Wednesday, June 15, 2011

Why Follow Blindly?

There was a story here in the news this morning about 3 women from out of town who followed their GPS in their rental car right into a lake.

Now, while this sounds insane, it is fairly consistent with what folks do in the fitness industry.  I know of countless trainer who follow this person's program or that person's program because it works, only to discover that it did not work so well for thier client or for them.  The same with some folks who contact me over the internet and want me to put together a program that they can follow.  I'm not really a big believer in this because if I haven't seen you move, or know anything about you, how do I know what's best for you?

Another example is the client who travels for work and tells you they did not exercise on their trip because the gym in the hotel did not have the machine, or the type of resistance that they have at home and they did not know what to do.  If you are a trainer, and this happens to you, you haven't done your job.  If you are a client, and this happens to you, get a new trainer. 

The whole idea of fitness is to create a healthy lifestyle.  This means that you eat helathy most (80-90%) of the time and that you can exercise on a daily basis.  To understand resistance training, you simply need to make your body move in the basic movements that we as humans do.  These movements are to bend, squat, push, pull, and rotate.  Does it matter what type of resistance it is?  Do your muscles really know thew difference between a dumbell and a rubber tube?  Muscles are pretty stupid, they only know that they have to work against a resistance.  As long as you know which direction to provide the resistance, you will get a great workout.

Try to remember to not follow progrmas blindly, know why you are doing something so you don't end up wet.

Thursday, May 20, 2010

Establishing a Total Care Network

As my work in post rehab training continues, I am asked many times about when strength and conditioning coaches or trainers should “refer out” a client who is experiencing difficulty in the training program. What would constitute a referral to a physician, Physical Therapist, or other medical professional or perhaps even another trainer? Is pain your primary reason? Are poor mechanical issues the culprit? The best interest of the client should always be kept in mind and if done well and with a systematic approach, you can provide the top notch care that your clients deserve.

Rather than taking a situational approach to a referral, it has been my experience to set up a system of health care providers and include the trainer as part of that system. This network of providers are the Physician, Physical Therapist, Chiropractor, Massage Therapist, Trainer, Nutritionist, and also an alternative medical provider such as an acupuncturist or herbalist (I’m on the west coast, give me a break). Each of these practitioners can provide a piece of the puzzle that can provide the total care of the client. Each can cross refer and the client can enter the network from any of these entry points. No one provider, no matter how good they are, can provide the complete care that the client needs. There are many who think that they can provide the total care, but each has their area of specialty and training. Let’s take a look at how each of the providers can help the client and how the care can be intertwined with the Physician and Physical Therapist being the closest in working with the trainer.

Physician: The Physician is the provider that will take care of all medical needs and in many cases is the catalyst that insurance companies need if there tests, procedures, or Physical Therapy that will need to be paid for or reimbursed to the client. The Physician is also the one who clients will go to when there is a general health issue that needs to be addressed. The Physician, in many cases can make the direct referral to any of the practitioners. In the case of the trainer, the physician can provide the annual physical for the client, then based on the results, can say that some better diet and proper exercise may be the best thing to do at first prior to getting on any drug therapies for cholesterol, blood pressure, blood sugar, or obesity issues. This is where the referral to the trainer comes in. The trainer is someone who the client can trust easier because the referral came from the physician and it keeps the client from seeing the big box trainer at the chain store fitness center. If there is an injury that must be addressed, there may be a referral to the PT, with the recommendation that the client begin an exercise program after dealing with the initial injury or problem. The PT is aware of the referral to them AND the trainer and this will enable them to continue the process. We use a fitness prescription pad that the physician can write out for the client that will state whether they need conditioning, flexibility work, strength, or movement training. The physician can check off what the client needs. We have found a very high compliance rate when the physician uses this “prescription” for fitness.

Physical Therapist: The PT is the provider that will deal with any of the musculoskeletal issues that the client is having. There may be some specific mobilization work, soft tissue work, or mechanical issues that maybe needed prior to the client working on a training program. The PT may also be one that the trainer refers to when they need answers to specific anatomical, mechanical, mobility, or stability issues. It is a great idea to have a PT that you can consult with, ask questions, and refer to when needed. PT’s a great source of information. It is very important that the trainer and PT work together in the client care. We have a system with our PT’s that was developed by Mark Looper, PT and Ken Cole, PT of Olympic Physical Therapy. The system uses color coded stages of work with a client/patient. When a client is injured we place them in a stage:

RED = Pain management and ROM work

YELLOW = Begin pain free movement of the area. May work on other areas outside the clinic.

GREEN = Aggressive movements still in the clinic. Regular, limited workouts with the trainer.

BLUE = Discharge from PT, full performance enhancement with the trainer.

During the phases of rehabilitation, there is communication throughout the network with the MD, PT, and trainer. This keeps everyone on the same page and gives the client/patient a good understanding and feeling of trust that they are getting complete care.


To establish these relationships, it is best to start with the PT. Find some PT’s in your area, ask around and find out who the better ones are. Make contact with the PT and get in to talk with them about the total care of the client and that you would like to establish a relationship so that you can have someone to refer to. A big mistake that many trainers make is just going in to look for clients and a referral source. Be sure that you are giving the impression (and also believe it) that you are looking to add a service for YOUR clients by having a PT to refer to. Ask to see if you can volunteer in the clinic or observe. As you establish this relationship and send them a few clients, your clients will speak for you and if you have good communication, the PT’s will send you post rehab clients. If you are a part time trainer and are wishing to move to full time in the future, see if you can get a part time job as an aide in a clinic. Think long term for your career and don’t shy away from the experience because it pays little. The payoff will come to you in knowledge.

The PT is also you’re in to the Physician. Most MD’s will not want to speak to a trainer directly unless they have an established relationship. Many of my clients are MD’s so that helps me quite a bit. PT’s regularly market to MD’s for their business and as the clients see the MD, they will refer to the PT. If you have the relationship established with the PT, it can carry over to the MD as well.

With the health care issues that are facing our country, good, established systems of care are in the best interest of any person. If the medical field recognizes the importance of regular exercise with a qualified trainer, there will be a greater chance that trainers will be considered a solid part of the preventative medicine cycle. We are seeing a larger blend of the Strength and Conditioning fields with the Physical Therapy field. Guys like Grey Cook and Gary Gray and certainly led the way in this direction. Recognizing the various roles that each part of a network can play are a big part of reaching the best goals for your clients. Maintaining your position as a professional will also beneficial in your marketing efforts and your reputation both in the training and medical fields.

Tuesday, May 11, 2010

Tate Latimer, a UA athlete, currently is ranked #2 overall in the state of WA in the 100 hurdles. Going for a state win. Good luck in the post season.

Sunday, March 7, 2010

Exercise Myths

Many exercise myths are exactly that, myths.  Take a look at some of the most popular of these thoughts and see where they stand.  Here is a story from Women's Day Magazine:

Exercise Myths Debunked

Thursday, December 17, 2009

New Year Resolutions? Or disappointments waiting to happen?

I find it very interesting this time of year to hear people start to talk about their resolutions when it comes to the New Year?  There are so many dramatic changes in the works.  As is most common, New Year's resolutions tend to lean toward fitness and nutrition. The most common being weight loss.

How many times do you hear "I'm going to lose 25 pounds this year" or "I'm resloving to be in shape this year"?  I know, I even say that myself.  As a trainer, I get many of my clients asking what they should resolve to do next year.  Should they lose "x" number of pounds, or should they bench press "x" number.  I really get tired of it.

What I rarely hear is how they will achieve goals.  I'd really like to hear someone say that they resolve to eat less junk food, or they resolve to eat less grains. Do you realize that when you talk about losing weight there needs to be a process to getting then desired results?  There aslo should be benchmarks along the way.  It is really common for someone to say I want to lose 40 pounds this year, so they go on a diet to lose it.  At the end of about 3 weeks, they are down 20 and think that they are doing well.  This person is really setting themselves up for a huge failure becuase they can't keep up what they are doing and the pace that they are losing weight.  As soon as the weight loss slows, they think that they are a failure and give it up.  Now they are back to the old eating habits and gain 25 pounds back.  That adds up to a +5 to me.

Is someone wants to lose 40 in the year, it is really less than a pound a week!  If I challenged you to lose 40 pounds, you would think that's a pretty big chunk of fat to lose and it might seem daunting.  If I challenged you to drink 16 more ounces of water a day, do you think that would be easier?  What about if I challenged you to cut out one of your fancy coffee drinks a week? 2 or 3 less pieces of bread?  You see where I'm going.  I'm trying to get you to make very small changes that will get you to lose 3/4 of a pound per week.  It doesn't take much.  Come back in one year and you are down 40 pounds!

BUT....This also means that you only have to lose about 3 1/2 pounds per month.  Measure yourself against that amount each month instead of trying to go for the whole 40, it works much easier that way. Seven pounds after two months, 10 after three.....this adds up to 40 after a year.  Now we are sounding like this is more achievable.  Go for it.

The same comes with fitness.  You can't try to get it all in the first 9 days of January!

Let's try this:  Resolve to do some sort of physical activity for only 10 minutes per day.  It doesn't matter what you do, just do 10 minutes.  What we are trying to do here is get past the hard part, establishing the habit.  Research has shown that it takes at least 21 days to develop a habit.  That's not 21 total days, that's 21 CONSECUTIVE days.  If you can move for 21 days, you are well on your way.

This will get you going, that's all we are trying to do.  It's not hard exercise.  You want to build up in the intensity so that you don't do more than your body is capable of.  If you do more that you are capable of, your body will fight that and provide you with a nice little thing call an overuse injury.  These are the nagging shoulder, knee, back, etc. injuries that stop you from exercising.

Remember, it's not that we are trying to get you fit in January, we are working to get your body PREPARED, to be fit.  It may take a while, but it will establish the long term habits and development that your body really needs.  That's a tough endevour in this "gotta have it now" society. 

You can't Fedex overnight your fitness and health.

Tuesday, November 24, 2009

Dealing with Shoulder Injuries

This is an article I wrote that appeared on and I have had many questions so I thought I would reprint it:

There is a common belief in the strength and conditioning community that overhead pressing exercise should not be used for the typical “shoulder athlete.” These athletes being from the sports of baseball, volleyball, tennis, and swimming. This belief is that the overhead pressing exercise will lead to injury, primarily a shoulder impingement.
When looking at typical overhead shoulder problems, there is usually a lack of certain mechanical requirements that enable a healthy movement. These are proper scapular control, good thoracic spine mobility, lumbar stability, and good hip mobility. I will also mention good C-spine stability is another preventor of many shoulder problems. Gray Cook calls this the joint by joint approach to movement and it makes things quite simple. Shoulder impingement problems are rarely caused by the shoulder, but rather a collection of poor function of the surrounding joints.
In working with swimming athletes, we find that a swimmer does not perform much in the way of co contraction due to the effect of gravity or being in a closed chain environment. With the exception of a few microseconds at the start and in open turns of the breast stroke and butterfly the swimmer is purely using concentric contractions. This alone, can result in a variety of injuries to the shoulder with repeated stresses to the extensors and internal rotators without the stabilizers kicking in. Take a look at the reasons why we switched away from machines using an open chain movement. No co contraction, no joint stability, which led to injury in the sporting activity. This is why swimmers are known to have shoulder injuries of the when, not if, variety.
The standard dry land training program typically consisted of simple rotator cuff exercises of internal/external rotation, flexion, and extension exercises with tubing.
It was economical and strengthened the shoulder to prevent injuries. This was usually combined with some push ups and some “ab” work consisting of crunches and straight leg throws. The isolation of the shoulders and the hip flexor dominant training has led and continues to cause the overuse shoulder injuries that swimmers endure.
Look at most swimmers and you will see a very anterior dominant musculature:
• large pecs
• wide lats
• six pack abs
• tremendous quads

From a postural viewpoint, the scapulae tend to be winged out, shoulders internally rotated, thoracic spine kyphotic, zero gluteal development, and little calf development.
When looking at the causes of shoulder injuries and returning to the joint by joint approach, we have found that the flexor dominant training of the hip leads to very tight hip flexors and poor glut utilization. The tight hip flexors, when kicking will lead to a hyperextension of the lumbar spine causing stress. The kyphotic thoracic spine will not allow good gliding of the scapula, which will lead to poor GH action and therefore, overuse injuries will occur.
To avoid such injuries, a total body approach to the shoulder must be taken. We build the shoulders from the ground up. We strengthen the shoulders by building a good foundation from the hips. Remember that when building a house, you need a strong foundation, then a good framework, a roof, and finally, you make it look nice. The hips need to gain good mobility and posterior strength in order for the (again repeating myself) lumbar spine to be stable, thoracic spine mobile, etc. Proper instruction and technique for our swimmers need to happen in this order to establish a relationship between the hips, core, and shoulder:
• correct squat
• correct lunge
• proper plank
• plank with rotation
• correct push up
• overhead squat
• single arm overhead walk
• single arm overhead lunge

Once the athlete has established this relationship with the core and the hips, we can begin pressing exercises. All of our pressing exercises are done with a dumbbell or kettlebell. I like the kettlebell because of the added stability requirements by not holding its center of gravity and you cannot “balance” the weight overhead. The pressing exercises utilizing the entire kinetic chain will work in the following progressions:

1. Good hip work
2. Static overhead hold and walk
3. Static overhead split squat
4. Static overhead hold and lunge
5. Lunge and press (to many variations)

The shoulder is a complex joint and is prone to injury in isolation. Many of the exercises that are used here for swimming athlete can transfer over to other athletes as to not be too “sport specific” in nature. Since we have put this program together for our athletes, we have had no issues with the shoulder in a very “shoulder injured” sport.
The key to good shoulder stability with the athlete is to look at the whole system instead of isolation in the shoulder itself. Good strength and good mobility are the foundations of the healthy athlete. As strength professionals, it is our duty to keep the athlete playing and competing in their sport, not to make a great lifter out of them.
©2009 Unlimited Athlete, Inc.

Sunday, November 15, 2009

Proud of "My Kids"

Yesterday was my birthday.  I had a very nice day and had many well wishes from folk all around.  Thanks to all.
I had a great evening watching "my kids",  as I like to call them, swimming at the Washington HS State swim championships. My own children are not in HS yet, but I went to a swim meet on my birthday.  It is always exciting watching all the hard work that they did in the gym pay off.  In nearly every final event, I was rooting for someone who has trained in my gym.  That is a very exciting thing.  I shared the successes with the kids, their parents, their friends, and their relatives.  I have a tendnecy to get close to the kids that train with me.  Not only am I their strength coach, but many times, I'm a father figure, a mentor, or just a sounding board.
I watched with pride each race and celebrated each success and felt the pain of some of the dissapointment.  The good thing was that the success heavily outweighed the dissapointment!
So, for anyone who trains athletes, make sure that you go to see them compete every once in a while.  It's well worth it.