Habits of Highly Effective People,” wrote on the habits practiced by highly productive people every day. It’s the second habit of “begin with the end in mind” that is all too often missed when it comes to a workout, and especially the warm-up.

As a fitness voyeur, I tend to watch how people workout, especially their exercise selection and technique. And if the timing is right and I see them enter the gym, I watch how they prepare for the workout. Here are some of my observations and suggestions on how to tweak the elements for better results.

Step 1: What’s the Goal?

Beginning with the end in mind is a concept often lost when it comes to warm-up routines. As the workout itself is the primary focus, we sometimes give little thought on how prepared the body needs to be for the loads, speed and the positions it will be in during the session. Even early on in my own personal trainer role, I’d fallen into the pattern where I had “warm-up” cards with preset routines that clients could follow to prep for their workout. Not much thought or attention was given to what the goal was for that training day. It was just a matter of picking the card or routine.

Even though there is much to be said for getting someone to warm-up and feel better, this does not do much for goal-specific workouts. If the workout plan for the session is an upper body biased routine, the approach needs to address movement enhancement that is also biased towards the upper body. If we take, for example, a strength endurance (OPT phase 2) resistance training workout with an emphasis on the upper body, the warm-up and movement preparation routine might look like this.

• Self-Myofascial Release (SMR)
  • Lats: Foam Roll with PNF Pattern
  • Pectoralis Major: Targeted Massage Ball (e.g., TriggerPoint MB1)
  • Thoracic Extension: Foam Roll
• Active Stretching (8-10 repetitions)
  • Quadruped Ball Reach
  • Pectoral Wall Stretch
• Core (8-12 repetitions)
  • Seated Reverse Wall Presses
  • Ball Shoulder Combination 1
  • Push-up Position Reach and Pull
• Balance and Integration (8-12 repetitions)
  • Single-leg Squat to Overhead Press
  • Side Lunge with ViPR Lateral Shift

The SMR around the shoulder complex allows for greater freedom of movement typically restricted by screen-based postures, (i.e., computer, tablet, phone). Once released, these areas can experience better movement as they go through active stretches.

The activation of the muscles is mission critical. Here in this example it’s the shoulder, rotator cuff and scapular stabilizers that need to be “turned on” or up regulated to be available to dynamically stabilize the region for the upcoming load and speed of the workout. Since this warm-up is more about the movement preparation portion of the workout, consider that the upper body strength endurance routine may include movements like:

These listed exercises offer different demands on the shoulder with varied angles, directions of applied resistance, and stability and stabilization demands. Movement preparation must prepare the region for everything planned in the workout.

This level of thought and consideration can be translated to other regions as well as levels of intensities. A general lower body session with the goal of power would have a different make up than a rotation-centric workout in a power phase.

Step 2: What’s available?

Environments will give different levels of access to equipment and space for the warm-up.

Open Field / Outdoor Conditioning

When doing a workout on court, competitive field or park, you may not have access to very much equipment. The warm-up may be relegated to body-weight movements or to whatever equipment you are able to bring.

The open space also offers some “yardage” for walking exercise variations, taking active patterns and making them a more dynamic pattern. For example, take a standing quadriceps stretch, hold and balance, then step forward and perform the same stretch pattern on the opposite leg. Perform this for 10 yards, space permitting. This same technique can be done with a knee hug, toe grab, etc.

Traditional Fitness Facilities

Most gyms and training facilities are outfitted with foam rollers and other tension release tools. Physioballs and other multifaceted tools like the TRX® Suspension Trainer or Core-Tex offer limitless options for mobility and activation.

Step 3: “Elevator, Going Up”

Most fitness professionals and exercisers don’t give much thought to the sequencing of their warm-up movements. As you prepare the body for optimal movement you want to consider the gradual escalation of the demands of the body. Here are some continuums to consider:

• Prone on floor to standing
• No movement to dynamic
• Light to heavy
• Local to global

As mobility is increased and muscular regions are activated, better coordination and recruitment can be achieved. An example of a non-ideal sequence might be starting with a Box Step Up to Balance to a Floor Bridge and then an Active Kneeling Hip Flexor Stretch. True, you are getting all the movements in and checking off the boxes, but what is being highlighted here is that there are more efficient and progressive ways to achieve the desired warm-up results. How would you adjust the sequence to make it more ideal? Sharing space and equipment may affect what is available and an occasional detour in planning can be expected in these environments.

Lets revisit the habit (of highly effective people) mentioned at the start of this blog, begin with the end in mind. Taking this habit of keeping the workout goal in mind first and applying it to movement preparation will do two things;

• Streamline the warm-up by eliminating redundant or unnecessary movements, and
• Enhance movement patterning

When these two things are accomplished you will have a well-managed and time efficient training session for yourself or personal training client and also have prepared the body for what’s coming its way.

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