Personal Trainer

PERSONAL TRAINER CERTIFICATION
www.ActionCertification.org
Table of Contents
Chapter 1: The Science of Exercise.................................................. 1
The Importance of Understanding the Science of Exercise........................2
Nervous System.......................................................................................3
Central Nervous System.............................................................................................................. 5
Peripheral Nervous System........................................................................................................ 5
Skeletal System........................................................................................6
Bones................................................................................................................................................... 6
Joints.................................................................................................................................................... 7
Muscular System......................................................................................8
Muscle Fibers.................................................................................................................................13
Cardiorespiratory System.......................................................................14
Heart..................................................................................................................................................15
Blood..................................................................................................................................................16
Lungs.................................................................................................................................................17
Energy Production.......................................................................................................................17
ATP............................................................................................................................................................................... 18
Glycolysis................................................................................................................................................................... 19
Summary...............................................................................................20
Review Questions...................................................................................20
References.............................................................................................22
Chapter 2: Biomechanics...............................................................23
What Is Biomechanics?..........................................................................24
The Importance of Biomechanics...........................................................25
Biomechanics and Exercise.....................................................................26
Warm-Up..........................................................................................................................................27
Cool-Down.......................................................................................................................................28
Motion and Kinematics..............................................................................................................29
Forces................................................................................................................................................30
Internal Forces....................................................................................................................................................... 31
External Forces....................................................................................................................................................... 32
Inertia......................................................................................................................................................................... 32
Stability of Equilibrium..............................................................................................................33
Anatomic Locations................................................................................34
Planes of Motion...........................................................................................................................35
Range of Motion............................................................................................................................37
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Muscle Actions.......................................................................................38
Modes of Muscle Strength.....................................................................40
Motor Control........................................................................................42
Proprioception..............................................................................................................................43
Motor Learning..............................................................................................................................45
References.............................................................................................49
Chapter 3: Client Assessment........................................................51

The Importance of a Client Assessment..................................................52
The General History Section of the Initial Client Assessment......................... 53
Occupation......................................................................................................................................53
Lifestyle............................................................................................................................................54
The Medical History Section of the Initial Client Assessment..................55
Injuries..............................................................................................................................................55
Surgeries..........................................................................................................................................56
Diseases and Medical Conditions..........................................................................................56
Medications.....................................................................................................................................57
Using a Questionnaire............................................................................58
Example of Initial Client Assessment Form......................................................................58
The ACTION Personal Training System Health Screening.........................59
PAR-Q.................................................................................................................................................59
PAR-Q, PARMED-X and PARMED-X for Pregnancy Printable Forms.......................60
Lifestyle Questionnaire..............................................................................................................61
Medical Screening........................................................................................................................62
The Physical Assessment Section............................................................63
Pulse...................................................................................................................................................63
Blood Pressure..............................................................................................................................64
Flexibility.........................................................................................................................................65
Posture..............................................................................................................................................66
Body Fat............................................................................................................................................67
Body Mass Index (BMI)..............................................................................................................68
Step Test...........................................................................................................................................69
Walk Test..........................................................................................................................................70
Muscular Performance...............................................................................................................71
How Thorough Should Each Initial Assessment Be?................................73

Personalizing or Designing Custom Test..................................................74
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The ACTION Personal Training System Assessment Tools........................77
Body Composition........................................................................................................................77
Cardiovascular Assessment.....................................................................................................80
Strength Assessment..................................................................................................................83
Ease of Movement Assessment..............................................................................................85
Functional Assessment..............................................................................................................87
Digital Posture Analysis.............................................................................................................91
Tracking Client Progress Using the ACTION Personal Training System......93
Measurement Tracking..............................................................................................................94
Fitness Assessment Tracking..................................................................................................95
Nutritional Tracking....................................................................................................................96
Competition Tracking.................................................................................................................97
Summary...............................................................................................98
References...........................................................................................100
Chapter 4: Introduction to Designing Programs............................101

Introduction to Designing Programs.....................................................102
The ACTION Personal Training System Goals and Preferences...............103
Experience and Goals..............................................................................................................103
Weight Loss Goals..................................................................................................................... 104
Resistance Training Preferences.........................................................................................106
Cardio Preferences.................................................................................................................... 107
Schedule Preferences...............................................................................................................108
Program Design....................................................................................109
Health Precautions to Consider when Designing a Program.................................110
Avoiding Overexertion and Injury......................................................................................111
Signs of Dangerous Dysfunctional Breathing................................................................112
Avoiding Discouragement......................................................................................................113
Aerobic Programs for Beginners...........................................................113
Physiological Factors to Consider in Designing Programs......................114
Types of Muscle Actions.........................................................................................................114
Energy Usage............................................................................................................................... 115
The Kinetic Chain......................................................................................................................115
Proper Positioning....................................................................................................................115
Types of Training Used in Exercise Program Design...............................116
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Principles of Exercise Training...............................................................118
Target Heart Rate......................................................................................................................119
Measuring Exercise Intensity...............................................................................................120
Measuring Caloric Use.............................................................................................................121
Principles of Resistance Training (RT)............................................................................122
Determining Resistance..........................................................................................................123
Determining Rest Periods......................................................................................................124
Resistance Training Modalities...........................................................................................125
Periodization............................................................................................................................... 126
Ways to Vary Volume and Intensity...................................................................................127
Overtraining................................................................................................................................ 127
Resistance Program Design Using the ACTION Personal Training System....129
Setting and Understanding Client Access Levels.........................................................129
Prerequisites to Building a Program.................................................................................130
Creating Your Own Custom Exercises...............................................................................131
Program Design.......................................................................................................................... 132
Program Design Options........................................................................................................134
Editing Programs.......................................................................................................................135
Workout Tracking.....................................................................................................................137
Tracking Cardiovascular Activity Using the ACTION Personal Training System.....138
Cardio Program.......................................................................................................................... 138
Summary.............................................................................................139
Review Questions.................................................................................139
References...........................................................................................140
Chapter 5: Flexibility....................................................................143
The Warm-Up.......................................................................................144
What is a Warm-Up?................................................................................................................144
Benefits of a Warm-Up............................................................................................................144
Warm-Up Considerations......................................................................................................145
Types of Warm-Ups..............................................................................145
General Warm-Up......................................................................................................................145
Activity-Specific Warm-Up....................................................................................................146
Passive Warm-Up......................................................................................................................146
Warm-Ups and Stretching....................................................................146

Flexibility.............................................................................................147
What is Flexibility?................................................................................................................... 147
The Importance of Flexibility...............................................................................................147
The Science of Flexibility.......................................................................................................148
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Types of Flexibility................................................................................149
Corrective Flexibility................................................................................................................149
Active Flexibility........................................................................................................................ 150
Functional Flexibility...............................................................................................................150
Stretching Techniques..........................................................................151
Static Stretching.........................................................................................................................151
Passive Stretching.....................................................................................................................153
Active and Active Assistive Stretching..............................................................................153
Proprioceptive Neuromuscular Facilitation Stretching............................................155
Dynamic and Ballistic Stretching........................................................................................155
Precautions and Safety.........................................................................157
Types of Stretches.....................................................................................................................157
Developing the Program.......................................................................159
Measuring Flexibility...............................................................................................................161
Summary.............................................................................................161
References...........................................................................................163
Chapter 6: Program Design Elements...........................................165

Cardiorespiratory Conditioning............................................................166
The Importance of Cardiorespiratory Fitness..............................................................166
Training Design.....................................................................................167
Postural Considerations........................................................................168
Smart Progression................................................................................168
Interval Training........................................................................................................................ 169
Interval Training Model........................................................................170
Stage Training.......................................................................................171
Circuit Training.....................................................................................171
Fat Burning................................................................................................................................... 172
Muscular Strength................................................................................173
Endurance Conditioning........................................................................................................175
The Adaptation of Strength Training................................................................................177
Flexibility Training................................................................................179
Types of Stretching................................................................................................................... 180
Things to Avoid....................................................................................182
Postural Muscle Imbalance...................................................................................................182
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Balance, Agility, Speed.........................................................................183
Balance........................................................................................................................................... 184
Balance Training........................................................................................................................ 184
Coordination and Speed.........................................................................................................186
Sensory Function.......................................................................................................................188
Speed.............................................................................................................................................. 189
Summary.............................................................................................189
References...........................................................................................191
Chapter 7: Warning Signs.............................................................193

The Warning Signs that Can Mean Trouble...........................................194
Muscle Cramps........................................................................................................................... 195
Dehydration................................................................................................................................. 196
Heat Exhaustion......................................................................................................................... 199
Heat Stroke................................................................................................................................... 200
How to Respond to Various Events.......................................................202
Dehydration that Leads to a Loss of Performance and Energy.............................202
Dehydration and Muscle Cramps.......................................................................................202
Heat Exhaustion that Causes Light-headedness, Dizziness and Cold, Clammy Skin.......204
Heat Exhaustion that Causes Nausea and Headaches...............................................204
Heat Stroke, High Body Temperature and Dry Skin...................................................204
Heat Stroke that Causes Confusion and Unconsciousness......................................205
Summary.............................................................................................208
References...........................................................................................209
Chapter 8: Special Populations....................................................211

Introduction to Special Populations......................................................212
Pregnant Women.................................................................................212
Designing a Safe Exercise Plan During Pregnancy......................................................213
Exercises to Perform and Avoid..........................................................................................214
Safety Precautions....................................................................................................................216
Seniors.................................................................................................217
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Youths..................................................................................................221
Training Programs and Supervision.................................................................................222
Preventing and Controlling Childhood Obesity............................................................222
Injured Persons....................................................................................224
Exercising with an Injury.......................................................................................................224
Exercising after an Injury.......................................................................................................225
Persons with Specific Medical Conditions.............................................226
Arthritis......................................................................................................................................... 226
Asthma........................................................................................................................................... 229
Preparing for Exercise.............................................................................................................229
Diabetes Mellitus.......................................................................................................................231
Hypertension.......................................................................................235
Monitoring Blood Pressure...................................................................................................236
Types of Exercises for Persons with Hypertension....................................................236
Summary.............................................................................................238
References...........................................................................................239
Chapter 9: Nutrition....................................................................243
Introduction to Nutrition......................................................................244
Recommended Caloric Intake..............................................................................................245
Nutrition for Working Out.....................................................................................................247
Carbohydrates......................................................................................249
Recommended Carbohydrate Intake................................................................................250
Types of Carbohydrates..........................................................................................................251
Carbohydrates for Working Out..........................................................................................252
Alcohol as a Carbohydrate?...................................................................................................253
Fats......................................................................................................254
The Role of Fats in the Body.................................................................................................254
Types of Fats................................................................................................................................ 256
Triglycerides......................................................................................................................................................... 256
Unsaturated Fats................................................................................................................................................ 256
Trans Fats.............................................................................................................................................................. 257
Saturated Fats..................................................................................................................................................... 257
Cholesterol............................................................................................................................................................. 257
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Problems with Fats...................................................................................................................258
Metabolic Syndrome......................................................................................................................................... 258
Obesity..................................................................................................................................................................... 258
Insulin Resistance............................................................................................................................................... 259
Heart Disease....................................................................................................................................................... 259
Fat Requirements......................................................................................................................259
Protein.................................................................................................260
Protein Digestion....................................................................................................................... 260
Factors that Affect Protein Requirements......................................................................262
Proper Hydration..................................................................................263
Sports Drinks vs. Water..........................................................................................................264
Signs of Dehydration................................................................................................................265
Hydration to Maximize Training.........................................................................................266
Supplements........................................................................................267
Types of Supplements..........................................................................268
Nutritional Programming with the ACTION Personal Training System...273
Setting Client Nutritional Preferences.............................................................................273
Prerequisites to Building a Nutritional Program.........................................................274
Adding Custom Foods and Recipes....................................................................................274
Building a Nutrition Program..............................................................................................276
Using the Nutrition Program................................................................................................278
Searching Recipes..................................................................................................................... 280
Favorite Recipes.........................................................................................................................281
Cookbooks and Grocery Lists...............................................................................................282
Micronutrient Analysis...........................................................................................................283
Nutritional Tracking.................................................................................................................284
Summary.............................................................................................285
References...........................................................................................287
Chapter 10: Legal/Business..........................................................291

Legal Issues..........................................................................................292
Slip and Fall.................................................................................................................................. 293
Equipment Usage......................................................................................................................294
Supplements................................................................................................................................ 295
Sexual Harassment................................................................................................................... 296
Personal Trainer Qualifications..........................................................................................297
Emergency Response...............................................................................................................298
Confidentiality............................................................................................................................ 298
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Risk Management................................................................................299
Proper Education......................................................................................................................299
Appropriate Training for Each Client...............................................................................300
Limiting Liability Through Avoidance, Retention, Reduction and Transfer....301
Proper Conduct.......................................................................................................................... 302
Proper Training Area...............................................................................................................302
Documentation........................................................................................................................... 302
Selling Your Services.............................................................................303
Marketing Your Business.......................................................................................................303
Determining the Cost of Your Service...............................................................................305
Retaining Clients..................................................................................306
READ—Rapport, Empathy, Assessment and Development....................................307
Customer Service....................................................................................................................... 308
Key Points for Success.............................................................................................................309
Referrals........................................................................................................................................ 310
Other Incentives......................................................................................................................... 311
Non-Compete Clauses.............................................................................................................311
Expanding Your Business......................................................................311
Organizing Your Business......................................................................................................312
The Business Plan.....................................................................................................................313
The Budget................................................................................................................................... 314
Establishing Policies................................................................................................................314
Clients............................................................................................................................................. 315
Advertisement............................................................................................................................ 316
Profits............................................................................................................................................. 317
Summary.............................................................................................318
References...........................................................................................321
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Chapter 1: The Science of Exercise
Topics Covered
The Importance of Understanding the Science of Exercise
Nervous System
Central Nervous System
Peripheral Nervous System
Skeletal System
Bones
Joints
Muscular System
Muscle Fibers
Cardiorespiratory System
Heart
Blood
Lungs
Energy Production
ATP
Glycolysis
withstand the stresses and strains of intense
The Importance of Understanding
effort without injury.
T
the Science of Exercise
Exercise has also been known to strengthen
raining or exercise should be a
bones by causing an increase in the bone mineral
positive and beneficial part of life.
density by increasing the rate at which minerals
It is a proven fact that exercise
like calcium are deposited in the bones. Since
improves a person’s overall health
bones naturally become weaker as people age,
when done on a regular basis. Besides its use
older adults are at a high risk for bone fractures.
in maintaining and losing weight, exercise is
However, moderate to strenuous exercise has
known to improve the heart and blood system
been known to reduce the risk of older adults
and to enhance muscular athletic
getting a fracture in the heels, hips
ability. It also prevents the onset
and other bones.
of brain diseases and boosts
Additionally, exercise protects
the effectiveness of the immune
the brain and nervous system and
system. These beneficial results are
helps to improve brain and nerve
due to the many physical changes
function. Research has shown that
that occur within the body during
regular exercise can protect cells
exercise.
in the brain and nerves from the
Over time with regular exercise,
injury or erosion that normally
the blood supply to the active
occurs with neurodegenerative
muscles improves, which causes
and neuromuscular disorders like Alzheimer’s
the capillaries to respond more quickly to the
and MS (multiple sclerosis). This means that
requirements of the muscles. Physical activity
exercise can also minimize the risk of dementia.
also enhances the mechanical effectiveness of
In addition, exercise and other physical activity
the heart by enhancing the volume of blood
can enhance nerve growth factors which are
that can be pumped. Due to this, training and
known to support the endurance and growth
exercise helps the heart learn to more quickly
of several nerve cells. This stimulation of nerve
adapt to exertion. It also increases the actual
cell growth ultimately leads to increased brain
mechanical strength of the muscle fiber and its
functioning through improvement of certain
surrounding membrane, allowing the heart to
types of learning. This exercise-induced
2
improvement in mental health also helps to the nervous system, skeletal system, muscular
prevent depression. system and cardio-respiratory system.
Exercising on a regular basis can also boost the

Nervous System
immune system, a natural defense mechanism
The nervous system serves as the control center
used to ward off foreign organisms, viruses and
of the body by integrating mass communication
chemicals. Though exercise does not enhance
networks consisting of billions of nerve cells
the normal functioning of the immune system,
called neurons, which are designed to convey
exercise does strengthen it in times of illness or
information. The three major functions of the
chronic disease such as obesity, cardiovascular
nervous system are sensory, integrative and
disease, diabetes and heart disease. Exercise
motor functioning. The ultimate
is believed to encourage
Exercising on a regular basis can purpose of this neural network is
strong immune responses
also boost the immune system. to gather information about our
by increasing antibody and
inner and external surroundings
immune cell responses. There has also been
(sensory function), process and interpret the
scientific data suggesting additional exercise-
information (integrative function), and then
induced immune responses may be an indirect
respond to these stimuli (motor function). The
consequence of the brain and nervous system
messages are relayed back and forth between
benefits of exercise.
different parts of the body.
Because physical activity leads to physiological
The neuron is the functional unit of the
changes in the body, it is important for physical
nervous system and the merging of these cells,
trainers to understand more about exercise
called neurons, creates the nerves of the body.
physiology, the study of the body’s responses and
The structure of neurons allows for very quick
adaptation to the stress of exercise. The major
communication to and from the cell as well as
systems of the body each have their individual
continuous conduction of signals across the
roles during exercise performance and they
neuron. A neuron’s main component is a cell
work interactively to respond to exercise. All
body, or soma, which contains the organelles
these factors should be taken into consideration
important to the proper functioning of this cell.
when planning an exercise training program.
A long branch called the axon projects out of
This chapter will cover details on aspects of
the soma and feeds information through nerve
3
impulses to muscles, organs and other neurons. to be myelinated or covered in a myelin sheath.
Shorter branches called dendrites project from This insulation helps signals to be transmitted
the soma, bringing information faster from one nerve cell to
from other neurons of the another. In the brain, many
nervous system. nerve cells are not myelinated
All the communication occurs since they are located close
across junctions referred to as together. But nerve cells that
synapses, which occur either have long axons or dendrites
between neurons or between a neuron and need myelin to speed up the transmission time
another cell type. A synapse is just a tiny empty for their signals.
space between two axons The different kinds of neurons
or dendrites from different are interneurons, motor
cells. Within these synapses, neurons and sensory neurons.
neurotransmitters, the major Interneurons transmit signals
chemical messengers of the from one neuron to another
nervous system, are released neuron. Motor neurons send
from the neurons before signals from the spinal cord or
the synapse and bind to the the brain to other areas of the
receiving cells located after the body. Sensory neurons send
synapse. This stimulates a signal that is called an signals from areas of the body to either the
action potential, which travels to the receiving spinal cord or to the brain.
cell, called a receptor, and then on to the cells The nervous system is composed of two major
that act on the signal in the desired location. compartments: the central nervous system
This is how the continuation signal the neuron (CNS) and the peripheral nervous system (PNS).
was transmitting makes it to the end location. The brain and the spinal cord, a long tubular
For example, a signal to move your finger would continuation of the brain, are collectively known
travel from the brain, through many neurons as the CNS. This is the source of conscious and
and finally to the muscle in your finger. unconscious thoughts, moods and emotions.
Neurons are usually covered in a layer of The PNS is comprised of all the nerves in the
insulation called myelin and are therefore said body, including the cranial and spinal nerves.
4
controls balance, posture and coordination.
The brain stem connects the cerebrum and
cerebellum to the spinal cord and is the center for
the control of visual and auditory reflexes, heart
rate, blood pressure and breathing. The entire
brain is protected by three layers of membranes
called meninges, which are located just under

Central Nervous System
the skull. The spinal cord branches out from the
The four major sections of the brain are the
brain stem and its function is to send, receive
cerebrum, diencephalons, cerebellum and the
and interpret nerve signals traveling between
brain stem. The cerebrum is the largest part
the brain and the rest of the body.
of the brain, comprising 85% of the brain’s
total weight. The cerebrum is divided into left Peripheral Nervous System
and right hemispheres that communicate with The PNS is further divided into the voluntary
each other to control muscles and organs as nervous system (somatic) and the involuntary
nervous system (autonomic). The
somatic system signals skeletal
muscles to control voluntary
movement. The autonomic system,
on the other hand, regulates the
contraction of internal organs and
therefore controls involuntary

well as thought, hearing and language. The
outer portion of the cerebrum is called the
cerebral cortex, which is primarily gray matter
containing nerve cells.
The central part of the brain is the
diencephalon, which includes glands important
for the release or regulation of hormones. The
cerebellum is located at the rear of the brain
and is similar in function to the cerebrum but
5
physiological processes like heart rate,
Skeletal System
digestion and breathing. Since these processes
The major function of the skeletal system is
could either be accelerated or decelerated, two
to provide form and shape to the body, thereby
distinct pathways of the autonomic nervous
giving protection and support, plus allowing
system (ANS) are present. The sympathetic ANS
bodily movement. The skeletal
kicks in under stress conditions
When beginning an system also helps in producing
and responds accordingly, exercise program, it is
blood and storing minerals for
usually accelerating bodily important that the
nervous system be the homeostasis of the body.
functions like heart rate, while properly trained.
The skeletal system determines
the parasympathetic pathways
our stature and the positioning of our bones
usually slow down bodily functions in rest
determines our shape and size.
conditions.
Our skeletal system is separated into two parts,
When beginning an exercise program, it is
the appendicular and the axial skeletal systems.
important that the nervous system be properly
The axial skeleton consists of the
trained to ensure that the right
skull, rib cage and our vertebral
movement patterns are being
column; the appendicular skeleton
developed. All movement within in
includes our upper and lower
the body is directly associated with
extremities.
the nervous system. This process
will help improve performance Bones

and decrease the risk of injuries. Bones also provide protection
For example, mechanoreceptors, for internal organs. For example,
the primary neurons important the ribcage protects the heart and
to fitness and physical movement, lungs in the chest cavity. Nutrients
respond to mechanical forces. and blood constituents are
These receptors, found in muscles, tendons and provided to the body from bone. Our bones form
ligaments, are responsible for sensing distortion junctions, referred to as joints, which are linked
in tissues, such as tension induced by exercise. by our connective tissue and muscles, and they
are the sites where movement due to muscle
contraction takes place.
6
In the skeletal system there are approximately surface of another, similar to the tire of a motor
206 bones, 177 of which are used in voluntary bike that rolls down a road. A good example of
movement. Our bones provide this movement in our body is
us with two primary functions during a knee extension when
during movement: support and the tibial condyles joint slides
leverage. Bones are the support across to what is known as the
system for soft tissues. Posture femoral condyles joint. The next
is an essential component of common movement is called
the support system provided the spin movement. This is
by our bones and is essential when one joint surface rotates
for the allocation of resources on another, similar to twisting
within the body. With regard to a lid off a jar of spaghetti sauce.
leverage, our bones act like rigid An example of this movement
levers, altering the direction and force exerted is when the forearm is rotated from the hand
by our muscles. facing down to the hand facing up.
Stretching is the best exercise for increasing

Joints
nutrition to the joints. Flexibility is the range
Our joints are formed by one bone that
of motion (ROM) available to a joint or joints.
articulates with another bone. Joints can be
Increased ROM can provide greater mechanical
categorized by their structure, function or
efficiency. This efficiency results in more
movement, known as arthrokinemeatics. The
effective and safer movement. A mobile joint
joints that are most affiliated with our body
moves more easily through a range of motion and
movement are known as the
it requires less energy. Healthy
synovial joints. These joints Stretching is the best
exercise for increasing flexibility means the capacity
are held by a joint capsule nutrition to the joints.
to move freely in all desired
and ligaments. They consist of
directions. The movement should be restricted
roughly 80% of the joints within the body and
to the intended movement capabilities or to the
have a large capacity for motion.
joint’s functional range of motion (FROM).
During a roll movement—especially during
exercise—a bone in the joint rolls across the
7
alternating large myosin and thin actin
Muscular System
strands made of protein.
The forces that help the body perform
Myosin develops in the middle
physical activity are supplied by the
of every M line, a line that runs the
muscular system. Muscle cells, also
length of myofibrils. The actin strands
known as fibers, are multinucleated
develop a Z shaped pattern down the
and connected in cylindrical bundles or
points that are anchored, commonly
individual cells. A single muscle is built
called a Z line, which is characterized
from many bundles of muscle fibers
by having a darker color than other
called fascicule. Connective tissues
areas. When stimulation occurs and an
run from one end of the muscle to the
action potential is received, the skeletal
other, binding cells together and giving
muscles carry out a contraction by
rise to muscle fiber bundles.
decreasing every sarcomere. The
Muscle tissue is categorized into three types
easiest way to understand contraction is
according to function and structure: cardiac,
probably through the sliding filament model of
smooth and skeletal. As the names suggest,
cardiac muscle is exclusively found in the walls
of the heart and smooth muscle composes the
epithelial of other hollow organs. Both of these
muscle groups are under involuntary control.
Skeletal muscle, however, is attached to the
skeleton and is under voluntary control. Due to
the important role of skeletal muscle in exercise contraction in a muscle. Actin and myosin fibers
and fitness, the following section reports more overlap in a contractile motion toward each
on the structure and function of skeletal muscle. other.
Skeletal muscle is composed of many thread- Myosin filaments have club-shaped heads
like striations and is attached to the skeleton. that project toward the actin filaments. Larger
The sarcomere is the basic contractile unit of structures, known as myosin heads, are found
the myofibril, expanding from a Z line to the along the myosin filament and give attachment
next closest Z line. Sarcomeres are composed of points on binding sites for the actin filaments.
8
Myosin heads move in a synchronized manner a muscle does not need to contract, calcium
toward the center of the sarcomere. They then ions are drawn out from the sarcomere and are
detach and reattach to the closest active site of stored back in the sarcoplasmic reticulum.
the actin filament. This is known as a “ratchet As a whole unit, skeletal muscles produce
type drive system.” As a result, this movement by pulling on the skeleton
process uses up large quantities of in a nervous system-controlled
adenosine triphosphate (ATP). manner. When a muscle shortens,
Where does the energy for it moves a bone by pulling on the
contraction come from? It comes tendons which attach the muscle to
directly from ATP, which is the the bone. The integration of bones,
energy source of the cell. The job skeletal muscles and joints create
of ATP is to link the cross bridges apparent movements like running
among myosin heads and actin and walking. Skeletal muscles can
filaments. Energy powers the even generate movements that
twisting of the myosin head. are more subtle, which result in

A muscle is stimulated
When used up, ATP converts to to contract when respiration, eye movements and
calcium is released.
adenosine diphosphate (ADP). A facial expressions. The number of
person’s muscles accumulate a small amount skeletal muscles used during a workout depends
of ATP by constantly reusing the ADP and entirely on which exercises are chosen and the
converting it back into ATP quickly. Inside methods used during their implementation.
muscle tissues there is a storage supply of a This determines which muscles and how many
high-speed recharge chemical called creatine are involved in the particular physical activity.
phosphate. This assists in producing the fast The skeletal muscles are grouped together,
renewal of ADP into ATP. though this does not mean that they function
What happens when a muscle needs to together. They can either function separately
contract? A muscle is stimulated to contract or in groups along with other muscles. Power
when calcium is released from the sarcoplasmic and muscle force are formed by the action of
reticulum into the sarcomere. Calcium ions are skeletal muscles. Moreover, muscle contraction
needed for every cycle of the sarcomere. It is movement can fulfill several other vital functions
calcium that reveals the actin binding sites. When in the human body, like heat production, posture
9
and joint stability. Sitting and standing with concentric muscle actions, referred to as
posture can be accomplished by contraction of muscle contractions, happen when the muscle
muscles. fibers are shortened. Eccentric muscle actions
As soon as the nervous system triggers generate force continuously during regular
movement in the body, the entire muscle does body movements and this tension causes the
not respond because a muscle has several muscles to lengthen. An example of this would
motor units (a motor neuron and the muscle be the movement of the quadriceps when a
fibers it innervates) and the movement may person walks down a steep hill. Other examples
require just a small part of the muscle. All of the would be when a person sits down on a bench
fibers contract when a motor unit is stimulated. or the action of the forearm flexor muscles
Clusters of motor units work in unison to when throwing a ball. Day-to-day tasks such as
manage the contractions of a muscle. Each fiber walking or jogging cause spur-of-the-moment
within the motor unit moves simultaneously. actions that are both eccentric and concentric.
One individual muscle might have several motor Isometric (static) muscle actions are a form
units and the nervous system may contact many of muscular activity that causes tension in the
or a small percentage of them. The frequency muscle; however, this action does not shorten or
at which the motor units fire is variable; it can lengthen the muscle.
be increased or decreased to help When a person begins body
control force production. Force training, the blood supply to
regulation is often referred to active muscles improves and the
as force gradation—this is what capillaries begin to respond at a
allows people to control their fast pace. Experts have determined
body movements. By combining that an increased amount of alkali
recruitment of motor units and is placed in the fibers to defuse the
the speed of their firing, patterns acid that develops by physical force.
of neural discharge allow a vast An increased amount of glycogen is
selection of weak to strong contractions. apparently placed in muscles to store energy,
There are three muscle actions: concentric thereby allowing the nervous system which
muscle actions, eccentric muscle actions controls the muscles to work more efficiently.
and isometric (static) muscle actions. The This is why the recovery process seems to
10
accelerate during training. Also, not considered a waste product; it
during training, the mechanical is a by-product of anaerobic effort.
strength of both the muscle fiber The majority of lactic acid buildup
and the membrane (sarcolemma) normally dissolves within 30 to 60
is enlarged so that they have the minutes.
ability to stand the aggressive According to physiologists, lactate
action of exercise without damage. buildup is not associated with
Muscle damage is often the post-exercise soreness and pain
result of aggressive training, that happens 24 to 48 hours after
which can cause a breakdown of muscle fibers. ending a normal training session. When enough
In fact, aggressive training does not cause oxygen is present, lactate is metabolized and can
a muscle to grow or the nervous system to actually be used as energy. The remaining two
adapt. A good example of this would be when types of soreness can happen for a prolonged
a person overstretches a muscle. If the muscle amount of time right after finishing a workout.
becomes damaged it will cause soreness and Muscle and joint soreness may develop a few
pain. Damaging a muscle during hours after a workout, followed

Skeletal muscles are
exercise doesn’t lead to nervous consistently making by a Delayed-Onset Muscle
extremely fine adjustments.
system adaptations. The damage Soreness (DOMS) which can last
lessens the blood supply to the scarred area for a few days. DOMS can happen when a person
because of buildup of trauma; therefore, the begins exercising after stopping for a while—
fibers become more prone to repeated injury. the body is simply adjusting to the exercise.
There are three types of muscle pain that Skeletal muscles are consistently making
people encounter after a workout. Soreness, extremely fine adjustments which hold the
often accompanied by a burning sensation, can human body in positions that are stationary.
be experienced after high-impact resistance The muscle tendons extend over body joints,
training, cardiorespiratory conditioning contributing to the stability of joints. This is
or even after cooling off following a high- particularly obvious in the shoulder and knee
impact exercise session. Soreness is due to an joints, where muscle tendons are a serious factor
accumulation of lactic acid during anaerobic in the stabilization of the joints. To maintain the
effort. It is important to note that lactic acid is temperature of the body, heat production is a
11
vital muscle by-product for metabolism. In fact, During a customized fitness training program
muscular contraction produces approximately that consists of aerobic and anaerobic exercises,
85% of the body’s heat. various types of muscles are used. Weightlifters
There are two different fiber types in the and bodybuilders use fast twitch muscle fibers,
muscles of the body: “slow twitch,” or Type I, and which provide brief bursts of strength, whereas
“fast twitch,” or Type II. More power is generated marathon runners, hikers, bicyclists and walkers
as the fibers of muscles move more rapidly. utilize slow twitch muscle fibers, which do not
In regards to fitness training that requires fatigue quickly.
endurance and stamina, slow twitch muscle Fast twitch fibers do not require oxygen;
fibers are utilized. Fast twitch muscle fibers instead they utilize sugars to produce body
are used for strength and intensity involved in fuel for optimal force and quick action involved
fitness training. In simpler terms, slow twitch in fitness training for strength. Slow fibers
fibers are considered low threshold because normally employ oxygen-utilizing (or aerobic
they are the first muscle fibers to be recruited
for physical activity, while fast twitch fibers are
considered high threshold because they are
only recruited under intense conditions. Slow-
twitch muscles are found more in muscles like
postural muscles. These slow-twitch muscles
must sustain contractions for long times without
fatigue. They depend relatively more on fats for
energy.
Slow Twitch Fibers (Type I) = Red in Color
Comparison of Slow- and Fast-Twitch Muscles: Fast Twitch Fibers (Type II) = White in Color
Slow-Twitch Fast-Twitch
pathways) to fuel activities that require lots of
Twitch Rate Slow Fast
Glycogen Content Low High

stamina and endurance. Research has shown
Glycolytic Capacity Low High that endurance athletes, like long-distance
Fatigue Resistance High Low
runners, produce less of a protein made mostly
Respiration Type Aerobic Anaerobic
Capillary Supply High Low

by fast twitch fibers due to a genetic mutation.
Sprinters and other athletes that rely on quick
12
bursts of energy, however, less frequently have baseball or throwing a boxing jab, entails
this mutation. diminishing braking on an eccentric level. This
Within the duration of eccentric (fast twitch) allows a much greater power to develop during
contraction, a muscle extends while under any movement. Eccentric contractions are still being
tension because an opposite force is greater than studied and researched for an ability to hasten
force produced by muscle. Instead of working to rehabilitation of injured or weak tendons. For
pull any joint in a direction of muscle contraction, example, Achilles tendonitis has been proven
muscles decelerate the body joint at an end of to derive therapeutic benefits from high load
any movement or else control repositioning eccentric contractions.
of any load. This happens involuntarily, such

Muscle Fibers
as attempting to move much too heavy weight
Protein filaments make up the muscle
for muscles to lift, or voluntarily, such as
fibers. Warm-up exercises increase muscle
smoothing out movement with muscles. During
temperatures, which allow for
the short term, strength training
Virtually any movement of greater mechanical efficiency.
involves contractions that are routine action involves
eccentric contractions. This efficiency is achieved by
both concentric (slow twitch)
lowered viscous resistance within
and eccentric, which appears to enhance the
muscles, which helps to decrease the viscosity of
strength of muscles more than fitness training
the muscle. In turn, this helps protein filaments
with concentric contractions alone.
that make up muscle fibers to contract with less
To safeguard body joints from any damage,
resistance, thus increasing the movement of the
eccentric contractions generally occur as
muscles.
a brake-like force on the opposition to a
Muscle fibers are specialized cells which are
contraction that’s concentric. Virtually any
controlled by the nervous system. The chief
movement of routine action involves eccentric
function of these fibers is muscle contractibility.
contractions assisting in the maintenance of
Where attached to internal organs, blood vessels
smooth body motions. Eccentric contractions
or bones, muscles are liable for movement.
can also slow down rapid muscle movements
Almost all bodily movements result from
like a throw or a punch. An aspect of training
contractions of the muscles. Of course there
for these rapid movements, like pitching a
are exceptions, such as cilia action, flagellum on
13
cells of sperm, and movements of amoeboid of • Transportation of oxygenated blood
several white blood cells. from the lungs to different parts of the
body and deoxygenated blood back to

Cardiorespiratory System
the lungs.
The cardiorespiratory system is an
• Distribution of nutrients (e.g., free fatty
umbrella term for the entire respiratory and
acids, glucose and amino acids) to cells.
cardiovascular systems. Acting together they
• Removal of end products and metabolic
offer oxygen, protective
waste products (carbon dioxide, lactate
agents and nutrients to
and urea) from the periphery for reuse
the tissues of the kinetic
or elimination.
chain, a term referring to
• Regulation of pH to control alkalosis and
the muscular, articular and
acidosis.
neural systems. The kinetic
• Transportation of enzymes and
chain is also a mechanism
hormones to control physiological
for removing waste by-
function.
products. Basically the cardiorespiratory system
• Maintenance of fluid volume which helps
is the support system for the kinetic chain to
in preventing dehydration.
produce movement.
• Maintenance of body temperature by
The cardiovascular system has three
absorbing and redistributing heat.
components: the heart, the blood vessels
The respiratory system is often referred
carrying blood between the heart and tissues,
to as the pulmonary system and is made up
and the blood itself. The
of soft tissues and skeletal
cardiovascular system plays an The cardiovascular system helps
with continuation of normal structures. The major role of
important role in maintaining function during exercise and rest.
the respiratory system is to
homeostasis in the body. It
make sure all cells function
also helps with continuation of normal function
properly. This system works closely with the
during exercise and rest. The cardiovascular
cardiovascular system to accomplish this task. It
system is accountable for the following seven
also provides a means of gathering oxygen from
functions in the body:
the environment and conveying it to the blood
14
stream. In order to accomplish the movement of from conduction passageways. Respiratory
air in, out and through the body, the functionality passageways allow oxygen and carbon dioxide
of the respiratory and respiratory passageways to go in and out of the blood.
must be integrated.
Heart
The primary respiratory muscles are the
The heart is a muscular pump. It rhythmically
external intercostals and diaphragm, which
contracts to push blood throughout the body.
help normal breathing, while the secondary
It is located in the center of the chest and is
respiratory muscles (pectorals minor and
flanked by the lungs. The heart weighs about
scalenes) aid in heavy, deep or forced breathing.
300 grams, with an average size of an adult fist.
All the structures that air travels through before
Clients should be advised for medical checkup
entering the two respiratory passageways
for diagnosing heart disease before selecting
are called conduction passageways. The
any kind of exercise or training program.
respiratory passageways collect the air coming
15
The heart is
Blood
composed of four
Blood transports the
hollow chambers.
necessary oxygen to tissues
Valves separate each
and gathers waste products
chamber from one
from all tissues. It also
another and from the
transports hormones and
arteries and major
delivers nutrients from the
veins, which prevents
gastrointestinal tract to specific tissues. Blood
backflow or spillage of blood back into the
provides a means to regulate the temperature
chambers. These chambers are divided into
of the body through its conduction of heat,
two interdependent but separate pumps on
primarily due to its water content and its flow
both sides. The interatrial spectum separates
path. Blood travels close to the skin which helps
these two pumps. Each side of the heart has
to give off heat or cool the skin, depending on the
two chambers: an atrium and a ventricle. The
environment. The regulation of the body’s water
right ventricle receives deoxygenated blood
content and acid balance is based on pH values
coming from the right atrium then pumps
and is dependent on the blood. The clotting
the deoxygenated blood to the lungs. The
mechanism of blood provides protection from
reoxygenated blood coming from the lungs is
excessive blood loss by sealing off damaged
received by the left atrium and then goes to the
tissue. Blood also generates specialized immune
left ventricle. When the left ventricle contracts, it
cells to fight against foreign toxins within
pushes the blood from the heart and distributes
the body, leading to a decrease in illnesses.
it to the body’s tissues. The amount of
Ironically, by the same
blood pumped out with each contraction
mechanism, blood can
of the ventricle is known as the stroke
promote the spread of
volume. Additionally, an adequate
foreign organisms that
oxygen supply is critical for myocardium
invade the body.
because, compared to skeletal muscle,
The ventricles of the
heart tissue has a very limited ability to
heart pump and disperse
generate energy anaerobically.
the blood throughout
16
the body. Simultaneously the blood is also re- is saturated by the lungs with incoming oxygen.
entering the heart. For proper circulation of Breathing, or ventilation, is the actual process of
blood throughout the body and back to the moving air in and out of the body.
heart there must be a network through which Breathing is divided into two phases: inspiration
blood can travel. This network is composed and expiration. Inspiratory ventilation is active
of blood vessels. Arteries are the vessels that while expiratory ventilation can be both active
carry blood from the heart to the entire body. and passive. When you inhale the diaphragm
Arteries are typically large and elastic and are contracts and flattens out. Also the rib muscles
further divided into medium-sized muscular lift the ribs up and outward. Thus the lungs get
arteries, which again branch into small more space to grow larger and fill up with air.
arteries called arterioles. These arterioles are The process is reversed during expiration. The
again divided into capillaries, which help the diaphragm relaxes, moves up and pushes the air
exchange of nutrients, oxygen, waste products out of the lungs. The rib muscles also relax and
and hormones. Veins are the blood vessels they move in. Now the lungs have smaller space,
that carry blood back to the heart. The waste causing the air to push out.
products collected in capillaries are transported Patients having problems with their lungs
for cleaning purposes by the veins. find difficulty with exercise. Training helps to
strengthen the lungs and muscles, improve

Lungs
endurance and reduce breathlessness.
The two lungs, located in the chest cavity, are
essential respiratory organs. Though humans Energy Production

have two lungs, they are non-identical and differ Energy is the capacity to do work. Chemical
in size. The left lung is typically smaller than the energy obtained from food is converted to
right lung. Lungs bring mechanical energy that
oxygen into the body then fuels physical activity,
and remove carbon often in the form of muscle
dioxide from the body. contractions. When energy
Deoxygenated blood is used, it is referred to as
coming from the right AN energy utilizing reaction.
ventricle of the heart In other words, energy is
17
collected from an energy utilizing source (the Oxidative energy production is the major source
breakdown of food) by some storage unit and of energy for greater than two minutes worth of
then transferred to a site that can use this energy. activity.
Energy is generated from fat, carbohydrates The ATP-CP system is inefficient in producing
and protein gathered from consumed food, and large amounts of ATP so training these systems
it can be produced aerobically (with oxygen) and is neither easy nor enjoyable for most clients.
anaerobically (without oxygen). The intensity The glycolytic system can generate a greater
of activity determines which energy system amount of energy than the ATP-CP system but
will predominate. The aerobic energy system it is very limited. Many training programs give
contributes toward certain goals, more importance to this system
while the anaerobic system can Energy is generated from fat, compared to the ATP-CP system
carbohydrates and protein.
be trained for other goals. There because a typical repetition
are three energy systems for the body which range of 8 to 12 repetitions falls within this
are: time frame. For long-term energy an oxidative
• Immediate Energy (ATP-CP system) system is needed. It depends mainly on fats and
• Short term Energy (Lactic acid or carbohydrates for generating ATP. Energy is
Glycolytic system) produced more slowly in this system compared
• Long term energy (Aerobic or Oxidative to other systems, because it requires a larger
system) amount of oxygen to meet the muscular needs
of exercise. Even though this is the slowest
system, it produces the greatest amount of ATP.
In this system, 1 glucose molecule generates 36
ATP molecules and in certain circumstances can
possibly generate up to 38 ATP molecules.
ATP
Adenosine triphosphate (ATP) is the storage
As each name suggests, each energy system
and transfer unit of energy within the cells of the
relates to different activity times. The ATP-CP
body. Because of this, ATP is called “the energy
system is used for activity up to 10 seconds while
currency” of the cell. At any one time the amount
glycolysis fuels activity up to about one minute.
18
of ATP stored in the body is very small so the can produce many more high-energy ATP
body needs to resynthesize ATP continuously. molecules. The anaerobic glycolytic system is
called the short- term energy system and is used
for high intensity efforts in a short period of time.
ATP is structurally composed of a nitrogen
based compound, adenine, a five-carbon sugar
called ribose and three phosphates. ATP has the
ability to store great amounts of energy in the For example, anaerobic glycolysis is needed for
chemical bonds of the phosphates. Essentially passing a participant in a 5 kilometer race with
this is the energy needed for the muscle a 60 second burst of speed.
contractions which create physical activity. The Pyruvate is one of the by-products of this
natural supply of ATP in each cell is inadequate; process. Two molecules of pyruvic acid are
therefore, cells must have a means of generating
more.
Glycolysis
Glycolysis typically takes place in the initial
stage of respiration in the presence of oxygen
but can also occur without oxygen present.
The breakdown of carbohydrates (glucose)
rapidly produces ATP. This metabolic pathway
occurs in almost every cell. Through anaerobic

usually oxidized from a single molecule of
glycolysis one glucose molecule will produce
glucose. A build up of lactic acid will occur
two ATP molecules while aerobic respiration
if pyruvate cannot be rapidly utilized by the
19
muscle cell. A large accumulation of lactic acid waste within muscles can create stiff joints and
triggers a drop in the pH of muscle cells, making muscles.
them acidic and possibly interfering with muscle When a client’s goal is health and fitness, the
contractions. It may cause a burning sensation personal trainer has to be aware of different
in the exercising muscles and should lead to kinds of exercise. A personal trainer should
stopping the activity or decreasing the intensity understand the roles of the cardiovascular and
of the activity. respiratory systems in exercise selection and
programming. The cardiovascular system is

Summary
very influential in the body’s ability to consume
All systems in the human body are related. The
oxygen. The personal trainer should also be
harmonious functioning of all these systems
aware of the science associated with energy
is necessary for good health. The exercises or
production to effectively use
training programs selected
it for the training of clients. To
must not destroy the original
achieve specific results, the
harmony present in the human
clients should have the ability
body. For example, alterations
to train and influence all three
in breathing patterns may
energy systems.
have a direct impact on the
components of the kinetic chain and may Review Questions

lead to dysfunction. If the breathing patterns 1. Which of the following is not a component of
become shallower, the body uses secondary the cardiovascular system?
respiratory muscles more than the diaphragm. a) The heart
It may negatively impact posture. This may also b) Blood
cause excessive muscular tension which results c) Blood vessels
in light-headedness, headaches and dizziness. d) Lungs
Short shallow breaths can also lead to altered 2. What are the three functions of the nervous
carbon dioxide and oxygen blood content. system? _______________________________________
It may cause feelings of anxiety. Inadequate ________________________________________________
oxygen which causes retention of metabolic ________________________________________________
20
3. The sensory neurons transmit nerve 9. Which of the following is NOT an organ or
impulses to which structures? tissue required to work intensely during a
a) Other neurons workout?
b) The brain a) Heart
c) The spinal cord b) Lungs
d) The brain and the spinal cord c) Muscle
4. One of the main purposes of exercise is to d) None of the above
exert the cardiovascular and respiratory 10. A personal trainer can cause a client injury
systems. True or False?______________________ with an inappropriate workout if the trainer
5. What are the three systems that are collectively is not aware of how the body works. True or
referred to as the kinetic chain?____________ False?_________________________________________
________________________________________________
Answers:
________________________________________________
1. d) Lungs.
6. Is the oxidative system for producing aerobic
2. 1) To gather information about our inner and
energy or anaerobic energy?________________
external surroundings (sensory function),
________________________________________________
2) to process and interpret the information
________________________________________________
(integrative function) and 3) to respond to
7. Which energy system is needed for running
these stimuli (motor function).
up a 100-yard hill as fast as possible?
3. d) The brain and the spinal cord.
a) Oxidative system
4. True.
b) ATP-CP system
5. The muscular, articular and neural systems.
c) Anaerobic Glycolysis/lactic acid system
6. Aerobic energy.
8. What is the function of the ATP-CP system?
7. b) The ATP-CP system.
a) To provide energy all the time
8. c) To provide energy for high intensity short
b) To provide energy for low intensity long
workouts.
workouts
9. d) None of the above.
c) To provide energy for high intensity
10. True.
short workouts
d) All of the above
21
Santana-Sosa E, Barriopedro MI, López-Mojares
References
LM, Pérez M, Lucia A. Exercise Training
Blumenthal JA, Babyak MA, Carney RM, Huber M,
is Beneficial for Alzheimer’s Patients.
Saab PG, Burg MM, Sheps D, Powell L, Taylor
International Journal of Sports Medicine.
CB, Kaufmann PG. Exercise, depression and
2008; 29(10):845-50.
mortality after myocardial infarction in the
Takahashi T, Arai Y, Hara M, Ohshima K, Koya S,
ENRICHED trial. Medicine and Science in
Yamanishi T. Effects of resistance training on
Sports and Exercise. 2004;36(5):746-55.
physical fitness, muscle strength and natural
Kai MC, Anderson M, Lau EM. Exercise
killer cell activity in female university
interventions: defusing the world’s
students. Japanese Journal of Hygiene.
osteoporosis time bomb. Bulletin of the World
2008;63(3):642-50.
Health Organization. 2003;81(11):827-30.
Yang N, MacArthur DG, Gulbin JP, Hahn AG,
Lange-Asschenfeldt C, Kojda G. Alzheimer’s
Beggs AH, Easteal S, North K. ACTN3
disease, cerebrovascular dysfunction and the
Genotype is Associated with Human Elite
benefits of exercise: from vessels to neurons.
Athletic Performance. Am J Hum Genet.
Experimental Gerontology. 2008;43(6):499-
2003;73(3):627-31.
504.
Rogers CJ, Zaharoff DA, Hance KW, Perkins SN,
Hursting SD, Schlom J, Greiner JW. Exercise
enhances vaccine-induced antigen-specific T
cell responses. Vaccine. 2008;26(42):5407-
15.
22
Chapter 2: Biomechanics
Topics Covered
What Is Biomechanics?
The Importance of Biomechanics
Biomechanics and Exercise
Warm-Up
Cool-Down
Motion and Kinematics
Forces
Internal Forces
External Forces
Inertia
Stability of Equilibrium
Anatomic Locations
Planes of Motion
Range of Motion
Muscle Actions
Modes of Muscle Strength
Motor Control
Proprioception
Motor Learning
science of deformable-body mechanics would
M
What Is Biomechanics?
look at the effect of external forces on tissues
echanics is the science
and organ systems. As the name suggests, fluid
studying the motion of objects
mechanics deals with the forces of fluids on and
and the forces that cause the
within the body such as blood flowing past heart
motion. Mechanics is often
valves and the effects of swimming on the body.
divided into three main areas including rigid
The study of biomechanics is relatively new to
body mechanics, deformable-body mechanics
the field of science and medicine. Biomechanics
and fluid mechanics. In rigid-body mechanics,
is the use of engineering principles, such as fluid
the object in question is treated as rigid and the
mechanics and thermodynamics, and applying
forces that act on the object are studied. In other
them to biological organisms. Biomechanics
words, the object does not deform by bending,
also incorporates mathematics
stretching or condensing.
and therefore mathematical
Rigid-body mechanics is often
concepts like calculus and
subdivided into the study of
vector algebra. These physical
statics and dynamics. Statics is
and mathematical principles
the mechanics of objects at rest
are applied to the conception,
or moving at an unchanging
design, development and
velocity. On the contrary, the
analysis of equipment and
mechanics of dynamics looks at
systems in biology. Therefore,
objects that are in accelerated
biomechanics is simply
motion.
the mechanics of tissues, joints and human
Segments of the body are often considered
movement. As a study on how the body moves
rigid elements, linked by bendable joints but
much like a machine, with principles of physics
this is not truly the case. Deformable-body
intertwined, biomechanics includes how “living
mechanics and fluid mechanics are more
forces interact within a living body.” Research
applicable to dynamic biological systems. How
in sports biomechanics may take the form of
forces are distributed within an object at the
describing movement for the enhancement
lowest levels encompasses deformable-body
of performance. Biomechanics is also often
mechanics. So if the object is the body, the
applied to sports medicine in the prevention of
24
sports-related injuries. To accomplish pressurized and that pressure can
this, computer modeling simulation of become elevated. This can then lead to
the body is used to aid in the study of damage of the optic nerve and eventual
biomechanics. blindness if left untreated. On the other
hand, the study of biomechanics can

The Importance of Biomechanics
help in the design of implants and prosthetic
Virtually all modern advancements of
devices that have mechanical function like
medical science and technology have involved
artificial hips and hearts used in transplantation
biomechanics. Because of this, biomechanics is
to correct biological dysfunctions.
thought to have made significant contributions
to the health sciences. Developments in the
field of biomechanics have improved our
understanding of normal and malignant tissue
abnormalities, the mechanics of neuromuscular
control, and the mechanics of lung and
cardiovascular function.
Biomechanics plays an important role in
growth, development, tissue remodeling and
physiological homeostasis. Molecular biology

One of the ultimate goals of biomechanics as it
deals heavily with the formation, design,
relates to exercise and sports is the improvement
function and production of molecules, which are
of performance. The most common way to
all biomechanical characteristics. For example,
improve performance is to develop training
mechanical forces stimulate bone growth and
techniques. Biomechanics is most useful when
determine how big and strong bones need to be
the dominant factor has to do with the action
to carry weight. Biomechanics also plays a role
of movements and not physical structure or
in some disease states by either being involved
physiological capacity. Using biomechanics to
in the onset of disease or being used to treat
improve performance may be accomplished
the diseases or other illnesses. For example,
in several ways. A trainer or coach may use
biomechanical principles are involved in the
biomechanics to correct skeletal or joint action
ocular disease glaucoma. The eye is internally
to improve skill. In addition, a biomechanical
25
researcher may discover new an injury and thus how to prevent
techniques that can be used to this injury from reoccurring.
perform skills. Furthermore, figuring out what
Biomechanics may also prove to exercises aid the rehabilitation
be useful in improving the design process after an injury may also
of sports equipment. An example of be possible through biomechanics.
this is the production of lighter and This is directly related to improving
more aerodynamic javelins or tennis racquets. athletic performance since the development of
Additionally, biomechanics has the potential to new techniques and equipment that prevent and
lead to improvements in athletic performance treat injuries are essential. Determining how to
through advanced strength training. decrease the impact of forces for a gymnast’s
Biomechanical analysis can uncover technique landing or creating shoes that are not stiff for
deficiencies and identify the type of training runners are also examples of how biomechanics
that a person requires in order to correct such can reduce injuries.
problems. For example,

Biomechanics and Exercise
a person may lack
Understanding how the body works when it
strength and endurance
moves in a certain way or with certain intensity
in certain muscle groups
is possible by studying a never-ending circle
or in their speed of
called the “human movement efficiency” circle.
movement. Knowledge
Regardless of “how” energy is used, biomechanics
of the biomechanical
also involves the “where” of energy usage and
properties of muscle
how that energy intermingles with the realm
groups and movement Warm-up exercises for 5
to 10 minutes gently get of physics, such as motion through skeletal
can allow trainers and the blood circulating.
muscles.
coaches to easily detect setbacks and
In general, muscles
adjust training regimens accordingly.
are composed of
Other goals of exercise and sport
millions of fibers, which
biomechanics include injury prevention
need to be warmed
and rehabilitation. Biomechanics can be
Cool-down exercises slow the heart up and cooled down
useful in determining what forces caused rate and stretch warm muscles.
26
to prevent muscle damage. These fibers are A proper warm-up raises the body temperature,
wrapped by fascia, or connective tissue, called which is beneficial because blood cells release
endomysium. Endomysium forms bundles that oxygen more rapidly at higher temperatures.
are surrounded by another layer of tissue called This leads to increased utilization of oxygen for
the perimysium. The perimysium is covered the muscles.
by a fibrous facial layer, named the epimysium.
This layer of tissue extends from the tendons
that connect bones to muscles. Moreover, the
area where the muscle attaches to a moveable
skeletal structure (e.g., elbow) is called the
insertion. An origin is defined as the area of the
body where tendons attach to immobile skeletal
structures.
It is well known that muscles

Blood cells release oxygen more Low Intensity Exercise Chart—
need oxygen, but it must be
rapidly at higher temperatures. Effects of warm-up exercise on
noted that special mechanics
oxygen-independent ATP re-
are involved in the process that enables muscles
synthesis and the oxygen deficit. Shown is ATP
to attain oxygen. More detailed components
re-synthesis from oxygen-independent routes
of muscle structure, its relation to the nervous
following 1 minute of moderate-intensity exercise
system, and how muscle structure stimulates
(75% of VO2max) and the calculated oxygen
motion are also factors for both anatomy and
deficit over the same period in individuals (n=6)
biomechanics.
who had performed 10 minutes of low-intensity
Warm-Up exercise (55% of VO2max) and 3 minutes of
Like many machines, the human body must passive recovery before the moderate-intensity
also warm up before sharply accelerating. There exercise (), compared with values obtained in
are typically five biomechanical benefits of the absence of prior low-intensity exercise ()
warming up. Cardiorespiratory enhancements Secondly, blood flow to active muscles
are the first benefit of a good warm-up because it increases during a warm-up and prevents
leads to less stress on a client’s lungs and heart. premature fatigue during the workout, not
27
to mention lactic acid buildup. Lactic acid is which make up muscle fibers, to move more
produced in muscle tissue during exercise, freely and allow muscles to contract with less
but causes muscle fatigue and cramps when resistance. Besides the muscular benefits, joints
large amounts accumulate. The steady flow of are lubricated during warm-ups and allow
blood to active muscles is due to vasodilatation, movements to be carried out easily.
which is an increase in the diameter of blood Fourthly, warming up enhances motor skills
vessels in order to accelerate the passage of and brain transmissions for continuous activity.
blood. Exercising and warming up leads to an With nervous impulses moving faster, muscle
increase in the body’s core temperature. This movements are made with more ease. Lastly,
increase in temperature causes large amounts symptoms of stress, pain or any discomfort
of blood to circulate within the body quickly. felt by the client from the skeletal muscles or
Increased blood flow means With an increased temperature, cardiovascular systems are
more oxygen is available to muscles become “stretchy” or more increased. Ironically, this
flexible, which makes it more difficult
tissues. In addition, proper to tear muscle fibers and decreases can be beneficial to physical
the occurrence of injuries.
blood circulation hinders training. If these symptoms
the accumulation of lactic acid, promotes occur during or toward the end of a workout,
the removal of metabolic by-products, and they can be taken as normal signs of fatigue.
stimulates the release of nutrient-filled fuel for In such cases, the trainer can assume that the
active muscles. current routine will not irritate any current
Thirdly, as mentioned before, a heightened bodily ailments and should be continued.
body temperature can be biologically beneficial. However, if bodily ailments present themselves
For instance, less muscle injuries occur when after a workout as a result of excessive
the body temperature rises in response to movement and weight training, then the client
warming up or exercising. With an increased will not benefit from the regimen and a different
temperature, muscles become “stretchy” or workout routine should be designed.
more flexible, which makes it more difficult to

Cool-Down
tear muscle fibers and decreases the occurrence
Just as a warm-up is crucial to any physical
of injuries. Additionally, the fluidity of muscle
activity, a “cool-down” is just as important.
fluids increases as body temperature elevates.
There are explicitly four reasons why this
This allows proteins such as actin and myosin,
28
is the case. The first reason is that cooling they will tear. A sudden increase or decrease in
down delays the onset of muscle soreness temperature will also cause similar tearing, so
after activity by reducing lactic acid buildup. the cool-down period allows the temperature to
Although the majority of muscle soreness is decrease slowly.
caused by irritated muscle tissue Fourthly, excess adrenaline
fibers from the activity itself, it Cooling down can keep muscle released during exercise can be
fibers warm for a lengthened
has been proven that lactic acid amount of time because muscle used up during the cool-down
fibers are gently stretched
can induce further irritation. after the workout. period. When blood carries
Secondly, if an exercise is unused adrenaline, the heart
stopped abruptly without a proper cool-down becomes stressed. By cooling down, a client’s
period, blood pools in the lower extremities body will not be as physically stressed after a
or limbs, a phenomenon known as venous workout. Until now, through understanding
pool. When this happens, blood supply to the biomechanics, many physical trainers
heart is compromised. Moreover, the heart is understood how to turn a client’s engine “on”
still pumping hard from the activity that was and “off”. However, now biomechanics can also
being performed. When both situations occur help trainers understand how to keep the engine
simultaneously, the heart is in dire need of in good condition when it is on and off.
oxygen, but is not be able to attain adequate

Motion and Kinematics
quantities of oxygenated blood because blood
Completely understanding the
has begun to accumulate in the
human body and the energy used
lower limbs. This leads to dizziness
in movement is the key to proper
and possibly fainting.
physical training and the improvement
Thirdly, consistent with
of fitness. In the field of mechanics, the
minimizing muscle soreness,
analysis of motion has physical as well
cooling down can keep muscle
as geometric (mathematic) properties.
fibers warm for a lengthened
The physical aspects primarily deal
amount of time because muscle
with the forces involved in movement
fibers are gently stretched after
and activity. These forces, both internal
the workout. The warmer the
and external, act on different points
tissue fibers are, the less likely
29
on the body and influence specific motion. is moved. Similar to rearrangement, speed can
Geometrical (mathematical) descriptions of be averaged as linear speed or angular speed.
motion involve location and orientation. Lastly, acceleration measures how quickly speed
The study of human motion itself is often has changed. Linear acceleration measures the
referred to as kinematics. Kinematics also change in linear speed (in a straight line) and
describes and analyzes motion without angular acceleration notes the change in angular
reference to mass, force or other circumstances speed (e.g., a circular movement). Virtually all
leading to motion. Kinematics involves five body movements involve acceleration. During
primary variables including the timing of running and jumping, the arms and legs are
movement, positioning, rearrangement, speed constantly accelerating rather than maintaining
and acceleration. a constant rate of motion.
Timing provides a measurement of how Judgments regarding normal and abnormal
long a movement lasts. This variable becomes motion also use kinematics. Geometrical
important when determining the mechanical (mathematical) parameters like length,
response to internal and external forces on rearrangement and angle can be used to
the body. The position of the body during the evaluate, for instance, a person’s walking
movement determines patterns. In this case,
the likelihood of an injury kinematics can be used on
occurring. For instance, each body segment or on
forces acting on a hyper- the body as a whole. The
extended (straight) arm use of kinematics can then
will be different from the be helpful in diagnosing
forces acting on a flexed locomotor problems and
(bent) arm. In terms of deciding which treatment
rearrangement, linear rearrangement measures regimens and movement therapy would be
the movement from one location to another, most beneficial.
typically in a straight line, while angular

Forces
rearrangement involves the rotation of the
Mechanics deals a lot with energy, such as
body. Related to this variable is speed (velocity)
where it goes and how it is used. Most of the
or the measure of how fast a part of the body
30
dynamic forces involved in being studied. The force acts
biomechanics and around on different parts of the body
any living system are kinetic but does not necessarily affect
energy. Kinetic energy is the the motion of the whole body.
energy of motion. This area of For example, muscles pull on
kinetics studies the relationship tendons which conversely pull
between an object’s movement and what caused on bones. The pulling force that acts on an
it. For example, when there is extra energy internal structure is called a tensile force. The
associated with an object like a ball that is structure being acted on is said to be under
tossed, the ball will move in a certain direction.
The energy used to move the ball is a form of
kinetic energy. In terms of biological systems,
kinetics examines the energy that causes the
body to move. The size of the force is directly
related to the weight of the object and how its
motion will change. Additionally, just as force
is required to start motion, it is also needed to

tension. The pushing forces are referred to as
stop motion.
compressive forces, which are forces that press
In simple terms, a force is a push or pull on an
objects together. In this case, the structure being
object. Force can cause an object to start, stop,
acted upon is under compression. In situations
move faster or slower or change directions in
where the tensile or compressive force is
movement. A force always exists between two
greater than what the object can withstand, the
objects whenever an interaction is initiated.
structure fails and can break. When this occurs
Forces can be classified as internal and external,
in the body, muscles, joints,
depending on the source of the
ligaments and bones can be
force.
damaged. Knowledge of internal
Internal Forces forces that can affect the body
Internal forces act within when it is in motion is important
the object (e.g., the body) for the prevention of injury.
31
Muscles are often thought of as the structures Inertia
that produce the force in the body that leads to Inertia is the property of an object to resist
motion. This is mainly because muscles produce changes in its motion. This outlines an important
motion in the limbs of the body. However, relationship between force and motion. A
muscles only produce internal movements more detailed explanation of inertia is given in
(forces) and are incapable of Newton’s first law of motion.

Pushing on a weight machine is an
producing changes in motion example of an external force. This law states that “a body
without external forces that Magnetic, electrical and gravitational which is at rest will remain
forces are all non-contact forces.
act on the body. In other at rest unless some external
words, the body can only cause changes in force is applied to it, and a body which is
motion if it pushes or pulls against an external moving at a constant speed in a straight line will
force. continue to do so unless some external force is
applied to it.” In other words, static objects have

External Forces
to be pushed or pulled to be moved. However, it
External forces on an object are due to the
influence of the surrounding environment.
External forces can either be contact forces,
which occur when objects physically touch
each other, or non-contact forces, forces
between objects that are not touching. The
most common forces are contact forces.
Pushing on a weight machine is an example
of an external force. Magnetic, electrical
and gravitational forces are all non-contact is thought that when an object is pushed across
forces. Friction, another non-contact external a floor it would eventually come to a stop. The
force, is an important force in every movement. object stops when the force is removed because
Basic activities like walking or jogging require there is also an opposite force on the object
frictional forces. For instance, shoes provide the (e.g., gravity or friction). The opposite force
proper frictional force between the surface of is primarily due to friction between the two
the feet and the ground or floor. surfaces.
32
Friction is defined as the resistance between of the body. The mass and inertia (resistance) of
two surfaces that are in contact with one the equipment and the body will determine the
another. When friction is reduced, possibly effort that is required to get the object moving
through the polishing of the surface, the pushed or stop the object from moving.
object has the potential to travel farther along

Stability of Equilibrium
the surface. The second part of the theory of
When the body is at rest or moving at a constant
inertia demonstrates a situation where there is
speed, the body is said to be in equilibrium.
no resistance due to friction or air resistance.
The major characteristic of equilibrium is that
In this case, the object will continue to move
the overall force on the body in all
if it does not come in contact with
directions is zero. This means that
another object or if the surface is
the rightward forces on the object are
never-ending.
balanced by the leftward forces and
Intuitively, heavier objects have
the upward forces are balanced by the
more inertia (resistance) than lighter
downward forces.
objects. However, the measure of
There are three types of equilibrium for an
inertia is not weight but rather mass. Weight
object depending on the stability of the body.
is the measure of the force of gravity acting
These classes are stable equilibrium, unstable
on an object. Mass is defined as the amount of
equilibrium and neutral equilibrium. For stable
matter in an object (an object’s composition)
equilibrium to occur, a slight disturbance must
and corresponds more closely to inertia. In
generate a force that restores the object to its
situations where gravity is negligible, the weight
equilibrium position. When a
of someone or something
The major characteristic of force causes an object to move
would change but not the equilibrium is that the overall force
on the body in all directions is zero. away from its equilibrium,
mass. For example, in space,
it is known as unstable
gravity does not pull objects down so objects
equilibrium. Neutral equilibrium occurs when
float and appear to be weightless. However,
there are no forces acting on an object.
in reality the object’s composition has not
Many everyday objects are constantly in a state
changed. This becomes important in sports
of equilibrium because of friction. An object may
and exercise when a person has to change the
rely on the friction of a surface to prevent it from
motion of a piece of exercise equipment or parts
33
moving. If the surface that the object was on was deal with body posture and alignment. When
frictionless, even the smallest force would cause it comes to body posture, anatomical (bodily)
a large object to slide in a particular direction. positions refer to reference points. Often times
The two important aspects of equilibrium it is important to be able to identify relative
in the human body are intrinsic (inward) and locations on the body and be able to access
extrinsic (outward) stability. For intrinsic these points on other people.
stability to occur, the segments of the body need Anatomical (bodily) locations relate the
to be balanced. The body has intrinsic muscular regions and specific arrangement of different
actions that control and body parts to the actual
stabilize an erect human position of the body.
body around the joints of Such reference points are
the spine and the limbs. This meant to expose special
stability requires a constant, relationships between how
conscious state that is bones, muscles and joints
controlled by the brain and are configured. Universally,
spinal cord (central nervous the most common position
system). The stability of the of reference is known as
whole body, with respect the basic anatomic position.
to objects that are supporting it, is extrinsic This is when one is standing facing forward with
stability. For example, a person standing on feet together and hands at the side. The feet and
the ground uses the ground to support the palms of the hands are also faced forward.
body, similar to a chair that a person may be Anatomical locations include the superior
occupying. (upper), inferior (lower), proximal (toward
center), distal (away from center), anterior

Anatomic Locations
(front), posterior (back), medial (middle),
Biomechanics involves another field
lateral (side), contralateral (opposite side) and
called kinesiology. Kinesiology emphasizes
ipsilateral (same side) positions. Superior refers
biomechanics when it comes to the muscular
to the upper parts of the body and inferior the
and skeletal system, not to mention the joints.
lower parts. For example, the knee is said to be
Physical trainers commonly use kinesiology to
superior to the ankle and the hand is inferior to
34
the shoulder. The area close to the center of the (body positions) applies the knowledge of axes
body or midline is known as proximal. Distal is rotation and muscle position to determine
the position farthest from the center. The front of which muscles may contribute to motion in a
the body is the anterior side and the back of the particular direction. Knowledge of how the body
body is the posterior side. Medial refers to the moves in relation to its spine, muscles and joints
middle of the body or the point where the body can help a trainer design routines that will be
can be divided into two halves. Lateral refers to beneficial for the client. Motion at the joints in
one side of the body. The right foot is said to be a particular direction often occurs by rotating
contralateral to the left foot; however, the right the joint approximately 90° or in other words,
foot is ipsilateral to up and down. This action is called joint
the right hand. motion, another understanding of how a
Some people have client’s body moves and works.
common natural Both kinesiology and biomechanics lead
body positions that to the understanding
cannot conform to of planes of motion. In
the basic anatomic this case plane means
position. One of direction. The planes of
these conditions is known as valgus or the motion refer to the three
outward curve of a limb. Conversely, there basic imaginary planes
is varus or the inward curving of a body part. that meet at one point
Simply stated, these anatomical conditions are in the body. Though
referred to as being “bowlegged” and “knock- motion is said to occur in a specific plane,
kneed,” respectively. motion does not strictly occur in one plane of
motion, but rather in multiple

Planes of Motion
planes. These planes include
Human movement in the
the sagittal plane, frontal plane
three dimensions is based
and the traverse plane. The
on a system of planes (flat
sagittal plane divides the body
surfaces) and axes (e.g., the
into the right and left sides. The
spine). Functional anatomy
frontal plane, also known as the
35
coronal plane, separates the body into front and to the trunk, the flexing of the spine, and
back sections. Lastly, the upper and lower areas ankle and foot flexing, as well as abduction
of the body are designated by the traverse plane. and adduction. Abduction simply refers to a
The sagittal plane separates a sideways movement of a limb away from the
client’s body into a right side and body, whereas adduction is the movement
a left side. This plane is used to that returns the limb to its original position.
perform most activities because it Hyperabduction and hyperadduction are
permits the flexing and extending movements that push limbs beyond their limits.
of muscles. Flexing basically means This is usually when injuries occur. Side lunges
“the bending of” and extensions and side lateral raises are examples of frontal
are the “straightening of.” Flexing plane movements.
is movement toward the middle of the body Lastly, the transverse plane
that decreases the angle between the two separates the body into an
moving segments of the body. This movement “upper” and “lower” half. This
is typically directed toward the upper parts of plane is considered rotational
the body such as the head, neck, trunk, upper motion. Because this plane
extremities and hips. Movements of the lower stresses movement along
extremities such as the knees, ankles and toes a vertical axis (the spine),
also move along the sagittal plane. Injuries often internal and external rotations occur. Movements
occur when joints and muscles are improperly of the leg or arm in a horizontal direction
flexed or overextended. Hyperflexion refers to are most common for this plane of motion.
flexing a part of the body too hard or beyond its Examples of this motion include throwing a ball,
normal limits. Extending a body swinging a bat and golfing. The foot is unique
part beyond its normal range is in that it has transverse plane abduction and
known as hyperextension. adduction. When the toes are pointed outward
The frontal plane involves and the foot is rotated outward, this motion is
movements from the front and termed abduction. Pointing the toes inward and
back of the body. Movements rotating the foot inward is termed adduction.
include those that are related
36
depending on the reference point. A positive
Range of Motion
rotation is in a counterclockwise direction while
Range of Motion (ROM) is a measure of the
a negative rotation is in a clockwise direction.
body’s flexibility by observing the number
For example, spinning a basketball
of degrees the body can move
on a finger is a rotating motion.
through a set of neutral positions
In terms of joint movement, the
and exercises. The anatomical
pivot point is the point around
reference position aids in accurate
which the joints rotate. The
measurements of the range of
fundamental movements at the
motion. The ROM at the joints is
pivot point are the roll, slide and
often considered since the majority of movement
spin. The majority of the body’s movements are
in the body occurs at the joints. The body as a
due to motions at the pivot points, or junctions,
whole or specific motion at the joints can occur
of the joints. A limited ROM in this area can be
through rearrangement, rotation or by some
caused by muscle weakness, nerve and spinal
combination of the two movements.
damage or even arthritis. Rotation of the trunk,
A motion of the body that moves all points on
or axial rotation, is another common activity of
straight lines over an identical distance is called
linear movement or rearrangement. Simply
stated, rearrangement is a movement of the
body that changes the final position of the body.
For example, when a person throws a baseball,
the body’s position completely changes after
the ball is thrown.
Rotation is different
from rearrangement. It is daily life. Many activities require the rotation of
the movement of an object the trunk through various degrees.
in circles. This movement The difference between rotation and
occurs with a constant angle of rotation around rearrangement is easy to differentiate. When
the center of the body. The rotation has a specific rearrangement occurs, the whole object moves
direction and may be positive or negative, to an entirely new position. When rotation
37
occurs, the object remains in the same place and muscles by the nervous system. This contributes
just moves around a fixed axis. However, as the to overall movement and stabilization. Bodily
body moves, rearrangement and rotation are movements are due to the contraction of skeletal
often combined. A body can begin an action by muscle, force and work generated by the body.
rotating and then start to move along a straight During typical strength training, various
line during the second part of the action. muscle groups contract hundreds of times to
The movement that needs to be carried out move the body. Muscles produce a variety of
determines whether or not the body will rotate actions to manipulate the external forces that
or be rearranged. act on them, such as gravity
Two major terms that define and external resistance. There
motion and describe rotation are three muscle actions:
include pronation (downward concentric muscle actions,
motion) and supination (upward eccentric muscle actions and
motion). These movements isometric (static) muscle
occur in the forearm and the actions. Often, day-to-day tasks
foot. In the hand and forearm, pronation occurs such as walking or jogging cause spur of the
when the palms are rotated in a downward moment actions that are a combination of all
position. The rotation of the foot in a direction three of the muscle actions.
that causes more weight to be supported on the Isometric literally means “same length”
inside of the foot is also pronation. Supination and an isometric muscle action occurs if the
is a rotation that causes the palms measurement of the force acting
to face upward or when the foot is on the muscle is exactly equal
rotated to cause weight to be on to the force of the muscle’s
the outside of the foot. resistance. In other words, the
muscle is exerting a force equal to

Muscle Actions
what is placed on it. In this case,
Overall, biomechanics research
the muscle generates force and
can improve exercise performance
attempts to shorten but cannot
and conditioning of muscles.
overcome the external resistance.
Muscle action is the activation of
38
An isometric muscle action does not cause a any resistance. The force that develops depends on
change in the length of the muscle fiber. However, the muscle tension needed to move the load and
there will be some shortening of elastic structures varies with joint position. This ultimately causes
such as tendons and connective tissue. Because the muscle-tendon unit to shorten. Concentric
there is no overall shortening of the muscle, actions are often referred to as the positive phases
this action is considered to be of repetition or most simply,
a stabilizing contraction. This muscle contractions. An arm curl
type of muscle action allows a with a dumbbell is an example
person to hold a position for a of a concentric muscle action.
relatively long period of time. Most people focus heavily on this
A bodybuilder’s pose is a great example of an muscle action and neglect the others. However, it
isometric contraction. is the combined action of all three contractions
Clinically, isometrics are used during the early that are necessary and important.
phases of rehabilitation when movement has to After an arm curl, the lowering of the dumbbell
be limited to prevent further injury. Isometric causes the muscle to lengthen. This lengthening
training is also important for people participating of an activated muscle is known as an eccentric
in activities that need the static (fixed) muscle muscle action. In this case, the force generated
contraction. Activities like surfing, rock climbing by the muscle is not enough to overcome the
and skiing often require the ability to maintain resistance being placed on it. Eccentric muscle
prolonged static positions. actions are considered to be
Practice in maintaining an muscle actions that generate
isometric hold on a climber’s force continuously during
wall or doing a pull-up can regular body movements. An
maximize isometric strength example of this would be the
training. Relatively very few athletic activities movement of the quadriceps when a person walks
involve isometric muscle actions so isometric down a steep hill. Other examples include when a
strength does not completely predict success in all person sits down on a bench or the action of the
sporting activities. forearm muscles when a ball is thrown.
Concentric muscle action occurs when the force Within the duration of an eccentric (fast twitch)
generated by the muscle is sufficient to overcome contraction, a muscle extends when it is under
39
tension because the opposite force is greater ability to hasten rehabilitation of injured or
than the force produced by the muscle. Instead weak tendons. For example, Achilles tendonitis
of working to pull the joint in the direction of the has been proven to derive therapeutic benefits
muscle contraction, muscles relax the joint at from high load eccentric contractions.
the end of the movement. This allows the joint to There has been much debate over the
be ready to repeat the movement and prevents importance of all three of these muscle
injury. Injuries can happen involuntarily, when contractions in strength training. Research
a person attempts to move objects attempts to determine which muscle
that are too heavy, or voluntarily, contraction leads to significant
when the body can accommodate increases in strength and muscle
the weight that is being lifted. mass. Eccentric and concentric
Eccentric contractions generally muscle contractions have been
happen with any abrupt force found to produce greater force than
in opposition to a concentric isometric muscle contractions and
contraction in order to secure the thus it has been hypothesized that
body’s joints from any damage. these actions are more important.
Virtually any routine movement involves While researchers have found that training
eccentric contractions, which assist in the with a focus on isometric muscle contractions
maintenance of smooth increases muscle strength and
body motions. Eccentric Eccentric and concentric muscle size, this impact has only been
contractions have been found to
contractions can also slow proven with respect to specific
produce greater force than
down rapid muscle movements isometric muscle contractions. joint angles. Isometric training
like a throw or a punch. An can therefore be beneficial, but
aspect of training for these rapid movements, it is important that all three muscle actions be
like pitching a baseball or throwing a boxing included in a workout routine for better muscle
jab, is being able to increase the body’s ability training.
to carry out a movement with much greater

Modes of Muscle Strength
power while being able to stop the movement
Muscle strength is one of the major
on a moment’s notice. Eccentric contractions
components of physical fitness. It refers to the
are still being studied and researched for the
40
maximum amount of force that a muscle can Contraction against a fixed, immovable object
exert or the capacity of a muscle to develop is involved in the isometric mode of muscle
voluntary tension. This tension is often strength testing. As with isometric
used to further increase the strength of muscle action, this is a static (fixed)
muscles. Strength training is often used exercise that occurs when a muscle
for conditioning, reducing fatigue and contracts without an observable
preventing muscle soreness as well as change in length. Although no physical
in instances of rehabilitation of injured work is being performed, this strength
athletes. Increasing aspects of muscle training mode generates a great deal of
strength training have been attributed tension and force. Ideally, muscles that
to high levels of athletic performance. are contracting isometrically can be held against
A common clinical method to determine an object that produces resistance for at least
muscle strength is the manual muscle test six seconds to allow peak tension in the muscle
(MMT), which is used to develop. These exercises are especially
to determine the
capability of muscles °
or groups of muscles
to provide support and
movement. A MMT is also a non-invasive way
to assess physical weakness, faulty posture,
muscle imbalance and sensitivities in the
neuromuscular (nerve and muscle) system.
Almost all modes of muscular strength are
related to each other and are related to various beneficial in the early rehabilitation process
forms of muscle actions. All these modes can be for clients after injury when other modes of
conducted through weight training and exercises strength training maybe too painful.
which use the body weight as resistance. Isotonics are carried out against a constant
Muscular strengthening is usually measured in or even variable force to lengthen or shorten
linear or rotational force and includes isometric, muscles through a specific range of motion.
isokinetic and isotonic modes. Due to this, concentric and eccentric muscle
41
actions are a major part of isotonic strength
Motor Control
training. Isotonic muscle strengthening occurs
The body must be able to exhibit precise
by lifting free weights and through many other
control over its segments. This segmental
basic movements. Other examples of isotonic
control incorporates processes involving all
exercises include hip extensions, hip abductions
components of the nerve, skeletal and muscular
and knee extensions.
systems to produce deliberate and effective
Isokinetics is exercising with a constant
motor responses. Motor control is simply the
resistance and a fixed speed. It can also be
ability to regulate and direct
simply defined as “constant
movement. The concept of
speed”. Isokinetic techniques
motor control addresses how
test joint movement rather
the central nervous system
than a specific muscle group.
(CNS) organizes and controls
Isokinetic actions are performed
the series of individual muscles
on a dynamometer, a device that
and joints. It also explains
accommodates the resistance based
how sensory information from the
on the amount of force produced. This
environment influences movement.
ultimately allows the movement to
Motor control is usually studied in
occur at a constant speed regardless
relation to specific activities and how
of force. The major advantage of
control processes work.
isokinetics over isometric strength
Muscle synergy, sequential
training is that maximum force, called
activation of muscle groups, is one
peak force, is produced throughout
of the most important concepts in
the entire range of motion. Many machines used
motor control. Muscles do not act alone but are
for isokinetic strength training are capable of
recruited by the CNS in groups. In other words,
concentric and eccentric training and achieve
these muscle groups operate as a functional
isokinetic exercise by changing the resistance
unit to become automatic and effortless. The
as the muscle contracts or expands. Due the
term used to define the functional grouping of
limited motility and the narrow bench of these
muscles is synergy.
machines, this mode of exercise may be difficult
initially.
42
These recruited muscle groups transmit movements. In order to accomplish this, sensory
force onto their respective bone based on the cues are obtained from muscular, skin, joint,
particular muscle-bone attachment tendon and ligament tissues. These
sites and the angle of attachment. inputs are then processed as sensory
This ultimately creates movement information (e.g., touch and sight) in
in the joints. Known as a force- the brain and spinal cord to regulate
couple, the sequential action of reflexes and motor control. Though
the muscle is responsible for this the initial sensing of the position
movement. The resultant motion of limbs in space was referred to as
depends on the structure of the joint and the proprioception, the definition of this system has
distinct pull of each muscle involved. been expanded to the interaction between the
sensory pathways and the motor system. The

Proprioception
combination of the sensory and motor system is
Motor control often involves cognition (learning
also known as the sensorimotor system.
and reasoning) and areas of perception known
as proprioception. Proprioception
is being able to sense the location
and position of parts of the body in
relation to each other and the body
as a whole. It is the ability to know if
the body is in motion and, when it is,
where each part is located during the
Proprioceptors, specialized nerve endings, are
located deep within the tissues of muscles, tendons
and joints. These are the nerves that respond to
the subconscious sense of position and movement,
and they also sense tissue deformations. With any
change in tissue pressure or if deformities develop,
these nerves send a signal to the brain and spinal
cord (central nervous system).
43
The two major categories of proprioceptors are system, the inner ear system and the sensory cell
muscle cells, which are located in the belly of the system. Importantly, the sensory cells act as the
muscle, and the tendon cells, which are located transporters of mechanical energy and provide
in the area where muscle fibers attach to tendon a sense of position and conscious awareness by
tissue. Muscle cells relay information directly to initiating reflexes that stabilize joints during a
the spinal cord from muscle fibers. Tendon cells movement. Next, the message is transferred to
monitor the amount of tension in muscle cells that the brain and spinal cord where it is processed
builds during stretching and contracting. at one of three levels of motor control. The first
There are three main groups of proprioceptors
-ligament, joint and skin proprioceptors; neck
and inner ear proprioceptors; and muscle
proprioceptors. Proprioceptors in the skin,
joints and ligaments send signals to the brain
when pressure changes or an injury occurs. The

level of motor control is a fast, reflex response
neck contains an extremely large number of
at the spinal cord level, necessary for protective
proprioceptors that are responsible for stabilizing
reflexive joint stabilization and the prevention of
the head upon the neck and the neck upon the
injuries in the skeletal system. The second level
body. The proprioceptors in the
of motor control involves the
inner ear give the body a sense
lower parts of the brain (e.g.,
of equilibrium or balance. This
brain stem). This part of the brain
is accomplished by nerves that
processes higher commands
measure the movement of fluid
and is involved in the timing
in the ear and send a signal to the
of motor activities, learning of
nervous system that controls the
planned movement and control of prolonged and
head’s position and its ability to move properly.
repetitive movements. Thirdly, processing at the
Through muscle contractions, the muscle
cerebral level controls voluntary motion. Cerebral
proprioceptors are directly involved in human
refers to the two halves of the brain, which are the
posture and movement.
dominant parts of the central nervous system.
When a part of the body is stimulated, the signal
is received at three separate places—the visual
44
The task of defining proprioception has Overall, differences in other aspects of motor
always been controversial; however, there are control between men and women are controversial.
various accepted methods used to assess the

Motor Learning
proprioceptive control of the joints. This includes
Motor learning is incorporating motor control
assessing joint position. In this assessment, the
processes with experiences. The combination of
limb is set at a certain angle. The subject is then
these processes leads to an increase in the ability
asked to recreate this angle. The deviation from
to develop skilled movements. After repeated
the actual angle determines the brain‘’ ability to
experience with a particular motion, one
sense the joint position.
learns to perform the movement
Another method to access
more efficiently. Motor learning
proprioception is the perception of
teaches the body and body parts
passive movement. In this method,
to work correctly and sequentially.
the ability to detect movement of the
Examples of this include throwing
limbs is tested. The subject’s eyes
a ball or climbing trees. Motor
are covered and a limb is placed at a
learning is also critical for the reflex
certain angle. The limb is then slowly
response.
moved and the subject is asked
Storing exercise routines in one’s memory
to indicate when motion is first detected. The
is necessary to develop motor learning skills.
measurement of the distance traveled between the
Feedback (memory) is a circular process in
time motion started and when it was first detected
which the movement of the body is returned
is recorded and assessed. Additional tests include
to the brain for processing. Feedback also uses
reaction time of reflexes and balance assessment
the senses (e.g., sight and sound) to aid in
for postural control.
motor patterns and allows efficient movements
Gender differences in proprioception have also
to be carried out. There are two major forms
been examined. Female athletes are thought to
of feedback – internal feedback and external
have deficits in proprioception, evidenced by a
feedback.
four- to sixfold higher incidence of knee injuries
Internal feedback is also referred to as
compared to their male counterparts. Other
sensory (senses) feedback. This is a process
studies, however, have shown no differences
in which sensory information such as sound is
in aspects of proprioception between genders.
45
used by the body to monitor movement as well an exercise routine. Analyzing the results of an
as the external environment. Information from exercise routine allows the client and trainer
to determine if the regimen is producing the
desired results. All forms of external feedback,
however, allow for the correction of performance
errors and improve efficiency.
posture, external forces and kinematics is used
to guide movement patterns. This is one of the
reasons why it is important to have proper form
when exercising: it ensures that the sensory
feedback is transmitting correct information to
the brain.
External feedback is provided by external
sources such as monitoring equipment, audio/
visual devices, a health care professional or a
personal trainer. External feedback provides Biomechanics is a relatively new field that
information on whether movement patterns includes applying principles of physics to
are correct or incorrect and associates such the human body and biological systems.
movements with internal feelings. External Biomechanics is often used to develop a
feedback can be in the form of processing better understanding of biological processes
physical performance or processing the results and exercise science through the study of
of an exercise routine. Analyzing physical motion, forces and the structure of the body.
performance provides information about the Biomechanics is often a useful tool for physical
quality of the movement. For instance, whether educators and athletic trainers. Applications
or not the body is in the correct position during of biomechanics include performance
46
improvement or the reduction of injuries. Many Muscles may contract concentrically,
aspects of rehabilitation after injury involve eccentrically or isometrically, depending on the
knowledge of biomechanical principles. relationship between forces like tension and
Exercise and sports biomechanics primarily resistance. Muscle actions also differ depending
contain aspects from the branch of mechanics on whether they are dynamic (moving) or
known as rigid-body mechanics. The static (still). Muscles move in functional groups
subdivisions of rigid-body mechanics include known as synergies, the sequential order of
analyzing the body’s movements muscle movements, to produce
mathematically (statistics) and The body is in a constant these distinct contractions.

state of motion that is
forces that cause movement Motor control, involving
controlled subconsciously
(dynamics). Kinematics, the when the body is at rest. the neuromuscular system,
study of the motion in the body, is important in regulating
is a major component of dynamics. Major and directing deliberate movement. The
mechanical concepts used in biomechanics neuromuscular system involves the relationship
include force, mass and inertia (the body’s between muscles and nerves. Proprioception
resistance a change in force). There are both is also essential for sensing the location,
external and internal forces that influence orientation and movement of the body using
motion in general. These forces can be caused internal stimuli. Motor learning allows muscles
by direct contact of another object with the to properly conduct repetitive movements.
body or by forces found in daily life, like gravity
and friction.
The body is in a constant state of motion that
is controlled subconsciously when the body
is at rest. The body is complex and moves in
three dimensions through a system of planes
and axes. This allows the body to create various
movements and attain a wide range of motion.
Joints, in particular, enhance the body’s ability
to carry out specific movements.
47
6. What is the opposite of the motion
Review Questions
pronation (to turn the palms face down)?
1. Which of the following is a not part of the
________________________________________________
study of biomechanics?
________________________________________________
a) Physics; fluid mechanics and
7. What are the three planes of motion that
thermodynamics (the study of energy)
intersect (meet at one point) in the body?
b) Biology; understanding tendons and
________________________________________________
muscles
________________________________________________
c) Mathematics; calculus and algebra
8. Concentric, eccentric and isometric/static are
d) Chemistry; the production of hormones
the names of three major types of what?__
during exercise
________________________________________________
2. Kinematics is the study of
________________________________________________
human motion. True or False?______________
9. How is muscle strength typically
3. What are three of the biomechanical processes
measured?____________________________________
that occur during a warm-up exercise?____
________________________________________________
________________________________________________
________________________________________________
________________________________________________
10. What system of the body plays a role in
4. What are the three groups of
proprioception (perception of an object’s
proprioceptors?______________________________
position)?
________________________________________________
a) Nervous system
________________________________________________
b) Cardiorespiratory system
5. As you walk from one end of the room to
c) Immune system
another, what forces are influencing your
d) Digestive system
movement?
a) Gravity
b) Friction
c) Tension
d) All of the above
48
Answers References
1. d) Chemistry; the production of hormones Bensoussan L, Viton JM, Barotsis N, Delarque
during exercise. A. Evaluation of patients with gait
2. True. abnormalities in physical and rehabilitation
3. Any three of these -1) Cardiorespiratory medicine settings. Journal of Rehabilitation
changes (increased utilization of oxygen Medicine. 2008;40(7):497-507.
by muscles); 2) increased blood flow Blumenthal JA, Babyak MA, Carney RM, Huber M,
to active muscles; 3) increased body Saab PG, Burg MM, Sheps D, Powell L, Taylor
temperature; 4) enhanced motor skills and CB, Kaufmann PG. Exercise, depression and
brain transmissions with nervous impulses mortality after myocardial infarction in the
moving faster; and 5) increased discomfort ENRICHED trial. Medicine and Science in
from muscles and cardiorespiratory system. Sports and Exercise. 2004;36(5):746-55.
4. 1) Ligament, joint and skin proprioceptors; Clark FJ, Grigg P, Chapin JW. The contribution
2) neck and inner ear proprioceptors; and 3) of articular receptors to proprioception
muscle proprioceptors. with the fingers in humans. Journal of
5. d) All of the above. Neurophysiology. 1989;61(1):186-93.
6. Supination. Drury DG. Strength and proprioception.
7. 1) The sagittal plane; 2) the frontal plane; Orthopedic Physical Therapy Clinic.
and 3) the traverse plane. 2000;9(4):549-61.
8. Muscle action. Famuła A, Nowotny-Czupryna O, Brzek
9. The manual muscle test (MMT). A, Nowotny J, Kita B. Telereceptive
10. a) Nervous system. and proprioceptive control of balance
vs. Body stability in elderly people.
Orthopedic Traumatology Rehabilitation.
2008;10(4):379-90.
49
Hewet TE, Paterno MV, Myer GD. Strategies Rossi-Durand C. Proprioception and myoclonus.
for enhancing proprioception and Neurophysiology Clinic. 2006;36(5-6):299-
neuromuscular control of the knee. Clinical 308.
Orthopedic Related Research. 2002;(402):76- Santana-Sosa E, Barriopedro MI, López-Mojares
94. LM, Pérez M, Lucia A. Exercise Training
Kai MC, Anderson M, Lau EM. Exercise is Beneficial for Alzheimer’s Patients.
interventions: defusing the world’s International Journal of Sports Medicine.
osteoporosis time bomb. Bulletin of the World 2008;29(10):845-50.
Health Organization. 2003;81(11):827-30. Stuempfle KJ, Drury DG, Wilson AL. Effect of load
Lange-Asschenfeldt C, Kojda G. Alzheimer’s position on physiological and perceptual
disease, cerebrovascular dysfunction and the responses during load carriage with an
benefits of exercise: from vessels to neurons. internal frame backpack. Ergonomics.
Experimental Gerontology. 2008;43(6):499- 2004;47(7):784-89.
504. Takahashi T, Arai Y, Hara M, Ohshima K, Koya S,
Rogers CJ, Zaharoff DA, Hance KW, Perkins SN, Yamanishi T. Effects of resistance training on
Hursting SD, Schlom J, Greiner JW. Exercise physical fitness, muscle strength and natural
enhances vaccine-induced antigen-specific T killer cell activity in female university
cell responses. Vaccine. 2008;26(42):5407- students. Japanese Journal of Hygiene.
15. 2008;63(3):642-50.
50
Chapter 3: Client Assessment
Topics Covered
The Importance of a Client Assessment
The General History Section of the Initial Client Assessment
Occupation
Lifestyle
The Medical History Section of the Initial Client Assessment

Injuries
Surgeries
Diseases and Medical Conditions
Medications
Using a Questionnaire
Example of Initial Client Assessment Form
The Physical Assessment Section

Pulse
Blood Pressure
Flexibility
Posture
Body Fat
Body Mass Index (BMI)
Step Test
Walk Test
Muscular Performance
How Thorough Should Each Initial Assessment Be?

Personalizing or Designing Custom Test
recording new results can also reveal areas of
The Importance of a Client
weakness that need improvement. Positive
A
Assessment
results on follow-up tests can also be used as a
fitness assessment is an essential
motivational tool.
part of the design of a healthy and
One of the most important
effective fitness
aspects of a fitness assessment
and/or weight
is determining whether the
loss program for individuals.
use of a personal trainer is
Fitness assessments can
necessary. A personal trainer
provide an estimated measure
guides and molds the exercise
of a client’s fitness level by
regimen that is best for a
measuring cardiorespiratory
client. However, in order for a
endurance, muscular
trainer to successfully design
endurance, strength, flexibility
an individualized regimen, it
and body composition. The
is imperative to have accurate and up-to-date
results of an assessment reveal a client’s current
information from an initial fitness assessment.
level of fitness and can be used to tailor an
This initial assessment should be performed
exercise program that fits the client’s specific
prior to the personal trainer’s
needs.
recommendation of an
Trainers should give pre-
exercise routine.. Personal
testing questionnaires that
trainers should also always
include surveys of medical
advise clients to get approval
history as well as current
or a clean bill of health from
lifestyle and fitness activities
their primary care physician
to client’s before assessments.
before starting any exercise program.
These questionnaires help a trainer understand
This chapter will discuss areas covered
a client’s lifestyle and medical history, since
during the overall assessment. The first part
these may significantly affect a client’s exercise
of the assessment usually involves acquiring
program. Once the initial assessment has
information about the client’s general history,
been performed, consistently monitoring and
such as occupation and habits. A personal
52
trainer needs to know if a client sits in front of trainer is to add that special benefit that a client
a computer all day or is constantly on the move. has been missing in order to reach weight-loss
Information like hobbies, regular activities and and/or fitness goals.
nutrition are also evaluated to assess the client’s

The General History Section of
lifestyle. Next, the client’s medical history is
the Initial Client Assessment
recorded, which includes injuries, surgeries,
diseases/conditions and medications. Occupation

In some cases, issues of concern are The first area covered during the initial
revealed during the fitness assessment and client assessment is the client’s occupation.
the personal trainer may need It is important to have an idea of
to ask the client to get medical the client’s daily work routine so
clearance prior to making any that the regimen can be scheduled
exercise recommendations. Once around the client’s current
the assessment is complete, the activities. If the client works 12
personal trainer reviews each hours a day, a personal trainer can
part of the evaluation in order to assume that this person hardly has
design an exercise regimen for the time to eat, let alone work out. In
client that is as compatible with his these cases, the personal trainers
lifestyle as possible. The personal must be creative and help clients
trainer must discuss the assessment with his manage exercise time efficiently. On the other
client and not simply read the responses on the hand, if the client is a stay-at-home parent,
questionnaire. the personal trainer knows this

In some cases, issues of
This chapter will point out concern are revealed during schedule is just as challenging
the fitness assessment.
crucial issues that a personal as that of a 12 hour worker’s but
trainer should recognize during the initial possibly more flexible. Keep in mind that one of
assessment. Asking additional questions can a personal trainer’s tasks is to tailor-make an
reveal details that will ensure the optimum exercise routine that fits a client’s lifestyle.
program design for the client. While it is well Working and daily lifestyle considerations
known that diet and exercise are foundations are also important and should be included in
of healthier lifestyles,, the role of a personal the assessment. For example, the client should
53
discuss whether or not there is time to take increase mental endurance as well as physical
a brisk 20 minute walk during lunchtime. A endurance. The personal trainer should be as
stay-at-home parent may have an elliptical or thorough as possible when collecting the client’s
treadmill in the home or be willing to invest in information during the initial assessment.
one. Some workplaces are equipped with fitness

Lifestyle
centers and this option could be considered in
The lifestyle section of the initial client
developing those clients’ exercise routines. In
assessment is where the trainer gains the most
recent years the rising cost of health insurance
personal information about their client. This
has prompted many employers to allow workout
section of the assessment reveals what the
time or to even pay for memberships at fitness
client does during free time as well as likes
centers. Many people are not aware of all of the
and dislikes. During this part of the
perks offered by their employer-
evaluation, a personal trainer may
generating this awareness can
discover that a client plays a certain
make a personal trainer’s role more
sport occasionally. Sometimes
impactful and the task of developing
people do not consider an occasional
the client’s exercise routine much
sporting activity (e.g., tennis or
easier.
golf) as physical exercise because
Another important detail to be
they do not do it regularly;
discussed is the nature of the
The rising cost of health however, a personal trainer may
client’s work or lifestyle. Factors
insurance has prompted many be able to assist a client in easily
to be noted when tailoring employers to allow workout
time or to even pay for incorporating an occasional
the client’s workout include: memberships at fitness centers.
sporting activity into an exercise
repetitive movements throughout
regimen. A study published in 2007 focused on
the day, the length of time spent standing during
the health benefits of tennis and showed that as
the day and the amount of time spent sitting
little as 30 minutes of moderate tennis playing
each day. Recommending exercises that cause
three times per week led to dramatic overall
the client’s to feel sore and unable to perform
health benefits. If the personal trainer discovers
work duties should be avoided. Knowing how
the client does not have a hobby or activity that
stressful the client’s job is can also help the
requires physical exertion, the personal trainer
personal trainer determine which exercises can
should recommend one for them.
54
Sessions with a personal trainer also provide food restaurants‘ nutritional guides are on the
a positive atmosphere for the client to ease into Internet for downloading. The trainer should
an exercise routine. Small changes to a client’s keep up-to-date with healthy eating guidelines
routine lifestyle can produce great benefits over in order to review them with clients. The trainer
time. One small change easily incorporated into can also suggest that clients take healthy snacks
most lifestyles on a daily basis is taking the to work or on outings instead of being tempted
stairs. Taking the stairs at work or using the by unhealthy snacks in vending machines and
stairs when possible (e.g., in a shopping center) convenience stores.
is a great way to enhance individual effort and Sub-sections in the initial assessment for
increase one’s fitness level. A study published physical activities, hobbies and nutrition let
in 2005 analyzed the effects of the client know the type of

Medical information shared by
stair climbing in a group of non- the client must be protected information the trainer is seeking.
and never shared with anyone.
active women. The women were This also helps the trainer remain
told to start by taking one flight of stairs per organized. Properly evaluating client lifestyles
day for week one and increasing this number enables trainers to design ways in which clients
to five flights a day by week seven. At the end can make small adjustments to daily routines as
of seven weeks, several of the women increased well as adapt to exercise programs that will help
their ability to utilize oxygen, which is a direct them fulfill their fitness goals.
measure of a person’s physical fitness.

The Medical History Section of the
Another aspect of the lifestyle assessment
Initial Client Assessment
is nutrition. This involves analyzing a client’s
For the medical history portion of the
eating habits. The trainer needs to know if the
assessment, the addition of a confidentiality
client typically eats on the run or prepares
clause should help put the client’s mind at ease
homemade meals
when revealing personal information. Medical
and takes time to
information shared by the client must be
sit and eat. Many
protected and never shared with anyone.
working Americans
eat on the run. With that in mind, the personal Injuries

trainer needs to be familiar with types of foods The client needs to disclose detailed
that are healthy for people on the go. Most fast information. Surprisingly, people tend to forget
55
old injuries that the personal trainer left them unable to perform certain
must take into account during the exercises, this is a significant fact
assessment. This is why a one- for the trainer to record. Sometimes
on-one session is better than just surgery can be performed without
reading what your client filled out in causing physical limitations, but the
the questionnaire. individual may have been left with more of a
If there are any new injuries (within the last physiological problem such as becoming short
year) the personal trainer may want the client to of breath easily. No amount of information is too
get a medical release form before beginning an small to note and numerous questions regarding
exercise routine. The trainer also needs to make previous surgeries should be asked. If there is
sure that on-going ailments are a surgical procedure the personal trainer is
considered when designing or not familiar with, it is the personal trainer’s
changing the client’s workout. responsibility to obtain more information
The proper regimen can speed about the procedure before recommending
up the recovery process. The an exercise regimen.
personal trainer must get as

Diseases and Medical
much pertinent information
Conditions
from the client as possible. The
This area of the assessment
initial client assessment is more
covers chronic problems the
than just a formality—it is a
client may have. Conditions such as shin
guide to the trainer’s and client’s
splints, sciatica (lower back pain), arthritis
success.
(inflammation of the joints) and hypertension
Surgeries (high blood pressure) are common ailments.
This section of the initial client If the client has a disease or condition that
assessment is fairly straightforward. In this the personal trainer is not familiar with, the
day and age, many people have had surgical trainer must obtain more information about it.
procedures and a personal trainer needs to Frequently, clients suffer from similar ailments
know about them before recommending an and, if a trainer has already done research on
exercise program. If a person had surgery that a particular condition, this information can
56
be used to help the trainer work quickly and As in the other sections, if the function of a
efficiently with new clients. certain drug is unknown the trainer must look
When clients inform personal trainers that into it. Knowing which drugs cause side effects,
they are suffering from one or more ailments, such as shortness of breath or fatigue, is vital.
trainers can respond accordingly by adding One method of treatment for high-blood
specific stretches that focus on problematic pressure, a common and often chronic problem
areas before and after workouts. Additional among Americans, is the use of diuretics.
exercises, however, should not cause excess Diuretics increase urine production and, by
discomfort. If clients feel that the pain level doing so, they remove excess water from the
experienced after workouts is too severe, they body. This is important for a personal trainer to
are less likely to continue. Knowing which drugs cause know because a client taking this
A diagram of the body can side effects, such as shortness medication will probably sweat
of breath or fatigue, is vital.
also be included with the and urinate more frequently
assessment so that the client than normal. Increased sweating
can clearly identify the source and urinating also increase
of chronic pain or discomfort. the loss of electrolytes, so the
Some people may not be trainer should recommend
familiar with anatomical terms that the client bring not only
and diagrams can aid them in showing trainers water to workout sessions but also fluids for
exactly where the pain is. However, personal replenishing electrolytes, such as Gatorade.
trainers must not diagnose client ailments. If a Knowing the type of medications a client is
client has unresolved issues, the trainer should allergic to is also important, so a section for
recommend that the client see a doctor prior to allergies should be included in the medical
beginning any fitness routine. section of the questionnaire. In addition to
allergies cause by medications, environmental

Medications
allergens need to be discussed. Whether or
This section of the assessment informs
not a person is allergic to bee or wasp stings
the trainer about the medications a client is
is a serious issue and, if so, not only should be
currently taking or has taken in the past, as well
written in the client’s assessment, the trainer
as those that cause the client allergic reactions.
should also know if the client generally carries
57
an Epipen. An Epipen is a self-administered
Example of Initial Client
shot of a hormone called epinephrine, a
Assessment Form
neurotransmitter that increases heart-rate and
Name_____________________________________________
helps open airways. In an emergency, having
DOB______________________________________________
this knowledge could save a client’s life. This Address__________________________________________
type of information can also help a personal ___________________________________________________
trainer decide on a suitable location for a client‘s Home Phone_____________________________________

Cell_______________________________________________
workout. Once again, obtaining as many details
Emergency Contact_____________________________
as possible is of the utmost importance for this
Phone____________________________________________
section of the assessment. General History:
Occupation______________________________________
Using a Questionnaire
___________________________________________________
In order to obtain as much information as Work Conditions (standing, sitting, etc,)______
possible, the personal trainer must be well ___________________________________________________
prepared, organized and extremely detailed How many hours per week do you typically
work?____________________________________________
when performing the initial assessment. Most
What time do you normally have lunch?
people already know that having a proper diet
___________________________________________________
and exercising regularly are among the best How long is your lunch break?_________________
ways to stay fit, but if they have decided to seek Are you opposed to working out at lunch?____
the advice of a personal trainer it is more than Is there a fitness center in your workplace?
___________________________________________________
likely because they feel like they are not reaching
How stressful is your job?______________________
their physical fitness goals. It is the duty of a
Lifestyle
personal trainer to create a specific exercise
Hobbies__________________________________________
regimen that produces the positive results the ___________________________________________________
client is seeking. Below is a guideline that can Physical Activities (softball, tennis, etc.)______
be used to design a questionnaire for the initial ___________________________________________________

___________________________________________________
client assessment.
Nutrition (eat on the go or prepare meals)___
___________________________________________________
58
Medical History: Allergies_________________________________________
Injuries and Dates_______________________________ ___________________________________________________
___________________________________________________ Medications_____________________________________
Surgeries and Dates_____________________________ ___________________________________________________
___________________________________________________
Conditions or Diseases (arthritis, hypertension,
Exercise 1: Go through a client
etc.)_______________________________________________ assessment with a classmate.
___________________________________________________
The ACTION Personal Training System Health Screening
The ACTION PTS Health Screening section is comprised of a series of questionnaires and screenings
that you may use to evaluate your client’s overall health and readiness for exercise.
PAR-Q
The ACTION PTS Online Par-Q will allow you to perform a basic health screening on your client prior to
beginning a physical fitness regimen. The Par-Q is a series of 7 basic health screening questions that
will allow you to assess whether your client needs a medical clearance prior to starting their exercise
59
routine. An answer of ‘yes’ to any of the 7 questions, will halt a client’s progress through the initial
setup and will require the completion of an extra waiver stating that they have received a physician’s
clearance. This should prompt you to send the client to their physician for a medical clearance.
PAR-Q, PARMED-X and PARMED-X for Pregnancy

Printable Forms
There are also several printable versions of the Health
Screening forms including:
PAR-Q — to give you the option of printing the PAR-Q form
to have the client complete and sign it.
PARMED-X — Clients in need of a medical clearance can
be printed a PARMED-X to be taken to their physician for
approval.
PARMED-X for Pregnancy — A client who is pregnant and
who did NOT exercise regularly prior to becoming pregnant
should be sent to their physician with a printed PARMED-X
for Pregnancy.
60
Lifestyle Questionnaire
The Lifestyle Questionnaire is designed to give you background information about your client’s health,
fitness, and nutritional habits. The form has a series of basic questions that you can use to develop
an overall picture of your client’s current health and wellness.
61
Medical Screening
The Medical Screening form provides emergency contact and physician’s information as well as a
more detailed idea of the client’s medical history. The form is broken into sections covering the client’s
General Medical Background, Lifestyle and Dietary Factors, Cardiovascular Screening, Musculoskeletal
Conditions, and Nutritional Information, as well as an area for them to provide any additional
information they see necessary.
62
calculate: count the number of heart beats for
The Physical Assessment Section
10 seconds then multiply by 6. The final number
Once the initial questionnaire is complete,
represents the current heart rate. To determine
a thorough assessment of the client’s physical
the heart rate during
status needs to be performed. This part of the
exercise, the activity
assessment includes several areas such as
should be interrupted and
checking the client’s pulse and blood pressure.
the pulse taken quickly
These vital signs, in addition to other areas of
to acquire the number of
physical fitness, will be discussed in detail in
heart beats per minute
the following sections.
(BPM) accurately. The
Before an assessment
pulse is normally lower
is performed, the client
Pulse taken at when an individual is
should be told to avoid Pulse taken the neck (above).
at the wrist. resting, but it increases
eating or smoking for at
during activity. This is primarily because more
least four hours prior to the assessment. This
oxygen-rich blood is needed during exercise or
is recommended but certainly not required.
other activity.
The client should also avoid performing both
A pulse can usually be felt in any place on the
cardiovascular and weight training exercises
body where an artery can be compressed against
at least 12 hours prior in order for the trainer
a bone, but it is most often located in two areas.
to get an accurate perspective of the client’s
The first site is at the thumb side of the wrist
physical capabilities.
Why do we care?
Pulse Because the pulse can be
used as an advanced warning
Pulse is the frequency of the heart beat. of impending illness. An
Arteries, which are blood vessels that carry increase of 10 BPM or more
from normal rate can indicate
oxygenated blood away from the heart to the health problems.Medications
can also affect one‘s heart rate.
rest of the body, produce a continuous pulse.
Checking the pulse is an easy way to determine right below the base of the thumb (radial pulse).
one’s current heart rate, or the number of The second is on the neck just below the jaw
heartbeats per minute (BPM), and it is easy to along the windpipe and throat (carotid pulse).
63
The tips of both the index and third finger are pressure is highest during activity and falls
used to find the artery and a watch is generally when resting or sleeping. Not only does blood
used to track the time. pressure change throughout the day, it also
Heart rates generally vary from person to responds to changes in emotion, such as feeling
person and also depend on a person’s age. The nervous or fearful.
heart rates of infants and children are higher
than that of adults age 18 and over. The resting
heart rate for an adult is between 60-100 BPM,
with the average heart rate being approximately
70 BPM. The heart rate of a child is normally
70-120 BPM, while an infant’s heart rate can
be typically between 100-160 BPM. Performing

Blood pressure is denoted as a reading of two
exercises that causes the pulse to exceed 85% of
numbers and measured in millimeter mercury
maximum heart rate is not recommended. The
(mmHg). The first number is the systolic
maximum heart rate and the optimal exercise
pressure which indicates the pressure of the
heart rate can be predicted using the following
contracting heart. The second number is the
equation:
diastolic pressure which indicates the pressure
Maximum heart rate = 220 – your age
of the heart when it is relaxing between beats.
Exercise heart rate = Resting heart rate + [0.6
Your systolic pressure is said to be “over” your
x (maximum heart rate-resting heart rate)]
diastolic pressure (i.e., 145/75 or 145 over 75
Exam Alert: mmHg). Normal blood pressure for adults is
What are two ways your
pulse can be taken? considered to be 120 over 80 mmHg, though
there are some considerations to this rule.

Blood Pressure
Medication for high blood pressure, a short-term
Blood pressure is the pressure of the blood
illness or medical conditions such as diabetes
against the walls of the arteries. This is created
and kidney disease can affect blood pressure.
by two forces: the force of the heart pumping
In addition, athletes tend to have lower blood
blood into the arteries throughout the body
pressures. The chart gives an indication of
and the resistance from these arteries. Blood
64
blood pressure ranges and the risk of high blood
Flexibility
pressure:
Flexibility is the ability of the body to adjust
Systolic Diastolic
Blood Pressure Category (First Number) (Second Number)
to various positions and is the key element to
Average <120 <80
Elevated 120-139 80-89 overall physical fitness. It is usually defined
Hypertensive Systolic Diastolic as the range of motion for a given joint and
Phase I 140-159 90-99 the ability of the joint to adapt to changing
Phase II >160 >100
requirements from the body. Usually, the best
The regulation of blood pressure is dependent
way to increase flexibility is through consistent
on two factors. One factor is the amount of blood
training. Flexibility training typically focuses
being pumped by the heart (cardiac output).
on breathing to bring about greater muscle
Why do we care? relaxation and correct body positioning.

High blood pressure carries Warmed-up muscles
with it a risk of heart disease.
are easier to stretch.
The other is resistance to blood flow from the Stretches should be held
arterial wall (peripheral resistance). The reason for 10–60 seconds to
for high blood pressure is an increase in one of guarantee an increase
these factors or a combination of the two. The in flexibility. Increased
brain also regulates blood pressure through the flexibility has benefits
nervous system. The tone of the blood vessels that include improved
is regulated by the sympathetic nervous system circulation, breathing and
which increases blood pressure. Conversely, the coordination, as well as preventing injuries that
parasympathetic nervous system lowers blood may occur during day-to-day activities. Lower
pressure. Both systems are perpetually active back and hamstring flexibility are especially
and they modulate constantly to regulate blood crucial in preventing back pain and lower back
pressure. injuries.
The most common way to test flexibility is by

Exam Alert:
performing a flexibility stretch test or the sit-
How does the body
regulate blood pressure? and-reach test. To perform the stretch test, the
individual sits on the floor with a measuring
65
stick or tape between the legs and then reaches to the nearest half-inch or centimeter and
forward as far as possible. The distance of the compared to a scale.
stretch is measured in inches and evaluated The sit-and-reach test is a reliable measure
based on a comparison to average flexibility of hamstring and lower-back flexibility, which
ratings. The chart on this page shows how can be used to estimate an individual’s overall
different levels of flexibility are rated. level of flexibility. Results may differ depending
The sit-and-reach test utilizes a sit-and-reach on the amount of time the individual spent
box or alternatively, a ruler placed and held warming up before the test was performed. In
between the feet. The subject order to keep data consistent,
sits on the floor, removes shoes testers should ensure that the
and places the sole of each foot same protocol is used for each
against the box approximately test. One advantage to the sit-
shoulder width apart. The and-reach test is the ease with
tester presses both knees against the floor and which it can be used. However, a proper sit-and-
instructs the subject to reach forward as far as reach box may be difficult to obtain and tests
possible along the measuring line. Both palms measured with a ruler would more than likely
should be face down, with one hand placed on be less accurate.
top of the other. The subject is allowed three Flexibility Rating Chart
Performance Males Females
Exceptional 20.5-23 in. 23-24.5 in.

Why do we care?
Inflexibility increases the Excellent 17.5-20 in. 20-22.5 in.
risk of joint and muscle Good 15.5-17 in. 18.5-19.5 in.
injury. Flexible muscles can
Fair 13.5-15 in. 16.5-18 in.
improve athletic performance
Poor 10.5-13 in. 14.5-16 in.
because activities become
easier and less exhausting. Below Poor 7-10 in. 12.5-14 in.
Posture
practice reaches and on the fourth reach, the
Posture involves keeping the body straight and
position is held for a minimum of two seconds
upright while performing daily activities such
and recorded. There should be no jerky
as sitting, walking and sleeping. Bad posture can
movements and the legs should remain flat. In
be developed by sitting for long periods of time,
order to rate the level of flexibility form the sit-
working at the computer for more than eight
and-reach test, the distance reached is recorded
66
hours a day, and standing or driving for a long and keeping the back straight are both important
time. Achieving good posture involves training elements of proper lifting. While standing close
the body to conform to a position that causes to the object, the individual should bend at the
the least amount of strain on the body. Proper knees and hips and then lift upward without
jerking. In addition, supportive footwear can
be worn when standing for prolonged periods
of time or lifting heavy objects. However, shoes
that can affect the body’s center of gravity and
change the alignment of the body should be
avoided.
Body Fat
Body fat is the percentage of fat the body
contains. For example, a 150 pound person
with 10% body fat has 15 pounds of body fat.
The other 135 pounds is lean

posture also involves keeping
Maintaining good posture prevents body mass and a combination
bones and joints aligned and the spine from becoming fixed
in an abnormal position. of bone, muscle, organ tissue,
decreasing unnecessary wear
blood, etc. When a person
and tear on the joints. In addition, maintaining
expresses a desire to lose weight, this usually
good posture prevents the spine from becoming
means a desire to lose body fat. However, a
fixed in an abnormal position. After an individual
small amount of body fat is necessary. This
learns how to correct bad posture, maintaining
small amount of essential fat is needed to help
good posture becomes automatic and requires
regulate body temperature, protect and insulate
little to no effort.
organs and serve as an energy source.
Requirements for good posture include sitting
% of Body Fat
and standing properly with the back straight and
Classification Males Females
the shoulders upright. The body weight should Slim 2-4 10-12
Athletic 6-13 14-20

be evenly distributed on both hips. Lifting objects
Fit 14-17 21-24
correctly is also good for maintaining correct
Average 18-25 25-31
posture. Having firm footing with a wide stance Overweight 25+ 32+
67
A number of tests are used to measure body to determine which people belong to certain
fat. One common method is the pinch test, weight categories (e.g., underweight, average,
which estimates body fat by skinfold thickness. overweight, obese). It is also used to indicate
The skin is pinched at three to nine different whether or not a person has weight-related
anatomical sites on the body such as the tricep, health problems such as heart disease or
bicep, abdominal and thigh. The pinch raises a diabetes. However, additional assessments such
double layer of skin as measuring skinfold thickness, evaluating
and the underlying diet and exercise regimen, measuring blood
adipose (fat) tissue pressure and getting family history are needed
but not the muscle. to determine if a person is at potential risk for
Skinfold calipers are developing weight-related
used to take a reading in millimeters. health problems.
Usually the sum of seven skinfold BMI is calculated in a
readings is calculated. Following is a similar way for adults and
table that rates the sums of several children; however, the
pinch tests. interpretations of the BMI often differ. BMI is

Very Below also dependent on age, race and gender. For
Fitness Good Good Normal Normal Poor
Males 60-80 81-90 91-110 111-150 >150
Average
instance, it is typical for women to have more
Females 70-90 91-100 101-120 121-150 >150
body fat than men. Also, as the body ages, the
Males 40-60 61-80 81-100 101-130 >130
Athlete
Females 50-70 71-85 86-110 111-130 >130 amount of body fat tends to increase. The first
test usually conducted after a BMI evaluation

Body Mass Index (BMI)
is the measurement of an individual’s waist
Units How to Calculate
circumference to determine the amount of
Using kilograms (kg) BMI = weight (kg) / [height (m)]2
and meters (m)
*For height taken in centimeters (cm), dividing abdominal fat. If a person has a relatively high
height in cm by 100 gives height in meters.
Using pounds (lb) BMI = weight (lb) / [height (in)]2 x 703 BMI but a small degree of abdominal fat, the
and inches (in)
person is not considered at risk of developing
Body Mass Index (BMI) provides an indication
health problems. If the BMI calculated for
of what body weight should be according to
an individual falls into the danger zone (e.g.,
height. BMI is considered as an alternative to
overweight or obese) and the person has two
measuring body fat and is used quite often
or more risks factors such as high cholesterol or
68
hypertension, then weight loss is recommended muscle groups for prolonged periods of time
to reduce health problems. at a moderate to high intensity. Lower levels of

Weight in Pounds
120 130 140 150 160 170 180 190 200 210 220 230 240 250
4’6” 29 31 34 36 39 41 43 46 48 51 53 56 58 60
4’8” 27 29 31 34 36 38 40 43 45 47 49 52 54 56
4’10” 25 27 29 31 34 36 38 40 42 44 46 48 50 52
5’0” 23 25 27 29 31 33 35 37 39 41 43 45 47 49
Height in Feet and Inches
5’2” 22 24 26 27 29 31 33 35 37 38 40 42 44 46
5’4” 21 22 24 26 28 29 31 33 34 36 38 40 41 43
5’6” 19 21 23 24 26 27 29 31 32 34 36 37 39 40
5’8” 18 20 21 23 24 26 27 29 30 32 34 35 37 38
cardiorespiratory fitness are associated with
5’10” 17 19 20 22 23 24 26 27 29 30 32 33 35 36
6’0” 16 18 19 20 22 23 24 26 27 28 30 31 33 34 an increased risk of developing cardiovascular
6’2” 15 17 18 19 21 22 23 24 26 27 28 30 31 32
6’4” 15 16 17 18 20 21 22 23 24 26 27 28 29 30 and respiratory diseases that may lead to
6’6” 14 15 16 17 19 20 21 22 23 24 25 27 28 29
premature death. Conversely, higher levels of
6’8” 13 14 15 17 18 19 20 21 22 23 24 25 26 28
Underweight Healthy Weight Overweight Obese cardiorespiratory fitness are associated with a
There are limitations associated with using decreased risk of death due to cardiovascular
BMI to determine ideal body weight and disease, as well as improved quality of sleep and
composition. From a BMI calculation it is not immunity.
clear if an individual’s actual weight has to do The Harvard step test, also known simply
with the amount of fatty tissue or lean muscle as the step test, and the bike test are the two
content. It is also hard to determine whether most commonly used cardiorespiratory and
changes in BMI over time are due to a change endurance tests. The test used in a certain
in fat or muscle content. Athletes typically have facility is based on the equipment available and
high BMIs because of their increased muscle number of people being tested. This step test is
mass and not because of body fat. efficient even when there is minimal equipment
present and can be done in almost any location.

Step Test
This test measures a person’s ability to exercise
The step test is designed to measure
continuously for extended periods of time
cardiovascular endurance and assess overall
without becoming extremely tired.
aerobic capacity. Cardiorespiratory and
The test uses a 12-inch high bench or step
endurance tests measure the ability of the
as the primary tool. The individual steps on
lungs and heart to absorb, transport and utilize
and off the bench or step for 3 minutes. More
oxygen. Fit individuals are able to use larger
69
specifically, the individual should step one foot quickly as possible while maintaining a steady
up and bring the other up, then step down in the walking pace. The test is scored in minutes and
same manner, maintaining a steady pace. After 3 seconds and the heart rate is recorded after
minutes of stepping, the client’s completion of the walk test.

It is important that any
heart rate is checked during what Similar to the step test, an active
participant in this test
is called the recovery period. warms up and stretches for heart rate that is close to the
at least 4-5 minutes.
This just means that the heart normal resting heart rate means
rate is checked about 1 minute after finishing the the individual is in good
exercise and the number is compared to normal shape.
values that have been previously established. This test also provides
The closer the active heart rate is to the normal an estimation of an
resting heart rate, the more fit the individual is. individual’s VO2 max, or
Heart Rates after 3 Minute Step Test (Males)* the maximum oxygen
Age 18-25 26-35 36-45 46-55 56-65 >65
Good to
consumption. In more
<84 <86 <90 <93 <96 <102
Excellent
Average specific terms, VO2 max
to Above 85-100 87-103 91-106 94-112 97-115 103-118
Average
Poor to is an indicator of the maximum amount of oxygen
>101 >104 >107 >113 >116 >119
Fair
Heart Rates after 3 Minute Step Test (Females)* that an individual can take in and utilize during
Age 18-25 26-35 36-45 46-55 56-65 >65 exercise. This value can be calculated using
Good to <93 <94 <96 <101 <103 <105
Excellent the Rockport Fitness Walking Test equation.
Average
to Above 94-110 95-111 97-119 102-124 104-126 106-130
Average VO2 max is measured in milliliters of oxygen
Poor to >111 >112 >120 >125 >127 >131
Fair
*Using a 60 second pulse count consumed per kilogram of body weight per
minute. This value also reflects the physical and

Walk Test
cardiorespiratory endurance of an individual.
Aerobic fitness is a good indicator of overall
Personal trainers often measure the VO2 max
fitness. For the 1 mile walk test, the course
of athletes to determine how much oxygen they
needs to be smooth and flat—ideally a ¼ mile
utilize during their workouts. This is normally
track. It is important that any participant in
done by using the “beep test,” also known as the
this test warms up and stretches for at least 4-5
multi-stage fitness test. This test is commonly
minutes, paying special attention to stretching
used for sports like hockey, soccer, rugby,
the leg muscles. An individual walks 1 mile as
football, cross-country and cricket to measure
70
the cardiorespiratory fitness of athletes. The Time (minutes and seconds) for Walk Test (Females)
Age 20-29 30-39 40-49 50-59 60-69 >70
test consists of an athlete running between two
Excellent <13:12 <13:42 <14:12 <14:42 <15:06 <18:18
points that are 20 meters apart. The running 13:12- 13:42- 14:12- 14:42- 15:06- 18:18-
Good 14:06 14:36 15:06 15:36 16:18 20:00
activity is synchronized to pre-recorded “beeps” 14:07- 14:37- 15:07- 15:37- 16:19- 20:01-
Average 15:06 15:36 16:06 17:00 17:30 21:48
that are played at set intervals. The intervals Fair 15:07- 15:37- 16:07- 17:01- 17:31- 21:49-
16:30 17:00 17:30 18:06 19:12 24:06
become increasingly shorter and the beeps are Poor >16:30 >17:00 >17:30 >18:06 >19:12 >24:06
played faster until the athlete can no longer

Muscular Performance
keep up the pace.
Muscular performance is tested by using
There are currently 23 levels in the beep test,
various forms of fitness and strength training
although some tests may only go up to level 17.
exercises. These exercises include the bench
The beep test is easy to perform as the audio
press, squats, ab crunches, push-ups and sit-ups.
track can be played in mp3 format, which
The bench press evaluates upper body strength
also decreases the risk of malfunctions from
and entails an individual lying on the back,
cassette tapes or compact disks. The beep test
lowering a weight to the chest level, and then
is not recommended for a person just starting
pushing it back up with arms straight and elbows
a fitness program, but would be a good tool
for active individuals interested in developing
higher levels of cardiorespiratory fitness.
Exam Alert:
In terms of fitness, what is VO2
and what does it measure? locked. The push-up
test also evaluates

Time (minutes and seconds) for Walk Test (Males)
muscular strength and
Age 20-29 30-39 40-49 50-59 60-69 >70
Excellent <11:54 <12:24 <12:54 <13:24 <14:06 <15:06 endurance in the upper
11:54- 12:24- 12:54- 13:24- 14:06- 15:06-
Good 13:00 13:30 14:00 14:24 15:12 15:48 body. Men and women usually adapt to different
13:01- 13:31- 14:01- 14:25- 15:13- 15:49-
Average floor positions while doing push-ups. Men are
13:42 14:12 14:42 15:12 16:18 18:48
13:43- 14:13- 14:43- 15:13- 16:19- 18:49-
Fair 14:30 15:00 15:30 16:30 17:18 20:18 typically fully extended with only the hands and
Poor >14:30 >15:00 >15:30 >16:30 >17:18 >20:18
toes in contact with the floor while women often
71
use a modified version of the push-up position 1 Minute Sit-up Test (Males)
Age 18-25 26-35 36-45 46-55 56-65 >65
in which the knees are bent and touch the floor.
Excellent >49 >45 >41 >35 >31 >28
Push-ups are counted until muscle fatigue and Good 39-49 35-45 30-41 25-35 21-31 19-28
exhaustion sets in and then evaluated based on Average 31-38 29-34 23-29 18-24 13-20 11-18
Poor 25-30 22-28 17-22 13-17 9-12 7-10

number accomplished.
Very Poor <25 <22 <17 <13 <9 <7
Push-up Test (Averaged for Males and Females)
Age 17-19 20-29 30-39 40-49 50-59 60-65 1 Minute Sit-up Test (Females)
Excellent >35 >36 >37 >31 >25 >23 Age 18-25 26-35 36-45 46-55 56-65 >65
Good 21-35 23-36 22-37 18-31 15-25 13-23 Excellent >43 >39 >33 >27 >24 >23
Average 6-20 7-22 5-21 4-17 3-14 2-12 Good 33-43 29-39 23-33 18-27 13-24 14-23
Poor 2-5 2-6 1-4 1-3 1-2 1 Average 25-32 21-28 15-22 10-17 7-12 5-13
Very Poor 0-1 0-1 0 0 0 0 Poor 18-24 13-20 7-14 5-9 3-6 2-4
Very Poor <18 <13 <7 <5 <3 <2

The sit-up test, or curl-up test, also evaluates
Squats focus more on strength training of
muscular endurance by testing the strength of
the lower body. The squat test is performed
an individual’s abdominal muscles. Abdominal
by bending the knees and hips, lowering the
strength is important for stabilizing the body
torso between the legs with the glutes near the
and maintaining good posture during exercise.
heels, and standing again to straighten up the
To perform the sit-up test an individual lies
body. This exercise can be done with weights to
on the back with the knees bent. The feet are
enhance muscle strength and development or
pressed to the ground and the hands are resting
without weights.
on the thighs. Next, the individual slightly raises
Squat Test (Males)
the upper body toward the ceiling while keeping Age 18-25 26-35 36-45 46-55 56-65 >65
the lower back pressed against the floor and Excellent >49 >45 >41 >35 >31 >28
Good 39-49 35-45 30-41 25-35 21-31 19-28

then slowly lies back down. It is important not
Average 31-38 29-34 23-29 18-24 13-20 11-18
to lift the torso by pulling the neck and to keep Poor 25-30 22-28 17-22 13-17 9-12 7-10
the lower back on the floor to avoid injuries. Very Poor <25 <22 <17 <13 <9 <7
The number of sit-ups an individual can do in
one minute is counted and compared to average
values.
72
Squat Test (Females) assessments are required for every new
Age 18-25 26-35 36-45 46-55 56-65 >65
client. However, a trainer can decide whether
Excellent >43 >39 >33 >27 >24 >23
Good 33-43 29-39 23-33 18-27 13-24 14-23

a thorough personal and physical assessment
Average 25-32 21-28 15-22 10-17 7-12 5-13 is necessary and right for every client on an
Poor 18-24 13-20 7-14 5-9 3-6 2-4
individual basis. The first step is for the trainer
Very Poor <18 <13 <7 <5 <3 <2
to gather necessary information about the client
Muscular performance tests measure both
through the initial interview and conversation,
muscle endurance and muscle strength. Muscle
in addition to any questionnaires that need to be
endurance is the ability for
filled out. The evaluation and interview, coupled
a muscle or muscle group
with a visual assessment of the client. should in
to exert force repeatedly.
most cases provide the information needed to
Muscle strength is the ability
determine what type of exercise routine is right
for a muscle or muscle group
for that person without having to complete the
to exert maximal force in
full physical assessment. In cases like these, the
a single repetition. Health related benefits of
trainer can also decide whether or not to omit
proper muscle fitness include a better resting
certain parts of the physical assessment.
metabolic rate, which means
Here is an example: John is
muscles burn more fat calories A trainer can decide whether
a thorough personal and a new client in his early 40s
even when an individual is physical assessment is necessary
and right for every client on who describes himself on his
at rest. Healthy muscles also an individual basis.
self-evaluations as a “couch
improve bone mass and glucose
potato” and admits he performs minimal to
(sugar) tolerance. Improving bone mass and
no cardiorespiratory exercises. Visually, he is
tolerance to glucose can decrease the risk of
slightly overweight and he discussed his poor
developing diseases such as osteoporosis and
eating habits during the interview. He decided
Type II Diabetes.
to start a personal training regimen in order to
How Thorough Should Each Initial lose weight and increase his cardiorespiratory
Assessment Be? health. In John’s case, a full physical assessment
After learning the many benefits of conducting would probably not be a good idea because it may
detailed personal and physical assessments, put John under unnecessary stress and pressure
personal trainers may decide that detailed that could discourage him from starting a fitness
73
program. The trainer would not necessarily need Most importantly, the trainer should be sure
the physical assessment to determine John’s not to do any tests that may injure or embarrass
current fitness level and could deduce that John the client. For example, an overweight client may
will need to start at a low intensity because he feel extremely embarrassed if asked to perform
is not currently exercising. In this case, knowing a sit-up test during the initial assessment.
John’s medical history, A client who admits to
family history, height, having a poor fitness level
weight and BMI may may become discouraged
be enough to design an with poor performance
exercise regimen for him. during physical tests. In
In another case, the some cases, the trainer
trainer may have a female may even have a client
client who has an average weight and exercises with pre-existing conditions that may affect
at a moderate level three times a week. She is their physical abilities and certain parts of the
interested in beginning a fitness program that physical assessment may cause them further
will encourage her to exercise more frequently injury. It is best for the trainer to always use his
and produce visible results since she says she judgment and avoid injury and embarrassment
has not seen any improvement in the last few to the client.
months. This client is a good candidate for a

Personalizing or Designing Custom
full physical assessment to determine a starting
Tests
point for her fitness program. Calculating her
Once the trainer has decided that a fitness
BMI, muscle strength and endurance, and
assessment is right for a client, the trainer then
performing at least one cardiorespiratory exam
needs to ascertain which specific tests are going
is a good idea as it allows both the trainer and
to be the most helpful in determining a good
client to discover her strengths and weaknesses.
fitness plan. The trainer also needs to decide
In this case, the trainer may also want to see her
when to perform both the initial assessment and
current exercise routine as she may be exercising
follow-up physical assessment. Some clients,
at an intensity that is too low to achieve results
mainly those with poor fitness levels, may
or performing the exercises incorrectly and
benefit from a few conditioning sessions before
putting herself at a risk for injury.
74
their physical assessment. This may even help current conditions. There may be cases where
reduce the risk of injury and embarrassment, certain tests need to be omitted or modified.
especially in individuals who already exhibit For example, a trainer may have a female
low levels of self-esteem. In addition, the client in her 30s who would like to lose her
client’s current physiological and emotional pregnancy weight. She had a C-section during
state should be considered when a physical delivery and although she has received medical
assessment is scheduled. clearance from her doctor to start an exercise
Let us say the first session with John (40-year- regimen, she has limited flexibility due to her
old male client) consists of a short warm-up, procedure. In this case, a flexibility test such
stretching and a discussion of his expectations as the sit-and-reach test may injure the client
for the program. He mentions if she is forced to stretch beyond

The client’s current
that he has slept poorly the night physiological and emotional her capabilities. Omitting that
state should be considered
before and has not eaten for when a physical assessment test until she begins her exercise
is scheduled.
the day. These factors will more routines and performing different
than likely influence his fitness assessment tests are going to be
assessment results. If he feels like more beneficial for this client.
he did poorly during the warm-up A personal trainer should also
and stretching exercise, he may listen to his client’s long-term
feel less motivated and display goals and expectations. A client
less effort during the physical who wishes to build muscle mass
assessment, which will result in lower scores. and improve overall muscle tone is probably
In John’s case, a fitness assessment one or two going to want muscle strength and endurance to
weeks into his training program may be a better be assessed immediately. Although the trainer
plan. After his initial assessment, a follow- may feel this is initially unnecessary, it may be
up assessment six to eight weeks later will be important to the client especially if the client
sufficient because clients usually show the most wants to set personal goals or know current
significant changes and improvements during fitness levels. A client may also want to avoid
that time frame. cardiorespiratory testing because it is seemingly
The personal trainer should also tailor the type irrelevant to the client’s goals; however, in cases
of tests used according to the client’s needs and like these, it is important for the trainer to
75
explain that cardiorespiratory assessments are The order of the fitness assessment tests is
necessary. On the other hand, some clients may also important. Here is the recommended order:
not even want to know their initial weight or BMI 1. Non-fatiguing tests (height/weight
because they may find it too discouraging. As measurements, skinfolds, vertical and
their trainer, keeping the client’s best interests broad jumps)
in mind is a must and in this situation, the trainer 2. Agility tests
can record the information without revealing it 3. Maximal strength and power tests
to the client. In addition, sometimes omitting a 4. Sprint tests
potentially embarrassing test is a better long- 5. Muscular endurance tests
term choice than performing the test right away 6. Flexibility tests
and deterring the client from returning. Warm-up and cool-down stretching exercises
Follow-up fitness tests can be performed are recommended before and after the
at regular intervals or as little as once every assessment in order to prevent muscle tearing
six months. Some clients will prefer a more and injury.
consistent routine so that they can quantitatively The different tests used to measure similar
track their progress whereas others would aspects are important as well. Beginning clients
prefer to get assessed as infrequently as with lower levels of fitness do not need to perform
possible. The six to eight week follow-up a beep test to measure cardiorespiratory health.
assessment is especially useful Instead they would benefit more

The six to eight week follow-up
to show results to the client. assessment is especially useful from the walking test. This is a
to show results to the client.
However, if the assessments test for less active individuals
are too frequent and show little change, the and basically consists of walking a mile at the
client may get discouraged because results are fastest comfortable pace and recording their
not seen each time. A trainer can avoid these heart rate after the walk. The trainer could then
issues by performing different tests at different calculate the VO2 max with a simple formula.
intervals. Tests like blood pressure or BMI are There are also different kinds of flexibility tests
easy to measure. For comparing results, though, besides the sit-and-reach test. For example, the
it is best to use the same tests in the same order trunk rotation test or groin flexibility test can be
as during previous assessments. used to measure flexibility in patients who have
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a limited range of motion. The most important client’s strengths, weaknesses and pre-existing
points to remember are considering the conditions when choosing the assessment tests.
The ACTION Personal Training System Assessment Tools
The ACTION PTS assessment tools are designed to allow you to establish a baseline starting point
for your clients as well as track their progress over time. The assessment tools can also be used to
effectively help you to build your personal training revenues by showing clients areas that they may
need improvement in and therefore may require your services.
There are 7 different assessment tools available for you to use:
Body Composition
The ACTION PTS Body Composition will allow you to estimate the body fat and lean mass levels of
your clients using a simple method of taking girth measurements. The Body Composition results are
then used to determine caloric consumption values for your clients and may also be re-assessed over
time and the progress recorded and tracked. There are several advantages of using this method of
body composition estimate:
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• Measurements are simple to take and may be done over clothing
• Simple measurements allow for greater consistency even with
different trainers taking measurement samples
• Very unobtrusive and comfortable for the client
• Girth measurement method is extremely reflective of actual results
achieved due to the direct correlation between weight and girth
losses or gains, and body fat changes
• Only equipment required is a tape measure
There are 2 different methods for achieving this estimate:
Method 1: Girth Measurements
By imputing your client’s height and weight, and the girth measurements of their shoulders, navel
(umbilicus), waist, and hips, the software will determine an estimate of their overall lean mass and
body fat values.
The following information will assist you in obtaining accurate measurements and therefore an
accurate body composition. Girth measurements may be taken in inches (in) or centimetres (cm).
Measurements may be done over or under clothing, but will typically be more accurate when done
directly on the skin. If you need to take them over clothing please ensure it is as lightweight as
possible and make sure similar clothing is worn each time measurements are taken.
Site 1 — Shoulders
This measurement is taken 1½“ (4 cm) below the top of the shoulder. Ensure that the client is standing
as upright as possible with the head up and the shoulders drawn back slightly. Where possible, use a
mirror to assist you. Do not pull the measuring tape too tight.
Site 2 — Navel
This site is measured at the exact height of the navel (umbilicus). Ensure that the measuring tape
remains level around the body. Do not pull the measuring tape too tight.
Site 3 — Waist
IMPORTANT — This site is measured at the narrowest point of the torso. For men this will often be just
below the navel (1-2” or 2-5 cm) and for women just above the navel (1-2” or 2-5 cm), but this is not
always the case. Do not pull the measuring tape too tight.
Site 4 — Hips
IMPORTANT — This site is measured at the widest point of the torso. Please ensure that the client’s feet
are together. The widest point of the torso will usually be across the gluteals but may also be slightly
higher or lower. This measurement may or may not be where the actual hip joint is. Remember you
are looking for the widest point. Do not pull the measuring tape too tight.
Method 2: Estimated Girth Measurements Using Clothing Size
You can use a dress size in the case of a female client, or pant and shirt size in the case if a male
client, to estimate their girth measurements, and therefore their body composition. While this method
may not be as accurate as the Girth Measurement method, it may prove to be more practical and
possibly more comfortable for clients that are quite overweight, or are uncomfortable with having
girth measurements done.
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Key Features of the ACTION Body Composition Page
A. Use the drop down to select, view, or edit any previous body composition completed with this
client
Select ‘Add New’ if you want to begin a new body composition – you can change the Assessment
Date using the field to the right if you have taken their measurements and are inputting them
on a different date
Select ‘Edit’ to make changes to any previous body composition
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Use the ‘Delete’ button to remove any previous body composition from the client’s records
Use the ‘Printable Fitness Assessment Page’ link to open a separate window that you may print
with all of the fitness assessment fields to record the data for input later
B. Use the drop downs to select either pounds (lb)or kilograms (kg) for the weight measurement
and inches (in) or centimetres (cm) for the girth measurements.
If you have completed a previous Body Composition with this client, their previous measurements
will be displayed
You can either input the height in feet (ft) and inches (in) on the left, or in total inches on the
right
If you prefer to use clothing size to estimate the girth measurements click the link immediately
below the height measurements to open a new window where you can input clothing size. The
girth measurements will now be estimated by the system
Using the directions outlined above, input the girth measurements for the mandatory fields plus
any optional measurements you would like to track
Once you have completed these steps, press the ‘Calculate’ button and the system will show the
body composition results on the right
You may also view their progress over time in the ‘Progress Tracking’ section of the system
C. You can confirm or make changes to Birthdate, Gender, and Preference information here
D. If you would like to add any notes to be saved with this Body Composition you may do so in the
‘Notes’ field
Once you have completed the Body Composition click ‘Save’ to save the results to the client’s
profile
Cardiovascular Assessment
The ACTION PTS Cardiovascular Assessment will allow
you to determine and record a resting heart rate and
an estimate V02 Maximum value for your clients. These
values can then be re-assessed over time and the progress
recorded and tracked.
You can use the Master Preferences (see Appendix: Admin
Menu: Settings and Tools) to select which cardiovascular
test you would like set as the default, or if there are any
tests you want removed as options to select.
Resting Heart Rate
The Resting heart Rate calculation may be determined in one of two ways:
1. Using the 15 second timer built into the software, simply enter the number of heartbeats that
occur and use the system to calculate the client’s resting heart rate
2. Use any other method you would prefer and enter the actual resting heart rate count
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There are several methods you can use to determine an Estimated V02 Maximum value:
Cooper 12 Minute Distance Test
For this test the object is to walk or run as far as you can in 12 minutes. It is best to use either an
outdoor track of 440 yard (400 meters) length or a treadmill set to a 2% incline. Record the total
distance covered in the 12 minutes. The system will calculate your estimated VO2 Max score
Rockport 1 Mile (1.6 km) Test
The object of this test is to walk or run for 1 mile (1.6 kilometres) and record your time in minutes and
seconds and heart rate at the end. It is best to use either an outdoor track of 440 yard (400 meters)
length or a treadmill set to a 2% incline. Record the total time and heart rate at the end of the test.
The system will calculate your estimated VO2 Max score
Bruce Treadmill Test
For this test you must use a treadmill and adjust the speed and incline according to the chart below.
The object is to keep going for as long as possible. This is an advanced test and should only be
completed by persons with a high fitness level. Record the total time in minutes and seconds at the
end of the test. The system will calculate your estimated VO2 Max score
Minute 00 — 1.7mph — @ 10% Incline
Direct Input Method (Other)
You can use any other method of preferences for determining estimated V02 Maximum and simply
enter the value into the system
Key Features of the ACTION Cardiovascular Assessment Page
A. Use the drop down to select, view, or edit any previous assessment completed with this client.
Select ‘Add New’ if you want to begin a new assessment – you can change the Assessment Date
using the field to the right if you have completed the assessment previously and are inputting
results on a different date.
Select ‘Edit’ to make changes to any previous assessment.
Use the ‘Delete’ button to remove any previous assessment from the client’s records.
B. The diagrams will assist you in finding either the Carotid or Radial pulse.
Use the 15 second timer and enter the number of heartbeats recoded, then click the ‘Calculate
(bpm) from 15 Second Beat Count’ button to have the software calculate the Resting Heart Rate.
Alternatively, you can enter the Resting Heart Rate directly
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C. Select the test you would prefer to use to determine the estimated V02 Maximum value, enter
the appropriate data as outlined in the test description and click ‘Calculate Score’.
The system will calculate the estimated V02 Maximum as well as displaying the Test Type, Rating,
and Average for your Age.
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You can then input a goal for your client and the chart on the right will show a visual representation
of where they are currently relative to their goal.
D. If you would like to add any notes to be saved with this assessment you may do so in the ‘Notes’
field.
Once you have completed the assessment click ‘Save’ to save the results to the client’s profile
Strength Assessment
The ACTION PTS Strength Assessment will allow you to estimate a 1
Repetition Maximum value for each of the major muscle groups by using
a test to exhaustion in a safe range of between 8 and 15 repetitions.
These values can then be re-assessed over time and the progress
recorded and tracked.
For each muscle group that you want to test you will be able to select
from up to 3 different exercises (see Appendix: Admin Menu: Settings
and Tools: Master Preferences for how to select the exercise choices).
Once an exercise is selected, have the client perform a warm up set
at light weight, then after a short rest have them perform 1 set using
a weight that exhausts them between 8 and 15 repetitions. If they are
unable to complete 8 repetitions you will need to reduce the weight, and
if they are able to complete more than 15 repetitions before exhaustion
then you will need to increase the weight.
Core exercises should be done using an isometric exercise and therefore
you will record the time they are able to hold the isometric position. The system will not estimate a
1 Repetition Maximum for core exercises.
Key Features of the ACTION Strength Assessment Page
B. Using the drop downs, select the exercise you would like to use for each muscle group that you
will test. Record the amount of weight used for the test, using the drop down to select between
lbs or kg.
Use the drop down to select the number of repetitions completed to exhaustion. The number of
repetitions must be between 8 and 15.
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Click the ‘Calculate’ button and the system will determine the ‘Calculated Maximum’ and a ‘Goal
Maximum’ for each muscle group tested. The ‘Goal Maximum’ is simply an estimate and you may
over-write this value with one of your choosing
C. The system will display a series of bar graphs displaying a visual representation of the client’s
current 1 repetition maximum score relative to their goal.
D. If you would like to add any notes to be saved with this assessment you may do so in the ‘Notes’
field.
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Ease of Movement Assessment
The ACTION PTS Ease of Movement Assessment is designed to test
for functional range of motion across key joints and to check for even
flexibility on both sides of the body. The goal should be to have ratings
of ‘Good’ for all of the key joints in the body and to have even range of
motion from side to side. Unbalanced range of motion from side to side
can potentially lead to injuries. To perform the tests as accurately as
possible it is suggested that a Goniometer is used to measure the joint
angles for Straight Leg Raise, and Internal and External Hip Rotations.
Straight Leg Raise
The Straight Leg Raise should be performed with the client lying in a
supine position with their arms to their sides. Starting with the right leg,
slowly raise the leg, keeping the knee fully extended, as far as the client
can comfortably go. Slowly lower and then repeat with the same leg. Using a Goniometer, measure
the joint angle at the hip (from the floor where the ankle was when lying supping to the position the
ankle is at the end) and record this value. Repeat with the left leg
Internal Hip Rotation
Begin with the client lying in a supine position with their arms to the sides. Slowly raise the right
leg until it is perpendicular to the floor, bending the knee to a 90 degree angle. Slowly rotate the
ankle away from the midline of the body, which will internally rotate the hip. Go as far as the client
can comfortably move, then return to the start position and repeat with the same leg. Using a
Goniometer, measure the joint angle by placing the Goniometer on the kneecap and measuring the
angle from the midline of the body (original position of the ankle) to the ankle with the hip internally
rotated. Repeat the procedure with the left leg
External Hip Rotation
Begin with the client lying in a supine position with their arms to the sides. Slowly raise the right
leg until it is perpendicular to the floor, bending the knee to a 90 degree angle. Slowly rotate the
ankle across the midline of the body, which will externally rotate the hip. Go as far as the client can
comfortably move, then return to the start position and repeat with the same leg. Using a Goniometer,
measure the joint angle by placing the Goniometer on the kneecap and measuring the angle from
the midline of the body (original position of the ankle) to the ankle with the hip externally rotated.
Repeat the procedure with the left leg
Quadriceps
With the client lying in a prone position, slowly draw the heel of the right leg towards the buttocks,
bending at the knee, as far as the client can comfortably go. Return to the starting position and repeat
with the same leg. Using a measuring tape or ruler, measure the distance between the heel and the
buttock and record this measurement. Use a measurement of ‘0’ if the heel touches the buttock.
Repeat with the left leg
Shoulders
With the client standing, have them extend the right arm above the head and left arm towards the
floor. Simultaneously have them drop their right hand behind their back while reaching up behind
the body with the left hand with the goal being to touch the hands together. Using a measuring tape
or ruler, measure the distance between the tips of the fingers of the right and left hand, and record
this measurement. Use a measurement of ‘0’ if the fingers are able to touch. Repeat with the arms in
opposite positions for the left side
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Key Features of the ACTION Ease of Movement Page

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B. Record the joint angles and measurements for each of the various tests, using the drop down to
select between inches and cm for the Quadriceps and Shoulder tests.
Click the ‘Calculate and Save’ button and the system will now display the results of the Ease of
Movement test with a rating of ‘Good’, ‘Satisfactory’, or ‘Needs Improvement’, and a simple ‘Yes’
or ‘No’ rating for whether the joints are even from the right to left side.
You may view their progress over time in the ‘Progress Tracking’ section of the system
C. If you would like to add any notes to be saved with this assessment you may do so in the ‘Notes’
field.
Functional Assessment
The ACTION PTS Functional Assessment is designed to test the body’s
overall core stability and endurance and the ability to perform basic
tasks. It is comprised of two separate tests, the Squat test and the
Marching test.
Squat Test
The squat test is performed starting with the client in a normal standing
position and then performing 10 -12 basic body weight squats. The
following criteria should be monitored and recorded:
Is full range of motion achieved (thighs parallel to floor)?
Full range of motion not achieved indicates possible:
• Tightness in lumbar-pelvic-hip complex
• Tightness in hamstrings
• Core weakness
• Poor balance and/or proprioception
• Lumber disk degeneration
Does the knee width remain constant?
Knee width changes indicate possible:
• Width decreases indicates possible:
–– Tightness in adductor muscles
–– Tightness in hip flexors
–– Prior hip / knee injury
• Width increases indicates possible:
–– Tightness in abductor muscles
–– Prior hip / knee injury
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Does their weight shift from their heels to toes?
Weight shifts from heels indicates possible:
• Core weakness
• Postural issues
• Inexperience with movement
Is there overall stability good?
Poor overall stability - indicates possible:
• Core weakness
• Inexperience with movement
Are they able to maintain a neutral spine position?
Unable to maintain neutral position (pelvic tilt) - indicates possible:
• Core weakness
• Tightness in hip flexors
Marching Test
The Marching test begins with the client standing in the center of an open space, preferably
somewhere as quiet as possible, and should be performed by marching on the spot at a pace of 2
steps per second bringing the knees to hip height. This test should be done for 1 minute with the EYES
CLOSED. The objective of this test is to determine overall stability and muscular balance. Record the
client’s starting and finishing positions, including the direction and approximate degrees of rotation.
Forward movement indicates possible:
• Core weakness
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Right or left curve indicates possible:
• Curve right, right shoulder sitting lower than left
• Curve left, left shoulder sitting lower than right
Slight curve (less than 45°)
• Previous hip, knee, or back injury
• Core weakness
• Slight lateral pelvic tilt
Large curve (more than 45°)
• Limb length difference one leg slightly shorter than other
• Lateral head tilt to one side
• Core weakness
• Possible disk degeneration
• Possible spinal scoliosis
• Lateral pelvic tilt
Key Features of the ACTION Functional Assessment Page
B. Have the client perform the Squat test and check the appropriate boxes for the parts of the test
they are capable of completing properly
The system will display a score and a bar graph displaying a visual representation of the client’s
score and their goal
C. Have the client perform the Marching test and input their score based on how far they move from
their starting position
D. You may view their progress over time in the ‘Progress Tracking’ section of the system
E. If you would like to add any notes to be saved with this assessment you may do so in the ‘Notes’
field.
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Digital Posture Analysis
The ACTION PTS Digital Posture Analysis is a basic postural assessment to help identify muscle
imbalances, postural issues, core weaknesses, and other potential causes of long term problems.
Please note that this is a very basic analysis and should not be relied upon to diagnose lordosis,
scoliosis, or other potentially serious back conditions. To perform this test you must have a wall
mounted or portable grid chart, a plumb line, and a digital camera. There are 2 components to this
analysis, the Rear Profile and the Side Profile.
Rear Profile
Have the client stand facing the grid chart in a normal, relaxed stance, with the ankles evenly spaced
on either side of the plumb line. Making sure you are centered on the chart, take a digital picture of
the client, ensuring you are far enough away to get the client’s entire body in the picture.
There are 5 criteria you are looking for on the rear profile:
1. Are the shoulders level and parallel to the ground?
2. Do the hands hang to the same height?
3. Are the hips level and parallel to the ground?
4. Are the knees at the same height?
5. Is the head upright with no tilt?
Each criterion that the client meets should be checked. The system keeps a running total of the score
as boxes are checked.
Side Profile
Have the client stand centered on, but facing to the right of, the grid chart in a normal relaxed stance,
with the ankles centered on the plumb line. Have the client close their eyes and relax forward,
bending at the waist and extending their hands towards the floor and then return to an upright,
relaxed position. Making sure you are centered on the chart, take a digital picture of the client,
ensuring you are far enough away to get the client’s entire body in the picture.
There are 5 criteria you are looking for on the side profile:
1. Are the ears, shoulders, hips, knees, and ankles aligned on the plumb line?
2. Do the hands hang in line with the front of the thighs?
3. Is the spine neutral with just a slight curvature?
4. Is the chin and jaw parallel to the ground?
5. Are the shoulders not rounded forward?
Each criterion that the client meets should be checked. The system keeps a running total of the score
as boxes are checked.
Key Features of the ACTION Digital Posture Analysis Page
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B. Using the ‘Browse’ or ‘Choose File’ button, upload the digital pictures of the client’s rear and side
profiles
C. Check each of the boxes that apply to the client’s profile pictures. The system will keep a running
total of their score from 0 to 5, with each checked box being worth a score of 1.
D. The system will display a series of bar graphs displaying a visual representation of the client’s
current score relative to their goal. You may view their progress over time in the ‘Progress Tracking’
section of the system
E. If you would like to add any notes to be saved with this assessment you may do so in the ‘Notes’
field.
Tracking Client Progress Using the ACTION Personal Training System
The Progress Tracking Tools in the ACTION PTS are designed to allow you to visually track the progress
of your clients. These tools are also accessible by your clients so they may view their progress as well.
The Progress Tracking area is broken down into 4 key elements:
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Measurement Tracking
Measurement Tracking is used to graph results of the Body Composition Fitness Assessment. There
are trend charts for Body Fat Percentage, Weight, the 4 mandatory measurements used in the body
composition (Shoulders, Navel, Waist and Hips), and the 4 option measurements (Biceps, Forearm,
Thigh, Calf)
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Fitness Assessment Tracking
Fitness Assessment Tracking will display trend graphs of the results of the Strength, Cardio, Postural,
and Functional Assessments
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Nutritional Tracking
The Nutritional Tracking is separated into Calories, Fats, Carbs, and Protein and each of these has
‘Daily’ and ‘Cumulative’ graphs.
The Daily graphs show a snapshot of each days ‘target’ intake versus the ‘actual’ intake.
The Cumulative graphs show a running total of all days in the past 3 months added together to show
a trend of what has been happening.
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Competition Tracking
The Competition Tracking is used to display the current status or results of a competition that the
client is involved in. The graph will show a visual representation of their ranking in the competition
while the chart below displays the details of the current ranking and status. Depending on the
‘Privacy’ settings of the Competition (see Appendix: Trainer Menu: Advanced Features: Competitions)
results will either be displayed showing the name of all participants, or only the clients name will be
displayed with the remaining names displayed as ‘Private’
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is used for these categories should be chosen
Summary
based on the client’s current fitness level.
A fitness assessment is a useful tool for
Although fitness assessments help personal
determining an exercise plan specific to
trainers design effective exercise routines, in
the client; however, a trainer should avoid
order for the regimen to be effective the trainer
implementing an exercise routine that may
must take care in standardizing the conditions
cause the client injury or embarrassment,
under which the assessments are performed.
either physical or emotional. There are several
Certain factors may influence test results and
components of a fitness assessment and some
will lead to an inaccurate assessment. A few
may be omitted or modified depending on the
of these factors include: ambient temperature,
client’s needs, conditions or goals. There are
noise, humidity and the condition of the client
also several different tests that can be used to
being assessed. The amount of sleep the client
measure the same aspect of a fitness assessment
had night before and the type of food and drink
(e.g., stretch test or sit & reach test). Some tests
the client consumed can affect performance
are designed for people who have high fitness
during the physical assessment. The time of
levels and may be unsuitable for a beginning
day and the test environment may also affect
client. On the other hand, some tests may not
the client’s performance so the trainer should
be challenging enough for a very athletic client.
try to maintain these conditions by keeping
It is best to schedule the initial and follow-
them constant. Despite these factors, fitness
up assessments according to what will best
assessments are still a great asset to a training
motivate and encourage the client. The order in
program as they provide the personal trainer
which fitness assessments should be carried out
and the client with a lot of information. Once the
is as follows: (1) Non-fatiguing tests, (2) Agility
client begins an exercise routine, progress can
tests, (3) Maximal strength and power tests, (4)
be used as a motivational tool to continue the
Sprint tests, (5) Muscular endurance tests, and
program.
(6) Flexibility tests. The specific type of test that
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c) There may be conflicts between
Review Questions
the recommended workout and the
1. What is the purpose of the initial client
medication
assessment?
d) The trainer may need to refill the
a) To learn about the client
prescription
b) To efficiently tailor the proper workout
6. Small changes in one’s daily routine like
regimen
parking farther away from a building or
c) To understand the likes and dislikes of
taking the stairs can have a large impact on
the client
fitness goals. True or False?_________________
d) All of the above
7. Why do most people hire a personal
2. One of the many jobs a personal trainer has
trainer?_______________________________________
is to advise the client on how to handle any
________________________________________________
unresolved medical issues they may have.
________________________________________________
True or False?_________________________________
8. The optimum regimen that is specific to the
3. In order to keep the client‘s medical
client’s needs can be best designed when the
information private the personal trainer
assessment is ________________________________.
should put a___________________________ in the
9. The best way to conduct an initial assessment
assessment form.
is to:
4. All of the following are considered lifestyle
a) Give the client the form to take home so
categories: hobbies, physical activities,
it is not filled out in a hurry
working in front of a computer and
b) Let the client fill the form out while
nutritional habits. True or False?___________
demonstrating how to stretch
5. Knowing what medications the client
c) Going over the form with the client
is taking and possible side effects are
personally
important because:
d) E-mail it so the client will not be
a) The trainer may need to borrow some if
inconvenienced by having to write the
the medication runs out
answers
b) The client may be allergic to certain
medications
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10. If the client has a condition such as lower
References
back pain, the trainer should encourage the
Babette M, Pluim J, Staal B, Marks BL, Miller S,
client to perform strength training for that
Miley D. Health benefits of tennis. British
region without prior approval from a health
Journal of Sports Medicine. 2007;41:760-68.
care physician. True or False?
Boreham CAG, Kennedy RA, Murphy MH,
Answers Tully M, Wallace WFM, Young I. Training
1. d) All of the above. effects of short bouts of stair climbing
2. False. on cardiorespiratory fitness, blood lipids
3. Confidentiality clause. and homocysteine in sedentary young
4. True. women. British Journal of Sports Medicine.
5. c) There may be conflicts between the 2005;39:590-93.
recommended workout and the medication. Frank J. Managing hypertension using
6. True. combination therapy. American Family
7. To add that special benefit that the client has Physician. 2008;77(9):1279-86.
been missing as a means of fulfilling weight- Hagberg LA, Lindholm L. Cost-effectiveness of
loss or fitness goals. healthcare-based interventions aimed at
8. Thorough. improving physical activity. Scandinavian
9. c) Going over the form with the client Journal of Public Health. 2006;34(6):641-53.
personally. Harris JR, Cross J, Hannon PA, Mahoney E, Ross-
10. False. Viles S. Employer adoption of evidence
based chronic disease prevention practice:
a pilot study. Preventing Chronic Disease.
2008;5(3):A92.
Ruser CB, Federman DG, Kashaf SS. Whittling
away at obesity and overweight. Small
lifestyle changes can have the biggest impact.
Postgraduate Medicine. 2005;117(1):31-34.
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Chapter 4: Introduction to Designing Programs
Topics Covered
Introduction to Designing Programs
Program Design
Health Precautions to Consider when Designing a Program
Avoiding Overexertion and Injury
Signs of Dangerous Dysfunctional Breathing
Avoiding Discouragement
Aerobic Programs for Beginners

Physiological Factors to Consider in Designing Programs
Types of Muscle Actions
Energy Usage
The Kinetic Chain
Proper Positioning
Types of Training Used in Exercise Program Design

Principles of Exercise Training
Target Heart Rate
Measuring Exercise Intensity
Measuring Caloric Use
Principles of Resistance Training (RT)
Determining Resistance
Determining Rest Periods
Resistance Training Modalities
Periodization
Ways to Vary Volume and Intensity
Overtraining
behavior change. As the intensity of the program
Introduction to Designing
increases, client compliance usually falls off and
T
Programs
it is up to the trainer to help keep the clients
motivated, enthusiastic and committed to

o design a training program
completing the program.
effectively, a personal trainer must
Client education plays a large role in the
have knowledge of anatomy and
development of a training program and its
physiology, kinesiology and basic nutrition, as
success. Teaching the client about
well as information about special
how the body works and what
populations like pregnant and
specific exercises accomplish is
post-natal women, adolescents,
important for the client to trust
the elderly, and those with chronic
in the program components, stay
medical conditions. Having this
motivated and feel connected to
kind of background information
the trainer. Education about the
will aid a trainer’s awareness of
importance of resistance training is
the proper postural alignments for
particularly important since many
different exercises, the indications
people still associate it with body
and contraindications for different
building and many women fear building up
populations, and the risks and precautions to be
muscle mass.
considered when designing the program.
Clients can educate trainers too. Client
Program success relies on the rapport and trust
feedback is crucial to the success of any training
between the client and the trainer so it helps if
program, and the trainer must take client needs
the trainer develops both communication and
and feelings into account when developing and
active listening skills. Clients need to feel that
adjusting program components.
they are in good hands and that they are working
Continuing education is also important. Clients
with a knowledgeable professional. They want
have many misconceptions about training
to feel as if their trainer is personally interested
due to faulty marketing campaigns. It helps if
in them and vested in their success.
the trainer stays on top of current events and
It is helpful to have knowledge of motivating
research in order to answer questions that may
techniques and know the principles of causing
come up.
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Trainers must educate clients about the types spotting techniques, assessments and assisted
of physical contact that they will use. Explain exercises. Be sure that the client is comfortable
the reasons behind any physical contact such as with these instances of physical contact.
The ACTION Personal Training System Goals and Preferences
The ACTION PTS Goals and Preferences tools are designed to let you record and save your clients
experience level, goals, schedule, and preferences. This information can then be used when building
a client’s programming or by the ACTION PTS for the ‘suggested’ features such as suggested resistance
programs and suggested nutritional programs.
Experience and Goals

The Experience and Goals page will allow you to set an
experience level for your client for resistance training and
cardiovascular training. Experience ratings begin with ‘No
Experience’ and go as high as ‘Advanced’ with detailed
descriptions for each rating.
Below the Experience rating where you will rate your
clients Goals based on priority. Up to 3 goals can be
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selected including 1st priority, 2nd priority, and 3rd priority goals. The goals may be chosen from
overall wellness, to muscular or cardiovascular based, or even sport specific goals.
Key Features of the ACTION Experience and Goals Page
A. Select the experience level for resistance training and cardiovascular activities using the buttons
B. Select first, second, and third priority goals from the, list of options
Weight Loss Goals

The Weight Loss Goals page is designed to provide a visual representation of various body fat
percentages. By selecting what the client’s appearance goal is the system can determine the goal
body fat percentage and therefore the goal weight. This system of determining a weight loss goal
will help to prevent unrealistic expectations of goals.
Once a goal weight has been determined the next step is to calculate the Weight Loss Type. This will
determine the amount of weekly fat loss the client can expect to see. There are various automatic
safeguards built into this selection system. By default, the system will not allow a weekly weight
loss that would require a deficit of more than 25% of total calories consumed. For example, a client
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that requires 2000 calories per day for their Basal Metabolic Rate would not have the option to select
a weight loss type that would require more than 500 calories per day, which is equal to 1 pound per
week. A client that is quite heavy and therefore has a much higher Basal Metabolic Rate would be
able to select higher weekly weight loss goals.
In addition, clients that are very heavy and need to see accelerated weight loss will have additional
options to not add calories required for exercise to their daily caloric goals. This will have the effect
of increasing their daily caloric deficit and accelerating weight loss.
The weight loss safeguards and exercise calories have options to override them in the Master
Preferences (see Appendix: Admin Menu: Settings and Tools: Master Preferences)
Once a Weight Loss Type has been selected the system will create a graph of the expected timeline
to achieve the goal weight.
Key Features of the ACTION Weight Loss Goals page
A. Use the body fat percentage drawings to select a goals body fat percentage
B. The system will calculate Goal Weight, Goal Body Fat Percentage, and Goal Body Fat Weight
C. Choose from the available Weight Loss Types for the client
D. The Goal Timeline will be calculated and graphed
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Resistance Training Preferences
The Resistance Training preferences is divided into 2 parts:
Equipment Availability is designed to allow you to remove entire resistance exercise groups based on
the equipment type used. This is beneficial if you do not have a specific type of equipment in your
facility or if you do not want the client to be using a particular type of equipment at this point. By
un-checking an equipment type, the system will then remove any exercise using this equipment type
from being used in a ‘Suggested Program’ for a client.
Trainers will always have the ability to manually select
any exercise regardless of if it has been removed as a
preference.
The Exclude Specific Exercises feature is designed to allow
for the removal of any specific exercise in the system
from being used in the Suggested Program feature. This is
valuable if the client has a specific injury or contraindication
that would require the exclusion of specific movements or
exercises.
Clicking on ‘View all [Muscle Group] Exercises’ will open a detailed list of all exercises for that muscle
group. Un-checking the box next to any exercise will then exclude that exercises from being suggested.
Changes that are made to the Resistance Training Preferences will not take effect until the next
program is created.
Key Features of the ACTION Resistance Training Preferences page
A. Un-check specific equipment types to remove them from the ‘Suggested Program’ feature
B. Click on ‘View all Exercises’ to see a detailed list of all available exercises for that muscle group
and un-check any exercises you want to remove from being suggested
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Cardio Preferences
The Cardio Preferences page allows the client or trainer to select specific types of cardiovascular
activities they are willing to perform. Any activity selected will be available in the Schedule Preferences
when selecting activities throughout the week and on the Cardio Program page. Cardiovascular
activities are broken down into the following groups: Basic, Group Fitness, Racquet Sports, Specialty,
Sports, and Water.
In many cases there is more than one ‘intensity’ option for a specific activity. Once an activity is
selected the different intensity options will be displayed. More than one intensity may be selected.
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Schedule Preferences
The Schedule Preferences is designed to allow the client or trainer to set up their typical weekly
schedule. The system will then use this information when building suggested resistance and cardio
programs.
The ‘Wake Up Time’ is used to determine the first meal time of the day and set the remainder of the
day’s meal times.
In the Resistance Training area of the schedule, the days of the week that the client will be doing
their resistance training program, the approximate time of day, and the amount of time they will
spend doing the workout should be set. More than one workout per day may be selected. To prevent
overtraining of muscle groups the system will suggest programs according to the following:
1–3 workouts per week — Whole Body Program
4–5 workouts per week — 2 Day Split Program
9+ workouts per week — 5 Day Split Program
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Although these programs are what will be suggested by the system, the trainer always has the ability
to manually create a program of their choosing.
In the case of making changes to existing Resistance Training Schedule Preferences, the system will
give 3 choices for when to apply these changes. They may be applied the next day, the following
week, or when the next program is created. Changes applied the following day or week will re-
schedule existing workouts in the current program.
The Cardio Training area of the schedule allows the day, time of day, duration, and activity to be
selected. More than one activity may be selected per day. Activities set to ‘Auto-Select’ will be
randomly chosen by the system based on the client’s Cardio Preferences (see Cardio Preferences
above). Suggested activities will then be added to the client’s Cardio Program.
Nutritional Preferences
Please see ‘Nutritional Programming with the ACTION Personal Training System’ in Chapter 9
Program Design for the client. After the assessments have been
Assessments are always the first step in done, an effective program can be developed. A
designing a program. They help the trainer program design will include types of exercise,
determine appropriate, customized goals to their duration, frequency, intensity, total time
set as well as make them safe and attainable spent training, short and long term goals and
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ways to maintain motivation. Training potential is the
The design is an interactive genetic potential of the client.
endeavor between the trainer If the client is unconditioned,
and the client. The trainer must the gains seen from beginning
measure the client’s acceptance training will be great. If the
of the program components client is highly fit, the gains will

“All that stands between
and define problems with a good body and a great be less. As clients approach their
motivation and other barriers body is someone to genetic potential, which is the
to achieving goals. Proper push you just a top level at which their bodies
goal development includes little further than you will perform, target goals must
would push yourself.”
educating a client about realistic be changed. As less dramatic
goals and time frames. progress is seen, clients may
The most important factor become bored or unmotivated,
to consider when designing a which will pose an additional
training program is the client’s problem to take into account
primary goal. No matter what when designing a program.
the trainer may believe the client needs, the

Health Precautions to Consider
trainer is being paid to help the client attain this
when Designing a Program
goal via healthy, safe methods. However, many
Performance Enhancement & Personal
clients come in with unrealistic expectations for
Training (Abbreviated Sample):
their body potential or want too much progress
Assessment Form (Medical/Health)
for too little work.
First Name_______________________________________
Goals need to be realistic based on the client’s Last Name_______________________________________
existing level of fitness, age and time constraints. □ Male □ Female
They should be aligned with the client’s interests Date of Birth_____________________________________

Height____________________________________________
and ability and then reevaluated at regular
Weight___________________________________________
intervals. Program design is never completely
Occupation______________________________________
done. Training programs must continually
change and evolve over time as the client’s
fitness and goals change.
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Have you ever suffered from any of the by having one or two sessions daily, extending
following: (Check all that apply)
warm-ups and decreasing intensity and duration
□ High Blood Pressure □ Heart Attack
in times of inflammation and increased pain.
□ Low Blood Pressure □ Diabetes
□ High Cholesterol □ Back/Knee Injury Anti-inflammatory medications may reduce the
□ Chest Pains □ Seizures client’s ability to evaluate pain during exercise

Do you smoke? so the trainer must be vigilant in watching and
□ Yes evaluating effort.
How many cigarettes per day?_________________
Osteoporosis is a disease that makes bones
At what age did you start?______________________
and joints fragile. Men over 80 and women
□ No, but I used to
□ No over 65 may have undiagnosed osteoporosis
Does your family have a history of the so trainers must use caution in determining
following: (Check all that apply) exercises and loads for older clients. In addition,
□ Heart Attack replaced hips or formerly fractured hips cannot
□ Heart Operations
maintain a normal level of stress.
□ High Blood Pressure
Aging populations have a decreased ability
□ Diabetes
to regulate fluid balances
Muscular imbalances create
Men over 80 and women over in response to dehydration
postural misalignment and injury. 65 may have undiagnosed
osteoporosis. and thirst and therefore the
They are caused by repetitive
sensations are compromised. It
movement, poor posture or weak/tight muscles.
may be necessary to monitor fluid intake in the
Muscular imbalances cause imbalances on
elderly as they exercise and educate them about
opposite sides of a joint and affect range of
the importance of regular hydration breaks.
movement. The objective in treating imbalances
is to strengthen weak muscles and stretch Avoiding Overexertion and Injury

shorter muscles. Always listen to the client’s feedback, both
Arthritis is joint inflammation or damage. while designing the program and while working
There are many different types of arthritis but through it. If the program is too aggressive for
osteoarthritis and rheumatoid arthritis are the the client’s goals or current abilities, it should be
most common. The goal in these cases is to scaled back. Learn to recognize physical danger
restore joint function. This is best accomplished signs of overexertion such as:
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• Dizziness to remind the client that new and unfamiliar
• Lightheadedness movement is typically uncomfortable at first.
• Complexion changes
Signs of Dangerous
• Profuse sweating
Dysfunctional Breathing
• Facial expressions
Dysfunctional breathing is very dangerous
• Muscle exhaustion
and can require medical attention. The trainer
• Improper posture
must watch a client’s chest to determine where
• Labored breathing
the breathing action is being generated and
• Faltering in movement
what muscles are being used. In dysfunctional
breathing, the breathing pattern is shallow; it
does not make use of the diaphragm and can
develop into a long-term bad habit. The use of
secondary muscles instead of primary muscles
for breathing (e.g., the diaphragm) affects
posture and tension. This can cause headaches,
lightheadedness and dizziness. In addition, the
spine and ribcage are used in normal breathing
and inadequate motion of these joints restricts
and stiffens them.
If exercises are properly explained before
beginning them, clients are less likely to overexert
themselves. When explaining an exercise to the
client, always include an explanation of what
muscle or muscle groups are being targeted.
Teach them the difference between muscle
fatigue and unintentional pain. If pain occurs

Excessive breathing leads to altered carbon
in a non-targeted, non-supporting or stabilizer
dioxide and oxygen levels in the blood, which
muscle, there may be a problem, but it is helpful
in turn triggers various physiological reactions.
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One of these reactions is anxiety in the client. harder it gets, the less the client will want to do
This ineffective breathing also results in lowered it.
oxygen levels. The retention of metabolic waste Reassessment tests should be given often
in the muscles causes them to become stiff and enough to encourage the client with regards
fatigued. to progress but not so frequently that not
Habitual dysfunctional breathing affects sleep enough measurable progress has occurred.
patterns and circulation. The trainer can help The reassessment can help the trainer track
correct and prevent dysfunctional breathing by progress, note ineffective exercises and adjust
watching the chest and teaching the client to the program accordingly.
breathe with the diaphragm.

Aerobic Programs for Beginners
Avoiding Discouragement Sometimes it is necessary to get clients
Equipment
Educating the client about ready to engage in more vigorous
realistic goals and time frames Fitness workouts by easing into aerobic
Triangle
will help a training program activity. Walking is a great
be successful. If the client exercise for beginners, as it is

User Trainer
has false expectations, relatively easy to maintain
discouragement and frustration, will quickly a constant intensity level and can be a group
follow. Overloading is necessary for a client to activity. If the client has had very low activity
make gains, but the trainer should levels up until beginning training,
be careful when increasing the load. walking frequently may help build
If the load is increased too quickly, up stamina so that other activities
the client may become overwhelmed can be added slowly and without
and/or discouraged. In addition, the overexerting the body.
client may begin to regress or, worse Swimming is a more difficult
yet, become injured, necessitating aerobic activity and some degree of
time away from training. Keep in skill is required, but the benefits of
mind that compliance with the water exercise are tremendous.

Aerobic exercise builds endurance
training program decreases as by keeping the heart pumping for A study found that aerobic
the intensity level increases. The an extended period of time. activities taking place in
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water have psychological benefits to clients. a day. If weight loss is the goal, 2000 calories
Being in the water hides physical defects and or more a week should be used by scheduling
provides support. Water aerobics are useful activity five days a week for 45 minutes each
for the disabled, obese, elderly and pregnant session.
populations. The buoyancy and resistance of Judging the effectiveness of exercise by caloric
water requires higher energy expenditures than use is difficult, as most sources of information on
land exercises but without straining joints or caloric use do not take into account coordination
causing pain. and skill level of the participant. An experienced
It is recommended that aerobic activity swimmer spends less energy to go the same
sessions last 20 to 60 minutes each or be broken pace as an inexperienced swimmer will use
into a series of 10 minute segments. If the client with an inefficient stroke. This is why the heart
has been sedentary, exercise must build up rate measurement is the best way to judge how
gradually. It is best to start with low intensity effective the aerobic exercise program is.
five minute bouts. If the client is deconditioned,

Physiological Factors to Consider
the trainer should schedule multiple, short daily
in Designing Programs
exercise sessions for that client’s best results.
Once the client has reached a level of fitness
The aerobic component of the training
enabling the trainer to incorporate strength
program should strive to use 77% to 90% of the
training, the trainer must create a well-
maximal heart rate or 60% to 80% of the heart
rounded strength program that not only uses
rate reserve. It should burn 150-400 calories
a variety of different muscle groups working
in complementary ways but also uses different
types of exercises. The various factors to be
considered in designing specific workouts are
described below.
Types of Muscle Actions

Exercises that include both concentric
and eccentric muscle actions are the most
effective in training programs. With concentric
muscle actions, sufficient force is produced to
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overcome external load and shorten the muscle. 2. The glycolic pathway is anaerobic.
Isometric muscle actions produce force but 3. The oxidative pathway is aerobic; it
there is no change in muscle length. Eccentric requires the presence of oxygen.
muscle actions produce force while the muscle

The Kinetic Chain
is lengthening—it is the resistance of the
The kinetic chain consists of the muscular,
movement.
articular and neural systems and refers to the
Energy Usage
ATP, adenosine triphosphate, is the typical
storage and transfer unit of energy that the body
uses. ATP is capable of storing large amounts
sensorimotor integration of these systems for
motor output; therefore, it includes all of the
major systems of the body used in motion and
their interaction with each other. Each system
works interdependently with the others for
structural and functional efficiency. If any

of energy, but the supply in each cell is limited
one of the systems does not work efficiently,
and the cell must have time to produce more in
compensations and adaptations occur in the
order to keep performing and to avoid damage
other systems. This can lead to tissue overload,
to the body.
decreased performance and predictable
There are three bioenergetic pathways
patterns of injury.
to produce ATP that should be taken into
consideration when designing fitness programs: Proper Positioning

1. ATP-creatine phosphate pathway Proper positioning of the body during exercise
(ATP-CP, also sometimes known as the is important to avoid injury and gain desired
Phosphagen system) is anaerobic. It does results. The trainer should look out for and
not require the use of oxygen. educate the client about maintenance of a
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changes the center of gravity for the body and
affects the function and efficiency of the kinetic
chain. Without proper posture, the body has a
propensity for degeneration of the joints, tissue
stress and injury.
The functional efficiency of the kinetic chain
lies in the ability of the neuromuscular system
neutral spine position: curving slightly inward to monitor and manipulate movement during
at the neck and lower back; curving slightly functional tasks using the least amount of
outward at the thoracic areas of the spine; energy possible. Functional strength is the
keeping shoulders back and away from the ears; ability of the neuromuscular system to perform
squaring hips; and avoiding hyperextention dynamic, eccentric, isometric and concentric
(“locking out”) of a joint. muscle actions in all three planes of motion.
The body must maintain a “postural

Types of Training Used in Exercise
equilibrium” to maintain balance; this is the
Program Design
position from which all movement begins and
Posture and Movement Training: Every
ends. Proper muscle lengths and tensions in the
movement requires a base from which to
relationships of force couples (muscles that
generate and accept force. This is the
work against each other or together) produce
role of posture. Posture is the alignment
proper posture. Postural distortion patterns
and function of all components of the
are predictable patterns of compensations
kinetic chain at any given
made by the body due to
moment, allowing all of the
muscle imbalances. If some
necessary body systems to
core muscles are weaker than
work together for smooth, safe motion. It is
they ought to be, the body will
controlled by the central nervous system.
compensate to regain postural equilibrium.
Posture is not static and is not only
Balance/Stability Training: Balance is
measured when standing. The body goes
the ability to maintain a position for a given
through constant adjustments to maintain
amount of time without moving. Work on
posture. Any deviations from proper posture
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core muscles increases muscle mass or size. It is the increase of
balance and stability. the size of muscle fibers. Once mass has
People who play sports accrued, strengthening and endurance training
use many nontraditional can make the most of the muscle.
movements that require good Cardiovascular Training: Components
balance, such as squat hops and single leg of cardiovascular programs include mode
hops. A number of exercises described in other of exercise, intensity of
sections (postural training, flexibility training) exercise, frequency of
can also help with balance. Care should be exercise and duration of
taken to include plenty of exercises that require each session. It is important
balance. to consider the sport,
Flexibility Training: Flexibility is the degree interest and common
to which a joint moves through a pain-free physical activity that the
range of motion. Factors to consider client employs. Training programs should
when designing flexibility training include exercises that most closely mimic
are: joint structure, the those activities and interests.
condition of soft tissue Functional Training: Functional
around the joint and training is custom designed for the
the length of muscles client. It is the choosing or creating of

Flexibility exercised help stretch
being stretched. These muscles, protect against injury activities and exercises that will best
and allow the maximum range
factors determine how help the client perform better in daily
of motion for joints
well the joints help life. Functional training can be those
facilitate movement. There is a large section on exercises that help an athlete perform better at
types of flexibility training a chosen sport or it can help the client
below. Resistance training builds with the physical activities

strength of muscles, bones,
Resistance Training: and surrounding soft tissue; done at work. Functional
burns fat; and may lower
The three primary goals can be helping an
cholesterol.
resistance goals are elderly person have better
hypertrophy, muscular strength and muscular balance to prevent falls.
endurance. Hypertrophy is the increase in
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Plyometrics: Plyometrics is used only with loss is one of the program goals, it is best to use
well-conditioned clients and athletes. These a variety of modes of cardiovascular training.
exercises are sports-specific and include This is called cross-training. Mixing modes
training for speed, strength, power, endurance, will increase fat loss and calorie-burning. As
flexibility and coordination for optimal sports mentioned above, be sure to take your client’s
performance. Plyometrics is based on using the specific needs and likes into account when
elastic property of muscles to create a greater planning cardiovascular training.
force. Its original use was as a Moderate intensity is the most
jumping exercise for the lower recommended and used mode
extremities but is now used for of aerobic activity. It is defined
the entire body. as the pace at which you break
Plyometrics is the use of a a sweat, have a slight increase
strength-shortening cycle and in heart rate, and can still easily
begins with rapid stretching speak and hold a conversation.
(eccentric muscle actions) This intensity can be achieved
which is followed by shortening of the same by either mode of cardiovascular exercise:
muscle (concentric muscle actions). machine or non-machine.
A study found that moderate intensity

Principles of Exercise Training
activities were not understood by clients when
Flexibility training can be helpful for all
verbally explained. Demonstrations of moderate
clients, including those interested mainly in
intensity exercises greatly increased proper
building muscular strength. “Muscle-bound”
exercise procedures and success. Be sure that
bodybuilders do have compromised range of
your client understands what is involved in an
motion (ROM) and flexibility. The desire for mass
exercise before they attempt it.
and strength must be weighed
Machine cardiovascular exercises include:
against the loss of flexibility and
• Stair Master
ROM.
• Treadmills
Cardiovascular health is central
• Rowing machines
to overall health and may be one
• Cycle ergometers
of your client‘s top concerns. If fat
• Elliptical trainers
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Non-Machine cardiovascular exercises for calculating your client’s targeted heart rate
include: zones. The Karvonen formula, discussed in
• Walking chapter 3, is more accurate because it takes into
• Jogging account the client’s current fitness level (given
• Running the inclusion of the resting heart rate). Another
• Swimming method is the percentage of maximal heart rate,
• Aerobic dance which is simpler and yields a more conservative
target HR than the Karvonen method. There are

Target Heart Rate
two steps to the percentage of maximal heart
What is your target heart rate range?
Intensity of Activity % Maximal Heart Rate*
rate formula:
Very Light <35 To determine the client’s maximum heart
Light 35-54
rate (HR) using the percentage of maximal
Moderate 55-70
Hard 71-90
heart rate formula:
Very Hard 91-99 220–Age of client = estimated maximum HR
Maximal 100
To determine the lower limit of the client’s
*Maximal heart rate = 220 - age
Calculating your maximal target heart rate range using the

percentage of maximal heart rate formula
training heart rate range:
For a moderately intense (55-70% maximum) activity level:
[220 - (your age)] x 0.55 to [220 - (your age)] x 0.70 Estimated maximum HR x percentage (60%)
Example:
Target heart rate range for a 54-year-old exercising at moderately intense To determine the upper limit of heart rate
activity:
[220 - 54] x 0.55 to [220 - 54] x 0.70 = 91 to 116 beats per minute
range that the client should work to achieve:
As mentioned above, heart rate is one of the
Estimated maximum HR x percentage (80%)
easiest measures of how much and what intensity
Resting heart rate is the number of heart beats
cardiovascular exercise the client is getting.
in 60 seconds. Many factors can influence this so
There are a number of factors that influence
it is best to take it upon waking or, at the least,
heart rate besides level of exercise, and they are
after five minutes of complete rest. To check
as follows: age, sex, fitness level, medications,
heart rate, check the pulse at the wrist or the
body position, blood volume, heart disease,
neck taking care not to apply too much pressure
temperature and humidity. The maximum
(that will distort the reading). The carotid artery
attainable heart rate decreases with age. Target
can be found with the index and middle fingers
heart rate should be between 60% and 80% of
at the side of the windpipe. The radial artery
the maximum heart rate. There are formulas
lies between the bone and tendon of the wrist,
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palm side and thumb side. Count the number
Measuring Exercise Intensity
of heart beats in 15 seconds and multiply by 4
Exercise intensity measurement consists
to determine the heart rate per minute. When
of the amount of oxygen consumed during
measuring heart rate during exercise, count the
exercise and the number of calories burned.
number of beats in 6 seconds and multiply by 10
It is important to determine individual ranges
or simply add a zero to the end of the number.
of target heart rates and to check heart rates
Stroke volume is the amount of blood pumped
frequently during the workout to be sure that
by the heart with each contraction of the
the client is working within both a safe and
ventricle. A trainer will not know what stroke
effective range.
volume a client has, but measuring heart rates
In order to see improvements in
gives a good indication of the
A trainer will not know what cardiovascular health, a certain
work being done by the heart. A
stroke volume a client has, but level of oxygen consumption
typical stroke volume is 75-80 measuring heart rates gives a
good indication of the work and/or heart rate reserve usage
mL per heart beat and the typical being done by the heart.
must be attained. Heart rate
heart rate is 70-80 beats per
reserve is the difference between
minute.
the client‘s resting heart rate and their maximum
Cardiac output is the amount of blood pumped
heart rate. In healthy adults, the aerobic level
per minute through the arteries to all the tissues
necessary to see improvement is between 50%
of the body, and it is calculated by multiplying
and 80% of the heart rate reserve.
the stroke volume by the heart rate.
Maximal oxygen consumption or usage is
generally accepted as the best measure of
gauging cardio-respiratory fitness. The highest
rate of oxygen transport and utilization is
achieved at the point of maximum physical
exertion. At rest, oxygen consumption is 3.5
mL of oxygen per kilogram of body weight per

Cardiac output = stroke volume (SV)
minute or 1 MET.
x heart rate (HR).
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These tests have errors of assumption built
Measuring Caloric Use
into them, meaning that they do not take
(METs x 3.5 x bodyweight in kilograms)/
individual differences into consideration but
200 = calories used per minute.
over time they can show trends.
Example: A client, who weighs 150 lbs or 68.2
kg (150 lbs/2.2 = 68.2 kg), using a treadmill
at 0% intensity or grade level walks at 7
mph or 11.2 km/hr (7 mph/1.61 = 11.2 km/
hr) for 45 minutes. This translates to 11.7
METs (taken from a standard MET table for
jogging).
(11.7 x 3.5 x 68.2)/200 = 14 calories per minute.
14 x 45 = 630 calories per workout.
Typical oxygen consumption is 45 to 80 mL X
kg X minutes or 11-23 METs. Maximal testing
is not viable or feasible for the personal trainer The Rate of Perceived Exertion (RPE) scale is
to measure so submaximal testing is used to a useful if subjective tool. The scale numbers
estimate it. are usually from 6 to 20 but other numbers are
used as well. The RPE scale measures feelings
of effort, strain, discomfort and fatigue during
aerobic and resistance training.
It was developed by the Swedish psychologist
Gunner Borg and is sometimes called the Borg
Scale. You can ask your clients to rate how much
exertion they are putting out on a scale of 6-20.
Submaximal tests exist that can give a sense of No exertion at all is a rating of 6, 7 is extremely
intensity of workouts. These include: light exertion, 9 is very light exertion, 11 is light,
• Rockport Walk Test 13 is somewhat hard, 15 is hard or heavy, 19 is
• Step Test extremely hard and 20 is maximal exertion.
• Field Protocols
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Name:________________________ Fitness Training Log (example) presently is used for general health and fitness.
Date: Day of Week: Weight:
Resistance training can affect almost every
Resting Heart Rate: Aerobic Workout:
system in the body and can greatly add to health

Body Part: # of Sets: Body Part: # of Sets:
benefits of any client population.
Resistance exercise and resistance training are
not the same thing. Resistance exercise refers to

Exercise Type SETS X REPS X
WEIGHT (lbs)
the protocol for a single exercise or workout.
Resistance training refers to the combination
of many consecutive sessions. RT must target a
specific muscle or muscle group.

Level of Muscle Soreness (1-10 Scale):
Level of Fatigue (1-10 Scale):

Resistance Training: Split Routines (example)
Notes: Program Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Total Total
Total Body Rest Rest Rest Rest Rest
Body Body
Upper
Upper Lower Upper Lower
or Lower Rest Rest Rest
Body Body Body Body
Body
Training logs are a good way to monitor exercise Chest & Back &
Pull/Push Triceps & Rest Legs Rest Biceps & Rest Rest
Shoulders Traps
intensity. They should include what exercises Body Part Back & Arms & Back & Arms &
Legs Rest Legs
Specific Chest Shoulders Chest Shoulders
are in the program and the corresponding
The SAID principle is Specific Adaptations
resistance or load, how fast repetitions are,
to Imposed Demands. An example of SAID is
how many sets and reps are performed, the
increasing the number of repetitions to increase
distance and intensity of the activity, and the
muscle endurance.
length of resting periods. The client should also
The overload principle states that as adaptation
record weight, resting heart rate, general health,
of the muscle or muscles to a stimulus are made,
general subjective experience of the workout,
an increased stimulus is required for further
and muscle soreness and fatigue on a scale of 1
improvement. The overload principle is the idea
to 10.
that each workout should place a progressively
Principles of Resistance Training higher demand on the muscle or muscles that
(RT) are targeted in order to get results.
Resistance training (RT) was first created The degree of overload depends on the
to help wounded soldiers recuperate. It later work load, the number of repetitions, the rest
became popular with body builders and between sets and the frequency. It is important
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to remember to increase the demand of each of reps leads to less fatigue in smaller
workout. Overload increases can be created muscle groups.
by increasing resistance or weight, increasing • Large muscle groups should be worked
repetitions, increasing sets or decreasing rest before small ones.
periods. • Alternate pushing and pulling for the
Periodized training Large muscle groups should total body workout.

be worked before small ones.
is the use of variation • Alternate upper and lower body
in a training program to prevent boredom and exercises.
optimize progress. Varying a program can be • Explosive/Power/Olympic type lifts
done by changing the choice of exercise, the should take place before basic strength
order that exercises are done in, the resistance and single-joint training.
level, the number or reps, the number of sets in • Exercise weak areas before strong areas.
each exercise, or the duration or rest between • The exercise program should move from
sets. the most intense exercises to the least
Beginners should have multiple sets of intense.
exercises of simple techniques. Technique and

Determining Resistance
technicality of activities should increase over
Resistance determination involves the use
the course of the program.
of repetition maximums (RMs). The repetition
Some guidelines for resistance exercise choice
maximum is the maximal load that can be lifted
are:
for a certain number of repetitions or absolute
• Start out with multi-joint activities
resistance (a specific number of reps).
and progress to less complex, single-
In a single training session, the RM target
joint exercises to target muscles more
should be based on the goal of the training session
specifically.
(i.e., strength, hypertrophy or endurance).
• The beginning of the program should
Training Adaptation Reps Sets Intensity
produce the greatest amount of muscle Strength 1-5 4-6 85-100%
mass and require the most energy. Hypertrophy 8-12 3-4 75-85%
Endurance 12-25 2-3 40-70%

Studies show that these components
are less effective at the end of a training When working with a new client the personal
program. A lessening in the amount trainer must assess the client’s strength to
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identify the proper weight (or load) to utilize Beginner or intermediate clients should have
during subsequent workouts. A 10 rep max test a 2-3 minute rest period because they have a
is a safe way of predicting the client’s maximal lower absolute resistance.
load. The personal trainer must first identify the If the goal is strength and muscle mass, both
weight that the client can lift using proper form long rest periods with heavy loading and short
for up to 10 reps (if the client surpasses 10 reps, rest periods with moderate loading can work
the personal trainer should allow the client 2-5 well. Short rest periods may increase anxiety
minutes to rest before making another attempt and fatigue. The greater the discomfort and
with a higher weight). The trainer can then use muscle fatigue, the more metabolic demand.
the Brzycki Formula to predict the client’s 1 rep Rest periods depend upon observation as well.
max. The trainer should observe the client for loss of
force, nausea, dizziness or fainting.
The trainer should consider that smaller

10 rep max tests should be included as part
muscle mass or single-joint exercises require
of the client’s fitness assessment and should be
shorter recovery periods, aging decreases
reevaluated every 4-6 weeks.
toleration of resistance exercise (meaning
Determining Rest Periods longer and more frequent rests are necessary),
ATP-creatine phosphate is the energy system and that the body’s bicarbonate and phosphate
and energy source used in resistance training. It levels buffer blood and muscle and are therefore
is used up quickly and needs time to replenish improved by the gradual use of shorter rest
itself. Resistance training that uses both periods.
glycolytic and ATP-creatine phosphate energy Interval Training for Different Energy Systems
% of Maximum
is best for enhancing muscle hypertrophy and Anaerobic
Power
Energy
System Taxed Time Interval
Work:Rest
Ratio
muscle definition. Less rest is needed when 90-100 Phosphogen 5-10 seconds 1:12 to 1:20
both energy sources are used. 75-90 Fast Glycolysis 15-30 seconds 1:3 to 1:5
For advanced training that involves absolute 30-75 Fast Glycolysis & 1-3 minutes 1:3 to 1:4
Oxidative
power and strength, few repetitions near

20-35 Oxidative >3 minutes 1:1 to 1:3
maximum resistance should be programmed

A very short rest is 1minute or less. A short rest
with 3-5 minute rest periods in-between.
is 1-2 minutes. A moderate rest is 2-3 minutes. A
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long rest is 3-4 minutes and a very long rest is5 Static Resistance Devices or Isometrics
minutes or longer. Static resistance devices involve pushing or
pulling an immovable entity such as a wall,

Resistance Training Modalities
Resistance training modalities include:
variable resistance devices, static resistance
devices, or isometrics and isokinetic devices.
Variable Resistance Devices

an overloaded barbell or a maxed-out weight
Variable resistance devices involve a pulley,
machine. Isometrics is a muscular movement in
lever arm or cam. They alter resistance through
which muscle length is unchanged. Isometrics
also pits a weak muscle against a strong one.
Isometrics or static resistance devices are
rarely used as they only improve progress by
5%. Their success is related to the number of
isometric actions, whether the action is maximal
or sub-maximal and the duration of the action.

range of movement in a continual contraction
Functional isometrics refers to their use when
that matches a strength curve.
athletes or clients must overcome a sticking
There are three kinds of curves relating
point in their progress.
to strength: bell-shaped, ascending and
Isokinetic Devices
descending. An example of ascending strength
Isokinetic devices use a variety of methods
curves is a squat. It uses only the top ½ or ¼ of
to provide maximum resistance and range
the repetition. It is not the full ROM. An example
of motion. Isokinetics are popular choices in
of a descending strength curve is rowing. It uses
rehabilitation facilities. They use either friction
only the bottom ½ of the repetition. An elbow
or compressed air to control the speed of
curl is an example of a strength curve that is bell
movement in an exercise or activity. Isokinetic
shaped. It is the middle of the ROM and leaves
devices are often used to train at fast rates of
off the beginning and ending points of the
speed like the type of velocities that occur in
repetition.
real-life sports.
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With isokinetics, the muscular action is levels up and increase effectiveness of the
performed at a constant angular limb velocity. training program. Periodic training is more
There is no set resistance and the action cannot effective than constant training exercises. It is
be accelerated. The more you push, the more the alternating of high loads of training with
resistance you get from the device. decreased loading phases. Variations in the
training program are necessary to first build
muscle mass and then strengthen that increased
mass.
The time frames of periodization are
microphases, mesophases and macrophases.
Hydraulic devices lack deceleration so there Microphases are up to seven days and one should
is no eccentric muscle activity employed. This occur at least every four weeks. Mesophases
halves efficiency because eccentric muscle is are anywhere from two weeks to a few months.
involved in injury protection. Pneumatic devices Four to six mesophases should occur in a year.
can be adjusted on both the The more mesophases that a
concentric and eccentric training period includes, the
muscle exercises. These more effective the training
are often used with older program will be. The sub-
populations but lack balance phases in mesophases are
and control components. preparation, competition,
Isokinetics are used in “prehabilitation” peaking and transition. Macrophase refers to
presently. This refers to their injury prevention the whole training program and usually consists
capabilities. They help clients to better resist of a year.
injury, decrease recovery time from injury and Non-linear periodization programs are used
lower the extent of damage. when the client may have time constraints and
a busy life.
Periodization
Traditional periodization involves varying
Periodization is the use of progressive
volume and intensity in a patterned way. The
cycles in resistance training. It is used to avoid
training program begins with a high volume of
overtraining, deter boredom, keep stimulus
exercises that are low in intensity. Progressively,
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the volume is lowered over time as the intensity • Changing exercises from primary to
of exercises is increased. Small variations occur assisted exercise or vice versa
in each one to four week microcycle. A chart of • Changing the repetition or range of
the intensity is a rising diagonal line. exercise
Stepwise periodization is the use of increasing • Changing the type of muscle contraction
intensity while decreasing volume of exercise • Adjusting speed of movement
during the training period. Repetitions generally • Altering rest periods between sets
decrease in the following manner: eight reps • Adjusting nutrition
down to five reps and then down to three reps.

Overtraining
In undulating periodization, volume and
Overtraining syndrome is a neuro-endocrine
intensity are increased and decreased but not in
disorder because it affects the nervous system
a traditional pattern.
and the hormonal system balance. Overtraining
Overreaching periodization consists of varying
results in “burn out,” “staleness” or “jet lag” and
the volume or the intensity over a short period
can compromise a training program for weeks
of time (one to two weeks) and then returning
or even months.
to the normal training program. Overreaching
is generally done with well-conditioned clients
and advanced athletes.
Ways to Vary Volume and

Intensity
• Changing the choice of exercises
• Varying the order of exercises Rest periods are where physiologic
• Adjusting resistance or load improvement occurs. The period after working
• Adjusting number of sets of an exercise out is when the body reacts to the stressors put
• Changing the number of exercises for a upon it and increases blood flow to the muscles,
specific muscle group increases glycogen stores, increases enzyme
• Altering joint angles and positioning systems and increases heart efficiency. When
• Changing an exercise from working a an athlete or client exercises intensely over a
single joint to multiple joints or vice versa long period of time without proper rest periods,
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regeneration does not occur and performance and a lowered heart rate for a given workload.
will plateau and then decline. It may result in hypoglycemia while exercising.
Overtraining has emotional, behavioral and It is important to rule out hidden illnesses
physical symptoms. An overtrained client as the cause of symptoms before assuming
may experience cumulative exhaustion that overtraining has occurred. Rest is the cure
continues even after rest, for overtraining. If the
like muscular soreness, overtraining has only
fatigue, changes in sleep, happened over three to
loss of appetite, weight four weeks, the problem
loss and weakened should be remedied by
immune system. There three to five days of rest.
may be serious mood The normal training
effects, including irritability, moodiness, program must be corrected before resuming
depression, loss of enthusiasm, loss of desire to exercise. The athlete or client should begin
compete, and an increase in illness and injuries. exercising only on alternate days with decreased
Physiologically, the body experiences increased volume of exercise for a few weeks.
cortisol levels (the hormone released when A training log can monitor the progress of the
we are stressed), lowered testosterone levels client and the success of the program. It can also
and a high level of muscular waste byproducts. prevent the occurrence of overtraining in the
Other life stressors can exacerbate overtraining first place. A training log should include:
symptoms. • Intensity of activity
There are two forms of overtraining: • Resting heart rates
sympathetic and parasympathetic. Sympathetic • Weight
overtraining syndrome is common in sprint- • General health
type sports and is characterized by an elevated • Subjective experience of the workout
resting heart rate. Parasympathetic overtraining • Levels of muscular soreness (on a 10
generally occurs in endurance sports. It is point scale)
characterized by a decreased resting heart rate • Fatigue (on a 10 point scale)
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Resistance Program Design Using the ACTION Personal Training System
The Resistance Training area of the ACTION PTS will allow you to create, edit, and track client’s
programs. There are 2 key components of the Resistance Training area; the Resistance Program, and
the Workout Tracking. Prior to building a program for a client you will want to make sure you have set
their access level and that they have completed the necessary pre-requisites.
Setting and Understanding Client Access Levels

Using the ‘Modules’ display of your Client Management area you may choose between several options
to control your client’s access levels to their programs. These options are:
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View — The View option will not allow client’s to make any alterations to any locked or unlocked
program. They have the ability to print workout cards and exercise description cards but may not
make any alterations to the program itself. This setting is designed primarily to be used for trainers
working with their clients in person.
Modify — The Modify option will allow clients to edit only the exercise selections of an unlocked
program. Once the client or trainer has locked the program no more edits can be made by the client.
Clients will also have the ability to have a new program suggested every 4 weeks, which they will
then be able to edit only the exercise selections until the new program is locked. This setting is
designed primarily for trainers working with clients online only.
No Restrictions — This option will allow clients the same level of access that a trainer has. They may
add new programs and copy or edit existing locked or unlocked programs. This setting is designed
for trainers working with advanced level clients where they want to offer a tool for the client to build
their own workouts.
Prerequisites to Building a Program

There are several pre-requisites that must be completed prior to a program being built or suggested
for a client. If any of these pre-requisites is incomplete when trying to build a client’s Resistance
Program the system will automatically re-direct the trainer to the Pre-Requisites page.
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The four pre-requisites that must be complete are:
PAR-Q — The PAR-Q (see Health Screening) is required to ensure the client has completed at least a
basic health screening prior to exercising
Body Composition — A Body Composition must be completed so the system has the necessary
customized calorie information based on the client’s lean mass values
Experience and Goals — These are required to ensure that the system has enough information about
the client’s experience level to suggest a safe and effective program
Schedule Preferences — The Schedule Preferences settings will determine what template program
will be suggested for the clients based on the number of workouts per week they have scheduled.
Additionally it will allow the system to be able to schedule the resistance program on the appropriate
days each week
Creating Your Own Custom Exercises

There are a larger variety of exercises included in the ACTION Personal Training System. All of these
exercises have both pictures and videos available.
You may add any custom exercises you wish to the system using the Custom Exercise page (Trainer
Menu: Advanced Features: Custom Exercises)
To add a custom exercise, select the appropriate muscle group from the choices at the top of the
page. If the exercise is compound, select the predominately used muscle group. The following fields
may now be completed (all fields are optional):
Name — Give the exercise a name

Full Description — Provide a full description of the movement of the exercise
Main Muscle Group — Primary muscle group (agonist) used during this exercise
Secondary Muscle Group — Secondary muscle group (synergist) used during this exercise
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Joint Type — Isolation or Compound movement
Stability Type — T he higher the stability rating the more difficult the exercise
is and the more stability required to complete the exercise
correctly
Equipment Needed — The type of equipment this exercise requires
Start Position — Upload a picture or drawing of the initial position for the exercise
End Position — Upload a picture or drawing of the finishing position for the
exercise
Third Position — Upload a picture or drawing of this exercise from a different
angle
Muscle Group — Upload a picture or drawing of the muscle groups used for the
exercise
Video Link — Insert a link to a video of the exercise
Program Design
The Resistance Program is one of the most powerful
features of the ACTION PTS system. It will allow you to
quickly and efficiently build effective resistance programs
for your clients.
The drop down box at the top of the page will allow you
to view any previous, current, or future program you have
designed. Simply select the appropriate program from the
drop down box. Below the drop down there are several
options:
Add New Program — This will begin a completely new
program. You will have 4 options for how you want to
build the new program (see Program Design Options below)
Edit Program — Will allow you to makes changes to the currently selected program
Copy Program — Copies and reproduces the currently selected program as a new program
Delete Program — Will delete the currently selected program
Below this you will find a series of program tools:
Print Workout — If the program is a split routine you can select which day of the split you would
like to print from the drop down and then select ‘Exercise Full Descriptions’, which will print detailed
pictures and instructions for all exercises on that day, or ‘Exercise Card’, which will print a card to
record weights, reps, and sets for up to 7 workouts. You may also use the ‘Email’ icon next to ‘Exercise
Card’ to send an email link of the exercise card directly to your client
Status — The status will show whether a program is ‘locked’ or ‘unlocked’. Locked programs have been
scheduled with a start date and number of weeks to use the program and are not editable by clients
who have ‘View’ or ‘Modify’ access levels (see Setting and Understanding Client Access Levels above)
Unlocked programs are not yet scheduled and may be edited at any time by the trainer or client’s with
‘Modify’ or ‘No Restrictions’ access levels
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Periodization — This will display a graph outlining the timeline and program types selected
Stretches — Gives several options for printable stretching routines
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Program Design Options
There are 4 options for building a resistance program:
suggested programs
The Suggested Program feature is the most quick and simple way to build a program for your client.
The system will take into account the client’s schedule and exercise preferences, experience level,
goals, and previous programs to build a completely customized resistance program. The system will
suggest the program template (e.g. whole body endurance, 2 day split hypertrophy, etc.) and all
exercises including reps, sets, and rest. Once the program is suggested you will have full editing
ability to make any changes desired (see Editing Programs below)
Suggested from Template Programs
The Suggested from Template feature will allow you to manually select the preferred program
template for your client and the system will then suggest the appropriate exercises based on the
clients preferences, goals and experience level. The completed program is fully editable.
Favorite Programs
The Favorite Program feature allows you to access any program that you have saved as a favorite
and use it as a template for any other client. Near the bottom of the Resistance Training Program
page there is a ‘Program Favorite Name:’ field where you can fill in a name to save this program as
a favorite. The program will now be added to your list of favorites and be available to use with any
other client. Once a favorite program is chosen it is fully editable.
Manually Creating Programs
Manually creating a program will allow you to select all of the criteria for the program manually,
including the template, split type, and exercises.
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Editing Programs
Regardless of the program design option chosen you have the ability to further customize any
resistance program. Clicking the ‘Edit Program’ button near the top of the page will activate the
editable fields in the resistance program. If you are editing a program that is ‘Locked’ you will be
prompted with a warning that this will ‘Unlock’ any future programs you have scheduled.
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Once you are in edit mode, you may make the following changes to programs (beginning from the
left side of the page):
Program Note — Use the ‘Note’ field below the program description to add custom
notes that will be printed on the program cards. You can also use
the ‘Note’ field next to each exercise.
Select, Edit, or Remove — By clicking on the drop down arrow next to the ‘Day’ you will be
Exercises for a Split Day taken to the Exercise Selection page where you can see exercises
that have already been selected, add additional exercises, or
remove exercises. Once you have completed any changes, clicking
‘Save’ at the bottom of the page will update your program with the
selected exercises.
Select, Edit, or Remove — Clicking the drop down next to any muscle group will take you to
Exercises for a Muscle Group the Exercise Selection page where you may select, add, or remove
exercises for that muscle group.
Add an Exercise — Use the ‘+’ symbol to add an addition exercise for the selected
muscle group
Order — You may change the order that exercises will print on program
cards by clicking the ‘Order’ link at the top of the exercise list. By
changing the exercise number the system will alter the order the
exercises are printed in on program cards to match the order in the
boxes.
Change Exercise — Using the drop down arrow next to the exercise name will open a
drop down list showing alternative exercises that may be selected.
Click on the green check mark next to the exercise you want to
select. You may also click the ‘Add Custom Exercise’ button at the
top of the drop down to be taken to the Custom Exercises page
where you can add your own custom exercises (see ‘Creating Your
Own Custom Exercises’ above)
Exercise Video — by clicking on the ‘Play’ icon next to the exercise name you may
watch a video of the exercise
Reps — Use the drop down to select the number or reps to be performed
for the exercise. The system will default to the number of reps in
the program template.
Sets — Use the drop down to select the number of set to be performed
for the exercise. The system will default to number of sets allowed
based on the schedule preference setting for time available for the
workout.
Rest — Select the amount of rest time between sets using the drop down.
The system will default to the rest time settings for the program
template.
Note — You may add custom notes that will be displayed on the printable
program cards.
Remove an Exercise — Use the ‘-‘ symbol to remove an exercise from the program.
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You may fill in the text box a the bottom of the page to save the current program as a ‘Favorite’ and
make it available to use with any other client. Any favorite program selected for a client is still fully
editable.
Once you have finished editing the program you can click ‘Save’ which will save the program but not
lock or schedule it, or you can ‘Save, Lock and Schedule for the Defined Period’ which schedules the
program based on the days in the Schedule Preferences, from the start date, for number of weeks
selected.
Workout Tracking
Once a program is locked and scheduled it will be available in the ‘Workout Tracking’. The workout
tracking page will allow for recording weight and reps completed for up to 5 sets per exercise. If the
exercise has been done before, then the weight and reps completed in the previous workout with
that exercise will be displayed beside each set.
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Tracking Cardiovascular Activity Using the ACTION Personal Training System
Cardio Program
The ACTION PTS Cardio Program is used to log and track cardiovascular
activities throughout the course of a week.
The system will use the information from the client’s Schedule
Preferences, Cardio Preferences, and Goals and Experience to develop a
suggested week of activity. The suggested activities can be selected by
the client by pre-selecting the activity of choice in the cardio component
of their schedule preferences. Cardio activities left as ‘Auto-Select’ will
be chosen by the system automatically.
The Cardio Program page can be used to view, edit, or delete planned
activities, add additional activities, or log competed activities.
Once a week is planned it may be saved for the current week, or saved
and set to repeat for up to 52 weeks.
138
3. What are physiological factors that one
Summary
should consider in designing a fitness
There is much to consider when designing a
program?
training program, but with time the personal
a) Muscle action
trainer will gain an instinct about design
b) ATP usage
components and creating programs will become
c) Proper positioning
easier and quicker.
d) All of the above
Program design is individualized. It requires
4. What are the three primary resistance
many assessments of the client before design
training goals?________________________________
can begin and then throughout the training
________________________________________________
program so that goals and exercises can be
________________________________________________
continually adjusted and updated. Designing
5. Plyometrics are used with exercise
a training program requires frequent, clear
beginners. True or False?____________________
communication between a trainer and the
6. Using a variety of modes of cardiovascular
client. The trainer must listen closely to client
training is called _____________________________.
feedback and educate the client.
7. How is exercise intensity measured?_______
A successful training program is continually
________________________________________________
assessed and makes use of periodization
________________________________________________
techniques so that the improvement gains
8. Periodization is:
remain noticeable to the client and keep the
a) Muscular action in which there is no
client motivated.
change in muscle length
Review Questions b) The use of progressive cycling in
1. What are some aspects of personal fitness resistance training
that are included in program design?______ c) The position from which all movement
________________________________________________ begins and ends
________________________________________________ 9. Name four ways that one can vary the
2. Postural misalignment and injury can be volume and intensity of exercise.___________
created by muscular imbalances. True or ________________________________________________
False?_________________________________________ ________________________________________________
________________________________________________
139
10. The two forms of overtraining are range of exercise; 10) Changing the type of
___________________________________________ and _ muscle contraction; 11) Adjusting speed
________________________________________________. of movement; 12) Altering rest periods
between sets; or 13) Adjusting nutrition.

Answers
10. Sympathetic and parasympathetic.
1. Anatomy, physiology, kinesiology, basic
nutrition and knowledge of training special References

populations. Brzycki, M. Strength Testing: Predicting a One-
2. True. Rep Max from Reps-to-Fatigue. JOPERD.
3. d) All of the above. 1993;-64(1):88-90.
4. Hypertrophy, muscular strength and Fowles JR, Sale DG, MacDougall JD. Reduced
muscular endurance. Strength After Passive Stretch of the Human
5. False. Plantar Flexors. Journal of Applied Physiology.
6. Cross-training. 2000;89(3):1179-88.
7. By the amount of oxygen consumed during Kokkonen J, Nelson AG, Cornwell A. Acute
exercise and the number of calories burned Muscle Stretching Inhibits Maximal Strength
8. b) The use of progressive cycling in resistance Performance. Resistance Quarterly: Exercise
training. and Sport. 1998;69(4):411-15.
9. Any three of the following 1) Changing the Malliaropoulos N, Papalexandris S, Papalada
choice of exercises; 2) Varying the order of A, Papacostas E. The Role of Stretching in
exercises; 3) Adjusting resistance or load; Rehabilitation of Hamstring Injuries: 80
4) Adjusting number of sets of an exercise; Athletes Follow-Up. Medicine & Sciences in
5) Changing the number of exercises for Sports & Exercise. 2004;36(5):756-59.
a specific muscle group; 6) Altering joint Nelson AG, Kokkonen J, Arnall DA. Acute
angles and positioning; 7) Changing an Muscle Stretching Inhibits Muscle Strength,
exercise from working a single joint to Endurance and Performance. Journal
multiple joints or vice versa; 8) Changing of Strength Conditioning and Resistance
exercises from primary to assisted exercise Training. 2005;19(2):338-43.
or vice versa; 9) Changing the repetition or
140
Spernoga SG, Uhl TL, Arnold BL, Gansneder Witvrouw E, Mahieu N, Danneels L, McNair
BM. Duration of Maintained Hamstring P. Stretching and Injury Prevention: An
Flexibility After a One-Time Modified Hold- Obscure Relationship. Sports Medicine.
Relax Stretching Protocol. Journal of Athletic 2004;34(7):443-49.
Training. 2001;36(1):44-48.
Thacker SB, Gilchrist J, Stroup DF, Kimsey CD Jr.
The Impact of Stretching On Sports Injury
Risk: A Systematic Review of the Literature.
Medicine & Science in Sports & Exercise.
2004;36(3):371-78.
141
Chapter 5: Flexibility
Topics Covered
The Warm-Up
What is a Warm-Up?
Benefits of a Warm-Up
Warm-Up Considerations
Types of Warm-Ups
General Warm-Up
Activity-Specific Warm-Up
Passive Warm-Up
Warm-Ups and Stretching
Flexibility
What is Flexibility?
The Importance of Flexibility
The Science of Flexibility
Types of Flexibility
Corrective Flexibility
Active Flexibility
Functional Flexibility
Stretching Techniques
Static Stretching
Passive Stretching
Active and Active Assistive Stretching
Proprioceptive Neuromuscular Facilitation Stretching
Dynamic and Ballistic Stretching
Precautions and Safety
Types of Stretches
Developing the Program
Measuring Flexibility
• Contributes to efficient removal of
The Warm-Up
metabolic by-products (e.g., lactic acid,
A
What is a Warm-Up? carbon dioxide, water)
warm-up is a short duration • Slowly increases blood flow to muscles
of activity preceding major • Makes muscle tissue more stretchable
exercise. A warm-up is necessary • Reduces risk of tearing muscle fibers,
to increase muscle temperature tendons and muscle tissue
and general core temperature of the body • Allows warmed muscles to move faster
and should be designed to avoid fatigue or and to generate more force for greater
reduction of energy stores. A warm-up improves mechanical efficiency
performance and personal well- •

Enhances neural transmission
being during exercise. Every and motor-unit recruitment
training session should begin • Allows nerve impulses to travel
with a warm-up. If a warm-up faster for quick reaction times
is not conducted, heart rate can •

Provides early alerts for
increase to dangerous levels to try potential musculoskeletal or
to supply the necessary oxygen to cardiorespiratory problems
the muscles. This can often lead There are many benefits to a warm-
to an increase in muscular injury. up before exercise. First, a warm-up
These kinds of injuries comprise produces an increase in metabolic
greater than 30% of injuries seen in sports requirements. The short period of time used for
medicine clinics. a warm-up corresponds to the time necessary
to allow the cardiorespiratory system to adjust

Benefits of a Warm-Up
blood flow effectively to the muscles, where the
• Increase in metabolic requirements
oxygen demand is great during exercise. This
• Makes physical performance more
adjustment makes physical performance more
effective and efficient
effective and efficient. Secondly, a warm-up
• Prevents blood lactic acid accumulation
prevents blood lactic acid accumulation in the
in the muscle (helps to prevent premature
muscle, which can lead to premature fatigue.
fatigue)
It also contributes to the efficient removal of
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metabolic by-products like lactic acid, carbon of 40-75 beats/minute to approximately 90-120
dioxide and water. A warm-up prevents the beats/minute. During the warm-up, the body
client from going from a state of inactivity to high temperature of the muscle tissue rises about
intense activity too quickly by slowly increasing 3.6 °F. The duration of the warm-up should be
blood flow to the muscles. Third, muscle tissue a minimum of 3-5 minutes; however, the actual
becomes more stretchable in response to warm- length should be based on the exercise activity
ups. The risk of tearing muscle fibers, tendons to follow. For elderly persons, pregnant women,
and muscle tissue is reduced. Additionally, overweight individuals or exercise beginners,
warmed-up muscles move faster and generate the warm-up should be more gradual and for
more force, allowing for greater mechanical a longer duration, typically 10-15 minutes. In
efficiency due to low resistance terms of activity, the warm-up
within the muscle. A fourth It is important to elevate should be controlled and go

the heart rate from the resting
benefit of a warm-up is that it heart rate of 40-75 beats/minute through an easy range of motion.
to approximately 90-120
enhances neural transmission It should never be beyond the
beats/minute.
and motor-unit recruitment. range of motion, which might
Nerve impulses travel faster in these cases ultimately cause pain and discomfort.
and allow for quicker reaction times. Lastly, a There are three major types of activities that
warm-up provides an early alert for potential can accomplish efficient warm-up: general,
musculoskeletal or cardiorespiratory problems. activity-specific and passive warm-up. Often,
These problems become apparent in a warm-up however, warm-up exercises may be grouped as
before they can cause serious injury during the active and passive.
higher intensities of exercise.

Types of Warm-Ups
Warm-Up Considerations
General Warm-Up
During a warm-up, the amount, intensity and
A general warm-up involves rhythmic and
duration should be adjusted according to the
continuous movement and callisthenic exercises.
individual’s current fitness level. The intensity
In this warm-up regimen, mostly large-muscle
of the warm-up is important in effectively
groups are engaged. Activities in a general
preparing the body for exercise. It is important to
warm-up include jogging, cycling and jumping
elevate the heart rate from the resting heart rate
rope. A general warm-up usually precedes an
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activity-specific warm-up and is more
Passive Warm-Up
appropriate than a passive warm-
A passive warm-up includes things like a hot
up when a demanding physical
shower, a massage and heat applications. This
activity is to follow. The aim of a
can have a positive effect and does not cause
general warm-up is to increase
fatigue in a person prior to the exercise session.
heart rate, blood flow, deep muscle
However, a passive warm-up is less likely to warm
temperature, respiration rate and
deep muscles and may
perspiration. Additionally, decreasing
even be counterproductive.
viscosity of joint fluids is one of the main goals
The increased surface
of a general warm-up.
temperature of the skin
Activity-Specific Warm-Up often leads blood vessels
An activity-specific warm-up includes that are close to the
movement that is actually a part of the main surface of the skin to dilate. Blood then moves to
physical activity. For example, an activity- the surface of the skin and away from working
specific warm-up can muscles.
include swinging a tennis

Warm-Ups and Stretching
racket before playing tennis
A misconception is that a warm-up and
or conducting light resistance
stretching are the same thing—they are
training movements before
not. A warm-up raises the body and muscle
weight lifting. This method of warming-up
temperature while stretching improves
is more desirable because it increases the
flexibility. In some instances, however, a warm-
temperature of the same muscle groups that will
up can, increase flexibility by increasing muscle
be used in the specific activity as well as serve as
elasticity. Due to these considerations, flexibility
a mental rehearsal. An activity-specific warm-
stretching should occur only after a warm-up.
up usually includes 8-12 minutes of dynamic
Some warm-up routines do not include
stretching, focusing on movements that work
flexibility training. However, the addition of
through the range of motion.
flexibility exercises are often part of a warm-up
routine and are often matched to the demands
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of the activity that will be conducted. It usually
The Importance of Flexibility
depends on the nature of the exercise that will
Flexibility is often a neglected part of physical
follow. If the activity will be of great intensity
fitness. A high level of flexibility can be gained
(e.g., basketball), then flexibility training would
quickly but can also be lost quickly through
be necessary. However, if the activity is more
inactivity. Also, levels of flexibility decrease
static (e.g., stationary biking), then flexibility
with age. Lack of flexibility can cause lower
training may be needed or the warm-up may
back and hamstring muscle pain and weak
only consist of static stretching.
abdominal muscles. In theory, the risk of injury
to the muscle-tendon unit is based on the
fact that tight muscles are more likely to be
strained compared to more flexible muscles. An
increase in the interaction of actin and myosin
filaments of the muscle occurs when a person
is more flexible and this ultimately improves
performance. This highlights the importance of
a consistent flexibility training program.
Improving flexibility can also lead to good
posture by realigning the skeletal structure
Flexibility that has adapted to poor posture and exercise
habits. The more unrestricted the movement

What is Flexibility?
is, the more flexible the body will be. Because
Flexibility is the ability of your joints to
of this, flexibility enhances safety and efficiency
move through a full range of motion. It is the
in conducting not only exercise
capacity to move freely in every
regimens but also daily tasks.
direction and, at times, beyond
Too much flexibility or overly
the normal range of motion.
restricted movement in the
Flexibility ultimately measures
body can lead to problems. This
the tightness of the muscles.
is often due to compromising
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joint stability. Forcing the body to a point of pain the greatest range of motion compared to other
is never encouraged. joints.
Another important aspect of designing an Another factor is age. People become less
effective flexibility training program is that the flexible with age and never again reach levels
correct performance and correct positioning of seen during early childhood due to a loss of
the exercises are conducted no matter which muscle elasticity. Early childhood is the best
training method is utilized. Stretching exercises time to start flexibility programs.
and techniques are often used in designing Females are typically more flexible than males.
a program to gain flexibility. Programs may This is thought to exist from childhood through
include a variety of techniques for the joints adult life. It is attributed to the anatomical
with periodic repetitions to chart progress. variation in joint structure seen in the trunk,
hips and ankles. At puberty, boys have increased

The Science of Flexibility
muscle size, stature and muscle strength that
One factor affecting flexibility is joint structure.
ultimately hinders flexibility. It has been proposed
Flexibility is joint specific. This is one of the
that increases in growth rates in different parts
primary limiting factors for the range of motion
of life may result in rigidity of bones composing
since the structure determines how much
a joint and therefore lead to decreased flexibility.
movement is available. Flexibility
The composition of connective
also varies between joints of the
tissue is another factor. This includes
body due to construction. One joint
cartilage, which lies between
may have above-average range
bones to provide protection at the
of motion and another joint have
contact points and offer padding
below-average range. Hinge-type
and shock-absorbing capabilities.
joints, including the joints of the
Ligaments, which connect bones,
knee and elbow, conduct only
Females are typically more offer stability and integrity to
backward and forward movement flexible than males.
joint structures, while tendons,
so they have less range of motion
which connect bone to muscle, lead to efficient
compared to ball and socket joints, like that of
bodily movement and play a role in flexibility.
the hip and shoulder. Movement is allowed in
The three layers that wrap the muscle, the
all anatomical planes in this area, which has
muscle fascia, play an even greater role. Muscle
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can be stretched to 150% of its length if relaxed It involves two main concepts known as
and unrestricted without any injurious effects. static stretching and self myofascial release
Ligaments and tendons, though (SMFR). Static stretching refers to
important to flexibility as a whole, stretching an antagonist muscle
are hard to stretch because of their to its maximum limit and holding
roles in stabilization and muscle the position for a period of time.
force protection. Muscle fascia is An antagonist muscle stretches
relatively easy to stretch. during a contraction while working against
agonist and synergist muscles. Agonist muscles

Types of Flexibility
initiate muscle contractions and synergist
Flexibility Training System (Integrated) muscles provide additional support the body
Flexibility training programs involve needs to perform a particular action. This type
increasing flexibility through a progression of of static stretching strengthens muscles and
three phases. The three phases, known as the prevents injuries or tearing of soft tissue.
flexibility continuum, are corrective, active and SMFR is a technique
functional flexibility. used to remove knots
Corrective Flexibility from muscles; these
• Static Stretching knots can
• Neuromuscular Stretching form during
• Neurodynamic Stretching vigorous exercises or stressful activities. This
• Self-Myofascial Release technique incorporates the use of a foam roll or
Active Flexibility cylindrical object and body pressure to massage
• Neuromuscular Stretching muscles and decrease micro-adhesions that
• Active Isolated Stretching lead to the formation of muscle knots. Micro-
Functional Flexibility adhesions that form during a workout stimulate
• Dynamic Stretching the release of healing proteins, which lead to
an increase in muscle density and metabolism.

Corrective Flexibility
Unfortunately, the release of proteins causes the
Corrective flexibility was designed to correct
development of knots within the muscle. Knots
muscle imbalances and improve joint ailments.
that are left untreated make muscles inflexible
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and tight and decrease a muscle’s ability to isolated stretching utilizes agonist and synergist
function and contract properly. Knots can also muscles to perform the entire movement of a
cause chronic muscle tension, joint pain and specific action while allowing the antagonist
poor posture. All these complications muscle to stretch. For example, when
can be avoided by simply massaging performing straight leg raises in a
muscles with a foam roll after a supine position, the hip flexor and
workout. In other words, SMFR is a quadriceps cause the leg to raise and
cool-down technique that leaves the allow the hamstring (antagonist) to be
muscle free of knots and in better stretched. Active-isolated stretching
shape by the start of the next workout techniques are held for approximately
regimen. 2 seconds and allow muscles to
Areas of the body that should be focused on when easily repair themselves and enhance daily
performing SMFR include: the gastrocnemius performance activity. This form of stretching
(calf muscle), tensor fascia latae/iliotibial tract also increases joint elasticity and improves
band (hip and leg muscle), adductor muscle (hip circulation. Overall, the active flexibility phase
muscle), piriformis (gluteal) muscle and the increases clients’ level of strength and prepares
latissimus dorsi (triangular back muscle). Static them for the final functional flexibility phase.
stretching followed by SMFR begins to improve

Functional Flexibility
flexibility and enhances the body’s ability to
The functional flexibility phase allows
heal its muscles after a workout. This is the first
individuals to achieve maximum extensibility of
part of the flexibility continuum.
soft tissue and neuromuscular control through
Active Flexibility dynamic stretching and SMFR. Dynamic
Active flexibility, the second phase of the stretching involves the combination of active
continuum, entails the use of SMFR and active- muscle exertion, speed of movement and
isolated stretching to improve the momentum to stretch
efficiency of neuromuscular (nerve and a particular muscle or
muscular) interactions. In addition, an group of muscles. This
increase in soft tissue extensibility can be form of stretching is
noticed by the end of this phase. Active- most often conducted
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before a competition and bouncing or jerking speed of stretch. Static stretching requires no
movements are avoided. Dynamic stretching voluntary muscular activity. Static stretching is
reduces muscle tightness, which is associated known to prevent overstretching and exceeding
with the occurrence of musculotendinous the normal range of motion while requiring a
(muscle and tendon) tears. The results of recent lower energy requirement. Lower instances
studies also suggest that dynamic stretches of muscle soreness are also associated with
before a competition are more beneficial than static stretching. Aspects of static stretching
static stretches. This final phase of the flexibility may also be included in the other forms of
continuum increases power in addition to stretching. Static stretching techniques include
strength. An important point to remember in the following:
regards to the flexibility continuum is that, for

Gastrocnemius stretch:
each phase, SMFR should be performed after
Stand upright facing a wall and place the left leg
stretching.
in front of the right leg. Hands should be raised
Stretching Techniques to shoulder level and placed against the wall.
We will discuss in further detail the following Slowly move
different forms of stretching: static, active, the right leg
proprioceptive neuromuscular facilitation, away from
dynamic and ballistic. the wall, keep
it straight and
Static Stretching
firmly press
Static stretching is slow and sustained
the heel into
stretching to increase movement at the
the floor. Hold the stretch for 20-30 seconds.
corresponding joint. It can be performed to
The calf muscle will be stretched. Repeat this
cool down muscles after a workout by holding
stretch with the left leg.
specific stretches for 10 seconds or to increase
range of movement and mobility by holding the Static standing adductor stretch:
stretches for 30 seconds. The benefits come from Stand upright with the feet placed
simultaneously relaxing and lengthening the approximately two shoulder lengths apart. Lift
stretched muscle. This type of stretch does not the right leg by bending at the knee and then
activate the stretch reflex because of the slow lower the body, leaning into the bent right leg.
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Keep the back front thigh to help you balance. Hold other arm
straight and use the straight up with hand in air. Pull navel inward,
arms to maintain squeeze butt muscles and rotate pelvis toward
balance while the front of the body. Move body forward slowly
holding for 20-30 until mild tension can be felt in the front of the
seconds. The left leg adductor will be stretched. hip/leg that is supporting your weight. Hold for
Repeat the stretch with the opposite leg. 20-30 seconds. Repeat on other side, switching
legs and arms.

Static standing psoas stretch:
Stand upright with one leg Static pectoral wall stretch:
bent and slightly forward and Stand perpendicular to a wall (or door
the other leg back. Rotate opening) with right foot forward and toes
toes of back foot inward. Pull pointing forward. Form a 90° angle with your
stomach inward. Squeeze arms, palms of hand flat against the wall/door
butt muscles and, while jam. Pull navel inward. Slowly lean forward until
rotating pelvis to the back, shift body forward a mild stretch is felt
and straighten the back leg. A mild tension in the front shoulder
should be felt in the front of the hip. Raise the and chest region.
arm (same side as the back leg) up and over to Hold for 20-30
the opposite side of the body while holding the seconds and repeat
pelvis position. Continue to hold this position 3 times.
and rotate backwards at a slow rate. Hold for

Static latissimus dorsi ball stretch:
20-30 seconds. Repeat on the opposite side.
Stand in front of a
Static kneeling hip flexor stretch: stability ball. Place the
Kneel down on one leg bottom side of right hand
with the back leg being on the ball with the thumb
bent at a 90° angle. Keep pointing upward. Roll the
posture tall. Internally ball to the left and kept the hips square keeping
rotate your back hip. the right fist on the ball. Draw in your core
Place same sided hand on tightly and prevent hips from moving to get the
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best stretch. Hold this position for 3-5 breaths
Active and Active Assistive
and then switch to left hand and roll ball to the
Stretching
right.
In active stretching, the person who is
Static upper trapezius/scalene stretch: stretching supplies the force of the stretch.
Stand upright with The stretched muscle is being actively engaged
a proper posture and moved through the range of motion. This
position and place requires energy greater than what is used for
the left arm behind static stretching. Active assistive stretching
the body. Pull the is sometimes considered a partner stretch. It
navel inward then retract and depress the is the same as
scapula on the left side. Tuck in the chin and tilt active stretching
the head from left side toward right side. Hold but the muscle
this position for 20-30 seconds, then repeat on being stretched
the right side. may also require some assistance to go through
the range of motion. This is most likely because

Passive Stretching
of muscular weakness.
Passive stretching is a
Active stretch techniques strengthen agonistic
form of static stretching
muscles while increasing active flexibility. Most
and is so named because it
active stretches do not need to be held for more
requires assistance, which
than 15 seconds and holding an active stretch
is needed from an external
position for more than 10 seconds is usually
force to reposition parts of
difficult. A variety of yoga exercises are active
the body. This force can be from gravity, which
stretches. Active stretch techniques include:
weighs the body down or from another person
like a personal trainer. To maximize results from Active Gastrocnemius stretch with
passive stretching, one should remain relaxed Pronation and Supination:
and stop any reflexive movement. Stand facing a wall in the lunge position and
lean against the wall, using the upper body
for support. The leg closest to the wall should
be bent and the leg behind the body should be
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straight. Pull the navel inward, lift the bent leg tension can be felt in front of the hip being
and rotate the body from left to right. The stretch stretched. Bend to the side and rotate toward
should be held the back. Hold for 2 seconds for 5-10 repetitions.
for 2 seconds
Active kneeling hip flexor stretch:
and performed
Kneel down on one leg with the back leg bent
5-10 times on
at a 90° angle. Keep posture tall. Internally rotate
both sides of
your back hip. Place
the body.
same sided hand on
Active supine biceps femoris stretch: front thigh to help
Lie on the back with both legs extended you balance. Hold
straight. Lift the right leg and bend the knee. other arm straight
up and down with hand in air overhead. Pull
navel inward, squeeze butt muscles and rotate
pelvis toward the back of the body. Move body
Place the right hand behind the right knee for forward slowly until mild tension can be felt in
support. Pull the navel inward and extend the the front of the hip/leg that is supporting your
leg towards the ceiling. Hold this stretch for 2 weight. Bend to the side and rotate toward the
seconds and repeat 5-10 times. Repeat with the back. Hold for 2 seconds for 5-10 repetitions.
left leg. Repeat on other side switching legs and arms.
Active standing psoas stretch: Active standing adductor stretch:

Stand upright with Stand upright in a proper posture position
one leg bent and with the feet placed two shoulder lengths apart.
slightly forward. Lift the right leg, bend the knee and slowly lower
Rotate the back leg the body. Use the arms to balance and keep the
inward. Draw the back straight. Hold the stretch for 2 seconds,
navel inward while repeat 5-10
raising the arm overhead. Squeeze butt muscles times then
and rotate backwards. Lean forward on the repeat with
front leg, controlling the movement, until slight the left leg.
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uncontrolled because of the high
Proprioceptive Neuromuscular
rate and degree of stretch as
Facilitation Stretching
well as force applied to induce
Proprioceptive neuromuscular facilitation
the stretch. The disadvantages
(PNF) stretching was initially developed as
of this stretching technique
a technique to relax muscle with increased
include the predisposition of the muscle to
activity but has been expanded to improve the
injury. This may outweigh any benefit from this
range of motion.
type of stretching. Ballistic stretching also has
It is thought to
a higher energy requirement, which may cause
be superior to
fatigue and hinder performance in the main
other stretching
exercise activity. Additionally, though it has a
methods because
greater range of motion than the static range of
it also assists in muscular relaxation. PNF makes
motion, some do not consider this an acceptable
use of both passive and active stretching. The type
method for increasing the range of motion.
utilized depends on what is the best response
Dynamic stretching techniques involve
to the stretch stimulus. It includes contract-
controlled arm and leg exercises that gradually
relax (hold-relax), which involves the muscle
increase speed of movement, range of motion
contracting and then relaxing. The muscle is
and extensibility. They usually comprise 8-12
then further stretched into its available range
repetitions or less and are a good warm-
of motion during the relax phase. In another
up routine for aerobic workouts. Dynamic
type of PNF, contract-relax-contract (hold-relax-
stretching techniques include the following:
hold), the same procedure is conducted but
the contraction of the antagonist muscle gains Prisoner squat:

slightly more range of motion. Stand upright with the feet shoulder length
apart and point the toes slightly outward in an

Dynamic and Ballistic Stretching
Dynamic stretching is often confused with
ballistic stretching. Ballistic stretching entails
quick jerking and bounce-like movements
on the resistant tissue. This stretching is
performed at high speeds and therefore is often
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angle. Place the hands behind the head and hold When coming out of the lunge position, pivot
the chest and shoulders in an upright position back to the starting position, then repeat on the
during the exercise. Bend at the hip and knees other side. Repeat the entire series 6-8 times.
and slowly lower the body. Balance on the heels,

Single-leg squat touchdown:
do not lean forward and make sure the knees do
Balance on one leg while keeping
not pass over the toes. Repeat 8-12 times.
the corresponding shoulder in line
Multiplanar lunge: with the knee and hip. Squat as far
This lunge involves three parts: the front as possible with the opposite leg
lunge, the side lunge and the turning lunge. elevated and extended forward.
For the front lunge, stand upright with the legs Do not allow the knee of the balance leg to go
together and the hands placed on the hips. Step over the toes. Return to the starting position
forward with the right leg and bend the right and repeat with the other leg.
leg at a 90° angle. Make sure not to extend the

Tube walking/side-to-side:
Stand upright with the feet
shoulder width apart and pointed
forward. Pull in the belly and
slightly bend the knees. Tighten the
knee over the toes and keep the upper body glutes and step toward the left with
upright. Return to the start position and repeat the left foot, then step toward the left with the
the lunge with the left leg. To perform the side right foot. Take 5-10 steps to the left, then 5-10
lunge, stand in the same starting position and steps to the right in the same manner. Perform
step to the side with the right leg. Bend at the this stretching exercise 1-5 times.
hips towards the right leg, keeping the torso

Medicine ball chop and lift:
upright and the hips facing forward. Return to
Stand upright with the feet two shoulder-
the starting position and repeat with the left leg.
lengths apart and slightly bend the knees. Hold
To perform the turning lunge, stand in the same
a medium-sized medicine ball with both hands
starting position and step to the side with the
above the head and bring the ball down in front
right foot at a 45° angle. Pivot the left foot while
of the torso in a chopping motion. The ball can
slowly lowering the body into a lunge position.
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be brought down to the
Types of Stretches
knee level or to the floor
for a greater challenge. Static Stretching:

While continuing to • Safest option for beginners
hold the ball, reverse • Most effective form of flexibility
directions and bring the techniques
ball back to the starting position over the head. • Lowest incidence of rate of injuries
Repeat 8-12 times and maintain a consistent • First phase of flexibility continuum
pace throughout the exercise.

Active Stretching:
Precautions and Safety • Tedious and difficult for average person
No two individuals are the same so each client • Agonist muscle strength and mental
interested in beginning a flexibility training concentration is needed to perform
program should have an effective regimen properly
specific to that client’s needs. The ease at which • If increase in range of movement is
flexibility can be increased is normally limited not noticed, passive or combination of
by muscle fascia (connective tissue), which passive and active stretching can be
causes the most resistance to improving range of performed
movement. Trainers and their clients enrolled in • Second phase of flexibility continuum
a training program should pay close attention to

Dynamic Stretching:
making sure range of movement can be altered
• Can be performed as active and/or
without causing joint injuries or increasing the
passive stretching
risk of serious injuries. Trainers should closely
• Dynamic active stretching utilizes
monitor their clients while stretching exercises
momentum to increase range of
are being performed, and clients should clearly
movement
understand how to perform movements and
• Safety is dependent on one’s flexibility
concentrate while performing stretches.
level, speed at which performed and
range of motion necessary
• High injury risk
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• Typically performed by athletes for a a combination of passive and active stretching.
specific event Passive stretching allows individuals to
• No substantial evidence that it is better gradually stretch the agonist muscle of interest
than other types of stretches and puts less strain on the agonist muscle.
• Third phase of flexibility continuum Combining passive and active stretches makes
By following concepts such as these, the the transition into the second phase of the
trainer and client can be reassured that flexibility continuum less stressful.
flexibility training will be conducted in a safe Dynamic stretching, the third part of the
manner. Static stretching is the safest option flexibility continuum, can also be performed
to start for individuals who are inactive or in an active and/or passive manner. Dynamic
who simply want to become more flexible. stretching differs from active stretching,
Static stretching belongs to the first part of however, by utilizing momentum to increase
the flexibility continuum and is range of movement. The safety

Static stretching is the safest
typically labeled as the safest of dynamic stretches depends on
option to start for individuals
and most effective form. Long- who are inactive or who simply the individual’s flexibility level,
want to become more flexible.
duration, low-force static the speed at which the movement
stretching exercises produce much more muscle is performed and the range of motion necessary
extensibility than active and dynamic stretches. to perform the stretch.
Static stretching also offers the lowest incidence Dynamic stretching is typically performed by
rate of injuries. athletes needing to prepare for a specific sports
Active stretching, unlike static stretching, routine or aggressive sporting event. Dancers,
is usually tedious and difficult for average divers and professional gymnasts extensively
individuals to perform. One common problem is use dynamic stretching. A high injury risk is
that most people do not have the agonist muscle associated with this form of stretching and,
strength and mental concentration needed to although many athletes prefer to use dynamic
properly perform active stretching techniques. stretches to warm-up, there is no substantial
Individuals who fall under this category scientific evidence that suggests dynamic
typically do not notice an increase in their stretching is better than any other form of
range of movement. One way to overcome this stretching. However, if an individual who
problem is by performing passive stretching or has been physically inactive for an extended
158
period of time needs to prepare for a vigorous be delayed. When requesting medical history
sporting event, (e.g., marathon) implementing information, the trainer must impress upon the
dynamic stretches in the beginning of the client the importance of thoroughly informing
training program may be justified. In every case, the trainer about every procedure had and any
safety precautions such as drinking and eating ailments currently causing issues.
properly before training, maintaining proper

Developing the Program
posture while training and concentrating should
Designing the right training program depends
be taken seriously.
on factors such as age, gender and the client’s
Individuals who suffer from a disease that
current and previous physical activity level.
limits or increases their range of motion or
Young children are usually more flexible than
who have had previous surgeries/injuries that
adults so exercises that may be easy for children
reduced or increased their flexibility must be
to perform might cause extreme difficulty for
cautious when stretching. Ailments such as
older individuals. Gender also plays a role in
arthritis cause a lot of pain for sufferers due to
levels of strength and flexibility. Men tend to be
inflamed joints. Putting unnecessary pressure
stronger than women, but women tend to be
on affected joints or stretching a muscle beyond
more flexible in the hip region.
its range of motion can leave
Knowing what type of surgeries or These factors may affect the
the individual in more pain and injuries an individual has had will
allow the trainer to suggest client’s ability to properly carry
discomfort than before starting stretching techniques that will not
out certain techniques and
the training program. re-injure or further injure the client
may also affect the outcome of
Knowing what type of surgeries or injuries
the stretch exercises. In addition to gender, a
an individual has had will allow the trainer to
client’s physical activity level is one of the most
suggest stretching techniques that will not re-
important factors to consider when designing a
injure or further injure the client. Sometimes
training program. A person who practiced karate
clients choose to take part in a training program
on a weekly basis for several years and then
in order to regain strength or flexibility they
took a break may be more flexible and stronger
may have lost due to an accident. If proper
than an individual who has not performed any
care is not taken when the training program is
form of physical activity for years. Knowing
designed or if the client is not closely monitored
details such as these ensure that each individual
when stretching, the recovery process may
159
achieves the desired results (the muscle’s ability to extend).
without pushing beyond the Warm muscle tissue is less stiff
body’s limits. than cold muscle tissue and
Goals such as improving range responds better during stretch
of movement in specific joints exercises. Warm-up exercises
and increasing endurance should also play a include running on a treadmill or stationary
role in how the training program is structured. cycling.
If a client needs to simply become more active Breathing properly allows the client to relax
and wishes to do so by first increasing the and smoothly progress into each stretching
level of flexibility, the training program may be exercise. Proper breathing also ensures that
comprised of mainly static stretching exercises. only the muscles of interest are being stretched
If a fairly active individual needs to increase and strengthened. Breathing properly relieves
strength and flexibility in the next two months muscle tension, which can cause unwanted
for an upcoming event, the training program muscle pain during and after the workout. The
may start off with static and active exercises trainer should clearly describe how to breathe
and then quickly shift to dynamic exercises. A during a stretch routine so the client can get
training program may also alternate between the most out of the workout regimen. In order
phases as the trainer and/or client see fit. to properly breathe throughout the routine, the
client must concentrate.

Three factors for Workout Design
Maintaining a proper posture while working
1. Warming up
out also involves concentration. Bad posture
2. Proper breathing
can lead to muscle knots and chronic muscle
3. Maintaining posture
pain, which cause the stretch exercises to be
Three important factors that should also
ineffective. Maintaining correct posture also
be included in the workout design include:
means properly extending the limbs during
warming up, proper breathing and maintaining
the workout. Overextending can cause serious
proper posture. Warm-up exercises have been
injuries and under-extending will lead to a lack
shown to reduce the body’s resistance to
of results. Only proper posture held throughout
stretching by increasing muscle temperature,
the exercise will lead to an increase in strength,
which in turn leads to an increase in elasticity
flexibility and range of motion.
160
program, a discussion with a trainer needs
Measuring Flexibility
to follow and the client needs to fully define
There is no single test that can be administered
medical history, physical activity history and
to test the flexibility of the whole body. However,
goals. The trainer must then use the
separate tests can measure the
information obtained to create a
flexibility at certain joint areas.
specific program that enhances the
Flexibility assessments include 3-5
client’s speed of movement, mobility,
minutes of warm-up and stretching
endurance, strength and flexibility
to avoid injury or muscle strain.
without causing injury or discomfort.
This test is often repeated every 4-6 weeks to
If the client is relaxed while working out and
monitor progress and help reach a higher level
notices positive results, the training program
of flexibility.
will be more successful.
The typical devices for measuring
Individuals who are suffering
flexibility include manual and
from a debilitating ailment (e.g.,
electric goniometers to measure
arthritis, muscle imbalance,
joint angles and the sit-and-
osteoporosis) or a recovering
reach test. These tests evaluate
from surgery or an injury need to
combined flexibility of the lower back and hips.
start with the corrective flexibility phase of the
Goniometry is the measurement of joint range
flexibility continuum. Individuals who are active
of motion measured in either linear units like
and possess high levels of flexibility may be able
inches and centimeters or angular units like the
to start at the functional flexibility phase, but
degrees of an arc.
they may also need to regress to the corrective
Summary and active phases during their training program.
Prior to starting a flexibility training program, Every individual, regardless of the strength and
clients should have a good understanding of their flexibility level, should perform SMFR after
current level of strength, flexibility, mobility working out. Warming up before exercising and
and range of motion. Previous injuries, ailments performing SMFR afterwards prevents muscle
and surgeries should also be considered prior ailments and serious injuries, helps remove
to beginning a training program. Once an unwanted muscle knots and allows muscles to
individual makes a decision to start a training be in better shape prior to the next workout.
161
Warming up softens muscles and improves 4. What are the three types of flexibility? ____
muscle elasticity and SMFR is a simple massage ________________________________________________
technique that enhances muscle healing, ________________________________________________
strength and extensibility. 5. Where should a client with arthritis start on
Breathing properly and maintaining proper the flexibility continuum?___________________
posture while performing stretches is also of ________________________________________________
the utmost importance. An individual can cause ________________________________________________
more damage to the body or delay healing 6. Which of the three phases belong to the
if stretches are not performed properly. The flexibility continuum?
client needs to ask questions when a particular a) Functional flexibility
movement of a stretch routine is not completely b) Ballistic flexibility
understood and make sure to concentrate at all c) Active flexibility
times. By following these guidelines, strength, d) Corrective flexibility
endurance and flexibility can be improved with 7. What is SMFR and what does the acronym
ease. stand for?_____________________________________
________________________________________________
Review Questions
________________________________________________
1. More than 30% of sports injuries seen are
8. Which three factors should be included in
due to a lack of a warm-up. True or False?_
the design of a training program?
________________________________________________
a) Breathing
2. Which of the following is NOT a type of
b) Running
passive warm-up?
c) Posture
a) Heat application
d) Warming up
b) Hot shower
9. What is the purpose of the corrective
c) Massage
flexibility phase?_____________________________
d) Stretching
________________________________________________
3. Because a warm-up can improve flexibility,
________________________________________________
stretching should be done after the warm-
up. True or False?____________________________
________________________________________________
162
Answers References
1. True. Cramer JT, Housh TJ, Weir JP, Johnson GO,
2. d) Stretching. Coburn JW, Beck TW. The acute effects of
3. True static stretching on peak torque, mean
4. Corrective, active and functional flexibility. power output, electromyography and
5. At the corrective flexibility phase of the mechanomyography. European Journal of
flexibility continuum. Applied Physiology. 2005;93(5-6):530-
6. a) Functional flexibility, c) active flexibility 39.
and d) corrective flexibility. Gleim GW, McHugh MP. Flexibility and its
7. It stands for Static stretching and self effects on sports injury and performance.
myofascial release and is the technique Sports Medicine. 1997;24(5): 289-99.
involved in corrective flexibility. Halbertsma JP, van Bolhuis AI, Göeken LN.
8. a) Breathing, c) posture and d) warming up. Sport stretching: effect on passive muscle
9. To correct muscle imbalances and improve stiffness of short hamstrings. Archives
joint ailments. of Physical Medicine and Rehabilitation.
1996;77(7):688-92.
Krivickas LS, Feinberg JH. Lower extremity
injuries in college athletes: relation
between ligamentous laxity and lower
extremity muscle tightness. Archives of
Physical Medicine and Rehabilitation.
1996;77(11):1139-43.
Sady SP, Wortman M, Blanke D. Flexibility
training: ballistic, static or proprioceptive
neuromuscular facilitation? Archives of
Physical Medicine and Rehabilitation.
1982;63(6):261-63.
163
Shrier I. Stretching before exercise does not Witvrouw E, Mahieu N, Danneels L, McNair
reduce the risk of local muscle injury: A P. Stretching and injury prevention: an
critical review of the clinical and basic obscure relationship. Sports Medicine.
science literature. Clinical Journal of 2004;34(7):443-49.
Sports Medicine. 1999;9:221-27. Woods K, Bishop P, Jones E. Warm-up
Smith CA. The warm-up procedure: to and stretching in the prevention of
stretch or not to stretch. A brief review. muscular injury. Sports Medicine.
Journal of Orthopedic Sports Physical 2007;37(12):1089-99.
Therapy. 1994;19(1):12-17. Yamaguchi T, Ishii K. Effects of static
Witvrouw E, Danneels L, Asselman P, D’Have stretching for 30 seconds and dynamic
T, Cambier D. Muscle flexibility as a risk stretching on leg extension power. The
factor for developing muscle injuries Journal of Strength Conditioning and
in male professional soccer players. A Research. 2005;19(3):677-83.
prospective study. American Journal of
Sports Medicine. 2003;31(1):41-46.
164
Chapter 6: Program Design Elements
Topics Covered
Cardiorespiratory Conditioning
The Importance of Cardiorespiratory Fitness
Training Design
Postural Considerations
Smart Progression
Interval Training
Interval Training Model
Stage Training
Circuit Training
Fat Burning
Muscular Strength
Endurance Conditioning
The Adaptation of Strength Training
Flexibility Training
Types of Stretching
Things to Avoid
Postural Muscle Imbalance
Balance, Agility, Speed
Balance
Balance Training
Coordination and Speed
Sensory Function
Speed
conditioning, it is important to apply the correct
C
Cardiorespiratory Conditioning
overload (increase in heart rate and return of
ardiorespiratory conditioning
blood to the heart) to properly strengthen the
is an activity used to improve
heart. The ultimate goal is to increase heart rate
the body’s ability to process and
and respiration in order to place appropriate
deliver oxygen, which produces the
stress on the cardiorespiratory system. The
energy required to complete a desired activity.
overload must be progressive and can be
It involves intense movements and activities
measured by increases in maximal oxygen
that stimulate the cardiovascular system. This
consumption (VO2 max). Sustaining a large
typically involves specific muscular endurance
volume of blood returning
training of the large muscles
to the heart is necessary to
of the hips, thighs and
see the positive effects of
buttocks and a focus on a
exercise. For example, lifting
client’s ability to perform
weights will increase heart
repetitive, moderate-to-high
rate but will not increase
intensity training routines. Cardiorespiratory
VO2 max and will not lead to a large volume of
training is often used to burn more calories than
blood returning to the heart. Thus, increasing
other areas of training and involves sport actions
heart rate alone does not always correlate with
that are high energy and nonstop. Common
work being done to train the cardiovascular
cardiorespiratory conditioning exercises include
system.
running, cycling and swimming. The body will
Since fitness of the cardiorespiratory system
adapt to the level of stress put upon it and in
is improved by enhanced heart function
turn require more energy. Ultimately, selecting
and use of oxygen by the working muscle to
the right training exercises is important in
produce energy, it should be added to any
obtaining maximal benefits.
exercise routine. Cardiorespiratory fitness also
The Importance of includes a decrease in the risk of death from
Cardiorespiratory Fitness heart disease and other causes, as well as an
As the respiratory system gathers oxygen, increase in the performance of daily activities.
the cardiovascular system processes and Cardiorespiratory conditioning reduces resting
distributes the oxygen. During cardiorespiratory heart rate and normalizes resting blood
166
pressure. Additional benefits of cardiovascular the transition from higher intensity exercise
conditioning include reduced stress levels and back to rest. The heart rate, blood pressure and
fatigue along with improved self-confidence. respiration rate is shifted downward and back
to rest. This gradual decrease will help in the

Training Design
removal of lactate from the muscle and aid
In designing a
in the dissipation of body heat.
cardiorespiratory
There are a few considerations to keep
training program,
in mind when determining the rest of the
it is important to
exercise intensity or the rate of work being
begin with a warm-
performed that is described as a speed or
up. This is usually
load of the body. The intensity should be
a 5-10 minute low intensity muscle activity,
recommended within a range that would allow
which may include stretching. It is at the lower
for increased cardiovascular health and oxygen
end of the intensity progression of the target
consumption. Intensity should be considered in
exercise and represents the transition from rest
conjunction with duration. Exercise intensity
to the main workout. The warm-up is followed
cannot be accurately chosen without taking
by the endurance or exercise phase. This is
duration into consideration since they are
the target of the workout and carries the main
inversely related. Frequency, the number of
cardiorespiratory benefits.
times the cardiorespiratory system is stressed,
Some exercises in this phase are weight-
also plays a pivotal role. There may be an
dependent. The intensity is maintained
advantage to more frequent training. Training
throughout the exercise and a relatively constant
two days a week or less does not really lead to
amount of energy is expended. Examples of
an improvement in oxygen consumption. The
weight-dependent exercises include walking and
optimal frequency for training is three to five
running. Other exercises do not factor in body
days a week, with exercise occurring every other
weight due to the support of the body during
day when possible, rather than consecutively, to
the routine (e.g., cycling and swimming). An
allow for proper rest.
appropriate cool-down period of approximately
In the design of a conditioning program, other
10 minutes of low intensity activity should
factors should be taken into account, including
follow the endurance phase; this represents
individual differences, physical limitations and
167
beginning fitness level. Age and health status Walks Distance Warm-Up Walking Cool-Down
Week (Week) (Miles) (Minutes) (Minutes) (Minutes)
5 4-5 2.0 5 34 5
of the individual will also help to determine an
6 4-5 2.25 5 36 5
appropriate cardiovascular training program.
7 4-5 2.50 5 38 5
Furthermore, the choice of the type of exercise 8 5 2.75 5 42 5
9 5 3.0 5 46 5
should be based upon interest, availability and
10 5 3.25 5 50 5
should lower the risk of injury.
Adaptation to a particular exercise routine
Postural Considerations can occur easily. When this happens, the same
Cardiorespiratory conditioning training amount of work is done in less time and it is
follows the same kinetic parameters as associated with less psychological disruption; in
flexibility and resistance addition, it results in lower
training. There are postural levels of fatigue or exertion.
considerations in selecting The workload must then be
the appropriate form of increased if benefits from
cardiorespiratory training training are to be seen.
for the beginner. Some Smart progression involves
people possess a rounded the progression from a
shoulder, forward head posture, an anteriorly lower intensity level to a higher intensity level,
rotated pelvis causing low back arches, feet longer duration, and/or increased frequency
that turn out or knees that move in. These of the exercise session. An effective guideline
factors can affect their performance on workout is to keep the increase in activity to no more
equipment, such as steppers and treadmills, as than 5% for each progression and the adaption
well as stationary bicycles. to this increase spread over a period of a week
or two. Additionally, change only one element

Smart Progression
(e.g., frequency, duration) at a time. Initial
Example: Progressive Walking Routine
Week Walks Distance Warm-Up Walking Cool-Down progression is from discontinuous to continuous
(Week) (Miles) (Minutes) (Minutes) (Minutes)
1 4 1.25 5 25 5 activity, which leads to a relatively rapid initial
2 3-4 1.25 5 25 5
progression.
3 4 1.50 5 30 5
4 4 1.75 5 32 5
168
depends on their varying abilities to deliver and
Interval Training
use oxygen. Interval training involves periods
The body adapts whenever possible so that
called intensity training, with an intermediate
it uses less energy to do the same processes.
effort that is above the comfortable level. This
Therefore, interval training, involving both
is often followed by cardio activity that is at the
aerobic and anaerobic processes, can maximize
comfortable level or lower. It is important to be
the amount of calories burned to ensure that
aware of the difference in effort exerted during
the body can maximize the energy used by the
the comfort zone versus the intensity training
body. This also involves maximizing the excess
zone.
post exercise oxygen consumption (EPOC). The
In interval training, any switch in the intensity
body’s metabolism is elevated after exercise
or duration leads to a switch in the particular
since fat burning is
energy system. There
often greater following
are many aspects
exercise. The higher
to interval training
the intensity of the
that are important
exercise, the greater
to gain maximal
the magnitude of EPOC.
benefits. An increase
Splitting the training
in cardiorespiratory
sessions into intervals
fitness or aerobic endurance can increase
also enhances the effects of EPOC.
a person’s ability to exercise for prolonged
Classic interval training principles are key to
periods of time at the limits of aerobic
cardiovascular training and can be applied
metabolism. Even individuals that are not
to beginners, less fit individuals and trained
physically fit can use interval training to raise
athletes. This is because interval training is
their anaerobic threshold. This change in
the best choice of conditioning to optimize
anaerobic threshold can allow for increasingly
aerobic benefits. Interval training is different
intense paces and longer durations, leading to
from the comfortable level of effort, where
increased work efforts in manageable doses.
there is a balance between energy demands
The more work that is performed, the more
by the muscle and aerobic metabolism. This
total calories and fat that are burned. More total
comfortable level is different for everyone and
169
exercise effort is accumulated during interval of external factors (e.g., weather and surfaces)
workouts, especially if there is a limited amount on training.
of time set aside for exercise. This allows for

Interval Training Model
a more effective use of time, no matter the
Example: Work to Rest Ratios for Various
fitness level. Additionally, training in intervals Exercises
% of Energy
Maximum System Exercise Exercise:Rest
increases exercise compliance. Interval training Power Stressed Duration Ratios
90-100 Phosphagen 5-10 sec 1:12 to 1:20

also offers exercise variety and enjoyment and
75-90 Glycolytic 15-30 sec 1:3 to 1:5
is also mentally engaging. It is used to avoid 30-75 Glycolytic & 1-3 min 1:2 to 1:4
Oxidative
monotonous exercise intensities and provide 20-35 Oxidative >3 min 1:1 to 1:3
positive motivation. Interval training also Concepts of the interval training model
decreases overuse injury potential. include the idea of speed play. Speed play is
Interval Training Using Optimum Running Times used in many instances and represents an easy-
Based on Best 10-km Time*
400 m to-use model for training. In speed play, there
200 m 400 m Intervals
Best Intervals Intervals (aerobic-
10-km time (anaerobic) (aerobic) anaerobic) are increases in cardiovascular efforts and then
(min:sec) (min:sec) (min:sec) (min:sec)
46:00 00:46 2:00 1:51 an adequate recovery period follows. In terms

43:00 00:43 1:52 1:44
of recovery, anaerobic conditioning is usually
40:00 00:40 1:45 1:37
performed at the expense of lactic acid buildup
37:00 00:38 1:37 1:29
34:00 00:36 1:30 1:16 in the muscles and blood. The length of time
* Example: A runner with 40 min. 10k best time to recover depends on the effort to recovery
should train 200 m intervals (half a lap on a track)
at 40 secs per interval (mainly using anaerobic ratio used in training. In the case of speed play,
system); if preferred interval workout is f 400 m
(1 lap), but desire is to still remain in aerobic zone recovery is usually three times as much rest
(so as to not build lactic acid), the runner would
complete interval in 1:45; final column is for the as intense training. For example, 5 minutes of
runner wanting interval workouts consisting of
400 m in which they would build speed in order hard pedaling on a stationary bike is followed
to get faster—they would cover 400 m in 1:37
(for the runner who runs a 40 min 10k, a 1:37 by about 15 minutes of rest. This is done as
would be very challenging and would require
both anaerobic and aerobic systems for energy). many times as is appropriate or according to
Heart monitors should be used for interval the physical capabilities of the client. Speed
training to assess the efforts of the training play works regardless of the physical fitness
program. A heart monitor provides more level since the training intensity can be kept to a
information than using time over distance specific fitness level.
measurements since it allows for the influence
170
called the stabilizing phase and is characterized
by a heart rate of 65-75% of the maximal heart
rate. Zone two has an increased heart rate of
about 80-85% of the maximal heart rate and is
Health and fitness interval training is more
structured than speed play. It can be performed
using the aerobic and anaerobic model. The
effort in this interval usually has a 1:1 effort to

near the point at which the body can no longer
recovery ratio. Excellent training techniques are
produce energy for the muscle. This is often
used to enhance cardiovascular performance
known as the anaerobic threshold and results
and variables, such as intensity, duration and
in more calories being burned, much of which
frequency, are often fixed according to goals.
comes from fat. Importantly, this does not lead
Since fitness interval training is the most
to the huge production of lactic acid. The third
structured type of interval training and is
and last zone is a true, high intensity workout
associated with high intensity performance, it
over a short amount of time. In this zone, the
is usually reserved for more highly conditioned
heart rate is 86-90% of the max. Zone three is
persons.
often used in conjunction with the other two
Stage Training zones to try and avoid a plateau in exercise.
Aspects of interval training can be broken Zone three is the power level.
down into three stages that use three different

Circuit Training
heart training zones. These zones are organized
Circuit training is one of the most beneficial
to maximize cardiorespiratory training benefits.
forms of cardiorespiratory training and, more
The goal of zone one is to increase blood supply
specifically, interval training. Combining aspects
to tissue and is often used for beginners to
of both cardiovascular and strength training, it
improve the delivery of oxygen throughout the
involves a series of resistance training exercises
body and remove waste. The first zone is also
171
back to back with very little rest or recovery
Fat Burning
period. The purpose is to keep the client
Respiratory Exchange Ratio (RER)
constantly moving and allow for major exercise RER Fat % Carb %
benefits without spending prolonged periods of 1.00 0 100
.98 6 94
time. Circuit training also differs from training
.96 12 88
programs that only target one or more specific .94 18 81
muscle groups. It is effective because it keeps .92 26 74

.90 32 68
pushing the body aerobically and challenges the
.88 38 62
strength of the body simultaneously. .86 47 53
The term “circuit” refers to a group of activities .84 53 47

.82 62 38
that are performed one after the other to form
RER Fat % Carb %
.80 68 32
.78 74 26
.76 81 18
.74 88 12
.72 94 6
.70 100 0
The primary reason for exercise is usually to
reduce total body fat. It is a common myth that
fat burning can only occur through extreme
cardiovascular exercise. There is no special
fat burning zone that needs to be reached
the workout regime. The activities that compose in order to cause the body to mainly use fat
a circuit can include squats, lunges, jumping rope as fuel. Conversely, as long as there is more
and back extensions. Once all these exercises energy being burned then being consumed,
are finished, you have completed one circuit. As fat is being burned. This plays into the law of
with other forms of training, it is important to thermodynamics.
warm up with light cardio and cool down with Besides glucose, fat is a major source of fuel
stretching. for exercise. The oxygen that enters the body
allows for fat or carbohydrates to be burned.
Fat and carbohydrates differ in the amount of
172
oxygen use. The body uses the most fat when has unrealistic expectations and the personal
the respiratory exchange ratio (RER), the ratio trainer needs to address those expectations at
of carbon dioxide produced to the volume of the beginning of the program; otherwise, both
oxygen consumed, is approximately 0.71. The parties will feel they failed. Another important
body uses respiratory gasses to estimate caloric aspect of developing muscular strength is rest
expenditure. For instance, at complete rest, the between workouts. Muscles become fatigued
amount of energy used is minimal so there is no and need rest to overcome this physiological
overall loss of weight. phenomenon. Slow oxidative fibers fatigue
slower than fast oxidative fibers but take twice

Muscular Strength
as long to recover. The majority of muscles
Example: Guidelines for a Hypertrophy Weight
Training Program contain both kinds of fibers. Working out many
Load 67-85% IRM
muscle groups at one time can minimize the
# of Exercises 6-9
# of Reps per Set 6-12 amount of fatigue a client will experience.
# of Sets per Exercise 3-6 There are various levels of working out a
Rest 3-5 Minutes
muscle. First is the mechanical force being used,
Speed Slow-Medium
Times per Week 2-4 which involves the energy directly expended to
Muscular strength is defined as the maximum produce the work necessary for the workout.
amount of weight any one muscle can endure Secondly, there is the neuromuscular aspect,
without strain. The idea of developing which involves the motor units
muscular strength focuses on of the nerves and the muscles
increasing muscle fibers that will they innervate. Motor units are
lead to hypertrophy (enlargement) important because they allow
of the muscle. This happens over movement and relaying
time with good strength training Muscle fiber hypertrophy and of messages to the central
splitting are found here.
without damaging the muscle nervous system to produce
Arrow marks split fiber.
from overexertion. The job of a Also, see how easy it is to the desired movement.
appreciate endomysium in this
personal trainer is to provide illustration. Whenever it is this The last is the metabolic
prominent, it is too thick.
gradual intensity that leads to activity involved. The body
gradual hypertrophy of the muscles. A client needs energy to produce any desired voluntary
trying to obtain muscular strength overnight movement. If a client is not properly hydrated
173
or does not have the proper nutrients, that a gradual process and overworking muscles will
client’s desire is of little use. Remember, part not help clients achieve their goals any faster.
of the trainer’s job is to make sure the client is Pacing is very important when building muscle
eating a diet conducive to the workout. If a client and it is easy to overdo workouts because
is mainly focusing on cardio, the trainer should soreness, feeling out of breath and fatigue are
propose eating more carbohydrates and, for a not immediate responses to these types of
focus on strength training, a good combination training.
of carbohydrates and protein. The trainer should Example: Relationship Between Volume &
Training
suggest an increase of 5-10% of lean proteins Objective # of
for Training Repetitions # of Sets
for resistance training. Resistance training that
Strength <6 2-6
leads to muscular strength and hypertrophy is Power 3-5 3-5
Hypertrophy 6-2 3-6
very individual and is one of the most important
Endurance (Strength) >12 2-3
aspects of personal training.
Resistance training can involve several ways
Developing a cardiovascular workout is a
to strengthen muscle. Free weights, weight
very general process. Once a client moves
machines, the client’s own body weight or
into muscular strength training, the personal
elastic resistance are all examples of ways
trainer must develop a workout that
to gain muscular strength via
is tailored to the client by taking a
resistance. Variance helps to keep
very thorough initial assessment. If a
the workout fresh and keeps clients
client’s expectations are going to be
on their toes. Varying the type of
met, the personal trainer must pay
resistance also gives clients a more
attention to what is going to work for
well-rounded workout because each
that individual client. Trainers should
type of resistance mechanism will
find out from clients what has worked
use different groups of muscles.
and what has not worked for them in
Another important issue of developing
the past. If a client has never done any resistance
muscular strength is working a muscle to
training, the trainer needs to make sure realistic
fatigue. This simply means that clients must
expectations are discussed. The number one
do enough repetitions until they cannot do
reason for failure of any workout is unrealistic
anymore, which is usually between 6-10
expectations. Muscular strength development is
174
repetitions (depending on the strength of the When clients first start resistance training,
client). The personal trainer must take great their endurance will be low, meaning the amount
care to work the client’s muscles to fatigue of time they can sustain their workout will be
but not to exhaustion. Remember, every client short. As they perform their workout over time,
is different so great attention to detail, as well their endurance will increase and their muscles
as individualization of the client’s workout, is can be worked for a longer period of time. As
very important. As a client’s muscular strength their endurance increases, a muscular strength
increases, the trainer will have to adjust the workout can quickly become a cardiovascular
number of repetitions. Sets are the number of workout and, if the client wants resistance
times clients do their prescribed training, this aspect needs to

The personal trainer must
number of repetitions. be carefully monitored. If this
take great care to work the
When clients start resistance client‘s muscles to fatigue happens to a client, resistance
but not to exhaustion.
training regimens, they should must be increased by increasing
only work out muscles two times per week with repetitions and/or sets or the amount of
at least a day of rest in between. There should weight. Endurance is important when allowing
also be proper rest between sets as well. Clients’ sustained movements with a load attached over
muscles require a recovery period before being a prolonged period of time.
fatigued again with another set. This is why a At the beginning of a new workout regimen,
high carbohydrate meal/snack is important a client will experience a lot of soreness due
before workouts and an increased protein meal to the buildup of lactic acid that is released
after a workout and possibly even the next day in the muscles from energy expenditure. As
is beneficial as well. a client gains endurance, the soreness will
subside because the muscles will better utilize

Endurance Conditioning
oxygen and less lactic acid will buildup, which
Example: Types of Aerobic Endurance Training
Types of
Exercise
# of Times
per Week
Length
of Session Intensity
in turn will result in less soreness. Some
Long, 30-120 Minutes
Slow Distance 1-2 (Distance of Race) 70% VO2 Max clients may view this lack of soreness as an
Pace/Tempo 1-2 20-30 Minutes Lactate Threshold
inefficient workout, which is not the case. As
3-5 Minutes
Interval 1-2 VO2 Max
(Work:Rest Ratio 1:1)
Repetition 1 30-90 Seconds VO2 Max
muscles develop, they will become less and
(Interval) (Work:Rest Ratio 1:5)
Variable: 70%
Fartlek 1 20-60 Minutes VO2 Max + bouts > less sore. Remember, endurance conditioning
Lactate Threshold
is something that should be addressed once the
175
client is comfortable with the regimen that the balance in order to reduce the chance of injuring
trainer and client have established together. joints. Stabilization is another important aspect
In the beginning, the most important thing and can be achieved with proper posture (even
to teach a client is technique. Lack of proper in non-training movements) and involves
technique in resistance training can lead ensuring the least amount of stress is put on
to undue stress as well as injuries. Before the joints. Muscular endurance is important in
endurance can begin to improve, proper stabilization because it helps recruit muscles
technique must be obtained. If that are involved in prime
a trainer is not familiar with a movements, which decreases
particular technique of a specific stress on the joints. If the
type of resistance training, such client’s muscles cannot sustain
as those that use elastic bands, the training over an extended
then the trainer should not period of time, the client is
recommend the exercise until likely to experience joint
the trainer has been educated problems. The prime movers
on proper form. Also, it is important to keep are responsible for providing force throughout
good records of the training the client is doing. the majority of the training, so they are the
Having individual records for each client is the most important muscles that need endurance
best way to achieve this and will help the trainer conditioning.
in the future when designing different programs Endurance conditioning is a progressive
for the client to achieve endurance conditioning. process that is achieved by slowly working all
Initial assessments are important to get started muscle groups targeted and increasing load and
but follow-ups are more important to keep longevity endurance over time. One positive
trainers and clients on track. aspect about endurance training is the finding
Endurance conditioning is important for that it does not disappear if the client misses some
maintaining the length-tension relationship time from training. Cardiovascular conditioning
between muscles. Instead of being over is much faster to “lose” than muscular strength
extended the muscles need to be kept in proper and conditioning. This makes sense because
contraction for maximal gain. The length- muscular conditioning takes much longer to
tension relationship is also important to keep achieve than cardiovascular conditioning. If a
176
client misses some sessions, the trainer should adapt, with the end result being hypertrophy of
offer encouragement by explaining all is not the muscles. In cardiovascular training, the heart
lost because of the absence. Very little muscular is a highly adaptable muscle, so cardiovascular
strength and conditioning is lost over the first adaptation to walking or running occurs quite
few months of stopping resistance training. The fast. On the other hand, skeletal muscles are
personal trainer should keep calling the client not highly adaptable and are challenged when
to reiterate the fact that little has been lost in “asked” to do things, such as lifting a heavy
terms of strength and conditioning. object. It takes much longer for these muscles to
Another interesting aspect to muscular adapt to a frequent stimulus such as resistance
strength and endurance conditioning is that it training because, physiologically speaking,
is much easier to maintain than cardiovascular muscles do not know the difference between
conditioning. One report showed that, once “training” and a transient need to take a heavy
the client’s goal is met, the client only needs to box from downstairs to upstairs. This is why
resistance train every 10 to 14 days to maintain achieving skeletal muscle adaptation takes
the same level of effort as long as the intensity much longer than achieving cardiovascular
remains the same as when the training was adaptation. Any hope for achieving muscular
more frequent. hypertrophy must be approached with patience
and encouragement from the personal trainer

The Adaptation of Strength
and the client. No one can perform resistance
Training
training for a month and expect to see significant
The principle of the adaptation
changes. Muscles need time
of strength training lies in the
and stimuli for adaptation
physiology of the human body. The
to occur. The body can
body wants to remain in equilibrium
“instruct” the muscles
so it will do what it needs to do in
to enlarge because the
order to be physiologically content.
stimulus is not going away
During resistance training, stress is
and the muscles will then
put on the body to achieve a desired
need to adapt.
look, feeling or strength. By adding this stress,
The body’s need to adapt in order to maintain
the body is conditioned to want to be able to
proper homeostasis is termed the general
177
adaptation syndrome. According to Hans Selye, Physiologically, the body will start to shut down,
a medical doctor in the early 20th century, which will leave your client feeling tired as well as
the body responds to stress in three different frustrated. This is why careful individualization
stages. The first is the alarm reaction, and it of a client’s workout is important. Not everyone
begins when the body is initially put under can do 3 sets of 15 repetitions lifting a 20 lb.
stress it must respond to, such as lifting weight barbell. The initial workout is the time when the
or resistance training. In order to respond, personal trainer needs to discover and record
the body needs more oxygen to produce more the client’s training limits.
strength so that it can keep up with the demand. In order for adaptation to occur, the body
In the beginning of any new workout regimen, must “think” there is a reason for adaptation.
it can be challenging to achieve the number of This requires an interaction of three primary
repetitions and sets that are being expected. As specificities: mechanical, neuromuscular and
time passes, the stress being put on the body metabolic. Mechanical specificity involves the
lessens, not because the 50 pound weight is any movements made to accommodate the specific
less, but because the body is adapting over time. load. Each muscle group, from the legs to the
The next stage is resistance development, when arms to the chest, has differing mechanical
the body is quite efficient at recruiting muscle specificities. One person may need heavier
fibers needed to lift weights being lifted at
a load and distribute slower speeds to produce
oxygen efficiently to maximal results. Another
the needed areas. At person may need lighter
this time, resistance weights at faster repetitions
training can feel like to achieve the best results.
a “breeze,” so something needs to change to As a personal trainer, it is important to be
prevent a loss of hypertrophy in the muscles. educated regarding the mechanical specificities
The load needs to be increased and/or more of the muscle groups.
repetitions added in order to add more stress Neuromuscular specificity has to do with the
that will prompt the body to move toward intensity of the contraction being elicited by the
adaptation. The last stage is exhaustion, which specific movement. The stronger the contraction,
the personal trainer should strive to avoid. the more motor units need to be recruited.
178
Over time, the neuromuscular specificity will ▪▪ Mild discomfort may occur but not
lead to hypertrophy due to the higher intensity pain
contraction required to lift the load. The last • Duration
specificity is the metabolic specificity, which ▪▪ Hold each stretch 10-30 seconds
has to do with the amount of energy required ▪▪ 3-5 repetitions for each stretch
to sustain each workout and how that energy is ▪▪ 15-30 minutes per session
utilized. It is important to understand that most ▪▪ Can combine with other exercises:
resistance training uses anaerobic respiration aerobic, resistance, etc.
to obtain its metabolic needs. A personal trainer Flexibility is the extent to which a joint passes
must be familiar with the concepts of anaerobic through a normal range of motion comfortably.
respiration versus aerobic and which exercises Flexibility training has become an important
typically use one or the other. Nutrition is very topic in maintaining a healthy lifestyle in a
important for any person undergoing a new sedentary society. It is an organized, regular
workout routine, especially resistance program of stretching used to elongate
training. Stress on muscle fibers soft tissues without resulting
needs to be alleviated and in injury. Some advantages to
this is accomplished through integrating flexibility training
proper protein intake. Protein into training programs include
provides the muscles with the relieving joint stress, improving
necessary amount of amino function and neuromuscular
acids for repairs to be made. efficiency. It can also help in
maintaining the normal functional

Flexibility Training
length of all muscles.
Example of Recommendations for Flexibility
In developing a flexibility training program,
Training:
several instructions should be integrated.
• Frequency
Stretching, which can occur at any time during
▪▪ 3 Days a Week—Daily
a workout, should follow a warm-up. The
• Intensity
increase in muscle tissue temperature decreases
▪▪ Stretch all major muscle groups and
stiffness and encourages flexibility. It can help a
joints
client’s performance so more is gained from the
179
training. Properly executed breathing exercises be conducted after a proper warm-up and the
reduce stress and tension in muscle tissue. It range of motion should be increased steadily.
is essential that proper posture is maintained Stretches for Various Body Parts
during stretches to prevent injury. Neck & Head • Flexors, extensors

• Forward flexion, extension,
The acronym FIDM stands for frequency, abduction, adduction
Shoulder • External & internal rotators
• Scapular retractors & depressors
intensity, duration and mode, all of which are
Elbow • Extensors, flexors
important factors to remember when preparing • Supinators, pronators
Wrist & Forearm • Flexors, wrist extension
flexibility programs for clients. Clients should
• Extensors, finger flexors
Hand • Abductors, thumb adductors
be advised to stretch two to three times a
• Forward flexion, extension,
week; however, little information reports any side bending, rotations hips
Lower Back, Trunk • Forward flexion, abduction,
adduction, extension
disadvantages to stretching every day. Intensity • External rotation, internal rotation
Knee • Flexors, extensors
can be achieved by placing a client in a position of
• Plantar flexors, dorsiflexors
slight discomfort before maintaining stretches. Foot & Ankle • Everter, inverters
• Extensors, toe flexors
The duration of stretching varies depending on
There are a variety of stretches that a trainer
which type of stretch is used, and the mode of
can have a client use in a flexibility training
flexibility should improve general stretching.
program. It is important to consider the
Types of Stretching client’s individual composition and goals in
There is a set of guidelines that will ensure the program before choosing which stretches
safe flexibility. The main muscle groups should to incorporate. This can help determine when
be stretched to achieve balance and should be to conduct the exercises and the intensity of
held for 10 to 60 seconds, which should be the the stretches to be used. Passive stretching
range to achieve mild intensity. Stretches should involves outside forces to help stretches. In
static stretching, flexibility is achieved with a
low chance of potential injury. The muscle of
interest should be held in a stretch for at least
20 seconds. Static stretching is one of the most
popular stretches used in fitness training today.
It is an example of corrective flexibility and uses

Active vs. Passive Stretching
autogenic inhibition to achieve its results. Active
180
stretching can increase the tendency of soft both. The speed of the range of motion should be
tissue to elongate and improve neuromuscular controlled to prevent injury. Both of these types
efficiency. Active stretching may be difficult for of stretching can be used for clients who are
clients because of the mental and athletes and preparing for sporting
physical endurance needed. Passive activities. However, caution should
stretching is preferred as stretches be practiced in using them for the
are eased. A combination of both general population.
active and passive stretching may Proprioceptive neuromuscular
satisfy some clients. facilitation (PNF) seeks to increase the range
of motion at joints by incorporating both active
and passive stretching. Three main methods are
used: contract-relax (CR), contract-relax with
agnostic contraction (CRAC) and contract-relax
with a passive stretch (CRAC-P). In CR, clients
experience little tension when increasing the

Ballistic Stretch Dynamic Stretch
degree of the contraction over a given period
There are similarities in using ballistic and
of time. After the contraction is maximized,
dynamic stretching. Because of the intensity
passive force is used. CRAC is like CR, but it
of the stretches, safety should be taken into
uses an active stretch rather than passive forces
consideration when performing them. Ballistic
after maximum contraction is used. CRAC-P is
stretching results in elongating a certain area
similar to CRAC but incorporates a passive force
of the body, which limits the available range
to complete the technique. PNF can work best
of motion. Momentum plays a major role in
for clients who are somewhat fit and willing to
accomplishing this action. There are certain
challenge themselves with this intense training;
disadvantages, which include muscle soreness
however, any client can engage in this vigorous
and the absence of tissue adaptation. In dynamic
training if the trainer is knowledgeable in the
stretching, a type of functional flexibility,
subject area. The trainer should also consider
momentum is used to increase the range of
the client’s limits.
motion. This type of stretching can be carried
Active-isolated stretching integrates an active
out actively, passively or as an arrangement of
stretch that then uses passive force followed
181
by static stretching. The opposite muscle to contribute to muscle imbalance, which leads to
the targeted muscle is contracted to isolate interferences within the kinetic chain.
the targeted one, then the targeted muscle is When injury occurs in the body, it can lead
relaxed. Afterward, a passive force, like the to inflammation and reduced elasticity of soft
trainer, is used to assist clients in finishing the tissue. This idea is based on Davis’s law, which
stretching. proposes that soft tissue rebuilds itself along
the lines of stress. The soft

Things to Avoid
tissue is rebuilt with inelastic
Flexibility training is also important in
collagen, usually inconsistent
promoting neuromuscular efficiency. To achieve
with the direction of muscle
this efficiency, correct flexibility in all planes
fibers. This tissue can later
of motion—sagittal, frontal
prevent the muscle fibers
and transverse—is needed.
from elongating properly and
Flexibility training must
results in reduced flexibility.
be an integrated program
The reduced inelasticity of soft tissue leads to
that incorporates a variety
altered length-tension relationships and altered
of flexibility techniques.
force-couple relationships. It can also result in
In developing a useful
arthokinetic dysfunction, which changes joint
program, the muscular,
motion. All of these alterations lead to muscle
nervous and skeletal system
imbalances.
can be thought of as a kinetic
chain. Each system works Postural Muscle Imbalances

together to ensure balance. Arthritis affects approximately 66 million
Any misalignment or damage to one system can Americans and contributes to inflammation
impact the effectiveness of the other systems. and damage of joints. The two most prevalent
This can lead to decreased neuromuscular types are osteoarthritis and rheumatoid
efficiency and overuse type of injuries. Muscle arthritis; however, more than 100 types exist.
imbalances may result from improper posture Osteoarthritis damages the cartilage of bones
or technique or injury. Pattern overload, where overtime, while the immune system tears down
the same pattern of motion is repeated, may also joint surfaces in rheumatoid arthritis. People
182
Balance, Agility, Speed
Everyday activities and sporting activities
require balance, stabilization and coordination.
For the body to master skills of movement,
with this condition are advised to conduct there is a constant need to change direction
flexibility techniques one to two times a day. and movement. Also known as skill-related
Warm-ups should be extended to ensure that components of fitness, these factors are key in
joints are not stiff. Those who are on current athletic endeavors and allow individuals to move
anti-inflammatory medications should be accurately, quickly and efficiently. Skill-related
monitored for stress levels.
Clients with osteoporosis and osteopenia are
losing bone density and are at a higher risk
for bone fractures. In performing flexibility
training, clients should steer clear of repetitive
exercises that use spinal twisting. Exercises that
encourage proper posture and spinal alignment
should be practiced. For those clients who have
had a hip fracture or replacement, exercises
should include internal rotation of the hip, hip
adduction and hip flexion.
There are times when clients should be
advised not to stretch, such as during the first
day to three days after a muscular or tendonous

fitness components are therefore stressed when
trauma. Training should
performance enhancement is the primary goal.
not take place after any
When used appropriately, balance, agility and
muscle or ligament sprains have
speed can create a synergy of muscle responses.
occurred or if joints or muscles
In turn, this can lead to a decreased risk of
are infected. Stop training if any
injury due to an increased ability to react to
discomfort is felt or if there is pain in the joint
changes in the environment. Persons engaging
or muscle when exercising.
183
in activities that require skill-related fitness Static, Peripheral and Dynamic Balance
components will benefit greatly from a warm- The most basic aspect of balance is static
up. balance. It is the ability to maintain central
balance, or equilibrium, while balancing on one

Balance
foot. Static balance is essential for activities that
Balance, the first and most fundamental
require prolonged periods of static positioning
component of biomechanical function, is one of
(e.g., rock climbing). The ability to balance and
the major factors in sports performance. Balance
reach away from the center of gravity is called
is defined as the ability to maintain
peripheral balance. This is usually
a certain position for a given
accomplished with reaching some
amount of time without a change
part of the body, such as the arms,
in movement. It involves being able
legs or torso, while maintaining
to maintain stability, even through
equilibrium. Conversely, dynamic
motion, environmental changes
balance is the ability to maintain
and gravity. Many activities rely
balance while in motion. While in
on the maintenance of balance to
motion, the body gains feedback
successfully complete the exercise,
through visual stimuli, kinesthetic
which involves a constant interplay
awareness and changes made by the nervous
between losing and regaining balance. This
system. Even standing still is an exercise in
is important not only in activities that require
dynamic balance since the body is constantly
standing positions but also in sitting positions.
swaying to all sides and balance is maintained
Balance is affected by three major principles:
through alternate contraction and relaxation of
center of gravity, base support, and the
the leg muscles.
relationship between center of gravity and base
support. The lower the center of gravity and Balance Training

the larger the base support, the smaller the Balance training prepares athletes to perform
amount of balance that is needed. Furthermore, when the center of mass moves outside of the
the closer a person’s center of gravity is to their base support. It has also been adopted to try and
base support, the smaller the amount of balance prevent injuries to the ankles and knee joints
needed. during sports and other activities. Balance can
184
be trained during an exercise by constantly movements through a full range of motion.
standing, walking or sitting on an uneven This ultimately improves the neuromuscular
or unstable surface. Appropriate balance efficiency of the entire kinetic chain. The
training should then stress an individual’s third and last level is power. Power exercises
limits of stability, which in turn increases the increase endurance, reactive joint stabilization,
awareness of the limit of stability by creating neuromuscular efficiency and eccentric
instability. Within balance training, the use of strength.
balance equipment Balance training is especially important for
can be used to create older adults. This group of individuals tends to
balance challenges lose lean body mass and
in multiple planes of Patients can balance on one is therefore more prone
motion. Equipment foot on a wobble board to to injury from falling.

enhance dynamic ankle
can improve reaction stability for training or ankle Initially, a trainer should
sprain rehabilitation.
times and dynamic functional use of core identify a client’s current
muscles. balance threshold before starting an activity-
Traditional training does not challenge the specific program. There are specific tests to
sensory mechanisms of the kinetic chain and determine balance deficiencies. The simplest
balance training fills the gaps. It improves of these is the Romberg test in which a client
dynamic joint stabilization or, in other words, stands with the feet together and eyes closed.
the ability of the kinetic chain to stabilize a The loss of balance is then checked. For a more
joint during movement. There are three levels difficult test, a client conducts this test while
of balance training that are similar to the three standing on only one leg, which is referred to as
levels of traditional training programs. The first a stork stand.
one is stabilization, which comprises exercises Another test that measures balance in
involving joint motions aimed at improving elderly persons is
stability of the joints. In this level, exercises are the functional reach
all based around positions where the body is test. As shown in the
unstable, such as when standing on one leg. The diagram, a client rests
second level is strength. Balance exercises for one fist on a wall while
strength are dynamic eccentric and concentric leaning as far forward
185
as possible. The client then moves the fist along Coordination
the wall as far as possible without taking a step Nearly all human movement occurs through
or off-balancing, and the distance that the fist multiple joints and muscle groups. When
moved is measured. A movement of less than six the body undergoes a new movement, the
inches means that there is a lack of balance and neuromuscular system limits the ability of the
thus a higher risk of falling. body to conduct a specific activity. This leads to
awkward and clumsy movement. It therefore
takes many tries to become familiar with
the activity. Coordination is the ability to use
multiple areas of the muscles and joints at the
same time while accurately performing motor
functions. Coordination complements other
skills like speed, agility and balance.
Specific requirements of coordinated
movement include several factors. Activity
perception is the basic element of coordination

Coordination and Speed
and is the awareness of volitional muscle
There is a direct relationship between
activity or joint positioning. Any activity
coordination and speed. Movements at varying
performed is evaluated by the central nervous
speeds produce differential
system. The learning process
demands for the control of
involved in the development
ongoing movements. Often,
of coordinated movement is
these ongoing movements need
considered feedback. Likewise,
to be precise and coordinated
the activity becomes more
in order to conduct the desired
accurate with repetition
motion. To understand how
and adjustments. Repetition thus allows the
each skill-related fitness component relates
performance to become more consistent. This
to each other, it is essential to be aware of
is a major requirement for development of total
importance of coordination and speed in human
coordination, which is when activity becomes
activity.
automatic and is no longer a conscious process.
186
During athletic performance, Agility
coordination allows for some Agility is the ability to rapidly
muscles to be stimulated to change body position with
provide activity while allowing speed and accuracy. Believed to
other muscle groups to be be influenced by heredity, this
inhibited to permit the activity. skill is integral to explosively
If a muscle is too weak to start, accelerate, decelerate
provide a necessary response, and change direction while
activity will be uncoordinated. maintaining control of the body
Lastly, inhibition is important and speed. Though there is a lack
since it is necessary for of agreement with the precise
undesired muscle activity or definition of agility, agility has
unwanted muscle responses to be cut down for relationships with trainable physical qualities
coordinated activity. such as strength, power and technique and it
There are two major types of coordination: has cognitive components such as anticipation.
intramuscular coordination and intermuscular Agility is related to coordination since it is
coordination. Intramuscular often referred to as the ability to coordinate
coordination is the ability of several sports-specific activities at once (e.g.,
the neuromuscular system dribbling a basketball while running). Agility
to allow for an optimal level is also aligned with balance in that it requires
of motor function. Muscles of the body to regulate shifts in the body’s center
the core-stabilization system of gravity. Activities such as climbing, skiing
need sustained contraction and snowboarding all require large amounts of
to improve intramuscular coordination. agility. These sports especially require agility of
Intermuscular coordination is the ability of the lower extremities. Upper-extremity agility
the neuromuscular system to allow muscles to is required for activities that require accurate
work together. Muscles of the core-movement movement of the fingers and hands.
system (e.g., hamstrings, adductors) must work Agility Training
synergistically with the stabilization system to Agility training can be very intense and it
ensure optimal coordination. places stress on joints, connective tissues and
187
tendons. Aerobic conditioning and and send impulses throughout the body and
regular exercise in a balance and are thus responsible for the neuromuscular
strengthening program should control, or proprioception. Found in the
be performed before starting a skin, joints, muscles, tendons and ligaments,
strenuous agility program. If a client these nerves maintain posture and balance,
is interested in improved agility awareness of joint position and movement.
for a specific sport, activities that They create the ability to change direction
test the client’s agility should closely resemble of movement and contribute to coordination to
that activity. The primary effect of training is to produce activity. Receptors within the skin are
increase body control. It is focused on controlling known as cutaneous receptors and are either
motor control in the neck, shoulder, back, hip, considered fast-adapting receptors or slow-
knee and ankle joints. Agility tests are similar to adapting receptors. Fast-adapting receptors
conditioning and practice drills used in various are responsible for vibration sense and sudden
sports (e.g., zigzag runs, hexagonal jump). changes in speed and movement. Slow-adapting
receptors are responsible for sensory

Sensory Function
perceptions like skin stretching
Agility, balance and coordination
as well as joint and limb position.
are controlled by proprioceptors of
Cutaneous receptors are not thought
the sensory system. Proprioception is
to play a major role in proprioception
the ability to transmit position sense,
but rather to provide cues regarding
interpret sensory information and
small sensory perception.
respond to it, all in order to execute conscious
Proprioceptors of the joints lie within the
or unconscious movement.
connective tissue of a joint’s
This is fundamental to accurate
capsule. Joint receptors respond
performance and plays an
to high velocity changes
important role in motor skills
when the joint accelerates or
and the ability to master specific
decelerates and they identify
tasks.
joint compression. Muscle
Proprioceptors are the specific
spindles and Golgi tendon
afferent nerves that receive
organs are the major receptors
188
of the muscles and tendons used to detect exercises, which increase the reaction time of
tension within the muscles. These receptors muscle actions. This is similar to other forms of
respond to muscle contraction, which can then training. Short runs are often used to evaluate
result in muscle relaxation. Muscle spindles speed.
respond to the stretch of a muscle and then act to

Summary
contract it. Proprioceptors are also found in the
Balance, agility, speed and coordination
knee and are generally not active in the middle
are all skill-related fitness components that,
ranges of movement, but they are activated
if improved, can lead to enhanced athletic
when ligaments are stressed. This produces an
performance. Balance is the body’s ability to
inhibitory response to the agonistic muscles.
maintain equilibrium by controlling the body’s
Speed center of gravity over its base
Precision of speed is fundamental support and is necessary for both
to coordination. Increasing the static and dynamic activities.
speed of athletic performance is Coordination is a complex process
a way to advance the difficulty of in which motion of the body is
coordination exercises. In other conducted through a combination
words, in order to be effective, speed must be of muscle groups working together with
accomplished by coordination. Speed implies appropriate timing. Coordination often
acceleration from a starting position. Speed of requires agility, which is the ability to control
the muscles is also limited by neuromuscular the direction of the body or body parts during
coordination. The neuronal system has a specific movement. Proprioception encompasses the
range of speed within which the body is allowed
to move.
Reactive training improves the range of
speed. It is comprised of quick and powerful
movements, involving eccentric contraction
and then concentric contraction. It begins
with less demanding exercises. As the body
adapts, training progresses to more demanding
189
body’s sensory function and is important to 5. A short duration of activity that precedes
sustain proper agility, balance and coordination. major exercise is:
Proprioception is the body’s ability to transmit a) Cool-down
afferent information regarding position sense, b) Stretching
to interpret this information and to respond to c) Warm-up
it accordingly. To varying degrees, receptors of 6. Flexibility is how far and how easily one can
the skin, muscle, tendons, joints and ligaments move the joints. True or False?_____________
all influence proprioception. ________________________________________________
7. What are some physical benefits to

Review Questions
improving flexibility?________________________
1. What is cardiorespiratory conditioning?___
________________________________________________
________________________________________________
________________________________________________
________________________________________________
8. Passive stretching requires additional
2. The progression from a lower intensity
mental and physical endurance compared to
level to a higher intensity level, longer
active stretching. True or False?____________
duration, and/or increased frequency of
________________________________________________
exercise is known as ________________________
9. What is the first and most fundamental
________________________________________________
component of biomechanical function in
________________________________________________
sports performance?_________________________
3. Fat burning can only occur through extreme
________________________________________________
cardiovascular exercise. True or False?____
________________________________________________
________________________________________________
10. Speed play only works with individuals who
4. What form of strength training leads to
are at an optimal level of physical fitness.
muscle hypertrophy? ________________________
True or False?________________________________
________________________________________________
________________________________________________
190
Davis WJ, Wood DT, Andrews RG, Elkind LM, Davis
Answers
WB. Concurrent training enhances athletes’
1. Cardiorespiratory conditioning is an activity
cardiovascular and cardiorespiratory
used to improve the body‘s ability to
measures. Journal of Strength and
process and deliver oxygen by using intense
Conditioning Research. 2008;22(5):1503-14.
movements and activities that stimulate the
Hawkins MN, Raven PB, Snell PG, Stray-Gundersen
cardiovascular system.
J, Levine BD. Maximal oxygen uptake as a
2. Smart progression.
parametric measure of cardiorespiratory
3. False.
capacity. Medicine and Science in Sports and
4. Resistance training.
Exercise. 2007;39(1):103-07.
5. c) Warm-up.
Henatsch HD, Langer HH. Basic neurophysiology
6. False.
of motor skills in sport: a review. International
7. Relieving joint stress, improving function and
Journal of Sports Medicine. 1985;6(1):2-14.
neuromuscular efficiency, and maintaining
Hrysomallis C. Relationship between balance
the normal functional length of all muscles.
ability, training and sports injury risk. Sports
8. False.
Medicine. 2007;37(6):547-56.
9. Balance.
Kallinen M, Markku A. Aging, physical activity
10. False.
and sports injuries. An overview of common
References sports injuries in the elderly. Sports Medicine.
Carson RG. Changes in muscle coordination 1995;20(1):41-52.
with training. Journal of Applied Physiology. Lephart SM, Henry TJ. Functional rehabilitation
2006;101(5):1506-13. for the upper and lower extremity. The
Chatara M et al. Effect of concurrent endurance Orthopedic Clinics of North America.
and circuit resistance training sequence on 1995;26(3):579-92.
muscular strength and power development. McNeal JR, Sands WA. Stretching for performance
Journal of Strength and Conditioning enhancement. Current Sports Medicine
Research. 2008;22(4):1037-45. Reports. 2006;5(3):141-46.
191
Rubini EC, Costa AL, Gomes PS. The effects of Woods K, Bishop P, Jones E. Warm-up and
stretching on strength performance. Sports stretching in the prevention of muscular
Medicine. 2007;37(3):213-24. injury. Sports Medicine. 2007;37(12):1089-
Sheppard JM, Young WB. Agility literature 99.
review: classifications, training and testing.
Journal of Sports Science. 2006;24(9):919-
32.
192
Chapter 7: Warning Signs
Topics Covered
The Warning Signs that Can Mean Trouble
Muscle Cramps
Dehydration
Heat Exhaustion
Heat Stroke
How to Respond to Various Events
Dehydration that Leads to a Loss of Performance and Energy
Dehydration and Muscle Cramps
Heat Exhaustion that Causes Light-headedness, Dizziness and Cold, Clammy Skin
Heat Exhaustion that Causes Nausea and Headaches
Heat Stroke, High Body Temperature and Dry Skin
Heat Stroke that Causes Confusion and Unconsciousness
Warning Signs that the Body Needs a Break or
The Warning Signs that Can the Individual is Training Too Hard
T
Mean Trouble Life Training Health
Signs Signs Signs
here are general warning signs Abnormal muscle
Increased tension soreness after Loss of appetite
that indicate when the body needs training
Fatigue during
the workout which Nausea
a break or that an individual may Increased anger remains throughout
the day
be training too hard. The early
Increased sleeping Loss of motivation Head colds
problems
warning signs can be put into three groups:
May indicate an May indicate undi- May indicate undi-
life signs, training signs and health signs. Life unregulated/un- agnosed neuromus- agnosed neuromus-
diagnosed mood cular disorder cular disorder
disorder
signs include loss of interest in activities that
the individual normally enjoys, increased If these warning signs are not properly
irritability, tension, anger and sleeping problems. heeded, the individual may develop muscle
Training signs that may cramps, dehydration, heat
appear are deterioration exhaustion or heat stroke.
in performance, cutting Severe complications
sessions short, abnormal like these can be avoided
muscle soreness after by ensuring the exercise
training, fatigue that lasts regimen does not cause
during the workout and the individual to over train
remains throughout the and allows for a recovery
day, and loss of motivation to train. Health period, which is the time for muscles to rest and
signs include aches and pains throughout the rejuvenate. While it is important to be observant
body, increased resting heart rate and/or blood and watch for these signs, it is also important
pressure, loss of appetite, nausea and head to keep the client motivated. When starting any
colds. new training program, the trainer should tell the
Warning Signs that the Body Needs a Break or client to expect some level of discomfort until
the Individual is Training Too Hard
getting used to the exercise regimen. Life signs
Life Training Health
Signs Signs Signs
are important because they can be indicative of
Loss of interest in Deterioration in Aches and pains
normally enjoyable performance throughout the body an unregulated or undiagnosed mood disorder.
activities
Increased resting
Increased irritability Cutting sessions Training and health signs may be an indication
heart rate and/or
short blood pressure
194
that there is a neuromuscular disorder that has a muscle or a few of its muscle fibers contracts
not been checked by a physician. If the personal involuntarily when it should not be contracting.
trainer notices any of the signs above, the trainer If the spasm persists for an extended period of
should strongly recommend that the client make time and increases in intensity, it becomes a
an appointment with a clinician. muscle cramp. In other words, a muscle cramp
If warning signs are not properly heeded,
individual may experience:
• Muscle cramps
• Dehydration
• Heat exhaustion
• Heat stroke
Do the following to help the individual: occurs when a muscle involuntarily contracts
• Make sure exercise regimen does not with an intense force and does not relax right
cause overtraining away. Muscle cramps can last for a few seconds,
• Exercise regimen should allow for a up to 15 minutes or even longer in some cases.
recovery period (muscle to rest and Such involuntary contractions cause palpable
rejuvenate) and visible hardening of the muscles that are
• Keep the client motivated cramping. Cramps sometimes cause no pain or
• Tell the client to expect some level of can be felt as mild twitching within the muscle,
discomfort when starting a new program or they can be so bad that they cause extreme
• If any of the three warning signs are seen, pain. Cramps that occur during or after training
personal trainer should recommend usually produce abrupt and severe pain.
client see a clinician
Muscle Cramps
During exercise, the muscles needed to
perform particular movements contract and
relax. Even muscles that support the head, neck
and back contract to maintain proper posture
during exercise. A muscle spasm is caused when
195
Cramps typically occur in the skeletal muscles imbalances lead to muscle cramping because
of the hands, legs, feet, thighs, the arch of the sodium and potassium are the main electrolytes
foot and, most often, in the calves (commonly utilized during exertion. For every two sodium
referred to as a charley horse). Each of molecules pumped out of your muscle cells,
these muscles can be controlled voluntarily. three are pumped back in—it is this mechanism
Involuntary muscles that make up organs such that keeps the muscles contracting properly and
as the uterus, intestinal tract, urine and bile not over-contracting, which can lead to muscle
passages, bronchial tubes and blood vessel walls cramps.
can also cramp. Cramps develop during several

Dehydration
conditions, which include improper stretching
Even when the temperature is not very hot,
before exercising, muscle fatigue, exercising in
many people get dehydrated because they
extremely warm temperatures, and
rely on their thirst to signal when
electrolyte imbalances of phosphate,
they should drink water during a
sodium, chloride, potassium or
workout. A large amount of bodily
calcium.
fluid is lost during exercise and this
Hydration is important in reducing
fluid must be replaced by drinking
muscle cramping because, as we
water periodically. Sweating is the
sweat, we lose electrolytes, such as
body‘s main cooling mechanism,
sodium and potassium, along with
Pickle juice is sometimes but overexertion, coupled with
water, which creates an imbalance
given to athletes who are neglecting to supply the body with
that can then lead to cramping. experiencing cramping.
an adequate amount of liquid,
Pickle juice is sometimes given to
can lead to dehydration. Dehydration causes
athletes who are experiencing cramping for the
a deterioration of both mental and physical
simple reason that it contains so much sodium
performance during a workout. The symptoms
that it can help restore some of the lost sodium
of dehydration include a decrease in sweating,
and relieve cramping. Gatorade is also used
an increase in body temperature, heat distress,
for this reason. Athletes who sweat a lot can
severe fatigue, unconsciousness and, in some
replenish the sodium and potassium they have
cases, death. If athletes exercising only stop for
lost through sweating by drinking Gatorade or
water breaks when they feel thirsty, they will
any other electrolyte-based drink. Electrolyte
196
more than likely become dehydrated. By the that are being utilized during the workout. The
time they feel thirsty, they may have already thickening of blood also means a decrease in
lost one to two liters (a quarter to half gallon) of blood volume and blood flow to the skin. As a
bodily fluid and by this point it may take more result, water and heat cannot be transported
than a few water breaks to replenish the body. to the skin and removed by sweating, and this
condition causes the body temperature to rise.
This form of heat stress can lead to severe
Lubricates joints dehydration, unconsciousness and, in some
cases, death.
Exercising produces heat in the body.

Performing high intensity exercises in hot,
Overheating can be avoided when the body
humid areas often leads to dehydration, but
properly transfers heat to the surface of the skin
exercising for prolonged periods of time in cool
in water droplets that form sweat and evaporate
areas can also cause significant fluid loss.
when they come in contact with the air. If fluids
Effects of Increasing Dehydration on Physical
Performance
are not replaced during exercise, the body will
Body Water
lose its ability to remove heat through water Loss Effects
0.5% Increased strain on the heart
evaporation. In addition, if an individual who is
1% Reduced aerobic endurance
exercising and not drinking liquid continues to 3% Reduced muscular endurance
Reduced muscle strength;
sweat, the level of water in the blood decreases 4% reduced fine motor skills; heat cramps
Heat exhaustion; cramping; fatigue;
and the blood thickens. This thickening of the 5% reduced mental capacity
blood places a strain on the heart by causing 6% Physical exhaustion; heatstroke; coma
it to pump more rapidly in order to maintain Brief bouts of dehydration have been shown
adequate blood flow to muscles and organs to decrease mental and physical performance
197
while prolonged dehydration can cause their way to dehydration. The best way to
problems with judgment, reaction time, prevent dehydration is to drink water all day
making decisions and concentration. When long. Simply drinking water right before a
exercising in cooler climates or during the workout or even during a workout is not the best
winter months, people need to be conscious of scenario to avoid dehydration. Staying hydrated
the fact that the cooler weather does not mean throughout the day is the best advice a personal
dehydration cannot occur. People trainer can give their clients.
often associate profuse sweating Drinking electrolyte-based drinks
with dehydration, but in cooler (e.g., Gatorade) after a workout is
climates sweating can be more a good way to replenish the fluids
insidious. Also, in colder climates a client has lost. It is not a good
people tend to layer on clothing to idea to recommend electrolyte-
work out—this can lead to more based drink consumption during
sweating and, because the extra the day because most clients
clothing can absorb more sweat, this can lead to are not likely to be losing electrolytes and may
inconspicuous dehydration. end up with an over-abundance of sodium and
potassium, which is not desired either.
There are other sources of water loss that
are termed senseless, meaning that the person
losing water is unaware of the water loss. The
greatest senseless water loss comes from the
respiratory system. Air is breathed in, warmed
and moistened in the upper respiratory tract
and then makes its way to the lungs to supply
the body with oxygen. When we breathe out,
our breath is humidified, meaning there is water

The thirst center in the hypothalamus of the
in the air, so we lose water. Obviously, when we
brain sends signals of thirst when the body has
exercise, we breathe more frequently; therefore,
lost a significant amount of fluid; therefore,
more water is lost. This additional water loss can
when clients feel thirsty, they are already on
also contribute to dehydration. It is important
198
to remind clients of all aspects of water loss as sweating cannot be replaced quickly enough to
many people do not realize they can become keep the body temperature from rising. When
dehydrated even if they are not sweating. exercising in a humid area, the body not only
loses water through sweating but also loses

Heat Exhaustion
electrolytes such as sodium.
Heat exhaustion normally occurs when an
Signs of Heat Exhaustion:
individual is playing, working or exercising
• Individual looks pale
in a hot and humid area that causes extensive
• Moist skin
sweating and overheating. The individual’s body
• Sweats profusely
temperature may be noticeably elevated but
• Increased pulse
usually does not rise above 104°F. The normal
• May have a headache
• May feel dizzy
• May be nauseous
• May have weakness
• May experience muscle cramps
• Body will be able to self-regulate its
temperature
When fluid and electrolytes are not replaced
quickly, the body’s circulatory system works
inadequately and the body undergoes a mild
form of shock. An individual who is suffering
from heat exhaustion will start to look pale,
develop moist skin, begin to sweat profusely
and have an increased pulse rate. The individual
may get a headache, experience muscle cramps,

body temperature is 98.6°F. An individual’s body
and feel dizzy, nauseous, and/or weak. The main
temperature slightly increases with activity.
difference between heat exhaustion and heat
Performing exercise in a hot and humid area
stroke is the temperature of the body. When a
causes the body temperature to rise too quickly.
person is suffering from heat exhaustion, they
In this case, the amount of water lost through
are still able to cool down if they are taken into
199
a cool place and are able to relax long enough to regulates the body’s ability to sweat but,
let the body self regulate its temperature. During during a heat stroke, the cooling system stops
heat stroke, the body is beyond self-regulation. working. A heat stroke usually occurs when
Heat stroke is a very dangerous condition. an individual is performing strenuous activity
under extremely hot conditions. The inability of

Heat Stroke
the body to control an elevated temperature can
Signs of Heat Stroke:
lead to brain damage and damage to vital organs.
• Body can no longer control its
When a heat stroke occurs, an individual’s body
temperature
temperature can be 105°F or higher.
• Body can no longer sweat
Heat strokes often develop rapidly; however,
• Brain damage can occur
there are several indicators,
• Damage to vital organs can
including deterioration in mental
occur
performance, confusion, dizziness,
• Body temperature is 105°F
hallucinations, unconsciousness,
or higher
and/or coma. In addition, the skin
• Deterioration in mental
becomes flushed, hot and dry. The
performance
person may also hyperventilate
• Confusion
and have high blood pressure that
• Dizziness
then drops dramatically after a
• Hallucinations
short period of time. Medical problems and
• Unconsciousness
medication that inhibit a person from sweating
• Coma is even possible
properly can predispose them to heat strokes.
• Skin is flushed, hot and dry
Infants and elderly persons have a higher
• Individual may hyperventilate
heat stroke risk than children and adults but,
• May have high blood pressure and then
regardless of age, individuals who are training
have it drop dramatically
under strenuous conditions should be closely
A heat stroke is a life-threatening medical
monitored.
condition/medical emergency. A heat stroke
When living in a hot or humid environment,
occurs when an individual’s body is no longer
as well as during the summer months, personal
able to control its temperature. The brain
200
trainers need to monitor their clients very counter antihistamine is Benadryl, and many of
carefully and avoid putting them in situations the prescription medications given for allergies
that would cause heat exhaustion and, most are antihistamines.
importantly, heat stroke. When taking the client’s Education on the part of the personal trainer
initial assessment, the personal trainer should regarding common medications is important
take great care to ensure the client provides an for this very reason. As stated previously, it is
accurate description of medications since some not the job of the personal trainer to provide
medications may elicit or predispose the client medical advice on medications; however, it is
to heat stroke. For example, antihistamines are important to recognize medications that may
commonly used to control allergies and are a influence the client’s workout regimen. Other
fairly frequent over-the-counter or prescription common medications a client may be taking are
medication taken for seasonal allergies or an those used to regulate hypertension, also known
allergic reaction. Antihistamines as high blood pressure. Many
lessen and/or prevent an allergic Sweating leads to a loss times, hypertension medications
of electrolytes and fluids
reaction by blocking the body’s and then to dehydration. are classified as diuretics, which
anti-inflammatory response. In cause the person to sweat more
part this is accomplished by decreasing bodily frequently. Remember, sweating leads to a
secretions (many people taking antihistamines loss of electrolytes and fluids and then to
complain of a dry mouth). A side effect of this dehydration. If a client is taking any medication
response is that people taking antihistamines for hypertension, the personal trainer should
may sweat less. As previously noted, sweating is know the type of medication and become
the body’s way of getting rid of excess heat and educated on the mechanism of the medicine’s
maintaining a body temperature below 104°F. action. If the medicine is a diuretic, the client
Therefore, the side effect of decreased sweating needs to be educated about the importance of
with antihistamines can leave clients prone to staying hydrated throughout the day, especially
overheating. Typically, allergies are a problem on workout days and, more importantly, during
in warmer weather, so it is more likely that a the summer months.
client will be taking an antihistamine during the
warmer months. The most common over-the-
201
example, water is lost through breathing because
How to Respond to Various Events
exhaled breath is moist. It is also lost through the
Dehydration that Leads to a Loss skin, even when an individual is not sweating,
of Performance and Energy and it is removed from the body through waste
If a client or the trainer notices a loss of and urine. Drinking sufficient amounts of water
energy, decreased performance, and/or daily ensures that the body is always properly
dehydration during hydrated and that its water reserves are full.
the client’s workout, Unfortunately, most people drink when they
the client should are feeling thirsty, not realizing that thirst is an
drink liquids that indicator that dehydration has already occurred.
contain electrolytes Drinking fixed amounts of liquids periodically
and carbohydrates. can prevent the development of dehydration.
Carbonated beverages
Dehydration and Muscle Cramps
(e.g., soda) should be
When a cramp develops during an exercise
avoided as they may
regimen and the individual is also dehydrated,
cause gastrointestinal
the individual should immediately stop
problems, flatulence and abdominal cramps.
exercising and massage the muscle that is
Sports drinks usually contain 6% carbohydrates
cramping. Gently stretching the muscle that
that the body can easily absorb. Carbohydrates
prevent flatulence that can be caused by
carbonated drinks. Water transports nutrients
to cells and removes waste from cells. Water
also acts as a skin lubricant (sweat) that helps
maintain an optimal body temperature by
removing heat from the body during a workout.
Water accounts for 60% of the total body
weight. Muscles and organs consist of
approximately 70% water, so adequate water
levels in the body should be maintained at all
times. The body loses water in several ways. For
202
is cramping until it stops cramping is another and taking good notes on clients can prevent a
solution. If an individual’s leg begins to cramp lot of these issues from occurring.
while lying down, putting weight on the leg At the initial assessment, the personal trainer
and walking around may relieve the cramp. should ask if the client has a history of muscle
Sometimes, consuming a sports drink that cramping and what were the conditions of those
contains sodium helps relieve muscle cramps cramps. For example, was the client performing
by restoring electrolyte levels. The sports drink cardiovascular training or resistance training
also begins to rehydrate the body. Properly when they experienced the cramping and
warming up and stretching before working out, did the cramping go away after the person
particularly focusing on muscles that normally became more acclimated to the workout? If a
cramp, can help to avoid muscle cramps and the client does experience a cramp, the best thing
recurrence of cramps. Staying hydrated before to do to is stop the activity and have the client
and during a workout can also prevent muscle rub out the cramp. If the
cramps. trainer and client feel
comfortable, the trainer
can offer to rub out the
cramp, especially if it is in
a hard to reach area. Also,
give the client something
to drink to replenish any
fluids lost, as this may be a contributing factor
to the cramping. Another important question to
Dehydration is an important aspect in pose is how long into a workout did the cramp
muscle cramps, but muscle fatigue is also a present itself, as this may give the trainer an idea
common cause of muscle cramps. If a client of how long to plan the workout. Remember,
is experiencing muscle cramps, this can be a clients experiencing too much discomfort will
clear indication of dehydration or overexertion. not want to continue with their workouts.
Again, it cannot stressed enough how important
it is to understand that clients are individuals
203
and the condition has not worsened to heat
Heat Exhaustion that Causes
stroke, which presents with a loss of sweating
Light-Headedness, Dizziness and
because the internal body is no longer able to
Cold, Clammy Skin
regulate the temperature via sweating.
Individuals experiencing heat exhaustion
should immediately relocate to a cool area, Heat Exhaustion that Causes

drink cold liquids and rest until their dizzy Nausea and Headaches
spell passes. Lying down and elevating the legs, When an individual is
increases blood flow to the brain and helps experiencing nausea and
alleviate dizziness. Gently stretching can also a headache in addition
help the individual improve blood circulation to heat exhaustion,
and prevent fainting. Wetting the skin and rehydrating quickly is of the
then sitting in front of a fan (or simply fanning utmost importance. Sports
the skin) will also lower body temperature. drinks and salty snacks are
recommended because they replace the salt
the body has lost. The individual should rest
in a cool area and lie down to help alleviate
the headache. Removing or loosening the
individual’s clothes and applying water to
the skin are also helpful. A person that has
suffered from heat exhaustion should avoid
The personal trainer should take great care strenuous activities for a few days to ensure
of a client if the trainer suspects the client is proper rehydration.
experiencing heat exhaustion. Upon standing,

Heat Stroke, High Body
the client may experience brief fainting, so
Temperature and Dry Skin
the personal trainer should support the client
If an individual begins to complain about
during relocation. The personal trainer should
having chills, has goose bumps on the skin, and
check to see if the client is sweating profusely,
is feeling pins and needles in the arms, blood
also called diaphoresis. This is a good indication
circulation to the skin is deteriorating and the
that the client is experiencing heat exhaustion
individual is beginning to have a heat stroke.
204
circulating from the skin’s surface to cool and
assist in bringing the internal blood to a lower
temperature and thereby eventually lowering
the core body temperature back to normal.
Heat stroke is usually a problem in hotter, more
humid climates, although it can occur during
Heat stroke is a serious medical condition that winter months.
should be treated immediately. Individuals who

Heat Stroke that Causes Confusion
are having a heat stroke typically have a high
and Unconsciousness
body temperature and dry skin. At the first
Confusion followed by unconsciousness means
sign of a heat stroke, an emergency medical
the individual has had a heat stroke. This is a
technician (EMT) should be contacted. The
medical emergency that can lead to death if it is
individual should be relocated to a cool location
not swiftly and properly treated. While waiting
and measures, such as the use of cold packs,
for medical professionals, the trainer should
should be taken to lower body temperature.
place the individual in an ice bath or use any
Normally, when a person is exercising or
other means to lower
just in the heat, the body generates internal
the body temperature
heat from metabolism, but during heat stroke
as fast as possible.
the external temperature becomes so hot that
Moistening the skin
the body cannot keep up with its own internal
with lukewarm water
temperature. The body becomes less efficient at
and using a fan to
dissipating the heat to the external environment
blow cool air on
via sweating. As a result, more heat is retained
the skin also helps lower body temperature.
internally and the person’s temperature begins
Sufficient amounts of cool liquids can be given
to rise. Any body temperature over 40°C or
periodically to individuals that are awake and
104°F is classified as heat stroke. A person
alert. People who have had a heat stroke may
suffering from this condition will
need to be hospitalized and monitored in order
need aid in cooling off the external
to determine if any damage has occurred to the
temperature via ice packs—
brain or vital organs.
this action enables the blood
205
Anytime vital signs, such as temperature, are In order to avoid developing such severe
out of the normal range, the brain or central complications while exercising, an individual
nervous system is always going to be affected. can follow these guidelines:
The brain is usually one of the first organs • Drink approximately three liters of liquid
affected, so personal trainers should look for every day, especially the day before a
signs and symptoms that may be altered via workout.
•
Drink at least two cups of
liquid two to three hours
before working out.
• Replace sweat that is lost by
drinking ½ cup or more of
liquid every 10 to 20 minutes.
• Monitor fluid loss and do not
rely on thirst to signal the
next water break.
• Re-hydrate within two hours
after exercising.
the central nervous system if they suspect their Research has shown that drinking liquids
client may be suffering from heat exhaustion or with 6% carbohydrates (e.g., energy drinks)
heat stroke. Remember, confusion will usually aids intestinal absorption and gastric emptying,
precede unconsciousness, so trainers must enhances the desire to drink during exercise,
pay close attention to clients’ mannerisms and reduces physical and mental fatigue, and thereby
speech on hot days. Do not bombard them with increases workout
questions throughout the workout, but it is a performance. It is also
good idea to ask questions periodically, mainly important to consider
to check their current mental status. Simple one the type of exercise that
answer questions can be a good indicator of is being performed when
how their mental status is without overexerting deciding how much
them. and how often fluid
206
should be consumed. Canoeists Surprisingly, this is a challenge for the majority
and runners usually drink of people.
approximately 500 milliliters of The importance of not becoming dehydrated
liquid per hour, while cyclists can is often stressed over the fact that a person can
drink up to 1.2 liters of liquid per become overhydrated, although this can be as
hour. This difference may be due big of a problem as dehydration. The majority of
to discomfort that runners and time this is not a problem as long as a client does
canoeists experience when they drink large not have heart or kidney trouble. As previously
amounts of water during exercising. They may stated, every client is different and a good initial
also feel that drinking more than assessment is so important for
500 milliliters of liquid in an hour this reason. Past and present
could slow them down. In such medical histories are important
cases, runners and canoeists have sections to bear in mind.
extended rehydration periods in Water intoxication, also called
order to fully replace the water hyponatremia, occurs when a
their bodies lost during exercise. person drinks so much water
Another important aspect of Hydration is good, but that the water dilutes the sodium
hydration is over-hydration, also must be matched by the in the body. When this happens,
correct sodium intake.
known as water intoxication or the electrolyte imbalance leads to
water excess. Although this concept may seem the person becoming confused or disoriented.
bizarre, it is increasingly becoming a problem for The brain is the primary organ affected by
people. Guidelines exist that indicate how much over-hydration, so a change in personality is
people should drink and how often, but once the first sign of water intoxication. Treatment
again, personal trainers need to understand and for water intoxication requires a doctor’s care.
stress to clients the notion of individuality. Some
people can drink copious amounts of water and
be physically okay, while others cannot. Clients
need to develop their own balance between
feeling thirsty and having to void too frequently.
207
Typically, diuretics are administered to rid the
Review Questions
body of excess fluid. During this time, careful
1. Muscle cramps can be caused by the
monitoring by a physician is best. Although
following:
water intoxication is rare and personal trainers
a) Electrolyte imbalances
will see more dehydration-related problems, it
b) Muscle fatigue
is important to be aware of this condition and
c) Dehydration
how to react if over-hydration is suspected.
d) All of the above
Also, personal trainers need to educate clients
2. If a person feels______________________________,
on both aspects of water balance.
dehydration has already started.
Summary 3. Dehydration can be avoided if a client drinks
Trainers and individuals who are exercising a lot of water right before training. True or
should pay close attention to the type and False?_________________________________________
quantity of liquids consumed the day before 4. Water is lost through
working out. Liquid should also be periodically a) Skin and respiratory tract
consumed during the workout. When possible, b) Urination and feces
training should be performed in cool, well- c) Skin
ventilated areas. If training requires that the d) Both a and b
individual exercise in a hot and humid area, 5. If a person is suffering from ________________,
sufficient amounts of cool liquids should be he should be relocated to a cool area where
consumed frequently. If ailments such as severe he can lie down and drink plenty of fluids.
muscle cramps, dehydration, heat exhaustion 6. If a person is suffering from ________________,
and heat stroke occur, even when necessary he needs medical attention in addition to
precautions are taken, the individual should being relocated to a cool area and given
refrain from exercising for several days following fluids.
the incident. 7. Over-hydration is a common problem that
can be treated with rest and fluid restriction.
True or False?________________________________
208
8. If a person is dehydrated, the best way to
References
overcome this is to consume:
Bentley S. Exercise-induced muscle cramps.
a) Water
Proposed mechanisms and management.
b) Electrolyte based drinks (e.g., Gatorade)
Sports Medicine. 1996;21(6):409-20.
9. Water intoxication causes thickening of
Casa DJ, Armstrong LE, Hilman SK, Montain
the blood and hypernatremia (too much
SJ, Reiff RV, Rich BS, Roberts WO, Stone
sodium). True or False?______________________
JA. National Athletic Trainer’s Association
10. A person suffering from heat exhaustion will
Position Statement: Fluid Replacement
have __________________________________________
of Athletes. Journal of Athletic Training.
skin, while a person suffering from heat
2005;35(2):212-24.
stroke will have ______________________________
Coyle EF. Fluid and carbohydrate replacement
skin.
during exercise: how much and why? Sports
Answers Science Exchange. 1994;50(7):3.
1. d) All of the above. Maughan L, Leiper JB, Shirreffs SM. Rehydration
2. Thirsty. and recovery after exercise. Sports Science
3. False. Exchange. 1996;62(9):3.
4. d) Both a & b. Ryan AJ, Lambert GP, Shi X, Chang RT, Summers
5. Heat exhaustion. RW, Gisolfi CV. Effect of hypohydration on
6. Heat stroke. gastric emptying and intestinal absorption
7. False. during exercise. Journal of Applied Physiology.
8. b) Electrolyte based drinks (e.g. Gatorade). 1998;84(5):1581-88.
9. False. Schwellnus MP, Drew N, Collins M. Muscle
10. Moist and flushed; hot and dry cramping in athletes—risk factors, clinical
assessment and management. Clinical Sports
Medicine. 2008;27(1):183-94.
Von Duvillard SP, Arciero PJ, Tietjen-Smith T,
Alford K. Sports drinks, exercise training
and competition. Current Sports Medicine
Reports. 2008;7(4):202-08.
209
Chapter 8: Special Populations
Topics Covered
Introduction to Special Populations
Pregnant Women
Designing a Safe Exercise Plan During Pregnancy
Exercises to Perform and Avoid
Safety Precautions
Seniors
Safety Precautions
Youths
Training Programs and Supervision
Preventing and Controlling Childhood Obesity
Safety Precautions
Injured Persons
Exercising with an Injury
Exercising after an Injury
Safety Precautions
Persons with Specific Medical Conditions
Arthritis
Asthma
Preparing for Exercise
Diabetes Mellitus
Hypertension
Monitoring Blood Pressure
Types of Exercises for Persons with Hypertension
healthy baby. However, exercising throughout
Introduction to Special
pregnancy is also of great importance. While a
A
Populations
pregnant woman may not be able to perform the
s we know, exercise is necessary
same exercise regimen as before her pregnancy,
to maintain our health. Some
there are several recommended exercises that
people have the misconception
can be performed during pregnancy that not
that, in order to be healthy, they
only promote the proper circulation of fluid
must engage in strenuous exercise. Personal
and nutrients to the baby but also keep the
trainers should educate people regarding
mother in top physical condition. Exercising
the difference between maintaining health
during pregnancy can also shorten the length of
and modifying body weight. Most physicians
time a mother needs to lose baby fat after the
will suggest 30 minutes of
baby is born. When a woman
continuous exercise per day in
becomes pregnant, she should
order to maintain health. The
speak with her doctor before
30 minutes, however do not
beginning a workout regimen
have to be continuous—they
and speak with a trainer to
can be broken up into shorter
make sure the appropriate
time periods throughout the
exercises are performed. The
day. A person’s attitude is
level and type of exercise that a
important and the personal trainer should
doctor and trainer recommend usually depends
encourage any exercise during the day. There
on a woman’s fitness level prior to becoming
is plethora of evidence stating that exercise can
pregnant.
stave off chronic illnesses such as heart disease
Although exercising while pregnant normally
and diabetes mellitus.
helps both the mother and baby, there are
certain cases, such as high-risk pregnancies or

Pregnant Women
complications that arise during the pregnancy,
When a woman becomes pregnant, she may
which can prevent a pregnant woman
think that eating healthy foods and getting
from exercising. However, under normal
a lot of rest are the top priorities in order to
circumstances, exercising provides many
stay fit throughout the pregnancy and have a
benefits to the mother and her growing baby.
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When a pregnant woman’s body begins performing exercises throughout the
to change, she may feel increasingly pregnancy that increase endurance can
fatigued and stressed about aches and help a woman get through long hours of
pains or other symptoms the pregnancy labor. Another essential benefit is that
may be causing. Exercise has been shown less fat will be gained if the mother was
to increase energy levels and lead to the properly exercising before she became
release of endorphins, which are chemicals pregnant and continued to do so throughout
produced naturally in the brain that lead to a the pregnancy. In addition, the mother will
decreased sensitivity to stress regain her normal size after
and pain. This can help relieve the baby is born more quickly
tension and help a pregnant than if she did not exercise
mother sleep comfortably. during pregnancy. Currently,
Exercise relieves back pain and studies are investigating the
improves posture by toning notion that exercising while
and strengthening muscles in pregnant can decrease the risk
the thighs, buttocks and back. of developing complications
Exercise also prevents joint such as gestational diabetes
damage by stimulating the release of relaxin, a and preeclampsia (pregnancy-induced high
hormone that increases the flexibility of joints blood pressure).
and ligaments.
Designing a Safe Exercise Plan
Exercise improves circulation within the
During Pregnancy
intestines, which in turn reduces constipation.
Designing a safe exercise program during
It also increases the circulation of blood to
pregnancy depends on whether or not the
the skin, which produces a healthy glow. One
woman was exercising before she came
of the most important benefits of exercising
pregnant, the stage of pregnancy at which she
during pregnancy is that it strengthens the
wants to start and whether or not complications
heart and body muscles. This plays a role in the
arise during the pregnancy. If a woman was
ease at which a mother goes into labor and the
exercising prior to her pregnancy, she can more
event of giving birth. For example, breathing
than likely continue her program by making a
exercises help manage pain during labor, and
213
few modifications. For example, and do not increase the risk of early
if a woman was in a weight lifting miscarriages, preterm deliveries
program before she became or low birth weights. In every case,
pregnant, she may be able to a woman who becomes pregnant
continue by lifting lighter weights. should have a discussion with her
She should not continue lifting doctor regarding plans to continue
the same weights because the or begin exercising. Complications
pregnancy already puts more strain on joints that usually limit a woman’s ability to exercise
and could lead to avoidable joint injuries. The during her pregnancy include:
stage at which a pregnant woman wants to begin • Early contractions
exercising also plays a role because the type • Vaginal bleeding
and level of exercise that can be done changes • Dizziness
as the pregnancy progresses. • Chest pain
During the first trimester, • Headache
exercises can be performed • Muscle weakness
in the supine (lying on the • Decreased fetal movement
back) position, but this is not • Dyspnea (shortness of breath) before
recommended after the first exercising
trimester. • High blood pressure that is pregnancy
According to the U.S. Department of Health induced
and Human Services, women should be • Premature rupture of the amniotic sac
exercising at least 2.5 hours a week to maintain (water breaking early)
their health. However, even if a woman was not • Calf swelling and pain
exercising before she became pregnant, she can

start performing slow, easy and short exercises.
Safe Exercises to Perform When Pregnant
Exercise intensity and speed can be increased
Low Impact Exercises:
as the expectant mother begins to feel stronger.
• Dancing
If the pregnancy is free of complications, the
• Yoga
risks of exercising at a moderate level are low
• Pilates
214
Water Exercises: exercises that can be performed during
• Swimming pregnancy, but walking is recommended more
• Water Aerobics often than biking. It is very easy to change the
Aerobic Exercises: pace during a walking routine. When walking
• Walking short distances is not a satisfying workout, the
• Bicycling distance can be increased or hills can be added
• Light/Low Impact Aerobics to the walk to increase the intensity. A pregnant
• Running (if a runner prior to pregnancy— woman who is not used to walking should start
modify routine) out by walking one mile or less, three times a
Weight Lifting (Less weight than prior to week. A warm-up and cool-down of at least five
pregnancy): minutes should be included in this workout
• Maintain health (not increase muscle) routine.
Dancing, yoga and Pilates are all fantastic As previously stated,
forms of low impact exercises that help stretch expectant mothers can
muscles. Swimming and water aerobics are continue to lift weights
but should decrease
the weight they have
been previously lifting.
Expectant mothers should also consult their
doctor before continuing a weight lifting
program to make sure this will not cause joint
also good exercises for an expectant mother. problems or complicate the pregnancy. If a
The water provides a pregnant woman with mother decides to continue lifting weights after
the ability to easily move around and stretch consulting her doctor, she should make sure to
almost all muscle groups. Swimming and water use less weight as the pregnancy progresses.
aerobics are especially beneficial because they Jumping and jerking movements should be
give a pregnant woman the feeling of buoyancy avoided during the pregnancy and an expectant
(weightlessness) at a time when she may feel mother, as well as her trainer, should focus on
pressure from her growing baby and increasing using exercise to maintain the mother’s health,
weight. Walking and biking are additional not increase muscle tone or mass.
215
Many pregnant women who were runners minute during exercise. If a heart monitor is
before becoming pregnant can continue not available, a talk test can be used. This test
running by modifying their routine. However, determines whether or not a pregnant woman
an expectant mother must remember that can have a conversation while she is exercising
exercises, such as running, should be or if she appears to be gasping for air
performed in moderation and do not when she tries to speak. When this
have to be performed on a daily basis. occurs, the expectant mother should
In addition, listening to the body and stop exercising or avoid the exercise that
its warning signs is of the utmost is causing the overexertion. Exercising
importance. For example, as a baby outside when it is hot and humid should
grows, the mother’s center of gravity changes, be avoided as well. When a pregnant woman
making it easier for an expectant mother to begins to overheat, this can be very dangerous
become dizzy or lose her balance. This occurs for her baby. Body temperatures higher than
especially during the last trimester. A growing 102.6˚F can harm a growing baby and cause
baby also puts more pressure on the lungs, birth defects. This is especially critical during
which decreases her ability to breathe properly the first trimester. Swimming is a good option
when she is exercising. Furthermore, energy on hot, humid days because it keeps the body
levels can change daily—if a pregnant woman cool. If swimming is not an option on that
feels extremely tired on the day she is supposed day, exercising in an air-conditioned facility is
to exercise, she should shift the workout to the recommended. As opposed to typical sportswear
next day, assuming she will be feeling better the that clings to the skin, pregnant women should
following day. wear comfortable, loose-fitting clothes while
exercising. Finally, as with any exercise routine,

Safety Precautions
adequate amounts of water should be consumed
There are several safety
before, during and after exercising.
precautions that a pregnant
If any of the following symptoms occur
woman, as well as her trainer,
during exercise, the expectant mother should
should not ignore. A pregnant
immediately stop and contact her doctor:
woman’s pulse rate should
• Dizziness
not rise above 140 beats per
• Severe fatigue
216
• Shortness of breath
• Heart palpitations (strong and rapid
Endurance Exercises
heartbeats)
In elderly persons, endurance exercises
• Headaches
increase the maximum amount of oxygen the
• Pain in the pelvis and/or back
body and muscles can uptake and transport.
• Bleeding
Endurance exercises reduce high blood pressure
Seniors and rapid heart rate as well. Endurance, especially
As people age, people often think that exercising cardiovascular strength, is necessary for elderly
is too tedious and may cause them unwanted persons to be able to shop and take care of
injuries. However, exercising at any themselves, perform housework,
age can improve an individual’s work outdoors (e.g., in a garden) and
quality of life. Elderly persons can enjoy recreational activities. In order
also exercise for short periods of to maintain their strength and level
time and still notice an increase in of endurance, exercises that increase
muscle strength and tone. Similar to their heart rate and breathing for
other individuals, elderly persons extended periods of time without
need to focus on strength training, causing complications should be
flexibility training and cardiovascular training performed. Beneficial exercises for the elderly
to maintain as much mobility and strength as include walking, swimming and dancing, while
their body allows. Ailments, such as arthritis,
often hinder their ability to move around, but
recent studies have shown that exercising can
reduce inflammation and pain that is caused by
arthritis. Strength training has also been shown
to improve muscle strength in elderly persons
who have suffered from a hip fracture. These
are just a few of the many benefits that exercise high-impact exercises such as running, cycling
provides to elderly persons. and jumping rope should be avoided because
they put a lot of strain on joints and muscles.
217
Low impact exercises should be performing this exercise. Arm raises strengthen
performed for 20 to 40 minutes at shoulder muscles and can be performed by
least 3 times a week. sitting in a chair with the arms facing the
Strengthening Exercises side of the body and raising both arms
Elderly persons can strengthen to the shoulder height. This position
their upper and lower body by is held for one second and then the
lifting weights or using weight lifting arms are lowered back down to the
machines. In the beginning of a weight individual’s side. Arm raises can be
lifting regimen, weights that can be effortlessly repeated 8 to 15 times.
lifted five times should be used. When this Lower back strength is also important for
routine becomes too easy, the same set of elderly persons because back pain is a symptom
weights should be lifted five times for two sets. that often occurs when people begin to age.
The routine can be increased periodically until Having a strong back makes it easier for the
the individual can do 15 continuous repetitions. elderly to stand up from a sitting position, get
When the individual can lift the weight 5 times into and out of a car, pick up objects, move
for 15 repetitions, the size of the weights can around and work in the yard. Back muscles can
be increased. This type of strength be strengthened by sitting upright
training can be performed for 30 to in a seat with the feet placed flat
40 minutes, 2 or 3 times a week. on the floor, arms bent and relaxed,
There are several strengthening then pulling the shoulders back as
exercises that can be performed at far as possible. Another exercise that
home. Plantar flexion is an exercise strengthens back muscles can be
that strengthens ankle and calf performed by lying on the floor and
muscles. To perform this exercise the individual placing a pillow or cushion under the hips. The
slowly raises their body so that they are standing arms are placed at the sides and the legs are
on their tiptoes and holds this position for one straight. The head and feet are slightly lifted off
second. This exercise can be repeated 8 to 15 of the floor at the same time and held for one
times and if the individual begins to feel stronger second. The individual can relax for a moment
after some time, they can alternate legs while and then repeat the exercise.
218
Stretching Exercises Calves and ankles can also be easily stretched
The muscles and joints of elderly persons by standing in front of a wall, fully extending
are often inflexible, stiff and inflamed. In order the hands and then placing them on the wall.
to avoid unnecessary injuries and lessen the The individual then moves one of their legs
backwards while keeping their foot and heel

pain that is caused by inflammation, stretching
pressed against the floor. This position is held for
exercises should be performed throughout the
10 to 30 seconds, then the knee is bent and the
week, especially before strength training. In fact,
leg is brought back to its original position. This
warm-ups and cool-downs should involve 5 to 15
stretch is performed again with the opposite
minutes of stretching before strength exercises are
leg and the entire exercise is repeated three to
performed. Elderly persons should make sure they
five times. Elderly persons should work closely
stretch their arms, shoulders, back, chest, stomach,
with a personal trainer to make sure stretches
thighs and calves. Shoulder rotations are easy to
are performed correctly and that posture is
perform and are often recommended. First, the
maintained throughout the stretch.
individual lies flat on the floor with
Balance Exercises
their head placed on a pillow. The
By helping older individuals
palms are placed face down and the
maintain posture and mobility,
elbows are bent so that the arms are
balance exercises have been
forming an angle. This position is held
shown to prevent injuries that are
for 10 to 30 seconds and
typically caused from falling. In
then the arms are rotated
addition, elderly persons who can maintain
so that the palms are facing
their balance also retain their independence
upward and held again for 10 to 30 seconds. This
by reducing their need for a walker, wheelchair
exercise can be repeated three to five times.
219
or assistance when it comes is by staying active, even if they cannot exercise
to moving around. In order to two or three times a week.
enhance an elderly person’s

Safety Precautions
ability to maintain their
Sarcopenia, a loss of muscle mass and
balance, trainers usually focus
strength and a decline of muscle tissue, also
on increasing the individual’s
occurs in people as they age. Experts suggest
core muscle strength.
that muscle mass decreases approximately 4%
One commonly used method
each decade from ages 25 to 50. Aerobic fitness,
of improving balance involves
which normally increases the amount of oxygen
the use of a Bosu balance trainer. This is an
that is delivered to muscles, is also hindered
exercise ball that has been cut in half (half-
as people age. This may reduce one’s mobility
ball) that engages small stabilizer muscles in
and alter daily activities. Joints become stiffer,
the upper and lower parts of the body that are
which often leads to a higher risk
normally not active. After a period
of injuries. Each year, more than
of time, the individual learns how
300,000 people are hospitalized for
to stabilize their body and maintain
broken hips caused by falls.
their balance on top of the half-ball. This form of
Recently, more and more scientists claim that
exercise also improves agility (needed to avoid
the complications of aging can be avoided or
falling), increases the ease at which an elderly
become less severe if people remain active as they
person can move and enhances their reaction
age. Older adults, regardless
time in case of an emergency.
of age, should make sure time
Simple balance training on a
is devoted to exercising on a
Bosu can greatly improve an
regular basis. Even exercising
elderly individual’s quality of
one or two times a week is more
life by increasing their mobility
healthy and beneficial than
and reducing injuries typically
being inactive. However, elderly
caused from falling down. In every case, it is
persons should constantly be aware of their level
important for elderly persons to remember that
of physical fitness by periodically undergoing
the best way to reduce the symptoms of aging
a medical examination and working under a
220
trainer’s supervision. The doctor will ensure foods. Overweight persons increase their
the patient is not putting too much strain on the chances of developing such conditions when
body and the trainer will ensure the exercises their weight continues to increase, so it is good
performed accommodate the advice for even young people
client’s current level of fitness. to manage their weight and
In addition, elderly persons physical activity.
who have chronic conditions Surveys performed over
should consider the role their recent years suggest that the
condition plays in their ability majority of obese children and
to exercise safely in order to avoid unnecessary youths are overweight due to an absence of
injuries. These persons should be sure to consult physical activities in their daily routine and an
regularly with their doctor and personal trainer. unhealthy diet. Years ago, children, youths and
If the individual begins to experience chest pain, adults alike used to walk or cycle to school or
shortness of breath or lightheadedness while work and play sports regularly. Nowadays,
exercising, they should stop and contact their people travel mainly by car and children are
doctor. transported to school by their parents or by
school buses. In the afternoons when kids return

Youths
from school, they
Children, teenagers and adolescents may
typically sit in front
often think they do not really need physical
of the television or
education classes or aerobic exercises to keep
computer for several
in shape, but inactive young people are just as
hours before going
susceptible to health problems as adults who
to bed. According to
are inactive. In fact, a large number of children
a U.S. National Diet
and youths are at risk for developing coronary
and Nutrition
artery disease (heart disease), type 2 diabetes,
Survey, 6 out
high blood pressure, high cholesterol and even
of 10 girls and 4 out of 10 boys are not
heart attacks because
engaging in physical activity for a minimum
of inactivity and
of one hour a day, which is recommended
consuming unhealthy
by health care professionals. Training
221
programs and classes that educate children and Training programs should offer students a
young people about how to get into shape or variety of options. Children and youths have
stay in shape will begin to lower the currently different personalities and will often prefer
increasing obesity rates. various types of exercises and sports. Parents,
teachers and trainers should pay close attention

Training Programs and
to behavioral patterns when a child or youth
Supervision
is engaging in recreational activities. When
Training programs are beneficial tools that can
individuals are performing an activity or sport
be used to combat obesity. They are sometimes
they do not like or find difficult, they may become
conducted in school for students or information
less motivated and will not reap the health
is given to parents seeking ways to help their child
benefits that performing a
reach their ideal weight and optimal physical
sport they are enthusiastic
fitness level. Training programs for parents
should include ways that their child’s activity
level and eating habits can be monitored and
improved. Training programs and supervision
also entail physical education, which means
making sure children are engaging regularly in
about can provide
them. Allow youths
to try a number of activities to find the exercise
or sport that is right for them and encourage
them to engage in this activity on a regular basis.
recreational activities. It is also important that

Preventing and Controlling
children and youths are supervised while they
Childhood Obesity
are exercising or playing sports, since a lack of
Preventing and controlling obesity involves
concentration or playing during training can
introducing a healthy and well-balanced diet to
lead to unnecessary accidents and injuries.
222
an obese child or youth that is overweight. Fatty very far from home, parents should encourage
foods like chips, hotdogs and hamburgers should walking instead of going by car. Taking children
be replaced with fruits, vegetables and starchy to a park regularly and playing sports with them
foods such as potatoes, also encourages children to
pasta and rice. In addition, become more active and
sodas and other carbonated shows that physical fitness
drinks should be replaced is important to their parents.
with fruit juice, milk and Parents can also make
water. Controlling obesity recreational activities fun by
also involves improving going to amusement parks,
eating habits. For example, if a parent and their riding bikes, swimming, etc. Avoid inactivity
child are used to eating meals at random times by reducing the amount of time the child or
during the day, regular eating intervals can be youth is allowed to watch television or play on
implemented with healthy snack foods between
meals. Eating while watching television should
also be avoided because the child will, more
than likely, not move around once they have
finished eating. If consuming fast food during
the week is the normal routine, try to encourage
the parents to implement a family night when
the whole family cooks healthy foods together.
Safety Precautions
the computer. Inactivity can also be avoided by
For children and youths who were previously
making sure children engage in activities that
inactive, doctors recommend that an easy
are appealing to them and give them a sense of
exercise be chosen and the intensity of physical
satisfaction. One may also consider rewarding
activity be gradually increased. Walking for
children and youths for maintaining healthy
approximately one hour a day is one of the easiest
eating habits and being active during the week
approaches to becoming physically active. If
by buying them a small gift, taking them to the
a child’s school or the shopping center is not
223
cinema or by another means that shows them been given some time to begin healing and if a
you are proud of the progress they have made. doctor recommends that a person do so. Putting
weight on injured parts of the body (e.g., a

Injured Persons
sprained ankle or broken bone) directly after
Physically active people who have recently
an accident can lead to a chronic condition or
been injured may think they have to stop
chronic pain. However, after a certain amount
exercising until they have fully recovered, but
of time a doctor may suggest specific exercises
this is not always true. According to the type of
to strengthen the injured area. In fact, not doing
injury you have, performing certain exercises
these exercises could prolong the recovery
under the supervision of a medical professional
period. When individuals begin performing
or physical therapist can speed up the recovery
exercises that involve injured body parts, they
time. However, it is important to only perform
should pay close attention to body warning signs.
exercises that a doctor recommends and do
Some people tend to push themselves when
so under close supervision to
they are exercising—for example, forcing one’s
avoid further injury. This is
self to do just one more sit-up even if they are
particularly good news
beginning to feel pain. For injured individuals,
for people who have
this can be quite harmful. When individuals
recently torn a ligament
start to feel increased pain in an injured region
or strained a muscle
or in other parts of the body, they should try a
and thought they would have to sit at home or
at their desk all day for the next couple of weeks.
An injured individual should speak with their
doctor about whether they can exercise and
what kind of exercise can be performed while
they are recovering. In most cases, people who
were already active only need to change certain
parts of their normal exercise regimen.
Exercising with an Injury different exercise or stop exercising. This will
Exercising with an injury should only be prevent further damage to the injured region.
considered if the injured part of the body has Following a doctor’s instructions is important
224
but listening to individual body signals also aids will avoid muscle imbalances by reducing the
the recovery process. need for overworked muscles to compensate for
weaker inactive muscles.

Exercising after an Injury
Once a person has fully Exercises to Perform and Avoid
recovered from an injury, they Exercises that put direct pressure on the
should educate themselves injured area should be avoided for some time.
about how to avoid further For example, if a person has a knee or foot
injuries or re-injuring the injury, they should avoid running or riding a
same area. One of the best bike. Instead, this person can concentrate on
ways to prevent future upper body strength while recuperating. Their
injuries is by learning to maintain balance and workout regimen can be modified to include
flexibility. This can be done at home or under exercises that can be performed while sitting
the supervision of a trained professional. It is or lying down. The same idea should be applied
important to make sure the personal trainer when the person has an injury in the upper part
or physical therapist has been informed about of the body, such as an elbow or shoulder, by
the recent injury or previous injuries before concentrating on the body’s lower regions. Yoga
beginning a new workout regimen. Tight muscles and Pilates are often recommended for people
can lead to imbalances in the body and this can who are recovering from an injury. These
cause accidents and injuries. Injuries can also exercises are easy on muscles and joints (e.g.,
be prevented if a person avoids overtraining. in the hands and feet) and typically improve
If muscles and joints are overworked, they are balance, flexibility and posture. Before starting
more susceptible to becoming damaged and one of these courses, the instructor should be
less able to protect their connective tissues, informed about the injury. If these exercises
which increases the risk of damaging cartilage, will be carried out at home, the individual
bones, ligaments and tendons. Training should should speak with a doctor or physical therapist
be performed throughout the week and at before beginning the exercise. Swimming and
regular intervals with recovery periods in water aerobics are typically good workouts for
between workouts. In addition, focusing on people who have strained muscles or broken
strengthening all of the body’s muscle groups bones in their legs or feet. The use of a pull-
225
buoy is especially helpful, as placing this device
between the thighs allows the lower part of the
body to float and forces the upper regions to do
all of the work. In every case, an injured person
should speak with a doctor or physical therapist
about the best time and types
of exercises that should be
performed.
Safety Precautions
It is very important to know
as much as possible about a client’s injury and Arthritis is separated into two major groups—
to work closely with the doctor on developing osteoarthritis and rheumatoid arthritis.
a workout regimen. The exact precautions a Osteoarthritis is due to the degeneration of
trainer needs to take will depend on the specific cartilage in the joints. This ultimately creates a
type of injury. It is better to take things too wearing of the bone surfaces where they come
slow than to risk re-injury or create a chronic
condition.
Persons with Specific Medical

Conditions
in contact and leads to inflammation and pain.
Arthritis
The most common areas where people develop
Arthritis is an inflammatory condition affecting
osteoarthritis are in the hands, knees, hips
the joints of the body and afflicts a majority of
and spine. The second major type of arthritis
older persons. Aging is often associated with
is rheumatoid arthritis, an autoimmune joint
degeneration of the functional ability of the
disease. In this case, the immune system attacks
body. However, arthritis does not just occur in
the tissues of the joints or organs. This too
the aging. Collectively affecting about 15% of
leads to pain and stiffness and the loss of joint
the general population, arthritis is one of the
integrity in multiple joint areas, most commonly
most prevalent chronic conditions in the U.S.
in the hands, feet, wrists and knees.
226
Managing Arthritis uptake due to decreased exercise
The major ways people with arthritis ability.
manage their arthritis is proper rest, If a client is under the supervision
exercise, a good diet and medication. of a fitness professional for exercise
Splints or braces can also help to training, both parties should be aware
lower arthritic pain. In cases of chronic of medications being taken (e.g.,
arthritis, when other methods do acetaminophen, NSAIDs, corticosteroids)
not prove effective, surgery could be as pain relievers to manage this
necessary. condition. For example, corticosteroids
In terms of exercise training, fitness can lead to osteoporosis, a condition
professionals should always be aware characterized by a decrease in bone
of the major types of arthritis density. This condition can
and determine whether hinder certain training
their client is arthritic. The routines because it causes
progress of arthritic clients in exercise training arthritic flare-ups and therefore affects the
programs should be closely monitored. Any client’s exercise tolerance.
movement that leads to persistent pain for Also, this medication is known to increase body
more than an hour following exercise should mass, anemia and gastrointestinal bleeding.
be noted. A good way to manage arthritis is Types of Exercise for Arthritis
to be aware of what types of activities lead to It used to be a common practice to avoid any
joint aggravation. These exercises should be type of strenuous exercise if the individual
modified or eliminated from the routine. They suffered from arthritis. The reason for this
often involve high intensity exercises or ones former misconception is that a lack of activity
that involve a high number of repetitions. People and complete rest was thought to have the
with osteoarthritis usually have a decrease in most benefit in managing arthritis. However,
strength and proprioception, which leads to research studies show that this is not the case.
postural alignment issues and decreased ability Joint pain and stiffness associated with arthritis
to balance while standing. can actually be heightened through inactivity
Other training considerations include morning due to muscle atrophy and lack of flexibility of
stiffness and lowering of the maximal oxygen the joint tissue. Therefore, inactivity is often
227
associated with the perpetuation of the chronic training and water exercises) to increase
pain cycle. Rather, there should be a balance muscle strength, which helps support and
of activity and rest. Consistent exercise protect joints; and endurance exercises
can have some great benefits for (e.g., swimming and cycling) to
clients with arthritis. Research in improve cardiovascular fitness,
sports medicine reports have control weight and improve
demonstrated that long- overall bodily function.
term strength training, including proprioceptive Range of motion exercises (E.G., dance, aerobics
training, can provide some immediate and and rowing), which decrease risk of orthopedic
prolonged relief to arthritic patients. The complications, can be enjoyable and therefore,
decrease in the symptoms of arthritis is increase exercise compliance. Exercise
primarily due to the increase in muscle strength programs with range of motion focus can include
gained from exercise training. Literature also anything from walking around the block, taking
supports the benefits of isometric strength a yoga class or playing a low-key game like golf.
training because strength can be developed in However, it is important to work only the pain-
joints with little to no movement, so it is less free range of motion that one can exhibit. In the
likely to inflame joints. People with arthritis case of strength training, weight training can
are advised to participate in structured exercise be conducted with small free weights, exercise
routines and work with their trainer in the machines or elastic bands to create resistance.
design of a personalized program to Correct body position when using
help restore their functional mobility. weights is crucial to avoid muscle tear
If a trainer cannot be consulted, then and more joint swelling. Low impact,
a strong increase in daily activities water-based exercise works well
can also be beneficial. because the body’s buoyancy reduces
Three types of exercises that are stress on hips, knees and spine, areas
best for arthritic people include primarily affected by arthritis. The
range of motion exercises (e.g., water should be about 83-88°F to be
stretching and dance) to maintain soothing to the joints. Some beneficial
normal joint movement and relieve modes of basic endurance exercises
stiffness; strengthening (e.g., weight that should be conducted include
228
stationary cycling and distance swimming. They and cold/dry air. Exercise can also reduce
should be preceded by extended warm-ups shortness of breath or dyspnea, which is
and include special considerations to exercise common among this population. Therefore, it
intensity and duration. is important that personal trainers understand
how to deal with people affected by asthma in
order to avoid complications.
Preparing for Exercise

Before setting up an exercise program, the
client should finish an asthma screening form
which can be used to figure out the appropriate
In rheumatoid arthritis, the joint structure
of the body is damaged through the wearing
away of cartilage as a result of autoimmune
degeneration. Improving muscle strength and
flexibility through a properly designed training
routine can complement the use of medication, kind, duration and frequency of the exercise
rest and diet to manage this type of arthritis. to be performed. It can also establish when
and where the client will exercise. It might be

Asthma
advantageous to work with the client’s doctor
There are more than 10
to learn more about the client’s condition. An
million Americans that suffer
asthma management team can help determine
from asthma or asthma-like
the most beneficial training program for the
symptoms, such as shortness
client.
of breath, coughing, headaches and abdominal
It is very important that a client have the asthma
pain. Exercising correctly can be helpful for
under control. This can be accomplished mainly
asthmatic clients by reducing their vulnerability
by using inhaled or oral drugs. Some clients may
to asthma triggers such as pollutants, allergies
229
use inhalers that can decrease the period. Depending on the individual, this period
chance of having an attack up can occur from half an hour to three hours after
to 2 hours after doing so if this the initial asthma attack.
action is taken approximately 15 If this technique is used, the following steps
to 30 minutes before exercise. can be taken:
Clients should also try to prevent 1. The technique should be discussed with the
interaction with variables that client’s physician.
contribute to asthmatic symptoms. 2. The client should take the normal medication.
3. Warm up for 10-15 minutes by having the
client’s heart rate at 50-60 percent of the
normal rate.
4. Cool down or stretch for 10-15 minutes and
have the client stay hydrated.
5. The client should work to 70-85% of the
normal heart rate.
When to Avoid Exercise
All exercise should stop when the client
experiences an asthma attack. The following
steps should be taken:

Proper warm-up
and cool-down 1. Place the client in an upright position.
may prevent or
reduce the 2. Unfasten any tight or restraining clothing.
incidence of 3. Ask the client where their medication is
exercise-induced
asthma. and allow the client to self-administer. It is
important to note that the personal trainer

The client may also consider exercising to
should have the knowledge or permission to
try and induce an asthma attack with mild
administer the medicine or should not do it
symptoms. This may be especially advantageous
at all.
if the client is an athlete. After the first attack,
4. Should symptoms persist for half an hour
there is a lower chance of another one occurring
or more, medical assistance should be
and this period is referred to as the refractory
requested immediately.
230
An asthma attack can medicine they are currently taking and
be brought on during how it can be influenced by exercise.
exercise and this is

Diabetes Mellitus
known as exercise-
Exercise can potentially reduce the risk
induced asthma (EIA).
of diabetes mellitus and help manage
It is present in children,
diabetes. There are two types of diabetes
adolescents and young adults who frequently
mellitus (type 1 and type 2) and personal
work out. This condition can be induced if the
trainers should familiarize themselves with the
client exercises constantly at 70% of aerobic
different types. Diabetes mellitus is a condition
capacity for a minimum of five minutes. It can
in which a person has high
happen either in the first
glucose in their blood.
6 to 12 minutes or last 5
Glucose is the primary
to 10 minutes of exercise.
fuel for our bodies and
Therefore, longer periods
the process of converting
of exercise consistent with
glucose into energy occurs
certain sports should be
within a cell. This process
limited or avoided.
is regulated by the hormone
EIA can also be avoided
insulin, which is secreted by
by exercising in the proper
the pancreas. The difference
weather conditions or
between type 1 and type 2
locations. Clients should exercise caution when
diabetes mellitus is seen at the molecular level.
the air is cold or dry. They should also limit
In type 1 diabetes mellitus, a person’s pancreas
exercise when they have a cold or viral infection.
malfunctions and starts to lose the ability to
Clients who suffer from asthma allergies should
secrete insulin. When a person with type 1
not exercise in outdoor locations where these
diabetes mellitus eats a meal, the pancreas
allergies can be activated by certain triggers.
does not secrete enough or any insulin. Without
There are certain medications that can bring
insulin, glucose cannot gain entry into the cells
about EIA, and clients should speak to their
and thus glucose accumulates in the blood,
doctor about which medications can do this.
which can elicit many dangerous outcomes.
They should learn more about the side effects to
231
People with type 1 diabetes mellitus can inject cardiovascular exercise. Exercise is beneficial
insulin that mimics their own insulin, which is to those individuals with diabetes mellitus
lacking, so that they can lead a mostly normal because it burns calories and can therefore help
life. People with type 2 diabetes mellitus have lower blood glucose. Burning extra calories
a different malfunction. These people typically can come from many different sources, such as
have normal insulin levels; however, for a reason taking stairs or parking further away at work or
yet to be understood, their cells stop responding the store. A cardiorespiratory
to the insulin. This essentially blocks glucose workout of walking briskly
from entering the cell, thus causing the person or a mild jog is a great way to
to have high blood glucose levels. manage diabetes or to help
Some research has shown that chronic reduce the risk of getting type 2
overeating, which can lead to being overweight, diabetes mellitus. Studies have
along with a sedentary lifestyle, can increase shown that as little as a 5%
the risk of developing type 2 diabetes mellitus. reduction in weight is enough
As with many chronic illnesses, being active to prevent type 2 diabetes mellitus. Along with
and maintaining health is believed to help keeping diabetes in check or reducing the risk
decrease the risk of developing type 2 diabetes of developing it, exercising also helps to stave
mellitus, along with good eating habits. Exercise off other chronic diseases, such as high blood
is beneficial for people with either type 1 or pressure or cardiovascular disease.
type 2 diabetes mellitus. Some people with Benefits & Risks of Exercising with Diabetes in
the Elderly
type 2 diabetes mellitus can manage their Benefits Risks
Increased exercise tolerance Sudden cardiac death
own diabetes with exercise and eating without
Increased glucose tolerance Injuries to the feet and joints
needing medication. In the next section, we Increased maximal O2 Hypoglycemia
consumption
will discuss the benefits of exercising in terms Increased muscle strength
Increased muscle mass
of reducing the risk for diabetes or how it can
Improved lipid profile
manage diabetes. Improved sense of well-being
Benefits and Risks of Exercising Decreased blood pressure
Decreased body fat
The majority of evidence from current
research suggests that there is a positive effect There are some risks that personal trainers
of exercise on diabetes mellitus, especially must be aware of if a client has diabetes. Taking
232
a good initial assessment should reveal this medications they are taking, which are designed
chronic condition, along with the medications to lower blood glucose. When they exercise, they
a diabetic client is taking. The trainer will also are further lowering their blood glucose—this
need to know if the diabetic is trying to use the could lead to hypoglycemia (low blood glucose)
workout being designed as a means to manage and can result in fainting. Some medications can
the diabetes. Fulfilling clients’ also cause hypoglycemia on their
goals is important, but trainers Heavy weight lifting is own; therefore, it is important to
not recommended for a
also need to be aware of any client with diabetes, as they know what medications clients
already have a lot of pressure
associated risks and be sure to ask are taking and the mechanism of
on the vessels within the eyes.
if their doctors advised them that those medications. Also, ensure
it was acceptable to try to manage their diabetes a glucose meter is handy and keep a sugary
without medication. One symptom of diabetes is snack on hand in case of this problem. Do not
called neuropathy—this condition occurs when give a diabetic client any food prior to checking
diabetes has damaged nerves in the extremities glucose levels because, if the glucose level is
and it renders the client unable to feel pain. For already high, the situation will worsen.
example, if a diabetic client with neuropathy Exercise Can Help Control Diabetes
gets a blister, it will go unnoticed, and this could Exercise helps to control diabetes mellitus
lead to an undetected and unmanaged infection, by burning more calories, which utilizes more
which will often lead to amputation. Trainers glucose than if a person were sedentary.
must be very careful and knowledgeable when
it comes to diabetic clients. For these clients,
you may recommend water exercises, since
walking or running may put too much strain on
their feet and legs. Also, heavy weight lifting is
not recommended for a client with diabetes, as
they already have a lot of pressure on the vessels
within the eyes. That is why exercise-induced
lower blood pressure helps with diabetes, as
it aids in decreasing vessel pressure. Another
important consideration is to be mindful of
233
Additionally, exercise has been shown to suffer from blood vessel constriction in the eye
increase the cells’ ability to utilize glucose and trainers want to minimize this side effect as
as well as increase the function of insulin. much as possible. Walking and light jogging are
Increasing cardiovascular great exercises for healthy
output also reduces blood diabetics. If the client is
pressure and, as stated experiencing numbing or
earlier, one effect of tingling in the extremities,
diabetes mellitus is that the trainer should
it can cause blood vessels recommend a swimming
to constrict (especially regimen or water aerobic
in the eye). Exercising type exercise. They can
can also lower LDL (bad also do stretching, yoga
cholesterol) and raise HDL (good cholesterol). or mild weight lifting and, if they feel capable, a
Lowering cholesterol has been shown to help stationary bike may also be an option.
control diabetes mellitus. Lowering triglycerides Precautions
is also important in maintaining a healthy Personal trainers should know if clients’
weight, as excess glucose is stored in fat tissue physicians have approved them for a workout
as triglycerides. As little as a 5-10% weight loss regimen. Trainer should ask what medications
can eliminate type 2 diabetes mellitus in some they are taking and if they have type 1 or type 2
people. Unfortunately, people who suffer from diabetes mellitus. In addition, the trainer should
type 1 diabetes mellitus will always be insulin determine if the client has neuropathy, as this
dependent, but a good exercise program can will be important in determining the workout
aid in their longevity and quality of life. Again, regimen. No straining exercises, such as heavy
exercise has a beneficial and broad-spectrum lifting or high resistance bands, should be used.
effect on overall health. Strength training is acceptable and building
Types of Exercises for Diabetics muscle is an excellent way to burn more calories
There are several safe exercises for diabetics. at rest; however, ensure it is not overdone. It
The only exercises unsafe for diabetics are heavy may be wise to purchase a glucose meter and
weight lifting and any other exercise that would keep glucose strips, prickers and gloves readily
cause a lot of straining. Most diabetics will available to test blood glucose levels if necessary.
234
Personal trainers will frequently encounter exercise, blood flow increases and blood vessels
clients with many different chronic illnesses. dilate. The inability of blood vessels to dilate
places more pressure on the heart and, as a
result, increases blood pressure. Exercise-
induced hypertension usually leads to a systolic
pressure of 250 mmHg (millimeters of mercury)
or higher. Systolic pressure is produced when
the heart is contracting. Systolic blood pressure
that rises to 200 mmHg during exercise is
normal, but if blood pressure rises above 220
mmHg, it needs to be monitored by a doctor and
Diabetes mellitus is quite prevalent and it is probably controlled with medication. Diastolic
likely that a trainer will eventually have a client pressure, which occurs when the heart is dilating
with this disorder. It is therefore important that (expanding) and relaxing, typically remains
trainers be aware of the general precautions and constant or drops slightly during exercise
details of type 1 versus type 2 diabetes mellitus due to increased blood flow. Some individuals
and the types of exercises appropriate for this exhibit an increase of diastolic pressure that is
demographic of client. approximately 10 mmHg or higher.
In contrast to exercise-induced
Hypertension
hypertension, in many persons
High blood pressure (hypertension)
regular exercise lowers high blood
or a dramatic increase in blood
pressure and reduces the risk of
pressure occasionally occurs during
developing heart disease. In fact, an
exercise. A study involving athletes
inactive lifestyle is one of the major
with mild hypertension, whose
causes for heart disease and obesity.
ages ranged from 55 to 75, showed
Regular exercise can also improve circulation
a correlation between exercise-induced
and increase the body’s utilization of oxygen
hypertension and an inhibited ability of blood
by strengthening the heart and cardiovascular
vessels to increase in size while exercises
system. In addition, regular exercise increases
were being performed. Normally, when people
one’s energy level and endurance while reducing
235
performed, activities that should be avoided,
when to take medication (e.g., before or after
exercising) and how often one’s pulse should be
measured during exercise. Typically, doctors and
trainers recommend that hypertension patients
gradually increase the amount of aerobic
exercise that is performed to approximately
20 or 30 minutes, at least 3 times a week.
The use of a portable heart monitor while

fatigue, shortness of breath and heart failure
exercising is also recommended for people with
symptoms.
hypertension. This allows these individuals to
Monitoring Blood Pressure determine if they are pushing themselves too
People who have a history of hypertension, or hard or if the activity needs to be changed. If a
know the condition runs in their family, should rapid or irregular heartbeat (heart palpitations)
develops during exercise, the individual should
rest by sitting for a few minutes and then check
the pulse again. If the pulse remains higher
than 100 beats per minute or the heartbeat is
still irregular, a doctor should be contacted.
When the individual is not exercising, lifting

Hypertension is
and pushing heavy objects should be avoided,
consistently high
blood pressure of at as well as household activities such as mowing,
least 140 (systolic) consult a doctor
over 90 (diastolic). scrubbing, shoveling or raking.
before beginning
an exercise regimen. Once the individual starts Types of Exercises for Persons
a routine, that individual should review the with Hypertension
exercise plan with a doctor on a regular basis. Exercises for Persons with Hypertension
Factors that should be discussed with a doctor • Stretching exercises
include: how much exercise can be performed ▪▪ Slowly lengthen muscles
daily, the types of exercises that should be Yoga (include warm-up and cool-down)
236
• Cardiovascular/aerobic exercises Cardiovascular exercise improves circulation
▪▪ Benefits the heart and the use of oxygen by strengthening the
Jogging/walking, cycling, golf, heart and lungs. When performed on a regular
swimming, etc. basis, cardiovascular exercise leads to improved
• Strengthening exercises breathing during exercise, decreases the
▪▪ Improves muscle tone and mass, heart rate and reduces high blood pressure.
endurance Recommended cardiovascular exercises include:
Walking, taking stairs, etc. jumping rope, jogging, walking, cycling (e.g.,
Exercises for persons with hypertension outdoors or stationary), rowing or canoeing,
are divided into three groups: stretching, cross-country skiing, skating, water aerobics,
cardiovascular/aerobic exercise and golf, fishing and swimming. Strengthening
strengthening exercises. Stretching involves exercises involve repetitive muscle contractions
slowly lengthening the body’s muscles. which improve muscle tone and
Performing specific stretch routines Stretching involves increase muscle mass. Strong
slowly lengthening
for the arms and legs before and after muscles also increase one’s
the body‘s muscles.
exercising prepares muscles for the endurance, allowing individuals
activity while reducing the risk of injuries and to perform more challenging exercise routines
muscle strains. A warm-up and cool-down of 5 for extended periods of time. Taking the stairs
to 10 minutes is normally recommended. The instead of the elevator is a form of strength
cool-down is especially important because blood training, as well as, getting off the bus one or
pressure medication often causes a significant two stops early and walking the remainder of
decrease in blood pressure after exercise or if the way. For individuals who drive to work daily,
an activity is abruptly interrupted. To avoid parking at the far end of the lot and walking to
this, the cool-down period should be at least 10 the building also builds strength.
minutes but longer if possible. Stretching also Exercise should be interrupted or avoided if
increases an individual’s flexibility and range of the following symptoms occur:
motion. Yoga is a good form of stretching. • Dizziness
Cardiovascular/aerobic exercise is physical • Lightheadedness
activity that incorporates the use of large muscle • Chest pain
groups and provides many benefits for the heart. • Weakness
237
• Irregular swelling or weight gain are appropriate and which exercises should be
• Pressure in the jaw, neck, chest or avoided.
shoulders
Review Questions
If any of these symptoms persist for more
1. Pregnant women in their second trimester
than a couple minutes after the activity is
should avoid lying on their backs while
discontinued, a doctor or emergency medical
performing exercises. True or False?_______
team should be contacted immediately.
________________________________________________
Summary 2. Which of the following activities is NOT
In general, special consideration needs to recommended for a pregnant woman?
be given to individuals within these special a) Pilates
populations. Depending on clients’ unique b) Light/low impact aerobics
situations, workout regimens need to be c) Long distance running
tailored to both protect them from further d) Swimming
complications and help them become stronger. 3. List three types of exercises that are
Pregnant women need to be aware of the impact beneficial for elderly persons.______________
of exercise not only on themselves but also on ________________________________________________
their growing baby. Elderly persons should use ________________________________________________
light weights and not overexert themselves. 4. What are some reasons for the current
Youths will benefit from exercise and enjoy the increase in childhood obesity?______________
process more if they are given several options ________________________________________________
from which to choose. People with recent ________________________________________________
injuries need to protect their injury but work 5. When can exercise-induced asthma (EIA)
to strengthen it at the same time. And those occur during exercise?
people with specific medical conditions need to a) During the first 6-12 minutes of exercise
work closely with their doctor when developing b) During the last 5-10 minutes of exercise
a workout regimen. Trainers need to listen to c) It can only happen after exercising for
clients to gather as much information as possible more than 30 minutes
about their specific situations and be prepared d) Both A and B
to consult with their doctors on which exercises
238
6. Which part of the body is typically NOT 6. b) Back.
affected when an individual suffers from 7. Pancreas.
osteoarthritis? 8. True.
a) Knees 9. Hypertension.
b) Back 10. Any three of these—yoga, jogging, taking the
c) Hips stairs, walking, cycling, golf and swimming.
d) Spine
References
7. Type 1 diabetes mellitus is caused by a
Bell R, Palma S. Antenatal exercise and birth
failure of what organ?_______________________
weight. Australian and New Zealand Journal
8. Type 2 diabetes mellitus can be managed
of Obstetrics and Gynecology. 2000;40(1):70-
with diet and exercise. True or False?______
73.
________________________________________________
Berger L, Klein C, Commandeur M. Evaluation
9. High blood pressure is referred to as ______
of the immediate and midterm effects of
________________________________________________.
mobilization in hot spa water on static and
10. Name three types of exercises that are
dynamic balance in elderly subjects. Ann
beneficial for persons with high blood
Readapt Med Phys. 2008;51(2):84-95.
pressure.______________________________________
Blackham J, Garry JP, Cummings DM, Russell RG,
________________________________________________
Dealleaume L. Does regular exercise reduce
________________________________________________
the pain and stiffness of osteoarthritis?
Answers Journal of Family Practice. 2008;57(7):476-
1. True. 77.
2. c) Long distance running. Bowman AJ, Clayton RH, Murray A, Reed JW,
3. Walking, dancing, swimming, light-to- Subhan MF, Ford GA. Baroreflex function in
moderate weight training. sedentary and endurance-trained elderly
4. There is the absence of physical activity in people. Age Ageing. 1997;26(4):289-94.
the daily routine of today’s youth and they Christiansen CL. The effects of hip and ankle
are participating in an unhealthy diet. stretching on gait function of older people.
5. d) Both a & b. Archives of Physical Medical Rehabilitation.
2008;89(8):1421-28.
239
Clark SL, Cotton DB, Pivarnik JM, Lee W, Hankins Qi L, Hu FB, Hu G. Genes, environment and
GD, Benedetti TJ, Phelan JP. Position change interactions in prevention of type 2 diabetes:
and central hemodynamic profile during A focus on physical activity and lifestyle
normal third-trimester pregnancy and changes. Current Molecular Medicine.
postpartum. American Journal of Obstetrics 2008;8(6): 519-32.
and Gynecology. 1991;164:883-87. Simonsick EM, Newman AB, Visser M, Goodpaster
Gaudin P, Leguen-Guegan S, Allenat B, Baillet B, Kritchevsky SB, Rubin S, Nevitt MC, Harris
A, Grange L, Juvin R. Is dynamic exercise TB. Mobility limitation in self-described
beneficial in patients with rheumatoid well-functioning older adults: importance
arthritis? Joint Bone Spine. 2008;75(1):11- of endurance walk testing. The Journals of
17. Gerontology. Series A, Biological Sciences and
Klaus D. Management of Hypertension in Medical Sciences. 2008;63(8):841-47.
Actively Exercising Patients: Implications Snapp CA, Donaldson SK. Gestational diabetes
for Drug Selection. Drugs. 1989;37(2):212- mellitus: physical exercise and health
18. outcomes. Biological Research for Nursing.
Ning Y, Williams MA, Dempsey JC, Sorensen 2008;10(2):145-55.
TK, Frederick IO, Luthy DA. Correlates Stathi A, Simey P. Quality of life in the Fourth
of recreational physical activity in early Age: exercise experiences of nursing home
pregnancy. Journal of Maternal Fetal residents. Journal of Aging and Physical
Neonatal Medicine. 2003;13(6):385-93. Activity. 2007;15(3):272-86.
Plasqui G. The role of physical activity in Stewart KJ, Sung J, Silber HA, Fleg JL, Kelemen
rheumatoid arthritis. Physiology and MD, Turner KL, Bacher AC, Dobrosielski
Behavior. 2008;94(2):270-75. DA, DeRegis JR, Shapiro EP, Ouyang P.
Portegijs E, Kallinen M, Rantanen T, Heinonen Exaggerated Exercise Blood Pressure is
A, Sihvonen S, Alen M, Kiviranta I, Sipilä Related to Impaired Endothelial Vasodilatory
S. Effects of resistance training on lower- Function. American Journal of Hypertension.
extremity impairments in older people with 2004;17(4):314-20.
hip fracture. Archives of Physical and Medical
Rehabilitation. 2008;(9):1667-74.
240
Wang TJ, Belza B, Elaine Thompson F, Whitney Weker H. Simple obesity in children: A study on
JD, Bennett K. Effects of aquatic exercise the role of nutritional factors. Med Wieku
on flexibility, strength and aerobic fitness Rozwoj. 2006;10(1):3-191.
in adults with osteoarthritis of the hip
or knee. Journal of Advanced Nursing.
2007;57(2):141-52.
241
Chapter 9: Nutrition
Topics Covered
Introduction to Nutrition
Recommended Caloric Intake
Nutrition for Working Out
Carbohydrates
Recommended Carbohydrate Intake
Types of Carbohydrates
Carbohydrates for Working Out
Alcohol as a Carbohydrate?
Fats
The Role of Fats in the Body
Types of Fats
Triglycerides
Unsaturated Fats
Trans Fats
Saturated Fats
Cholesterol
Problems with Fats
Metabolic Syndrome
Obesity
Insulin Resistance
Heart Disease
Fat Requirements
Protein
Protein Digestion
Factors that Affect Protein Requirements
Proper Hydration
Sports Drinks vs. Water
Signs of Dehydration
Hydration to Maximize Training
Supplements
Types of Supplements
energy; the other 60% is lost as heat. The rate
O
Introduction to Nutrition
of sweating increases in the body’s attempt to
ne of the most important aspects
lower its temperature. Because of this, frequent
of designing a complete personal
hydration is an important component of proper
program for a client is advice on
nutrition in order to maintain the body’s water
proper nutrition. Regardless of a
content and replace any fluid lost as sweat.
client’s goals for personal fitness and training,
For athletes and physically active adults, each
the fundamentals of a proper diet do not change.
meal should consist of 65% of the calories
In fact, a training regimen combined with proper
from carbohydrates, specifically complex
nutrition will enhance the client’s health and
carbohydrates, 15–20% from lean protein and
performance, help fight disease and infection,
15–20% from fat. Carbohydrates,
increase energy and reduce
which are converted to the
total body fat. It is the job of the
forms glucose and glycogen, are
personal trainer to be armed with
the body’s primary source of
information on proper nutrition
instant energy and longer term
as a means of counteracting the
energy storage, respectively.
popularity of fad diets and the
Additionally, carbohydrates are
“lose weight quickly” mentality.
required to burn fat; without a
The relationship between physical activity and
sufficient quantity of carbohydrates, a person
caloric intake is a simple one: eat fewer calories
will not effectively lose body fat. Protein is
than you burn and you will lose weight; eat more
required to build and repair body tissues and
calories than what you expend and you will gain
structures. It is also used in the process of
weight. All of life’s processes require the energy
synthesizing hormones and hemoglobin, and
provided by food and exercise only increases
is the body’s alternative source of energy if
these requirements. However, knowing when to
there is an insufficient source of carbohydrates.
eat and what to eat at each meal is the key to the
Fats are also an important aspect of a proper
client achieving fitness and training goals. Keep
nutrition regimen and should not be feared. Fats
in mind, however, that exercise increases the rate
are needed for the proper absorption of many
at which calories are burned; however, only 40%
vitamins, minerals and supplements, and they
of the potential energy in food is converted into
244
function as the long-term energy storage for the For example, if a client participated in a normal
body. 40-minute strength training session, then the
trainer calculates that the client expended

Recommended Caloric Intake
approximately 240 calories
Although a client should not
[because (6.8 METs x 3.5 x 50
become obsessive over daily
kg)/200=6 calories/minute] for
calorie intake, it is helpful
that session. Next the trainer
to establish caloric intake
estimates the time spent in
requirements. There are
activity outside of scheduled
two simple ways to do this:
exercise. For a sedentary person, add 20-40%
determine a client’s resting metabolic rate
of the RMR; for a moderately active person,
(RMR) and lean body weight (LBW). The resting
add 40-60% of the RMR; and for a very active
metabolic rate is the amount of energy needed
person add 60-80% of the RMR. A moderately
to sustain the body at rest and is determined by
active client weighing 150 pounds requires 750
multiplying the body weight by 10. For example,
calories for daily activity:
if a client weighs 150 pounds, the RMR is 1,500,
(150 lbs x 10 = 1500 RMR) x
meaning that the client requires at least 1,500
50% moderate activity =
calories per day. Next, estimate the calories
750 moderate daily activity calories
expended for scheduled exercise and training.
To determine the total calorie requirement
For easy activities, a person will expend
per day, add the RMR plus the formal exercise
around 3-5 calories per minute. For moderate
plus the daily activity:
activity, assign 6-10 calories per minute and,
1,500 RMR calories + 240 formal exercise calories
for strenuous activity, estimate 11-15 calories
750 activity calories = 2,490 total
per minute. To calculate the calories used for
calories required per day
scheduled training, multiply the number of
The other method to determine daily calorie
minutes spent in that activity (do not count time
requirements for a client is to estimate the
spent resting and recovering) by the assigned
client’s lean body weight (LBW). To use this
calories burned per minute for that level of
method, a trainer must know the client’s body
intensity.
fat percentage, which is multiplied by the client’s
weight to determine the body fat weight.
245
For example, a client weighing 150 pounds begins to gain fat and the goal is to lose fat, it
with a 22% body fat percentage has a body may be necessary to adjust calorie intake.
fat weight of 33 pounds of body fat. Additionally, many factors can influence daily
150 lbs x 22% body fat = 33 lbs body fat energy requirements. The resting metabolic
Next, the trainer determines the client’s lean rate and daily activity will use most of the
body weight by subtracting the body fat from available energy per day. The rest of the energy
the total weight. For this client, the lean body that is used is determined by such factors as sex,
weight would be 117 pounds, indicating that activity level, weight, body composition and age.
the client’s bones, muscle and soft tissue Many clients will be interested in how to put
weigh 117 pounds. on muscle while simultaneously reducing body
150 lbs – 33 lbs body fat = 117 lbs LBW fat—unfortunately, they often turn to diets where
(lean body fat weight ) they dramatically lower total energy intake.
To determine the lower range of your client‘s This practice is actually counterproductive
calorie intake, multiply her LBW by 16. This because they will burn into their lean body
client requires at least 1,872 calories per day. mass. This will reduce their total muscle mass
To find the upper limit of the calorie intake, and decrease their metabolic rate, the rate at
add 500 calories, which for this client would which they burn calories. The result of a lower
equal 2,372 calories per day. metabolic rate is usually an increase in body
117 LBW x 16 = 1872 weight (from an increase in body fat) due to the
lower range of calorie intake body’s inability to effectively burn the calories
(117 LBW x 16) + 500 = 2372 that are consumed. Conversely, many people
upper limit of calorie intake will turn to eating a high amount of protein;
Notice that there is a slight difference in however, a high-protein diet does
daily calorie requirements between the not amount to more muscle mass
two methods. The RMR determination because muscles are unable to
can be higher by up to 1,000 calories store excess protein. Additionally,
since it takes into account scheduled a client may want to consume high
and nonscheduled training. Regardless calorie shakes or other dietary
of the method used, however, it is important supplements, wrongly thinking that the calories
to remember that this is an estimate. If a client will be turned into muscle. Unfortunately, all
246
extra energy that is not used, regardless of the and fats, it is also important to determine
form, is stored as fat. what a client will eat before, during and after
The goal for nutrition is to have a client in an the workout. Although the timing and type
energy balance, consuming and burning an equal of nutrition to suggest to a client has been
amount of calories. Many studies now suggest determined by science, all people are different
that the best way to achieve energy balance is and this regimen may take experimentation to
to spread the intake of calories evenly over the determine what works for each individual client.
course of the day by eating small, frequent meals, Although eating before a workout or
rather than three large meals separated by long competition can cause stomach discomfort and
time gaps. This practice has been shown to have diarrhea, it is important that a client eat before
many benefits, including maintaining metabolic participating in physical activity to maintain
rate and blood sugar level, decreasing body fat constant blood sugar levels and prevent
and increasing lean body mass, early fatigue. Following a few

The goal for nutrition is to have
and improving performance. a client in an energy balance, guidelines can help eliminate
Additionally, energy deficits can consuming and burning an equal any possible discomfort. First,
amount of calories.
be better managed or possibly a client should be consuming a
eliminated by spreading calorie intake evenly low-fat, high carbohydrate diet daily. This will
over the entire day. Problems caused by energy help ensure that there are adequate energy
deficits, which can be most evident early in stores (in the form of glycogen) in the muscles
the day or after intense training, include the and liver. A client should avoid meals high in fat
following: an inability to maintain energy stores and protein immediately prior to activity. If the
(affecting endurance), an inability to maintain planned activity will be shorter than an hour,
lean muscle mass and metabolic rate, and an eating foods such as breads and pasta should be
increased risk of injury due to both muscle and sufficient. However, if the activity will last longer
mental fatigue. than an hour, foods with lower glycemic indexes,
such as bananas and oatmeal, are recommended

Nutrition for Working Out
because they provide sustained energy.
Not only is it important for a client to eat small
For short workouts (less than 30 minutes), it
frequent meals throughout the day that contain
is usually unnecessary for a client to eat during
the correct proportion of carbohydrates, protein
the activity. However, for light to moderate
247
intensity exercise, most people can tolerate more than 2 hours. It should consist of about
small amounts of plain food and this may 300 calories of carbohydrate-rich foods such as
increase their performance. For activities lasting bananas. It is also recommended that protein,
longer than 60 minutes, maintaining a sufficient such as that provided by lean meats and low-
fluid and carbohydrate supply becomes a fat milk, be a part of the recovery meal. Protein
challenge. For fluids, a client’s sweat loss should helps shuttle blood glucose to muscles to
match their fluid intake. To determine if fluids replenish glycogen stores and is needed for cell
are being adequately replenished, weigh the and tissue repair following a workout.
client before, during and after long, vigorous Proper nutrition is extremely important for
workouts. Ingesting enough carbohydrates is a person’s health and performance. Although
also important to maintain the trainer and client should

The recovery diet is an often
blood sugar levels and both be aware of what the
overlooked but extremely important
ensure endurance for long component of the client’s performance client is eating, the process
on days following training.
workouts. Every hour of does not have to be complex.
endurance exercise requires approximately The trainer can monitor the client’s eating
100-300 carbohydrate calories or about 0.5- habits for several weeks by having the client
0.8 grams of carbohydrate per pound of body keep a food journal. Additionally, trainers can
weight. help clients learn to read food
The recovery diet is an often labels to determine how many
overlooked but extremely important grams of carbohydrate, fat and
component of the client’s performance protein they are consuming per
on days following training. The day. It may also be helpful to
priorities are carbohydrate and fluid suggest that clients buy a food
replacement. After exercise, a client scale so they can accurately
should begin to immediately replace measure serving sizes. After
fluid loss by drinking water (possibly sports the trainer and client have determined a
drinks if severely dehydrated) and by eating regimen for exercise nutrition, it will still require
food with high water content. After stopping the periodic adjustments to ensure that the client is
activity, the first major intake of food should be performing as well as possible.
approximately no less than 15 minutes and no
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There are six essential classes of nutrients however, it can only use glucose as a form of
the body needs to function properly. The first is energy. When someone drinks milk, for instance,
carbohydrates, the body’s primary fuel sources. the galactose is absorbed and transported to the
Fat is the second—despite popular belief, the liver where enzymes in the liver convert galactose
body does need fat to transport vitamins A, D, (or any other carbohydrate) into glucose for the
E and K. The third class of nutrients is proteins, body to use. Any excess glucose is converted into
which help to keep our bodies supplied with the glycogen, which is the storage molecule made
eight essential amino acids. The next is vitamins. from glucose. Glycogen is stored in the liver. When
Vitamins work as coenzymes to aid the many the body needs it, the liver converts the glycogen
enzymatic processes occurring in the body at back to glucose for use. For any active person,
any given moment. The fifth is minerals, such carbohydrates are the number one source of
as zinc and iron, which function as cofactors for energy because they are metabolized the fastest.
many biological processes. Without iron, the Fat is the slowest to be metabolized and protein
body could not transport oxygen to any tissues. is somewhere in the middle; therefore a good
The last but not least is water. The body needs balance of all three is necessary.
water, plain and simple. Carbohydrates have received a bad reputation in
recent years due to diets such as the Atkins and

Carbohydrates
South Beach Diet. However, not all carbohydrates
Carbohydrates are chains of sugars held
are bad, and a good understanding of this is key
together by chemical bonds. Sugars are also
to any client who is trying to improve
known as saccharides. There are
overall health. Carbohydrates are
five monosaccharides, or single
more than just sugar. Complex
sugars, that are the building blocks
carbohydrates like the fiber found
for carbohydrates. Three of the
in fruits, vegetables, cereals and
best-known monosaccharides are:
whole grains are important energy
glucose, fructose and galactose (milk
sources for the body. Fiber is also
sugar). The body can absorb several
important for maintaining the health
different types of monosaccharides
and function of the digestive system
and disaccharides (simple sugars made up of
as well as for weight control. Trainers should
two monosaccharides, like sucrose and lactose);
make sure clients fully understand food groups
249
and classifications before they start omitting food In general, the abundance of calories should
items from their diets. A good understanding of come from carbohydrates. Dietary guidelines
food labels is important. currently recommend that 40-60% of daily
So what is the difference between simple calories come from carbohydrates—for an active
carbohydrates and complex carbohydrates? The person, 60-65% is probably best. Carbohydrates
term complex carbohydrate simply means that the are the main fuel of muscles. Many people think
source is primarily made from monosaccharides, that increasing the amount of protein will
disaccharides or polysaccharides. In general, increase their muscle size. Protein is important
monosaccharidesanddisaccharidesareconsidered after a strenuous workout because the amino
simple. An example of a simple carbohydrate acids in protein are used to help repair and
would be a soda, which is made from high fructose renew muscles; however, during a workout, the
corn syrup (fructose is a monosaccharide). Breads body is using carbohydrates for fuel.
made from bleached flour Of course, exercise
are also considered simple physiology is not that simple,
carbohydrates. Care should as fat is also being used at
be taken with wheat bread: low levels during training.
if the labeling does not In reality, a combination of
state 100% whole wheat or fat and carbohydrates are
other whole grains, it is not used during any workout.
a complex carbohydrate and therefore no better While carbohydrates are used to fuel the body
than white bread. An apple is also a complex when the body is at work, fat is the main source
carbohydrate. It has fructose (or fruit sugar), but of fuel when the body is at rest or during low
it is plant material that contains cellulose, which is levels of exercise. The problem is that most
a polysaccharide. Vegetables are polysaccharides American diets contain an overabundance of
and thus considered complex. fat. A person should be eating 200-300 grams
of carbohydrates based on a 2000 calories/

Recommended Carbohydrate
day diet. There are 4 calories in every gram of
Intake
carbohydrate or protein, and there are 9 calories
A food pyramid shows that the suggested
per every gram of fat.
foundation for any dietary plan is carbohydrates.
250
and nutrition, so it is important to have an
Types of Carbohydrates
understanding of the basics of nutrition. Most
Not surprisingly, a candy bar, which is mostly
people trying to lose weight want to omit food
sugar and fat, is not the same as an apple or an
groups or extremely limit an entire nutrient
orange. The fruit is more nutritionally dense
class. The advice should be that fad diets do
because, while it also has sugar, it has fiber and
not work in the long run. Instead,
vitamins that are also good for
The body lacks the enzyme clients should educate themselves
the body. If an individual is just
to break down cellulose. on the six classes of nutrients the
counting calories, some candy
body needs for proper function.
bars may seem similar to some fruits. A banana,
It is very important when trying to achieve or
for example, is a high carbohydrate fruit and
maintain a healthy standard of living to include
may have the same calories as a candy bar,
maintaining proper weight and muscle mass.
but the banana is more nutritious. Vegetables
GI
contain very little sugar but can still be high Classification Range Examples
most fruit and vegetables
in carbohydrates. Potatoes, for example, are (except potatoes, water-
55 or less melon), grainy breads, pasta,
Low GI legumes/pulses, milk, products
considered more of a starch (carbohydrate) extremely low in carbohydrates
(fish, eggs, meat, nuts, oils)
than a vegetable. Broccoli is another vegetable, whole wheat products, brown
Medium GI 56-69 rice, basmati rice, orange
but its carbohydrates come from its high content sweet potato, table sugar
corn flakes, baked potato,
of cellulose. The body lacks the enzyme to break watermelon, some white rices
High GI 70-99 (e.g., jasmine), croissant, white
bread, candy, cereal
down cellulose, making broccoli a good source
100 straight glucose
of fiber and low in calories. We cannot digest
Most people have heard about the glycemic
the majority of the vegetable, but we get many
index and personal trainers are undoubtedly
nutrients in the form of vitamins and minerals;
going to be asked about it by clients. The
therefore, broccoli is a high-density food for this
glycemic index is a ranking of carbohydrates
reason.
based on their simplicity; simple carbohydrates
While it is not bad to occasionally eat a candy
have a higher GI and vice versa. When a person
bar, the majority of carbohydrate calories
consumes a carbohydrate-rich meal, digestive
should come from foods that are nutritionally
enzymes break down the carbohydrates
dense. A personal trainer will be asked all
starting in the mouth. Digestion continues in the
sorts of questions regarding health, fitness
251
stomach; however, the majority of carbohydrate means to label a food as either a good or bad
digestion occurs in the small intestines. carbohydrate. The lower the GI for a particular
The simpler the sugar, the easier and faster food, the better it is because the insulin released
the breakdown of that carbohydrate is going will be gradual since the body will take longer
to occur. The idea behind simple sugars being to break down a complex carbohydrate than a
“bad” derives from studies showing a “crash” simple carbohydrate. A personal trainer should
after a meal of mostly simple carbohydrates. also advise a client that no foods need to be
This is believed to happen because digestion totally eliminated. Once a food is omitted, it
occurs so fast that the result is a huge spike in becomes that much more alluring. Clients should
insulin, which is responsible for transporting allow themselves to still enjoy an occasional ice
glucose into the cells. A huge sugar spike means cream or candy, just not every day. A dietary plan
a “crash” will follow, leaving the individual followed 60-70% of the time is still successful.
feeling sluggish. This is also believed to be Many clients will think if they “cheat” on their
one of the leading causes in type II diabetes. A diet one day, there is no use working out or
person eating in this fashion is following the plan for the rest
A huge sugar spike means a
constantly cycling between this “crash” will follow, leaving the of the day. This is not the case
individual feeling sluggish.
spiked insulin and then a huge so trainers should advise them
drop. The cells stop responding to the insulin to forget the slip-up and keep moving forward.
stimulus and stop letting the glucose from the One Friday night binge or skipped workout is
high carbohydrate meals into the cells. The not failure. Trainers need to keep clients, as well
result is high glucose in the blood, also known as themselves, positive.
as diabetes. Type II diabetes is different than

Carbohydrates for Working Out
type I because, in type I, there is a defect in the
As already stated, an extremely athletic
production of insulin—this is usually a genetic
person should be consuming 60% of calories
defect and has nothing to do with how the
from carbohydrates. Fluids are also important
person eats. This is also why type II diabetes is
in order to stay hydrated throughout the
a gradual process: it takes time for the cells to
day; however, clients should try to not drink
finally stop responding.
copious amount of water a few hours before or
The glycemic index was designed to help
during their workout. They should try to avoid
reduce type II diabetes by giving people a
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caffeinated and carbonated drinks on workout from various grains which are themselves
days. Studies have shown that for every hour carbohydrates. However, there are very few
of endurance workout (cardio), a person needs residual carbohydrates left over from the
100-300 carbohydrate calories. Trainers should processes of making alcohol. To be more specific,
recommend that, approximately three hours beer and wine are made through a process of
before clients work out, they should eat a high fermentation so these types of alcohol contain
carbohydrate meal equivalent to what will a small amount of carbohydrates. However,
be needed for their workout. They can have a liquor such as whiskey or vodka is made from
small snack right before, such as crackers and a distillation process which leaves nothing but
juice, if they like. Preferably, the ethanol. Another important

If a person is trying to lose
some of the meal should come weight, it is important to aspect of alcohol is that despite
decrease the amount of alcohol.
from foods with a low glycemic what most people hear, the
index, which will keep them feeling fuller longer breakdown products are not sugar. When
and help to avoid any “crashing” due to insulin alcohol of any sort is consumed, it is metabolized
spiking. After their workout, trainers may want in the liver by an enzyme called alcohol
to suggest a slightly higher protein meal to help dehydrogenase, and that enzyme breaks alcohol
repair any muscle damage from their session. down into a chemical called acetate. Acetate is
On non-workout days, they should try to stay not a sugar and thus not a carbohydrate.
within their recommended caloric intake; 40- Alcohol does have a lot of calories. Next to
60% of their daily calories should be coming fat, it has the most: 7 calories for every gram
from carbohydrates. of alcohol. If a person is trying to lose weight,
it is important to decrease the amount of

Alcohol as a Carbohydrate?
alcohol because it is very calorie dense but
Many people enjoy a beer or wine at the
provides virtually no nutritional value. This
end of their day to help them relax. Clients
is why beer companies have tried decreasing
may wonder if this is hurting or slowing their
the amount of carbohydrates in beer in order
progress or how alcohol factors into their daily
to lower calories without lowering alcohol
caloric intake and overall nutrition. Contrary to
content. The focus on lowering carbohydrates
popular belief, alcohol is not a carbohydrate. It
has given the general public the impression that
contains carbohydrates because it is generated
alcohol is a carbohydrate, while in actuality it
253
has more calories than carbohydrates and is 30% of a person’s daily calories coming from
not a carbohydrate. If trainers are asked this fat is ideal for maintaining a healthy weight,
question, the response to give is that alcohol keeping up bodily energy levels and maintaining
is not a carbohydrate nor is it converted into metabolic functions. Those who aim to lose
a carbohydrate, and it has more calories than body fat as part of their workout goals may
a carbohydrate. Another important fact about restrict fats to as low as about 10% of their daily
alcohol is that it is a diuretic, which means that calories; however, limiting one’s intake to lower
it blocks the hormone responsible for keeping than this is not advisable due to the important
water in the body and will cause the person to role of fats in the body.
excrete more urine than normal. Also, alcoholic

The Role of Fats in the Body
drinks are often laden with sugary mixtures,
Most athletes understand that the body relies
such as margaritas and daiquiris, that are
primarily on carbohydrates as an immediate
high in simple sugars and that are essentially
source of energy. Fats, however, are also very
empty calories. Beer or wine is a much better
important in the release of energy to the muscles
alternative.
of the body. They are the most concentrated
Fats energy source in the body and provide over
Fats, or lipids as they are commonly referred double the amount of calories per gram than
to in nutritional circles, are an important part of protein or carbohydrates; 9 calories versus 4
the diet. It is essential that personal calories. Because fats are so energy
Fats are very important in
trainers and clients understand the the release of energy to the dense, they should be eaten wisely.
muscles of the body.
role of particular fats in the body When calorie requirements for a
in order to include them in the diet in the most person increase, as they do during a training
beneficial way. Many people have either a fear of schedule, their fat requirement also increases.
eating fat and avoid it altogether or a misguided It is advisable to make sure that when food
belief that athletes can benefit from a high-fat consumption is increased in order to increase
diet for increased performance. It is generally calories, fat intake stays in the same ratio. High-
accepted that neither a very low fat nor a very fat, low-carbohydrate diets, which are very
high fat diet is ultimately beneficial for active popular among people currently, are generally
individuals. A balanced diet with between 25- thought to be inappropriate for athletes seeking
254
to increase their energy output because of the allows the messages to move around the body
potential to starve the body of energy from without difficulty.
carbohydrates. Many people who make the loss of body fat
It is important to understand the role of a goal of their exercise program may complain
fats in the transportation of vitamins around that they do not feel full or satisfied after a
the body. Many essential vitamins cannot be well-balanced meal. Fats play a role in helping
utilized by the body without to provide this feeling. They
the fats that provide the Hormones regulate many different stay in the stomach longer and
body systems and have a large
medium for them to enter the therefore create the sense of
effect on energy levels and the
body’s cells. Physically active building of muscle tissue. feeling fuller for a longer period
adults will often gain benefits of time. The ability of the fat
from carefully supplementing with fat-soluble molecule to require a longer time to break down
vitamins (A, D, E and K) and essential fatty acids. can also help prevent people from overeating.
These vitamins act as anti-oxidants, helping to The cells that make up all of the body’s organs
repair the damaged cells and tissue in the body and tissues, including the muscles, require fats
that are a normal result of working out. Healthy to help send and receive signals from other
fats in the diet ensure that these vitamins are of cells. This is especially important in the brain,
the most benefit to clients. where fatty acid chains assist messages to cross
Hormones are extremely important chemicals synapses as the neurons fire. New studies also
in the body. They regulate many different body stress the importance of “brown fat” in signaling
systems and have a large effect on energy levels cells to create muscle tissue, which is essential
and the building of muscle tissue. In order for the human body and especially those of
for the body to manufacture these important athletes.
regulatory hormones, it must have fats. Fats A complex mixture of nutrients, minerals and
form the precursors, or first steps, that allow vitamins must pass in and out of cells through
the body to make what it needs. the cell membranes in order to be used by the
Nerve fibers in the body transmit messages body. Lipid molecules are able to control this
to muscles and organs via electrical impulses. process, ensuring the body is able to extract
Fats are used by the body to compose a myelin what it needs for optimal functioning from the
sheath which coats these nerve fibers and foods eaten.
255
Fats not only act as a physical buffer for the commonly found in vegetable oils, avocados
organs, protecting them if the body suffers a and walnuts. The body converts ALA to EPA and
blow or a fall, but more importantly, they form DHA in order to use it for cellular functions. Fish
a kind of barrier around the organs, protecting oil supplements are readily available for those
them from disease organisms and toxins until who find it difficult or unpalatable to eat fish
they can be removed from the body. once or twice a week as recommended to meet
the body’s need for EPA and DHA omega-3 fatty

Types of Fats
acids.
Fat molecules are referred to as fatty acids.
They are essentially long chains of hydrocarbons Triglycerides

(longer than a typical acid) with a carboxyl group The “normal” fats that we eat are composed
on the end. There are many different kinds of of three fatty acid chains bonded together with
fatty acids that vary slightly in the numbers and glycerol. These are known as triglycerides and
composition of their hydrocarbons. an excess of these molecules can cause fatty
build up around the body. The types of fatty acids
that make up these molecules determine the
properties of the particular fats. For example,
whether a fat is a solid or a liquid at room
temperature or whether or not it saturates,
is determined by the particular acid chains
Some of the most beneficial types of fats are that make up the triglycerides. Some studies
known collectively as omega-3 fatty acids. show that an increased intake of medium-
These fatty acids assist in brain function chain triglycerides (MCT) may be a good way
and are important for the health of the heart for athletes to positively increase their caloric
and the joints. There are three main types of intake, but these studies are not conclusive.
omega-3 fatty acids: Docosahexaenoic acid

Unsaturated Fats
(DHA), Eicosapentaenoic acid (EPA) and Alpha-
These fats have certain hydrogen atoms
linolenic acid (ALA).
missing from their carbon/hydrogen chains,
EPA and DHA are found primarily in fatty
forcing the carbons to make a double bond.
fish like sardines and salmon, while ALA is
For this reason, these fats are liquid at room
256
temperature. Those with one double bond are Saturated Fats
referred to as mono-unsaturated fats. Examples These fats have every bond filled with a
are olive oil and canola oil. Fats with double hydrogen atom and are, therefore, termed
carbon bonds are referred to as poly-unsaturated. “saturated” or “filled up.” They are solid at room
Many researchers and nutritionists recommend temperature and have received considerable
that mono-unsaturates should make up a large negative attention because of the link between
proportion of the fats consumed by a healthy, their consumption and increased blood
active person. It should be noted, however, cholesterol levels and heart disease. Because
that current research shows that unsaturated they are both saturated and solid, they are more
fats should not be heated, as this changes the likely to deposit in the walls of the arteries,
properties of the oil and makes them act more creating blockages. Recent studies have
like a trans fat in the body. shown, however, that because of their chemical
composition, these fats may not be as bad for

Trans Fats
the body as originally thought and cooking with
Trans fats refer to a group of unsaturated fats
butter, a saturated fat, is now preferred over
that are normally liquid at room temperature
margarine among many nutrition
but have been “hydrogenated”
Trans fats are difficult for scientists. Although eating butter
in order to make them solid. the body to metabolize and
are associated with health and other saturated fats, such as
This process is used, for problems like high cholesterol
and heart disease. those found in red meats, should
example, to turn vegetable oils
be limited, these fats are currently
into margarine. The fat is heated to a high
preferred by health professionals over trans
temperature to break the double bonds and
fats. Part of the reason is that the molecules that
attach hydrogen to them. Trans fats are difficult
form a saturated fat are more easily recognized
for the body to metabolize and are associated
and processed by the body than the physically-
with health problems like high cholesterol and
altered molecules of trans fats.
heart disease. Most studies conclude that eating
less hydrogenated fats will likely decrease LDL Cholesterol

levels. Many prepared foods, like cakes and The amount of cholesterol and fat found in
chips, are made with trans fats because they are people’s diets is directly related to the amount
inexpensive to use in the processing of foods. of cholesterol circulating in their blood. Studies
257
Saturated Monounsaturated Polyunsaturated Cholesterol Vitamin E
g/100g g/100g g/100g mg/100g mg/100g
Animal fats
Lard 40.8 43.8 9.6 93 0.00
Butter 54.0 19.8 2.6 230 2.00
Vegetable fats
Coconut oil 85.2 6.6 1.7 0 .66
Palm oil 45.3 41.6 8.3 0 33.12
Cottonseed oil 25.5 21.3 48.1 0 42.77
Wheat germ oil 18.8 15.9 60.7 0 136.65
Soya oil 14.5 23.2 56.5 0 16.29
Olive oil 14.0 69.7 11.2 0 5.10
Corn oil 12.7 24.7 57.8 0 17.24
Sunflower oil 11.9 20.2 63.0 0 49.0
Safflower oil 10.2 12.6 72.1 0 40.68
Rapeseed/Canola Oil 5.3 64.3 24.8 0 22.21
have shown that eating foods high in saturated diet high in saturated or trans fats can contribute
fats (e.g., butter) or trans fats (e.g., margarine) to this syndrome. A simple way to help protect
increase the amount of “bad” cholesterol, or against this combination of health problems
LDL, in the blood. High LDL cholesterol levels is to keep the polyunsaturated/saturated fat
have been linked to heart disease in many ratio of the diet in a healthy range. Balancing
individuals. Raising levels of “good” cholesterol, fats with carbohydrates and protein, as well as
or HDL, in the blood can help to lower the LDL. eating plenty of fiber, can also protect against
Foods that raise HDL cholesterol include those developing this deadly combination.
high in omega-3 fatty acids, high-fiber foods like

Obesity
oat bran and lentils, and oils like olive oil and
Fat molecules in excess of what is needed
canola oil.
by the body form large droplets, or globules,
Problems with Fats that clump together and form adipose tissue,
or white fat. This fat collects in the body’s

Metabolic Syndrome
“problem areas” and it is difficult for the body
This is a group of symptoms that includes
to burn these fatty deposits because they are
obesity, insulin resistance and cardiovascular
not well supplied with blood, which carries the
problems. Overeating in general and eating a
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hormones that assist in the process of burning the stress on the heart from supplying excess
white fat. body tissue with blood, can also contribute to
Consuming more than 30% of calories problems with proper heart functioning.
from fat slows metabolism and contributes

Fat Requirements
to the depositing of dietary fat in stores in
Different people have different fat
the body. Obesity is not simply a result of
requirements. Those who have high cholesterol,
the overconsumption of fat. There are many
who are obese or who are suffering from other
environmental, physical and social factors that
conditions, such as high blood pressure or heart
contribute to a person’s likelihood of becoming
disease, will need to pay very careful attention
obese. Understanding that these factors all
to the types of fats they eat to best control
play a role in storing excess fat in the body is
their conditions. Most people
important when making dietary Consuming more than 30%
of calories from fat slows can benefit from a diet lower
and exercise recommendations.
metabolism and contributes in saturated fat and higher in
to the depositing of dietary
Insulin Resistance fat in stores in the body. unsaturated fat, with care taken
Insulin resistance is a condition that increases to avoid partially hydrogenated oils or trans fats
a person’s risk of developing diabetes or heart and attention given to include good sources of
disease. Storing excess fat increases a person’s omega-3 fatty acids. A good way to avoid the
risk of developing insulin resistance because consumption of “bad” and unwanted fats is to
fat in the body interferes with the ability of the avoid processed and prepared foods. If clients
muscles to use insulin properly. Studies suggest prepare their own foods, they will be better
that there is a clear connection between excess able to control the type and amount of fats
fat and the inability to use insulin properly. they ingest. Fats are an important component
of a healthy diet and essential to an active and

Heart Disease
optimally-functioning metabolism. It is not
Saturated fats have long been connected to
necessary to be obsessed with fat consumption
problems with heart muscle function. Arteries
but understanding the functions of fat in the
that supply the heart with blood become
body will help personal trainers better advise
hardened and clogged from the build-up of fats,
clients about their individual dietary needs.
which negatively affects their ability to function
properly. High LDL cholesterol levels, as well as
259
amino acids are alanine, asparagine, aspartic
Protein
acid, cysteine, glutamic acid, glycine, proline,
Proteins are large molecules made up of
serine and tyrosine. These amino acids are
individual amino acids linked together by a
synthesized by the body in sufficient amounts
peptide bond, similar to pearls on a necklace.
using fats and carbohydrates as building block
The amino acids are arranged in a
precursors.
specific sequence that folds into particular
3-dimensional structures to yield a specific Protein Digestion

functional protein. Proteins have a number of In order to build protein in the body, the
functions in the body, including building and ingested protein must first be broken down
repairing tissue, synthesizing into its individual amino
hormones and other enzymes acids through the process of
and functioning as an digestion. Where the amino
energy source for the body acids end up after digestion
in the event of insufficient will depend on the needs of
carbohydrate levels. Good the body. If too little protein
sources of protein include meats, eggs, legumes, is consumed, the body will begin to burn lean
nuts and dairy products such as low-fat milk muscle mass. Excess protein is not stored in
and cheese. the muscles for muscle building; it is instead
There are 20 different amino acids and they converted to fat or carbohydrate and then
can be divided into two main classes: essential stored, or it is excreted in urine.
and non-essential. Essential amino acids are Digestion of proteins begins in the stomach
those that cannot be synthesized by the body where harsh hydrochloric acid causes the
and must be obtained by food or supplements. protein to denature or unfold. This unfolding
These include leucine, isoleucine, valine, allows proteases (enzymes that cut proteins)
lysine, threonine, tryptophan, methionine, such as pepsin to begin to break the peptide
phenylalanine, histidine and arginine. The last bonds between the amino acids, releasing short
two amino acids are termed semi-essential as polypeptide (protein) chains and individual
they are produced at levels too low to sustain amino acids. In the small intestines, the
growth, especially in children. The non-essential polypeptides are further broken into chains
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of two to three amino acids. The resulting contain a ratio of different amino acids that are
dipeptides and tripeptides are absorbed most suited for the needs of the human body.
through the cells lining the For example, a chicken egg has
small intestines and are further a BV of 94 while beef has a BV
cut into individual amino of 76. Unfortunately, BV content
acids which then enter the is an idea that is often misused,
bloodstream. They then travel especially by marketers of
to the liver and other tissues for protein supplements. They try
protein synthesis. to sell the idea that if someone
Not all protein-rich foods who is already consuming
are able to equally satisfy the body’s need for adequate protein takes a high-BV supplement,
amino acids. When determining the quality of then that person will build muscle to a greater
a protein, physiologists examine the amino acid degree than someone who is not taking the
content, the digestibility of the protein and its supplement. However, excess protein is not
bioavailability, as well as the ability of Biological Value of Some Protein-Rich Foods
Biological
the body to incorporate that protein’s
Met Phe
Value
+ +
amino acids into its own tissues. There Ile Leu Val Thr Cys Trp Lys Tyr His
Egg, chicken 1,0 1,0 1,0 1,0 1,0 1,0 1,0 1,0 1,0 0,94
are several methods to determine these
Milk, human 1,1 1,4 1,0 1,0 1,1 1,6 1,0 1,0 0,9 0,95
values, such as the protein efficiency Milk, cow 1,1 1,3 1,0 0,9 0,7 1,3 1,3 0,9 1,1 0,90
ratio (PER), which examines the ability of Muscle, beef 0,8 0,9 0,7 0,9 0,9 0,9 1,4 0,7 1,6 0,76
Soybeans 1,0 0,9 0,8 0,8 0,6 1,3 1,1 1,0 1,4 0,75
the amino acids to be incorporated into
Rice 0,8 0,9 0,9 0,8 0,9 1,2 0,5 1,2 0,8 0,75
tissues by measuring muscle growth. Wheat 0,6 0,8 0,6 0,7 0,8 1,1 0,4 0,8 1,0 0,67
However, the values were determined for Potatoes 0,6 1,1 0,8 1,3 0,6 1,9 1,4 0,8 1,1 0,67
Oats 0,8 0,8 0,8 0,7 0,6 1,2 0,6 1,0 1,1 0,66
lab rats, which may have different amino
Corn 1,0 1,7 0,8 0,7 1,1 0,5 0,4 1,0 1,0 0,60
acid requirements than humans. Source: McGilvery, Biochemistry, 1970
Historically, protein quality was determined stored for later use in the muscles; any unused
by measuring the biological value (BV), which amino acids are stored as fat or are excreted
measures nitrogen incorporation from digested from the body. One advantage, though, of
proteins. Proteins with a higher BV score consuming foods with a high BV is that a
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person’s amino acid requirement can be met
Factors that Affect Protein
with less total protein, thus a person may be
Requirements
able to cut calories from his diet if the goal is to
The primary uses for amino acids in the body
lose weight. Conversely, if one consumes low-BV
are the anabolic processes, such as building
foods, more protein will be needed to satisfy the
muscle mass. Therefore, it is not surprising that
amino acid requirement. The shortcomings of
athletes have a higher requirement for protein
using BV is that it does not include factors that
than a sedentary population. Having a sufficient
affect digestion of protein and it measures the
supply of amino acids enhances protein
maximum potential of amino acid incorporation
synthesis for muscle building
and not an actual value. The primary uses for amino
acids in the body are the during anaerobic activities and
The current preferred method
anabolic processes, such as for muscle recovery and repair
to determine protein quality is building muscle mass.
afterwards. Endurance athletes
referred to as the protein digestibility corrected
also have a need for increased protein intake.
amino acid score, or PDCAAS. This method
For example, marathoners may not want to
determines the content of amino acids of certain
“bulk up,” but having extra protein prevents lean
proteins based on the actual amino acid needs
muscle mass from being consumed for energy
of children between the ages of two and five
during long runs, which will have an overall
(an age group that is considered to be the most
detrimental effect on endurance abilities.
nutritionally-demanding). This method is not
Protein requirements increase as total energy or
without its flaws. PDCAAS measures the amount
calorie intake decreases overall. When there is
of protein present in feces and compares that
an insufficient supply of carbohydrates available
to what is eaten. The result is the amount of
for energy, the body will instead use amino
protein utilized by the body. However, most of
acids as its primary energy source. Additionally,
the protein that reaches the colon is consumed
children, pregnant and breastfeeding mothers
by bacteria and would not be present in the
and those recovering from trauma or surgery
feces. According to measures by the PDCAAS
have an increased need for protein in their diets.
method, it would appear that protein has been
However, consuming too much protein if part
digested and used by the body, when in fact it
of a high-calorie diet will cause the excess protein
has not.
to be stored as fat rather than used for muscle
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building. High-protein fad diets that propose temperature regulation, lubricating tissues
cutting down or eliminating carbohydrates as a and joints and is especially important for
way to lose weight can lead to the development the elimination of waste. When adding extra
of metabolic ketosis that, if severe enough, can physical activity such as moderate exercise, the
lead to coma and death. High protein diets have need for water grows.
also been thought to increase blood lipid levels When we exercise we use many different
and blood pressure, which can increase the risk muscles. Each muscle generates heat when in
for cardiovascular disease. High protein diets motion and that heat translates into an overall
may stress the kidneys and, in extreme cases, higher body temperature. The body starts to
this can lead to kidney failure. Additionally, perspire to regulate temperature. When we
high protein diets can lead to calcium loss from sweat our body loses valuable nutrients that
bones, which can be extremely dangerous for can increase the chance of muscle cramps and
older, female clients because it increases their injury. Replacing fluids throughout exercise is
risk of osteoporosis. Although athletes and vital to productive training and overall health.
those individuals who regularly exercise need Sweat is mostly water but the other mineral
a slight increase in protein over the rest of the content proportions can vary from individual
population, it is important to stress a balanced to individual. The minerals present in sweat
diet when advising clients on nutrition. Too are: calcium, sodium, potassium, magnesium,
much of anything is not a good idea and that and trace amounts of copper, iron, chromium,
also goes for protein. nickel, zinc and lead. The amount of each is
tied to how often the individual exercises and

Proper Hydration
to that individual’s ability
The function of water in the
to dissipate heat, which
human body is extensive and
can depend on individual
should be repeatedly emphasized
acclimation to climate.
to any athlete. Water makes up
The process of sweating
about 50% of a woman’s total
is actually controlled
body weight and about 60% in
in the brain. The skin is
men. Water is responsible for
one receptor that sends
digestion, sweating to maintain
information to the brain
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but the core temperature is the main catalyst Each drop of sweat takes water and electrolytes
that stimulates sweating. Sweating is actually a out of the body. Replacing electrolytes is vital
twofold process. The sweat on skin evaporates, to hydration during exercise so that the body
cooling the skin, but the actual act of sweating has all the necessary tools to communicate
cools the core temperature in the body. and regulate temperature. Sports drinks often
Replacing fluid lost through sweating is one contain electrolytes such as potassium or
of the most important elements of effective sodium chloride and have become a popular
training. It is important that hydration happens water replacement, especially for elite athletes.
before, during and after exercise. If a client begins Are sports drinks a more effective means of
exercising in a dehydrated state, it is impossible hydration?
to catch up. To help avoid dehydration and its

Sports Drinks vs. Water
many complications, drink 15 fluid ounces
Looking at the differences between sports
of water or sports drinks 2 to 3 hours before
drinks and water can aid clients in the decision
exercising and then 10 fluid ounces again 10-15
as to which is a better choice for
minutes prior to the activity.
Electrolytes carry electrical their hydration. Water is often free
Electrolytes are positively and impulses, such as muscle
contractions and nerve or low-cost, which makes it a more
negatively charged ions. A common
impulses, to other cells. cost-effective means of hydrating,
electrolyte is known as sodium
but the lack of flavor can make it a
chloride, which is table salt. Other electrolytes
bit boring. This can be easily altered by adding
are potassium, calcium, magnesium, phosphate
lemon to water or purchasing flavored water
and sulfate. Electrolytes have a vital function
Sports drinks come in a variety of flavors that
throughout the body. They carry electrical
may tend to prompt more drinking because
impulses, such as muscle contractions and
the taste is more enjoyable. The real difference
nerve impulses, to other cells. This function
between sports drinks and water is the
is most important to the heart, nerves and
electrolyte content. Sports drinks are formulated
muscles. The kidneys are responsible for
with sodium, potassium and a healthy dose of
maintaining concentrations of electrolytes in
carbohydrates to enhance energy supply. The
the blood. When training, the electrolyte level
sodium can also lift and maintain the sodium
begins to change because of loss via sweating.
balance in the blood, which will keep more fluid
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in the system, whereas water will stimulate the quickly enough for an athlete to continue. If an
kidneys to turn on urine production. athlete is even moderately dehydrated it can
For a variety of reasons the sugar content in take many hours for them to consume enough
sports drinks can be an issue for some athletes. fluid to safely continue their training. The first
Luckily, manufacturers have begun to produce signs of mild to moderate dehydration are:
sugar free or low sugar sports drinks. Often • Sticky, dry mouth
the choice between sports drinks and water • Fatigue
depends on the individual and the type of • Headache
exercise or training being performed. Someone • Lightheadedness or dizziness
taking a brisk 30 minute walk will do fine with a • Muscle weakness
bottle of water, while an elite athlete vigorously At the first sign of these mild to moderate
training over a period of hours will need the dehydration symptoms, athletes should stop,
extra ingredients found in sports drink a sports drink and some

If an athlete is even moderately
drinks to regulate electrolytes dehydrated it can take many water and discontinue exercise.
hours for them to consume
and enable necessary hydration enough fluid to safely continue It is unlikely they will be able to
their training.
without overdoing it. For these “catch up” their hydration level
intensely training athletes, often the best course to safely continue training. Children have higher
of action is a combination of sports drinks and metabolic rates and require more fluid than
water before, during and after their workout. an adult, regardless of their smaller size. Their
kidneys are not able to conserve fluid as well as

Signs of Dehydration
their adult counterparts so they must be closely
When individuals are not getting enough to
monitored to avoid dehydration.
drink, their body will begin to tell them through
Severe dehydration symptoms include:
a variety of symptoms. If these symptoms are
• Very dry mouth
ignored, they can grow worse and, in the worst
• Extreme thirst
case scenario dehydration, they can lead to
• Rapid heartbeat
death. At the first sign of dehydration, it is vital
• Confusion and irritability
that any athlete stop, hydrate and then gauge if
• Sunken eyes
activity should be continued. It can be difficult
• Cessation of sweating
to get enough fluid in or for the body to hydrate
• Fever
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In the most extreme, cases dehydration can health professionals to monitor them should
cause fainting and unconsciousness. One of the experiment with hydration levels at any kind of
best indicators of dehydration is urine color. extreme.
Amber colored or dark yellow urine is a sign

Hydration to Maximize Training
of dehydration. Clear or light colored urine
Athletes who know how to fuel their bodies
demonstrates adequate hydration.
with nutrition and hydration are able to do
Thirst is a natural indicator to hydrate the
more for longer periods of time. They will
body but unfortunately it is not always the best
begin to understand the level of hydration they
indicator. During normal daily activities people
need throughout their training. But a personal
can trust thirst to remind them when they need
trainer must emphasize the need
to drink water, but during exercise
A U.S. Army study found that for hydration on a daily basis and
it cannot be relied upon as an “dehydration in excess of 2%
of body weight consistently not just during exercise. Everyone
adequate reminder. Hydration impairs aerobic exercise
performance.” benefits from adequate hydration
must occur before, during and
but an athlete who begins training
after physical needs during training. In addition,
with any kind of hydration deficit will quickly
there is a condition called hyponatremia, which
learn that it is difficult if not impossible to
is water intoxication. This condition results in a
recover from that deficit.
dilution of salt or sodium in the body. Athletes
The optimum level of hydration is the same
may experience this if they drink too much
for every human being. Athletes, however,
water without also drinking a sports drink
are unique: their ultimate level depends on
with necessary electrolytes. This is the primary
the intensity of exercise or training, climate,
reason why sports drinks are an important
altitude and the conditioning of the athlete.
addition to any training program. A U.S. Army
The American College of Sports Medicine
study found that “dehydration in excess of 2%
recommends that athletes who exercise for
of body weight consistently impairs aerobic
60 minutes or more at high intensity include
exercise performance” but effects can begin to
sports drinks in their regimen. The drink should
be seen at only 0.5%. This study goes on to warn
include approximately 100 calories per 8
of the dangers of hyponatremia from hyper
ounces to meet athletes’ calorie needs. General
-hydrating before, during or after exercise.
recommendations for athletes performing a
Only elite athletes with access to qualified
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moderate training or exercise session include a normal hydration level, maintain it throughout,
drinking 20 fluid ounces about 3 hours before and hydrate adequately to recover for optimum
exercise, 8 fluid ounces every 15 minutes results and safety.
throughout exercise and, if exercising for an

Supplements
hour or more, 8 fluid ounces of a sports drink
In an attempt to gain a competitive edge in
every 15 minutes. The carbohydrate content
sports performance or to ensure the maximum
of sports drinks should be no more than 8%
effect of sports training, people often resort
carbohydrate solution. In other words, the level
to supplements. Supplementation is a legal
of glucose should be less than 8%. A simple
and popular way to support physically active
way to re-hydrate after exercise is to weigh
individuals. Athletes seek means
before and after training and
The carbohydrate content of to improve their performance
then drink 20 fluid ounces for sports drinks should be no more
than 8% carbohydrate solution. beyond training alone. Often,
every pound lost. Athletes need
supplements are used to obtain
to replenish glycogen stores by ingesting a 4-1
adequate calorie intake, resynthesize energy
ratio of carbohydrates to protein within 2 hours
and increase tolerance in training. Other major
of training.
goals in using supplements are the use of
A 2008 University of Connecticut study looked
energy efficiently with quick recovery and the
at the effects of hydration and its connection
enhancement of physical power or the ability
to muscle damage. Studying different levels
to produce energy specifically for athletic
of hydration in physically compatible study
performance. Additionally, noncompetitive
participants showed that the optimal state of
athletes and fitness enthusiasts are turning to
hydration to protect athletes from injury is an
supplements to lose weight, add muscle mass,
euhydrated state, or normal state of body water
prevent injury, relieve pain and alleviate stress.
content. They found that this allowed athletes to
Hundreds of dietary supplements have
“maximize endogenous hormonal, mechanical
been marketed in the form of protein shakes,
and metabolic benefits.”
powders, energy bars and sports drinks. Certain
While there is a school of thought that elite
supplements are beneficial to certain people
athletes can “hyper-hydrate” before working
under certain circumstances so it is important
out, most sports science experts are coming to
to determine the extent of exercise and training
agree that an average athlete should start out at
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that will be performed to adequately choose the Normally, the amount of ATP available for
supplements that will give the best results. use by the muscle is very small so it must
be made continuously. Creatine phosphate

Types of Supplements
(CP) is one of the three pathways used for the
Creatine
production of ATP by muscle fibers. The high-
Creatine is a nitrogenous amine and natural
energy phosphate from CP is transferred to
dietary constituent of animal foods. It is
re-phosphorylate ATP from ADP by creatine
normally found in animal flesh, especially those
kinase. This rapid reaction is conducted in one
animals that are physically active. Primary
enzymatic step but is limited by the amount of
food sources of creatine are fish and red meat;
stored creatine or PCr in free muscle.
thus, vegetarians may have lower serum
Creatine is one of the most popular and
concentrations of creatine. Creatine absorption
well-known supplements used by athletes.
is highest after carbohydrate intake. Creatine is
Many professional sports teams actually
not an essential nutrient since adequate amounts
supply creatine to their athletes.
can be synthesized by the body.
Benefits of creatine may also Supplementation is thought to
Normally, creatine is synthesized be due to the person’s ability
elevate muscle creatine stores.
from the amino acids methionine, to increase strength from
harder training. Additionally, creatine increases
glycine and arginine by the liver,
the amount of water that each
kidney and pancreas to be used anaerobically
muscle cells hold—thus it increases the size of
as a fuel. Since only approximately 2 grams are
the muscle and therefore power outputs.
needed for daily activities, it must be constantly
Research has shown that creatine
resynthesized for use because only a limited
monohydrate supplementation may improve
amount of creatine is stored for several seconds
athletic performance in activities that are
for activity.
marked with high intensity. Benefits of creatine
Creatine participates in the production and
may also be due to the person’s ability to increase
maintenance of ATP and therefore plays an
strength from harder training and maintain
important role in cellular energy production.
strength and power for repeated short-duration
Creatine regenerates ATP in skeletal muscle in
movements. If this is the case, creatine may not
the form of phosphocreatine (PCr). PCr gives
be beneficial for sedentary persons. Creatine
up its phosphate to facilitate ATP synthesis.
supplements are used extensively in resistance-
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exercise training and are marketed as a body- or more amino acids are popular as sports
building and strength-boosting aid. Resistance enhancers. These amino acid supplements have
training is known to stress the ATP-CP energy been promoted on the market with claims that
system and it is the primary energy system for these products are more rapidly digested and
this type of training. absorbed than protein obtained from food. The
The most common regimen for claim is that amino acid supplements can inhibit
supplementation follows a 2 phase cycle. The muscle loss, maintain immune system function
first phase, or loading phase, consists of taking and promote glucose/glycogen metabolism.
about 20-25g/day for 5-10 days. After the However, evidence for the athletic benefits
loading phase, the maintenance phase is utilized of isolated amino acids is mixed. It has been
to sustain a beneficial amount in the body. The found that large intakes of some single amino
maintenance phase is of variable length and acids may interfere with absorption and lead
usually consists of taking 2-5g/day. Intake of to imbalances in metabolism, so it is wise to
supplemental creatine can increase muscle monitor usage of amino acid supplements.
creatine levels for several weeks. Only longer Glutamine
periods of supplementation help in training Glutamine is a 5-carbon compound with
and shorter periods do not enhance exercise two nitrogen groups. An amide derivative of
performance. It is important to note that creatine the amino acid, glutamine, is converted to its
has not been thoroughly tested for natural form in tissues of the liver,
Glutamine is the most
safety so it may be wise to avoid common amino acid in brain, kidney, skeletal muscle and
muscle and plasma.
usage of creatine supplementation intestine. Food sources include foods
if energy consumption is adequate. Creatine rich in protein, such as milk and meat, and plant
supplements can be associated with weight gain foods, such as spinach, parsley and cabbage.
so anyone taking them should be advised. Glutamine is the most common amino acid
Amino Acid Supplements in muscle and plasma. It accounts for about
The 20 amino acids are the basic building 10% of the amino acid content in muscle
blocks for protein and therefore build cellular protein and upwards of 50% of the amino
tissue. Each of these amino acids has unique acids released from muscle during exercise
metabolic properties in human physiology. stress. Glutamine provides nitrogen and carbon
Amino acid supplements containing one molecules for synthesis of macromolecules and
269
energy production. It also neutralizes cortisol, that this growth hormone produces anabolic
a steroid hormone that induces catabolism and effects, including the stimulation of protein and
accompanies strenuous exercise. Under certain nucleic acid synthesis in the skeletal muscle.
physiological conditions (e.g., injuries, infections This also leads to an increase in muscle mass and
and extreme stress), glutamine a decrease in body fat. Arginine

Besides oral supplements,
stores in the muscles can be athletes often inject large is also thought to be involved in
amounts of arginine, which
depleted and supplementation may cause a temporary rise in several other physiological areas
becomes necessary to maintain growth hormone levels. of interest to athletes, including
adequate concentrations in the body. Lasting creatine synthesis, release of insulin and removal
fatigue is often also associated with low plasma of toxic ammonia. Besides oral supplements,
glutamine levels. Glutamine is also important for athletes often inject large amounts of arginine,
athletes in terms of recovery and healing, and which may cause a temporary rise in growth
thus glutamine is considered an indispensable hormone levels.
amino acid during stress. Branched-Chain Amino Acids (BCAA)
Glutamine supplements are currently available Branched-chain amino acids (BCAA) include
as L-glutamine and are in the form of individual leucine, isoleucine and valine. These amino
supplements or protein supplements. Usually, acids have been hypothesized to help in
supplements are taken several hours before or resistance-training by improving endurance
after food to prevent interaction with regular exercise performance. BCAAs are important
dietary amino acids. nitrogen sources for alanine, which is converted
Arginine to glucose as a fuel source. Importantly, BCAAs
Arginine is a conditionally essential amino compete with tryptophan for entry into the
acid and one of the most commonly used amino brain and can thus prevent fatigue. The central
acid supplements for sports training due to fatigue hypothesis suggests that an increase
its postulated stimulatory effects on human of serotonin in the brain impairs the function
growth hormone (HGH) production. Others of the central nervous system during bouts
hypothesize that arginine stimulates the release of prolonged exercise and can then hinder
of HGH by increasing upstream hormones that sports performance. This increase in serotonin
act on this endocrine pathway. It is well-known synthesis is ultimately due to the elevated levels
270
of tryptophan, which is a precursor of serotonin. with caffeine can cause insomnia, restlessness,
Thus, hindering levels of tryptophan by BCAA is anxiety, high blood pressure and headaches.
thought to prevent the onset of fatigue. Caffeine is believed to be useful in improving
Caffeine endurance by increasing effective fat
Caffeine is the most widely consumed metabolism during exercise. It may also work
psychoactive drug used worldwide. Caffeine is by enhancing exercise capacity and recovery
a central nervous system stimulant and often from fatigue if exhaustion normally ensues
increases both adrenaline and noradrenaline after 30-60 minutes, since this is when there is
concentration after ingestion. The main sources a peak plasma concentration. This is especially
of caffeine are coffee, tea and cocoa products. true for exercises like cycling and swimming.
Additionally, it is contained in many energy Caffeine can improve aerobic endurance during
drinks. short-term, extreme exercise, increase fat
The benefits of using caffeine as an ergogenic oxidation and decrease the perception of pain,
aid is that it is inexpensive and has little to no all which can allow for more intensity in athletic
adverse health effects. A high rate of tolerance performance. Recently, caffeine has been shown
is associated with caffeine usage, which then to decrease plasma potassium levels. This is
leads to reduced dose effects. More caffeine is important because during exercise, potassium
then needed to get the same benefits as before. is transported out of muscle cells, leading
At high doses, caffeine can be used as a diuretic, to a decrease in muscular force output. For
which also increases the chance supplementation, caffeine can

The benefits of using caffeine
for dehydration. One should as an ergogenic aid is that it is also be obtained from herbal
never increase the consumption inexpensive and has little to no sources with high content, like
adverse health effects.
of caffeine before exercise for this guarana and kola nut.
reason and because caffeine can increase heart Conjugated Linoleic Acid (CLA)
rate. But if caffeine is consumed normally, the Conjugated linoleic acid (CLA) is the collective
same amount can be ingested since adaptation name given to a group of linoleic acids, the
of caffeine occurs. If heart measurements are parent compound of the omega-6 group of
being taken as a part of training, one should not unsaturated fatty acids. An isomer of linoleic
consume caffeine or other stimulants for at least acid, CLA is an essential fatty acid and must be
30 minutes prior to exercise. Overstimulation provided in consumed food. It is mostly found
271
in corn, sunflower, peanut and soy oils. The CLA stored like traditional fats but are directly used
used for supplements are from these oils but for energy through oxidation by the liver or in
can also be found naturally in dairy products peripheral tissue. Additionally, MCT oils are
and beef. metabolized more as a carbohydrate than as a
CLA is primarily marketed as a weight-loss fat, but have a higher energy density.
and muscle-building supplement. However, Supplements with MCT oils are used as
there is no real clinical evidence to support muscle builders and as an energy source.
CLA supplementation. Because of these effects, MCT oils are used to increase total intake of
CLA is thought to prevent muscle wasting and calories in athletes who need high energy for
improves body composition. The sports performance. They are

MCT oils are synthetically
typical recommended dosage is 3-6 derived dietary fats processed thought to improve athletic
from coconut oil.
g/day. performance because these oils
Medium Chain Triglycerides (MCT Oil) can enter the mitochondria without carnitine,
Medium chain triglycerides or MCT oils, are a unlike other fats and they also help conserve
class of lipids made from saturated fatty acids muscle stores of carbohydrates. Improvement in
6-12 carbons in length. MCT oils are synthetically muscular development and increases in the loss
derived dietary fats processed from coconut oil. of body fat from enhanced metabolic rate are
These oils were initially formulated for people other benefits of MCT oils. Also hypothetically
who were unable to digest regular fat since they MCT can aid in recovery from injury by adding
are less viscous. Instead of long carbon chains more calories that spare lean muscle without
like regular fats, MCT oils have much shorter becoming body fat if excess fat is ingested. If
carbon chains and can therefore be digested, taken, doses should be monitored because large
transported and metabolized quicker and amounts may be associated with gastrointestinal
easier. Medium chain triglycerides are also not disturbances like intestinal cramping.
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Nutritional Programming with the ACTION Personal Training System
The Nutritional Program component of the ACTION PTS will allow you to create completely customized
nutritional systems for your clients. All programs are based on the client’s lean mass values (from
the Body Composition) and nutritional preferences. The system can be used as a simple tracking tool
where clients can record the foods they eat and receive feedback on their nutritional content, or can
be used as a full functional program including the ability to have meals suggested that will meet their
nutritional needs.
The client ALWAYS has complete control over their nutritional systems and may make any changes
they desire. This is done to ensure that the ACTION PTS falls within the scope of practice of a Personal
Trainer. There is no food or meal prescriptions, simply suggestions that your client may choose to
follow that will help guide them to a well balanced diet.
Setting Client Nutritional Preferences

Prior to building a nutritional program you may want to ensure that the client has set any nutritional
preferences they may have. The Nutritional Preferences area is located in the Main menu, under Goals
and Preferences. Clients can exclude food groups they prefer not to eat, or may even exclude specific
foods by entering the name of the food in the spaces provided. The system will then disregard any
foods or recipes that contain items from the food groups or individual foods that have been excluded.
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Prerequisites to Building a Nutritional Program
Prior to be able to use the ‘Suggested’ features of the nutritional system the ACTION PTS system must
have the Lean Mass value for the client as determined in the Body Composition. If you try to access the
Nutritional Program prior to completing the client’s Body Composition the system will default to the
‘Prerequisites’ page and indicate that the Body Composition must be completed prior to continuing.
The Lean Mass value is used to determine the client’s Basal Metabolic Rate which will allow for a
more accurate estimate of the client’s caloric needs.
Adding Custom Foods and Recipes

You can add an unlimited number of custom foods or recipes to the ACTION PTS system. In the Main
menu, under Nutritional Systems, in the Recipes section you will find the ‘Add Custom Recipes’ and
‘View or Add Custom Foods’ buttons.
Adding Custom Recipes
To add a Custom Recipe simply click on the ‘Add Custom Recipe’ button and you will be taken to the
custom recipe builder page where you can add the following information:
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• Recipe Name • Marinating Time (if applicable)
• Description and Preparation Instructions • What Meal Type the Recipe is Suitable for
• Number of Servings the Recipe Makes • Option to Add a Side Dish to the Recipe
• Preparation Time • Recipe Ingredients
• Cooking Time
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To add recipe ingredients, click on a blank field and start typing the name of the ingredient. The
system will automatically refine the search for the ingredient based on what you type. If you find
the ingredient in the list then click on the name of the ingredient and the system will add it to the
recipe. You can now adjust the Unit of Measure and Amount of the ingredient. If you do not find the
ingredient in the list you can add the ingredient as a Custom Food if you wish (see Add Custom Foods
below).
Once you have added all of the ingredients to the recipe you have several options:
• Save and Calculate — this will save the recipe and calculate the nutritional content based on the
ingredients you have added. You will remain on the Recipe Builder page
• Save and Add Another Recipe — will save the recipe and open a new blank recipe for you to create
• Save and Copy this Recipe — will save the current recipe and open a copy of the recipe that you
can then make changes to and save as a new recipe. This is helpful if you are adding recipes that
are similar or are the same but use different side dishes
• Return to Recipe List — will save the current recipe and take you back to the recipe search page
• Make this recipe available for all users — This option is available for Administrators and Trainers
ONLY and will add the current recipe to a master list that will be available for all users.
Add Custom Foods
You can add Custom Foods in two ways. On the
recipe builder page you can click the ‘Add Custom
Food if not found in list’ button, or from the
Recipes main page you can click the ‘Add Custom
Food’ button. Selecting either of these will take
you to the Custom Food builder (shown at right).
Here you can enter any nutritional info you have
for your Custom Food.
Building a Nutrition Program

There are multiple options for building a Nutritional
Program using the System. They range from a
basic ‘food log’ to a completely suggested week
customized completely to the individual user.
Pre-defined Weeks, Prep and Cook Times, and Max
Ingredients
Pre-defined weeks can be set up to allow you to
have clients only be able to select from limited
recipe or food choices. Once a pre-defined week
is set up, it will be available to be selected in the
drop down list.
Prep and cook time maximums may be selected
from the drop down list and the system will then
limited recipes suggestions to those parameters
that fall within the selected range. For example,
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if a user were to select a max prep time of 10 minutes, the system will not suggest any recipes with
a prep time over 10 minutes.
Max ingredients works very similar to the prep and cook time limits. The user can select the maximum
number of ingredients they want their suggested recipes to contain and the system will ignore any
recipes with a higher number of ingredients.
Suggested Programs
There are 2 types of Suggested Weeks:
Suggest My Favorites will only use recipes that the user has set as a ‘Favorite’ to build their week’s
nutritional program. There must be a minimum of 5 favorite recipes saved for each meal type for
the ‘Suggest My Favorites’ option to appear. The system will aim to balance calories, macronutrients,
micronutrients, and food guidelines (e.g. MyPlate) as closely as possible through an advanced
algorithm.
Suggest My Week will use all system and custom recipes that are not excluded based on client
preferences (see Setting Client Nutritional Preferences above) to build a suggested weeks program.
The system will aim to balance calories, macronutrients, micronutrients, and food guidelines (e.g.
MyPlate) as closely as possible through an advanced algorithm.
Using a Previous Week
The Use a Previous Week option will become available as soon as at least one week has been
suggested for a client. The using a previous week option will allow a client to view and edit any
previously suggested weekly nutritional program. Any recipes ‘unchecked’ in the previous week
viewer will automatically be re-suggested by the system.
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Choosing Recipes Manually
The ‘Choose Recipes Manually option will create a blank template week that has no foods or recipes
suggested. Users can then either manually add foods or recipes using the ‘Add a Food’ or ‘Choose a
Recipe’ options for each meal, or they can have suggestions made one meal at a time by using the
‘Favorite Recipes’ or ‘Suggest Recipes’ options. These 2 options will display a list of applicable recipes
that may be used for that meal that fall within 10% of their caloric goals for that meal.
Using the Nutrition Program

Basic Information
At the top of the ‘Nutritional Program’ page you will find the basic
information for using the program. The day highlighted in red is the
currently selected day. Any other day of the week may be chosen by
simply clicking on the appropriate button. In addition previous weeks
may be viewed or future weeks planned by using the drop down and
selecting a date in the past or future.
The left side of the page contains to applicable ‘food guide’ information
for the country or residence. The options are the ‘Canada Food Guide’ for
Canadian residents, the Australian Food Pyramid’ for Australian residents,
and the MyPlate for the United States and all other countries. The food
guide list the goal and target values for the applicable system.
The center of the page contains the Caloric Goals for the currently selected day. This includes the BMI/
BMR (Body’s Basic Requirement) calories, the number of calories required for planned cardiovascular
training on that day (Cardiovascular Training), the average number of calories used for resistance
training throughout the current week (Resistance Training), the caloric deficit required to meet the
weight loss goals (Weight Loss Deficit), and the target number of calories for the selected day (Target)
The right side of the page contain the Micro-Nutrient information for the currently selected day.
This includes the target and actual values for calories, fats, carbs, and protein. The actual values are
updated every time a change is made to the program itself (e.g. switching a recipe)
Listed vertically down the left side of the page is the ideal meal time for each meal and snack of the
day and amount of water that should be consumed throughout the day.
At the bottom of the page there are options to:
‘Re-Suggest My Week’ which will delete the currently planned week and allow the option of rebuilding
the weekly nutritional program using the options outlined above in the ‘Suggested Programs’ section.
‘Copy Day’ which will copy the currently selected days recipes and foods to any day within a 2 week
period.
Once a nutritional program is built there are many different options available to further customize or
change the program. These features are outlined in the sections below:
Basic Features
To get more detailed information about any food or recipe simply click on the name of the food or
recipe and the system will open a separate window with detailed information.
There are buttons on each meal of the day to perform the following tasks:
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279
‘Favorite Recipes’ will display a list of suggested recipes that are categorized as favorite recipes (see
Favorite Recipes below) and are within 10% of the nutritional goals for that meal. Any recipe may be
selected and added to the current meal by clicking on the green check mark.
‘Suggest Recipes’ will display a list of suggested recipes that are within 10% of the nutritional goals for
that meal. The suggested recipes will be from all system and custom recipes, excluding and recipes
that do not fall into the clients Nutritional Preferences (see above). Any recipe may be selected and
added to the current meal by clicking on the green check mark.
‘Choose a Recipe’ will allow for manually selecting any system or custom recipe to be added to the
current meal.
‘Add a Food’ will allow for an individual food to be added to the current meal. This may be a system
or custom food or a custom food may be created.
Clicking the ‘Remove’ icon on the far right of the page next to each recipe or food will remove that
food or recipes from the meal.
With any of the above options, all calorie, and macronutrient and micronutrient total are automatically
added to the meal total and the ‘Actual’ value at the top of the page.
Advanced Features
Some of the more advanced features available for each meal are:
The icon in the ‘Fav’ column may be clicked to automatically add a meal to the favorites list. This
will turn the icon green. Clicking the icon a second time will add the recipes to the excluded list and
the icon will turn red. Clicking it for a third time will remove the recipe from both the favorite and
excluded lists and the icon will return to the default grey color.
Clicking the ‘Edit’ icon will open a copy of any system recipe where changes can be made to the recipe
and it can then be re-named and saved as a custom recipe. This works well for making small changes
to system recipes such as substituting one or two foods.
Clicking the ‘Lock’ icon will lock the currently selected recipe in for the selected meal until it is
unlocked. This is particularly effective for clients who may eat the same meal every day. Regardless
of how a nutritional week is built in the future, any locked recipe will be suggested for the selected
meal until the recipe is unlocked.
Searching Recipes
The ‘Recipes’ link (Main: Nutritional Systems) may be used to add new custom foods or recipes and
to search for existing recipes. A search may be done using any combination of the following fields:
Search for — type in all or part of any food or recipe to refine the search results
Meal Type — searches may be conducted for recipes only of a certain meal type
Include Recipe Types — System recipes (default recipes provided in the system), Custom recipes
(recipes that have been added by the user), or All recipes
Number of Results — the smaller the number of results to display the faster the search will load
Max Prep Time (min) — The maximum preparation time, in minutes, that the recipe should be
Max Cook Time (min) — The maximum cooking time, in minutes, that the recipes should be
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Sort Results By — Results may be sorted by name, or various calorie or macronutrient information
Favorite Recipes
Favorite recipes will be suggested based on nutritional preferences and the ease of preparation. When
visiting this page the system will display suggested favorites with grey checkmark icons. Clicking on
the grey icons will lock the recipe in as a favorite. (It will turn green)
At any time you can remove a recipe from your favorites list by clicking on the green icon ( ). A
red icon ( ) means that the recipes will be excluded from any future suggestions, and a grey icon
( ) means that the recipe can still be suggested but is no longer in your favorites.
You can also add recipes to your favorites list from your ‘Nutritional Program’ and the ‘Recipes’ area by
simply clicking on the checkmark icon until it turns green.
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Cookbooks and Grocery Lists
Cookbook
The Cookbook link will open a separate window with a
printable version of the current day’s recipes. At the top of
the page a different day of the week may be selected for
printing or the drop down may be used to select different
weeks.
By default, all of the calorie, macronutrient and food guide
information will be displayed and printed. The ‘card view’
checkbox may be selected to remove all of the nutritional
information and only display and print the basic recipe information.
To get more detailed information about any individual food, click on the food name and the system
will open a separate window with detailed micronutrient information about that food item.
The ‘Print’ button may be used to print the cookbook. Some browsers block this type of control button
from working, in which case the page may be printed by selecting File: Print from the main browser
bar.
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Grocery List
The Grocery List link will open a separate window with a printable grocery list. The default is to display
all foods for every recipe for the entire week. The checkboxes at the top of the page may be used to
select specific days of the week to print and the drop down may be used to select a different week.
Foods are categorized into groups that are typically found together in the grocery store.
The ‘Print’ button may be used to print the grocery list. Some browsers block this type of control
button from working, in which case the page may be printed by selecting File: Print from the main
browser bar.
Micronutrient Analysis
The Micro Nutrient Analysis link will open a separate window with a detailed micronutrient analysis.
This includes a full Vitamin, Mineral and Essential Amino Acid list, as well as some other key nutrients.
The list contains the Recommended Intake (where applicable), the actual Intake, and the Percentage
of Recommended intake achieved (where applicable).
The default analysis is for the entire current week’s foods and recipes but any individual day may be
selected by clicking on the buttons at the top of the page.
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To see a breakdown of the source of any individual micronutrients the name of the micronutrient may
be clicked on and a separate window will open with a complete list of all foods and recipes for the
selected day(s) and the amount of the selected micronutrient contained within these foods.
Nutritional Tracking
Nutritional Tracking is part of the Progress Tracking section in the Main Menu. The Nutritional Tracking
will provide graphs of daily and cumulative totals for both target and actual values for calories, fats,
carbs, and protein. These graphs serve to show trends in nutritional habits.
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the cells, protecting nerve fibers, providing the
Summary
building blocks for hormones and supplying a
In summary, the majority of a person’s
concentrated source of energy. About 25-30%
calories should come from carbohydrates. Your
of a healthy person’s daily calories should come
client should be aware that the best sources of
from fat. Following a fat-restricted diet (less
carbohydrates are fruits and vegetables, which
than 10% of daily calories) can lead to problems
also contain vitamins and minerals. Simple
with the body’s metabolic functioning. Too much
sugars, such as table sugar or high fructose corn
fat in the diet (more than 35% of daily calories)
syrup, should be avoided. Clients should eat a
can also cause problems, such as increasing the
high-carbohydrate meal with a good variety
chances of obesity and heart disease. Lipids
of complex carbohydrates approximately 3
are composed of long acid-chain molecules
hours prior to a workout and then consume
bonded together to form different kinds of fats.
an additional small snack of crackers right
Unsaturated fats, like olive oil, are generally
before the workout. A follow-up meal higher
better for the body’s health. Saturated fats, like
in protein after the workout is important to
butter, should be limited because of their links
provide the necessary amino acids to help
with heart disease. Some fats, like omega-3
repair and refresh the muscles. The glycemic
fatty acids found in oily fish, can help the body
index is a good reference for those concerned
function more optimally and reduce cholesterol
with eating too many carbohydrates. Personal
and the chances of heart disease. Other fats,
trainers should never recommend that clients
like partially-hydrogenated oils or trans fats,
omit carbohydrates from their diet, not even
are detrimental to health because they raise
for a couple of weeks. The muscles rely on
cholesterol levels. Depending on their current
carbohydrates to get the necessary glucose as
health status and their weight loss goals, people
their fuel. Moderation is also good advice to give
have different fat requirements. However, too
a client. Candy, ice cream or beer/wine/liquor is
little or too much fat—i.e., any extreme—is not
okay, as long as it is not the bulk of their calories
advisable for most people.
and not consumed on a daily basis.
The proper addition of protein to the diet
Fats are also an important part of the daily
is yet another aspect of good nutrition.
diet. They serve many functions in the body,
Ingestion of protein provides the body with
including allowing vitamins to move throughout
the amino acids it needs to perform several
285
bodily functions. Lean meats, eggs, nuts, dairy keeps people going, what supplies the energy
products and legumes are all good sources of for everything they do. Good nutrition will
protein and should be incorporated into every maintain bodily functions, such as breathing,
meal. However, clients should be informed that and internal processes, such as maintaining
if too much protein is ingested, it will not be heart and brain function, all of which require
stored as protein and instead will be stored as energy. Just to stay alive, the body is equipped
fat. This fact is often unknown to clients who are with a certain amount of calories it needs and
attempting to follow the popular high-protein, this is dictated by hormones released from the
low-carbohydrate diets. thyroid gland. Maintaining proper nutrition is
Hydration is a crucial aspect of nutrition and important in all aspects of good health. A good
must be maintained during workouts by the balance between carbohydrates, protein and
intake of plenty of water. Sports drinks are fat will provide clients with the best possible
usually an unnecessary source of calories and nutrition, and trainers that learn about the most
sugar, which is fine for athletes training for popular supplements can help advise clients
hours vigorously but may inhibit weight loss in when certain elements are missing in their
clients trying to lose weight. If sports drinks are clients’ diets.
preferred for hydrating clients that want to lose

Review Questions
weight, sugar free ones are the best option.
1. The glycemic index is a ranking of
When clients feel their diet is not providing
___________________ based on their simplicity.
enough nutrients, they may turn to supplements.
2. Dietary guidelines currently recommend
While it is always best to attempt to get
20-30% of your daily calories come from
nutrition from food, it is sometimes difficult
carbohydrates. True or False? ______________
and supplements can help fill in the gaps. There
3. Fat is necessary for the body in order to:
are several types of supplements available and
a) Help us feel satiated
great care should be taken to discuss the risks
b) Transport vitamins A and D
and benefits of the specific supplement a client
c) Protect nerve fibers
is considering.
d) Form hormones
Nutrition is very important for any active
e) All of the above
person. It is the body’s source of fuel—it is what
286
4. Fat is important as a bodily energy source c) Decrease the perception of pain
because: d) Allow for more intensity in athletic
a) It is converted more efficiently than performance
carbohydrates e) All of the above
b) It provides more than double the calories 10. When should you advise your clients to
per gram than other energy sources hydrate? ______________________________________
c) It can be eaten in unlimited quantities ________________________________________________
without excess storage

Answers
d) It is the body’s primary source of energy
1. Carbohydrates.
e) All of the above
2. False.
5. Eating hydrogenated fats can
3. e) All of the above.
___________________________________ LDL levels.
4. b) It provides more than double the calories
6. The current method to determine the
per gram than other energy sources.
amount of protein in food is referred to as
5. Increase.
the PDCAAS. True/False ____________________
6. True.
7. When there is an insufficient supply of
7. b) Amino acids.
carbohydrates available for energy, the body
8. False.
will instead use ______________________________
9. e) All of the above.
as its primary energy source.
10. Before, during and after exercise.
a) Sugar
b) Amino acids References

c) Creatine Bloomer RJ. The role of nutritional supplements
d) Fat in the prevention and treatment of resistance
e) All of the above exercise-induced skeletal muscle injury.
8. Creatine is an essential nutrient. True or Sports Medicine. 2007;37(6):519-32.
False?_________________________________________ Brosnan JT, Brosnan ME. Creatine: endogenous
9. Caffeine can: metabolite, dietary and therapeutic
a) Improve aerobic endurance during supplement. Annual Review in Nutrition.
short-term, extreme exercise 2007;27:241-61.
b) Increase fat oxidation
287
Graham TE. Caffeine, coffee and ephedrine: Montain SJ. Hydration recommendations for
impact on exercise performance and sport. Current Sports Medicine Reports.
metabolism. Canadian Journal of Applied 2008;7(4):187-92.
Physiology. 2001;26 Suppl:S103-19. Mozaffarian D, Ascherio A, Hu FB, Stampfer MJ,
Grunewald KK, Bailey RS. Commercially Willett WC, Siscovick DS, Rimm EB. Interplay
marketed supplements for bodybuilding between different polyunsaturated fatty
athletes. Sports Medicine. 1993;15(2):90- acids and risk of coronary heart disease in
103. men. Circulation. 2005;111:157-64.
Hoffman JR, Falvo MJ. Protein-Which is Paddon-Jones D, Borsheim E, Wolfe RR. Potential
Best? Journal of Sports Science Medicine. ergogenic effects of arginine and creatine
2004;3:118-30. supplementation. Journal of Nutrition.
Hu FB, Willett WC. Optimal Diets for Prevention 2004;134(10 Suppl):2888S-94S.
of Coronary Heart Disease. JAMA. Persky AM, Rawson ES. Safety of creatine
2002;288:2569-78. supplementation. Subcellular Biochemistry.
Jenkinson DM, Harbert AJ. Supplements 2007;46:275-89.
and sports. American Family Physician. Phillips GC. Glutamine: the nonessential amino
2008;78(9):1039-46. acid for performance enhancement. Current
Juhn M. Popular sports supplements Sports Medicine Reports. 2007;6(4):265-68.
and ergogenic aids. Sports Medicine. Schaafsma G. The protein digestibility-corrected
2003;33(12):921-39. amino acid score. Journal of Nutrition.
Lattavo A, Kopperud A, Rogers PD. Creatine and 2000;130(7):1865S-67S.
other supplements. Pediatric Clinics of North Tseng YH, Kokkotou E, Schulz TJ, Huang TL,
America. 2007;54(4):735-60. Winnay JN, Taniguchi CM, Tran TT, Suzuki
Lichtenstein AH, Kennedy E, Barrier P, Danford R, Espinoza DO, Yamamoto Y, Ahrens MJ,
D, Ernst ND, Grundy SM, Leveille GA, Van Dudley AT, Norris AW, Kulkarni RN, Kahn
Horn L, Williams CL, Booth SL. Dietary fat CR. New role of bone morphogenetic
consumption and health. Nutrition Reviews. protein 7 in brown adipogenesis and energy
1998;56(5 Pt 2):S3-19. expenditure. Nature. 2008;454:1000-04.
288
Yamamoto LM, Judelson DA, Farrell MJ, Lee EC,
Armstrong LE, Casa DJ, Kraemer WJ, Volek
JS, Maresh CM. Effects of hydration state and
resistance exercise on markers of muscle
damage. Journal of Strength and Conditioning
Research. 2008;22(5):1387-93.
289
Chapter 10: Legal/Business
Topics Covered
Legal Issues
Slip and Fall
Equipment Usage
Supplements
Sexual Harassment
Personal Trainer Qualifications
Emergency Response
Confidentiality
Risk Management Expanding Your Business
Proper Education Organizing Your Business
Appropriate Training for Each Client The Business Plan
Limiting Liability Through Avoidance, The Budget
Retention, Reduction and Transfer Establishing Policies
Proper Conduct Clients
Proper Training Area Advertisement
Documentation Profits
Selling Your Services
Marketing Your Business
Determining the Cost of Your Service
Retaining Clients
READ—Rapport, Empathy, Assessment
and Development
Customer Service
Key Points for Success
Referrals
Other Incentives
Non-Compete Clauses
• Negligence—Failure to comply with
A
Legal Issues
known standards
s rewarding as it can be to work as
• Waiver—A document signed by clients
a personal trainer and positively
that they are knowingly participating in
impact a client’s health and
activities that may cause them an injury
fitness, there are some legal issues
and that they are waiving legal action
to be considered. Personal
should injury occur
trainers must understand
• Risk Management—Processes in place to
their role when it comes to
ensure the least amount of harm will come
putting clients at risk for injury.
to clients. Essentially being proactive by
Trainers have to do everything
following safety procedures, properly
in their power to ensure their
informing clients of risk and having all
clients’ safety through proper
proper documentation completed prior
technique and proper spotting,
to any activities
by not overexerting them and
• Tort Law—Regulates civil wrong-doing
by ensuring that the workout environment is
Clients have a right to a safe environment
safe. There are some legal terminologies trainer
whether their trainer is working for a fitness
should know and below is a list and a brief detail
facility or independently.
of their definition.
Ensuring the client‘s safety
• Contract Law—Regulates laws
is the trainer’s duty. Hazards
that govern individuals who enter
must be taken care of or proper
into a contract
warning must be given. Do not
• Duty of Care—The responsibility
allow a client to workout with
one has to protect another from
faulty equipment. Personal
harm, especially in a service-
trainers should have a plan
oriented client relationship
as to what workout areas
• Informed Consent—Ensuring
clients are going to be using,
clients understand they are voluntarily
so it is wise to make a routine of checking that
entering into the activities set forth by
equipment prior to clients’ sessions. Make sure
their trainers
292
the area being used for a workout is • Slip and Fall
clean of any liquids or hazards. • Equipment Usage
In a fitness facility environment • Supplements
there are many potential hazards • Sexual Harassment
which can harm a client. Make sure • Proper Qualifications
there are no water bottles lying • Emergency Response
around that could be a potential tripping hazard. • Client Confidentiality
Any fluid not cleaned up can also cause slippage

Slip and Fall
of hands or a slip and fall. Towels left behind can
Slipping and falling
also lead to accidental injury. Both the trainer
that led to injury
and the client must be cautious of bodily fluids—
was the number
left behind towels can be a source of bacteria or
one complaint of
infectious disease. If possible, sanitize
clients against their
equipment before a client uses it.
personal trainer. As stated previously, ensuring
There are so many potential risks
a safe environment is key to clients. This can be
that a client can encounter under a
accomplished by being diligent about routines.
trainer’s supervision that they cannot
When first starting out, it is easy to develop
all be eliminated; however, personal
habits, so trainer must try to make sure the
trainers that are aware of their duties
habits developed are good ones. Make it a habit
to ensure clients’ safety will quickly recognize
to check a client‘s workout environment prior to
an unsafe situation. Last and most importantly,
a session in order to decrease the chance that the
trainer should use common sense.
client may have a slip and fall incident. Obviously
Every year clients make legal claims against
a fitness facility is very dynamic, but if a trainer
personal trainers. This section will briefly
has checked a client‘s areas prior to use, any out
discuss some of these and how risk management
of place items should be very apparent as the
comes into play when trying to avoid these
workout progresses from station to station.
situations and, most importantly, avoid injury
Personal trainers need to become very
to clients. Below is the list of the most common
observant as part of their risk management
claims against personal trainers, as compiled by
technique. Review a client’s attire and if, for
insurance companies:
293
example, the shoes report documents and trainer notes will help to
being worn do put as much detail into the report as possible.
not fit properly or Another recommendation is that trainers log
are inappropriate their precheck of equipment with the date, time
for working out, and condition of the specific piece of equipment
the trainer should checked. This may seem time consuming
bring it to the and tedious, but it is better to have too much
client’s attention. Clothing that is restrictive or information than not enough.
too loose can also cause a slip and fall, so once
again, trainers need to make the client aware.
If a trainer deems a situation or environment
unsafe, the trainer should not continue because
in the end, the trainer will be held liable by the
employer at the least and also possibly by the
client. Clients should be advised of requirements Equipment Usage

from day one of training: proper shoes and Improper use of equipment is the second
attire are a must. Clients need to be informed most reported injury claim against personal
that if compliance is not met, their trainers. As such, personal trainers
session cannot proceed for their need to ensure clients know how to
own safety. use equipment before they begin
Another good habit for trainers a designated activity. Many times
to adopt is documenting a slip clients will say they know how
and fall immediately after the to use a particular machine even
incident and writing down the though they have never used it.
circumstances. As time passes and Fitness equipment seems intuitive
the story is retold, information but, in reality, some of it is quite
may be mistakenly added or taken complicated to set up, and proper
out. If trainers write details down immediately, technique is a must. Instead of asking clients if
there is a better chance at resolving the issue they know how to use the equipment, trainers
quickly. Most facilities have their own incident should take the initiative to just show them.
294
This will keep clients from stating incorrectly that being stated, some personal trainers sell
that they know how and give trainers the supplements or the company or fitness facility
opportunity to demonstrate both proper they work for sells them. This aspect of
setup and use of the equipment. personal training may be part of a job
Trainers need to periodically check and description. This is where education
document the equipment maintenance regarding what is being sold becomes of
record. They may want to inform clients the utmost importance.
of this documentation if they feel it may There have been liability cases where
be important. There are many pieces of personal trainers and the facilities
equipment that trainer and clients will use and they work for have been held accountable for
all situations cannot be covered, but the two selling supplements containing ephedra to a
main safety rules for equipment client. In one case, the client
usage are proper set up and had hypertension and, since
usage. It is also essential that all ephedra raises blood pressure
working equipment, whether by increasing heart rate, the
it be resistance bands or high client died. As stated throughout
tech machines, be in good this literature, it is absolutely
condition. All equipment should essential that trainers take a
be inspected for safety. detailed initial assessment that
includes any chronic illnesses a client has and

Supplements
what medications are being taken. Trainers need
Supplement usage can be a sensitive subject
to be involved and take own notes versus simply
for some people and will most likely depend on
giving clients questionnaires to fill out. Also,
the trainer’s own personal
trainers should not recommend supplements
beliefs, as there is no law
that they would not take themselves or that they
governing what a personal
do not know what the active ingredients are and
trainer can recommend or
what they do.
sell to a client in terms of supplementation. As a
There are also illegal substances that are
general rule, it is not recommended that trainers
available to clients, such as human growth
sell or advise clients on any supplement. With
hormone or anabolic steroids. Trainers may
295
get approached with inquiries about how to made to insurance companies against personal
obtain such items. We cannot stress enough trainers. Sexual harassment comes in all
for trainers not to get involved in this area forms—male to female, male to male or female
of supplementation, as it is illegal and highly to female.
dangerous. Personal trainers should advocate a Some people are just
healthy road to fitness and stress the importance not comfortable being
of hard work. Becoming touched by an unfamiliar
fit is not an overnight person. A good initial
process and a pill will not assessment can address
get a client there. The fact this; so trainers should
that a client has sought out a personal trainer not be afraid to ask this question. They should
means that client is ready to make the necessary inform clients that, at times, touching may
changes in daily life. These are the aspects be necessary and ask them how comfortable
that trainers should stress and they should do they are with this. Another aspect of sexual
everything in their power to deter someone harassment can develop when a trainer and
from trying to obtain results through the use of client develop a personal relationship. As
illegal substances. Again documentation is key. stated before, a personal trainer is sometimes
Personal trainers should report any attempt in an intimate situation with a client and if
at seeking these items to a supervisor; even if a relationship develops, it is unacceptable,
nothing comes of it, the trainer will be absolved inappropriate and unprofessional. Also, there
of any wrongdoing. may be certain backlashes once the relationship
ends. It is best to end the professional

Sexual Harassment
relationship if a personal relationship
Another sensitive subject is sexual
develops with a client. Most fitness
harassment. Personal trainers are in
facilities will not tolerate this behavior.
intimate situations with clients. Some
Sexual harassment is a claim that
clients will understand this and others
often arises because one person’s idea
may misconstrue or be uncomfortable
of what is acceptable is not the same
with the amount of touching that may
as another person’s. It is hard to prove
occur. This was the third highest claim
and usually rests on the credibility of
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the persons involved. The best way to avoid a particular fitness facility staffs improperly
any incidence that can be perceived as sexual certified personal trainers or that the personal
harassment is to not touch the client. Trainers trainers do not hold the credentials advertised.
can demonstrate to clients how particular Importantly, trainers should not overstate
maneuvers should be conducted qualifications and should keep certifications
by positioning a “barrier” handy, as it is the right of any client who may ask
between the client and the to see credentials. People pay for a service from
trainer; i.e., a trainer could trainers or providers on their behalf and they
“touch” the client with an object, expect to get what they pay for. If a trainer is
such as a ball. Trainer should not certified and the facility is claiming that the
also avoid private settings where the situation trainer is, it is up to the trainer to set the record
has only the two parties as witnesses. When straight because this is misrepresentation on
doing body fat measurements, where touching behalf of both the facility and the trainer, and it
is required and expected, trainers should have is grounds for legal action should a client wish
another personal trainer present and document to take it that far.
who that person is in case there is any question Another area regarding personal trainer
later. Because sexual harassment is in the eyes qualifications is claiming to work with a specific
of the person being “harassed,” the best thing to demographic such as elderly people. If a
do is to leave no question, which can be done facility advertises this service and the personal
by avoiding touching. If spotting or touching is trainer assigned to these clients does not have
required, trainers can use a prop (e.g., a ball), to the appropriate certifications to serve this
avoid direct contact. population, the liability is put on the personal
trainer. If a trainer wants to work with a special

Personal Trainer Qualifications
needs group, such as the elderly
Personal trainer qualifications
or those afflicted with arthritis,
deal more with a fitness facility
the trainer needs to get the
than individual personal trainers.
proper training needed. The
Those reading this literature are
bottom line is for trainers not to
on their way to becoming certified
overstate qualifications or allow
personal trainers. Some clients will claim that
297
their employers to overstate their credentials in the position of having to explain to a client
and to obtain any additional training required and/or employer why certifications are not
to serve special populations. up to date. Documentation is also important
in terms of the trainer’s and facility‘s liability

Emergency Response
in an emergency. Proper reporting of the fact
A personal trainer will be faced
is crucial while leaving out any
with numerous situations that
biased opinions of the incident. Most
will require emergency responses.
facilities have their own internal
This may be directly, with their
form for incident reports, so trainers
own client, or indirectly, in their
need to familiarize themselves with
vicinity. A certified personal trainer
them. Independent trainers can
is required to be CPR compliant and
generate their own forms to keep on
some certifications require first aid training
hand in case something happens. During the
and automated external defibrillator training as
course of a personal training career, it is likely
well. If a trainer’s certification does not require
that the trainer is going to be faced with an
the latter two as part of the requirements, it
emergency response situation, and that trainer
is recommended that the trainer obtain this
may be required to render life saving aid to an
training anyway. Any facility the trainer works
individual.
for should have a standard operating procedure
if an emergency response situation arises Confidentiality

and the trainer should be familiar with this Confidentiality is one of the most important
procedure. CPR, first aid and AED certifications aspects of personal training. A client is sharing
must be renewed and trainer should keep track very personal information with a trainer at any
of when their certifications given time. It is up to the trainer
expire so they can keep them up to maintain professionalism
to date. and not discuss or gossip about
These are also certifications any information that is given in
that a client has a right to ask a professional setting. A client
about and see upon request. may be hesitant to disclose
A trainer does not want to be details about a condition, which
298
can hinder progress or cause injury. It is not when some mishap occurs. Despite taking as
necessary, but a trainer may want to become many precautions as possible and following all
HIPAA compliant. HIPAA (Health Insurance the rules, accidents will happen. Trainers are
Portability & Accountability Act) is a 2003 law in a business of serving people. The fact that
passed by Congress which states that people will get hurt and people will
health care professionals are not be unsatisfied is unavoidable. What
allowed to release personal health steps can personal trainers take or
information of clients to third parties. what risk management can be put
While a trainer is not classified as a into place that can protect them,
health care professional, it is wise to let a client their job and their certification when something
know that the trainer understands and abides bad happens? Although this is not an enjoyable
by HIPAA. A client might then be more at ease topic, it is important that a personal trainer
in disclosing any ailments or medications that understands how to minimize liability.
may affect training, which will help the trainer Risk can be managed through:
tailor a more effective workout. A good initial • Proper Education
assessment should include a confidentiality • Appropriate Training for Each Client
agreement. • Limiting Liability Through Avoidance,
Retention, Reduction and Transfer

Risk Management
• Proper Conduct
Risk management simply means the avoidance
• Proper Training Area
of liability in the event that something goes
• Documentation
wrong. There are certain steps a personal trainer
can follow to reduce the chances of liability Proper Education

Becoming a personal trainer only requires
completing the certification process. If
individuals are serious about personal training,
they will strive to obtain a higher degree in
some sort of exercise physiology area. The more
education a trainer has, the less likely that trainer
will make avoidable mistakes. Common sense
299
indicates that diet and exercise workout to the client. Knowing
will gain fitness, so what is a clients and their needs will
personal trainer bringing to greatly reduce their chances of
the table? The more education injury and therefore will limit
a personal trainer has, the less the trainer’s liability. If a client
likely any highly educated client has back problems, the trainer
is to question actions. A good understanding of should avoid any exercises that could further
anatomy and physiology is extremely important. exacerbate the problem. Remember, not every
What are common injuries? Most people know problem is going to be physical. Some people
tearing the anterior cruciate ligament (ACL) have physiological or chronic illnesses, such as
is not good, but a good trainer knows where it high blood pressure or heart conditions. Again,
is located, what movements could result in its it is a personal trainer’s job to know this, and
injury and what tests are done to confirm any the trainer cannot make a client with heart
injury. Most clients will not have a clue about problems run miles at a time. The personal
anatomy and physiology, but they expect that trainer should make sure any client who is under
their personal trainer will. A wise move for a the care of a physician for any condition has a
trainer is to invest in a good anatomy book and signed release form from that doctor stating it is
study basic anatomical structure and typical okay to participate in a physical fitness routine.
sports injuries. The bottom line is, take the time to personalize
clients’ workouts to meet their needs. Trainers

Appropriate Training for Each
should not allow clients to do exercises that will
Client
exacerbate any injury. Clients expect personal
Every client a personal trainer will have will
trainers to remember things, so it may be a good
be different, so the trainer should tailor the
idea to review a new client’s information prior
to a session until the trainer becomes familiar
with the history. This practice will help the
trainer to avoid making “dumb” mistakes that
may lead to injury.
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Retention
Limiting Liability through
Retention of clients is great way to avoid
Avoidance, Retention, Reduction
liability because there is a sense of loyalty felt
and Transfer
by clients they have developed a good
Limiting liability is not meant to teach
professional relationship with their
tricks to avoid any wrong doing. It is
trainers. Clients are less likely to
meant to increase client safety
pursue any action if trainers
while reducing trainers’ risks
have retained them for an
and protecting their job and
extended period of time.
certifications. Certifications
Reduction
are easy to initially obtain but are
Within any profession, guidelines
usually difficult to reinstate, so personal
are constantly changing and some are
trainers want to protect their certifications
mandated while others are not. Trainers are
as much as possible. Liability can be limited by
likely to be aware of some mandates, but they
following four steps:
should take the responsibility to keep up with
• Avoidance
all of them. Familiarizing oneself with annual
• Retention
changes will greatly reduce liability, especially
• Reduction
when changes affect more of the legal aspect of
• Transfer
personal training versus the practical aspect.
Avoidance
Transfer
Avoidance simply means to avoid any
The most recommended way to transfer legal
dangerous action that will lead to a raised
liability is to obtain liability insurance. This
risk for injury. Undoubtedly, clients want to
type of insurance requires a fee, which provides
be challenged and personal trainers want to
trainers with services, just as with health or
provide this, but not at any cost. For example,
car insurance. Some of these services include
maybe a client prefers outdoor activities versus
legal representation and any fines set forth
a gym setting. While this is fine, a trainer should
by court proceedings. While annual costs will
not take a client cycling or running on busy
never exceed the annual liability, it is well worth
streets. Instead, the choice should be a park or
the cost should an event happen that requires
designated path where there is less likelihood
paying a large amount of money if found liable.
injury.
301
Just as with any insurance, what goes in is not make sure the environment is appropriate.
usually what comes back in return, but it is Places like parks are an appropriate setting.
peace of mind and the assurance of coverage for Trainers do not want to take clients to a place
any mishap that may occur. where they will feel uncomfortable. Trainers
should use good judgment and common sense,

Proper Conduct
and they should also be cautious of settings
Behaving in a professional manner,
that are too intimate
especially in a customer service field
or private. A fitness
like personal training, is a must.
facility is actually the
Having a crude sense of humor or
best, most appropriate
making inappropriate jokes can lead
place to train. Should a
to unwanted outcomes even though no
client request another
harm is meant. The best practice of risk
place, the trainer should use good judgment
management is simply not to do it. Remember,
when agreeing, which will reduce liability for
sexual harassment is on a continuum, so what a
any wrongdoing. Some employers will not allow
trainer may deem appropriate may not be in the
off-site training, so the trainer needs to know
eyes of others and may leave the trainer having
the policy on this issue.
to offer an explanation in an awkward situation.
A trainer can also be on the receiving end, which Documentation

the trainer will want to report and document and No matter what the occurrence, proper
potentially end services with that individual. documentation can greatly assist the trainer if
Most importantly, acting professionally can a client takes legal
greatly reduce the risk of any reprimand. action. In the case of
an injury, if the trainer

Proper Training Area
properly annotated
As discussed earlier, a safe training area is the
that the equipment or the area was checked and
personal trainer’s responsibility and checking
can show documentation of that check, as well
areas prior to training will decrease incidences
as proving a history of this practice, the trainer
of injury. Also, if the trainer and client are
is at much less risk. Most personal trainers will
training in a non-traditional area, such as those
not take the time to check an area, let alone
not located in a fitness facility, the trainer must
302
document their check, but trainers should make by forming an introductory
it a habit from day one. They should keep a small packet for clients filled with
notebook with the date, time and client number. needed information. Creating
It is wise to never use names when writing an identity can help a trainer
informal documentation. When trainers have get noticed at work or can help
to fill out incident reports, they use as many if the decision is made to open a private business
details as possible, and they simply state facts, in the future. Trainers considering opening their
not opinions. Documentation is a good practice own business can learn practical skills from
for risk management because it allows a record their current employer: interviewing, hiring,
of events when they actually occurred. If an sales, organization and time management are
individual is asked to recall something, even the some important skills for business owners.
next day, key events are often forgotten. Personal Websites
trainers should always document anything they A website is an excellent advertising tool.
think may be of importance. Constructing a website can be done in three
steps. First, decide the purpose of the website

Selling Your Services
and include information, graphics, videos and
One of the most important goals
relevant links. Second, begin to develop the
in creating a business is obtaining
page by figuring out an appropriate domain
and keeping clients. Getting
name that will attract potential clients and
potential clients in a business can be achieved
choose a reliable Internet Service Provider to
many ways. Develop a name for the business
register the name. Make the website interactive
through various marketing strategies to
and include the
help expand it successfully.
intended information.
Marketing Your Business The more visual and
In this technology-driven age, interesting (including
computers are a convenient and popular quizzes, polls, ways
information search tool. When trainers to calculate BMI, etc.),
work for established businesses, they can the more successful
work on individualizing themselves from it will become.
other workers. This can be accomplished Remember to update
303
the site with current facts and articles so clients services of personal trainers. It can sometimes
will benefit from the latest changes in health and replace and be less costly than the client
fitness. There is lots of competition from other introductory packet.
websites, so visiting them can help in obtaining A useful brochure should contain the following
information. Links relating to health and fitness information:
websites can also be attached. Finally, the 1. Front page: logo, business name, credentials
website should be launched in order to ensure of the personal trainer(s), contact
continued success. Getting clients to visit the information, mission statement (if business
website and spreading its existence through has one)
word-of-mouth can help the business expand. 2. Back Page: contact information, promotions
Business Cards and Brochures or special deals, positive client feedback
Besides developing a website, there are other 3. Inside: qualifications and experience of
ways of marketing the business. Personal personal trainers, more information about
trainers should develop a consistent logo, the company and owner, brief explanation
color and design to appear on all of their and general benefits of fitness training,
business materials and have business cards services and programs offered
available and accessible to clients. The cards 4. Proper targeting to intended clientele
should emphasize qualifications and necessary 5. Easy to read, clear layout, limiting word
contact information without appearing too crowding
crowded. Create brochures and place them by 6. Accurate facts and updates when needed
business cards to Steps for Successful Marketing
attract clients. The Selling services requires knowledge of
brochures should marketing and how to use it successfully. It mainly
include information consists of research to keep the business up-to-
on benefits not date and is not costly or difficult to accomplish.
offered by other Selling services can be accomplished with the
health centers, the following steps:
purpose of the 1. Identify needs: Find a need that the current
business and the marketplace has not fulfilled.
304
2. Conduct Research: Collect facts related to 2. Highlight a client’s positive results (with
that need. client’s permission) through different
3. Satisfy: Make a service that fulfills the need. sources.
4. Promote: Showcase the service 3. Offer gift certificates or
to clients so they are aware of discounts.
the ability of the business to 4. Mail postcards or items with the
satisfy the need. company’s contact information.
5. Distribute: Use advertisements and other 5. Develop a line of products like t-shirts, caps,
information to let clients know about the gym bags, etc., with the company’s name
services. 6. Promote ads through local TV and radio
6. Acquire new business: Make sales and try to stations and newspaper.
keep clients’ commitments. 7. Offer clients and other professionals benefits
When marketing a business, becoming for referring the company’s services.
involved in community activities can be very

Determining the Cost of Your
advantageous. Involvement is inexpensive
Service
and useful for individuals who own their own
Pricing is based on a variety of factors. Think
business. Participating in community or public
about the salaries of employees and taxes that
speaking events related to fitness training is
have to be paid to the government.
a great way to appeal to the
Also take into account the telephone,
media and sell the business.
uniforms, equipment, supplies
If there is a local newspaper
and liability insurance. Consider
or TV station at the event,
the pricing after completing the
highlighting the benefits of a
following 10-step assessment. It is
business can be useful and less
based on setting up a reliable annual income
expensive than placing an ad.
by answering some questions and doing some
Additional Ideas for Marketing Your
math.
Business
1. Determine an annual income, which is the
Other ways to sell your services include:
12-month salary you require.
1. Create a periodical newsletter and distribute
it through mail, email, fax and websites.
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2. Figure out how much income will be earned 9. Keep a file of new contact information for all
weekly (divide wanted annual income by 50 clients so they can be contacted for personal
instead of 52 to take into account vacations, sales by showing them a few exercises.
sick days, etc.). 10. Follow-up with clients by sending a thank
3. Next, figure out you card and contact them about a week
how many clients after that to talk about things to do during
and sessions are the next appointment.
needed weekly There are several elements to running a
to achieve the weekly income (divide successful business. Commit to clients by
wanted weekly income by amount earned staying professional and dependable. Take the
per session and divide the number of paid initiative to create a program suitable for clients.
sessions by the number of clients). Use clients’ feedback as a guide to improve the
4. Determine the closing percentage by business in the future. A trainer should always
dividing the number of people interested in be ready to change the program to better suit
a sale by the number who actually signed up. a client’s needs. Having the ability to keep
5. Set a realistic timeframe within which the a professional disposition when providing
number of new desired clients services, collecting money or

Use clients‘ feedback as
needed to fulfill the weekly a guide to improve the listening to complaints can help the
business in the future.
amount will actually sign up. business run smoothly.
6. Divide the number of new

Retaining Clients
desired clients by the closing percentage and
One of the most important goals in a business
determine how long it will take to contact
should be to produce a profit. However, health
those clients each week.
and fitness professionals should also focus
7. Divide the number from #6 by 5 weekdays
on getting and retaining clients. When this is
to determine how many clients to contact
accomplished, there is a long-term partnership
per day.
between both which can be fruitful and
8. Consider the number from #7 and decide
profitable.
how many clients can be contacted every
hour depending on the trainer’s daily
schedule.
306
friendly tone of voice and make eye contact
READ—Rapport, Empathy,
when addressing clients.
Assessment and Development
For empathy, trainers should strive to
Because there are a variety of places for
understand the thought process behind actions.
people to exercise, excelling in customer
Motivation helps people make decisions. It is
service is essential to rise above
best to understand a client’s
the competition. This can be
intentions in personal training
accomplished by improving
by asking a few questions.
rapport, empathy, assessment
Trainers should ask which goals
and development (READ).
clients are trying to accomplish
When forming a rapport with
and discuss the importance of
clients, confidence, enthusiasm
reaching them. They should find out how long
and professionalism are very important. When
their clients have been trying to achieve the
trainers are confident, they are friendly and
goals and any past obstacles
can explain the importance
that prevented them from
of fitness training, which
reaching them. Knowing the
will help clients trust
motivation behind wanting
them. Clients can see when
to workout can help in
a person is enthusiastic
forming an exercise routine.
and willing to help them.
During the initial
They are more likely to
assessment, the trainer
stay at a health club with
should ask the client
individuals they know are
questions to find out
beneficial to them. Clients
more about the client’s
assess professionalism by what they hear
requirements, which can help the client
and see from trainers. It is necessary to dress
feel more engaged in the training program.
keenly and always be free to communicate with
Questions should be nondirective ones, which
clients. Trainers should not be preoccupied
require an answer more expanded than yes
with computers, leaning against furniture or
or no. Understanding the most important
keep clients waiting. They should also have a
needs of the client can help trainers figure out
307
the best ways to accomplish Many trainers need to realize
their clients’ goals. Directive the benefits and advantages
questions, in turn, result in a they have to offer a client.
yes or no answer, which can be Clients want trainers who can
useful in reassuring a client’s explain how personal training
responses to other questions. can help their lives. They want
For example, a trainer can someone to give them proper
paraphrase what the client has just said and ask guidance during an exercise to make sure it
the client to verify. is safe and effective. A trainer needs to find a
A trainer should develop individualized way to fit conveniently into a client’s schedule.
programs by taking into account the client’s Upgrading the intensity in exercise levels can
needs and goals. This should help trainers give experienced clients a refreshing new
realize the best course action. The time of day, challenge. Trainers should also be prepared
medical conditions and other factors should be to work with special needs populations, such
taken into account. as people with long-term illnesses or injuries.
In order to satisfy a client population, try the

Customer Service
following:
The following is a list of useful
1. Have a client introductory packet
guidelines for customer service:
ready that contains credentials
1. Always make time to greet
and qualifications.
club members (even if off
2. Be certified in CPR & other first
shift).
aid training.
2. Exhibit a welcoming and
3. Become a member in professional
professional attitude.
organizations to show clients an interest in
3. Treat each question with careful
and dedication to the profession.
consideration.
4. Develop a fitness program based on the
4. Express ideas with clear verbal
client’s medical history, needs and goals.
communication and body language.
5. Have knowledge of nutrition, which can be
5. Be enthusiastic to hear complaints and deal
advantageous to clients.
with them accordingly.
308
6. Seek help from other professionals when them if possible. In making these contacts, a
needed. trainer needs to make sure to exhibit maturity
7. Keep up to date on business policies and a professional appearance.
concerning bills, liability insurance, etc. Avoid actions that could
8. Make safety a priority and practice warming potentially lose clients, such
up, cooling down and using equipment as failing to follow-up with
properly. them. They may lose confidence
9. Pay attention to client’s concerns. trainers that are unable to
10. Keep each session interesting in order to answer questions or lead them in
keep clients coming back. the right direction to find answers. Clients look
forward to follow-ups and comments on their

Key Points for Success
progress. Trainers need to make sure to have
Finding and keeping a clientele is a process.
time to complete current appointments before
First, trainers should be aware of their
recruiting new clients. It may be advantageous to
qualifications. They should assess whether or
hire additional employees when taking on more
not they are educated to deal with different
clients. Take time and consideration
when expanding a business.
There are a variety of ways to invest
age or special needs populations. In assessing more time with a client including:
a client initially, if a trainer is uncomfortable 1. Take interest in the client outside the
about any information, it is better to let that training area: Trainers can talk to a client’s
client train with someone else. Being ill- health care professional if requested or
equipped to deal with a certain client can lead necessary or watch the client engage in
to losing that client and others if the reputation physical activity.
of the business is harmed. Networking with 2. Become well-rounded: Read a variety of
health care professionals and those associated newspapers, magazines or articles not
with personal training can help in recruiting necessarily related to health and fitness.
clients. A trainer can get in contact with doctors, Clients come from different career levels
physical therapists, nutritionists and dieticians and being well-rounded may help trainers
and leave business cards or brochures with relate to them more easily.
309
3. Train off-site: Switch workout places from clients. Long-term clients are usually pleased by
inside to outside to add more variety to their current trainer and will have no problem
routines. speaking about the benefits of personal training.
4. Get to know the client: Knowing more about After a referral is made, trainers should do
a client’s hobbies and interests may fortify the following to turn potential clients into new
the relationship between the trainer and clients:
client. 1. Mail a client introductory packet
5. Use effective ways to get and to the potential new client.
keep clients. Mailing clients 2. Call to arrange an introductory
does carry some cost and can meeting; do not wait for the
recruit only a few clients out of the hundreds new client to call you.
of letters sent. If this is a preferred method, 3. Pay attention to the client’s history and
letters need to be sent to a targeted client disposition to discuss how personal training
population. A useful way to attract clients is can be advantageous to them.
to have current clients refer them. Referrals 4. Listen to the client attentively by using eye
are free but can only be successful if trainers contact and mentally recording what is
provide incentives and helpful reminders to being said.
make referrals. Remind clients that referrals 5. Assess the client’s goals to better understand
are the main way of expanding business how to successfully achieve them.
and ask them for recommendations to their 6. Close the deal by summarizing what the
friends and family. Using this method with client has just discussed regarding goals and
close clients can make referrals a reliable needs and suggest convenient ways to fit
way to attracting new clients. training into the client’s schedule.
7. Prepare an outline of the exercises planned

Referrals
and useful information if the client commits
Although some trainers maybe uncomfortable
to training.
with approaching clients to make referrals,
8. Review policies and fees to find what is best
there are a few things they should keep in mind.
suited for the client.
Most clients will understand the importance
9. Have the confidence to ask a potential client
of expanding a business and acquiring new
to sign up for training.
310
10. After completing the introductory meeting,
follow-up to close the sale if the client has
not already signed up.
Other Incentives
There are several things that can be done to
attract new clients. Provide clients with trial
offer coupons or the option to purchase gift
certificates. People who receive these offers
personally are likely to give training a try and
may continue once they realize the benefits. over with another trainer. If a trainer has a
If a client was referred, remember to follow- business and employs fellow trainers, it is best
up with the potential new to strengthen the relationship
member and thank the client between the parties to avoid future
who did the referral. Participate conflicts rather than relying on the
in public speaking events non-compete clause.
related to training to promote services. Those

Expanding Your Business
listening may commit to the services or pass
Being a personal trainer is what an individual
on information about the business. Send thank
makes of it. Some people are content with
you notes to clients or other professionals when
working for an organization such as a fitness
appropriate.
center, while others opt to work as a contractor,
Non-Compete Clauses perhaps working for a company who contracts
Sometimes health clubs or businesses require out the training services. Many personal trainers
a contractual non-compete clause to be signed want to make a business out of their training by
by trainers before working. This is done in the seeking their own clients and negotiating their
hopes of preventing trainers from leaving and own prices. This next section focuses on those
taking clients with them. However, this contract who wish to start their own business or be hired
is very challenging to enforce in court. Should as a contractor.
this happen, clients will usually follow a trainer First the basics. Some terminology to become
they have been working with rather than start familiar with are the terms sole proprietor,
311
individual contractor, partnership, corporation multiple locations and the freedom to make
and S-corporation. Prospective owners must their own schedule. The services provided are
decide which category best fits their needs. not directly paid to the personal trainer by the
client. The personal trainer receives payment

Organizing Your Business
from the person/company that contracted them
Sole Proprietor
out. The downside is that the personal trainer
The trainer is the sole
has little flexibility in negotiating salary, as it
owner/operator of the
is usually predetermined and set by the hiring
business. Usually it only
individual or company.
requires a license from
Partnership
the particular state/
A partnership is an agreement between more
local government in which the business will be
than one individual entering into a business.
located. This is the least expensive and most
There may be formal
simple business model. There a few negatives
documentation of the
to this type of proprietorship. One is the large
partnership, which is
amount of money that must be available up
usually handled by an
front in order to start up the business. Another
attorney. The partners
is that the personal liability always falls back on
may also enter into an informal
the sole proprietor. All legalities or IRS dealings
agreement. This is not recommended because
are considered one and the same for the sole
if problems arise, proving verbal agreements
proprietor, meaning there is no separation of
can be difficult. If the parties are not planning
personal versus business situations, as there is
to enter into a formal agreement, they should at
only one owner.
least get the agreeing terms in writing and signed
Independent Contractor
by all parties. Federal or state governments do
This is an individual who
not tightly regulate partnerships. A pitfall
provides his services on a
to a partnership is that liability is
hired-out basis for another
placed on all partners regardless
company or individual. Being an
of fault. An advantage is that
independent contractor allows
startup expenses can be shared
personal trainers to work at
312
and all parties will bring their own expertise to a corporation, usually the owner or owners are
the business. taxed on their business as well as their salaries,
Corporation seemingly being double taxed. However, with an
A corporation is a true S-Corporation this does not happen. It gives the
business entity and must owners the freedom to distribute dividends as
abide by federal, state and they choose. Basically, the big difference is how
local regulations set forth the business is classified with the IRS and thus
for corporations. Unlike sole proprietorships or how taxes are handled.

Business Type Comparison Chart
partnerships where liability rests in the owners’
Type of
Business Definition Advantages Disadvantages
hands, a corporation is a legal entity of its own. Sole Business owned Work for yourself Start-up expenses
Proprietorship by one person & and personal
Managers and owners are not necessarily legally the operating
license is obtained
accountability due
to any debt
from the state/local
responsible in liability situations. Corporations city in which the
business resides
Independent A personal trainer Set schedules, Health club may
are governed by charters and bylaws. Investors Contractor who is paid by variety of locations, determine amount
health clubs in ex- paid per session paid for services
change for personal
usually encumber the startup expenses of a training services
Partnership Business owned by Compilation of Can be accountable
corporation. Transfer of ownership is much 2+ people informally financial resources for partner‘s failures
or by contract & talent
easier than with other types of business models. Corporation Formal business Investors have Costs, regulation
ruled by a contract limited liability
& bylaws; separate
S-Corporation from owners &
managers
An S-corporation combines the advantages Corporation treated Limited risk, no
S Corporation as proprietorship or double taxation
partnership
of all three types of business models and is
The Business Plan

Once a decision is made
to have a business, the
owner’s first priority is to make a business
plan. This should include plans for the budget,
established policies for employees and clients,
advertisements and profits. Writing out or
usually the best alternative for a small business. making a list of all pertinent processes and
It protects the owners from personal asset loss costs will help with organization as well as
and limits the risk of the individuals involved. In preparation for potential hurdles.
313
Monies earned:
The Budget
a) Determine a per session amount—see
Owners can make categories
profits section.
for how monies will be
allocated. For example: Establishing Policies

Monies required for everyday business Employees
operation: a) How will salaries be determined? Will
a) Salaries the arrangement be a baseline with the
b) Insurances potential for performance-based raises
c) Equipment or will the pay be based on experience, or
d) Taxes a combination of both? As an employer,
e) Electricity, phone, water, office supplies, the owner should establish how salaries
etc. will be determined and have it in writing.
f) Travel b) Will health insurance be offered to
Monies required for annual training: employees? As of right now, small
a) Certifications businesses are not
b) Specialized training (i.e., for people with required to offer
disabilities) health insurance
c) Mandated training (This may come up to their employees
without notice such as when laws that by law; however,
govern areas may overlap. For example, owners should be prepared
health care information privacy is for this to change in case there
regulated by the HIPAA act. As of now, is a requirement to do so in the future.
personal trainers do not have to be c) How many full-time, part-time or
HIPAA compliant, but this independent contractors will
may change. If so, owners be hired and be on the payroll?
would have to ensure all This is important when trying to
trainers employed took a budget expenses.
proper HIPAA course.) d) How will vacation, personal
time, sick time be handled?
314
It is better to have established guidelines c) What forms of payment will be
versus just “winging it.” Employees need accepted? There are three major forms
structure and conflict among them will of payment—cash, check or debit/credit
be better avoided if there are established card. If debit/credit card payments are
guidelines. accepted, the company may also wish to
offer automatic deduction. Many clients

Clients
view this as convenient and it will assure
a) What sort of clients will services be
that payments will be delivered on time,
offered to? This is not meant to exclude
every month.
any demographic, but to avoid liability.
d) If a client is late to a session, are they
Owners must make sure they are
allowed to make up the time?
qualified to provide services to people
e) If a client is going on vacation, should
who may require special training. For
their sessions carry over?
example, people who have physical
Having clear guidelines governing employee
disabilities may require a trainer to
and client policies is the best way to run
have more specialized training. If the
a successful business. These lists are not
company is not prepared to offer proper
exhaustive or all-inclusive but allow examples
training to individuals who may need
of ideas on what to ask. When guidelines are
specialized training, resources should be
preset there is less likely to be confusion in the
able for the company’s trainers to refer
future. Policies should always be written in a
these clients to known trainers that do
contract style document that will be signed by
offer specialized training. In these cases,
the employee or client signifying agreement to
however, it is important that these clients
the guidelines set forth. It is a good idea to go
understand the company is not refusing
to several similar businesses and get ideas in
to train them but instead considers it
terms of how they run their business policywise
wise to encourage them to use a trained
specialist.
b) How will clients be charged? Will it be by
the session or by the hour? Prices should because they are likely to be up-to-date with all
be competitive. of the current regulations. Owners must also
315
make sure that guidelines are compliant with c) The Internet is where most people find
current federal, state and local regulations. It is their information in today’s world. An
a good idea to outline the business in a mission owner should strongly consider hiring
statement style that highlights key points as to someone to generate and maintain
the philosophy upon which it will be operated. a website. The ideal website will
Include the vision and important characteristics, include the mission statement, any
such as honesty and integrity. Every person is specialized skills the trainers may have,
different and holds various values to varying an appointment scheduler, pricing and
degrees, but if the owner lays out the design and contact information.
show clients and employees, they will better d) The radio is also a good place to advertise,
understand the type of business person that the but homework needs to be done to figure
owner is trying to be. out what local stations are the most
popular and which are affiliated with

Advertisement
the clientele being sought. It is possible
A good advertisement will be the key to a
to get sponsorships if employees are
successful business.
wearing the station logo in exchange
a) How much do can be spent?
for advertisement. Be creative and
In the beginning (at least the
explore all avenues.
first year), the owner should
e) Television is also a great place to
budget more for advertising. If
advertise but can be very expensive.
potential clients do not know
Again, local channels are the ideal
about the company, how can
place to advertise, but timing can
they seek its services?
be an issue in terms of cost. Choose
b) What type of advertising will be used?
wisely if selecting television.
After determining how much to spend,
f) Old fashioned flyers still work and are
this is the second most important area
relatively cheap. Partnering up with
for focus. There are so many avenues
other businesses around is a great way to
to explore for advertising: the Internet,
distribute flyers. The company can offer
radio, television, flyers and billboards
to set up a place for other firm’s flyers
are the most popular.
or business cards and they reciprocate.
316
Reach out to other local businesses like will be based the your skills to market
health stores, especially ones that are and sell the company’s service. After all,
locally owned and operated. Owners there will be competition in the personal
can also set up incentive training business, so the owner

Make sure money is not being
programs where a free must figure out what makes
wasted on a demographic that
lunch is given for every is not likely to become the the business better/different
company’s clientele.
five customers they refer. than the others. That is what
g) Billboards may sound old-fashioned, but the marketing and advertising needs to
they still work. People driving by still portray.
look at billboards.
Profits
h) Who will be targeted? Knowing whom to
a) How much money does the owner want
target can be tricky. Everyone would like
the company to make? In the first year,
to be in shape and have the
and maybe even the first few years,
luxury of having a personal
the goal is to not be in the red
trainer for guidance but
(negative); furthermore, breaking
realistically not everyone
even is good and being in the
can afford one. Make sure
black (positive) is excellent. It is
money is not being wasted
important that a good budget is in place
on a demographic that is not likely
to know what expenses are and what
to become the company’s clientele.
amount needs to be made. Pricing must
Wherever the business location is,
be set such that the firm is competitive
the owner needs to examine the area
but also makes enough money to pay the
carefully and decide who might be likely
bills. In order to determine pricing, the
to want and afford the services.
owner needs to do some case studies.
i) Where will the target market be? Owners
What are the most successful personal
do not want to market in a place that is
training businesses in the area charging?
not likely to gain new clients. Every city
What are the mediocre ones charging?
is different and it is important to pick
b) Next, comparisons need to be made
the place wisely. Smaller cities are not
between what the firm’s prices are for
likely to give much clientele. Success
317
services and what competitors prices failure. If a trainer does not feel business
are for those services, and then make savvy, education on running a small
prices equal to those of competitors that business via books or extra classes is a
most closely match the firm’s offerings. good option. Taking on this endeavor
It is likely that a potential client has been is very challenging and knowing and
other places and if prices seem higher admitting what one does not know can
than competitors, the firm needs to be only help. There are multitudes of ways
able to explain why. This is why casing to help gain the knowledge that may be
competition is important and why an lacking, so an individual should not be
owner should highlight what makes afraid to use them.
the company and its training better/

Summary
different in advertisements. Pricing
Because of the intensive work and complex
varies from state to state, city to city and
interactions with clients associated with personal
company to company. Only the owner
training, a personal trainer is responsible for
can set the pricing based on the area
many legal issues. It is important to understand
and business. However, charging inflated
all legal issues and responsibilities so they can
prices to make ends meet is not going to
be accurately addressed. They can include issues
work and people will see right through
of negligence or not fulfilling duty, of failure to
that. Startup money is vital; an owner
provide emergency support and of not gaining
needs to make sure sufficient funds are
the appropriate informed consent. In addition,
available to sustain the business for
they can include tort law or legal rights between
the first year. In order to save money,
individuals in relation to civil injuries. Ensuring
minimal hiring should be done until it
appropriate exercise regimes for clients is a
is determined that the business has the
simple way to avoid any legal problems.
clientele to sustain more employees. The
Additionally, many personal trainers operate
last thing an owner wants to do is have
out of their own facilities and within their
to let someone go because too many
own knowledge of personal training. In these
people were hired. An owner can be the
situations, it is important to understand any
best personal trainer, but bad business
potential legal action that can be brought
practices are a sure way to guarantee
318
against the personal trainer. This is important to 2. As a personal trainer, you are required by
not only protect the client but also the personal law to follow the HIPAA regulations. True or
trainer. Risk management through proper False?_________________________________________
education, training, extensive documentation 3. Explain how a trainer would deal with a
and practicing limited liability can all be used to client who has a specific condition that the
completely avoid or greatly reduce the chances trainer has not been certified to handle. __
of liability in case of wrongdoing. ________________________________________________
Personal trainers should also be well-versed ________________________________________________
in business aspects of their profession. It is 4. Liability can be reduced by the following:
important to have a sound business model in a) Avoidance
order to grow clientele and maximize profits. b) Retention
The use of technology to create websites and c) Reduction
business cards, identifying current marketplace d) Transfer
needs and offering discounts are all important e) All of the above
marketing strategies used to grow a business. 5. List four components of a good website.
READ (rapport, empathy, assessment and a) ____________________________________________
development) can help a personal trainer b) ____________________________________________
connect with clients and excel in customer c) ____________________________________________
service. There are many different levels to d) ____________________________________________
organized business, with sole proprietorship 6. When considering customer service, the
being the simplest and commonest practice acronym, READ, stands for:
of securing a business. However, getting into a) Rapport, Encouragement, Assessment
business with others in a partnership or a bigger and Development
corporation are other possibilities. b) Reduction, Empathy, Assessment and
Development
Review Questions
c) Rapport, Empathy, Assessment,
1. What is the most common complaint made
Development
by clients against their personal trainer?__
________________________________________________
________________________________________________
319
7. In order to become a personal trainer, an client to another trainer certified in the
individual needs to obtain a bachelor’s appropriate area.
degree in Personal Training from an 4. e) All of the above.
accredited institution. True or False?______ 5. Any of the following: a purpose; graphics
8. Name the and relevant links to other health and
difference between a corporation and an fitness sites; an appropriate domain name to
S-corporation.________________________________ generate and drive the business; interactive
________________________________________________ content (e.g., quizzes, polls, ways to calculate
________________________________________________ BMI); up-to-date information.
9. What are the components of a Business 6. c) Rapport, Empathy, Assessment,
Plan? Development.
a) ____________________________________________ 7. False.
b) ____________________________________________ 8. A corporation is a true business entity
c) ____________________________________________ and must abide by federal, state and local
d) ____________________________________________ regulations set forth for corporations. An
10. You should check the________________________ S-corporation is usually the best alternative
__________ website to ensure that the online for a small business. It protects the owners
certification program chosen is accredited. from personal asset loss and limits the risk
of the individuals involved. In a corporation,

Answers
usually the owner or owners are taxed
1. Slipping and falling that led to injury is the
on their business as well as their salaries,
number one complaint of clients against
seemingly being double taxed; however,
their personal trainer.
with an S-Corporation this does not happen.
2. False, but that may change in the future.
It gives the owners the freedom to distribute
3. Personal trainers need to ensure that they
dividends as they choose. Basically, the big
receive the proper additional training
difference is how the business is classified
and certification for special needs groups.
with the IRS and thus how taxes are handled.
However, if the trainer cannot achieve the
9. Budget, established policies for employees
necessary certification in a timely manner,
and clients, advertisements and profits.
the trainer should refer the special needs
320
10. National Organization for Competency Manley RS, O‘Brien KM, Samuels S. Fitness
Assurance at www.noca.org. instructors’ recognition of eating disorders
and attendant ethical/liability issues. Eating

References
Disorders. 2008;16(2):103-16.
Eickhoff-Shemek JM, White CJ. The legal aspects:
Melton DI, Katula JA, Mustian KM. The current
Internet personal training and/or coaching:
state of personal training: an industry
what are the legal issues? ACSM’S Health &
perspective of personal trainers in a small
Fitness Journal. 2005;9(3):29-31.
Southeast community. Journal of Strength
Goldman E, Couzelia P. The business side of
wellness coaching. ACSM’S Health & Fitness
Robinson EM, Graham LB, Bauer MA. The National
Journal. 2007;11(5):38-39.
Strength and Conditioning Association is the
Malek MH, Nalbone DP, Berger DE, Coburn JW.
preferred certification for personal training
Importance of health science education for
employment in southeastern Massachusetts.
personal fitness trainers. Journal of Strength
Journal of Strength Conditioning Research.
2006;20(2):450-51.
321
copyright © 2012 ACTION Certification
All rights reserved. This book is protected by copyright. No part of this book may be reproduced
in any form or by any means including photocopying, or utilized by any information storage and
retrieval system without written permission from the copyright owner.
The publisher is not responsible (as a matter of product liability, negligence, or otherwise) for any
injury resulting from any material contained herein. This publication contains information relating
to general principles of medical care that should not be construed as specific instructions for
individual patients.

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PERSONAL TRAINER CERTIFICATION

Chapter 3: Client Assessment........................................................51

How Thorough Should Each Initial Assessment Be?................................73

Chapter 4: Introduction to Designing Programs............................101

Warm-Ups and Stretching....................................................................146

Chapter 6: Program Design Elements...........................................165

Chapter 7: Warning Signs.............................................................193

Chapter 8: Special Populations....................................................211

Chapter 10: Legal/Business..........................................................291

prevent depression. system and cardio-respiratory system.

Exercising on a regular basis can also boost the

the soma, bringing information faster from one nerve cell to

from other neurons of the another. In the brain, many

nervous system. nerve cells are not myelinated

All the communication occurs since they are located close

across junctions referred to as together. But nerve cells that

synapses, which occur either have long axons or dendrites

space between two axons The different kinds of neurons

or dendrites from different are interneurons, motor

cells. Within these synapses, neurons and sensory neurons.

neurotransmitters, the major Interneurons transmit signals

chemical messengers of the from one neuron to another

nervous system, are released neuron. Motor neurons send

from the neurons before signals from the spinal cord or

receiving cells located after the body. Sensory neurons send

The brain stem connects the cerebrum and

cerebellum to the spinal cord and is the center for

the control of visual and auditory reflexes, heart

rate, blood pressure and breathing. The entire

brain is protected by three layers of membranes

called meninges, which are located just under

nervous system (autonomic). The

somatic system signals skeletal

muscles to control voluntary

movement. The autonomic system,

on the other hand, regulates the

contraction of internal organs and

therefore controls involuntary

outer portion of the cerebrum is called the

cerebral cortex, which is primarily gray matter

containing nerve cells.

The central part of the brain is the

diencephalon, which includes glands important

for the release or regulation of hormones. The

cerebellum is located at the rear of the brain

and is similar in function to the cerebrum but

will help improve performance Bones

For example, mechanoreceptors, for internal organs. For example,

to fitness and physical movement, lungs in the chest cavity. Nutrients

respond to mechanical forces. and blood constituents are

are the sites where movement due to muscle

contraction takes place.

movement. Our bones provide this movement in our body is

us with two primary functions during a knee extension when

during movement: support and the tibial condyles joint slides

leverage. Bones are the support across to what is known as the

is an essential component of common movement is called

the support system provided the spin movement. This is

by our bones and is essential when one joint surface rotates

for the allocation of resources on another, similar to twisting

leverage, our bones act like rigid An example of this movement

by our muscles. facing down to the hand facing up.

Stretching is the best exercise for increasing

exercise—a bone in the joint rolls across the