ACT Personal Trainer Certification Textbook v1 2

ACT
Personal Trainer Certification

www.ACTcertification.org
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Table of Contents
Chapter 1: The Science of Exercise................................................ 9
Topics Covered......................................................................................9
The Importance of Understanding the Science of Exercise...................10
Nervous System..................................................................................11
Central Nervous System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Peripheral Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Skeletal System...................................................................................15
Bones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Joints. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Muscular System.................................................................................16
Muscle Fibers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Cardiorespiratory System....................................................................24
Heart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Blood. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Lungs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Energy Production. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
ATP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Glycolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Summary............................................................................................30
Review Questions................................................................................31
References..........................................................................................33
Chapter 2: Biomechanics............................................................ 35
Topics Covered....................................................................................35
What Is Biomechanics?.......................................................................36
The Importance of Biomechanics........................................................37
Biomechanics and Exercise..................................................................39
Warm-Up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Cool-Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Motion and Kinematics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Forces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Internal Forces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
External Forces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Inertia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Stability of Equilibrium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
1
Anatomic Locations.............................................................................48
Planes of Motion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Range of Motion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Muscle Actions....................................................................................52
Modes of Muscle Strength..................................................................55
Motor Control.....................................................................................57
Proprioception. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Motor Learning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
References..........................................................................................65
Chapter 3: Client Assessment..................................................... 67

Topics Covered....................................................................................67
The Importance of a Client Assessment...............................................68
The General History Section of the Initial Client Assessment...................... 69
Occupation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Lifestyle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
The Medical History Section of the Initial Client Assessment...............72
Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Surgeries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Diseases and Medical Conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Using a Questionnaire.........................................................................75
Example of Initial Client Assessment Form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
The Physical Assessment Section.........................................................76
Pulse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Blood Pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Posture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Body Fat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Body Mass Index (BMI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Step Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Walk Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Muscular Performance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
How Thorough Should Each Initial Assessment Be?.............................88

Personalizing or Designing Custom Test...............................................89
Summary............................................................................................92
2
References..........................................................................................94
Chapter 4: Introduction to Designing Programs........................... 97

Topics Covered....................................................................................97
Introduction to Designing Programs....................................................98
Program Design...................................................................................99
Health Precautions to Consider when Designing a Program. . . . . . . . . . . . . . 100
Avoiding Overexertion and Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Signs of Dangerous Dysfunctional Breathing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Avoiding Discouragement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Aerobic Programs for Beginners........................................................ 103
Physiological Factors to Consider in Designing Programs................... 104
Types of Muscle Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Energy Usage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
The Kinetic Chain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Proper Positioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Types of Training Used in Exercise Program Design............................ 106
Principles of Exercise Training............................................................ 109
Target Heart Rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Measuring Exercise Intensity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Measuring Caloric Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Principles of Resistance Training (RT). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Determining Resistance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Determining Rest Periods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Resistance Training Modalities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Periodization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Ways to Vary Volume and Intensity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Overtraining. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Summary.......................................................................................... 120
Review Questions.............................................................................. 121
References........................................................................................ 122
Chapter 5: Flexibility................................................................. 125

Topics Covered.................................................................................. 125
3
The Warm-Up.................................................................................... 126
What is a Warm-Up?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Benefits of a Warm-Up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Warm-Up Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Types of Warm-Ups........................................................................... 128

General Warm-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Activity-Specific Warm-Up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Passive Warm-Up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Warm-Ups and Stretching................................................................. 129

Flexibility.......................................................................................... 129
What is Flexibility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
The Importance of Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
The Science of Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Types of Flexibility............................................................................. 131

Corrective Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Active Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Functional Flexibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Stretching Techniques....................................................................... 134

Static Stretching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Passive Stretching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Active and Active Assistive Stretching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Proprioceptive Neuromuscular Facilitation Stretching. . . . . . . . . . . . . . . . . . . 138
Dynamic and Ballistic Stretching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Precautions and Safety...................................................................... 141
Types of Stretches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Developing the Program.................................................................... 144
Measuring Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Summary.......................................................................................... 146
References........................................................................................ 148
Chapter 6: Program Design Elements........................................ 151

Topics Covered.................................................................................. 151
Cardiorespiratory Conditioning......................................................... 152
The Importance of Cardiorespiratory Fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Training Design.................................................................................. 153
4
Postural Considerations..................................................................... 154
Smart Progression............................................................................. 154
Interval Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Interval Training Model..................................................................... 157
Stage Training.................................................................................... 158
Circuit Training.................................................................................. 158
Fat Burning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Muscular Strength............................................................................. 160
Endurance Conditioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
The Adaptation of Strength Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Flexibility Training............................................................................. 167
Types of Stretching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Things to Avoid................................................................................. 170
Postural Muscle Imbalance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Balance, Agility, Speed...................................................................... 171
Balance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Balance Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Coordination and Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Sensory Function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Summary.......................................................................................... 178
References........................................................................................ 180
Chapter 7: Warning Signs.......................................................... 183

Topics Covered.................................................................................. 183
The Warning Signs that Can Mean Trouble........................................ 184
Muscle Cramps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Dehydration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Heat Exhaustion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Heat Stroke. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
How to Respond to Various Events.................................................... 193
Dehydration that Leads to a Loss of Performance and Energy. . . . . . . . . . . . 193
Dehydration and Muscle Cramps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Heat Exhaustion that Causes Light-headedness, Dizziness and Cold,
Clammy Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Heat Exhaustion that Causes Nausea and Headaches . . . . . . . . . . . . . . . . . . . . 195
5
Heat Stroke, High Body Temperature and Dry Skin . . . . . . . . . . . . . . . . . . . . . . 196
Heat Stroke that Causes Confusion and Unconsciousness. . . . . . . . . . . . . . . . 196
Summary.......................................................................................... 199
References........................................................................................ 201
Chapter 8: Special Populations................................................. 203

Topics Covered.................................................................................. 203
Introduction to Special Populations................................................... 204
Pregnant Women.............................................................................. 204
Designing a Safe Exercise Plan during Pregnancy. . . . . . . . . . . . . . . . . . . . . . . . 206
Exercises to Perform and Avoid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Safety Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Seniors.............................................................................................. 209
Youths............................................................................................... 214
Training Programs and Supervision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Preventing and Controlling Childhood Obesity. . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Injured Persons................................................................................. 217

Exercising with an Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Exercising after an Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Persons with Specific Medical Conditions.......................................... 220
Arthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
Asthma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Preparing for Exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Diabetes Mellitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
Hypertension.................................................................................... 231
Monitoring Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
Types of Exercises for Persons with Hypertension. . . . . . . . . . . . . . . . . . . . . . . 232
Summary.......................................................................................... 234
References........................................................................................ 236
6
Chapter 9: Nutrition................................................................. 239
Topics Covered.................................................................................. 239
Introduction to Nutrition................................................................... 240
Recommended Caloric Intake. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Nutrition for Working Out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Carbohydrates................................................................................... 246
Recommended Carbohydrate Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Types of Carbohydrates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Carbohydrates for Working Out. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Alcohol as a Carbohydrate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Fats................................................................................................... 251
The Role of Fats in the Body. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Types of Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Triglycerides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Unsaturated Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Trans Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Saturated Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Problems with Fats. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Metabolic Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Insulin Resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Fat Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Protein.............................................................................................. 258
Protein Digestion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Factors that Affect Protein Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Proper Hydration............................................................................... 262
Sports Drinks vs. Water. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Signs of Dehydration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Hydration to Maximize Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Supplements..................................................................................... 267
Types of Supplements....................................................................... 267
Summary.......................................................................................... 273
References........................................................................................ 276
Chapter 10: Legal/Business....................................................... 279

Topics Covered.................................................................................. 279
7
Legal Issues....................................................................................... 280
Slip and Fall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Equipment Usage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Supplements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Sexual Harassment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Personal Trainer Qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Emergency Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Confidentiality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Risk Management............................................................................. 288
Proper Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Appropriate Training for Each Client. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Limiting Liability Through Avoidance, Retention, Reduction and Transfer. . 290
Proper Conduct. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Proper Training Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Documentation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Selling Your Services.......................................................................... 292
Marketing Your Business. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Determining the Cost of Your Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Retaining Clients............................................................................... 297
READ—Rapport, Empathy, Assessment and Development. . . . . . . . . . . . . . . 297
Customer Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Key Points for Success. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Referrals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
Other Incentives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Non-Compete Clauses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
Expanding Your Business................................................................... 302
Organizing Your Business. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
The Business Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
The Budget. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Establishing Policies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Clients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
Advertisement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Profits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Summary.......................................................................................... 310
References........................................................................................ 313
8
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
learn to more quickly adapt to exertion. It also
The Importance of Understanding
increases the actual mechanical strength of the
T
the Science of Exercise
muscle fiber and its surrounding membrane,
raining or exercise should be
allowing the heart to withstand the stresses
a positive and beneficial part
and strains of intense effort without injury.
of life. It is a proven fact that
Exercise has also been known to strengthen
exercise improves a person’s
bones by causing an increase in the bone
overall health when done on a regular basis.
mineral density by increasing the rate at
Besides its use in maintaining
which minerals like calcium are
and losing weight, exercise is
deposited in the bones. Since
known to improve the heart and
bones naturally become weaker
blood system and to enhance
as people age, older adults are
muscular athletic ability. It
at a high risk for bone fractures.
also prevents the onset of
However, moderate to strenuous
brain diseases and boosts the
exercise has been known to
effectiveness of the immune
reduce the risk of older adults
system. These beneficial results
getting a fracture in the heels,
are due to the many physical
hips and other bones.
changes that occur within the
Additionally, exercise protects the brain and
body during exercise.
nervous system and helps to improve brain
Over time with regular exercise, the blood
and nerve function. Research has shown that
supply to the active muscles improves,
regular exercise can protect cells in the brain
which causes the capillaries to respond more
and nerves from the injury or erosion that
quickly to the requirements of the muscles.
normally occurs with neurodegenerative and
Physical activity also enhances the mechanical
neuromuscular disorders like Alzheimer’s
effectiveness of the heart by enhancing the
and MS (multiple sclerosis). This means
volume of blood that can be pumped. Due
that exercise can also minimize the risk of
to this, training and exercise helps the heart
10
dementia. In addition, exercise and other Because physical activity leads to
physical activity can enhance nerve growth physiological changes in the body, it is
factors which are known to important for physical
support the endurance and Exercising on a regular basis can trainers to understand more
growth of several nerve cells. also boost the immune system. about exercise physiology, the
This stimulation of nerve cell study of the body’s responses
growth ultimately leads to increased brain and adaptation to the stress of exercise. The
functioning through improvement of certain major systems of the body each have their
types of learning. This exercise-induced individual roles during exercise performance
improvement in mental health also helps to and they work interactively to respond to
prevent depression. exercise. All these factors should be taken
Exercising on a regular basis can also into consideration when planning an exercise
boost the immune system, a natural defense training program. This chapter will cover
mechanism used to ward off foreign organisms, details on aspects of the nervous system,
viruses and chemicals. Though exercise does skeletal system, muscular system and cardio-
not enhance the normal functioning of the respiratory system.
immune system, exercise does strengthen it

Nervous System
in times of illness or chronic disease such as
The nervous system serves as the control
obesity, cardiovascular disease, diabetes and
center of the body by integrating mass
heart disease. Exercise is believed to encourage
communication networks consisting of
strong immune responses by increasing
billions of nerve cells called neurons, which
antibody and immune cell responses. There has
are designed to convey information. The three
also been scientific data suggesting additional
major functions of the nervous system are
exercise-induced immune responses may
sensory, integrative and motor functioning.
be an indirect consequence of the brain and
The ultimate purpose of this neural network
nervous system benefits of exercise.
is to gather information about our inner and
11
external surroundings (sensory function), All the communication occurs across
process and interpret the information junctions referred to as synapses, which occur
(integrative function), and then respond to either between neurons or between a neuron
these stimuli (motor function). and another cell type. A
The messages are relayed back synapse is just a tiny empty

Dendrites
and forth between different Electrical Impulses space between two axons
parts of the body. Neuron

Synapse
or dendrites from different
The neuron is the functional cells. Within these synapses,

Axon
unit of the nervous system neurotransmitters, the

Receptor
and the merging of these cells, major chemical messengers
called neurons, creates the nerves of the body. of the nervous system, are released from the
The structure of neurons allows for very quick neurons before the synapse and bind to the
communication to and from receiving cells located after
the cell as well as continuous The merging of neuron cells the synapse. This stimulates a
create the nerves of the body.
conduction of signals across signal that is called an action
the neuron. A neuron’s main NEURON Dendrites

potential, which travels to the
(receivers)
component is a cell body, or receiving cell, called a receptor,

Nucleus
soma, which contains the Cell Body and then on to the cells that
organelles important to the act on the signal in the desired

Schwann’s
Cells
proper functioning of this cell. Axon
(the conducting fiber)
(they make the myelin)
location. This is how the
A long branch called the axon Node of

Ranwier
Axon Terminals
(transmitters)
continuation signal the neuron
projects out of the soma and Myelin Sheath

(insulating fatty layer that
was transmitting makes it to
speeds transmission)
feeds information through the end location. For example, a
nerve impulses to muscles, organs and other signal to move your finger would travel from
neurons. Shorter branches called dendrites the brain, through many neurons and finally to
project from the soma, bringing information the muscle in your finger.
from other neurons of the nervous system.
12
Peripheral Nervous System Central Nervous System
The nervous system is composed of two
Cranial Nerve Brain
major compartments: the central nervous
Spinal Nerve Spinal Cord
system (CNS) and the peripheral nervous
system (PNS). The brain and the spinal cord,
a long tubular continuation of the brain,
are collectively known as the CNS. This is
the source of conscious

Neurons are usually covered This is the source of conscious
and unconscious thoughts, and unconscious thoughts,
in a layer of insulation called moods and emotions.
moods and emotions. The
myelin and are therefore said
PNS is comprised of all the nerves in the body,
to be myelinated or covered in a myelin sheath.
including the cranial and spinal nerves.
This insulation helps signals to be transmitted
faster from one nerve cell to another. In the Central Nervous System
brain, many nerve cells are not myelinated The four major sections of the brain are the
since they are located close together. But nerve cerebrum, diencephalons, cerebellum and the
cells that have long axons or dendrites need brain stem. The cerebrum is the largest part
myelin to speed up the transmission time for of the brain, comprising 85% of the brain’s
their signals. total weight. The cerebrum is divided into left
The different kinds of neurons are and right hemispheres that communicate with
interneurons, motor neurons and sensory each other to control muscles and organs as
neurons. Interneurons transmit signals from well as thought, hearing and language. The
one neuron to another neuron. Motor neurons outer portion of the cerebrum is called the
send signals from the spinal cord

Telencephalon: Cerebrum
Forebrain
Thalamus
or the brain to other areas of Diencephalon
Hypothalamus Right Cerebral Left Cerebral
Hemisphere Hemisphere
the body. Sensory neurons send Pituitary Gland
signals from areas of the body to Cerebral Cortex
Midbrain
either the spinal cord or to the Brain Stem
Hindbrain
Pons
Medulla Oblongata
Cerebellum
brain.
Spinal Cord
13
cerebral cortex, which is primarily gray matter on the other hand, regulates the contraction
containing nerve cells. of internal organs and therefore controls
The central part of the brain is the involuntary physiological processes like
diencephalon, which includes glands important

Somatic Motor Neuron
for the release or regulation of hormones. The Somatic ACh*

Motor
Neuron
cerebellum is located at the rear of the brain
(Myelinated)
Spinal Cord Effector
and is similar in function to the cerebrum but

*ACh: contraction of skeletal muscle (excitatory transmitters)
Autonomic Motor Neuron

Autonomic
controls balance, posture and coordination. Motor
Neurons
ACh
or NE*
ACh
The brain stem connects the cerebrum and
Spinal Cord Preganglionic Postganglionic
Autonomic Effectors
Neuron (most Neuron
cerebellum to the spinal cord and is the center are myelinated)
Ganglion
(unmyelinated)
*ACh or NE: contraction of smooth or cardiac muscle, stimulation

or inhibition of glandular secretion (excitatory neuro-transmitters)
for the control of visual and auditory reflexes,
heart rate, blood pressure and breathing. The

heart rate, digestion and breathing. Since
entire brain is protected by three layers of
these processes could either be accelerated
membranes called meninges,
or decelerated, two distinct
which are located just under When beginning an
exercise program, it is pathways of the autonomic
the skull. The spinal cord important that the
nervous system (ANS) are
branches out from the brain nervous system be
properly trained. present. The sympathetic
stem and its function is to
ANS kicks in under stress
send, receive and interpret nerve signals
conditions and responds accordingly, usually
traveling between the brain and the rest of the
accelerating bodily functions like heart
body.
rate, while the parasympathetic pathways
Peripheral Nervous System usually slow down bodily functions in rest
The PNS is further divided into the voluntary conditions.
nervous system (somatic) and the involuntary When beginning an exercise program, it is
nervous system (autonomic). The somatic important that the nervous system be properly
system signals skeletal muscles to control trained to ensure that the right movement
voluntary movement. The autonomic system, patterns are being developed. All movement
14
within in the body is directly associated with the appendicular skeleton includes our upper
the nervous system. This process will help and lower extremities.
improve performance and decrease the risk

Bones
of injuries. For example, mechanoreceptors,
Bones also provide protection for internal
the primary neurons important to fitness and
organs. For example, the ribcage protects the
physical movement, respond to mechanical
heart and lungs in the chest cavity. Nutrients
forces. These receptors, found in muscles,
and blood constituents are provided to the
tendons and ligaments, are responsible for
body from bone. Our bones form junctions,
sensing distortion in tissues, such as tension
referred to as joints, which are linked by our
induced by exercise.
connective tissue and muscles, and they are
Skeletal System the sites where movement due to muscle
The major function of the skeletal system is contraction takes place.
to provide form and shape to the body, thereby In the skeletal system there are approximately
giving protection and support, plus allowing 206 bones, 177 of which are used in voluntary
bodily movement. The skeletal movement. Our bones provide
system also helps in producing us with two primary functions
blood and storing minerals for during movement: support and
the homeostasis of the body. The leverage. Bones are the support
skeletal system determines our system for soft tissues. Posture
stature and the positioning of is an essential component of
our bones determines our shape the support system provided
and size. by our bones and is essential
Our skeletal system is for the allocation of resources
separated into two parts, the within the body. With regard to
appendicular and the axial leverage, our bones act like rigid
skeletal systems. The axial skeleton consists of levers, altering the direction and force exerted
the skull, rib cage and our vertebral column; by our muscles.
15
An example of this movement is when the
Joints
forearm is rotated from the hand facing down
Our joints are formed by one bone that
to the hand facing up.
articulates with another bone. Joints can be
Stretching is the best
categorized by their structure,
exercise for increasing
function or movement, known
Pivot Joint nutrition to the joints.
as arthrokinemeatics. The
Flexibility is the range of
joints that are most affiliated
Ball and Socket Joint motion (ROM) available to
with our body movement are
a joint or joints. Increased
known as the synovial joints. Hinge Joint
ROM can provide greater
These joints are held by a
mechanical efficiency.
Ellipsoid Joint
joint capsule and ligaments.
This efficiency results in
They consist of roughly 80%
Saddle Joint
more effective and safer
of the joints within the body
movement. A mobile
and have a large capacity for Gliding Joint
joint moves more easily
motion.
through a range of motion and it requires
During a roll movement—especially during
less energy. Healthy flexibility means the
exercise—a bone in the joint rolls across the
capacity to move freely
surface of another, similar to the
Stretching is the best in all desired directions.
tire of a motor bike that rolls down exercise for increasing
nutrition to the joints. The movement should
a road. A good example of this
be restricted to the
movement in our body is during a
intended movement capabilities or to the
knee extension when the tibial condyles joint
joint’s functional range of motion (FROM).
slides across to what is known as the femoral
condyles joint. The next common movement Muscular System

is called the spin movement. This is when The forces that help the body perform
one joint surface rotates on another, similar physical activity are supplied by the muscular
to twisting a lid off a jar of spaghetti sauce. system. Muscle cells, also known as fibers, are
16
multinucleated and connected in of alternating large myosin and thin
cylindrical bundles or individual actin strands made of protein.
cells. A single muscle is built from Myosin develops in the middle
many bundles of muscle fibers of every M line, a line that runs
called fascicule. Connective tissues the length of myofibrils. The actin
run from one end of the muscle to strands develop a Z shaped pattern
the other, binding cells together and down the points that are anchored,
giving rise to muscle fiber bundles. commonly called a Z line, which is
Muscle tissue is categorized into characterized by having a darker
three types according to function color than other areas. When
and structure: cardiac, smooth and stimulation occurs and an action
skeletal. As the names suggest, potential is received, the skeletal
cardiac muscle is exclusively found muscles carry out a contraction
in the walls of the heart and smooth by decreasing every sarcomere.
muscle composes the epithelial of other The easiest way to understand contraction is
hollow organs. Both of these muscle groups probably through the sliding filament model
are under involuntary control. Skeletal muscle,

Sarcoplasmic
however, is attached to the skeleton and is Muscle Fiber Reticulum
under voluntary control. Due to the important Myosin
role of skeletal muscle in exercise and fitness,
the following section reports more on the

Sarcomere
Myofibril Actin
structure and function of skeletal muscle.
Skeletal muscle is composed of many thread-

of contraction in a muscle. Actin and myosin
like striations and is attached to the skeleton.
fibers overlap in a contractile motion toward
The sarcomere is the basic contractile unit of
each other.
the myofibril, expanding from a Z line to the
Myosin filaments have club-shaped heads
next closest Z line. Sarcomeres are composed
that project toward the actin filaments.
17
Larger structures, known as myosin heads, phosphate. This assists in producing the fast
are found along the myosin filament and renewal of ADP into ATP.
give attachment points on binding sites for What happens when a muscle needs to
the actin filaments. Myosin heads move in a contract? A muscle is stimulated to contract
synchronized manner toward when calcium is released from
the center of the sarcomere. the sarcoplasmic reticulum into
They then detach and reattach the sarcomere. Calcium ions are
to the closest active site of the needed for every cycle of the
actin filament. This is known as sarcomere. It is calcium that
a “ratchet type drive system.” reveals the actin binding sites.
As a result, this process uses up When a muscle does not need
large quantities of adenosine to contract, calcium ions are
triphosphate (ATP). drawn out from the sarcomere
Where does the energy for and are stored back in the
contraction come from? It sarcoplasmic reticulum.
comes directly from ATP, which is the energy As a whole unit, skeletal muscles produce
source of the cell. The job of ATP is to link the movement by pulling on the skeleton in a
cross bridges among myosin heads and actin nervous system-controlled manner. When a
filaments. Energy powers the twisting of the muscle shortens, it moves a bone by pulling
myosin head. When used up, ATP converts on the tendons which attach the muscle to
to adenosine diphosphate (ADP). A person’s the bone. The integration of bones, skeletal
muscles accumulate a small muscles and joints create
amount of ATP by constantly A muscle is stimulated apparent movements like

to contract when
reusing the ADP and converting calcium is released. running and walking. Skeletal
it back into ATP quickly. Inside muscles can even generate
muscle tissues there is a storage supply of a movements that are more subtle, which result
high-speed recharge chemical called creatine in respiration, eye movements and facial
18
expressions. The number of skeletal muscles fibers it innervates) and the movement may
used during a workout depends entirely on require just a small part of the muscle. All
which exercises are chosen and the methods of the fibers contract when a motor unit is
used during their implementation. This stimulated. Clusters of motor units work
determines which muscles in unison to manage the
and how many are involved Muscle contraction movement contractions of a muscle. Each
can fulfill several other vital
in the particular physical functions in the human body. fiber within the motor unit
activity. moves simultaneously. One
The skeletal muscles are grouped together, individual muscle might have several motor
though this does not mean that they function units and the nervous system may contact many
together. They can either function separately or a small percentage of them. The frequency at
or in groups along with other muscles. which the motor units fire is variable; it can be
Power and muscle force increased or decreased to help
are formed by the action of control force production. Force
skeletal muscles. Moreover, regulation is often referred to
muscle contraction movement as force gradation—this is what
can fulfill several other vital allows people to control their
functions in the human body, body movements. By combining
like heat production, posture recruitment of motor units
and joint stability. Sitting and and the speed of their firing,
standing with posture can be patterns of neural discharge
accomplished by contraction of allow a vast selection of weak to
muscles. strong contractions.
As soon as the nervous system triggers There are three muscle actions: concentric
movement in the body, the entire muscle does muscle actions, eccentric muscle actions
not respond because a muscle has several and isometric (static) muscle actions. The
motor units (a motor neuron and the muscle concentric muscle actions, referred to as
19
muscle contractions, happen when the muscle why the recovery process seems to accelerate
fibers are shortened. Eccentric muscle actions during training. Also, during training, the
generate force continuously during regular mechanical strength of both the muscle fiber
body movements and this tension causes the and the membrane (sarcolemma) is enlarged
muscles to lengthen. An example of this would so that they have the ability to stand the
be the movement of the quadriceps when a aggressive action of exercise without damage.
person walks down a steep hill. Other examples Muscle damage is often the result of
would be when a person sits down on a bench aggressive training, which can cause a
or the action of the forearm flexor muscles breakdown of muscle fibers. In fact, aggressive
when throwing a ball. Day-to-day tasks such as training does not cause a muscle to grow or the
walking or jogging cause spur-of-the-moment nervous system to adapt. A good example of
actions that are both eccentric and concentric. this would be when a person overstretches a
Isometric (static) muscle actions are a form muscle. If the muscle becomes damaged it will
of muscular activity that causes tension in the cause soreness and pain. Damaging a muscle
muscle; however, this action during exercise doesn’t lead to

Muscle damage is often the
does not shorten or lengthen result of aggressive training. nervous system adaptations.
the muscle. The damage lessens the blood
When a person begins body training, the supply to the scarred area because of buildup
blood supply to active muscles improves and of trauma; therefore, the fibers become more
the capillaries begin to respond at a fast pace. prone to repeated injury.
Experts have determined that an increased There are three types of muscle pain that
amount of alkali is placed in the fibers to people encounter after a workout. Soreness,
defuse the acid that develops by physical force. often accompanied by a burning sensation, can
An increased amount of glycogen is apparently be experienced after high-impact resistance
placed in muscles to store energy, thereby training, cardiorespiratory conditioning
allowing the nervous system which controls or even after cooling off following a high-
the muscles to work more efficiently. This is impact exercise session. Soreness is due to an
20
accumulation of lactic acid during anaerobic Skeletal muscles are consistently making
effort. It is important to note that lactic acid extremely fine adjustments which hold the
is not considered a waste human body in positions that
product; it is a by-product of are stationary. The muscle
anaerobic effort. The majority tendons extend over body
of lactic acid buildup normally joints, contributing to the
dissolves within 30 to 60 stability of joints. This is
minutes. particularly obvious in the
According to physiologists, shoulder and knee joints,
lactate buildup is not associated where muscle tendons
with post-exercise soreness are a serious factor in the
and pain that happens 24 to stabilization of the joints. To
48 hours after ending a normal maintain the temperature of
training session. When enough the body, heat production is a
oxygen is present, lactate is metabolized vital muscle by-product for metabolism. In fact,
and can actually be used as energy. The muscular contraction produces approximately
remaining two types of soreness can happen 85% of the body’s heat.
for a prolonged amount of There are two different
time right after finishing a Skeletal muscles are fiber types in the muscles of
consistently making
workout. Muscle and joint extremely fine adjustments. the body: “slow twitch,” or
soreness may develop a few Type I, and “fast twitch,” or
hours after a workout, followed by a Delayed- Type II. More power is generated as the fibers
Onset Muscle Soreness (DOMS) which can of muscles move more rapidly. In regards
last for a few days. DOMS can happen when to fitness training that requires endurance
a person begins exercising after stopping for and stamina, slow twitch muscle fibers are
a while—the body is simply adjusting to the utilized. Fast twitch muscle fibers are used
exercise. for strength and intensity involved in fitness
21
training. In simpler terms, slow twitch fibers fuel for optimal force and quick action involved
are considered low threshold because they in fitness training for strength. Slow fibers
are the first muscle fibers to be recruited for normally employ oxygen-utilizing (or aerobic
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.
Comparison of Slow- and Fast-Twitch Muscles:

Slow-Twitch Fast-Twitch
Slow Twitch Fibers (Type I) = Red in Color
Twitch Rate Slow Fast
Fast Twitch Fibers (Type II) = White in Color
Glycogen Content Low High
Glycolytic Capacity Low High pathways) to fuel activities that require lots of
Fatigue Resistance High Low
stamina and endurance. Research has shown
Respiration Type Aerobic Anaerobic
Capillary Supply High Low

that endurance athletes, like long-distance
runners, produce less of a protein made mostly

During a customized fitness training
by fast twitch fibers due to a genetic mutation.
program that consists of aerobic and anaerobic
Sprinters and other athletes that rely on quick
exercises, various types of muscles are used.
bursts of energy, however, less frequently have
Weightlifters and bodybuilders use fast twitch
this mutation.
muscle fibers, which provide brief bursts of
Within the duration of eccentric (fast twitch)
strength, whereas marathon runners, hikers,
contraction, a muscle extends while under any
bicyclists and walkers utilize slow twitch
tension because an opposite force is greater
muscle fibers, which do not fatigue quickly.
than force produced by muscle. Instead of
Fast twitch fibers do not require oxygen;
working to pull any joint in a direction of
instead they utilize sugars to produce body
22
muscle contraction, muscles decelerate the movement. Eccentric contractions are still
body joint at an end of any movement or else being studied and researched for an ability
control repositioning of any load. This happens to hasten rehabilitation of injured or weak
involuntarily, such as attempting to move tendons. For example, Achilles tendonitis has
much too heavy weight for muscles to lift, or been proven to derive therapeutic benefits
voluntarily, such as smoothing out movement from high load eccentric contractions.
with muscles. During the short term, strength

Muscle Fibers
training involves contractions that are both
Protein filaments make up the muscle
concentric (slow twitch) and eccentric, which
fibers. Warm-up exercises increase muscle
appears to enhance the strength of muscles
temperatures, which allow for greater
more than fitness training with concentric
mechanical efficiency. This efficiency is
contractions alone.
achieved by lowered viscous resistance
To safeguard body joints
within muscles, which helps
from any damage, eccentric Virtually any movement of
to decrease the viscosity
contractions generally occur routine action involves
eccentric contractions. of the muscle. In turn, this
as a brake-like force on the
helps protein filaments that
opposition to a contraction
make up muscle fibers to contract with less
that’s concentric. Virtually any movement of
resistance, thus increasing the movement of
routine action involves eccentric contractions
the muscles.
assisting in the maintenance of smooth body
Muscle fibers are specialized cells which
motions. Eccentric contractions can also slow
are controlled by the nervous system. The
down rapid muscle movements like a throw
chief function of these fibers is muscle
or a punch. An aspect of training for these
contractibility. Where attached to internal
rapid movements, like pitching a baseball or
organs, blood vessels or bones, muscles
throwing a boxing jab, entails diminishing
are liable for movement. Almost all bodily
braking on an eccentric level. This allows
movements result from contractions of the
a much greater power to develop during
muscles. Of course there are exceptions, such
23
as cilia action, flagellum on cells of sperm, • Transportation of oxygenated blood
and movements of amoeboid of several white from the lungs to different parts of the
blood cells. body and deoxygenated blood back to
the lungs.
Cardiorespiratory System
• Distribution of nutrients (e.g., free
The cardiorespiratory system
fatty acids, glucose and amino acids) to
is an umbrella term for the entire Lungs Heart
cells.
respiratory and cardiovascular Veins Arteries
• Removal of end products and metabolic
systems. Acting together they
waste products (carbon dioxide, lactate
offer oxygen, protective agents
and urea) from the periphery for reuse
and nutrients to the tissues
or elimination.
of the kinetic chain, a term
• Regulation of pH to control alkalosis
referring to the muscular, articular and neural
and acidosis.
systems. The kinetic chain is also a mechanism
• Transportation of enzymes and
for removing waste by-products. Basically the
hormones to control physiological
cardiorespiratory system is the support system
function.
for the kinetic chain to produce movement.
• Maintenance of fluid volume which
The cardiovascular system has three
helps in preventing dehydration.
components: the heart, the blood vessels
• Maintenance of body temperature by
carrying blood between the heart and tissues,
absorbing and redistributing heat.
and the blood itself. The
The respiratory system
cardiovascular system plays an
The cardiovascular system helps is often referred to as the
important role in maintaining with continuation of normal
function during exercise and rest. pulmonary system and is
homeostasis in the body. It
made up of soft tissues
also helps with continuation of
and skeletal structures. The major role of the
normal function during exercise and rest. The
respiratory system is to make sure all cells
cardiovascular system is accountable for the
function properly. This system works closely
following seven functions in the body:
24
Central
Nervous
System
Autonomic Somatic
Nervous Nervous
System System
Sympathic Parasympathic
Nervous Nervous
System System
Relaxes
Increases Bronchi
Heartbeat Rate Constricts
& Blood Decreases Bronchi
Pressure Heartbeat Rate
& Blood
Pressure Diaphragm &
Heart Lungs Intercostal
Increases & Muscles
Mechanical Decreases
Feedback Lung Capacity
(Positive Pressure
Increases
Heartbeat Rate)
with the cardiovascular system to accomplish respiratory muscles (pectorals minor and
this task. It also provides a means of gathering scalenes) aid in heavy, deep or forced breathing.
oxygen from the environment and conveying All the structures that air travels through before
it to the blood stream. In order to accomplish entering the two respiratory passageways
the movement of air in, out and through the are called conduction passageways. The
body, the functionality of the respiratory and respiratory passageways collect the air coming
respiratory passageways must be integrated. from conduction passageways. Respiratory
The primary respiratory muscles are the passageways allow oxygen and carbon dioxide
external intercostals and diaphragm, which to go in and out of the blood.
help normal breathing, while the secondary
25
and then goes to the left ventricle. When the
Heart
left ventricle contracts, it pushes the blood
The heart is a muscular pump. It rhythmically
from the heart and distributes it to the body’s
contracts to push blood throughout the body. It
tissues. The amount
is located in the center of
to Lungs of blood pumped out
the chest and is flanked Pulmonary Veins
to Lungs
from Lungs
AO PA
Pulmonary Veins
from Lungs
with each contraction
by the lungs. The heart Superior Vena Cava
LA Mitral Valve
Atrial Septum Aortic Valve
of the ventricle is
RA
weighs about 300 grams, LV
Tricuspid Valve
RV
Ventricular Septum known as the stroke
with an average size Inferior Vena Cava
AO–Aorta volume. Additionally,

of an adult fist. Clients Pulmonary Valve
PA–Pulmonary Artery
LA–Left Atrium
RA–Right Atrium an adequate oxygen
should be advised for oxygen-rich blood
oxygen-poor blood
LV–Left Ventricle
RV–Right Ventricle
supply is critical for
medical checkup for
myocardium because,
diagnosing heart disease before selecting any
compared to skeletal muscle, heart tissue
kind of exercise or training program.
has a very limited ability to generate energy
The heart is composed of four hollow
anaerobically.
chambers. Valves separate each chamber from
one another and from the arteries and major Blood

veins, which prevents backflow or spillage of Blood transports the necessary oxygen
blood back into the chambers. These chambers to tissues and gathers waste products from
are divided into two interdependent but all tissues. It also transports hormones and
separate pumps on both sides. The interatrial delivers nutrients from the gastrointestinal
spectum separates these two pumps. Each tract to specific tissues. Blood provides a
side of the heart has two chambers: an atrium means to regulate the temperature of the body
and a ventricle. The right ventricle receives through its conduction of heat, primarily due
deoxygenated blood coming from the right to its water content and its flow path. Blood
atrium then pumps the deoxygenated blood travels close to the skin which helps to give
to the lungs. The reoxygenated blood coming off heat or cool the skin, depending on the
from the lungs is received by the left atrium environment. The regulation of the body’s
26
water content and acid Head
nutrients, oxygen, waste
balance is based on pH values products and hormones.
and is dependent on the blood. Lungs Lungs

Veins are the blood vessels
The clotting mechanism of that carry blood back to the
blood provides protection heart. The waste products

Rest of Body
from excessive blood loss collected in capillaries are
by sealing off damaged Blood carrying oxygen in arteries transported for cleaning
Blood carrying carbon dioxide in veins
tissue. Blood also generates purposes by the veins.
specialized immune cells to fight against

Lungs
foreign toxins within the body, leading to a
The two lungs, located in the chest cavity, are
decrease in illnesses. Ironically, by the same
essential respiratory organs. Though humans
mechanism, blood can promote the spread of
have two lungs, they are non-identical and
foreign organisms that invade the body.
differ in size. The left lung is typically smaller
The ventricles of the heart pump and
than the right lung. Lungs bring oxygen into
disperse the blood throughout the body.
Simultaneously the blood is also re-entering

Trachea
the heart. For proper circulation of blood Right Upper Lobe

Pulmonary Vein
Left Bronchus
throughout the body and back to the heart
Right Bronchus Left Upper Lobe
there must be a network through which blood Pulmonary Arteries

Right Middle Lobe
Bronchioles
can travel. This network is composed of blood Pleura
Right Lower Lobe
vessels. Arteries are the vessels that carry RIGHT LUNG LEFT LUNG
Left Lower Lobe
blood from the heart to the entire body. Arteries oxygen-rich blood
oxygen-poor blood
are typically large and elastic and are further
divided into medium-sized muscular arteries,

the body and remove carbon dioxide from
which again branch into small arteries called
the body. Deoxygenated blood coming from
arterioles. These arterioles are again divided
the right ventricle of the heart is saturated by
into capillaries, which help the exchange of
the lungs with incoming oxygen. Breathing, or
27
ventilation, is the actual process of moving air energy is collected from an energy utilizing
in and out of the body. source (the breakdown of food) by some
Breathing is divided into two phases: storage unit and then transferred to a site that
inspiration and expiration. Inspiratory can use this energy.
ventilation is active while expiratory Energy is generated from fat, carbon dioxide
ventilation can be both active and passive. and protein gathered from consumed food, and
When you inhale the diaphragm contracts it can be produced aerobically (with oxygen)
and flattens out. Also the rib muscles lift the and anaerobically (without oxygen). The
ribs up and outward. Thus the lungs get more intensity of activity determines which energy
space to grow larger and fill system will predominate.
up with air. The process is Energy is generated from fat, The aerobic energy system
carbon dioxide and protein.
reversed during expiration. contributes toward certain
The diaphragm relaxes, moves up and pushes goals, while the anaerobic system can be
the air out of the lungs. The rib muscles also trained for other goals. There are three energy
relax and they move in. Now the lungs have systems for the body which are:
smaller space, causing the air to push out. • Immediate Energy (ATP-CP system)
Patients having problems with their lungs • Short term Energy (Lactic acid or
find difficulty with exercise. Training helps to Glycolytic system)
strengthen the lungs and muscles, improve • Long term energy (Aerobic or Oxidative
endurance and reduce breathlessness. system)

CRT
Energy Production MITOCHONDRIA CYTOSOL
Energy is the capacity to do work. Chemical Cr

ATP ATP
ATP ATP
energy obtained from food is converted to CK CK CK CK ATPase
ADP ADP
ADP ADP
PCr
mechanical energy that then fuels physical
activity, often in the form of muscle contractions.

oxidative glycolysis cytosolic cytosolic
When energy is used, it is referred to as AN phosphorylation ATP/ADP ratio ATP-consumption
energy utilizing reaction. In other words,
28
As each name suggests, each energy system of exercise. Even though this is the slowest
relates to different activity times. The ATP-CP system, it produces the greatest amount
system is used for activity up to 10 seconds of ATP. In this system, 1 glucose molecule
while glycolysis fuels activity up to about one generates 36 ATP molecules and in certain
minute. Oxidative energy production is the circumstances can possibly generate up to 38
major source of energy for greater than two ATP molecules.
minutes worth of activity.

ATP
The ATP-CP system is inefficient in producing
Adenosine triphosphate (ATP) is the storage
large amounts of ATP so training these
and transfer unit of energy within the cells of
systems is neither easy nor enjoyable for most
the body. Because of this, ATP is called “the
clients. The glycolytic system can generate
energy currency” of the cell. At any one time
a greater amount of energy than the ATP-CP
the amount of ATP
system but it is very H H
N stored in the body
limited. Many training Adenosine
C N
N C C H
is very small so
programs give more
H C C N the body needs to
importance to this Phosphate Groups N
H resynthesize ATP
system compared to H O C H H
O OH O
H
C
C H C O
H H
O continuously.
the ATP-CP system O P O P
C
O P
H H
O O ATP is structurally
O O H
because a typical
Ribose composed of a
repetition range of 8
nitrogen based
to 12 repetitions falls within this time frame.
compound, adenine, a five-carbon sugar
For long-term energy an oxidative system
called ribose and three phosphates. ATP has
is needed. It depends mainly on fats and
the ability to store great amounts of energy
carbohydrates for generating ATP. Energy is
in the chemical bonds of the phosphates.
produced more slowly in this system compared
Essentially this is the energy needed for the
to other systems, because it requires a larger
muscle contractions which create physical
amount of oxygen to meet the muscular needs
activity. The natural supply of ATP in each
29
cell is inadequate; therefore, cells must have a in a 5 kilometer race with a 60 second burst
means of generating more. of speed.
Pyruvate is one of the by-products of this

Glycolysis
process. Two molecules of pyruvic acid are
Glycolysis typically takes place in the initial
stage of respiration in the presence of oxygen Glucose

2 ATP
but can also occur without oxygen present. Anaerobic Glycolysis
The breakdown of carbohydrates (glucose) G-3-P
Net 2 ATP
rapidly produces ATP. This metabolic pathway e-/H+
Fermentation
occurs in almost every cell. Through anaerobic pyruvic acid Lactic Acid
Fermentation permits more glycolysis

glycolysis one glucose molecule will produce
by removing the product of glycolysis,
two ATP molecules while aerobic respiration pyruvic acid. Eventually lactic acid
builds up and contributes to muscle
can produce many more high-energy ATP fatigue.
molecules. The anaerobic glycolytic system
is called the short- term energy system and usually oxidized from a single molecule of
is used for high intensity efforts in a short glucose. A build up of lactic acid will occur
if pyruvate cannot be rapidly utilized by the

Creatine~P Glycogen Glucose or
Other Fuel muscle cell. A large accumulation of lactic
Glycolysis Respiration acid triggers a drop in the pH of muscle cells,
Creatine Lactic Acid
+ ~P + ~P
~P making them acidic and possibly interfering
+
with muscle contractions. It may cause a
CO2 + H2O
ATP burning sensation in the exercising muscles
and should lead to stopping the activity or

Muscle decreasing the intensity of the activity.
Contraction
Summary
period of time. For example, anaerobic All systems in the human body are related.
glycolysis is needed for passing a participant The harmonious functioning of all these
30
systems is necessary for good health. The very influential in the body’s ability to consume
exercises or training programs selected must oxygen. The personal trainer should also be
not destroy the original harmony present in aware of the science associated with energy
the human body. For example, production to effectively use
alterations in breathing it for the training of clients.
patterns may have a direct To achieve specific results,
impact on the components the clients should have the
of the kinetic chain and may ability to train and influence
lead to dysfunction. If the all three energy systems.
breathing patterns become

Review Questions
shallower, the body uses secondary respiratory
1. Which of the following is not a component
muscles more than the diaphragm. It may
of the cardiovascular system?
negatively impact posture. This may also cause
a) The heart
excessive muscular tension which results in
b) Blood
light-headedness, headaches and dizziness.
c) Blood vessels
Short shallow breaths can also lead to altered
d) Lungs
carbon dioxide and oxygen blood content.
2. What are the three functions of the nervous
It may cause feelings of anxiety. Inadequate
system? _______________________________________
oxygen which causes retention of metabolic
_ _______________________________________________
waste within muscles can create stiff joints
_ _______________________________________________
and muscles.
3. The sensory neurons transmit nerve
When a client’s goal is health and fitness, the
impulses to which structures?
personal trainer has to be aware of different
a) Other neurons
kinds of exercise. A personal trainer should
b) The brain
understand the roles of the cardiovascular and
c) The spinal cord
respiratory systems in exercise selection and
d) The brain and the spinal cord
programming. The cardiovascular system is
31
4. One of the main purposes of exercise is to a) Heart
exert the cardiovascular and respiratory b) Lungs
systems. True or False?______________________ c) Muscle
5. What are the three systems that are d) None of the above
collectively referred to as the kinetic 10. A personal trainer can cause a client
chain?_________________________________________ injury with an inappropriate workout if
_ _______________________________________________ the trainer is not aware of how the body
_ _______________________________________________ works. True or False?________________________
6. Is the oxidative system for producing

Answers:
aerobic energy or anaerobic energy?_______
1. d) Lungs.
_ _______________________________________________
2. 1) To gather information about our inner
_ _______________________________________________
and external surroundings (sensory
7. Which energy system is needed for running
function), 2) to process and interpret the
up a 100-yard hill as fast as possible?
information (integrative function) and 3) to
a) Oxidative system
respond to these stimuli (motor function).
b) ATP-CP system
3. d) The brain and the spinal cord.
c) Anaerobic Glycolysis/lactic acid system
4. True.
8. What is the function of the ATP-CP
5. The muscular, articular and neural
system?
systems.
a) To provide energy all the time
6. Aerobic energy.
b) To provide energy for low intensity
7. b) The ATP-CP system.
long workouts
8. c) To provide energy for high intensity
c) To provide energy for high intensity
short workouts.
short workouts
9. d) None of the above.
d) All of the above
10. True.
9. Which of the following is NOT an organ or
tissue required to work intensely during a
workout?
32
Santana-Sosa E, Barriopedro MI, López-
References
Mojares LM, Pérez M, Lucia A. Exercise
Blumenthal JA, Babyak MA, Carney RM, Huber
Training is Beneficial for Alzheimer’s
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Patients. International Journal of Sports
L, Taylor CB, Kaufmann PG. Exercise,
Medicine. 2008; 29(10):845-50.
depression and mortality after myocardial
Takahashi T, Arai Y, Hara M, Ohshima K, Koya S,
infarction in the ENRICHED trial. Medicine
Yamanishi T. Effects of resistance training
and Science in Sports and Exercise.
on physical fitness, muscle strength
2004;36(5):746-55.
and natural killer cell activity in female
Kai MC, Anderson M, Lau EM. Exercise
university students. Japanese Journal of
interventions: defusing the world’s
Hygiene. 2008;63(3):642-50.
osteoporosis time bomb. Bulletin
Yang N, MacArthur DG, Gulbin JP, Hahn AG,
of the World Health Organization.
Beggs AH, Easteal S, North K. ACTN3
2003;81(11):827-30.
Genotype is Associated with Human Elite
Lange-Asschenfeldt C, Kojda G. Alzheimer’s
Athletic Performance. Am J Hum Genet.
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2003;73(3):627-31.
and the benefits of exercise: from vessels
to neurons. Experimental Gerontology.
2008;43(6):499-504.
Rogers CJ, Zaharoff DA, Hance KW, Perkins
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33
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
forces are distributed within an object at the
M
What Is Biomechanics?
lowest levels encompasses deformable-body
echanics is the science
mechanics. So if the object is the body, the
studying the motion of
science of deformable-body mechanics would
objects and the forces that
look at the effect of external forces on tissues
cause the motion. Mechanics
and organ systems. As the name suggests, fluid
is often divided into three main areas
mechanics deals with the forces of fluids on
including rigid body mechanics, deformable-
and within the body such as blood flowing past
body mechanics and fluid mechanics. In rigid-
heart valves and the effects of
body mechanics, the object
swimming on the body.
in question is treated as
The study of biomechanics
rigid and the forces that act
is relatively new to the field
on the object are studied.
of science and medicine.
In other words, the object
Biomechanics is the use
does not deform by bending,
of engineering principals,
stretching or condensing.
such as fluid mechanics
Rigid-body mechanics is
and thermodynamics, and
often subdivided into the
applying them to biological
study of statics and dynamics. Statics is the
organisms. Biomechanics also incorporates
mechanics of objects at rest or moving at an
mathematics and therefore mathematical
unchanging velocity. On the contrary, the
concepts like calculus and vector algebra.
mechanics of dynamics looks at objects that
These physical and mathematical principals
are in accelerated motion.
are applied to the conception, design,
Segments of the body are often considered
development and analysis of equipment and
rigid elements, linked by bendable joints but
systems in biology. Therefore, biomechanics
this is not truly the case. Deformable-body
is simply the mechanics of tissues, joints and
mechanics and fluid mechanics are more
human movement. As a study on how the body
applicable to dynamic biological systems. How
36
moves much like a machine, with principles of function and production of molecules, which
physics intertwined, biomechanics includes are all biomechanical characteristics. For
how “living forces interact within example, mechanical forces stimulate
a living body.” Research in sports bone growth and determine how
biomechanics may take the form big and strong bones need to be to
of describing movement for the carry weight. Biomechanics also
enhancement of performance. plays a role in some disease states
Biomechanics is also often applied by either being involved in the onset
to sports medicine in the prevention of sports- of disease or being used to treat the diseases
related injuries. To accomplish this, computer or other illnesses. For example, biomechanical
modeling simulation of the body is used to aid principals are involved in the ocular disease
in the study of biomechanics. glaucoma. The eye is internally pressurized
and that pressure can become elevated. This

The Importance of Biomechanics
can then lead to damage of the optic nerve and
Virtually all modern advancements of
eventual blindness if left untreated. On the
medical science and technology have involved
other hand, the study of biomechanics can help
biomechanics. Because of this, biomechanics is
in the design of implants and prosthetic devices
thought to have made significant contributions
that have mechanical function like artificial
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
deals heavily with the formation, design,
37
hips and hearts used in transplantation to performance through advanced strength
correct biological dysfunctions. training. Biomechanical analysis can uncover
One of the ultimate goals of biomechanics technique deficiencies and identify the type
as it relates to exercise and sports is the of training that a person requires in order
improvement of performance. to correct such problems. For
The most common way to example, a person may lack
improve performance is to strength and endurance in
develop training techniques. certain muscle groups or in their
Biomechanics is most useful speed of movement. Knowledge
when the dominant factor has to of the biomechanical properties
do with the action of movements of muscle groups and movement
and not physical structure or can allow trainers and coaches
physiological capacity. Using biomechanics to to easily detect setbacks and adjust training
improve performance may be accomplished regimens accordingly.
in several ways. A trainer or coach may use Other goals of exercise and sport
biomechanics to correct skeletal or joint action biomechanics include injury prevention and
to improve skill. In addition, rehabilitation. Biomechanics
a biomechanical researcher Other goals of exercise and sport can be useful in determining
biomechanics include injury
may discover new techniques prevention and rehabilitation. what forces caused an injury
that can be used to perform and thus how to prevent this
skills. injury from reoccurring. Furthermore, figuring
Biomechanics may also prove to be useful out what exercises aid the rehabilitation
in improving the design of sports equipment. process after an injury may also be possible
An example of this is the production of lighter through biomechanics. This is directly related
and more aerodynamic javelins or tennis to improving athletic performance since
racquets. Additionally, biomechanics has the the development of new techniques and
potential to lead to improvements in athletic equipment that prevent and treat injuries are
38
essential. Determining how to decrease the the tendons that connect bones to muscles.
impact of forces for a gymnast’s landing or Moreover, the area where the muscle attaches
creating shoes that are not stiff for runners to a moveable skeletal structure (e.g., elbow)
are also examples of how biomechanics can is called the insertion. An origin is defined as
reduce injuries. the area of the body where tendons attach
to immobile skeletal
Biomechanics and Exercise
structures.
Understanding how the body works when
It is well known that
it moves in a certain way or with certain
muscles need oxygen,
intensity is possible by studying a never-
but it must be noted that
ending circle called the “human movement
special mechanics are
efficiency” circle. Regardless of “how” energy
involved in the process
is used, biomechanics also involves the
that enables muscles
“where” of energy usage and how that energy
Warm-up exercises for 5 to attain oxygen. More
intermingles with the realm of physics, such to 10 minutes gently get
the blood circulating. detailed components of
as motion through skeletal
muscle structure, its relation
muscles.
to the nervous system,
In general, muscles are
and how muscle structure
composed of millions of fibers,
stimulates motion are also
which need to be warmed up
factors for both anatomy and
and cooled down to prevent Cool-down exercises slow the heart
rate and stretch warm muscles.
biomechanics.
muscle damage. These fibers
are wrapped by fascia, or connective tissue, Warm-Up

called endomysium. Endomysium forms Like many machines, the human body must
bundles that are surrounded by another layer of also warm up before sharply accelerating.
tissue called the perimysium. The perimysium There are typically five biomechanical
is covered by a fibrous facial layer, named the benefits of warming up. Cardiorespiratory
epimysium. This layer of tissue extends from enhancements are the first benefit of a good
39
warm-up because it leads to less stress on recovery before the moderate-intensity exercise
a client’s lungs and heart. A proper warm- (), compared with values obtained in the
up raises the body temperature, which is absence of prior low-intensity exercise ()
beneficial because blood cells release oxygen Secondly, blood flow to active muscles
more rapidly at higher temperatures. This increases during a warm-up and prevents
leads to increased utilization of oxygen for the premature fatigue during the workout, not
muscles. to mention lactic acid buildup. Lactic acid is
produced in muscle tissue during exercise, but

180 causes muscle fatigue and cramps when large
ATP production from oxygen independent
160
With Prior Low Intensity Exercise
amounts accumulate. The steady flow of blood
routes (mmol.kg-1 dry weight)
140 Without Prior Low Intensity Exercise
120 to active muscles is due to vasodilatation,

100
which is an increase in the diameter of blood
80
60 vessels in order to accelerate the passage of

40
blood. Exercising and warming up leads to an
20
0
0.0 1.0 2.0 3.0 4.0
increase in the body’s core temperature. This
Oxygen deficit (L)
increase in temperature causes large amounts
of blood to circulate within the body quickly.

Low Intensity Exercise Chart—Effects of
Increased blood flow means more oxygen is
warm-up exercise on oxygen-independent ATP
available to tissues. In addition, proper blood
re-synthesis and the oxygen deficit. Shown is
circulation hinders the
ATP re-synthesis from oxygen-
accumulation of lactic acid,
independent routes following Blood cells release oxygen more
promotes the removal of
1 minute of moderate- rapidly at higher temperatures.
metabolic by-products, and
intensity exercise (75% of
stimulates the release of
VO2max) and the calculated oxygen deficit over
nutrient-filled fuel for active muscles.
the same period in individuals (n=6) who had
Thirdly, as mentioned before, a heightened
performed 10 minutes of low-intensity exercise
body temperature can be biologically beneficial.
(55% of VO2max) and 3 minutes of passive
40
For instance, less muscle injuries occur when cases, the trainer can assume that the current
the body temperature rises in response to routine will not irritate any current bodily
warming up or exercising. With an increased ailments and should be continued.
temperature, muscles become “stretchy” or However, if bodily ailments present
more flexible, which makes it themselves after a
more difficult to tear muscle fibers workout as a result of

With an increased temperature,
and decreases the occurrence of muscles become “stretchy” or more excessive movement
flexible, which makes it more difficult
injuries. Additionally, the fluidity to tear muscle fibers and decreases and weight training,
the occurrence of injuries.
(viscosity) of muscle fluids then the client will
increases as body temperature not benefit from
elevates. This allows proteins such as actin and the regimen and a different workout routine
myosin, which make up muscle fibers, to move should be designed.
more freely and allow muscles to contract with

Cool-Down
less resistance. Besides the muscular benefits,
Just as a warm-up is crucial to any physical
joints are lubricated during warm-ups and
activity, a “cool-down” is just as important.
allow movements to be carried out easily.
There are explicitly four reasons why this
Fourthly, warming up enhances motor
is the case. The first reason is that cooling
skills and brain transmissions for continuous
down delays the onset of muscle soreness
activity. With nervous impulses moving
after activity by reducing lactic acid buildup.
faster, muscle movements are made with
Although the majority of muscle soreness is
more ease. Lastly, symptoms of stress, pain
caused by irritated muscle tissue fibers from
or any discomfort felt by the client from the
the activity itself, it has been proven that lactic
skeletal muscles or cardiovascular systems
acid can induce further irritation.
are increased. Ironically, this can be beneficial
Secondly, if an exercise is stopped abruptly
to physical training. If these symptoms occur
without a proper cool-down period, blood
during or toward the end of a workout, they
pools in the lower extremities or limbs, a
can be taken as normal signs of fatigue. In such
41
phenomenon known as venous pool. When unused adrenaline, the heart becomes stressed.
this happens, blood supply to the heart is By cooling down, a client’s body will not be
compromised. Moreover, the heart is still as physically stressed after a workout. Until
pumping hard from the activity now, through understanding
that was being performed. biomechanics, many physical

Cooling down can keep muscle
When both situations occur fibers warm for a lengthened trainers understood how to
amount of time because muscle
simultaneously, the heart is fibers are gently stretched turn a client’s engine “on”
after the workout.
in dire need of oxygen, but is and “off”. However, now
not be able to attain adequate biomechanics can also help
quantities of oxygenated blood because blood trainers understand how to keep the engine
has begun to accumulate in the lower limbs. in good condition when it is on and off.
This leads to dizziness and possibly fainting.

Motion and Kinematics
Thirdly, consistent with minimizing muscle
Completely understanding the human body
soreness, cooling down can keep muscle fibers
and the energy used in movement is the key to
warm for a lengthened amount of time because
proper physical training and the improvement
muscle fibers are gently stretched after the
of fitness. In the field of mechanics, the analysis
workout. The warmer the tissue
of motion has physical as well
fibers are, the less likely they
as geometric (mathematic)
will tear. A sudden increase or
properties. The physical aspects
decrease in temperature will
primarily deal with the forces
also cause similar tearing, so
involved in movement and
the cool-down period allows the
activity. These forces, both
temperature to decrease slowly.
internal and external, act on
Fourthly, excess adrenaline
different points on the body
released during exercise can be
and influence specific motion.
used up during the cool-down
Geometrical (mathematical)
period. When blood carries
42
descriptions of motion involve location and the rotation of the body. Related to this
orientation. variable is speed (velocity) or the measure of
The study of human motion itself is often how fast a part of the body is moved. Similar
referred to as kinematics. Kinematics also to rearrangement, speed can be averaged
describes and analyzes motion without as linear speed or angular speed. Lastly,
reference to mass, force acceleration measures
or other circumstances how quickly speed
leading to motion. has changed. Linear
Kinematics involves acceleration measures
five primary variables the change in linear
including the timing of speed (in a straight
movement, positioning, line) and angular
rearrangement, speed acceleration notes
and acceleration. the change in angular
Timing provides a measurement of how speed (e.g., a circular movement). Virtually
long a movement lasts. This variable becomes all body movements involve acceleration.
important when determining the mechanical During running and jumping, the arms and
response to internal and external forces on legs are constantly accelerating rather than
the body. The position of the body during the maintaining a constant rate of motion.
movement determines the likelihood of an Judgments regarding normal and abnormal
injury occurring. For instance, forces acting motion also use kinematics. Geometrical
on a hyper-extended (straight) arm will be (mathematical) parameters like length,
different from the forces acting on a flexed rearrangement and angle can be used to
(bent) arm. In terms of rearrangement, linear evaluate, for instance, a person’s walking
rearrangement measures the movement from patterns. In this case, kinematics can be used
one location to another, typically in a straight on each body segment or on the body as a
line, while angular rearrangement involves whole. The use of kinematics can then be
43
helpful in diagnosing locomotor problems directions in movement. A force always exists
and deciding which treatment regimens and between two objects whenever an interaction
movement therapy would be most beneficial. is initiated. Forces can be classified as internal
and external, depending on

Forces
the source of the force.
Mechanics deals a lot
with energy, such as where Internal Forces

it goes and how it is used. Internal forces act within
Most of the dynamic forces the object (e.g., the body)
involved in biomechanics being studied. The force acts
and around any living on different parts of the body
system are kinetic energy. Kinetic energy is but does not necessarily affect the motion of
the energy of motion. This area of kinetics the whole body. For example, muscles pull on
studies the relationship between an object’s tendons which conversely pull on bones. The
movement and what caused it. For example, pulling force that acts on an internal structure
when there is extra energy associated with is called a tensile force. The structure being
an object like a ball that is tossed, the ball will acted on is said to be under tension. The
move in a certain direction. The energy used pushing forces are referred to as compressive
to move the ball is a form of kinetic energy. In

Relationship of Tension to Muscle Length
terms of biological systems, kinetics examines The Sarcomere Whole Muscle
the energy that causes the body to move. The Normal sarcomere length
Optimum length for
maximum tension
(b)
1.0
size of the force is directly related to the weight (a)
Muscle Tension
2.0 2.25
μm μm
Tension
1.65
0.5 μm
of the object and how its motion will change.
1.25
μm
(c)
0
60 80 100 120 140 160
Additionally, just as force is required to start Percent of resting length 3.65
μm
Muscle Length
At this length there is maximum overlap of This applies to the entire muscle as
motion, it is also needed to stop motion. myofilaments producing maximum number
of crossbridges and maximum amount of
well as to individual sarcomeres.
tension.
In simple terms, a force is a push or pull
on an object. Force can cause an object to forces, which are forces that press objects
start, stop, move faster or slower or change together. In this case, the structure being acted
44
upon is under compression. In situations External forces can either be contact forces,
where the tensile or compressive force is which occur when objects physically touch
greater than what the object can withstand, each other, or non-contact forces, forces
the structure fails and can between objects that are
break. When this occurs in not touching. The most
the body, muscles, joints, common forces are contact
ligaments and bones can forces. Pushing on a weight
be damaged. Knowledge machine is an example of
of internal forces that can an external force. Magnetic,
affect the body when it is in electrical and gravitational
motion is important for the forces are all non-contact
prevention of injury. forces. Friction, another non-contact external
Muscles are often thought of as the force, is an important force in every movement.
structures that produce the force in the body Basic activities like walking or jogging require
that leads to motion. This is mainly because frictional forces. For instance, shoes provide
muscles produce motion in the the proper frictional
limbs of the body. However, Pushing on a weight machine is an force between the
muscles only produce internal example of an external force. surface of the feet
Magnetic, electrical and gravitational
movements (forces) and are forces are all non-contact forces. and the ground or
incapable of producing changes floor.
in motion without external forces that act on

Inertia
the body. In other words, the body can only
Inertia is the property of an object to
cause changes in motion if it pushes or pulls
resist changes in its motion. This outlines an
against an external force.
important relationship between force and
External Forces motion. A more detailed explanation of inertia
External forces on an object are due to the is given in Newton’s first law of motion. This
influence of the surrounding environment. law states that “a body which is at rest will
45
remain at rest unless some external force is farther along the surface. The second part of
applied to it, and a body which is moving at a the theory of inertia demonstrates a situation
constant speed in a straight line will continue where there is no resistance due to friction
to do so unless some external force is applied or air resistance. In this case, the object will
to it.” In other words, static objects have to be continue to move if it does not come in contact
with another object or if the surface is

Newton’s Laws of Motion
never-ending.
Force
The marble speeds up
rolling down the ramp. Intuitively, heavier objects have more
inertia (resistance) than lighter objects.

Force The marble slows down However, the measure of inertia is not
rolling up the ramp.
weight but rather mass. Weight is the
The marble will neither slow down nor speed measure of the force of gravity acting
Force up rolling on a perfectly horizontal surface.
on an object. Mass is defined as the
amount of matter in an object (an
object’s composition) and corresponds

pushed or pulled to be moved. However, it is
more closely to inertia. In situations where
thought that when an object is pushed across
gravity is negligible, the weight of someone
a floor it would eventually come to a stop.
or something would change but not the mass.
The object stops when the force is removed
For example, in space, gravity does not pull
because there is also an opposite force on the
objects down so objects float and appear to
object (e.g., gravity or friction). The opposite
be weightless. However, in reality the object’s
force is primarily due to friction between the
composition has not changed. This becomes
two surfaces.
important in sports and exercise when a
Friction is defined as the resistance between
person has to change the motion of a piece of
two surfaces that are in contact with one
exercise equipment or parts of the body. The
another. When friction is reduced, possibly
mass and inertia (resistance) of the equipment
through the polishing of the surface, the
and the body will determine the effort that is
pushed object has the potential to travel
46
required to get the object moving or stop the Many everyday objects are constantly in a
object from moving. state of equilibrium because of friction. An
object may rely on the friction of a surface

Stability of Equilibrium
to prevent it from moving. If the surface that
When the body is at rest or moving at a
the object was on was frictionless, even the
constant speed, the body is said to be in
smallest force would cause a large object to
equilibrium. The major characteristic of
slide in a particular direction.
equilibrium is that the overall force
The two important aspects of
on the body in all directions is zero. Equilibrium Types
equilibrium in the human body are
This means that the rightward
Stable
intrinsic (inward) and extrinsic
forces on the object are balanced
Unstable (outward) stability. For intrinsic
by the leftward forces and the
Neutral stability to occur, the segments
upward forces are balanced by the
of the body need to be balanced.
downward forces.
The body has intrinsic muscular actions that
There are three types of equilibrium for an
control and stabilize an erect human body
object depending on the stability of the body.
around the joints of the spine and the limbs.
These classes are stable equilibrium, unstable
This stability requires a
equilibrium and neutral
constant, conscious state
equilibrium. For stable The major characteristic of
equilibrium is that the overall force that is controlled by the
equilibrium to occur, a on the body in all directions is zero.
brain and spinal cord
slight disturbance must
(central nervous system).
generate a force that restores the object to
The stability of the whole body, with respect
its equilibrium position. When a force causes
to objects that are supporting it, is extrinsic
an object to move away from its equilibrium,
stability. For example, a person standing on
it is known as unstable equilibrium. Neutral
the ground uses the ground to support the
equilibrium occurs when there are no forces
body, similar to a chair that a person may be
acting on an object.
occupying.
47
together and hands at the side. The feet and
Anatomic Locations
palms of the hands are also faced forward.
Biomechanics involves another field
Anatomical locations include the superior
called kinesiology. Kinesiology emphasizes
(upper), inferior (lower), proximal (toward
biomechanics when it comes to the muscular
center), distal (away from center), anterior
and skeletal system, not to mention the joints.
(front), posterior (back), medial (middle),
Physical trainers commonly use kinesiology
lateral (side), contralateral (opposite side)
to deal with body posture and alignment.
and ipsilateral (same side) positions. Superior
When it comes to body posture, anatomical
refers to the upper parts of the body and
(bodily) positions refer
11. Head tilted forward and downward inferior the lower
to reference points. Often
parts. For example,
times it is important 9. Jaw drops 10. Increased curvature of neck
7. Sagging chest and rounded shoulders

8. Increased curvature of upper spine
the knee is said to be
to be able to identify
5. Protruding abdomen
6. Increased curvature
of lower spine superior to the ankle
relative locations on
4. Pelvis tilted forwards,
causing buttocks to protrude and the hand is inferior
the body and be able to
3. Whole body leans forward to the shoulder. The
access these points on 2. Hyper-extended knees
area close to the center
other people.
of the body or midline
Anatomical (bodily) 1. Bony misalignments force the arches to lower, shifting the
center of gravity inward and forward. This generates
imbalances throughout the entire musculoskeletal structure.
is known as proximal.
locations relate the
Distal is the position
regions and specific arrangement of different
farthest from the center. The front of the body
body parts to the actual position of the body.
is the anterior side and the back of the body is
Such reference points are meant to expose
the posterior side. Medial refers to the middle
special relationships between how bones,
of the body or the point where the body can
muscles and joints are configured. Universally,
be divided into two halves. Lateral refers to
the most common position of reference is
one side of the body. The right foot is said to
known as the basic anatomic position. This is
be contralateral to the left foot; however, the
when one is standing facing forward with feet
right foot is ipsilateral to the right hand.
48
Some people have common natural body at the joints in a particular direction often
positions that cannot conform to the basic occurs by rotating the joint approximately
anatomic position. One of these conditions is 90° or in other words, up and down. This
known as valgus action is called joint motion, another
or the outward understanding of how a client’s body
curve of a limb. Femur moves and works.
Conversely, there Both kinesiology and biomechanics
is varus or the lead to the understanding of planes

Fibula
inward curving Tibia of motion. In this case
of a body part. plane means direction.
Simply stated, The planes of motion
these anatomical conditions are referred to Valgus or

refer to the three basic
bowlegged
deformity
as being “bowlegged” and “knock-kneed,” imaginary planes that
respectively. meet at one point in the
body. Though motion

Planes of Motion
is said to occur in a
Human movement in the three dimensions
specific plane, motion
is based on a system of planes (flat surfaces)
does not strictly occur in one plane of motion,
and axes (e.g., the spine). Functional anatomy
but rather in multiple planes. These planes
(body positions) applies the knowledge of axes
include the sagittal plane, frontal plane and
rotation and muscle position to determine
the traverse plane. The sagittal plane divides
which muscles may contribute to motion in a
the body into the right and left
particular direction. Knowledge
Frontal sides. The frontal plane, also
of how the body moves in Sagittal
known as the coronal plane,
relation to its spine, muscles
separates the body into front
and joints can help a trainer Transverse
and back sections. Lastly, the
design routines that will be
upper and lower areas of the
beneficial for the client. Motion
49
body are designated by the related to the trunk, the flexing of the spine,
traverse plane. and ankle and foot flexing, as well as abduction
The sagittal plane and adduction. Abduction simply refers to a
separates a client’s body sideways movement of a limb away from the
into a right side and a left body, whereas adduction is the movement
side. This plane is used to that returns the limb to its original position.
perform most activities Hyperabduction and hyperadduction are
because it permits the flexing movements that push limbs beyond their
and extending of muscles. Flexing basically limits. This is usually when injuries occur. Side
means “the bending of” and extensions are lunges and side lateral raises are examples of
the “straightening of.” Flexing is movement frontal plane movements.
toward the middle of the body that decreases Lastly, the transverse
the angle between the two moving segments of plane separates the body
the body. This movement is typically directed into an “upper” and
toward the upper parts of the body such as the “lower” half. This plane
head, neck, trunk, upper extremities and hips. is considered rotational
Movements of the lower extremities such as motion. Because this
the knees, ankles and toes also move along plane stresses movement
the sagittal plane. Injuries often occur when along a vertical axis (the
joints and muscles are improperly flexed or spine), internal and external rotations occur.
overextended. Hyperflexion refers to flexing Movements of the leg or arm in a horizontal
a part of the body too hard or beyond direction are most common for this
its normal limits. Extending a body part plane of motion. Examples of this
beyond its normal range is known as motion include throwing a ball,
hyperextension. swinging a bat and golfing. The foot is
The frontal plane involves movements unique in that it has transverse plane
from the front and back of the body. abduction and adduction. When the
Movements include those that are toes are pointed outward and the foot
50
is rotated outward, this motion is 180°
a baseball, the body’s position
termed abduction. Pointing the toes completely changes after the ball is
inward and rotating the foot inward thrown.
is termed adduction. Rotation is different from
rearrangement. It is the movement

Range of Motion
of an object in circles. This
Range of Motion (ROM) is a measure of the
movement occurs with a constant angle of
body’s flexibility by observing the number
rotation around the center of the body. The
of degrees the body can move through a set
rotation has a specific direction and may be
of neutral positions and
positive or negative, depending
exercises. The anatomical
on the reference point. A positive
reference position aids in
rotation is in a counterclockwise
accurate measurements of
direction while a negative rotation
the range of motion. The
is in a clockwise direction. For
ROM at the joints is often
example, spinning a basketball
considered since the majority
on a finger is a rotating motion.
of movement in the body
In terms of joint movement, the pivot point is
occurs at the joints. The body as a whole
the point around which the joints rotate. The
or specific motion at the joints can occur
through rearrangement, rotation or by some
combination of the two movements. Quadriceps Tendon
A motion of the body that moves all points Femur

Patella
Load
on straight lines over an identical distance is Motion
Articular Cartilage
Meniscus
called linear movement or rearrangement.
Fibrous Capsule
Motion
Simply stated, rearrangement is a movement Patellar Ligament
Articular Cartridge Load
of the body that changes the final position of
Tibia
the body. For example, when a person throws
51
fundamental movements at the pivot point Two major terms that define motion
are the roll, slide and spin. The majority of the and describe rotation include pronation
body’s movements are due to motions at the (downward motion) and supination (upward
pivot points, or junctions, motion). These movements

Pronation
of the joints. A limited ROM occur in the forearm and
in this area can be caused the foot. In the hand and
by muscle weakness, nerve forearm, pronation occurs
and spinal damage or even when the palms are rotated
arthritis. Rotation of the in a downward position.
trunk, or axial rotation, is The rotation of the foot in a

Supination
another common activity of direction that causes more
daily life. Many activities require the rotation weight to be supported on the inside of the
of the trunk through various degrees. foot is also pronation. Supination is a rotation
The difference between rotation and that causes the palms to face upward or when
rearrangement is easy to differentiate. When the foot is rotated to cause weight to be on the
rearrangement occurs, the whole object moves outside of the foot.
to an entirely new position. When rotation

Muscle Actions
occurs, the object remains in the same place
Overall, biomechanics research can improve
and just moves around a fixed axis. However, as
exercise performance and conditioning of
the body moves, rearrangement and rotation
muscles. Muscle action is
are often combined.
the activation of muscles
A body can begin an When rotation occurs, the object
remains in the same place and just by the nervous system.
action by rotating and moves around a fixed axis.
This contributes to overall
then start to move along
movement and stabilization.
a straight line during the second part of the
Bodily movements are due to the contraction
action. The movement that needs to be carried
of skeletal muscle, force and work generated
out determines whether or not the body will
by the body.
rotate or be rearranged.
52
During typical strength An isometric muscle action
Isometric Contraction
Muscle contracts but does not shorten
training, various muscle does not cause a change
groups contract hundreds in the length of the muscle

No Movement
of times to move the body. (a) fiber. However, there will be
Concentric Contraction
Muscles produce a variety some shortening of elastic

Movement
of actions to manipulate the structures such as tendons
(b)
external forces that act on and connective tissue. Because
Eccentric Contraction
them, such as gravity and there is no overall shortening
Movement
external resistance. There of the muscle, this action is
(c)
are three muscle actions: considered to be a stabilizing
concentric muscle actions, eccentric muscle contraction. This type of muscle action allows
actions and isometric (static) muscle actions. a person to hold a position for a relatively long
Often, day-to-day tasks such as walking or period of time. A bodybuilder’s pose is a great
jogging cause spur of the moment actions that example of an isometric contraction.
are a combination of all three of the muscle Clinically, isometrics are used during the early
actions. phases of rehabilitation when
Isometric literally means movement has to be limited to
“same length” and an prevent further injury. Isometric
isometric muscle action training is also important for
occurs if the measurement people participating in activities
of the force acting on the that need the static (fixed)
muscle is exactly equal to the force of the muscle contraction. Activities like surfing, rock
muscle’s resistance. In other words, the muscle climbing and skiing often require the ability to
is exerting a force equal to what is placed on maintain prolonged static positions. Practice
it. In this case, the muscle generates force and in maintaining an isometric hold on a climber’s
attempts to shorten but cannot overcome the wall or doing a pull-up can maximize isometric
external resistance. strength training. Relatively very few athletic
53
activities involve isometric muscle actions so resistance being placed on it. Eccentric muscle
isometric strength does not completely predict actions are considered to be muscle actions
success in all sporting activities. that generate force continuously during
Concentric muscle action regular body movements.
occurs when the force An example of this would
generated by the muscle be the movement of
is sufficient to overcome the quadriceps when a
any resistance. The force person walks down a
that develops depends on steep hill. Other examples
the muscle tension needed to move the load include when a person sits down on a bench
and varies with joint position. This ultimately or the action of the forearm muscles when a
causes the muscle-tendon unit to shorten. ball is thrown.
Concentric actions are often referred to as the Within the duration of an eccentric (fast
positive phases of repetition or most simply, twitch) contraction, a muscle extends when it
muscle contractions. An arm curl with a is under tension because the opposite force is
dumbbell is an example of a concentric muscle greater than the force produced by the muscle.
action. Most people focus heavily on this Instead of working to pull the joint in the
muscle action and neglect the others. However, direction of the muscle contraction, muscles
it is the combined action of relax the joint at the end of
all three contractions that are the movement. This allows

After an arm curl, the lowering
necessary and important. of the dumbbell causes the the joint to be ready to repeat
muscle to lengthen.
After an arm curl, the the movement and prevents
lowering of the dumbbell injury. Injuries can happen
causes the muscle to lengthen. This lengthening involuntarily, when a person attempts to move
of an activated muscle is known as an eccentric objects that are too heavy, or voluntarily, when
muscle action. In this case, the force generated the body can accommodate the weight that is
by the muscle is not enough to overcome the being lifted.
54
Eccentric contractions generally happen with contractions in strength training. Research
any abrupt force in opposition to a concentric attempts to determine which muscle
contraction in order to secure the body’s contraction leads to significant increases
joints from any damage. Virtually any routine in strength and muscle mass. Eccentric
movement involves eccentric and concentric muscle
contractions, which assist in the contractions have been
maintenance of smooth body Constant found to produce greater

Load
motions. Eccentric contractions force than isometric muscle
can also slow down rapid muscle contractions and thus it

Eccentric
movements like a throw or a has been hypothesized
Action
punch. An aspect of training for that these actions are
these rapid movements, like more important. While
pitching a baseball or throwing a boxing jab, researchers have found that training with
is being able to increase the body’s ability a focus on isometric muscle contractions
to carry out a movement with much greater increases muscle strength and size, this
power while being able impact has only been proven
to stop the movement Eccentric and concentric muscle with respect to specific joint
contractions have been found to
on a moment’s notice. produce greater force than angles. Isometric training
Eccentric contractions isometric muscle contractions. can therefore be beneficial,
are still being studied but it is important that all
and researched for the ability to hasten three muscle actions be included in a workout
rehabilitation of injured or weak tendons. For routine for better muscle training.
example, Achilles tendonitis has been proven

Modes of Muscle Strength
to derive therapeutic benefits from high load
Muscle strength is one of the major
eccentric contractions.
components of physical fitness. It refers to the
There has been much debate over the
maximum amount of force that a muscle can
importance of all three of these muscle
exert or the capacity of a muscle to develop
55
voluntary tension. This tension is often used resistance. Muscular strengthening is usually
to further increase the strength of muscles. measured in linear or rotational force and
Strength training is often used for conditioning, includes isometric, isokinetic and isotonic
reducing fatigue and preventing muscle modes.
soreness as well as in instances of Contraction against a fixed,
rehabilitation of injured athletes. immovable object is involved in the
Increasing aspects of muscle isometric mode of muscle strength
strength training have been testing. As with isometric muscle
attributed to high levels of athletic action, this is a static (fixed) exercise
performance. that occurs when a muscle contracts
A common clinical method without an observable change in
to determine muscle strength length. Although no physical work
is the manual muscle test (MMT), which is is being performed, this strength training
used to determine the capability of muscles mode generates a great deal of tension and
or groups of muscles to provide support and force. Ideally, muscles that are contracting
movement. A MMT is also a non-invasive way isometrically can be held against an object that
to assess physical weakness, faulty posture, produces resistance for at least six seconds to
muscle imbalance allow peak tension in the muscle to develop.
and sensitivities in Isometric Test Positions
the neuromuscular Extended

72°
Position Flexed
Position
(nerve and muscle) 12 24 36 48
0 60
72
system.
Almost all modes of muscular strength are
related to each other and are related to various
forms of muscle actions. All these modes
can be conducted through weight training
and exercises which use the body weight as
56
These exercises are especially beneficial in the based on the amount of force produced. This
early rehabilitation process for clients after ultimately allows the movement to occur
injury when other modes of strength training at a constant speed regardless of force. The
maybe too painful. major advantage of isokinetics over isometric
Isotonics are carried strength training is that
out against a constant maximum force, called peak
or even variable force force, is produced throughout
to lengthen or shorten the entire range of motion.
muscles through a specific Many machines used for
range of motion. Due isokinetic strength training
to this, concentric and are capable of concentric
eccentric muscle actions are a major part of and eccentric training and achieve isokinetic
isotonic strength training. Isotonic muscle exercise by changing the resistance as the
strengthening occurs by lifting free weights muscle contracts or expands. Due the limited
and through many other basic motility and the narrow bench
movements. Other examples of of these machines, this mode of
isotonic exercises include hip exercise may be difficult initially.
extensions, hip abductions and

Motor Control
knee extensions.
The body must be able to
Isokinetics is exercising with a
exhibit precise control over its
constant resistance and a fixed
segments. This segmental control
speed. It can also be simply defined
incorporates processes involving
as “constant speed”. Isokinetic
all components of the nerve,
techniques test joint movement
skeletal and muscular systems
rather than a specific muscle group. Isokinetic
to produce deliberate and effective motor
actions are performed on a dynamometer,
responses. Motor control is simply the ability
a device that accommodates the resistance
to regulate and direct movement. The concept
57
of motor control addresses how the central the joint and the distinct pull of each muscle
nervous system (CNS) organizes and controls involved.
the series of individual muscles and joints. It

Proprioception
also explains how sensory information from
Motor control often involves cognition
the environment influences movement. Motor
(learning and reasoning) and areas of perception
control is usually studied in
known as proprioception.
relation to specific activities
Proprioception is being able to
and how control processes
sense the location and position
work.
of parts of the body in relation
Muscle synergy, sequential
to each other and the body as a
activation of muscle groups,
whole. It is the ability to know if
is one of the most important
the body is in motion and, when
concepts in motor control.
it is, where each part is located
Muscles do not act alone but are
during the movements. In order to accomplish
recruited by the CNS in groups. In other words,
this, sensory cues are obtained from muscular,
these muscle groups operate as a functional
unit to become automatic and effortless. The (A) (B)

Motor
Cortex Basal
Ganglia
Task Inputs
Afferent Efferent
term used to define the functional grouping of Signal Signal
Task Planning
Brain
muscles is synergy.
Cerebellum
Brain Stem
Motor Nuclei
PN
These recruited muscle groups transmit Spinal Cord Network Spinal
Interneurons
(C) Motor
Neurons
Spinal
force onto their respective bone based on Regulator
Ia Ia
Sensorimotor II II
the particular muscle-bone attachment sites

α α
System
Sensors Muscles y2 y2 y y2
2
Renshaw
Cells
Joints
and the angle of attachment. This ultimately Spindles
Flexor Extensor
Movements (D)
creates movement in the joints. Known as
GTO Ib
GTO Ib
Segment
Bone
a force-couple, the sequential action of the

skin, joint, tendon and ligament tissues. These
muscle is responsible for this movement. The
inputs are then processed as sensory information
resultant motion depends on the structure of
58
(e.g., touch and sight) in the brain and spinal cord of the muscle, and the tendon cells, which are
to regulate reflexes and motor control. Though located in the area where muscle fibers attach
the initial sensing of the position of limbs in to tendon tissue. Muscle cells relay information
space was referred to as proprioception, the directly to the spinal cord from muscle fibers.
definition of this system has been expanded to Tendon cells monitor the amount of tension in
the interaction between the sensory pathways muscle cells that builds during stretching and
and the motor system. The combination of the contracting.
sensory and motor system is also known as the There are three main groups of proprioceptors
sensorimotor system. -ligament, joint and skin proprioceptors; neck
and inner ear proprioceptors;

Golgi tendon reflex protects the muscle from excessively heavy loads by causing the muscle to relax and drop the load.
Muscle
Contracts
Inhibiting
1
1 Neuron from Golgi
and muscle proprioceptors.
Interneuron tendon organ fires.
3 Proprioceptors in the skin, joints

2
Motor Neuron 2 Motor neuron
is inhibited.
Golgi Tendon
Organ and ligaments send signals to the
3
Muscle relaxes.
brain when pressure changes or
Muscle contraction stretches Golgi 4
tendon organ If excessibe load is
placed on muscle,
Golgi tendon reflex 4
Load is dropped.
an injury occurs. The neck contains
causes relaxation,
thereby protecting
muscle.
an extremely large number of
proprioceptors that are responsible

Proprioceptors, specialized nerve endings,
for stabilizing the head upon the neck and the
are located deep within the tissues of muscles,
neck upon the body. The proprioceptors in the
tendons and joints. These are the nerves
inner ear give the body a sense of equilibrium
that respond to the subconscious sense of
or balance. This is accomplished by nerves
position and movement, and they also sense
that measure the movement of fluid in the ear
tissue deformations. With any change in tissue
and send a signal to the nervous system that
pressure or if deformities develop, these nerves
controls the head’s position and its ability to
send a signal to the brain and spinal cord (central
move properly. Through muscle contractions,
nervous system).
the muscle proprioceptors are directly involved
The two major categories of proprioceptors
in human posture and movement.
are muscle cells, which are located in the belly
59
When a part of the body is stimulated, the signal learning of planned movement and control of
is received at three separate places—the visual prolonged and repetitive movements. Thirdly,
system, the inner ear system and the sensory cell processing at the cerebral level controls
system. Importantly, the sensory cells act as the voluntary motion. Cerebral refers to the two
transporters of mechanical energy and provide halves of the brain, which are the dominant parts
a sense of position and conscious awareness by of the central nervous system.
initiating reflexes that stabilize joints during a The task of defining proprioception has
movement. Next, the message is transferred to always been controversial; however, there are
the brain and spinal cord where it is processed various accepted methods used to assess the
at one of three levels of motor control. The proprioceptive control of the joints. This includes
assessing joint position. In this assessment, the

Merkel’s Nerve
Complex
Merkel’s Nerve
Meissner’s
Corpuscle limb is set at a certain angle. The subject is then
Complex
Hair
Sweat
Follicle
Receptor
Free Nerve
Ending
asked to recreate this angle. The deviation from
Gland
Free Nerve
Ending
Ruffini’s End
Organ
the actual angle determines the brain‘’ ability to
Pacinian
Corpuscle
Pacinian
Corpuscle sense the joint position.
Another method to access

Frontal Lobe
Left Hemisphere
proprioception is the perception of
first level of motor Parietal Lobe
passive movement. In this method, the

control is a fast, reflex Occipital Lobe
Cerebrum
ability to detect movement of the limbs
response at the spinal
is tested. The subject’s eyes are covered
cord level, necessary Cerebellum
Temporal Lobe
and a limb is placed at a certain angle.
for protective reflexive Spinal Cord Brain Stem
The limb is then slowly moved and

joint stabilization and
the subject is asked to indicate when motion is
the prevention of injuries in the skeletal system.
first detected. The measurement of the distance
The second level of motor control involves the
traveled between the time motion started
lower parts of the brain (e.g., brain stem). This
and when it was first detected is recorded and
part of the brain processes higher commands
assessed. Additional tests include reaction time
and is involved in the timing of motor activities,
60
of reflexes and balance assessment for postural Motor learning is also critical for the reflex
control. response.
Gender differences in proprioception have also Storing exercise routines in one’s memory
been examined. Female athletes are thought to is necessary to develop motor learning skills.
have deficits in proprioception, evidenced by a Feedback (memory) is a circular process in
four- to sixfold higher incidence of knee injuries which the movement of the body is returned
compared to their male counterparts. Other to the brain for processing. Feedback also
studies, however, have shown no differences uses the senses (e.g., sight and sound) to
in aspects of proprioception between genders. aid in motor patterns and allows efficient
Overall, differences in other aspects of movements to be carried out. There are two
motor control between men and women are major forms of feedback – internal feedback
controversial. and external feedback.
Internal feedback is also referred to as

Motor Learning
sensory (senses) feedback. This is a process
Motor learning is incorporating motor
in which sensory information such as sound
control processes with experiences. The
is used by the body to
combination of these
monitor movement as well
processes leads to an increase
as the external environment.
in the ability to develop skilled
Information from posture,
movements. After repeated
external forces and kinematics
experience with a particular
is used to guide movement
motion, one learns to perform
patterns. This is one of the
the movement more efficiently.
reasons why it is important
Motor learning teaches the
to have proper form when
body and body parts to work
exercising: it ensures that
correctly and sequentially. Examples of this
the sensory feedback is transmitting correct
include throwing a ball or climbing trees.
information to the brain.
61
External feedback is provided by external Biomechanics is a relatively new field that
sources such as monitoring equipment, audio/ includes applying principles of physics to
visual devices, a health care professional or a the human body and biological systems.
personal trainer. External feedback provides Biomechanics is often used to develop a
information on whether movement patterns better understanding of biological processes
and exercise science through the study of

Brain
Coach
Operative
Spinal Athlete Feedback
Cord Motor Control
Information
Exercises
Sensory
Information
Muscles
Integral Changes in Medical
Feedback Organism Control
Sensory
Neuron
Improved
are correct or incorrect and associates such Physical
Abilities
movements with internal feelings. External Skills
feedback can be in the form of processing

Performance
physical performance or processing the results
Level
of an exercise routine. Analyzing physical
motion, forces and the structure of the body.
performance provides information about
Biomechanics is often a useful tool for physical
the quality of the movement. For instance,
educators and athletic trainers. Applications
whether or not the body is in the correct
of biomechanics include performance
position during an exercise routine. Analyzing
improvement or the reduction of injuries. Many
the results of an exercise routine allows the
aspects of rehabilitation after injury involve
client and trainer to determine if the regimen
knowledge of biomechanical principles.
is producing the desired results. All forms
Exercise and sports biomechanics
of external feedback, however, allow for the
primarily contain aspects from the branch of
correction of performance errors and improve
mechanics known as rigid-body mechanics.
efficiency.
62
The subdivisions of rigid-body mechanics Muscles may contract concentrically,
include analyzing the body’s movements eccentrically or isometrically, depending on
mathematically (statistics) and forces that the relationship between forces like tension
cause movement (dynamics). Kinematics, the and resistance. Muscle actions also differ
study of the motion in the body, is a major depending on whether they are dynamic
component of dynamics. Major mechanical (moving) or static (still). Muscles move in
concepts used in biomechanics include force, functional groups known as synergies, the
mass and inertia (the body’s resistance a sequential order of muscle movements,
change in force). There are to produce these distinct
both external and internal The body is in a constant contractions. Motor control,
state of motion that is
forces that influence motion involving the neuromuscular
controlled subconsciously
in general. These forces can when the body is at rest. system, is important in
be caused by direct contact regulating and directing
of another object with the body or by forces deliberate movement. The neuromuscular
found in daily life, like gravity and friction. system involves the relationship between
The body is in a constant state of motion that muscles and nerves. Proprioception is also
is controlled subconsciously when the body is essential for sensing the location, orientation
at rest. The body is complex and moves in three and movement of the body using internal
dimensions through a system of planes and stimuli. Motor learning allows muscles to
axes. This allows the body to create various properly conduct repetitive movements.
movements and attain a wide range of motion.
Joints, in particular, enhance the body’s ability
to carry out specific movements.
63
a) Gravity
Review Questions
b) Friction
1. Which of the following is a not part of the
c) Tension
study of biomechanics?
d) All of the above
a) Physics; fluid mechanics and
6. What is the opposite of the motion
thermodynamics (the study of energy)
pronation (to turn the palms face down)?
b) Biology; understanding tendons and
_ _______________________________________________
muscles
_ _______________________________________________
c) Mathematics; calculus and algebra
7. What are the three planes of motion that
d) Chemistry; the production of hormones
intersect (meet at one point) in the body?
during exercise
_ _______________________________________________
2. Kinematics is the study of human motion.
_ _______________________________________________
True or False?________________________________
8. Concentric, eccentric and isometric/static
3. What are three of the biomechanical
are the names of three major types of
processes that occur during a warm-up
what?__________________________________________
exercise?______________________________________
_ _______________________________________________
_ _______________________________________________
_ _______________________________________________
_ _______________________________________________
9. How is muscle strength typically
4. What are the three groups of
measured?____________________________________
proprioceptors?______________________________
_ _______________________________________________
_ _______________________________________________
_ _______________________________________________
_ _______________________________________________
10. What system of the body plays a role in
5. As you walk from one end of the room to
proprioception (perception of an object’s
another, what forces are influencing your
position)?
movement?
a) Nervous system
b) Cardiorespiratory system
c) Immune system
d) Digestive system
64
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 by Medicine. 2008;40(7):497-507.
muscles); 2) increased blood flow to active Blumenthal JA, Babyak MA, Carney RM, Huber
muscles; 3) increased body temperature; M, Saab PG, Burg MM, Sheps D, Powell
4) enhanced motor skills and brain L, Taylor CB, Kaufmann PG. Exercise,
transmissions with nervous impulses depression and mortality after myocardial
moving faster; and 5) increased discomfort infarction in the ENRICHED trial. Medicine
from muscles and cardiorespiratory and Science in Sports and Exercise.
system. 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 of articular receptors to proprioception
3) 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.
65
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. 308.
Clinical Orthopedic Related Research. Santana-Sosa E, Barriopedro MI, López-
2002;(402):76-94. Mojares LM, Pérez M, Lucia A. Exercise
Kai MC, Anderson M, Lau EM. Exercise Training is Beneficial for Alzheimer’s
interventions: defusing the world’s Patients. International Journal of Sports
osteoporosis time bomb. Bulletin Medicine. 2008;29(10):845-50.
of the World Health Organization. Stuempfle KJ, Drury DG, Wilson AL. Effect
2003;81(11):827-30. of load position on physiological and
Lange-Asschenfeldt C, Kojda G. Alzheimer’s perceptual responses during load
disease, cerebrovascular dysfunction carriage with an internal frame backpack.
and the benefits of exercise: from vessels Ergonomics. 2004;47(7):784-89.
to neurons. Experimental Gerontology. Takahashi T, Arai Y, Hara M, Ohshima K, Koya S,
2008;43(6):499-504. Yamanishi T. Effects of resistance training
Rogers CJ, Zaharoff DA, Hance KW, Perkins on physical fitness, muscle strength
SN, Hursting SD, Schlom J, Greiner JW. and natural killer cell activity in female
Exercise enhances vaccine-induced university students. Japanese Journal of
antigen-specific T cell responses. Vaccine. Hygiene. 2008;63(3):642-50.
2008;26(42):5407-15.
66
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
consistently monitoring and recording new
The Importance of a Client
results can also reveal areas of weakness that
A
Assessment
need improvement. Positive results on follow-
fitness assessment is an
up tests can also be used as a motivational
essential part of the design of
tool.
a healthy and effective fitness
One of the most important aspects of a fitness
and/or weight loss program for
assessment is determining whether the use
individuals. Fitness assessments can provide
of a personal trainer is necessary. A personal
an estimated measure of a client’s fitness level
trainer guides and molds the exercise regimen
by measuring cardiorespiratory endurance,
that is best for a client. However, in order for a
muscular endurance, strength, flexibility
trainer to successfully design an individualized
and body composition. The
regimen, it is imperative to
results of an assessment
have accurate and up-to-
reveal a client’s current level
date information from an
of fitness and can be used to
initial fitness assessment.
tailor an exercise program
This initial assessment
that fits the client’s specific
should be performed prior
needs.
to the personal trainer’s
Trainers should give pre-
recommendation of an
testing questionnaires that
exercise routine.. Personal
include surveys of medical
trainers should also always
history as well as current
advise clients to get approval
lifestyle and fitness activities to client’s before
or a clean bill of health from their primary
assessments. These questionnaires help a
care physician before starting any exercise
trainer understand a client’s lifestyle and
program.
medical history, since these may significantly
This chapter will discuss areas covered
affect a client’s exercise program. Once the
during the overall assessment. The first part
initial assessment has been performed,
68
of the assessment usually involves acquiring This chapter will point out crucial issues that
information about the client’s general history, a personal trainer should recognize during the
such as occupation and initial assessment. Asking
habits. A personal trainer additional questions can
needs to know if a client reveal details that will
sits in front of a computer ensure the optimum
all day or is constantly on program design for the
the move. Information client. While it is well
like hobbies, regular known that diet and
activities and nutrition are also evaluated to exercise are foundations of healthier lifestyles,,
assess the client’s lifestyle. Next, the client’s the role of a personal trainer is to add that
medical history is recorded, which includes special benefit that a client has been missing
injuries, surgeries, diseases/conditions and in order to reach weight-loss and/or fitness
medications. goals.
In some cases, issues of concern are revealed

The General History Section of
during the fitness assessment and the personal
the Initial Client Assessment
trainer may need to ask the client to get
medical clearance prior to making any exercise Occupation

recommendations. Once the assessment is The first area covered during the initial
complete, the personal trainer reviews each client assessment is the client’s occupation.
part of the evaluation in order to design an It is important to have an idea of the client’s
exercise regimen for the client daily work routine so that the
that is as compatible with In some cases, issues of regimen can be scheduled

concern are revealed during
his lifestyle as possible. The the fitness assessment. around the client’s current
personal trainer must discuss activities. If the client works
the assessment with his client and not simply 12 hours a day, a personal trainer can assume
read the responses on the questionnaire. that this person hardly has time to eat, let alone
69
work out. In these cases, the personal trainers employers to allow workout time or to even
must be creative and help clients manage pay for memberships at fitness centers. Many
exercise time efficiently. On the people are not aware of all of the
other hand, if the client is a stay- perks offered by their employer-
at-home parent, the personal generating this awareness can
trainer knows this schedule is make a personal trainer’s role
just as challenging as that of a 12 more impactful and the task of
hour worker’s but possibly more developing the client’s exercise
flexible. Keep in mind that one routine much easier.
of a personal trainer’s tasks is to Another important detail to
tailor-make an exercise routine be discussed is the nature of the
that fits a client’s lifestyle. client’s work or lifestyle. Factors
Working and daily lifestyle considerations to be noted when tailoring the client’s workout
are also important and should be included in include: repetitive movements throughout the
the assessment. For example, the client should day, the length of time spent standing during
discuss whether or not there is time to take a the day and the amount of time spent sitting
brisk 20 minute walk during each day. Recommending
lunchtime. A stay-at-home exercises that cause the

The rising cost of health
parent may have an elliptical insurance has prompted many client’s to feel sore and unable
employers to allow workout
or treadmill in the home or be time or to even pay for to perform work duties should
memberships at fitness centers.
willing to invest in one. Some be avoided. Knowing how
workplaces are equipped stressful the client’s job is can
with fitness centers and this option could also help the personal trainer determine which
be considered in developing those clients’ exercises can increase mental endurance as
exercise routines. In recent years the rising well as physical endurance. The personal
cost of health insurance has prompted many trainer should be as thorough as possible when
70
collecting the client’s information during the that requires physical exertion, the personal
initial assessment. trainer should recommend one for them.
Sessions with a personal trainer also provide

Lifestyle
a positive atmosphere for the client to ease
The lifestyle section of the initial client
into an exercise routine. Small changes to a
assessment is where the trainer gains the most
client’s routine lifestyle can produce great
personal information about
benefits over time. One small
their client. This section of the
change easily incorporated into
assessment reveals what the
most lifestyles on a daily basis
client does during free time as
is taking the stairs. Taking the
well as likes and dislikes. During
stairs at work or using the stairs
this part of the evaluation, a
when possible (e.g., in a shopping
personal trainer may discover
center) is a great way to enhance
that a client plays a certain
individual effort and increase
sport occasionally. Sometimes
one’s fitness level. A study published in 2005
people do not consider an occasional sporting
analyzed the effects of stair climbing in a group
activity (e.g., tennis or golf) as physical exercise
of non-active women. The women were told
because they do not do it regularly; however,
to start by taking one flight of stairs per day
a personal trainer may be able to assist a
for week one and increasing this number to
client in easily incorporating an occasional
five flights a day by week seven. At the end of
sporting activity into an exercise regimen. A
seven weeks, several of the women increased
study published in 2007 focused on the health
their ability to utilize oxygen, which is a direct
benefits of tennis and showed that as little as
measure of a person’s physical fitness.
30 minutes of moderate tennis playing three
Another aspect of the lifestyle assessment
times per week led to dramatic overall health
is nutrition. This involves analyzing a client’s
benefits. If the personal trainer discovers
eating habits. The trainer needs to know if the
the client does not have a hobby or activity
client typically eats on the run or prepares
71
homemade meals to exercise programs that will help them fulfill
and takes time to their fitness goals.
sit and eat. Many

The Medical History Section of the
working Americans
Initial Client Assessment
eat on the run. With that in mind, the personal
For the medical history portion of the
trainer needs to be familiar with types of
assessment, the addition of a confidentiality
foods that are healthy for people on the go.
clause should help put the client’s mind at
Most fast food restaurants‘ nutritional guides
ease when revealing personal information.
are on the Internet for downloading. The
Medical information shared by the client must
trainer should keep up-to-date with healthy
be protected and never shared with anyone.
eating guidelines in order to review them
with clients. The trainer can also suggest Injuries

that clients take healthy snacks to work or on The client needs to disclose detailed
outings instead of being tempted by unhealthy information. Surprisingly, people tend to forget
snacks in vending machines old injuries that the personal
and convenience stores. trainer must take into account
Sub-sections in the initial during the assessment. This is
assessment for physical why a one-on-one session is
activities, hobbies and better than just reading what
nutrition let the client know the your client filled out in the
type of information the trainer questionnaire.
is seeking. This also helps the If there are any new injuries
Medical information shared by
trainer remain organized. (within the last year) the
the client must be protected
Properly evaluating client and never shared with anyone. personal trainer may want
lifestyles enables trainers to the client to get a medical
design ways in which clients can make small release form before beginning an exercise
adjustments to daily routines as well as adapt routine. The trainer also needs to make sure
72
that on-going ailments are considered when easily. No amount of information is too small
designing or changing the client’s workout. to note and numerous questions regarding
The proper regimen can speed up the recovery previous surgeries should be asked. If there
process. The personal trainer must get as is a surgical procedure the personal trainer is
much pertinent information from the client not familiar with, it is the personal trainer’s
as possible. The initial client assessment is responsibility to obtain more information
more than just a formality—it is a guide to about the procedure before recommending an
the trainer’s and client’s exercise regimen.
success.
Diseases and Medical Conditions
Surgeries This area of the assessment
This section of the covers chronic problems the
initial client assessment client may have. Conditions
is fairly straightforward. such as shin splints, sciatica
In this day and age, (lower back pain), arthritis
many people have had (inflammation of the joints)
surgical procedures and and hypertension (high
a personal trainer needs blood pressure) are common ailments. If
to know about them the client has a disease or condition that
before recommending the personal trainer is not familiar with, the
an exercise program. If a trainer must obtain more information about it.
person had surgery that Frequently, clients suffer from similar ailments
left them unable to perform certain exercises, and, if a trainer has already done research on
this is a significant fact for the trainer to record. a particular condition, this information can
Sometimes surgery can be performed without be used to help the trainer work quickly and
causing physical limitations, but the individual efficiently with new clients.
may have been left with more of a physiological When clients inform personal trainers that
problem such as becoming short of breath they are suffering from one or more ailments,
73
trainers can respond accordingly by adding as well as those that cause the client allergic
specific stretches that focus on problematic reactions. As in the other sections, if the
areas before and after workouts. Additional function of a certain drug is unknown the
exercises, however, should not cause excess trainer must look into it. Knowing which drugs
discomfort. If clients feel that the pain level cause side effects, such as shortness of breath
experienced after workouts is too severe, they or fatigue, is vital.
are less likely to continue. One method of treatment for high-blood
A diagram of the body can also be included pressure, a common and often chronic
with the assessment so that the client can clearly problem among Americans, is the use of
identify the source of chronic diuretics. Diuretics increase
pain or discomfort. Some Knowing which drugs cause urine production and, by
side effects like shortness of
people may not be familiar breath or fatigue are vital. doing so, they remove excess
with anatomical terms and water from the body.
diagrams can aid them in This is important for a
showing trainers exactly personal trainer to know
where the pain is. However, because a client taking this
personal trainers must not medication will probably
diagnose client ailments. If a sweat and urinate more
client has unresolved issues, frequently than normal.
the trainer should recommend that the client Increased sweating and urinating also increase
see a doctor prior to beginning any fitness the loss of electrolytes, so the trainer should
routine. recommend that the client bring not only
water to workout sessions but also fluids for

Medications
replenishing electrolytes, such as Gatorade.
This section of the assessment informs
Knowing the type of medications a client is
the trainer about the medications a client
allergic to is also important, so a section for
is currently taking or has taken in the past,
allergies should be included in the medical
74
section of the questionnaire. In addition to reaching their physical fitness goals. It is the
allergies cause by medications, environmental duty of a personal trainer to create a specific
allergens need to be discussed. Whether or exercise regimen that produces the positive
not a person is allergic to bee or wasp stings results the client is seeking. Below is a guideline
is a serious issue and, if so, not only should be that can be used to design a questionnaire for
written in the client’s assessment, the trainer the initial client assessment.
should also know if the client generally carries

Example of Initial Client
an Epipen. An Epipen is a self-administered
Assessment Form
shot of a hormone called epinephrine, a
Name_____________________________________________
neurotransmitter that increases heart-rate
DOB______________________________________________
and helps open airways. In an emergency, Address__________________________________________
having this knowledge could save a client’s ___________________________________________________
life. This type of information can also help a Home Phone_____________________________________

Cell_______________________________________________
personal trainer decide on a suitable location
Emergency Contact_____________________________
for a client‘s workout. Once again, obtaining
Phone____________________________________________
as many details as possible is of the utmost General History:
importance for this section of the assessment. Occupation_ _____________________________________
___________________________________________________
Using a Questionnaire Work Conditions (standing, sitting, etc,)______
In order to obtain as much information as ___________________________________________________
possible, the personal trainer must be well How many hours per week do you typically
work?____________________________________________
prepared, organized and extremely detailed
What time do you normally have lunch?
when performing the initial assessment. Most
___________________________________________________
people already know that having a proper diet How long is your lunch break?_________________
and exercising regularly are among the best Are you opposed to working out at lunch?____
ways to stay fit, but if they have decided to Is there a fitness center in your workplace?
___________________________________________________
seek the advice of a personal trainer it is more
How stressful is your job?______________________
than likely because they feel like they are not
75
Lifestyle These vital signs, in addition to other areas of
Hobbies__________________________________________
physical fitness, will be discussed in detail in
___________________________________________________
the following sections.
Physical Activities (softball, tennis, etc.)______
___________________________________________________ Before an assessment is performed, the client
___________________________________________________ should be told to avoid eating or smoking for at

Nutrition (eat on the go or prepare meals)___ least four hours prior to the assessment. This
___________________________________________________
is recommended but certainly not required.
Medical History:
The client should also avoid performing both
Injuries and Dates_______________________________
cardiovascular and weight training exercises
___________________________________________________
Surgeries and Dates_____________________________ at least 12 hours prior in order for the trainer
___________________________________________________ to get an accurate perspective of the client’s
Conditions or Diseases (arthritis, physical capabilities.
hypertension, etc.)______________________________
___________________________________________________ Pulse
Allergies_ ________________________________________ Pulse is the frequency of the heart beat.
___________________________________________________
Arteries, which are blood vessels that carry
Medications_ ____________________________________
oxygenated blood away from the heart to the
___________________________________________________
rest of the body, produce a continuous pulse.
Checking the pulse is an easy way to determine

Exercise 1: Go through a client
assessment with a classmate. one’s current heart rate, or the number of
heartbeats per minute (BPM), and it is easy
to calculate: count the number of heart beats

The Physical Assessment Section
for 10 seconds then multiply by 6. The final
Once the initial questionnaire is complete, a
number represents the current heart rate. To
thorough assessment of the client’s physical
determine the heart rate during exercise, the
status needs to be performed. This part of
activity should be interrupted and the pulse
the assessment includes several areas such as
taken quickly to acquire the number of heart
checking the client’s pulse and blood pressure.
76
beats per minute (BPM) accurately. The heart rates of infants
pulse is normally lower when an individual and children are higher
is resting, but it increases during activity. than that of adults age
This is primarily because more oxygen- 18 and over. The resting
rich blood is needed during exercise or heart rate for an adult is
other activity. between 60-100 BPM,
A pulse can usually with the average heart

Pulse taken at
be felt in any place the neck (above). rate being approximately
on the body where 70 BPM. The heart rate of a child is

Pulse taken
at the wrist.
an artery can be normally 70-120 BPM, while an infant’s
compressed against heart rate can be typically between 100-
a bone, but it is most often located in two 160 BPM. Performing exercises that causes
areas. The first site is at the thumb side of the pulse to exceed 85% of maximum heart
rate is not recommended. The maximum heart

Why do we care?
rate and the optimal exercise heart rate can be
Because the pulse can be
used as an advanced warning predicted using the following equation:
of impending illness. An
increase of 10 BPM or more Maximum heart rate = 220 – your age
from normal rate can indicate
Exercise heart rate = resting heart rate + 0.6
health problems.Medications
can also affect one‘s heart rate. (maximum heart rate – resting heart rate)
the wrist right below the base of the thumb Exam Alert:
(radial pulse). The second is on the neck just What are two ways your
pulse can be taken?
below the jaw along the windpipe and throat
(carotid pulse). The tips of both the index and

Blood Pressure
third finger are used to find the artery and a
Blood pressure is the pressure of the blood
watch is generally used to track the time.
against the walls of the arteries. This is created
Heart rates generally vary from person to
by two forces: the force of the heart pumping
person and also depend on a person’s age. The
77
blood into the arteries throughout the body there are some considerations to this rule.
and the resistance from these arteries. Blood Medication for high blood pressure, a short-
pressure is highest during activity and falls term illness or medical conditions such as
when resting or sleeping. Not only does diabetes and kidney disease can affect blood
blood pressure change throughout the day, it pressure. In addition, athletes tend to have
also responds to changes in emotion, such as lower blood pressures. The chart gives an
feeling nervous or fearful. indication of blood pressure ranges and the
risk of high blood pressure:

Blood Flow Blood Flow
Systolic Diastolic
Blood Pressure Category (First Number) (Second Number)
Average <120 <80
Vessel Resistance
Elevated 120-139 80-89
Blood Pressure
Hypertensive Systolic Diastolic
Blood Flow
Phase I 140-159 90-99
Phase II >160 >100

Blood pressure, the outward pressure of blood against blood vessel walls, is the
The regulation of blood pressure is

product of blood flow from the heart and inward resistance of blood vessel walls.
dependent on two factors. One factor is the

Blood pressure is denoted as a reading of
amount of blood being pumped by the heart
two numbers and measured in millimeter
(cardiac output). The other is resistance to
mercury (mmHg). The first number is the
blood flow from the arterial wall (peripheral
systolic pressure which indicates the pressure
resistance). The reason for high blood pressure
of the contracting heart. The
is an increase in one of these
second number is the diastolic
Why do we care? factors or a combination of the
pressure which indicates the High blood pressure carries
with it a risk of heart disease. two. The brain also regulates
pressure of the heart when
blood pressure through the
it is relaxing between beats.
nervous system. The tone of the blood vessels
Your systolic pressure is said to be “over” your
is regulated by the sympathetic nervous system
diastolic pressure (i.e., 145/75 or 145 over 75
which increases blood pressure. Conversely,
mmHg). Normal blood pressure for adults is
the parasympathetic nervous system lowers
considered to be 120 over 80 mmHg, though
78
blood pressure. Both systems are perpetually include improved circulation, breathing and
active and they modulate constantly to regulate coordination, as well as preventing injuries
blood pressure. that may occur during day-to-day activities.
Lower back and hamstring flexibility are

Exam Alert:
especially crucial in preventing back pain and
How does the body
regulate blood pressure? lower back injuries.
The most common way to test flexibility is by
Flexibility performing a flexibility stretch test or the sit-
Flexibility is the ability of the body to adjust and-reach test. To perform the stretch test, the
to various positions and is the key element to individual sits on the floor with a measuring
overall physical fitness. It is usually stick or tape between the legs
defined as the range of motion and then reaches forward as far
for a given joint and the ability as possible. The distance of the
of the joint to adapt to changing stretch is measured in inches and
requirements from the body. evaluated based on a comparison
Usually, the best way to increase to average flexibility ratings. The
flexibility is through consistent chart on the following page shows
training. Flexibility training how different levels of flexibility
typically focuses on breathing to are rated.
bring about greater muscle The sit-and-reach test
relaxation and correct utilizes a sit-and-reach
body positioning. box or alternatively, a ruler
Warmed-up muscles are placed and held between
easier to stretch. Stretches the feet. The subject sits on
should be held for 10¬60 the floor, removes shoes
seconds to guarantee an increase in flexibility. and places the sole of each foot against the
Increased flexibility has benefits that box approximately shoulder width apart. The
79
tester presses both knees against the floor and the individual spent warming up before the
instructs the subject to reach forward as far as test was performed. In order to keep data
possible along the measuring line. Both palms consistent, testers should ensure that the same
should be face down, with one hand placed on protocol is used for each test. One advantage
top of the other. The subject is allowed three to the sit-and-reach test is the ease with which
it can be used. However, a proper sit-and-
Why do we care? reach box may be difficult to obtain and tests

Inflexibility increases the
measured with a ruler would more than likely
risk of joint and muscle
injury. Flexible muscles can be less accurate.
improve athletic performance
because activities become Flexibility Rating Chart
easier and less exhausting. Performance Males Females
Exceptional 20.5-23 in. 23-24.5 in.
Excellent 17.5-20 in. 20-22.5 in.
practice reaches and on the fourth reach, Good 15.5-17 in. 18.5-19.5 in.
Fair 13.5-15 in. 16.5-18 in.

the position is held for a minimum of two
Poor 10.5-13 in. 14.5-16 in.
seconds and recorded. There should be no
Below Poor 7-10 in. 12.5-14 in.
jerky movements and the legs should remain

Posture
flat. In order to rate the level of flexibility form
Posture involves keeping the body straight
the sit-and-reach test, the distance reached is
and upright while performing daily activities
recorded to the nearest half-inch or centimeter
such as sitting, walking and
and compared to a scale.
sleeping. Bad posture can be
The sit-and-reach test Bad posture can be developed by
sitting for long periods of time, developed by sitting for long
is a reliable measure of working at the computer for more
periods of time, working
hamstring and lower- than eight hours a day, and
standing or driving for a long time. at the computer for more
back flexibility, which can
than eight hours a day, and
be used to estimate an
standing or driving for a long time. Achieving
individual’s overall level of flexibility. Results
good posture involves training the body to
may differ depending on the amount of time
conform to a position that causes the least
80
Poor Posture Good Posture Poor Posture
object, the individual should bend at the knees
Forward
Forward Head
Head
and hips and then lift upward without jerking.
Rounded
Shoulders In addition, supportive footwear can be worn
Weak
Abdominal
Flat Balanced Sway
Muscles when standing for prolonged periods of time
Back Upright Back
Posture
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
amount of strain on the body. Proper posture
Body fat is the percentage of fat the body
also involves keeping bones and joints aligned
contains. For example, a 150 pound person
and decreasing unnecessary wear and tear
with 10% body fat has 15 pounds of body fat.
on the joints. In addition, maintaining good
The other 135 pounds is lean body mass and
posture prevents the spine from becoming
a combination of bone, muscle, organ tissue,
fixed in an abnormal position. After an
blood, etc. When a person expresses a desire
individual learns how to correct bad posture,
to lose weight, this usually means a desire
maintaining good posture becomes automatic
to lose body fat. However, a small amount of
and requires little to no effort.
body fat is necessary. This small amount of
Requirements for good posture include
essential fat is needed to help regulate body
sitting and standing properly with the back
temperature, protect and insulate organs and
straight and the shoulders upright. The body
serve as an energy source.
weight should be evenly distributed on both
% of Body Fat
hips. Lifting objects correctly is also good
Classification Males Females
for maintaining correct posture. Having firm Slim 2-4 10-12
Athletic 6-13 14-20

footing with a wide stance and keeping the
Fit 14-17 21-24
back straight are both important elements
Average 18-25 25-31
of proper lifting. While standing close to the Overweight 25+ 32+
81
A number of tests are used to measure body
Body Mass Index (BMI)
fat. One common method is the pinch test,
Units How to Calculate
which estimates body fat by skinfold thickness.
Using kilograms (kg) BMI = weight (kg) / [height (m)]2
and meters (m)
The skin is pinched at three to nine different *For height taken in centimeters (cm), dividing
height in cm by 100 gives height in meters.
Using pounds (lb) BMI = weight (lb) / [height (in)]2 x 703

and inches (in)
Body Mass Index (BMI) provides an
indication of what body weight should be
according to height. BMI is considered as
an alternative to measuring body fat and
is used quite often to determine which
anatomical sites on people belong to certain weight categories
the body such as the (e.g., underweight, average, overweight,
tricep, bicep, abdominal and thigh. The pinch obese). It is also used to indicate whether
raises a double layer of skin and the underlying or not a person has weight-related health
adipose (fat) tissue but not the muscle. problems such as heart disease or diabetes.
Skinfold calipers are used to take a reading in However, additional assessments such as
millimeters. Usually the sum of seven skinfold measuring skinfold thickness, evaluating
readings is calculated. Following is a table that diet and exercise regimen, measuring blood
rates the sums of several pinch tests. pressure and getting family history are needed
Very Below to determine if a person is at potential risk for
Fitness Good Good Normal Normal Poor
Males 60-80 81-90 91-110 111-150 >150
Average
developing weight-related health problems.
Females 70-90 91-100 101-120 121-150 >150
BMI is calculated in a similar way for adults
Males 40-60 61-80 81-100 101-130 >130
Athlete
Females 50-70 71-85 86-110 111-130 >130 and children; however, the interpretations of
the BMI often differ. BMI is also dependent
on age, race and gender. For instance, it is
typical for women to have more body fat
than men. Also, as the body ages, the amount
82
of body fat tends to increase. The first test clear if an individual’s actual weight has to do
usually conducted after a BMI evaluation is with the amount of fatty tissue or lean muscle
the measurement of an individual’s waist content. It is also hard to determine whether
circumference to determine the amount of changes in BMI over time are due to a change
abdominal fat. If a person has a relatively high in fat or muscle content. Athletes typically have
BMI but a small degree of abdominal fat, the high BMIs because of their increased muscle
person is not considered at risk of developing mass and not because of body fat.
health problems. If the BMI calculated for

Step Test
an individual falls into the danger zone
The step test is designed to measure
(e.g., overweight or obese) and the person
cardiovascular endurance and assess overall
has two or more risks factors such as high
cholesterol or hypertension, then weight loss
is recommended to reduce health problems.

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 aerobic capacity. Cardiorespiratory and
5’8” 18 20 21 23 24 26 27 29 30 32 34 35 37 38
endurance tests measure the ability of the
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 lungs and heart to absorb, transport and utilize
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 oxygen. Fit individuals are able to use larger
6’6” 14 15 16 17 19 20 21 22 23 24 25 27 28 29
muscle groups for prolonged periods of time
6’8” 13 14 15 17 18 19 20 21 22 23 24 25 26 28
Underweight Healthy Weight Overweight Obese at a moderate to high intensity. Lower levels of
There are limitations associated with using cardiorespiratory fitness are associated with
BMI to determine ideal body weight and an increased risk of developing cardiovascular
composition. From a BMI calculation it is not and respiratory diseases that may lead to
83
premature death. Conversely, higher levels of that the heart rate is checked about 1 minute
cardiorespiratory fitness are associated with a after finishing the exercise and the number
decreased risk of death due to cardiovascular is compared to normal values that have been
disease, as well as improved quality of sleep previously established. The closer the active
and immunity. heart rate is to the normal resting heart rate,
The Harvard step test, also known simply the more fit the individual is.
as the step test, and the bike test are the two Heart Rates after 3 Minute Step Test (Males)
Age 18-25 26-35 36-45 46-55 56-65 >65
most commonly used cardiorespiratory and
Excellent <79 <81 <83 <87 <86 <88
endurance tests. The test used in a certain Good 79-99 81-99 83-103 87-105 86-103 88-103
facility is based on the equipment available Average 100-116 100-117 104-119 106-122 104-120 104-120
Poor 117-128 118-128 120-130 123-132 121-129 121-130

and number of people being tested. This step
Very Poor >128 >128 >130 >132 >129 >130
test is efficient even when there is minimal
Heart Rates after 3 Minute Step Test (Females)
equipment present and can be done in almost Age 18-25 26-35 36-45 46-55 56-65 >65
any location. This test measures a person’s Excellent <85 <88 <90 <94 <95 <90
Good 85-108 88-111 90-110 94-115 95-112 90-115

ability to exercise continuously for extended
Average 109-126 112-126 111-128 116-129 113-128 116-128
periods of time without becoming extremely Poor 127-140 127-138 129-140 130-135 129-139 129-134
tired. Very Poor >140 >138 >140 >135 >139 >134
The test uses a 12-inch high bench or step

Walk Test
as the primary tool. The individual steps on
Aerobic fitness is a good indicator of
and off the bench or step for 3 minutes. More
overall fitness. For the 1 mile walk test, the
specifically, the individual should step one foot
course needs to be smooth
up and bring the other up, then
It is important that any and flat—ideally a ¼ mile
step down in the same manner, participant in this test
track. It is important that any
maintaining a steady pace. warms up and stretches for
at least 4-5 minutes. participant in this test warms
After 3 minutes of stepping,
up and stretches for at least 4-5
the client’s heart rate is checked during what
minutes, paying special attention to stretching
is called the recovery period. This just means
the leg muscles. An individual walks 1 mile as
84
quickly as possible while maintaining a steady as the multi-stage fitness test. This test is
walking pace. The test is scored in minutes commonly used for sports like hockey, soccer,
and seconds and the heart rate is recorded rugby, football, cross-country and cricket to
after completion of the walk test. measure the cardiorespiratory
Similar to the step test, an active fitness of athletes. The test
heart rate that is close to the consists of an athlete running
normal resting heart rate means between two points that are 20
the individual is in good shape. meters apart. The running activity
This test also provides an is synchronized to pre-recorded
estimation of an individual’s VO2 “beeps” that are played at set
max, or the maximum oxygen intervals. The intervals become
consumption. In more specific increasingly shorter and the beeps
terms, VO2 max is an indicator of the maximum are played faster until the athlete can no longer
amount of oxygen that an individual can take keep up the pace.
in and utilize during exercise. This value can There are currently 23 levels in the beep test,
be calculated using the Rockport Fitness although some tests may only go up to level 17.
Walking Test equation. VO2 max is measured in The beep test is easy to perform as the audio
milliliters of oxygen consumed track can be played in mp3
per kilogram of body weight The VO2 max test is commonly format, which also decreases
used for sports like hockey,
per minute. This value also soccer, rugby, football, the risk of malfunctions from
reflects the physical and cross-country and cricket to cassette tapes or compact
measure the cardiorespiratory
cardiorespiratory endurance fitness of athletes. disks. The beep test is not
of an individual. recommended for a person
Personal trainers often measure the VO2 max just starting a fitness program, but would be
of athletes to determine how much oxygen they a good tool for active individuals interested in
utilize during their workouts. This is normally developing higher levels of cardiorespiratory
done by using the “beep test,” also known fitness.
85
Time (minutes and seconds) for Walk Test (Males)
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
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
13:01- 13:31- 14:01- 14:25- 15:13- 15:49-
Average 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
Poor >14:30 >15:00 >15:30 >16:30 >17:18 >20:18 muscular strength and
Time (minutes and seconds) for Walk Test (Females) endurance in the upper
Age 20-29 30-39 40-49 50-59 60-69 >70 body. Men and women
Excellent <13:12 <13:42 <14:12 <14:42 <15:06 <18:18
usually adapt to different floor positions
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
while doing push-ups. Men are typically fully
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
15:07- 15:37- 16:07- 17:01- 17:31- 21:49-
extended with only the hands and toes in
Fair 16:30 17:00 17:30 18:06 19:12 24:06
Poor >16:30 >17:00 >17:30 >18:06 >19:12 >24:06

contact with the floor while women often use
a modified version of the push-up position in
which the knees are bent and touch the floor.
Push-ups are counted until muscle fatigue and
exhaustion sets in and then evaluated based
on number accomplished.
Muscular Performance Push-up Test (Averaged for Males and Females)

Age 17-19 20-29 30-39 40-49 50-59 60-65
Muscular performance is tested by using
Excellent >35 >36 >37 >31 >25 >23
various forms of fitness and strength training Good 21-35 23-36 22-37 18-31 15-25 13-23
exercises. These exercises include the bench Average 6-20 7-22 5-21 4-17 3-14 2-12
Poor 2-5 2-6 1-4 1-3 1-2 1

press, squats, ab crunches, push-ups and sit-
Very Poor 0-1 0-1 0 0 0 0
ups. The bench press evaluates upper body
The sit-up test, or curl-up test, also evaluates
strength and entails an individual lying on the
muscular endurance by testing the strength of
back, lowering a weight to the chest level, and
an individual’s abdominal muscles. Abdominal
then pushing it back up with arms straight and
strength is important for stabilizing the body
elbows locked. The push-up test also evaluates
and maintaining good posture during exercise.
86
To perform the sit-up test an individual lies heels, and standing again to straighten up the
on the back with the knees bent. The feet body. This exercise can be done with weights
are pressed to the ground and the hands are to enhance muscle strength and development
resting on the thighs. Next, the individual or without weights.
slightly raises the upper body toward the Squat Test (Males)
Age 18-25 26-35 36-45 46-55 56-65 >65
ceiling while keeping the lower back pressed
Excellent >49 >45 >41 >35 >31 >28
against the floor and then slowly lies back Good 39-49 35-45 30-41 25-35 21-31 19-28
down. It is important not to lift the torso by 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

pulling the neck and to keep the lower back
Very Poor <25 <22 <17 <13 <9 <7
on the floor to avoid injuries. The number of
Squat Test (Females)
sit-ups an individual can do in one minute is Age 18-25 26-35 36-45 46-55 56-65 >65
counted and compared to average values. Excellent >43 >39 >33 >27 >24 >23
1 Minute Sit-up Test (Males) Good 33-43 29-39 23-33 18-27 13-24 14-23
Age 18-25 26-35 36-45 46-55 56-65 >65 Average 25-32 21-28 15-22 10-17 7-12 5-13
Excellent >49 >45 >41 >35 >31 >28 Poor 18-24 13-20 7-14 5-9 3-6 2-4
Good 39-49 35-45 30-41 25-35 21-31 19-28 Very Poor <18 <13 <7 <5 <3 <2
Average 31-38 29-34 23-29 18-24 13-20 11-18 Muscular performance tests measure both
Poor 25-30 22-28 17-22 13-17 9-12 7-10
muscle endurance and muscle strength. Muscle
Very Poor <25 <22 <17 <13 <9 <7
endurance is the ability for a muscle or muscle
1 Minute Sit-up Test (Females)
Age 18-25 26-35 36-45 46-55 56-65 >65
group to exert force repeatedly. Muscle strength
Excellent >43 >39 >33 >27 >24 >23 is the ability for a muscle or muscle group to
Good 33-43 29-39 23-33 18-27 13-24 14-23
exert maximal force in a single repetition.
Average 25-32 21-28 15-22 10-17 7-12 5-13
Poor 18-24 13-20 7-14 5-9 3-6 2-4

Health related benefits of
Very Poor <18 <13 <7 <5 <3 <2 proper muscle fitness include
Squats focus more on strength training of a better resting metabolic rate,
the lower body. The squat test is performed which means muscles burn
by bending the knees and hips, lowering the more fat calories even when
torso between the legs with the glutes near the an individual is at rest. Healthy
87
muscles also improve bone mass and glucose cases like these, the trainer can also decide
(sugar) tolerance. Improving bone mass and whether or not to omit certain parts of the
tolerance to glucose can decrease the risk of physical assessment.
developing diseases such as osteoporosis and Here is an example: John is a new client in
Type II Diabetes. his early 40s who describes himself on his self-
evaluations as a “couch potato” and admits

How Thorough Should Each Initial
he performs minimal to no cardiorespiratory
Assessment Be?
exercises. Visually, he is slightly overweight
After learning the many benefits of
and he discussed his poor eating habits during
conducting detailed personal and physical
the interview. He decided to start a personal
assessments, personal trainers may decide
training regimen in order to lose weight and
that detailed assessments are required for
increase his cardiorespiratory health. In John’s
every new client. However, a trainer can decide
case, a full physical assessment
whether a thorough personal
A trainer can decide whether would probably not be a good
and physical assessment is a thorough personal and
idea because it may put John
necessary and right for every physical assessment is necessary
and right for every client on under unnecessary stress and
client on an individual basis. an individual basis.
pressure that could discourage
The first step is for the trainer to
him from starting a fitness program. The
gather necessary information about the client
trainer would not necessarily need the physical
through the initial interview and conversation,
assessment to determine John’s current
in addition to any questionnaires that need to
fitness level and could deduce that John will
be filled out. The evaluation and interview,
need to start at a low intensity because he is
coupled with a visual assessment of the client.
not currently exercising. In this case, knowing
should in most cases provide the information
John’s medical history, family history, height,
needed to determine what type of exercise
weight and BMI may be enough to design an
routine is right for that person without having
exercise regimen for him.
to complete the full physical assessment. In
88
In another case, the trainer may have a female the client. For example, an overweight client
client who has an average weight and exercises may feel extremely embarrassed if asked
at a moderate level three times a week. She to perform a sit-up test during the initial
is interested in beginning a fitness program assessment. A client who admits to having a
that will encourage poor fitness level may
her to exercise more become discouraged
frequently and produce with poor performance
visible results since during physical tests.
she says she has not In some cases, the
seen any improvement trainer may even have a
in the last few months. client with pre-existing
This client is a good conditions that may
candidate for a full affect their physical
physical assessment to determine a starting abilities and certain parts of the physical
point for her fitness program. Calculating her assessment may cause them further injury. It is
BMI, muscle strength and endurance, and best for the trainer to always use his judgment
performing at least one cardiorespiratory and avoid injury and embarrassment to the
exam is a good idea as it allows both the client.
trainer and client to discover her strengths

Personalizing or Designing Custom
and weaknesses. In this case, the trainer may
Tests
also want to see her current exercise routine
Once the trainer has decided that a fitness
as she may be exercising at an intensity that
assessment is right for a client, the trainer then
is too low to achieve results or performing the
needs to ascertain which specific tests are going
exercises incorrectly and putting herself at a
to be the most helpful in determining a good
risk for injury.
fitness plan. The trainer also needs to decide
Most importantly, the trainer should be sure
when to perform both the initial assessment
not to do any tests that may injure or embarrass
and follow-up physical assessment. Some
89
clients, mainly those with poor fitness levels, assessment, a follow-up assessment six to eight
may benefit from a few conditioning sessions weeks later will be sufficient because clients
before their physical assessment. This may usually show the most significant changes and
even help reduce the risk of injury and improvements during that time frame.
embarrassment, especially in The personal trainer should
individuals who already exhibit also tailor the type of tests used
The client’s current
low levels of self-esteem. In physiological and emotional according to the client’s needs
state should be considered
addition, the client’s current when a physical assessment and current conditions. There
is scheduled.
physiological and emotional may be cases where certain tests
state should be considered need to be omitted or modified.
when a physical assessment is scheduled. For example, a trainer may have a female
Let us say the first session with John (40- client in her 30s who would like to lose her
year- old male client) consists of a short pregnancy weight. She had a C-section during
warm-up, stretching and a discussion of his delivery and although she has received medical
expectations for the program. clearance from her doctor to
He mentions that he has slept start an exercise regimen, she
poorly the night before and has limited flexibility due to
has not eaten for the day. her procedure. In this case, a
These factors will more than flexibility test such as the sit-
likely influence his fitness and-reach test may injure the
assessment results. If he feels client if she is forced to stretch
like he did poorly during the beyond her capabilities.
warm-up and stretching exercise, he may Omitting that test until she begins her exercise
feel less motivated and display less effort routines and performing different assessment
during the physical assessment, which will tests are going to be more beneficial for this
result in lower scores. In John’s case, a fitness client.
assessment one or two weeks into his training A personal trainer should also listen to his
program may be a better plan. After his initial client’s long-term goals and expectations. A
90
client who wishes to build muscle mass and a more consistent routine so that they can
improve overall muscle tone is probably going quantitatively track their progress whereas
to want muscle strength and endurance to be others would prefer to get assessed as
assessed immediately. Although the trainer infrequently as possible. The six to eight week
may feel this is initially unnecessary, it may follow-up assessment is especially useful to
be important to the client show results to the client.
especially if the client wants The six to eight week follow-up However, if the assessments
assessment is especially useful
to set personal goals or know to show results to the client. are too frequent and show
current fitness levels. A client little change, the client may
may also want to avoid cardiorespiratory get discouraged because results are not seen
testing because it is seemingly irrelevant to each time. A trainer can avoid these issues by
the client’s goals; however, in cases like these, performing different tests at different intervals.
it is important for the trainer to explain that Tests like blood pressure or BMI are easy to
cardiorespiratory assessments are necessary. measure. For comparing results, though, it is
On the other hand, some clients may not best to use the same tests in the same order as
even want to know their initial weight or BMI during previous assessments.
because they may find it too discouraging. As The order of the fitness assessment tests
their trainer, keeping the client’s best interests is also important. Here is the recommended
in mind is a must and in this situation, the order:
trainer can record the information without 1. Non-fatiguing tests (height/weight
revealing it to the client. In addition, sometimes measurements, skinfolds, vertical and
omitting a potentially embarrassing test is a broad jumps)
better long-term choice than performing the 2. Agility tests
test right away and deterring the client from 3. Maximal strength and power tests
returning. 4. Sprint tests
Follow-up fitness tests can be performed 5. Muscular endurance tests
at regular intervals or as little as once 6. Flexibility tests
every six months. Some clients will prefer
91
Warm-up and cool-down stretching the client; however, a trainer should avoid
exercises are recommended before and after implementing an exercise routine that may
the assessment in order to prevent muscle cause the client injury or embarrassment,
tearing and injury. either physical or emotional. There are several
The different tests used to measure similar components of a fitness assessment and some
aspects are important as well. Beginning may be omitted or modified depending on
clients with lower levels of fitness do not the client’s needs, conditions or goals. There
need to perform a beep test to measure are also several different tests that can be
cardiorespiratory health. Instead they would used to measure the same aspect of a fitness
benefit more from the walking test. This is a assessment (e.g., stretch test or sit & reach
test for less active individuals and basically test). Some tests are designed for people who
consists of walking a mile at the fastest have high fitness levels and may be unsuitable
comfortable pace and recording their heart for a beginning client. On the other hand,
rate after the walk. The trainer could then some tests may not be challenging enough for
calculate the VO2 max with a simple formula. a very athletic client. It is best to schedule the
There are also different kinds of flexibility tests initial and follow-up assessments according
besides the sit-and-reach test. For example, to what will best motivate and encourage the
the trunk rotation test or groin flexibility client. The order in which fitness assessments
test can be used to measure flexibility in should be carried out is as follows: (1) Non-
patients who have a limited range of motion. fatiguing tests, (2) Agility tests, (3) Maximal
The most important points to remember are strength and power tests, (4) Sprint tests, (5)
considering the client’s strengths, weaknesses Muscular endurance tests, and (6) Flexibility
and pre-existing conditions when choosing tests. The specific type of test that is used for
the assessment tests. these categories should be chosen based on
the client’s current fitness level.

Summary
Although fitness assessments help personal
A fitness assessment is a useful tool for
trainers design effective exercise routines, in
determining an exercise plan specific to
92
order for the regimen to be effective the trainer c) To understand the likes and dislikes of
must take care in standardizing the conditions the client
under which the assessments are performed. d) All of the above
Certain factors may influence test results and 2. One of the many jobs a personal trainer has
will lead to an inaccurate assessment. A few is to advise the client on how to handle any
of these factors include: ambient temperature, unresolved medical issues they may have.
noise, humidity and the condition of the client True or False?________________________________
being assessed. The amount of sleep the client 3. In order to keep the client‘s medical
had night before and the type of food and drink information private the personal trainer
the client consumed can affect performance should put a___________________________ in the
during the physical assessment. The time of assessment form.
day and the test environment may also affect 4. All of the following are considered lifestyle
the client’s performance so the trainer should categories: hobbies, physical activities,
try to maintain these conditions by keeping working in front of a computer and
them constant. Despite these factors, fitness nutritional habits. True or False?___________
assessments are still a great asset to a training 5. Knowing what medications the client
program as they provide the personal trainer is taking and possible side effects are
and the client with a lot of information. Once important because:
the client begins an exercise routine, progress a) The trainer may need to borrow some
can be used as a motivational tool to continue if the medication runs out
the program. b) The client may be allergic to certain
medications
Review Questions
c) There may be conflicts between
1. What is the purpose of the initial client
the recommended workout and the
assessment?
medication
a) To learn about the client
d) The trainer may need to refill the
b) To efficiently tailor the proper workout
prescription
regimen
93
6. Small changes in one’s daily routine like
Answers
parking farther away from a building or
1. d) All of the above.
taking the stairs can have a large impact
2. False.
on fitness goals. True or False?_ ____________
3. Confidentiality clause.
7. Why do most people hire a personal
4. True.
trainer?_______________________________________
5. c) There may be conflicts between
_ _______________________________________________
the recommended workout and the
_ _______________________________________________
medication.
8. The optimum regimen that is specific to
6. True.
the client’s needs can be best designed
7. To add that special benefit that the client
when the assessment is _____________________.
has been missing as a means of fulfilling
9. The best way to conduct an initial
weight-loss or fitness goals.
assessment is to:
8. Thorough.
a) Give the client the form to take home so
9. c) Going over the form with the client
it is not filled out in a hurry
personally.
b) Let the client fill the form out while
10. False.
demonstrating how to stretch
c) Going over the form with the client References

personally Babette M, Pluim J, Staal B, Marks BL, Miller S,
d) E-mail it so the client will not be Miley D. Health benefits of tennis. British
inconvenienced by having to write the Journal of Sports Medicine. 2007;41:760-
answers 68.
10. If the client has a condition such as lower Boreham CAG, Kennedy RA, Murphy MH,
back pain, the trainer should encourage Tully M, Wallace WFM, Young I. Training
the client to perform strength training for effects of short bouts of stair climbing
that region without prior approval from a on cardiorespiratory fitness, blood lipids
health care physician. True or False? and homocysteine in sedentary young
94
women. British Journal of Sports Medicine. Harris JR, Cross J, Hannon PA, Mahoney E, Ross-
2005;39:590-93. Viles S. Employer adoption of evidence
Frank J. Managing hypertension using based chronic disease prevention practice:
combination therapy. American Family a pilot study. Preventing Chronic Disease.
Physician. 2008;77(9):1279-86. 2008;5(3):A92.
Hagberg LA, Lindholm L. Cost-effectiveness of Ruser CB, Federman DG, Kashaf SS. Whittling
healthcare-based interventions aimed at away at obesity and overweight.
improving physical activity. Scandinavian Small lifestyle changes can have the
Journal of Public Health. 2006;34(6):641- biggest impact. Postgraduate Medicine.
53. 2005;117(1):31-34.
95
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
feel as if their trainer is personally interested
Introduction to Designing
in them and vested in their success.
T
Programs
It is helpful to have knowledge of motivating
techniques and know the principles of causing

o design a training program
behavior change. As the intensity of the
effectively, a personal trainer
program increases, client compliance usually
must have knowledge of
falls off and it is up to the trainer to help keep
anatomy and physiology, kinesiology and basic
the clients motivated, enthusiastic
nutrition, as well as information
and committed to completing the
about special populations like
program.
pregnant and post-natal women,
Client education plays a large
adolescents, the elderly, and
role in the development of a
those with chronic medical
training program and its success.
conditions. Having this kind of
Teaching the client about how
background information will aid a
the body works and what
trainer’s awareness of the proper
specific exercises accomplish is
postural alignments for different
important for the client to trust
exercises, the indications and
in the program components, stay
contraindications for different populations,
motivated and feel connected to the trainer.
and the risks and precautions to be considered
Education about the importance of resistance
when designing the program.
training is particularly important since many
Program success relies on the rapport
people still associate it with body building and
and trust between the client and the trainer
many women fear building up muscle mass.
so it helps if the trainer develops both
Clients can educate trainers too. Client
communication and active listening skills.
feedback is crucial to the success of any training
Clients need to feel that they are in good
program, and the trainer must take client needs
hands and that they are working with a
and feelings into account when developing
knowledgeable professional. They want to
and adjusting program components.
98
Continuing education is also important. their duration, frequency, intensity, total time
Clients have many misconceptions about spent training, short and long term goals and
training due to faulty marketing campaigns. ways to maintain motivation. The design is
It helps if the trainer stays on top of current an interactive endeavor between the trainer
events and research in order and the client. The trainer
to answer questions that must measure the client’s
may come up. acceptance of the program
Trainers must educate components and define
clients about the types of problems with motivation
physical contact that they and other barriers to
will use. Explain the reasons achieving goals. Proper

“All that stands between
behind any physical contact a good body and a great goal development includes
such as spotting techniques, body is someone to educating a client about
assessments and assisted push you just a realistic goals and time
exercises. Be sure that the

little further than you frames.
would push yourself.”
client is comfortable with The most important factor
these instances of physical to consider when designing
contact. a training program is the
client’s primary goal. No

Program Design
matter what the trainer may
Assessments are always
believe the client needs,
the first step in designing
the trainer is being paid
a program. They help the trainer determine
to help the client attain this goal via healthy,
appropriate, customized goals to set as well
safe methods. However, many clients come in
as make them safe and attainable for the
with unrealistic expectations for their body
client. After the assessments have been done,
potential or want too much progress for too
an effective program can be developed. A
little work.
program design will include types of exercise,
99
Goals need to be realistic based on the Assessment Form (Medical/Health)
First Name_______________________________________
client’s existing level of fitness, age and time
Last Name_______________________________________
constraints. They should be aligned with
□ Male □ Female
the client’s interests and ability and then Date of Birth_____________________________________
reevaluated at regular intervals. Program Height____________________________________________
design is never completely done. Training Weight_ __________________________________________
Occupation_ _____________________________________
programs must continually change and evolve
Have you ever suffered from any of the
over time as the client’s fitness and goals
following: (Check all that apply)
change.
□ High Blood Pressure □ Heart Attack
Training potential is the genetic potential □ Low Blood Pressure □ Diabetes
of the client. If the client is unconditioned, □ High Cholesterol □ Back/Knee Injury
the gains seen from beginning training will □ Chest Pains □ Seizures
be great. If the client Do you smoke?

Muscular imbalances □ Yes
is highly fit, the gains create postural
misalignment How many cigarettes per day?_________________
will be less. As clients and injury. At what age did you start?______________________
approach their genetic □ No, but I used to
potential, which is the top level at which their □ No
bodies will perform, target goals must be Does your family have a history of the
changed. As less dramatic progress is seen, following: (Check all that apply)
□ Heart Attack
clients may become bored or unmotivated,
□ Heart Operations
which will pose an additional problem to take
□ High Blood Pressure
into account when designing a program. □ Diabetes
Muscular imbalances create postural
Health Precautions to Consider
misalignment and injury. They are caused by
when Designing a Program
repetitive movement, poor posture or weak/
Performance Enhancement & Personal
tight muscles. Muscular imbalances cause
Training (Abbreviated Sample):
imbalances on opposite sides of a joint and
100
affect range of movement. The objective in Osteoporosis is a disease that makes bones
treating imbalances is to strengthen weak and joints fragile. Men over 80 and women
muscles and stretch shorter muscles. over 65 may have undiagnosed osteoporosis
Arthritis is joint inflammation or damage. so trainers must use caution in determining
There are many different types of arthritis but exercises and loads for older clients. In
osteoarthritis and rheumatoid addition, replaced hips or
arthritis are the most common. Men over 80 and women over formerly fractured hips
65 may have undiagnosed
The goal in these cases is to cannot maintain a normal
osteoporosis.
restore joint function. This level of stress.
is best accomplished by having one or two Aging populations have a decreased ability
sessions daily, extending warm-ups and to regulate fluid balances in response to
decreasing intensity and duration in times dehydration and thirst and therefore the
of inflammation and increased pain. Anti- sensations are compromised. It may be
inflammatory medications may reduce the necessary to monitor fluid intake in the elderly
client’s ability to evaluate pain during exercise as they exercise and educate them about the
so the trainer must be vigilant in watching and importance of regular hydration breaks.
evaluating effort.
Avoiding Overexertion and Injury
Always listen to the client’s feedback, both
Stressed
Stiffness
Shoulders while designing the program and while working
Over-used, through it. If the program is too aggressive for
Tired Muscles Sore Joints
the client’s goals or current abilities, it should
Back Ache
Tendonitis be scaled back. Learn to recognize physical
Tendonitis danger signs of overexertion such as:

Aching Joints
• Dizziness
Strained
Muscles Muscle • Lightheadedness
Spasms
Stiff Joints • Complexion changes
• Profuse sweating
101
• Facial expressions can develop into a long-term bad habit. The
• Muscle exhaustion use of secondary muscles instead of primary
• Improper posture muscles for breathing (e.g., the diaphragm)
• Labored breathing affects posture and tension. This can cause
• Faltering in movement headaches, lightheadedness and dizziness.
If exercises are properly explained before In addition, the spine and ribcage are used
beginning them, clients are less likely to in normal breathing and inadequate motion
overexert themselves. When of these joints restricts and

The trainer must watch a client‘s
explaining an exercise to chest to determine where the stiffens them.
breathing action is being generated
the client, always include an Excessive breathing leads
and what muscles are being used.
explanation of what muscle to altered carbon dioxide
or muscle groups are being targeted. Teach and oxygen levels in the blood, which in turn
them the difference between muscle fatigue triggers various physiological reactions. One
and unintentional pain. If pain occurs in a non- of these reactions is anxiety in the client. This
targeted, non-supporting or stabilizer muscle, ineffective breathing also results in lowered
there may be a problem, but it is helpful to oxygen levels. The retention of metabolic
remind the client that new and unfamiliar waste in the muscles causes them to become
movement is typically uncomfortable at first. stiff and fatigued.
Habitual dysfunctional breathing affects

Signs of Dangerous
sleep patterns and circulation. The trainer
Dysfunctional Breathing
can help correct and prevent dysfunctional
Dysfunctional breathing is very dangerous
Rib cage
and can require medical attention. The trainer expands as Air Rib cage gets
smaller as rib
Air
rib muscles inhaled exhaled
contract muscles relax
must watch a client’s chest to determine where
the breathing action is being generated and

Lung
what muscles are being used. In dysfunctional
Diaphragm
breathing, the breathing pattern is shallow;
Inhalation Exhalation
it does not make use of the diaphragm and

Diaphragm Contracts Diaphragm Relaxes
(moves down) (moves up)
102
breathing by watching the chest and teaching so frequently that not enough measurable
the client to breathe with the diaphragm. progress has occurred. The reassessment can
help the trainer track progress, note ineffective

Avoiding Discouragement
exercises and adjust the program accordingly.
Educating the client about realistic goals
and time frames will help a training Aerobic Programs for Beginners
program be successful. If the client has Sometimes it is necessary to get clients
false expectations, discouragement ready to engage in more vigorous
and frustration, will quickly follow. workouts by easing into aerobic

Equipment
Overloading is necessary for a activity. Walking is a great exercise
client to make gains, but the Fitness for beginners, as it is relatively

Triangle
trainer should be careful easy to maintain a constant
when increasing the load. If intensity level and can be

User Trainer
the load is increased too a group activity. If the
quickly, the client may become overwhelmed client has had very low activity levels up until
and/or discouraged. In addition, the client may beginning training, walking frequently may
begin to regress or, worse yet, help build up stamina so that
become injured, necessitating other activities can be added
time away from training. Keep in slowly and without overexerting
mind that compliance with the the body.
training program decreases as Swimming is a more difficult
the intensity level increases. The aerobic activity and some
harder it gets, the less the client degree of skill is required, but
will want to do it. the benefits of water exercise
Reassessment tests should are tremendous. A study found
be given often enough to that aerobic activities

Aerobic exercise builds endurance
encourage the client with by keeping the heart pumping for taking place in water have
regards to progress but not an extended period of time. psychological benefits to
103
clients. Being in the water hides physical scheduling activity five days a week for 45
defects and provides support. Water aerobics minutes each session.
are useful for the disabled, obese, elderly and Judging the effectiveness of exercise by
pregnant populations. The buoyancy and caloric use is difficult, as most sources
resistance of water requires higher energy of information on caloric use do not take
expenditures than land exercises but without into account coordination and skill level of
straining joints or causing pain. the participant. An experienced swimmer
It is recommended that aerobic activity spends less energy to go the same pace as
sessions last 20 to 60 minutes each or be an inexperienced swimmer will use with an
broken into a series of 10 minute segments. inefficient stroke. This is why the heart rate
If the client has been sedentary, exercise must measurement is the best way to judge how
build up gradually. It is best to start with low effective the aerobic exercise program is.
intensity five minute bouts. If the client is

Physiological Factors to Consider
deconditioned, the trainer should schedule
in Designing Programs
multiple, short daily exercise sessions for that
Once the client has reached a level of fitness
client’s best results.
enabling the trainer to incorporate strength
The aerobic component
training, the trainer must
of the training program Exercise Target Zone Chart
200 create a well-rounded
should strive to use 77%
180 strength program that
An
to 90% of the maximal ae
rob
not only uses a variety
Heart Rate—Beats per Minute
ic
Th
heart rate or 60% to 160 res
ho
ld of different muscle
Zo % of
ne
80% of the heart rate 140 Tar
Maximum
get H Heart Rate
ear groups working in
reserve. It should burn tR 85%-100%
ate
120 Zon complementary ways but
e
150-400 calories a day. Fat
65%-85%
Bur
ning
Zon
also uses different types
100 50%-65%
If weight loss is the goal, e
Recovery of exercises. The various
Zone 50% or less
2000 calories or more a 80
20 25 30 35 40 45 50 55 60 65+ factors to be considered
week should be used by Age
104
in designing specific workouts are described amounts of energy, but the supply in each
below. cell is limited and the cell must have time to
produce more in order to keep performing

Types of Muscle Actions
and to avoid damage to the body.
Exercises that include both concentric and
There are three bioenergetic pathways
eccentric muscle actions are the most effective
to produce ATP that should be taken into
in training programs. With concentric muscle
consideration when
actions, sufficient force
designing fitness programs:
is produced to overcome
1. ATP-creatine phosphate
external load and shorten
pathway (ATP-CP, also
the muscle. Isometric muscle
sometimes known as the
actions produce force but
Phosphagen system) is
there is no change in muscle
anaerobic. It does not require the use
length. Eccentric muscle actions produce
of oxygen.
force while the muscle is lengthening—it is
2. The glycolic pathway is anaerobic.
the resistance of the movement.
3. The oxidative pathway is aerobic; it
Energy Usage requires the presence of oxygen.
ATP, adenosine triphosphate, is the typical

The Kinetic Chain
storage and transfer unit of energy that the
The kinetic chain consists of the muscular,
body uses. ATP is capable of storing large
articular and neural systems and refers to the
Phosphagen System
Overwork Results in Weak & Tight
Muscles
8-10 seconds (100 m)
Sprinter
Adhesion- The Cumulative

Glycogen-lactic Acid System Fibrosis Friction Pressure,
(Scar Tissue) Inury Cycle & Tension
1.3-1.6 minutes (400 m) Leads to
Swimmer
Formation of
Decreased Circulation
Swelling (Edema)
Aerobic Respiration
Decreased Oxygen Called “Hypoxia”
Marathon Runner Unlimited Time (15 Km)
105
sensorimotor integration of these systems for slightly outward at the thoracic areas of the
motor output; therefore, it includes all of the spine; keeping shoulders back and away
major systems of the body used in motion and from the ears; squaring hips; and avoiding
their interaction with each other. Each system hyperextention (“locking out”) of a joint.
works interdependently with the others for

Types of Training Used in
structural and functional efficiency. If any
Exercise Program Design
one of the systems does not work efficiently,
Posture and Movement Training: Every
compensations and adaptations occur in the
movement requires a base from which to
other systems. This can lead to tissue overload,
decreased performance and predictable
patterns of injury.
Hypertonicity
of the erector
Proper Positioning spinae, which
leads to
Hypertonicity
of the
hyperlordosis abdominal
muscles
Proper positioning of the body during leads to
ptosis.
exercise is important to avoid injury and gain
generate and accept force. This is the role of
posture. Posture is the alignment and function
of all components of the kinetic chain at any
given moment, allowing all of the necessary
body systems to work together for smooth,
desired results. The trainer should look out safe motion. It is controlled by the central
for and educate the client about maintenance nervous system.
of a neutral spine position: curving slightly Posture is not static and is not only measured
inward at the neck and lower back; curving when standing. The body goes through
106
constant adjustments to maintain posture. or together) produce proper posture. Postural
Any deviations from proper posture changes distortion patterns are predictable patterns
the center of gravity for the body and affects of compensations made by the body due to
the function and efficiency of the kinetic muscle imbalances. If some core muscles are
chain. Without proper posture, the body has weaker than they ought to be, the body will
a propensity for degeneration of the joints, compensate to regain postural equilibrium.
tissue stress and injury. Balance/Stability Training:
The functional efficiency of Balance is the ability to maintain
the kinetic chain lies in the a position for a given amount
ability of the neuromuscular of time without moving. Work
system to monitor and on core muscles increases
manipulate movement during balance and stability. People
functional tasks using the least who play sports use many
amount of energy possible. nontraditional movements
Functional strength is the ability of the that require good balance, such as squat hops
neuromuscular system to perform dynamic, and single leg hops. A number of exercises
eccentric, isometric and concentric muscle described in other sections (postural training,
actions in all three planes of motion. flexibility training) can also help with balance.
The body must maintain Care should be taken to
a “postural equilibrium” to include plenty of exercises
maintain balance; this is that require balance.
the position from which all Flexibility Training:
movement begins and ends. Flexibility is the degree to
Proper muscle lengths and which a joint moves through
tensions in the relationships Flexibility exercised help stretch a pain-free range of motion.
muscles, protect against injury
of force couples (muscles and allow the maximum range Factors to consider when
of motion for joints
that work against each other designing flexibility training
107
are: joint structure, the condition of soft tissue Cardiovascular Training: Components
around the joint and the length of muscles of cardiovascular programs include mode of
being stretched. These factors determine how exercise, intensity of
well the joints help facilitate movement. There exercise, frequency of
is a large section on types of flexibility training exercise and duration
below. of each session. It is
important to consider
the sport, interest
and common physical
activity that the client employs. Training
programs should include exercises that most
closely mimic those activities and interests.
Functional Training: Functional training
is custom designed for the client. It is the
choosing or creating of activities and exercises

Resistance Training: The three primary
that will best help the client perform better
resistance goals are hypertrophy, muscular
in daily life. Functional training can be those
Resistance training builds exercises that help an athlete perform better

strength of muscles, bones,
and surrounding soft tissue; at a chosen sport or it can help the client with
burns fat; and may lower the physical activities done at work. Functional
cholesterol.
goals can be helping an elderly person have
strength and muscular better balance to prevent falls.
endurance. Hypertrophy Plyometrics: Plyometrics is used only with
is the increase in muscle well-conditioned clients and athletes. These
mass or size. It is the exercises are sports-specific and include
increase of the size of muscle fibers. Once mass training for speed, strength, power, endurance,
has accrued, strengthening and endurance flexibility and coordination for optimal sports
training can make the most of the muscle. performance. Plyometrics is based on using
108
the elastic property of muscles to create a will increase fat loss and calorie-burning. As
greater force. Its original use was as a jumping mentioned above, be sure to take your client’s
exercise for the lower specific needs and likes
extremities but is now used Power Skipping Repeated Tuck Jumps

into account when planning
for the entire body. cardiovascular training.

Repeated Long Jumps Diagonal Obstacle Jump
Plyometrics is the use Moderate intensity is
of a strength-shortening the most recommended

Alternate Leg Bounding Squat Jump
cycle and begins with rapid and used mode of aerobic
stretching (eccentric muscle Single Leg Hops

activity. It is defined as the
actions) which is followed by shortening of the pace at which you break a sweat, have a slight
same muscle (concentric muscle actions). increase in heart rate, and can still easily speak
and hold a conversation. This intensity can be

Principles of Exercise Training
achieved by either mode of cardiovascular
Flexibility training can be helpful for all
exercise: machine or non-machine.
clients, including those interested mainly in
A study found that moderate intensity
building muscular strength. “Muscle-bound”
activities were not understood by clients
bodybuilders do have compromised range of
when verbally explained. Demonstrations of
motion (ROM) and flexibility. The desire for
moderate intensity exercises greatly increased
mass and strength must be weighed against
proper exercise procedures and success. Be
the loss of flexibility and ROM.
sure that your client understands what is
Cardiovascular health is central to overall
involved in an exercise before they attempt it.
health and may be one of your client‘s top
Machine cardiovascular exercises include:
concerns. If fat loss is one
• Stair Master
of the program goals, it
• Treadmills
is best to use a variety of
• Rowing machines
modes of cardiovascular
• Cycle ergometers
training. This is called cross-
• Elliptical trainers
training. Mixing modes
109
Non-Machine cardiovascular exercises age. Target heart rate should be between 60%
include: and 80% of the maximum heart rate. There are
• Walking formulas for calculating your client’s targeted
• Jogging heart rate zones. The Karvonen formula,
• Running discussed in chapter 3, is more accurate
• Swimming because it takes into account the client’s
• Aerobic dance current fitness level (given the inclusion of
the resting heart rate). Another method is the

Target Heart Rate
percentage of maximal heart rate, which is
What is your target heart rate range?
Intensity of Activity % Maximal Heart Rate*
simpler and yields a more conservative target
Very Light <35 HR than the Karvonen method. There are two
Light 35-54
steps to the percentage of maximal heart rate
Moderate 55-70
Hard 71-90
formula:
Very Hard 91-99 To determine the client’s maximum heart
Maximal 100
rate (HR) using the percentage of maximal
*Maximal heart rate = 220 - age
Calculating your maximal target heart rate range using the

percentage of maximal heart rate formula
heart rate formula:
For a moderately intense (55-70% maximum) activity level:
[220 - (your age)] x 0.55 to [220 - (your age)] x 0.70 220–Age of client = estimated maximum HR
Example:
Target heart rate range for a 54-year-old exercising at moderately intense To determine the lower limit of the client’s
activity:
[220 - 54] x 0.55 to [220 - 54] x 0.70 = 91 to 116 beats per minute
training heart rate range:
As mentioned above, heart rate is one of
Estimated maximum HR x percentage (60%)
the easiest measures of how much and what
To determine the upper limit of heart
intensity cardiovascular exercise the client
rate range that the client should work to
is getting. There are a number of factors that
achieve:
influence heart rate besides level of exercise,
Estimated maximum HR x percentage (80%)
and they are as follows: age, sex, fitness level,
Resting heart rate is the number of heart
medications, body position, blood volume,
beats in 60 seconds. Many factors can influence
heart disease, temperature and humidity. The
this so it is best to take it upon waking or, at
maximum attainable heart rate decreases with
110
the least, after five minutes of complete rest. by multiplying the stroke volume by the heart
To check heart rate, check the pulse at the rate.
wrist or the neck taking care not to apply too
much pressure (that will distort the reading).
The carotid artery can be found with the index X
and middle fingers at the side of the windpipe.
The radial artery lies between the bone and Preload Contractility Afterload Heart Rate
tendon of the wrist, palm side and thumb side. Stroke Volume X Heart Rate = Cardiac Output
Count the number of heart beats in 15 seconds Cardiac output = stroke volume (SV)
and multiply by 4 to determine the heart x heart rate (HR).
rate per minute. When measuring heart rate

Measuring Exercise Intensity
during exercise, count the number of beats in
Exercise intensity measurement consists
6 seconds and multiply by 10 or simply add a
of the amount of oxygen consumed during
zero to the end of the number.
exercise and the number
Stroke volume is the amount
A trainer will not know what of calories burned. It is
of blood pumped by the heart stroke volume a client has, but
important to determine
with each contraction of the measuring heart rates gives a
good indication of the work individual ranges of target
ventricle. A trainer will not being done by the heart.
heart rates and to check heart
know what stroke volume a
rates frequently during the workout to be sure
client has, but measuring heart rates gives a
that the client is working within both a safe
good indication of the work being done by the
and effective range.
heart. A typical stroke volume is 75-80 mL per
In order to see improvements in
heart beat and the typical heart rate is 70-80
cardiovascular health, a certain level of oxygen
beats per minute.
consumption and/or heart rate reserve usage
Cardiac output is the amount of blood
must be attained. Heart rate reserve is the
pumped per minute through the arteries to
difference between the client‘s resting heart
all the tissues of the body, and it is calculated
rate and their maximum heart rate. In healthy
111
adults, the aerobic level necessary to see
Lactate Concentration (mMol/l)

177
improvement is between 50% and 80% of the
170
10
heart rate reserve.
Heart Rate
158
Maximal oxygen consumption or usage is 5 147
135
generally accepted as the best measure of 2.5
122
1
gauging cardio-respiratory fitness. The highest 30 35 40 45 50 55
Oxygen Consumption (ml/min/kg)
rate of oxygen transport and utilization is
achieved at the point of maximum physical Submaximal tests exist that can give a sense
exertion. At rest, oxygen consumption is 3.5 of intensity of workouts. These include:
mL of oxygen per kilogram of body weight per • Rockport Walk Test
minute or 1 MET. • Step Test
• Field Protocols
Measuring Caloric Use
These tests have errors of assumption built
(METs x 3.5 x bodyweight in kilograms)/
into them, meaning that they do not take
200 = calories used per minute.
individual differences into consideration but
Example: A client, who weighs 150 lbs or
over time they can show trends.
68.2 kg (150 lbs/2.2 = 68.2 kg), using a
treadmill at 0% intensity or grade level

20—Maximal exertion
walks at 7 mph or 11.2 km/hr (7 mph/1.61 =

19—Extremely hard
11.2 km/hr) for 45 minutes. This translates 17—Very hard
to 11.7 METs (taken from a standard MET 15—Hard or heavy
table for jogging). 13—Somewhat hard
(11.7 x 3.5 x 68.2)/200 = 14 calories per minute. 11—Light
14 x 45 = 630 calories per workout. 9—Very light
Typical oxygen consumption is 45 to 80 mL X 8—Extremely light
kg X minutes or 11-23 METs. Maximal testing 6—No exertion at all
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.
112
are usually from 6 to 20 but other numbers are Training logs are a good way to monitor
used as well. The RPE scale measures feelings exercise intensity. They should include
of effort, strain, discomfort and fatigue during what exercises are in the program and the
aerobic and resistance training. corresponding resistance or load, how fast
It was developed by the Swedish psychologist repetitions are, how many sets and reps are
Gunner Borg and is sometimes called the performed, the distance and intensity of the
Borg Scale. You can ask your clients to rate activity, and the length of resting periods.
how much exertion they are putting out on a The client should also record weight, resting
scale of 6-20. No exertion at all is a rating of heart rate, general health, general subjective
6, 7 is extremely light exertion, 9 is very light experience of the workout, and muscle
exertion, 11 is light, 13 is somewhat hard, 15 soreness and fatigue on a scale of 1 to 10.
is hard or heavy, 19 is extremely hard and 20

Principles of Resistance Training
is maximal exertion.
Name:________________________ Fitness Training Log (example)
(RT)
Date: Day of Week: Weight: Resistance training (RT) was first created
Resting Heart Rate: Aerobic Workout:
to help wounded soldiers recuperate. It
Body Part: # of Sets: Body Part: # of Sets: later became popular with body builders
Body Part: # of Sets: Body Part: # of Sets: and presently is used for general health and
Body Part: # of Sets: Body Part: # of Sets:
fitness. Resistance training can affect almost
Exercise Type SETS X REPS X WEIGHT (lbs) every system in the body and can greatly add
to health benefits of any client population.
Resistance exercise and resistance training
are not the same thing. Resistance exercise

Level of Muscle Soreness (1-10 Scale):
refers to the protocol for a single exercise or
Level of Fatigue (1-10 Scale):
Notes: workout. Resistance training refers to the
combination of many consecutive sessions.
RT must target a specific muscle or muscle
group.
113
Resistance Training: Split Routines (example) Periodized training is the use of variation in
Program Monday Tuesday Wednesday Thursday Friday Saturday Sunday
a training program to prevent boredom and
Total Total
Total Body Rest Rest Rest Rest Rest
Body Body
optimize progress. Varying a program can be
Upper
Upper Lower Upper Lower
or Lower Rest Rest Rest
Body
Body Body Body Body done by changing the choice of exercise, the
Chest & Back &
Pull/Push Triceps & Rest Legs Rest Biceps & Rest Rest order that exercises are done in, the resistance
Shoulders Traps
Body Part
Specific
Back &
Chest
Legs
Arms &
Shoulders
Rest
Back &
Chest
Legs
Arms &
Shoulders
level, the number or reps, the number of sets in
The SAID principle is specific adaptations each exercise, or the duration or rest between
to imposed demands. An example of SAID sets.
is increasing the number of repetitions to Beginners should have multiple sets of
increase muscle endurance. exercises of simple techniques. Technique and
The overload principle states that as technicality of activities should increase over
adaptation of the muscle or muscles to a the course of the program.
stimulus are made, an increased stimulus Some guidelines for resistance exercise
is required for further improvement. The choice are:
overload principle is the idea that each workout • Start out with multi-joint activities
should place a progressively and progress to less complex,

Large muscle groups should
higher demand on the muscle be worked before small ones. single-joint exercises to target
or muscles that are targeted in muscles more specifically.
order to get results. • The beginning of the program should
The degree of overload depends on the produce the greatest amount of muscle
work load, the number of repetitions, the rest mass and require the most energy.
between sets and the frequency. It is important Studies show that these components
to remember to increase the demand of each are less effective at the end of a training
workout. Overload increases can be created program. A lessening in the amount of
by increasing resistance or weight, increasing reps leads to less fatigue in smaller
repetitions, increasing sets or decreasing rest muscle groups.
periods. • Large muscle groups should be worked
before small ones.
114
• Alternate pushing and pulling for the during subsequent workouts. A 10 rep max test
total body workout. is a safe way of predicting the client’s maximal
• Alternate upper and lower body load. The personal trainer must first identify
exercises. the weight that the client can lift using proper
• Explosive/Power/Olympic type lifts form for up to 10 reps (if the client surpasses
should take place before basic strength 10 reps, the personal trainer should allow
and single-joint training. the client 2-5 minutes to rest before making
• Exercise weak areas before strong another attempt with a higher weight). The
areas. trainer can then use the Brzycki Formula to
• The exercise program should move predict the client’s 1 rep max.
from the most intense exercises to the weight lifted

1 rep max =
least intense. 1.0278 - (0.0278 * # of reps)
10 rep max tests should be included as part

Determining Resistance
of the client’s fitness assessment and should
Resistance determination involves the use
be reevaluated every 4-6 weeks.
of repetition maximums (RMs). The repetition
maximum is the maximal load that can be lifted Determining Rest Periods
for a certain number of repetitions or absolute ATP-creatine phosphate is the energy system
resistance (a specific number of reps). and energy source used in resistance training.
In a single training session, the RM target It is used up quickly and needs time to replenish
should be based on the goal of the training itself. Resistance training that uses both
session (i.e., strength, hypertrophy or glycolytic and ATP-creatine phosphate energy
endurance). is best for enhancing muscle hypertrophy and

Training Adaptation Reps Sets Intensity
muscle definition. Less rest is needed when
Strength 1-5 4-6 85-100%
both energy sources are used.
Hypertrophy 8-12 3-4 75-85%
Endurance 12-25 2-3 40-70% For advanced training that involves absolute
When working with a new client the personal power and strength, few repetitions near
trainer must assess the client’s strength to maximum resistance should be programmed
identify the proper weight (or load) to utilize with 3-5 minute rest periods in-between.
115
Beginner or intermediate clients should have A very short rest is 1minute or less. A short
a 2-3 minute rest period because they have a rest is 1-2 minutes. A moderate rest is 2-3
lower absolute resistance. minutes. A long rest is 3-4 minutes and a very
If the goal is strength and muscle mass, both long rest is5 minutes or longer.
long rest periods with heavy loading and short

Resistance Training Modalities
rest periods with moderate loading can work
Resistance training modalities include:
well. Short rest periods may increase anxiety
variable resistance devices, static resistance
and fatigue. The greater the discomfort and
devices, or isometrics and isokinetic devices.
muscle fatigue, the more metabolic demand.
Variable Resistance Devices
Rest periods depend upon observation as well.
Variable resistance devices involve a pulley,
The trainer should observe the client for loss
lever arm or cam. They alter resistance through
of force, nausea, dizziness or fainting.
The trainer should consider that smaller
muscle mass or single-joint exercises
require shorter recovery periods, aging
decreases toleration of resistance exercise
(meaning longer and more frequent rests are
necessary), and that the body’s bicarbonate

range of movement in a continual contraction
and phosphate levels buffer blood and muscle
that matches a strength curve.
and are therefore improved by the gradual use
There are three kinds of curves relating
of shorter rest periods.
to strength: bell-shaped, ascending and
Interval Training for Different Energy Systems
% of Maximum descending. An example of ascending strength
Anaerobic Energy Work:Rest
Power System Taxed Time Interval Ratio
curves is a squat. It uses only the top ½ or ¼ of
90-100 Phosphogen 5-10 seconds 1:12 to 1:20
the repetition. It is not the full ROM. An example
75-90 Fast Glycolysis 15-30 seconds 1:3 to 1:5
of a descending strength curve is rowing. It
Fast Glycolysis &
30-75 1-3 minutes 1:3 to 1:4
Oxidative
uses only the bottom ½ of the repetition. An
20-35 Oxidative >3 minutes 1:1 to 1:3
elbow curl is an example of a strength curve
116
that is bell shaped. It is the middle of the ROM rehabilitation facilities. They use either friction
and leaves off the beginning and ending points or compressed air to control the speed of
of the repetition. movement in an exercise or activity. Isokinetic
Static Resistance Devices or Isometrics devices are often used to train at fast rates of
Static resistance devices involve pushing or speed like the type of velocities that occur in
pulling an immovable entity such as a wall, real-life sports.
With isokinetics, the muscular action is
performed at a constant angular limb velocity.
There is no set resistance and the action cannot
be accelerated. The more you push, the more
resistance you get from the device.
an overloaded barbell or a maxed-out weight
machine. Isometrics is a muscular movement in
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 Hydraulic devices lack deceleration so there
of isometric actions, whether the action is is no eccentric muscle activity employed. This
maximal or sub-maximal and the duration of halves efficiency because eccentric muscle
the action. Functional isometrics refers to their is involved in injury protection. Pneumatic
use when athletes or clients must overcome a devices can be adjusted on both the concentric
sticking point in their progress. and eccentric muscle exercises. These are often
Isokinetic Devices used with older populations but lack balance
Isokinetic devices use a variety of methods and control components.
to provide maximum resistance and range Isokinetics are used in “prehabilitation”
of motion. Isokinetics are popular choices in presently. This refers to their injury prevention
117
capabilities. They help clients to better resist in mesophases are preparation, competition,
injury, decrease recovery time from injury and peaking and transition. Macrophase refers
lower the extent of damage. to the whole training program and usually
consists of a year.
Periodization
Non-linear periodization programs are used
Periodization is the use of progressive
when the client may have time constraints and
cycles in resistance training. It is used to avoid
a busy life.
overtraining, deter boredom, keep stimulus
Traditional periodization involves varying
levels up and increase effectiveness of the
volume and intensity in a patterned way.
training program. Periodic training is more
The training program begins with a high
effective than constant training exercises.
volume of exercises that are low in intensity.
It is the alternating of high loads of training
Progressively, the volume is lowered over
with decreased loading
time as the intensity of
phases. Variations in 12 Week Periodization Chart
exercises is increased.
Training Intensity Level
12
the training program 10
8 Small variations occur
are necessary to first 6
4 in each one to four week
build muscle mass and 2
0 microcycle. A chart of
1 2 3 4 5 6 7 8 9 10 11 12
then strengthen that Weeks
the intensity is a rising
increased mass.
diagonal line.
The time frames of periodization are
Stepwise periodization is the use of increasing
microphases, mesophases and macrophases.
intensity while decreasing volume of exercise
Microphases are up to seven days and one
during the training period. Repetitions
should occur at least every four weeks.
generally decrease in the following manner:
Mesophases are anywhere from two weeks to
eight reps down to five reps and then down to
a few months. Four to six mesophases should
three reps.
occur in a year. The more mesophases that a
In undulating periodization, volume and
training period includes, the more effective
intensity are increased and decreased but not
the training program will be. The sub-phases
in a traditional pattern.
118
Overreaching periodization consists of
Overtraining
varying the volume or the intensity over a
Overtraining syndrome is a neuro-endocrine
short period of time (one to two weeks) and
disorder because it affects the nervous system
then returning to the normal training program.
and the hormonal system balance. Overtraining
Overreaching is generally done with well-
results in “burn out,” “staleness” or “jet lag”
conditioned clients and advanced athletes.
and can compromise a training program for
Ways to Vary Volume and weeks or even months.

Intensity
Normal Periodization
• Changing the choice of exercises of Training
• Varying the order of exercises

Quick
• Adjusting resistance or load Recovery Still
Possible by
Tapering
Performance
• Adjusting number of sets of an
Underrecovery
Overreaching
exercise Time
• Changing the number of exercises for a

Rest periods are where physiologic
specific muscle group
improvement occurs. The period after working
• Altering joint angles and positioning
out is when the body reacts to the stressors
• Changing an exercise from working a
put upon it and increases blood flow to the
single joint to multiple joints or vice
muscles, increases glycogen stores, increases
versa
enzyme systems and increases heart efficiency.
• Changing exercises from primary to
When an athlete or client exercises intensely
assisted exercise or vice versa
over a long period of time without proper
• Changing the repetition or range of
rest periods, regeneration does not occur and
exercise
performance will plateau and then decline.
• Changing the type of muscle
Overtraining has emotional, behavioral and
contraction
physical symptoms. An overtrained client
• Adjusting speed of movement
may experience cumulative exhaustion that
• Altering rest periods between sets
continues even after rest, like muscular
• Adjusting nutrition
119
soreness, fatigue, changes in sleep, loss of overtraining has occurred. Rest is the cure
appetite, weight loss and weakened immune for overtraining. If the overtraining has only
system. There may be happened over three to
serious mood effects, Overtraining four weeks, the problem

Syndrome
including irritability, should be remedied
Performance Psychological
Problems Problems
moodiness, depression, by three to five days
loss of enthusiasm, loss Physiological of rest. The normal

Problems
of desire to compete, training program must

Major problems resulting from overtraining
and an increase in be corrected before
illness and injuries. Physiologically, the body resuming exercise. The athlete or client should
experiences increased cortisol levels (the begin exercising only on alternate days with
hormone released when we are stressed), decreased volume of exercise for a few weeks.
lowered testosterone levels and a high level of A training log can monitor the progress of the
muscular waste byproducts. Other life stressors client and the success of the program. It can
can exacerbate overtraining symptoms. also prevent the occurrence of overtraining in
There are two forms of overtraining: the first place. A training log should include:
sympathetic and parasympathetic. • Intensity of activity
Sympathetic overtraining syndrome is • Resting heart rates
common in sprint-type sports and is • Weight
characterized by an elevated resting heart • General health
rate. Parasympathetic overtraining generally • Subjective experience of the workout
occurs in endurance sports. It is characterized • Levels of muscular soreness (on a 10
by a decreased resting heart rate and a lowered point scale)
heart rate for a given workload. It may result • Fatigue (on a 10 point scale)
in hypoglycemia while exercising.

Summary
It is important to rule out hidden illnesses
There is much to consider when designing a
as the cause of symptoms before assuming
training program, but with time the personal
120
trainer will gain an instinct about design a) Muscle action
components and creating programs will b) ATP usage
become easier and quicker. c) Proper positioning
Program design is individualized. It requires d) All of the above
many assessments of the client before design 4. What are the three primary resistance
can begin and then throughout the training training goals?________________________________
program so that goals and exercises can be _ _______________________________________________
continually adjusted and updated. Designing _ _______________________________________________
a training program requires frequent, clear 5. Plyometrics are used with exercise
communication between a trainer and the beginners. True or False?____________________
client. The trainer must listen closely to client 6. Using a variety of modes of cardiovascular
feedback and educate the client. training is called _____________________________.
A successful training program is continually 7. How is exercise intensity measured?_______
assessed and makes use of periodization _ _______________________________________________
techniques so that the improvement gains _ _______________________________________________
remain noticeable to the client and keep the 8. Periodization is:
client motivated. a) Muscular action in which there is no
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?_ ________________________________________
_ _______________________________________________
3. What are physiological factors that one
_ _______________________________________________
should consider in designing a fitness
_ _______________________________________________
program?
121
10. The two forms of overtraining are exercises from primary to assisted exercise
_ ____________________ and ______________________. or vice versa; 9) Changing the repetition or
range of exercise; 10) Changing the type of

Answers
muscle contraction; 11) Adjusting speed
1. Anatomy, physiology, kinesiology, basic
of movement; 12) Altering rest periods
nutrition and knowledge of training special
between sets; or 13) Adjusting nutrition.
populations.
10. Sympathetic and parasympathetic.
2. True.
3. d) All of the above. References

4. Hypertrophy, muscular strength and Brzycki, M. Strength Testing: Predicting a One-
muscular endurance. Rep Max from Reps-to-Fatigue. JOPERD.
5. False. 1993;-64(1):88-90.
6. Cross-training. Fowles JR, Sale DG, MacDougall JD. Reduced
7. By the amount of oxygen consumed Strength After Passive Stretch of the
during exercise and the number of calories Human Plantar Flexors. Journal of Applied
burned Physiology. 2000;89(3):1179-88.
8. b) The use of progressive cycling in Kokkonen J, Nelson AG, Cornwell A. Acute
resistance training. Muscle Stretching Inhibits Maximal
9. Any three of the following 1) Changing the Strength Performance. Resistance Quarterly:
choice of exercises; 2) Varying the order of Exercise and Sport. 1998;69(4):411-15.
exercises; 3) Adjusting resistance or load; Malliaropoulos N, Papalexandris S, Papalada
4) Adjusting number of sets of an exercise; A, Papacostas E. The Role of Stretching in
5) Changing the number of exercises for Rehabilitation of Hamstring Injuries: 80
a specific muscle group; 6) Altering joint Athletes Follow-Up. Medicine & Sciences in
angles and positioning; 7) Changing an Sports & Exercise. 2004;36(5):756-59.
exercise from working a single joint to
multiple joints or vice versa; 8) Changing
122
Nelson AG, Kokkonen J, Arnall DA. Acute Thacker SB, Gilchrist J, Stroup DF, Kimsey
Muscle Stretching Inhibits Muscle Strength, CD Jr. The Impact of Stretching On Sports
Endurance and Performance. Journal Injury Risk: A Systematic Review of the
of Strength Conditioning and Resistance Literature. Medicine & Science in Sports &
Training. 2005;19(2):338-43. Exercise. 2004;36(3):371-78.
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 Obscure Relationship. Sports Medicine.
Hold-Relax Stretching Protocol. Journal of 2004;34(7):443-49.
Athletic Training. 2001;36(1):44-48.
123
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
• Prevents blood lactic acid accumulation
The Warm-Up
in the muscle (helps to prevent
A
What is a Warm-Up? premature fatigue)
warm-up is a short duration • Contributes to efficient removal of
of activity preceding major metabolic by-products (e.g., lactic acid,
exercise. A warm-up is necessary carbon dioxide, water)
to increase muscle temperature • Slowly increases blood flow to muscles
and general core temperature of the body and • Makes muscle tissue more stretchable
should be designed to avoid • Reduces risk of tearing muscle
fatigue or reduction of fibers, tendons and muscle tissue
energy stores. A warm-up • Allows warmed muscles to move
improves performance and faster and to generate more force
personal well-being during for greater mechanical efficiency
exercise. Every training • Enhances neural transmission
session should begin with and motor-unit recruitment
a warm-up. If a warm-up is • Allows nerve impulses to travel
not conducted, heart rate faster for quick reaction times
can increase to dangerous • Provides early alerts for
levels to try to supply the potential musculoskeletal or
necessary oxygen to the muscles. This can cardiorespiratory problems
often lead to an increase in muscular injury. There are many benefits to a warm-up
These kinds of injuries comprise greater before exercise. First, a warm-up produces
than 30% of injuries seen in sports medicine an increase in metabolic requirements. The
clinics. short period of time used for a warm-up
corresponds to the time necessary to allow

Benefits of a Warm-Up
the cardiorespiratory system to adjust blood
• Increase in metabolic requirements
flow effectively to the muscles, where the
• Makes physical performance more
oxygen demand is great during exercise. This
effective and efficient
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adjustment makes physical performance more can cause serious injury during the higher
effective and efficient. Secondly, a warm-up intensities of exercise.
prevents blood lactic acid accumulation in the

Warm-Up Considerations
muscle, which can lead to premature fatigue.
During a warm-up, the amount, intensity
It also contributes to the efficient removal of
and duration should be adjusted according
metabolic by-products like lactic acid, carbon
to the individual’s current fitness level. The
dioxide and water. A warm-up prevents the
intensity of the warm-up is important in
client from going from a state of inactivity
effectively preparing the body for exercise. It
to high intense activity too quickly by slowly
is important to elevate the heart rate from the
increasing blood flow to the muscles. Third,
resting heart rate of 40-75 beats/minute to
muscle tissue becomes more stretchable in
approximately 90-120 beats/minute. During
response to warm-ups. The
the warm-up, the body
risk of tearing muscle fibers,
It is important to elevate temperature of the muscle
tendons and muscle tissue the heart rate from the resting
heart rate of 40-75 beats/minute tissue rises about 3.6 °. The
is reduced. Additionally, to approximately 90-120
beats/minute. duration of the warm-up
warmed-up muscles
should be a minimum of 3-5
move faster and generate
minutes; however, the actual length should be
more force, allowing for greater mechanical
based on the exercise activity to follow. For
efficiency due to low resistance within the
elderly persons, pregnant women, overweight
muscle. A fourth benefit of a warm-up is that
individuals or exercise beginners, the warm-
it enhances neural transmission and motor-
up should be more gradual and for a longer
unit recruitment. Nerve impulses travel
duration, typically 10-15 minutes. In terms of
faster in these cases and allow for quicker
activity, the warm-up should be controlled and
reaction times. Lastly, a warm-up provides an
go through an easy range of motion. It should
early alert for potential musculoskeletal or
never be beyond the range of motion, which
cardiorespiratory problems. These problems
might ultimately cause pain and discomfort.
become apparent in a warm-up before they
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There are three major types of activities that
Activity-Specific Warm-Up
can accomplish efficient warm-up: general,
An activity-specific warm-up includes
activity-specific and passive warm-up. Often,
movement that is actually a part of the main
however, warm-up exercises may be grouped
physical activity. For example, an activity-
as active and passive.
specific warm-up can
Types of Warm-Ups include swinging a
tennis racket before

General Warm-Up
playing tennis or
A general warm-up involves rhythmic
conducting light
and continuous movement and callisthenic
resistance training
exercises. In this warm-
movements before weight lifting. This
up regimen, mostly
method of warming-up is more desirable
large-muscle groups
because it increases the temperature of the
are engaged. Activities
same muscle groups that will be used in the
in a general warm-
specific activity as well as serve as a mental
up include jogging,
rehearsal. An activity-specific warm-up
cycling and jumping
usually includes 8-12 minutes of dynamic
rope. A general warm-
stretching, focusing on movements that
up usually precedes an
work through the range of motion.
activity-specific warm-
up and is more appropriate than a passive Passive Warm-Up

warm-up when a demanding physical activity A passive warm-up includes things like a
is to follow. The aim of a general warm-up is hot shower, a massage and heat applications.
to increase heart rate, blood flow, deep muscle This can have a positive effect and does not
temperature, respiration rate and perspiration. cause fatigue in a person prior to the exercise
Additionally, decreasing viscosity of joint fluids session. However, a passive warm-up is less
is one of the main goals of a general warm-up. likely to warm deep muscles and may even
128
be counterproductive. The increased surface follow. If the activity will be of great intensity
temperature of the skin often leads blood (e.g., basketball), then flexibility training would
vessels that are close to the surface of the be necessary. However, if the activity is more
skin to dilate. static (e.g., stationary biking), then flexibility
Blood then training may be needed or the warm-up may
moves to the only consist of static stretching.
surface of the
Warm-up Exercises
skin and away
from working
muscles.
Warm-Ups and Stretching

Back/Hamstrings Neck/Shoulders
A misconception is that a warm-up and
stretching are the same thing—they are

Quads/Hip Flexors
not. A warm-up raises the body and muscle
temperature while stretching improves
flexibility. In some instances, however, a Lowerback Back/Hamstrings
warm-up can, increase flexibility by increasing

Flexibility
muscle elasticity. Due to these considerations,
flexibility stretching should occur only after a What is Flexibility?

warm-up. Flexibility is defined as how far and how
Some warm-up routines do not include easily one can move the joints or the range of
flexibility training. However, the addition of motion at a joint or joints. It is the capacity to
flexibility exercises are often part of a warm-up move freely in every direction and, at times,
routine and are often matched to the demands beyond the normal range of motion. Flexibility
of the activity that will be conducted. It usually ultimately measures the tightness of the
depends on the nature of the exercise that will muscles.
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restricted movement in the body can lead to
The Importance of Flexibility
problems. This is often due to compromising
Flexibility is often a neglected part of physical
joint stability. Forcing the body to a point of
fitness. A high level of flexibility can be gained
pain is never encouraged.
quickly but can also be lost quickly through
Another important aspect of designing an
inactivity. Also, levels of flexibility decrease
effective flexibility training program is that the
with age. Lack of flexibility can cause lower
correct performance and correct positioning
back and hamstring muscle
of the exercises are
pain and weak abdominal
conducted no matter which
muscles. In theory, the risk
training method is utilized.
of injury to the muscle-
Stretching exercises and
tendon unit is based on the
techniques are often used in
fact that tight muscles are
designing a program to gain
more likely to be strained
flexibility. Programs may
compared to more flexible muscles. An
include a variety of techniques for the joints
increase in the interaction of actin and myosin
with periodic repetitions to chart progress.
filaments of the muscle occurs when a person
is more flexible and this ultimately improves The Science of Flexibility

performance. This highlights the importance One factor affecting flexibility is joint
of a consistent flexibility training program. structure. Flexibility is joint specific. This
Improving flexibility can also lead to good is one of the primary limiting factors for
posture by realigning the skeletal structure the range of motion since the structure
that has adapted to poor posture and exercise determines how much movement is available.
habits. The more unrestricted the movement Flexibility also varies between joints of the
is, the more flexible the body will be. Because of body due to construction. One joint may have
this, flexibility enhances safety and efficiency above-average range of motion and another
in conducting not only exercise regimens but joint have below-average range. Hinge-type
also daily tasks. Too much flexibility or overly joints, including the joints of the knee and
130
elbow, conduct only backward and forward The composition of connective tissue is
movement so they have less range of motion another factor. This includes cartilage, which
compared to ball and socket lies between bones to provide
joints, like that of the hip and Pivot Ball and Socket protection at the contact
shoulder. Movement is allowed Hinge

points and offer padding and
in all anatomical planes in this Saddle

Condyloid
shock-absorbing capabilities.
area, which has the greatest Ligaments, which connect bones,
range of motion compared to offer stability and integrity to

Gliding
other joints. joint structures, while tendons,
Another factor is age. People which connect bone to
become less flexible with age Females are typically more muscle, lead to efficient bodily
flexible than males.
and never again reach levels movement and play a role in
seen during early childhood flexibility. The three layers
due to a loss of muscle elasticity. Early that wrap the muscle, the muscle fascia, play an
childhood is the best time to start flexibility even greater role. Muscle can be stretched to
programs. 150% of its length if relaxed and unrestricted
Females are typically more flexible than without any injurious effects. Ligaments and
males. This is thought to exist from childhood tendons, though important to flexibility as a
through adult life. It is attributed to the whole, are hard to stretch because of their roles
anatomical variation in joint structure seen in stabilization and muscle force protection.
in the trunk, hips and ankles. At puberty, Muscle fascia is relatively easy to stretch.
boys have increased muscle size, stature

Types of Flexibility
and muscle strength that ultimately hinders
flexibility. It has been proposed that increases Flexibility Training System (Integrated)
in growth rates in different parts of life may Corrective Flexibility
result in rigidity of bones composing a joint • Static Stretching
and therefore lead to decreased flexibility. • Neuromuscular Stretching
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• Neurodynamic Stretching perform a particular action. This type of static
• Self-Myofascial Release stretching strengthens muscles and prevents
Active Flexibility injuries or tearing of soft tissue.
• Neuromuscular Stretching
• Active Isolated Stretching
Functional Flexibility
• Dynamic Stretching
Flexibility training programs involve
increasing flexibility through a progression of
three phases. The three phases, known as the

SMFR is a technique used to remove knots
flexibility continuum, are corrective, active
from muscles; these knots can form during
and functional flexibility.
vigorous exercises or stressful activities. This
Corrective Flexibility technique incorporates the use of a foam roll
Corrective flexibility was or cylindrical object and body
designed to correct muscle pressure to massage muscles
imbalances and improve joint and decrease micro-adhesions
ailments. It involves two main that lead to the formation of
concepts known as static muscle knots. Micro-adhesions
stretching and self myofascial that form during a workout
release (SMFR). Static stretching refers to stimulate the release of healing proteins,
stretching an antagonist muscle to its maximum which lead to an increase in muscle density
limit and holding the position for a period of and metabolism. Unfortunately, the release
time. An antagonist muscle stretches during a of proteins causes the development of knots
contraction while working against agonist and within the muscle. Knots that are left untreated
synergist muscles. Agonist muscles initiate make muscles inflexible and tight and decrease
muscle contractions and synergist muscles a muscle’s ability to function and contract
provide additional support the body needs to properly. Knots can also cause chronic muscle
132
tension, joint pain and poor posture. All these of this phase. Active-isolated stretching utilizes
complications can be avoided by simply agonist and synergist muscles to perform the
massaging muscles with a foam roll entire movement of a specific
after a workout. In other words, SMFR action while allowing the
is a cool-down technique that leaves antagonist muscle to stretch.
the muscle free of knots and in better For example, when performing
shape by the start of the next workout straight leg raises in a supine
regimen. position, the hip flexor and
Areas of the body that should be quadriceps cause the leg to
focused on when performing SMFR raise and allow the hamstring
include: the gastrocnemius (calf (antagonist) to be stretched.
muscle), tensor fascia latae/iliotibial Active-isolated stretching
tract band (hip and leg muscle), adductor techniques are held for approximately 2
muscle (hip muscle), piriformis (gluteal) seconds and allow muscles to easily repair
muscle and the latissimus dorsi (triangular themselves and enhance daily performance
back muscle). Static stretching followed activity. This form of stretching also increases
by SMFR begins to improve flexibility and joint elasticity and improves circulation.
enhances the body’s ability to heal its muscles Overall, the active flexibility phase increases
after a workout. This is the first part of the clients’ level of strength and prepares them
flexibility continuum. for the final functional flexibility phase.
Active Flexibility Functional Flexibility

Active flexibility, the second phase of the The functional flexibility phase allows
continuum, entails the use of SMFR and active- individuals to achieve maximum extensibility
isolated stretching to improve the efficiency of soft tissue and neuromuscular control
of neuromuscular (nerve and muscular) through dynamic stretching and SMFR.
interactions. In addition, an increase in soft Dynamic stretching involves the combination
tissue extensibility can be noticed by the end of active muscle exertion, speed of movement
133
and momentum to stretch a particular muscle
Static Stretching
or group of muscles. This form of stretching is
Static stretching is slow and sustained
stretching to increase movement at the
corresponding joint. It can be performed to
cool down muscles after a workout by holding
specific stretches for 10 seconds or to increase
range of movement and mobility by holding the
stretches for 30 seconds. The benefits come
most often conducted before a competition and from simultaneously relaxing and lengthening
bouncing or jerking movements are avoided. the stretched muscle. This type of stretch
Dynamic stretching reduces muscle tightness, does not activate the stretch reflex because
which is associated with the occurrence of of the slow speed of stretch. Static stretching
musculotendinous (muscle and tendon) tears. requires no voluntary muscular activity. Static
The results of recent studies also suggest that stretching is known to prevent overstretching
dynamic stretches before a competition are and exceeding the normal range of motion
more beneficial than static stretches. This final while requiring a lower energy requirement.
phase of the flexibility continuum increases Lower instances of muscle soreness are also
power in addition to strength. An important associated with static stretching. Aspects of
point to remember in regards to the flexibility static stretching may also be included in the
continuum is that, for each phase, SMFR should other forms of stretching. Static stretching
be performed after stretching. techniques include the following:
Stretching Techniques Gastrocnemius stretch:

We will discuss in further detail the following Stand upright facing a wall and place the left
different forms of stretching: static, active, leg in front of the right leg. Hands should be
proprioceptive neuromuscular facilitation, raised to shoulder level and placed against the
dynamic and ballistic. wall. Slowly move the right leg away from the
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of back foot inward. Pull stomach inward.
Keep the knee straight and
heel on the floor. Gradually
Squeeze butt muscles and, while rotating
lean forward—usually
against a wall—until a
gentle pull is felt in the pelvis to the back, shift body forward and
upper ⅓ or ½ of the lower
leg (knee to mid-calf).
straighten the back leg. A mild tension should
be felt in the front of
the hip. Raise the arm
(same side as the back
leg) up and over to the

wall, keep it straight and firmly press the
opposite side of the
heel into the floor. Hold the stretch for 20-30 Start Finish
body while holding the
seconds. The calf muscle will be stretched.
pelvis position. Continue to hold this position
Repeat this stretch with the left leg.
and rotate backwards at a slow rate. Hold for
Static standing adductor stretch: 20-30 seconds. Repeat on the opposite side.
Stand upright with the feet placed

Static kneeling hip flexor stretch:
approximately two shoulder lengths apart. Lift
Kneel down on one leg with the back leg
the right leg by bending at
being bent at a 90° angle. Keep posture tall.
the knee and then lower
Internally rotate your back hip. Place same
the body, leaning into the
sided hand on front thigh to help you balance.
bent right leg. Keep the
Start Finish
Hold other arm straight up with hand in air.
back straight and use the
Pull navel inward, squeeze butt muscles and
arms to maintain balance
rotate pelvis toward the front of the body.
while holding for 20-30 seconds. The left leg
Move body forward
adductor will be stretched. Repeat the stretch
slowly until mild
with the opposite leg.
tension can be felt in
Static standing psoas stretch: the front of the hip/
Stand upright with one leg bent and slightly leg that is supporting
Start Finish
forward and the other leg back. Rotate toes your weight. Hold for
135
20-30 seconds. Repeat on other side, switching position for 3-5 breaths and then switch to left
legs and arms. hand and roll ball to the right.
Static pectoral wall stretch: Static upper trapezius/scalene stretch:

Stand perpendicular to a wall (or door Stand upright with a proper posture position
opening) with right foot forward and toes and place the left arm behind the body. Pull
pointing forward. the navel inward then retract and depress the
Form a 90° angle scapula on the
with your arms, left side. Tuck
palms of hand flat in the chin and
against the wall/ tilt the head

Start Finish
Start Finish
door jam. Pull from left side
navel inward. Slowly lean forward until a mild toward right side. Hold this position for 20-30
stretch is felt in the front shoulder and chest seconds, then repeat on the right side.
region. Hold for 20-30 seconds and repeat 3

Passive Stretching
times.
Passive stretching is a
Static latissimus dorsi ball stretch: form of static stretching
Stand in front of a and is so named because
stability ball. Place the it requires assistance,
bottom side of right which is needed from
hand on the ball with an external force to
the thumb pointing reposition parts of the
upward. Roll the ball body. This force can be from gravity, which
to the left and kept the weighs the body down or from another person
hips square keeping the right fist on the ball. like a personal trainer. To maximize results
Draw in your core tightly and prevent hips from passive stretching, one should remain
from moving to get the best stretch. Hold this relaxed and stop any reflexive movement.
136
exercises are active stretches. Active stretch
Active and Active Assistive
techniques include:
Stretching
In active stretching, the person who is Active Gastrocnemius stretch with
stretching supplies the force of the stretch. Pronation and Supination:
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 straight. Pull the navel inward, lift
The stretched muscle is being actively engaged
and moved through the range of motion. This
requires energy greater than what is used for Start Movement Finish
static stretching. Active assistive stretching
the bent leg and rotate the body from left to
is sometimes considered a partner stretch.
right. The stretch should be held for 2 seconds
It is the same as active stretching but the
and performed 5-10 times on both sides of the
muscle being stretched may also require some
body.
assistance to go through the range of motion.
This is most likely because of muscular Active supine biceps femoris stretch:
weakness. Lie on the back with both legs extended
Active stretch techniques strengthen straight. Lift the right leg and bend the knee.
agonistic muscles while increasing active
flexibility. Most active stretches do not need to
be held for more than 15 seconds and holding Start Movement Finish
an active stretch position for more than 10
Place the right hand behind the right knee for
seconds is usually difficult. A variety of yoga
support. Pull the navel inward and extend the
137
leg towards the ceiling. Hold this stretch for 2 in air overhead. Pull navel inward, squeeze
seconds and repeat 5-10 times. Repeat with butt muscles and rotate pelvis toward the
the left leg. back of the body. Move body forward slowly
until mild tension can be felt in the front of the

Active standing psoas stretch:
hip/leg that is supporting your weight. Bend
Stand upright with one leg bent and slightly
to the side and rotate toward the back. Hold
forward. Rotate the back leg inward. Draw the
for 2 seconds for 5-10 repetitions. Repeat on
navel inward while
other side switching legs and arms.
raising the arm
overhead. Squeeze Active standing adductor stretch:

butt muscles and Stand upright in a proper posture position
rotate backwards. with the feet placed two shoulder lengths

Start Movement Finish
Lean forward on
the front leg, controlling the movement, until
slight tension can be felt in front of the hip
being stretched. Bend to the side and rotate Start Movement Finish
toward the back. Hold for 2 seconds for 5-10

apart. Lift the right leg, bend the knee and
repetitions.
slowly lower the body. Use the arms to balance
Active kneeling hip flexor stretch: and keep the back straight. Hold the stretch
Kneel down on one leg with the back leg bent for 2 seconds, repeat 5-10 times then repeat
at a 90° angle. Keep posture tall. Internally with the left leg.
rotate your back hip. Place same sided hand

Proprioceptive Neuromuscular
on front thigh to
Facilitation Stretching
help you balance.
Proprioceptive neuromuscular facilitation
Hold other arm
(PNF) stretching was initially developed as
straight up and
a technique to relax muscle with increased
down with hand Start Movement Finish
activity but has been expanded to improve the
138
range of motion. It is thought to be superior and degree of stretch as well as force applied
to other stretching methods because it also to induce the stretch. The disadvantages
of this stretching technique include the
predisposition of the muscle to injury. This
may outweigh any benefit from this type
of stretching. Ballistic stretching also has a
higher energy requirement, which may cause
fatigue and hinder performance in the main
assists in muscular relaxation. PNF makes use exercise activity. Additionally, though it has a
of both passive and active stretching. The type greater range of motion
utilized depends on what is the best response than the static range
to the stretch stimulus. It includes contract- of motion, some do
relax (hold-relax), which involves the muscle not consider this an
contracting and then relaxing. The muscle is acceptable method for
then further stretched into its available range increasing the range of
of motion during the relax phase. In another motion.
type of PNF, contract-relax-contract (hold- Dynamic stretching techniques involve
relax-hold), the same procedure is conducted controlled arm and leg exercises that gradually
but the contraction of the antagonist muscle increase speed of movement, range of motion
gains slightly more range of motion. and extensibility. They usually comprise 8-12
repetitions or less and are a good warm-

Dynamic and Ballistic Stretching
up routine for aerobic workouts. Dynamic
Dynamic stretching is often confused with
stretching techniques include the following:
ballistic stretching. Ballistic stretching entails
quick jerking and bounce-like movements Prisoner squat:

on the resistant tissue. This stretching is Stand upright with the feet shoulder length
performed at high speeds and therefore is apart and point the toes slightly outward in
often uncontrolled because of the high rate an angle. Place the hands behind the head and
139
hold the chest and shoulders in an upright to the starting position and repeat with the
position during the exercise. Bend at the hip left leg. To perform the turning lunge, stand
and knees and slowly lower the body. Balance
on the heels, do not lean forward and make
sure the knees do not pass over the toes.
Repeat 8-12 times.
Start Movement Finish
in the same starting position and step to the
side with the right foot at a 45° angle. Pivot the
left foot while slowly lowering the body into a
Start Movement Finish lunge position. When coming out of the lunge
position, pivot back to the starting position,
Multiplanar lunge: then repeat on the other side. Repeat the
This lunge involves three parts: the front entire series 6-8 times.
lunge, the side lunge and the turning lunge.

Single-leg squat touchdown:
For the front lunge, stand upright with the legs
Balance on one leg while
together and the hands placed on the hips. Step
keeping the corresponding
forward with the right leg and bend the right
shoulder in line with the knee
leg at a 90° angle. Make sure not to extend the
and hip. Squat as far as possible
knee over the toes and keep the upper body
with the opposite leg elevated
upright. Return to the start position and repeat
and extended forward. Do not
the lunge with the left leg. To perform the side
allow the knee of the balance
lunge, stand in the same starting position and
leg to go over the toes. Return to the starting
step to the side with the right leg. Bend at the
position and repeat with the other leg.
hips towards the right leg, keeping the torso
upright and the hips facing forward. Return
140
Tube walking/side-to-side: the head. Repeat 8-12 times and maintain a
Stand upright with the feet consistent pace throughout the exercise.
shoulder width apart and

Precautions and Safety
pointed forward. Pull in the
No two individuals are the same so each
belly and slightly bend the
client interested in beginning a flexibility
knees. Tighten the glutes and
training program should have an effective
step toward the left with the
regimen specific to that client’s needs. The
left foot, then step toward the
ease at which flexibility can be increased is
left with the right foot. Take 5-10 steps to the
normally limited by muscle fascia (connective
left, then 5-10 steps to the right in the same
tissue), which causes the most resistance to
manner. Perform this stretching exercise 1-5
improving range of movement. Trainers and
times.
their clients enrolled in a training program
Medicine ball chop and lift: should pay close attention to making sure
Stand upright with the feet two shoulder- range of movement can be altered without
lengths apart and slightly bend the knees. causing joint injuries or increasing the risk
Hold a medium- of serious injuries. Trainers should closely
sized medicine ball monitor their clients while stretching exercises
with both hands are being performed, and clients should clearly
above the head understand how to perform movements and
and bring the ball concentrate while performing stretches.
down in front of the

Types of Stretches
torso in a chopping
motion. The ball can Static Stretching:

be brought down to the knee level or to the • Safest option for beginners
floor for a greater challenge. While continuing • Most effective form of flexibility
to hold the ball, reverse directions and bring techniques
the ball back to the starting position over
141
• Lowest incidence of rate of injuries • No substantial evidence that it is better
• First phase of flexibility continuum than other types of stretches
• Third phase of flexibility continuum

Active Stretching:
By following concepts such as these, the
• Tedious and difficult for average
trainer and client can be reassured that
person
flexibility training will be conducted in a safe
• Agonist muscle strength and mental
manner. Static stretching is the safest option
concentration is needed to perform
to start for individuals who are inactive or
properly
who simply want to become more flexible.
• If increase in range of movement is
Static stretching belongs to the first part of the
not noticed, passive or combination
flexibility continuum and is typically labeled
of passive and active stretching can be
as the safest and most effective form. Long-
performed
duration, low-force
• Second phase of flexibility
Static stretching is the safest static stretching
continuum option to start for individuals
exercises produce
who are inactive or who simply
Dynamic Stretching: want to become more flexible. much more muscle
• Can be performed as active and/ extensibility than
or passive stretching active and dynamic stretches. Static stretching
• Dynamic active stretching utilizes also offers the lowest incidence rate of
momentum to increase range of injuries.
movement Active stretching, unlike static stretching,
• Safety is dependent on one’s flexibility is usually tedious and difficult for average
level, speed at which performed and individuals to perform. One common problem
range of motion necessary is that most people do not have the agonist
• High injury risk muscle strength and mental concentration
• Typically performed by athletes for a needed to properly perform active stretching
specific event techniques. Individuals who fall under this
142
category typically do not notice an increase use dynamic stretching. A high injury risk is
in their range of movement. One way to associated with this form of stretching and,
overcome this problem is by performing although many athletes prefer to use dynamic
passive stretching or a combination of passive stretches to warm-up, there is no substantial
and active stretching. Passive stretching scientific evidence that suggests dynamic
allows individuals to gradually stretch the stretching is better than any other form of
agonist muscle of interest and puts less strain stretching. However, if an individual who
on the agonist muscle. Combining passive and has been physically inactive for an extended
active stretches makes the transition into the period of time needs to prepare for a vigorous
second phase of the flexibility continuum less sporting event, (e.g., marathon) implementing
stressful. dynamic stretches in the
Dynamic stretching, the Passive stretching allows beginning of the training

individuals to gradually
third part of the flexibility stretch the agonist muscle. program may be justified. In
continuum, can also be every case, safety precautions
performed in an active and/or passive manner. such as drinking and eating properly before
Dynamic stretching differs from active training, maintaining proper posture while
stretching, however, by utilizing momentum training and concentrating should be taken
to increase range of movement. The safety of seriously.
dynamic stretches depends on the individual’s Individuals who suffer from a disease that
flexibility level, the speed at which the limits or increases their range of motion or
movement is performed and the range of who have had previous surgeries/injuries that
motion necessary to perform the stretch. reduced or increased their flexibility must be
Dynamic stretching is typically performed by cautious when stretching. Ailments such as
athletes needing to prepare for a specific sports arthritis cause a lot of pain for sufferers due to
routine or aggressive sporting event. Dancers, inflamed joints. Putting unnecessary pressure
divers and professional gymnasts extensively on affected joints or stretching a muscle beyond
143
its range of motion can leave the individual in to perform might cause extreme difficulty for
more pain and discomfort than before starting older individuals. Gender also plays a role in
the training program. levels of strength and flexibility. Men tend to be
Knowing what type of surgeries or injuries stronger than women, but women tend to be
an individual has had will allow the trainer more flexible in the hip region. These factors
to suggest stretching techniques that will may affect the client’s ability to properly carry
not re-injure or further injure the client. out certain techniques and may also affect the
Sometimes clients choose to take part in a outcome of the stretch exercises. In addition to
training program in order to regain strength gender, a client’s physical activity level is one of
or flexibility they may have the most important factors
lost due to an accident. If to consider when designing

Knowing what type of surgeries or
proper care is not taken injuries an individual has had will a training program. A person
allow the trainer to suggest
when the training program stretching techniques that will not who practiced karate on
is designed or if the client re-injure or further injure the client a weekly basis for several
is not closely monitored years and then took a break
when stretching, the recovery process may may be more flexible and stronger than an
be delayed. When requesting medical history individual who has not performed any form
information, the trainer must impress upon the of physical activity for years. Knowing details
client the importance of thoroughly informing such as these ensure that each individual
the trainer about every procedure had and any achieves the desired results without pushing
ailments currently causing issues. beyond the body’s limits.
Goals such as improving range of movement

Developing the Program
in specific joints and increasing endurance
Designing the right training program depends
should also play a role in how the training
on factors such as age, gender and the client’s
program is structured. If a client needs to
current and previous physical activity level.
simply become more active and wishes to do
Young children are usually more flexible than
so by first increasing the level of flexibility,
adults so exercises that may be easy for children
144
the training program may be comprised of Breathing properly allows the client to relax
mainly static stretching exercises. If a fairly and smoothly progress into each stretching
active individual needs to exercise. Proper breathing also
increase strength and flexibility Goal 1 Met ensures that only the muscles
Goal 2Met
in the next two months for an of interest are being stretched
Goal 3Met
upcoming event, the training Goal 4Met and strengthened. Breathing

Goal 5Met
program may start off with properly relieves muscle tension,
static and active exercises and which can cause unwanted
then quickly shift to dynamic exercises. A muscle pain during and after the workout. The
training program may also alternate between trainer should clearly describe how to breathe
phases as the trainer and/or client see fit. during a stretch routine so the client can get
the most out of the workout regimen. In order

Three factors for Workout Design
to properly breathe throughout the routine,
1. Warming up
the client must concentrate.
2. Proper breathing
Maintaining a proper posture while working
3. Maintaining posture
out also involves concentration. Bad posture
Three important factors that should also
can lead to muscle knots and chronic muscle
be included in the workout design include:
pain, which cause the stretch exercises to be
warming up, proper breathing and maintaining
ineffective. Maintaining correct posture also
proper posture. Warm-up exercises have been
means properly extending the limbs during
shown to reduce the body’s resistance to
the workout. Overextending can cause serious
stretching by increasing muscle temperature,
injuries and under-extending will lead to
which in turn leads to an increase in elasticity
a lack of results. Only proper posture held
(the muscle’s ability to extend). Warm muscle
throughout the exercise will lead to an increase
tissue is less stiff than cold muscle tissue and
in strength, flexibility and range of motion.
responds better during stretch exercises.
Warm-up exercises include running on a Measuring Flexibility

treadmill or stationary cycling. There is no single test that can be
administered to test the flexibility of the whole
145
body. However, separate tests can measure trainer needs to follow and the client needs to
the flexibility at certain joint areas. Flexibility fully define medical history, physical activity
assessments include 3-5 minutes history and goals. The trainer must
of warm-up and stretching to avoid then use the information obtained
injury or muscle strain. This test is to create a specific program that
often repeated every 4-6 weeks to enhances the client’s speed of
monitor progress and help reach a movement, mobility, endurance,
higher level of flexibility. strength and flexibility without
The typical devices for measuring flexibility causing injury or discomfort. If the client is
include manual and electric goniometers to relaxed while working out and notices positive
measure joint angles and the sit- results, the training program will
and-reach test. These tests evaluate be more successful.
combined flexibility of the lower Individuals who are suffering
back and hips. Goniometry is the from a debilitating ailment (e.g.,
measurement of joint range of arthritis, muscle imbalance,
motion measured in either linear osteoporosis) or a recovering from
units like inches and centimeters or angular surgery or an injury need to start with the
units like the degrees of an arc. corrective flexibility phase of the flexibility
continuum. Individuals who are active and

Summary
possess high levels of flexibility may be able
Prior to starting a flexibility training program,
to start at the functional flexibility phase, but
clients should have a good understanding
they may also need to regress to the corrective
of their current level of strength, flexibility,
and active phases during their training
mobility and range of motion. Previous
program. Every individual, regardless of the
injuries, ailments and surgeries should also
strength and flexibility level, should perform
be considered prior to beginning a training
SMFR after working out. Warming up before
program. Once an individual makes a decision
exercising and performing SMFR afterwards
to start a training program, a discussion with a
146
prevents muscle ailments and serious injuries, 3. Because a warm-up can improve flexibility,
helps remove unwanted muscle knots and stretching should be done after the warm-
allows muscles to be in better shape prior to up. True or False?____________________________
the next workout. Warming up softens muscles _ _______________________________________________
and improves muscle elasticity and SMFR is 4. What are the three types of flexibility? ____
a simple massage technique that enhances _ _______________________________________________
muscle healing, strength and extensibility. _ _______________________________________________
Breathing properly and maintaining proper 5. Where should a client with arthritis start
posture while performing stretches is also on the flexibility continuum?_______________
of the utmost importance. An individual can _ _______________________________________________
cause more damage to the body or delay _ _______________________________________________
healing if stretches are not performed properly. 6. Which of the three phases belong to the
The client needs to ask questions when a flexibility continuum?
particular movement of a stretch routine is a) Functional flexibility
not completely understood and make sure to b) Ballistic flexibility
concentrate at all times. By following these c) Active flexibility
guidelines, strength, endurance and flexibility d) Corrective flexibility
can be improved with ease. 7. What is SMFR and what does the acronym
stand for?_____________________________________
Review Questions
_ _______________________________________________
1. More than 30% of sports injuries seen are
_ _______________________________________________
due to a lack of a warm-up. True or False?_
8. Which three factors should be included in
_ _______________________________________________
the design of a training program?
2. Which of the following is NOT a type of
a) Breathing
passive warm-up?
b) Running
a) Heat application
c) Posture
b) Hot shower
d) Warming up
c) Massage
d) Stretching
147
9. What is the purpose of the corrective
References
flexibility phase?_____________________________
Cramer JT, Housh TJ, Weir JP, Johnson GO,
_ _______________________________________________
Coburn JW, Beck TW. The acute effects of
_ _______________________________________________
static stretching on peak torque, mean
10. SMFR should be performed after stretching.
power output, electromyography and
True or False?________________________________
mechanomyography. European Journal
Answers of Applied Physiology. 2005;93(5-
1. True. 6):530-39.
2. d) Stretching. Gleim GW, McHugh MP. Flexibility and its
3. True effects on sports injury and performance.
4. Corrective, active and functional flexibility. Sports Medicine. 1997;24(5): 289-99.
5. At the corrective flexibility phase of the Halbertsma JP, van Bolhuis AI, Göeken
flexibility continuum. LN. Sport stretching: effect on passive
6. a) Functional flexibility, c) active flexibility muscle stiffness of short hamstrings.
and d) corrective flexibility. Archives of Physical Medicine and
7. It stands for Static stretching and self Rehabilitation. 1996;77(7):688-92.
myofascial release and is the technique Krivickas LS, Feinberg JH. Lower extremity
involved in corrective flexibility. injuries in college athletes: relation
8. a) Breathing, c) posture and d) warming between ligamentous laxity and lower
up. extremity muscle tightness. Archives of
9. To correct muscle imbalances and improve Physical Medicine and Rehabilitation.
joint ailments. 1996;77(11):1139-43.
10. False.
148
Sady SP, Wortman M, Blanke D. Witvrouw E, Danneels L, Asselman P, D’Have
Flexibility training: ballistic, static T, Cambier D. Muscle flexibility as a risk
or proprioceptive neuromuscular factor for developing muscle injuries
facilitation? Archives of Physical Medicine in male professional soccer players. A
and Rehabilitation. 1982;63(6):261- prospective study. American Journal of
63. Sports Medicine. 2003;31(1):41-46.
Shrier I. Stretching before exercise does Witvrouw E, Mahieu N, Danneels L, McNair
not reduce the risk of local muscle P. Stretching and injury prevention: an
injury: A critical review of the clinical obscure relationship. Sports Medicine.
and basic science literature. Clinical 2004;34(7):443-49.
Journal of Sports Medicine. 1999;9:221- Woods K, Bishop P, Jones E. Warm-up
27. and stretching in the prevention of
Smith CA. The warm-up procedure: to muscular injury. Sports Medicine.
stretch or not to stretch. A brief review. 2007;37(12):1089-99.
Journal of Orthopedic Sports Physical Yamaguchi T, Ishii K. Effects of static
Therapy. 1994;19(1):12-17. stretching for 30 seconds and dynamic
stretching on leg extension power. The
Journal of Strength Conditioning and
Research. 2005;19(3):677-83.
149
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
C
Cardiorespiratory Conditioning The Importance of Cardio-
ardiorespiratory conditioning respiratory Fitness
is an activity used to improve As the respiratory system gathers oxygen,
the body’s ability to process and the cardiovascular system processes
deliver oxygen, which produces and distributes the oxygen. During
the energy required to complete a desired cardiorespiratory conditioning, it is important
activity. It involves intense movements and to apply the correct overload (increase in
activities that stimulate the cardiovascular heart rate and return of blood to the heart) to
system. This typically properly strengthen the

Oxygen Consumption Relative to Exercise Intensity
involves specific muscular heart. The ultimate goal is

Ocygen Consumption
♦ ♦ ♦ ♦
♦
endurance training of the ♦
VO2 max
to increase heart rate and
♦
♦
large muscles of the hips, ♦ respiration in order to
♦
♦
thighs and buttocks and a place appropriate stress
Exercise Intensity
focus on a client’s ability on the cardiorespiratory
to perform repetitive, moderate-to-high system. The overload must be progressive
intensity training routines. Cardiorespiratory and can be measured by increases in maximal
training is often used to burn more calories oxygen consumption (VO2 max). Sustaining a
than other areas of training and involves sport large volume of blood returning to the heart is
actions that are high energy and nonstop. necessary to see the positive effects of exercise.
Common cardiorespiratory conditioning For example, lifting weights will increase heart
exercises include running, cycling and rate but will not increase VO2 max and will not
swimming. The body will adapt to the level lead to a large volume of blood returning to the
of stress put upon it and in turn require more heart. Thus, increasing heart rate alone does
energy. Ultimately, selecting the right training not always correlate with work being done to
exercises is important in obtaining maximal train the cardiovascular system.
benefits.
152
Since fitness of the cardiorespiratory system the endurance or exercise phase. This is the
is improved by enhanced heart function target of the workout and carries the main
and use of oxygen by the working muscle to cardiorespiratory benefits.
produce energy, it should be added to any Some exercises in this phase are weight-
exercise routine. Cardiorespiratory fitness dependent. The intensity is maintained
also includes a decrease in the risk of death throughout the exercise and a relatively
from heart disease and other causes, as well constant amount of energy is expended.
as an increase in the performance of daily Examples of weight-dependent exercises
activities. Cardiorespiratory conditioning include walking and running. Other exercises
reduces resting heart rate and normalizes do not factor in body weight due to the support
resting blood pressure. Additional benefits of of the body during the routine (e.g., cycling
cardiovascular conditioning include reduced and swimming). An appropriate cool-down
stress levels and fatigue along with improved period of approximately 10 minutes of low
self-confidence. intensity activity should follow the endurance
phase; this represents the transition from

Training Design
higher intensity exercise back to rest.
In designing a
Daily Exercise Session The heart rate, blood pressure and
cardiorespiratory
Warm-up Conditioning Cool-down respiration rate is shifted downward
training program, 1 Minute
Walk/Slow jog 2-3 Minutes
Low Intensity
and back to rest. This gradual
it is important 2-3 Minutes
Stretching
20-45 Minutes
Cardiorespiratory
Exercises
2-3 Minutes
or Strength
Activity
3-4 Minutes
Stretching
decrease will help in the removal of
to begin with a Calisthenics
lactate from the muscle and aid in the

Period 1 Period 2 Period 3
warm-up. This
Total Time is Generally 30-60 Minutes dissipation of body heat.
is usually a 5-10
There are a few considerations
minute low intensity muscle activity, which
to keep in mind when determining the rest
may include stretching. It is at the lower end of
of the exercise intensity or the rate of work
the intensity progression of the target exercise
being performed that is described as a speed
and represents the transition from rest to the
or load of the body. The intensity should be
main workout. The warm-up is followed by
153
recommended within a range that would Furthermore, the choice of the type of exercise
allow for increased cardiovascular health should be based upon interest, availability and
and oxygen consumption. Intensity should should lower the risk of injury.
be considered in conjunction with duration.

Postural Considerations
Exercise intensity cannot be accurately chosen
Cardiorespiratory conditioning training
without taking duration into consideration
follows the same kinetic parameters as
since they are inversely related. Frequency,
flexibility and resistance
the number of times
Good Posture Poor Posture
training. There are
the cardiorespiratory Correct Head
Posture Headaches
Neck Pain postural considerations in

system is stressed, Square Shoulders
selecting the appropriate

also plays a pivotal Center of Gravity
of the Body/S2 Level Pelvis
Back Pain
Sacrum form of cardiorespiratory

role. There may
training for the beginner.
be an advantage
Some people possess a
to more frequent
rounded shoulder, forward
training. Training two days a week or less
head posture, an anteriorly rotated pelvis
does not really lead to an improvement in
causing low back arches, feet that turn out or
oxygen consumption. The optimal frequency
knees that move in. These factors can affect
for training is three to five days a week, with
their performance on workout equipment,
exercise occurring every other day when
such as steppers and treadmills, as well as
possible, rather than consecutively, to allow
stationary bicycles.
for proper rest.
In the design of a conditioning program, other Smart Progression

factors should be taken into account, including Example: Progressive Walking Routine
Walks Distance Warm-Up Walking Cool-Down
Week
individual differences, physical limitations and (Week) (Miles) (Minutes) (Minutes) (Minutes)
1 4 1.25 5 25 5
beginning fitness level. Age and health status 2 3-4 1.25 5 25
of the individual will also help to determine an 3 4 1.50 5 30 5
4 4 1.75 5 32 5
appropriate cardiovascular training program.
154
Walks Distance Warm-Up Walking Cool-Down Initial progression is from discontinuous to
Week (Week) (Miles) (Minutes) (Minutes) (Minutes)
5 4-5 2.0 5 34 5
continuous activity, which leads to a relatively
6 4-5 2.25 5 36 5
rapid initial progression.
7 4-5 2.50 5 38 5
8 5 2.75 5 42 5
9 5 3.0 5 46 5
Interval Training
10 5 3.25 5 50 5 The body adapts whenever possible so that
Adaptation to a particular exercise routine it uses less energy to do the same processes.
can occur easily. When this happens, the same Therefore, interval training, involving both
amount of work is done in less time and it is aerobic and anaerobic processes, can maximize
associated with less psychological disruption; the amount of calories burned to ensure that
in addition, it the body can maximize
results in lower 02 Deficit the energy used by the

4
levels of fatigue body. This also involves
3
or exertion. The Alactacid maximizing the excess
2
workload must EPOC post exercise oxygen
1 Lactacid
then be increased consumption (EPOC).
if benefits from 0 2 4 6 8 10 12 14 The body’s metabolism

Rest Exercise Recovery (minutes)
training are to is elevated after exercise
be seen. Smart progression involves the since fat burning is often greater following
progression from a lower intensity level to exercise. The higher the intensity of the
a higher intensity level, longer duration, exercise, the greater the magnitude of EPOC.
and/or increased frequency of the exercise Splitting the training sessions into intervals
session. An effective guideline is to keep also enhances the effects of EPOC.
the increase in activity to no more than Classic interval training principles are key to
5% for each progression and the adaption cardiovascular training and can be applied
to this increase spread over a period of a to beginners, less fit individuals and trained
week or two. Additionally, change only one athletes. This is because interval training is
element (e.g., frequency, duration) at a time. the best choice of conditioning to optimize
155
aerobic benefits. Interval training is different increased work efforts in manageable doses.
from the comfortable level of effort, where The more work that is performed, the more
there is a balance between energy demands total calories and fat that are burned. More
by the muscle and aerobic metabolism. This total exercise effort is accumulated during
comfortable level is different for everyone and interval workouts, especially if there is a
depends on their varying abilities to deliver and limited amount of time set aside for exercise.
use oxygen. Interval training involves periods This allows for a more effective use of time, no
called intensity training, with an intermediate matter the fitness level. Additionally, training
effort that is above the comfortable level. This in intervals increases exercise compliance.
is often followed by cardio activity that is at Interval training also offers exercise variety
the comfortable level or lower. It is important and enjoyment and is also mentally engaging.
to be aware of the difference in effort exerted It is used to avoid monotonous exercise
during the comfort zone versus the intensity intensities and provide positive motivation.
training zone. Interval training also decreases overuse injury
In interval training, any switch in the potential.
intensity or duration leads to a switch in the Interval Training Using Optimum Running Times
Based on Best 10-km Time*
particular energy system. There are many 400 m
200 m 400 m Intervals
Best Intervals Intervals (aerobic-
aspects to interval training that are important 10-km time (anaerobic) (aerobic) anaerobic)
(min:sec) (min:sec) (min:sec) (min:sec)
to gain maximal benefits. An increase in 46:00 00:46 2:00 1:51
43:00 00:43 1:52 1:44

cardiorespiratory fitness or aerobic endurance
40:00 00:40 1:45 1:37
can increase a person’s ability to exercise
37:00 00:38 1:37 1:29
for prolong periods of time at the limits of 34:00 00:36 1:30 1:16
aerobic metabolism. Even individuals that are * Example: A runner with 40 min. 10k best
time should train 200 m intervals (half a lap
not physically fit can use interval training to on a track) at 40 secs per interval (mainly
using anaerobic system); if preferred interval
raise their anaerobic threshold. This change in workout is f 400 m (1 lap), but desire is to still
remain in aerobic zone (so as to not build lactic
anaerobic threshold can allow for increasingly acid), the runner would complete interval in
1:45; final column is for the runner wanting
intense paces and longer durations, leading to interval workouts consisting of 400 m in which
they would build speed in order to get faster—
156
they would cover 400 m in 1:37 (for the runner of speed play, recovery is usually three times
who runs a 40 min 10k, a 1:37 would be very
challenging and would require both anaerobic as much rest as intense training. For example,
and aerobic systems for energy).
% Max HR Response of Beginner to 1 Minute Sets of Swing with
Heart monitors should be used for interval 1 Minute Interval Rest (Data Taken at 30 Second Intervals During Set)
100
training to assess the efforts of the training 90 ♦ 88

89
♦
♦ 85
♦ 81 ♦ 82 ♦ 81 ♦ 81
program. A heart monitor provides more 80 ♦ 79
% Max HR
♦ 73 ♦ 72
70 ♦ 69 ♦ 69
information than using time over distance
♦ 61 ♦ 63
60
measurements since it allows for the influence
50
♦ 45
of external factors (e.g., weather and surfaces) 40
0 30 60 0 30 60 0 30 60 0 30 60 0 30 60
on training. Time each set (seconds)
5 minutes of hard pedaling on a stationary

Interval Training Model
bike is followed by about 15 minutes of rest.
Example: Work to Rest Ratios for Various
Exercises This is done as many times as is appropriate
% of Energy
Maximum System Exercise Exercise:Rest
Power Stressed Duration Ratios or according to the physical capabilities of
90-100 Phosphagen 5-10 sec 1:12 to 1:20
the client. Speed play works regardless of
75-90 Glycolytic 15-30 sec 1:3 to 1:5
30-75 Glycolytic & 1-3 min 1:2 to 1:4

the physical fitness level since the training
Oxidative
20-35 Oxidative >3 min 1:1 to 1:3 intensity can be kept to a specific fitness level.
Concepts of the interval training model Health and fitness interval training is
include the idea of speed play. Speed play is more structured than speed play. It can be
used in many instances and represents an performed using the aerobic and anaerobic
easy-to-use model for training. In speed play, model. The effort in this interval usually
there are increases in cardiovascular efforts has a 1:1 effort to recovery ratio. Excellent
and then an adequate recovery period follows. training techniques are used to enhance
In terms of recovery, anaerobic conditioning cardiovascular performance and variables,
is usually performed at the expense of lactic such as intensity, duration and frequency, are
acid buildup in the muscles and blood. The often fixed according to goals. Since fitness
length of time to recover depends on the effort interval training is the most structured type
to recovery ratio used in training. In the case of interval training and is associated with high
157
intensity performance, it is usually reserved comes from fat. Importantly, this does not lead
for more highly conditioned persons. to the huge production of lactic acid. The third
and last zone is a true, high intensity workout

Stage Training
over a short amount of time. In this zone, the
Aspects of interval training can be broken
heart rate is 86-90% of the max. Zone three is
down into three stages that use three
often used in conjunction with the other two
Ph
a s zones to try and avoid a plateau in exercise.
Ph e r
Powe
7
a s
Ph e
a s 6 Zone three is the power level.
Ph e
ngth
a 5
P
h
s
e Stre
P
h
a
s
e
4 Circuit Training
P a 3 ation
h s
b iliz
a e Sta Circuit training is one of the most beneficial
s 2
e
1 forms of cardiorespiratory training and, more
specifically, interval training. Combining
different heart training zones. These zones aspects of both cardiovascular and strength
are organized to maximize cardiorespiratory
training benefits. The goal of zone one is
to increase blood supply to tissue and is
often used for beginners to improve the
deliverance of oxygen throughout the body
and remove waste. The first zone is also 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
near the point at which the body can no longer training, it involves a series of resistance
produce energy for the muscle. This is often training exercises back to back with very little
known as the anaerobic threshold and results rest or recovery period. The purpose is to
in more calories being burned, much of which keep the client constantly moving and allow
158
for major exercise benefits without spending RER Fat % Carb %
prolong periods of time. Circuit training also .80 68 32

.78 74 26
differs from training programs that only
.76 81 18
target one or more specific muscle groups. It .74 88 12
is effective because it keeps pushing the body .72 94 6

.70 100 0
aerobically and challenges the strength of the
The primary reason for exercise is usually to
body simultaneously.
reduce total body fat. It is a common myth that
The term “circuit” refers to a group of
fat burning can only occur through extreme
activities that are performed one after the other
cardiovascular exercise. There is no special
to form the workout regime. The activities
fat burning zone that needs to be reached
that compose a circuit can include squats,
in order to cause the body to mainly use fat
lunges, jumping rope and back extensions.
as fuel. Conversely, as long as there is more
Once all these exercises are finished, you have
energy being burned then being consumed,
completed one circuit. As with other forms of
fat is being burned. This plays into the law of
training, it is important to warm up with light
thermodynamics.
cardio and cool down with stretching.
Besides glucose, fat is a major source of fuel
Fat Burning for exercise. The oxygen that enters the body
Respiratory Exchange Ratio (RER) allows for fat or carbohydrates to be burned.
RER Fat % Carb %
Fat and carbohydrates differ in the amount of
1.00 0 100
.98 6 94 oxygen use. The body uses the most fat when
.96 12 88 the respiratory exchange ratio (RER), the ratio
.94 18 81
of carbon dioxide produced to the volume of
.92 26 74
.90 32 68 oxygen consumed, is approximately 0.71.
.88 38 62 The body uses respiratory gasses to estimate
.86 47 53
caloric expenditure. For instance, at complete
.84 53 47
.82 62 38 rest, the amount of energy used is minimal so
there is no overall loss of weight.
159
parties will feel they failed. Another important
Muscular Strength
aspect of developing muscular strength is rest
Example: Guidelines for a Hypertrophy Weight
Training Program between workouts. Muscles become fatigued
Load 67-85% IRM
and need rest to overcome this physiological
# of Exercises 6-9
# of Reps per Set 6-12 phenomenon. Slow oxidative fibers fatigue
# of Sets per Exercise 3-6 slower than fast oxidative fibers but take twice
Rest 3-5 Minutes
as long to recover. The majority of muscles
Speed Slow-Medium
Times per Week 2-4 contain both kinds of fibers. Working out
Muscular strength is defined as the maximum many muscle groups at one time can minimize
amount of weight any one muscle can the amount of fatigue a client will experience.
endure without strain. The There are various levels of
idea of developing muscular working out a muscle. First
strength focuses on increasing is the mechanical force being
muscle fibers that will lead to used, which involves the energy
hypertrophy (enlargement) of directly expended to produce
the muscle. This happens the work necessary for the

Muscle fiber hypertrophy and
over time with good workout. Secondly, there is
splitting are found here.
strength training without Arrow marks split fiber. the neuromuscular aspect,
Also, see how easy it is to
damaging the muscle from appreciate endomysium in this which involves the motor
illustration. Whenever it is this
overexertion. The job of units of the nerves and the
prominent, it is too thick.
a personal trainer is to muscles they innervate.
provide gradual intensity that leads to gradual Motor units are important because they allow
hypertrophy of the muscles. A client trying movement and relaying of messages to the
to obtain muscular strength overnight has central nervous system to produce the desired
unrealistic expectations and the personal movement.
trainer needs to address those expectations at The last is the metabolic activity involved.
the beginning of the program; otherwise, both The body needs energy to produce any
160
desired voluntary movement. If a client is not from clients what has worked and what has
properly hydrated or does not have the proper not worked for them in the past. If a client has
nutrients, that client’s desire is of little use. never done any resistance training, the trainer
Remember, part of the trainer’s needs to make sure realistic
job is to make sure the client is expectations are discussed. The
eating a diet conducive to the number one reason for failure
workout. If a client is mainly of any workout is unrealistic
focusing on cardio, the trainer expectations. Muscular strength
should propose eating more development is a gradual process
carbohydrates and, for a focus and overworking muscles will
on strength training, a good not help clients achieve their
combination of carbohydrates goals any faster. Pacing is very
and protein. The trainer should suggest important when building muscle and it is easy
an increase of 5-10% of lean proteins for to overdo workouts because soreness, feeling
resistance training. Resistance training that out of breath and fatigue are not immediate
leads to muscular strength and hypertrophy responses to these types of training.
is very individual and is one of the most Example: Relationship Between Volume &
Training
important aspects of personal training. Objective # of
for Training Repetitions # of Sets
Developing a cardiovascular workout is a Strength <6 2-6
very general process. Once a client moves Power 3-5 3-5

Hypertrophy 6-2 3-6
into muscular strength training, the personal
Endurance (Strength) >12 2-3
trainer must develop a workout that is
Resistance training can involve several ways
tailored to the client by taking a very thorough
to strengthen muscle. Free weights, weight
initial assessment. If a client’s expectations
machines, the client’s own body weight or
are going to be met, the personal trainer must
elastic resistance are all examples of ways
pay attention to what is going to work for that
to gain muscular strength via resistance.
individual client. Trainers should find out
Variance helps to keep the workout fresh
161
and keeps clients on their toes. Varying the a recovery period before being fatigued
type of resistance also gives clients a more again with another set. This is why a high
well-rounded workout because each type carbohydrate meal/snack is important before
of resistance mechanism will use different workouts and an increased protein meal after
groups of muscles. a workout and possibly even the next day is
Another important issue of developing beneficial as well.
muscular strength is working a muscle to

Endurance Conditioning
fatigue. This simply means that clients must
Example: Types of Aerobic Endurance Training
do enough repetitions until they cannot do Types of
Exercise
# of Times
per Week
Length
of Session Intensity
Long, 30-120 Minutes
anymore, which is usually between 6-10 Slow Distance 1-2 (Distance of Race) 70% VO2 Max
Pace/Tempo 1-2 20-30 Minutes Lactate Threshold

repetitions (depending on the strength of the
3-5 Minutes
Interval 1-2 VO2 Max
(Work:Rest Ratio 1:1)
client). The personal trainer must take great Repetition 1 30-90 Seconds VO2 Max
(Interval) (Work:Rest Ratio 1:5)
Variable: 70%
care to work the client’s muscles to fatigue but Fartlek 1 20-60 Minutes VO2 Max + bouts >
Lactate Threshold
not to exhaustion. Remember, every client is When clients first start resistance training,
different so great attention to detail, as well their endurance will be low, meaning the
as individualization of the client’s workout, is amount of time they can sustain their workout
very important. As a client’s muscular strength will be short. As they perform their workout
increases, the trainer will have to adjust the over time, their endurance will increase and
number of repetitions. Sets are their muscles can be worked

The personal trainer must
the number of times clients do take great care to work the for a longer period of time.
client‘s muscles to fatigue
their prescribed number of As their endurance increases,
but not to exhaustion.
repetitions. a muscular strength workout
When clients start resistance training can quickly become a cardiovascular workout
regimens, they should only work out muscles and, if the client wants resistance training,
two times per week with at least a day of rest this aspect needs to be carefully monitored.
in between. There should also be proper rest If this happens to a client, resistance must
between sets as well. Clients’ muscles require be increased by increasing repetitions and/
162
or sets or the amount of weight. Endurance technique must be obtained. If a trainer is not
is important when allowing sustained familiar with a particular technique of a specific
movements with a load attached over a type of resistance training, such as those that
prolonged period of time. use elastic bands, then the trainer should
At the beginning of a new workout regimen, not recommend the exercise until the trainer
a client will experience a lot of soreness due has been educated on proper form. Also, it is
to the buildup of lactic acid that is released important to keep good records of the training
in the muscles from energy expenditure. As the client is doing. Having individual records
a client gains endurance, the soreness will for each client is the best way to achieve this
subside because the muscles will better utilize and will help the trainer in the future when
oxygen and less lactic acid will Normal

Operating
designing different programs for
Force (% age maximum contraction)
Range
100
buildup, which in turn will Active Force the client to achieve endurance
result in less soreness. Some 50

conditioning. Initial assessments
clients may view this lack are important to get started but
of soreness as an inefficient follow-ups are more important to

0 1.0 2.0
workout, which is not the case. Length (proportion of resting length)

keep trainers and clients on track.
As muscles develop, they will become less and Endurance conditioning is important for
less sore. Remember, endurance conditioning maintaining the length-tension relationship
is something that should be addressed once between muscles. Instead of being over
the client is comfortable with the regimen extended the muscles need to be kept in
that the trainer and client have established proper contraction for maximal gain. The
together. length-tension relationship is also important
In the beginning, the most important thing to keep balance in order to reduce the chance
to teach a client is technique. Lack of proper of injuring joints. Stabilization is another
technique in resistance training can lead important aspect and can be achieved
to undue stress as well as injuries. Before with proper posture (even in non-training
endurance can begin to improve, proper movements) and involves ensuring the least
163
amount of stress is put on the joints. Muscular the client misses some time from training.
endurance is important in stabilization because Cardiovascular conditioning is much faster
it helps recruit muscles that are involved in to “lose” than muscular strength and
prime movements, which decreases stress conditioning. This makes sense because
on the joints. If the client’s muscles cannot muscular conditioning takes much longer to
sustain the training over an extended period achieve than cardiovascular conditioning. If a
of time, the client is likely to experience joint client misses some sessions, the trainer should
problems. The prime movers are responsible offer encouragement by explaining all is not
for providing force throughout the majority of lost because of the absence. Very little muscular
the training, so they are the most important strength and conditioning is lost over the first
muscles that need endurance conditioning. few months of stopping resistance training.
Stretches for Various Body Parts The personal trainer should keep calling the
Neck & Head • Flexors, extensors
client to reiterate the fact that little has been
• Forward flexion, extension,
abduction, adduction
Shoulder • External & internal rotators lost in terms of strength and conditioning.
• Scapular retractors & depressors
Another interesting aspect to muscular
Elbow • Extensors, flexors
• Supinators, pronators strength and endurance conditioning is that it
Wrist & Forearm • Flexors, wrist extension
• Extensors, finger flexors is much easier to maintain than cardiovascular
Hand • Abductors, thumb adductors
• Forward flexion, extension,
conditioning. One report showed that, once
side bending, rotations hips
Lower Back, Trunk • Forward flexion, abduction, the client’s goal is met, the client only needs to
adduction, extension
• External rotation, internal rotation resistance train every 10 to 14 days to maintain
Knee • Flexors, extensors
the same level of effort as long as the intensity
• Plantar flexors, dorsiflexors
Foot & Ankle • Everter, inverters
• Extensors, toe flexors remains the same as when the training was
Endurance conditioning is a progressive more frequent.
process that is achieved by slowly working

The Adaptation of Strength
all muscle groups targeted and increasing
Training
load and longevity endurance over time. One
The principle of the adaptation of strength
positive aspect about endurance training
training lies in the physiology of the human
is the finding that it does not disappear if
164
body. The body wants to remain in equilibrium encouragement from the personal trainer
so it will do what it needs to do in order to be and the client. No one can perform resistance
physiologically content. During resistance training for a month and expect to see
training, stress is put on the body to achieve significant changes. Muscles need time and
a desired look, feeling or strength. By adding stimuli for adaptation to occur. The body can
this stress, the body is conditioned to want “instruct” the muscles to enlarge because the
to be able to adapt, with the end result being stimulus is not going away and the muscles
hypertrophy of the muscles. In cardiovascular will then need to adapt.
training, the heart is a highly adaptable muscle, The body’s need to adapt in order to
so cardiovascular adaptation to walking or maintain proper homeostasis is termed
running occurs quite fast. the general adaptation

The body’s resistance to stress can only
last so long before exhaustion sets in.
On the other hand, skeletal syndrome. According to
muscles are not highly Hans Selye, a medical doctor

Stress
adaptable and are challenged Resistance
in the early 20th century, the
when “asked” to do things, Stressor

body responds to stress in
Occurs
such as lifting a heavy object. three different stages. The

Phase 1 Phase 2 Phase 3
It takes much longer for Alarm
Reaction
Resistance
(Cope with
Exhaustion
(Reserves
first is the alarm reaction,
(Mobilize Stressor) Depleted)
Resources)
these muscles to adapt to a and it begins when the body
frequent stimulus such as resistance training is initially put under stress it must respond to,
because, physiologically speaking, muscles do such as lifting weight or resistance training. In
not know the difference between “training” order to respond, the body needs more oxygen
and a transient need to take a heavy box from to produce more strength so that it can keep
downstairs to upstairs. This is why achieving up with the demand. In the beginning of any
skeletal muscle adaptation takes much longer new workout regimen, it can be challenging to
than achieving cardiovascular adaptation. achieve the number of repetitions and sets that
Any hope for achieving muscular hypertrophy are being expected. As time passes, the stress
must be approached with patience and being put on the body lessens, not because the
165
50 pound weight is any less, but because the This requires an interaction of three primary
body is adapting over time. specificities: mechanical, neuromuscular and
The next stage is resistance development, metabolic. Mechanical specificity involves the
when the body is quite efficient at recruiting movements made to accommodate the specific
muscle fibers needed to lift a load and load. Each muscle group, from the legs to the
distribute oxygen efficiently to the needed arms to the chest, has differing mechanical
areas. At this time, resistance training can feel specificities. One person may need heavier
like a “breeze,” so something needs to change weights being lifted at slower speeds to
to prevent a loss of hypertrophy in the muscles. produce maximal results. Another person may
The load needs to be need lighter weights

Nutrition
increased and/or more at faster repetitions
repetitions added in Resistance

to achieve the best
Increasing Muscle Mass Rest
Training
order to add more results. As a personal
stress that will prompt Genetics

trainer, it is important
the body to move to be educated
toward adaptation. The last stage is exhaustion, regarding the mechanical specificities of the
which the personal trainer should strive to muscle groups.
avoid. Physiologically, the body will start to Neuromuscular specificity has to do with
shut down, which will leave your client feeling the intensity of the contraction being elicited
tired as well as frustrated. This is why careful by the specific movement. The stronger the
individualization of a client’s workout is contraction, the more motor units need to
important. Not everyone can do 3 sets of 15 be recruited. Over time, the neuromuscular
repetitions lifting a 20 lb. barbell. The initial specificity will lead to hypertrophy due to the
workout is the time when the personal trainer higher intensity contraction required to lift
needs to discover and record the client’s the load. The last specificity is the metabolic
training limits. specificity, which has to do with the amount of
In order for adaptation to occur, the body energy required to sustain each workout and
must “think” there is a reason for adaptation. how that energy is utilized. It is important to
166
understand that most resistance training uses ▪▪ Hold each stretch 10-30 seconds
anaerobic respiration to obtain its metabolic ▪▪ 3-5 repetitions for each stretch
needs. A personal trainer must be familiar with ▪▪ 15-30 minutes per session
the concepts of anaerobic respiration versus ▪▪ Can combine with other exercises:
aerobic and which exercises typically use one aerobic, resistance, etc.
or the other. Nutrition is very important Flexibility is the extent to which a
for any person undergoing a new joint passes through a normal
workout routine, especially range of motion comfortably.
resistance training. Stress Flexibility training has
on muscle fibers needs become an important topic
to be alleviated and this in maintaining a healthy
is accomplished through lifestyle in a sedentary
proper protein intake. Protein society. It is an organized,
provides the muscles with the regular program of stretching
necessary amount of amino acids used to elongate soft tissues
for repairs to be made. without resulting in injury. Some advantages
to integrating flexibility training into training

Flexibility Training
programs include relieving joint stress,
Example of Recommendations for Flexibility
improving function and neuromuscular
Training:
efficiency. It can also help in maintaining the
• Frequency
normal functional length of all muscles.
▪▪ 3 Days a Week—Daily
In developing a flexibility training program,
• Intensity
several instructions should be integrated.
▪▪ Stretch all major muscle groups
Stretching, which can occur at any time
and joints
during a workout, should follow a warm-up.
▪▪ Mild discomfort may occur but not
The increase in muscle tissue temperature
pain
decreases stiffness and encourages flexibility.
• Duration
167
It can help a client’s performance so more is and the range of motion should be increased
gained from the training. Properly executed steadily.
breathing exercises reduce stress and tension There are a variety of stretches that a trainer
in muscle tissue. It is essential that proper can have a client use in a flexibility training
posture is maintained during stretches to program. It is important to consider the
prevent injury. client’s individual composition and goals in
The acronym FIDM stands for frequency, the program before choosing which stretches
intensity, duration and mode, all of which to incorporate. This can help determine when
are important factors to remember when
preparing flexibility programs for clients.

Force Active
Clients should be advised to stretch two to
three times a week; however, little information

Passive
reports any disadvantages to stretching every Length
day. Intensity can be achieved by placing Active vs. Passive Stretching
a client in a position of slight discomfort to conduct the exercises and the intensity of
before maintaining stretches. The duration the stretches to be used. Passive stretching
of stretching varies depending on which type involves outside forces to help stretches. In
of stretch is used, and the mode of flexibility static stretching, flexibility is achieved with
should improve general stretching. a low chance of potential injury. The muscle
of interest should be held in a stretch for at

Types of Stretching
least 20 seconds. Static stretching is one of
There is a set of guidelines that will ensure
the most popular stretches used in fitness
safe flexibility. The main muscle groups should
training today. It is an example of corrective
be stretched to achieve balance and should be
flexibility and uses autogenic inhibition to
held for 10 to 60 seconds, which should be
achieve its results. Active stretching can
the range to achieve mild intensity. Stretches
increase the tendency of soft tissue to elongate
should be conducted after a proper warm-up
and improve neuromuscular efficiency. Active
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stretching may be difficult for clients because both. The speed of the range of motion should
of the mental and physical endurance needed. be controlled to prevent injury. Both of these
Passive stretching is preferred as stretches types of stretching can be used for clients
are eased. A combination of both who are athletes and preparing
active and passive stretching for sporting activities. However,
may satisfy some clients. caution should be practiced
There are similarities in using in using them for the general
ballistic and dynamic stretching. population.
Because of the intensity of the stretches, Proprioceptive neuromuscular facilitation
safety should be taken into consideration (PNF) seeks to increase the range of motion
when performing them. Ballistic stretching at joints by incorporating both active and
results in elongating a certain area of the body, passive stretching. Three main methods are
which limits the available range of motion. used: contract-relax (CR), contract-relax with
Momentum plays a major role in accomplishing agnostic contraction (CRAC) and contract-relax
this action. There are certain disadvantages, with a passive stretch (CRAC-P). In CR, clients
which include muscle soreness and the experience little tension when increasing the
absence of tissue adaptation. In dynamic degree of the contraction over a given period
of time. After the contraction is maximized,
passive force is used. CRAC is like CR, but it
uses an active stretch rather than passive
forces after maximum contraction is used.
CRAC-P is similar to CRAC but incorporates a

Ballistic Stretch Dynamic Stretch passive force to complete the technique. PNF
stretching, a type of functional flexibility, can work best for clients who are somewhat
momentum is used to increase the range of fit and willing to challenge themselves with
motion. This type of stretching can be carried this intense training; however, any client can
out actively, passively or as an arrangement of engage in this vigorous training if the trainer is
169
knowledgeable in the subject area. The trainer of injuries. Muscle imbalances may result
should also consider the client’s limits. from improper posture or technique or injury.
Active-isolated stretching integrates an Pattern overload, where the same pattern of
active stretch that then uses passive force motion is repeated, may also contribute to
followed by static stretching. The opposite muscle imbalance, which leads to interferences
muscle to the targeted muscle is contracted within the kinetic chain.
to isolate the targeted one, then the targeted When injury occurs in the body, it can lead
muscle is relaxed. Afterward, a passive force, to inflammation and reduced elasticity of soft
like the trainer, is used to assist clients tissue. This idea is based on Davis’s
in finishing the stretching. Skull

law, which proposes that soft tissue
rebuilds itself along the lines of stress.

Things to Avoid Shoulder
The soft tissue is rebuilt with inelastic
Flexibility training is also important
Kidney
collagen, usually inconsistent with
in promoting neuromuscular
Pelvic
the direction of muscle fibers. This
efficiency. To achieve this efficiency,
tissue can later prevent the muscle
correct flexibility in all planes Thigh
fibers from elongating properly and
of motion—sagittal, frontal and
Shin
results in reduced flexibility. The
transverse—is needed. Flexibility
Ankle
reduced inelasticity of soft tissue
training must be an integrated
leads to altered length-tension
program that incorporates a variety
relationships and altered force-couple
of flexibility techniques. In developing a
relationships. It can also
useful program, the muscular, nervous and
result in arthokinetic
skeletal system can be thought of as a kinetic
dysfunction, which
chain. Each system works together to ensure
changes joint motion.
balance. Any misalignment or damage to one
All of these alterations
system can impact the effectiveness of the
lead to muscle
other systems. This can lead to decreased
imbalances. Tight Muscles Weak Muscles
neuromuscular efficiency and overuse type
170
alignment should be practiced. For those clients
Postural Muscle Imbalances
who have had a hip fracture or replacement,
Arthritis affects approximately 66 million
exercises should include internal rotation of
Americans and contributes to inflammation
the hip, hip adduction and hip flexion.
and damage of joints. The two most prevalent
There are times when clients should be
Normal Joint Rheumatoid Arthritis Osteoarthritis
advised not to stretch, such as during the
Bone
Bone
first day to three days after a muscular or
Fibrous Loss
Bone
Sheath
tendonous trauma. Training should not take
Spurs
Thickened
Synovial Synovial
Membrane Changes
Synovial
Membrane Eroded
Cartilage place after any muscle or ligament sprains have
Degenerated
Cartilage
Cartilage
occurred or if joints or muscles are infected.
types are osteoarthritis and rheumatoid Stop training if any Distal Biceps
Tendon Rupture
arthritis; however, more than 100 types exist. discomfort is felt or
Osteoarthritis damages the cartilage of bones if there is pain in the joint or
overtime, while the immune system tears muscle when exercising.
down joint surfaces in rheumatoid arthritis.

Balance, Agility, Speed
People with this condition are advised to
Everyday activities and sporting activities
conduct flexibility techniques one to two
require balance, stabilization and coordination.
times a day. Warm-ups should be extended
For the body to master skills of movement,
to ensure that joints are not stiff. Those who
there is a constant need to change direction
are on current anti-inflammatory medications
and movement. Also known as skill-related
should be monitored for stress levels.
components of fitness, these factors are key
Clients with osteoporosis and osteopenia
in athletic endeavors and allow individuals
are losing bone density and are at a higher risk
to move accurately, quickly and efficiently.
for bone fractures. In performing flexibility
Skill-related fitness components are therefore
training, clients should steer clear of repetitive
stressed when performance enhancement is
exercises that use spinal twisting. Exercises
the primary goal. When used appropriately,
that encourage proper posture and spinal
171
Body being able to maintain stability, even through
Composition
motion, environmental changes and gravity.
Flexibility Strength
Health Many activities rely on the maintenance of

Related Fitness
balance to successfully complete the exercise,
Lung Efficiency
which involves a constant interplay between
Muscular Cardiovascular
Endurance Fitness losing and regaining balance. This is important
Reaction
not only in activities that require standing
Time
Agility Coordination positions but also in sitting positions.
Skill Related Balance is affected by three major

Fitness
principles: center of gravity, base support,
Speed Power Balance
and the relationship between center of gravity
Health and Skill Related Fitness and base support. The lower the center of
balance, agility and speed can create a synergy gravity and the larger the base support, the
of muscle responses. smaller the amount of balance that is needed.
In turn, this can lead to a decreased risk of Furthermore, the
injury due to an increased ability to react to closer a person’s
changes in the environment. Persons engaging center of gravity
in activities that require skill-related fitness is to their base
components will benefit greatly from a warm- support, the smaller the amount of balance
up. needed.
Static, Peripheral and Dynamic Balance

Balance
The most basic aspect of balance is static
Balance, the first and most fundamental
balance. It is the ability to maintain central
component of biomechanical function, is one
balance, or equilibrium, while balancing
of the major factors in sports performance.
on one foot. Static balance is essential for
Balance is defined as the ability to maintain
activities that require prolonged periods of
a certain position for a given amount of time
static positioning (e.g., rock climbing). The
without a change in movement. It involves
172
ability to balance and reach away from the Appropriate balance training should then
center of gravity is called peripheral balance. stress an individual’s limits of stability, which
This is usually accomplished with reaching in turn increases the awareness of the limit of
some part of the body, such as the arms, legs stability by creating instability. Within balance
or torso, while maintaining equilibrium. training, the use of balance equipment can be
Conversely, dynamic balance is the ability to used to create balance challenges in multiple
maintain balance while in motion. While in planes of motion. Equipment can improve
motion, the body gains feedback through visual reaction times and dynamic functional use of
stimuli, kinesthetic awareness and changes core muscles.
made by the nervous Traditional training does not challenge the
system. Even standing sensory mechanisms of the kinetic chain and
still is an exercise in balance training
dynamic balance since Patients can balance on one fills the gaps. It
foot on a wobble board to
the body is constantly enhance dynamic ankle improves dynamic
stability for training or ankle
swaying to all sides joint stabilization
sprain rehabilitation.
and balance is maintained through or, in other words,
alternate contraction and relaxation of the leg the ability of the kinetic chain to stabilize a
muscles. joint during movement. There are three levels
of balance training that are similar to the

Balance Training
three levels of traditional training programs.
Balance training prepares athletes to
The first one is stabilization, which comprises
perform when the center of mass moves
exercises involving joint motions aimed at
outside of the base support. It has also been
improving stability of the joints. In this level,
adopted to try and prevent injuries to the
exercises are all based around positions where
ankles and knee joints during sports and
the body is unstable, such as when standing on
other activities. Balance can be trained during
one leg. The second level is strength. Balance
an exercise by constantly standing, walking
exercises for strength are dynamic eccentric
or sitting on an uneven or unstable surface.
173
AB = Aquatics
and concentric movements through a full 2008 Olympic Sports AC = Table Tennis
Use the diagram to map each sport to the skills required to compete. AD = Track & Field
AE = Cycling
range of motion. This ultimately improves the Speed AF = Handball
A AG = Kayaking
AH = Triathlon
Strength Accuracy BC = Fencing
neuromuscular efficiency of the entire kinetic H B BD = Shooting
BE = Pentathlon
BF = Basketball
chain. The third and last level is power. Power BG = Gymnastics
BH = See EH
CD = See AC
Agility Dexterity
exercises increase endurance, reactive joint
CE = Tennis
G C CF = Sailing
CG = Volleyball
CH = Weightlifing
stabilization, neuromuscular efficiency and DE = Rowing
DF = Badminton
DG = Equestrian
Teamwork Coordination
eccentric strength.
DH = Archery
F D EF = Soccer
Endurance EG = Judo/Taekwondo
E EH = Boxing
Balance training is FG = Baseball/Softball
FH = Hockey
GH = Wrestling
especially important
a wall while leaning as far forward as possible.
for older adults. This
The client then moves the fist along the wall
group of individuals Normal 26 Inches
as far as possible without taking a step or

tends to lose lean
off-balancing, and the distance that the fist
body mass and is
moved is measured. A movement of less than
therefore more prone
six inches means that there is a lack of balance
to injury from falling. Initially, a trainer should
and thus a higher risk of falling.
identify a client’s current balance threshold
before starting an activity-specific program. Coordination and Speed

There are specific tests to determine balance There is a direct relationship between
deficiencies. The simplest of these is the coordination and speed. Movements at varying
Romberg test in which a client stands with speeds produce differential demands for the
the feet together and eyes closed. The loss of control of ongoing movements. Often, these
balance is then checked. For a more difficult ongoing movements need to be precise and
test, a client conducts this test while standing coordinated in order to conduct the desired
on only one leg, which is referred to as a stork motion. To understand how each skill-related
stand. fitness component relates to each other, it
Another test that measures balance in is essential to be aware of importance of
elderly persons is the functional reach test. As coordination and speed in human activity.
shown in the diagram, a client rests one fist on
174
Coordination the development of coordinated movement
Nearly all human movement occurs through is considered feedback. Likewise, the activity
multiple joints and muscle groups. When becomes more accurate with repetition and
the body undergoes a new adjustments. Repetition
movement, the neuromuscular thus allows the
system limits the ability of the performance to become
body to conduct a specific more consistent. This
activity. This leads to awkward is a major requirement
and clumsy movement. It for development of total

“Strength and speed are useful, son,
therefore takes many tries but coordination is crucial!” coordination, which is
to become familiar with the when activity becomes
activity. Coordination is the ability to use automatic and is no longer a conscious
multiple areas of the muscles and joints at the process. During athletic performance,
same time while accurately performing motor coordination allows for some muscles to be
functions. Coordination complements other stimulated to provide activity while allowing
skills like speed, agility and balance. other muscle groups to be inhibited to permit
Specific requirements the activity. If a muscle is too

Descending
of coordinated movement Command weak to provide a necessary
include several factors. A B response, activity will be
Activity perception is the Locomotor CPG uncoordinated. Lastly,

Left Leg Right Leg
basic element of coordination Network Network inhibition is important since
and is the awareness of E E it is necessary for undesired

C
volitional muscle activity or muscle activity or unwanted
F F
joint positioning. Any activity muscle responses to be
performed is evaluated by the Motor

Output
Afferent
Feedback
Motor
Output
cut down for coordinated
central nervous system. The Left Right activity.

Leg Leg
learning process involved in
175
There are two major types of coordination: such as anticipation. Agility is related to
intramuscular coordination and intermuscular coordination since it is often referred to as
coordination. Intramuscular the ability to coordinate several sports-
coordination is the ability of specific activities at once (e.g., dribbling
the neuromuscular system to a basketball while running). Agility
allow for an optimal level of is also aligned with balance in that it
motor function. Muscles of requires the body to regulate shifts in the
the core-stabilization system body’s center of gravity. Activities such
need sustained contraction as climbing, skiing and snowboarding
to improve intramuscular coordination. all require large amounts of agility. These
Intermuscular coordination is the ability of sports especially require agility of the lower
the neuromuscular system to allow muscles to extremities. Upper-extremity agility is
work together. Muscles of the core-movement required for activities that require accurate
system (e.g., hamstrings, adductors) must movement of the fingers and hands.
work synergistically with the stabilization Agility Training
system to ensure optimal coordination. Agility training can be very intense and it
Agility places stress on joints, connective tissues and
Agility is the ability to rapidly change body tendons. Aerobic conditioning and regular
position with speed and accuracy. Believed to exercise in a balance and strengthening
be influenced by heredity, this skill is integral program should be
to explosively start, accelerate, decelerate and performed before starting a
change direction while maintaining control strenuous agility program.
of the body and speed. Though there is a lack If a client is interested
of agreement with the precise definition of in improved agility for a
agility, agility has relationships with trainable specific sport, activities
physical qualities such as strength, power and that test the client’s agility
technique and it has cognitive components should closely resemble
176
that activity. The primary effect of training or proprioception. Found in the skin, joints,
is to increase body control. It is focused on muscles, tendons and ligaments, these nerves
controlling motor control in the neck, shoulder, maintain posture and balance, awareness of
back, hip, knee and ankle joints. Agility tests joint position and movement. They therefore
are similar to conditioning and practice drills give agility to change direction of movement
used in various sports (e.g., zigzag runs, and contribute to coordination to produce
hexagonal jump). activity. Receptors within the skin are known
as cutaneous receptors and are either

Sensory Function
considered fast-adapting receptors or
Agility, balance and
slow-adapting receptors. Fast-adapting
Brain
coordination are controlled

receptors are responsible for vibration
by proprioceptors of
Central sense and sudden changes in speed and
the sensory system.
Nervous
System
movement. Slow-adapting receptors

Proprioception is the ability
are responsible for sensory perceptions
Foot
to transmit position sense,

like skin stretching as well as joint and
interpret sensory information and respond
limb position. Cutaneous receptors are not
to it, all in order to execute conscious or
thought to play a major role in proprioception
unconscious movement. This is fundamental to
but rather to provide cues regarding small
accurate performance and plays an important
sensory perception.
role in motor skills and the
Proprioceptors of the joints
ability to master specific
Supraspinal
Commands
lie within the connective
tasks.
tissue of a joint’s capsule.
Proprioceptors are the
Synapse
Model
Neuron
Model
Motor-unit
Model
Joint receptors respond
specific afferent nerves that
to high velocity changes
receive and send impulses
Afferents
(Golgi Tendons & Muscle Spindles)
Muscle
Model
when the joint accelerates
throughout the body and by Laris Rådman
or decelerates and they

are thus responsible for Mechanical
Model identify joint compression.
the neuromuscular control,
177
Muscle spindles and Golgi tendon organs movements, involving eccentric contraction
are the major receptors of the muscles and and then concentric contraction. It begins with
tendons used to detect tension within the less demanding exercises. As the body adapts,
muscles. These receptors respond to muscle training progresses to more demanding
contraction, which can then result in muscle exercises, which increase the reaction time of
relaxation. Muscle spindles respond to the muscle actions. This is similar to other forms of
stretch of a muscle and then act to contract it. training. Short runs are often used to evaluate
Proprioceptors are also found in the knee and speed.
are generally not active in the middle ranges

Summary
of movement, but they are activated when
Balance, agility, speed and coordination
ligaments are stressed. This produces an
are all skill-related fitness components that,
inhibitory response to the agonistic muscles.
if improved, can lead to enhanced athletic
Speed performance. Balance is the body’s ability
Precision of speed is fundamental to maintain equilibrium by
to coordination. Increasing the controlling the body’s center
speed of athletic performance is of gravity over its base support
a way to advance the difficulty of and is necessary for both
coordination exercises. In other static and dynamic activities.
words, in order to be effective, Coordination is a complex
speed must be accomplished by coordination. process in which motion of the body is
Speed implies acceleration from a starting conducted through a combination of muscle
position. Speed of the muscles is also limited groups working together with appropriate
by neuromuscular coordination. The neuronal timing. Coordination often requires agility,
system has a specific range of speed within which is the ability to control the direction
which the body is allowed to move. of the body or body parts during movement.
Reactive training improves the range of Proprioception encompasses the body’s
speed. It is comprised of quick and powerful sensory function and is important to sustain
178
proper agility, balance and coordination. 3. Fat burning can only occur through extreme
Proprioception is the body’s ability to transmit cardiovascular exercise. True or False?____

Interdependence Among the Biomotor Abilities _ _______________________________________________
Strength Endurance Speed Coordination Flexibility 4. What form of strength training leads to
muscle hypertrophy? ________________________

Muscular Speed
Agility Mobility
Endurance Endurance
_ _______________________________________________
_ _______________________________________________
Power 5. A short duration of activity that precedes
major exercise is:

Maximum Anaerobic Aerobic Maximum Perffect Full Range
Strenth Endurance Endurance Speed Coordination of Flexibility
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
the skin, muscle, tendons, joints and ligaments can 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
level to a higher intensity level, longer
to active stretching. True or False?_________
duration, and/or increased frequency of
_ _______________________________________________
exercise is known as ________________________
_ _______________________________________________
_ _______________________________________________
179
9. What is the first and most fundamental
References
component of biomechanical function in
Carson RG. Changes in muscle coordination
sports performance?_________________________
with training. Journal of Applied Physiology.
_ _______________________________________________
2006;101(5):1506-13.
_ _______________________________________________
Chatara M et al. Effect of concurrent endurance
10. Speed play only works with individuals
and circuit resistance training sequence on
who are at an optimal level of physical
muscular strength and power development.
fitness. True or False?_______________________
Journal of Strength and Conditioning
Answers Research. 2008;22(4):1037-45.
1. Cardiorespiratory conditioning is an Davis WJ, Wood DT, Andrews RG, Elkind
activity used to improve the body‘s ability LM, Davis WB. Concurrent training
to process and deliver oxygen by using enhances athletes’ cardiovascular and
intense movements and activities that cardiorespiratory measures. Journal
stimulate the cardiovascular system. of Strength and Conditioning Research.
2. Smart progression. 2008;22(5):1503-14.
3. False. Hawkins MN, Raven PB, Snell PG, Stray-
4. Resistance training. Gundersen J, Levine BD. Maximal oxygen
5. c) Warm-up. uptake as a parametric measure of
6. False. cardiorespiratory capacity. Medicine
7. Relieving joint stress, improving function and Science in Sports and Exercise.
and neuromuscular efficiency, and 2007;39(1):103-07.
maintaining the normal functional length Henatsch HD, Langer HH. Basic
of all muscles. neurophysiology of motor skills in sport:
8. False. a review. International Journal of Sports
9. Balance. Medicine. 1985;6(1):2-14.
10. False.
180
Hrysomallis C. Relationship between balance Rubini EC, Costa AL, Gomes PS. The effects of
ability, training and sports injury risk. stretching on strength performance. Sports
Sports Medicine. 2007;37(6):547-56. Medicine. 2007;37(3):213-24.
Kallinen M, Markku A. Aging, physical activity Sheppard JM, Young WB. Agility literature
and sports injuries. An overview of review: classifications, training and testing.
common sports injuries in the elderly. Journal of Sports Science. 2006;24(9):919-
Sports Medicine. 1995;20(1):41-52. 32.
Lephart SM, Henry TJ. Functional rehabilitation Woods K, Bishop P, Jones E. Warm-up and
for the upper and lower extremity. The stretching in the prevention of muscular
Orthopedic Clinics of North America. injury. Sports Medicine. 2007;37(12):1089-
1995;26(3):579-92. 99.
McNeal JR, Sands WA. Stretching for
performance enhancement. Current Sports
Medicine Reports. 2006;5(3):141-46.
181
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
d) Increased anger
The Warning Signs that Can
e) Increased sleeping problems
T
Mean Trouble
f) Mayindicateanunregulated/undiagnosed
here are general warning signs
mood disorder
that indicate when the body needs
2. Training Signs
a break or that an individual may
a) Deterioration in performance
be training too hard. The early
b) Cutting sessions short
warning signs can be put into three groups:
c) Abnormal muscle soreness after training
life signs, training signs and health signs. Life
d) Fatigue during the workout which
signs include loss of interest in activities that
remains throughout the day
the individual normally enjoys, increased
e) Loss of motivation
irritability, tension, anger and sleeping
f) May indicate undiagnosed neuromuscular
problems. Training signs that may appear are
disorder
deterioration in performance, cutting sessions
3. Health Signs
short, abnormal muscle soreness after
a) Aches and pains throughout the body
training, fatigue that lasts during the workout
b) Increased resting heart rate and/or
and remains throughout the day, and loss of
blood pressure
motivation to train. Health signs include aches
c) Loss of appetite
and pains throughout the body, increased
d) Nausea
resting heart rate and/or blood pressure, loss
e) Head colds
of appetite, nausea and head colds.
f) May indicate undiagnosed neuromuscular
Warning signs that the body needs a break
disorder
or the individual is training too hard:
If these warning signs are not properly
1. Life Signs
heeded, the individual may develop muscle
a) Loss of interest in normally enjoyable
cramps, dehydration, heat exhaustion or heat
activities
stroke. Severe complications like these can
b) Increased irritability
be avoided by ensuring the exercise regimen
c) Increased tension
184
does not cause the individual to over train and • Exercise regimen should allow for a
allows for a recovery period, which is the time recovery period (muscle to rest and
for muscles to rest and rejuvenate. While it is rejuvenate)
important to be observant and watch for these • Keep the client motivated
signs, it is also important to keep the client • Tell the client to expect some level
motivated. When starting any new training of discomfort when starting a new
program, the trainer should tell the client to program
expect some level of discomfort until getting • If any of the three warning signs
used to the exercise regimen. Life signs are are seen, personal trainer should
important because they can be indicative of an recommend client see a clinician
unregulated or undiagnosed mood disorder.

Muscle Cramps
Training and health signs may be an indication
During exercise, the muscles needed to
that there is a neuromuscular disorder that
perform particular movements contract and
has not been checked by a physician. If the
relax. Even muscles that support the head,
personal trainer notices any of the signs
neck and back contract to maintain proper
above, the trainer should strongly recommend
posture during exercise. A muscle spasm is
that the client make an appointment with a
caused when a muscle or a few of its muscle
clinician.
fibers contracts involuntarily when it should
If warning signs are not properly heeded,
not be contracting. If the spasm persists for
individual may experience:
an extended period of time and increases in
• Muscle cramps
intensity, it becomes a muscle cramp. In other
• Dehydration
• Heat exhaustion
• Heat stroke 1. Calf 2. Calf 3. Calf Muscle

Muscle Muscle Doesn’t Relax,
at Rest Contracts Causing
Do the following to help the individual: when Cramp
Flexed
• Make sure exercise regimen does not
cause overtraining
185
words, a muscle cramp occurs muscles can be controlled
when a muscle involuntarily voluntarily. Involuntary muscles
contracts with an intense force that make up organs such as the
and does not relax right away. uterus, intestinal tract, urine
Muscle cramps can last for a few and bile passages, bronchial
seconds, up to 15 minutes or tubes and blood vessel walls can
even longer in some cases. Such also cramp. Cramps develop
involuntary contractions cause during several conditions,

Pickle juice is sometimes
palpable and visible hardening given to athletes who are which include improper
of the muscles that are cramping. experiencing cramping. stretching before exercising,
Cramps sometimes cause no muscle fatigue, exercising in
pain or can be felt as mild twitching within extremely warm temperatures, and electrolyte
the muscle, or they can be so bad that they imbalances of phosphate, sodium, chloride,
cause extreme pain. Cramps that occur during potassium or calcium.
or after training usually produce abrupt and Hydration is important in reducing muscle
severe pain. cramping because, as we sweat, we lose
electrolytes, such as sodium and potassium,

Muscle Tone
Reduced Circulation
● Ischemia
along with water, which creates an imbalance
● Retention of Metabolic Wastes
that can then lead to cramping. Pickle juice
Irritation Fatigue is sometimes given to athletes who are

Possible Inflammation
experiencing cramping for the simple reason
that it contains so much sodium that it can

Pain-spasm Cycle Chronic Phase
help restore some of the lost sodium and
Cramps typically occur in the skeletal muscles relieve cramping. Gatorade is also used for
of the hands, legs, feet, thighs, the arch of the this reason. Athletes who sweat a lot can
foot and, most often, in the calves (commonly replenish the sodium and potassium they
referred to as a charley horse). Each of these have lost through sweating by drinking
186
Gatorade or any other electrolyte-based performance during a workout. The symptoms
drink. Electrolyte imbalances lead to muscle of dehydration include a decrease in sweating,
cramping because sodium and potassium are an increase in body temperature, heat distress,
the main electrolytes utilized during exertion. severe fatigue, unconsciousness and, in some
For every two sodium molecules pumped out cases, death. If athletes exercising only stop for
of your muscle cells, three are pumped back water breaks when they feel thirsty, they will
in—it is this mechanism that keeps the muscles more than likely become dehydrated. By the
contracting properly and not over-contracting, time they feel thirsty, they may have already
which can lead to muscle lost one to two liters (a
cramps. Regulates body

temperature
quarter to half gallon)
Moistens tissues
such as those in
of bodily fluid and by
Dehydration
the mouth, eyes
and nose
Lubricates joints
this point it may take

Even when the
more than a few water
temperature is not very Protects body
organs and Lessens the burden
tissues on the kidneys and
liver by flushing out breaks to replenish the
hot, many people get waste products
Helps prevent
constipation
body.
dehydrated because they
Carries nutrients
Exercising produces
rely on their thirst to signal Helps dissolve
minerals and and oxygen to
cells
other nutrients
to make them heat in the body.
when they should drink accessible to
the body
Overheating can be
water during a workout.
avoided when the body
A large amount of bodily
properly transfers heat
fluid is lost during exercise
to the surface of the skin in water droplets that
and this fluid must be replaced by drinking
form sweat and evaporate when they come in
water periodically. Sweating is the body‘s
contact with the air. If fluids are not replaced
main cooling mechanism, but overexertion,
during exercise, the body will lose its ability
coupled with neglecting to supply the body
to remove heat through water evaporation.
with an adequate amount of liquid, can
In addition, if an individual who is exercising
lead to dehydration. Dehydration causes a
and not drinking liquid continues to sweat,
deterioration of both mental and physical
187
the level of water in the blood decreases and Effects of Increasing Dehydration on Physical
Performance
the blood thickens. This thickening of the Body Water
Loss Effects
blood places a strain on the heart by causing 0.5% Increased strain on the heart
it to pump more rapidly in order to maintain 1% Reduced aerobic endurance
3% Reduced muscular endurance
adequate blood flow to muscles and organs
Reduced muscle strength;
4% reduced fine motor skills; heat cramps
that are being utilized during the workout.
Heat exhaustion; cramping; fatigue;
5%
The thickening of blood also means a decrease reduced mental capacity
6% Physical exhaustion; heatstroke; coma
in blood volume and blood flow to the skin. As
Brief bouts of dehydration have been shown
a result, water and heat cannot be transported
to decrease mental and physical performance
to the skin and removed by sweating, and this
while prolonged dehydration can cause
condition causes the body temperature to rise.
problems with judgment, reaction time,
This form of heat stress can lead to severe
making decisions and concentration. When
Dehydration exercising in cooler climates or during the

serious effects Physical Activity
winter months, people need to be conscious
Breathing Sweating
of the fact that the cooler weather does not
Leads to: Loss of Fluid mean dehydration cannot occur. People often
Nausea, headaches,
irrationality, muscle associate profuse sweating with dehydration,
Blood More Viscous
cramps, rise in body
temperature, and
dizziness Blood Circulation Slows
but in cooler climates sweating can be more
insidious. Also, in colder climates people tend

Reduced Circulation Reduced Nutrients
to layer on clothing to work out—this can
dehydration, unconsciousness and, in some lead to more sweating and, because the extra
cases, death. clothing can absorb more sweat, this can lead
Performing high intensity exercises in hot, to inconspicuous dehydration.
humid areas often leads to dehydration, but The thirst center in the hypothalamus of
exercising for prolonged periods of time in the brain sends signals of thirst when the
cool areas can also cause significant fluid loss. body has lost a significant amount of fluid;
therefore, when clients feel thirsty, they are
188
2. Heat There are other sources of water loss that
Stimulates
3. Hypothalamus
Hypothalamus
Stimulates Sweat are termed senseless, meaning that the person
Glands to Secrete
Fluid
losing water is unaware of the water loss. The
greatest senseless water loss comes from the
respiratory system. Air is breathed in, warmed

1. Muscular 4. Evaporation of
Activity
Fluid Cools Body
and moistened in the upper respiratory tract
Increases
Body Heat
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

already on their way to dehydration. The best
water in the air, so we lose water. Obviously,
way to prevent dehydration is to drink water
when we exercise, we breathe more frequently;
all day long. Simply drinking
Normal Temperature therefore, more water is
water right before a workout (little or no exercise)
Daily Water Input Daily Water Output lost. This additional water
or even during a workout
Source mL
loss can also contribute to
is not the best scenario to Source
Food
mL
1000
Urine
Feces
1250
100
dehydration. It is important to
Fluids 1200 Skin 850
Metabolism 350 Lungs 350
Total 2550 Total 2550
avoid dehydration. Staying

remind clients of all aspects of
hydrated throughout the day
water loss as many people do
is the best advice a personal
not realize they can become
trainer can give their clients.
dehydrated even if they are
Drinking electrolyte-based
not sweating.
drinks (e.g., Gatorade) after a workout is
a good way to replenish the fluids a client Heat Exhaustion

has lost. It is not a good idea to recommend Heat exhaustion normally occurs when an
electrolyte-based drink consumption during individual is playing, working or exercising
the day because most clients are not likely to in a hot and humid area that causes extensive
be losing electrolytes and may end up with sweating and overheating. The individual’s
an over-abundance of sodium and potassium, body temperature may be noticeably elevated
which is not desired either. but usually does not rise above 104°F.
189
Heat Index Table • Sweats profusely
Relative Humidity (%)
Temp
• Increased pulse
40 45 50 55 60 65 70 75 80 85 90 95 100
°F
110 136 • May have a headache

108 130 137
106 124 130 137
• May feel dizzy
104 119 124 131 137
102 114 119 124 130 137
• May be nauseous
100 109 114 118 124 129 136
• May have weakness
98 105 109 113 117 123 128 134
96 101 104 108 112 116 121 126 132
• May experience muscle cramps
94 97 100 102 106 110 114 119 124 129 135
92 94 96 99 101 105 108 112 116 121 126 131
• Body will be able to self-regulate its
90 91 93 95 97 100 103 106 109 113 117 122 127 132
88 88 89 91 93 95 98 100 103 106 110 113 117 121 temperature
86 85 87 88 89 91 93 95 97 100 102 105 108 112
84 83 84 85 86 88 89 90 92 94 96 98 100 103 When fluid and electrolytes are not replaced
82 81 82 83 84 84 85 86 88 89 90 91 93 95
80 80 80 81 81 82 82 83 84 84 85 86 86 87 quickly, the body’s circulatory system works
Extreme Danger:
Caution: Fatigue
Heat Stroke or
Sunstroke Likely
Possible inadequately and the body undergoes a mild
With Prolonged
Exposure and/or
Physical Activity
Extreme Caution:
Sunstroke, Muscle
Danger: Sunstroke, form of shock. An individual who is suffering
Muscle Cramps, and/or
Cramps, and/or Heat
Heat Exhaustion Likely
Exhaustion Possible
from heat exhaustion will start to look pale,
develop moist skin, begin to sweat profusely

The normal body temperature is 98.6°F.
and have an increased pulse rate. The
An individual’s body temperature slightly
individual may get a headache, experience
increases with activity. Performing exercise
muscle cramps, and feel dizzy, nauseous, and/
in a hot and humid area causes the body
or weak. The main difference between heat
temperature to rise too quickly. In this case, the
exhaustion and heat stroke is the temperature
amount of water lost through sweating cannot
of the body. When a person is suffering from
be replaced quickly enough to keep the body
heat exhaustion, they are still able to cool
temperature from rising. When exercising in
down if they are taken into a cool place and
a humid area, the body not only loses water
are able to relax long enough to let the body
through sweating but also loses electrolytes
self regulate its temperature. During heat
such as sodium.
stroke, the body is beyond self-regulation.
Signs of Heat Exhaustion:
Heat stroke is a very dangerous condition.
• Individual looks pale
• Moist skin
190
of the body to control an elevated temperature
Heat Stroke
can lead to brain damage and damage to
Signs of Heat Stroke:
vital organs. When a heat stroke occurs, an
• Body can no longer control its
individual’s body temperature can be 105°F
temperature
or higher.
• Body can no longer sweat
Heat strokes often develop rapidly; however,
• Brain damage can occur
there are several indicators, including
• Damage to vital organs can occur
deterioration in mental performance,
• Body temperature is 105°F or higher
confusion, dizziness, hallucinations,
• Deterioration in mental performance
unconsciousness, and/or coma. In addition,
• Confusion
the skin becomes flushed, hot and dry. The
• Dizziness
person may also hyperventilate and have high
• Hallucinations
blood pressure that then drops dramatically
• Unconsciousness
after a short period of time. Medical problems
• Coma is even possible
and medication that inhibit a person from
• Skin is flushed, hot and dry
sweating properly can predispose them to
• Individual may hyperventilate
heat strokes. Infants and elderly persons
• May have high blood pressure and then
have a higher heat stroke risk than children
have it drop dramatically
and adults but, regardless of age, individuals
A heat stroke is a life-threatening medical
who are training under strenuous conditions
condition/medical emergency. A heat stroke
should be closely monitored.
occurs when an individual’s body is no longer
When living in a hot or humid environment,
able to control its temperature. The brain
as well as during the summer months, personal
regulates the body’s ability to sweat but,
trainers need to monitor their clients very
during a heat stroke, the cooling system stops
carefully and avoid putting them in situations
working. A heat stroke usually occurs when
that would cause heat exhaustion and, most
an individual is performing strenuous activity
importantly, heat stroke. When taking the
under extremely hot conditions. The inability
191
client’s initial assessment, the personal the warmer months. The most common over-
trainer should take great care to ensure the the-counter antihistamine is Benadryl, and
client provides an accurate description of many of the prescription medications given
medications since some medications may elicit for allergies are antihistamines.
or predispose the client to heat stroke. For Education on the part of the personal
example, antihistamines are commonly used to trainer regarding common medications is
control allergies and are a fairly important for this very reason.
frequent over-the-counter or As stated previously, it is not
prescription medication taken the job of the personal trainer
for seasonal allergies or an to provide medical advice
allergic reaction. Antihistamines on medications; however,
lessen and/or prevent an allergic it is important to recognize
reaction by blocking the body’s medications that may influence
anti-inflammatory response. the client’s workout regimen.
In part this is accomplished Other common medications
by decreasing bodily secretions a client may be taking are
(many people taking antihistamines complain those used to regulate hypertension, also
of a dry mouth). A side effect of this response known as high blood pressure. Many times,
is that people taking antihistamines may hypertension medications are classified as
sweat less. As previously noted, sweating is diuretics, which cause the person to sweat
the body’s way of getting rid of excess heat and more frequently. Remember, sweating leads
maintaining a body temperature below 104°F. to a loss of electrolytes and fluids and then to
Therefore, the side effect of decreased sweating dehydration. If a client is taking any medication
with antihistamines can leave clients prone to for hypertension, the personal trainer should
overheating. Typically, allergies are a problem know the type of medication and become
in warmer weather, so it is more likely that a educated on the mechanism of the medicine’s
client will be taking an antihistamine during action. If the medicine is a diuretic, the client
192
needs to be educated about the importance of approximately 70% water, so adequate water
staying hydrated throughout the day, especially levels in the body should be maintained at all
on workout days and, more importantly, during times. The body loses water in several ways.
the summer months. For example, water is lost through breathing
because exhaled breath is moist. It is also lost

How to Respond to Various Events
through the skin, even when an individual is
Dehydration that Leads to a Loss not sweating, and it is removed from the body
of Performance and Energy through waste and urine. Drinking sufficient
If a client or the trainer notices a loss of amounts of water daily ensures that the
energy, decreased performance, and/or body is always properly hydrated and that its
dehydration during the client’s workout, water reserves are full. Unfortunately, most
the client should drink liquids that contain people drink when they are feeling thirsty, not
electrolytes and carbohydrates. realizing that thirst is an indicator
Carbonated beverages (e.g., soda) that dehydration has already
should be avoided as they may occurred. Drinking fixed amounts of
cause gastrointestinal problems, liquids periodically can prevent the
flatulence and abdominal cramps. development of dehydration.
Sports drinks usually contain 6%

Dehydration and Muscle
carbohydrates that the body can
Cramps
easily absorb. Carbohydrates prevent
When a cramp develops during an exercise
flatulence that can be caused by carbonated
regimen and the individual is also dehydrated,
drinks. Water transports nutrients to cells and
the individual should immediately stop
removes waste from cells. Water also acts as a
exercising and massage the muscle that is
skin lubricant (sweat) that helps maintain an
cramping. Gently stretching the muscle that
optimal body temperature by removing heat
is cramping until it stops cramping is another
from the body during a workout.
solution. If an individual’s leg begins to cramp
Water accounts for 60% of the total body
while lying down, putting weight on the leg and
weight. Muscles and organs consist of
193
walking around may relieve 100%
Brain indication of dehydration
80.5%
the cramp. Sometimes, or overexertion. Again, it

Bone
13%
consuming a sports drink 75%

cannot stressed enough
that contains sodium helps Kidneys

how important it is to
82.7%
relieve muscle cramps by understand that clients are

Muscle
75.6%
restoring electrolyte levels. Blood

individuals and taking good
90.7%
The sports drink also begins notes on clients can prevent
to rehydrate the body. a lot of these issues from

0%
Properly warming up and occurring.
stretching before working out, particularly At the initial assessment, the personal trainer
focusing on muscles that normally cramp, should ask if the client has a history of muscle
can help to avoid cramping and what were the conditions of those
cramps. For example, was the client performing
cardiovascular training or resistance training
when they experienced the cramping and
did the cramping go away after the person
became more acclimated to the workout? If a
client does experience a cramp, the best thing
to do to is stop the activity and have the client
rub out the cramp. If
muscle cramps and the recurrence of cramps. the trainer and client
Staying hydrated before and during a workout feel comfortable, the
can also prevent muscle cramps. trainer can offer to
Dehydration is an important aspect in rub out the cramp,
muscle cramps, but muscle fatigue is also a especially if it is in a
common cause of muscle cramps. If a client is hard to reach area.
experiencing muscle cramps, this can be a clear Also, give the client
194
something to drink to replenish any fluids then sitting in front of a fan (or simply fanning
lost, as this may be a contributing factor to the skin) will also lower body temperature.
the cramping. Another important question to The personal trainer should take great care
pose is how long into a workout did the cramp of a client if the trainer suspects the client is
present itself, as this may give the trainer experiencing heat exhaustion. Upon standing,
an idea of how long to plan the workout. the client may experience brief fainting,
Remember, clients experiencing too much so the personal trainer should support the
discomfort will not want to continue with client during relocation. The personal trainer
their workouts. should check to see if the client is sweating
profusely, also called diaphoresis. This is a

Heat Exhaustion that Causes
good indication that the client is experiencing
Light-Headedness, Dizziness
heat exhaustion and the condition has not
and Cold, Clammy Skin
worsened to heat stroke, which presents with
Individuals experiencing heat exhaustion
a loss of sweating because the internal body is
should immediately relocate to a cool area,
no longer able to regulate the temperature via
drink cold liquids and rest until their dizzy
sweating.
spell passes. Lying down and elevating the legs,
increases blood flow to the brain and helps Heat Exhaustion that Causes
Use a fan
Nausea and Headaches
to lower
temperature
When an individual is experiencing nausea
Apply cold
compresses Elevate feet
and a headache in addition to heat exhaustion,
rehydrating quickly is of
the utmost importance.

Have the person lie down
Give fluids
Sports drinks and salty
snacks are recommended

alleviate dizziness. Gently stretching can also
because they replace
help the individual improve blood circulation
the salt the body has
and prevent fainting. Wetting the skin and
lost. The individual
195
should rest in a cool area and lie down to help Normally, when a person is exercising or
alleviate the headache. Removing or loosening just in the heat, the body generates internal
the individual’s clothes and applying water to heat from metabolism, but during heat stroke
the skin are also helpful. A person that has the external temperature becomes so hot
suffered from heat exhaustion should avoid that the body cannot keep up with its own
strenuous activities for a few days to ensure internal temperature. The body becomes
proper rehydration. less efficient at dissipating the heat to the
external environment via sweating. As a

Heat Stroke, High Body
result, more heat is retained internally and the
Temperature and Dry Skin
person’s temperature begins to rise. Any body
If an individual begins
temperature over 40°C or
to complain about having
104°F is classified as heat
chills, has goose bumps
stroke. A person suffering
on the skin, and is feeling
from this condition will
pins and needles in the
need aid in cooling off the
arms, blood circulation to
external temperature via
the skin is deteriorating
ice packs—this action enables the blood
and the individual is beginning to have a
circulating from the skin’s surface to cool and
heat stroke. Heat stroke is a serious medical
assist in bringing the internal blood to a lower
condition that should be treated immediately.
temperature and thereby eventually lowering
Individuals who are having a heat stroke
the core body temperature back to normal.
typically have a high body temperature and
Heat stroke is usually a problem in hotter,
dry skin. At the first sign of a heat stroke, an
more humid climates, although it can occur
emergency medical technician (EMT) should
during winter months.
be contacted. The individual
should be relocated to a cool Heat Stroke that Causes

location and measures, such Confusion and Unconsciousness
as the use of cold packs, should Confusion followed by unconsciousness
be taken to lower body temperature. means the individual has had a heat stroke.
196
This is a medical emergency that can lead to affected, so personal trainers should look for
death if it is not swiftly and properly treated. signs and symptoms that may be altered via
While waiting for medical the central nervous system if
professionals, the trainer they suspect their client may be
should place the individual in suffering from heat exhaustion
an ice bath or use any other or heat stroke. Remember,
means to lower the body confusion will usually precede
temperature as fast as possible. unconsciousness, so trainers
Moistening the skin with must pay close attention
lukewarm water and using a to clients’ mannerisms and
fan to blow cool air on the skin also helps lower speech on hot days. Do not bombard them
body temperature. Sufficient amounts of cool with questions throughout the workout, but
liquids can be given periodically to individuals it is a good idea to ask questions periodically,
that are awake and alert. People who have had mainly to check their current mental status.
a heat stroke may need to be hospitalized and Simple one answer questions can be a good
monitored in order to determine if any damage indicator of how their mental status is without
has occurred to the brain or vital organs. overexerting them.
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
Does patient have significant CNS involvement
(ataxia, coma, confusion, irritability, seizures)? liquid every day, especially the day
Yes No
Heatstroke Heat Exhaustion

before a workout.
Immediate Management: Immediate Management: • Drink at least two cups of liquid two to
Address ABCs Hydrate
Initiate EMS Remove from heat source
Remove patient from heat
Begin cooling, if feasible
Monitor for resolution
three hours before working out.
• Replace sweat that is lost by drinking

Management in a medical facility: Did symptoms resolve within
Continue cooling to core temperature of 38°C (100.4°F) 20 to 30 minutes?
Laboratory tests to rule out other entities
Yes No
Monitor renal function
Caution patient about re-exposure
Provide patient education regarding Activate heatstroke

½ cup or more of liquid every 10 to 20
prevention of heat-related illness algorithm
minutes.
197
• Monitor fluid loss and do not rely on fully replace the water their bodies lost during
thirst to signal the next water break. exercise.
• Re-hydrate within two hours after Another important aspect of hydration is
exercising. over-hydration, also known as
Research has shown that drinking water intoxication or water excess.
liquids with 6% carbohydrates Although this concept may seem
(e.g., energy drinks) aids intestinal bizarre, it is increasingly becoming
absorption and gastric emptying, a problem for people. Guidelines
enhances the desire to drink exist that indicate how much
during exercise, reduces physical people should drink and how often,
and mental fatigue, and thereby but once again, personal trainers
increases workout performance. It is also need to understand and stress to clients the
important to consider the type of exercise that notion of individuality. Some people can drink
is being performed when deciding how much copious amounts of water and be physically
and how often fluid should be consumed. okay, while others cannot. Clients need to
Canoeists and runners usually drink develop their own balance between
approximately 500 milliliters of feeling thirsty and having to void
liquid per hour, while cyclists can too frequently. Surprisingly, this is a
drink up to 1.2 liters of liquid per challenge for the majority of people.
hour. This difference may be due to The importance of not becoming
discomfort that runners and canoeists dehydrated is often stressed over
experience when they drink large the fact that a person can become
amounts of water during exercising. They overhydrated, although this can be as big of
may also feel that drinking more than 500 a problem as dehydration. The majority of
milliliters of liquid in an hour could slow them time this is not a problem as long as a client
down. In such cases, runners and canoeists does not have heart or kidney trouble. As
have extended rehydration periods in order to previously stated, every client is different and
198
a good initial assessment is so important for intoxication is rare and personal trainers will
this reason. Past and present medical histories see more dehydration-related problems, it is
are important sections to bear important to be aware of this
in mind. condition and how to react if
Water intoxication, also over-hydration is suspected.
called hyponatremia, occurs Also, personal trainers need
when a person drinks so to educate clients on both
much water that the water aspects of water balance.
dilutes the sodium in the

Hydration is good, but Summary
body. When this happens, the must be matched by the
Trainers and individuals who
electrolyte imbalance leads to correct sodium intake.
are exercising should pay close
the person becoming confused
attention to the type and quantity of liquids
or disoriented. The brain is the primary
consumed the day before working out. Liquid
organ affected by over-hydration, so a change
should also be periodically consumed during
in personality is the first sign of water
the workout. When possible, training should
intoxication. Treatment for water intoxication
be performed in cool, well- ventilated areas. If
Tissue Response
Isonatremia to Hyponatremia training requires that the individual exercise
Na+ Na+
Interstitium Interstitium
Na+ Na+ H 2O
in a hot and humid area, sufficient amounts of
Normal Saline Na+
Na+ cool liquids should be consumed frequently.
Na+
Na+
If ailments such as severe muscle cramps,
Homeostasis Electrolyte Imbalance
Na+
dehydration, heat exhaustion and heat stroke
Blood Vessel Blood Vessel
occur, even when necessary precautions are

requires a doctor’s care. Typically, diuretics
taken, the individual should refrain from
are administered to rid the body of excess
exercising for several days following the
fluid. During this time, careful monitoring
incident.
by a physician is best. Although water
199
8. If a person is dehydrated, the best way to
Review Questions
overcome this is to consume:
1. Muscle cramps can be caused by the
a) Water
following:
b) Electrolyte based drinks (e.g.,
a) Electrolyte imbalances
Gatorade)
b) Muscle fatigue
9. Water intoxication causes thickening of
c) Dehydration
the blood and hypernatremia (too much
d) All of the above
sodium). True or False?______________________
2. If a person feels______________________________,
10. A person suffering from heat exhaustion
dehydration has already started.
will have ______________________________________
3. Dehydration can be avoided if a client
skin, while a person suffering from heat
drinks a lot of water right before training.
stroke will have ______________________________
True or False?________________________________
skin.
4. Water is lost through
a) Skin and respiratory tract Answers

b) Urination and feces 1. d) All of the above.
c) Skin 2. Thirsty.
d) Both a and b 3. False.
5. If a person is suffering from ________________, 4. d) Both a & b.
he should be relocated to a cool area where 5. Heat exhaustion.
he can lie down and drink plenty of fluids. 6. Heat stroke.
6. If a person is suffering from ________________, 7. False.
he needs medical attention in addition to 8. b) Electrolyte based drinks (e.g.
being relocated to a cool area and given Gatorade).
fluids. 9. False.
7. Over-hydration is a common problem 10. Moist and flushed; hot and dry
that can be treated with rest and fluid
restriction. True or False?___________________
200
Ryan AJ, Lambert GP, Shi X, Chang RT, Summers
References
RW, Gisolfi CV. Effect of hypohydration on
Bentley S. Exercise-induced muscle cramps.
gastric emptying and intestinal absorption
Proposed mechanisms and management.
during exercise. Journal of Applied
Sports Medicine. 1996;21(6):409-20.
Physiology. 1998;84(5):1581-88.
Casa DJ, Armstrong LE, Hilman SK, Montain
Schwellnus MP, Drew N, Collins M. Muscle
SJ, Reiff RV, Rich BS, Roberts WO, Stone
cramping in athletes—risk factors, clinical
JA. National Athletic Trainer’s Association
assessment and management. Clinical
Position Statement: Fluid Replacement
Sports Medicine. 2008;27(1):183-94.
of Athletes. Journal of Athletic Training.
Von Duvillard SP, Arciero PJ, Tietjen-Smith T,
2005;35(2):212-24.
Alford K. Sports drinks, exercise training
Coyle EF. Fluid and carbohydrate replacement
and competition. Current Sports Medicine
during exercise: how much and why?
Reports. 2008;7(4):202-08.
Sports Science Exchange. 1994;50(7):3.
Maughan L, Leiper JB, Shirreffs SM. Rehydration
and recovery after exercise. Sports Science
Exchange. 1996;62(9):3.
201
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
a lot of rest are the top priorities in order to
Introduction to Special
stay fit throughout the pregnancy and have a
A
Populations
healthy baby. However, exercising throughout
s we know, exercise is necessary
pregnancy is also of great importance. While a
to maintain our health. Some
pregnant woman may not be able to perform
people have the misconception
the same exercise regimen as before her
that, in order to be healthy, they
pregnancy, there are several recommended
must engage in strenuous exercise. Personal
exercises that can be performed during
trainers should educate people regarding
pregnancy that not only
the difference between
promote the proper
maintaining health and
Physical Health & circulation of fluid and
modifying body weight. Activity
Physical
Fitness
Wellness
nutrients to the baby but
Most physicians will suggest
Heredity
also keep the mother in
30 minutes of continuous Other Lifestyles
Environment top physical condition.
exercise per day in order Personal Attributes
Complex relationships among physical activity,

Exercising during
to maintain health. The 30 physical fitness, health, wellness and other
factors (Adapted from Bouchard, et al., 1990) pregnancy can also shorten
minutes, however do not
the length of time a mother
have to be continuous—they can be broken up
needs to lose baby fat after the baby is born.
into shorter time periods throughout the day. A
When a woman becomes pregnant, she should
person’s attitude is important and the personal
speak with her doctor before beginning a
trainer should encourage any exercise during
workout regimen and speak with a trainer
the day. There is plethora of evidence stating
to make sure the appropriate exercises are
that exercise can stave off chronic illnesses
performed. The level and type of exercise
such as heart disease and diabetes mellitus.
that a doctor and trainer recommend usually
depends on a woman’s fitness level prior to

Pregnant Women
becoming pregnant.
When a woman becomes pregnant, she may
Although exercising while pregnant normally
think that eating healthy foods and getting
helps both the mother and baby, there are
204
certain cases, such as high-risk that increases the flexibility of joints
pregnancies or complications that and ligaments.
arise during the pregnancy, which Exercise improves circulation
can prevent a pregnant woman from within the intestines, which in
exercising. However, under normal turn reduces constipation. It also
circumstances, exercising provides increases the circulation of blood to
many benefits to the mother and the skin, which produces a healthy
her growing baby. When a pregnant glow. One of the most important
woman’s body begins to change, she may feel benefits of exercising during pregnancy
increasingly fatigued and stressed about aches is that it strengthens the heart and body
and pains or other symptoms the pregnancy muscles. This plays a role in the ease at which
may be causing. Exercise has been shown to a mother goes into labor and the event of
increase energy levels and lead to the release giving birth. For example, breathing exercises
of endorphins, which help manage pain during

Active Mums-To-Be
are chemicals produced Specific Exercise Class for Pregnancy labor, and performing
naturally in the brain Improves mood

swings Less physical
exercises throughout the
Improves your
self-image discomfort
that lead to a decreased pregnancy that increase

Control weight Benefits from
sensitivity to stress endurance can help a
Prevents
gain exercising low-back pain
during
pregnancy
and pain. This can help Improves
woman get through long
circulation Sleep better
relieve tension and help Research has

hours of labor. Another
Improve transfer shown that Increases your
of oxygen (gas women who chances of
a pregnant mother sleep exchange) at the
placenta.
exercise don’t
have low birth
having easier,
shorter, and less
essential benefit is that
weight babies, complicated
but they do have labours
comfortably. Exercise more lighter
babies and fewer
less fat will be gained if
big babies.
relieves back pain and the mother was properly
improves posture by toning and strengthening exercising before she became pregnant and
muscles in the thighs, buttocks and back. continued to do so throughout the pregnancy.
Exercise also prevents joint damage by In addition, the mother will regain her normal
stimulating the release of relaxin, a hormone size after the baby is born more quickly
205
than if she did not exercise the pregnancy already puts more
during pregnancy. Currently, strain on joints and could lead
studies are investigating the to avoidable joint injuries. The
notion that exercising while stage at which a pregnant woman
pregnant can decrease the risk wants to begin exercising also
of developing complications plays a role because the type and
such as gestational diabetes and level of exercise that can be done
preeclampsia (pregnancy-induced high blood changes as the pregnancy progresses. During
pressure). the first trimester, exercises can be performed
in the supine (lying on the back) position,

Designing a Safe Exercise Plan
but this is not recommended after the first
during Pregnancy
trimester.
Designing a safe exercise program during
According to the U.S. Department of
pregnancy depends on whether or not the
Health and Human Services, women should
woman was exercising before she came
be exercising at least 2.5 hours a week to
pregnant, the stage of pregnancy at which she
maintain their health. However, even if a
wants to start and whether or
woman was not exercising before
not complications arise during
she became pregnant, she can
the pregnancy. If a woman was
start performing slow, easy and
exercising prior to her pregnancy,
short exercises. Exercise intensity
she can more than likely continue
and speed can be increased as
her program by making a few
the expectant mother begins to
modifications. For example, if a
feel stronger. If the pregnancy is
woman was in a weight lifting
free of complications, the risks
program before she became
of exercising at a moderate level
pregnant, she may be able to
are low and do not increase the risk of early
continue by lifting lighter weights. She should
miscarriages, preterm deliveries or low birth
not continue lifting the same weights because
206
weights. In every case, a woman who becomes Water Exercises:
pregnant should have a discussion with her • Swimming
doctor regarding plans to continue or begin • Water Aerobics
exercising. Complications that usually limit Aerobic Exercises:
a woman’s ability to exercise during her • Walking
pregnancy include: • Bicycling
• Early contractions • Light/Low Impact Aerobics
• Vaginal bleeding • Running (if a runner prior to
• Dizziness pregnancy—modify routine)
• Chest pain Weight Lifting (Less weight than prior to
• Headache pregnancy):
• Muscle weakness • Maintain health (not increase muscle)
• Decreased fetal movement Dancing, yoga and Pilates are all fantastic
• Dyspnea (shortness of breath) before forms of low impact exercises that help stretch
exercising muscles. Swimming and water aerobics are
• High blood pressure that is pregnancy also good exercises for an expectant mother.
induced The water provides a pregnant woman with
• Premature rupture of the amniotic sac the ability to easily move around and stretch
(water breaking early)
• Calf swelling and pain

Safe Exercises to Perform When Pregnant
Low Impact Exercises:
• Dancing
• Yoga
almost all muscle groups. Swimming and water
• Pilates
aerobics are especially beneficial because they
207
give a pregnant woman the feeling of buoyancy use less weight as the pregnancy progresses.
(weightlessness) at a time when she may feel Jumping and jerking movements should be
pressure from her growing baby avoided during the pregnancy and
and increasing weight. Walking and an expectant mother, as well as
biking are additional exercises that her trainer, should focus on using
can be performed during pregnancy, exercise to maintain the mother’s
but walking is recommended health, not increase muscle tone or
more often than biking. It is very mass.
easy to change the pace during a Many pregnant women who were
walking routine. When walking runners before becoming pregnant
short distances is not a satisfying workout, can continue running by modifying their
the distance can be increased or hills can be routine. However, an expectant mother must
added to the walk to increase the intensity. A remember that exercises, such as running,
pregnant woman who is not used to walking should be performed in moderation and do not
should start out by walking one mile or less, have to be performed on
three times a week. A warm-up and cool-down a daily basis. In addition,
of at least five minutes should be included in listening to the body and
this workout routine. its warning signs is of
As previously stated, expectant mothers can the utmost importance.
continue to lift weights but should decrease For example, as a baby
the weight they have been previously lifting. grows, the mother’s
Expectant mothers should also consult their center of gravity changes,
doctor before continuing a weight lifting making it easier for an expectant mother
program to make sure this will not cause joint to become dizzy or lose her balance. This
problems or complicate the pregnancy. If a occurs especially during the last trimester. A
mother decides to continue lifting weights after growing baby also puts more pressure on the
consulting her doctor, she should make sure to lungs, which decreases her ability to breathe
208
properly when she is exercising. Furthermore, 102.6˚F can harm a growing baby and cause
energy levels can change daily—if a pregnant birth defects. This is especially critical during
woman feels extremely tired on the day she the first trimester. Swimming is a good option
is supposed to exercise, she should shift the on hot, humid days because it keeps the body
workout to the next day, assuming she will be cool. If swimming is not an option on that
feeling better the following day. day, exercising in an air-conditioned facility
is recommended. As opposed to typical

Safety Precautions
sportswear that clings to the skin, pregnant
There are several safety
Safe women should wear comfortable, loose-fitting
precautions that a pregnant
Pregnancy clothes while exercising. Finally, as with any
woman, as well as her Exercise
exercise routine, adequate amounts of water
trainer, should not ignore.
should be consumed before, during and after
A pregnant woman’s pulse
exercising.
rate should not rise above
If any of the following symptoms occur
140 beats per minute
during exercise, the expectant mother should
during exercise. If a heart
immediately stop and contact her doctor:
monitor is not available,
• Dizziness
a talk test can be used. This test determines
• Severe fatigue
whether or not a pregnant woman can have a
• Shortness of breath
conversation while she is exercising or if she
• Heart palpitations (strong and rapid
appears to be gasping for air when she tries to
heartbeats)
speak. When this occurs, the expectant mother
• Headaches
should stop exercising or avoid the exercise
• Pain in the pelvis and/or back
that is causing the overexertion. Exercising
• Bleeding
outside when it is hot and humid should be
avoided as well. When a pregnant woman Seniors

begins to overheat, this can be very dangerous As people age, people often think that
for her baby. Body temperatures higher than exercising is too tedious and may cause them
209
unwanted injuries. However, exercising at any blood pressure and rapid heart rate as well.
age can improve an individual’s quality of life. Endurance, especially cardiovascular strength,
Elderly persons can also exercise for short is necessary for elderly persons to be able to
periods of time and still notice an increase in shop and take care of themselves, perform
muscle strength and tone. Similar housework, work outdoors (e.g., in
to other individuals, elderly a garden) and enjoy recreational
persons need to focus on strength activities. In order to maintain
training, flexibility training and their strength and level of
cardiovascular training to maintain endurance, exercises that increase
as much mobility and strength their heart rate and breathing for
as their body allows. Ailments, extended periods of time without
such as arthritis, often hinder causing complications should be
their ability to move around, but performed. Beneficial exercises
recent studies have shown that exercising can for the elderly include walking, swimming
reduce inflammation and pain that is caused and dancing, while high-impact exercises such
by arthritis. Strength training has also been as running, cycling and jumping rope should
shown to improve muscle strength in elderly be avoided because they put a lot of strain
persons who have suffered from a hip fracture.
These are just a few of the many benefits that
exercise provides to elderly persons.

Endurance Exercises
In elderly persons, endurance exercises
increase the maximum amount of oxygen

on joints and muscles. Low impact exercises
the body and muscles can uptake and
should be performed for 20 to 40 minutes at
transport. Endurance exercises reduce high
least 3 times a week.
210
Strengthening Exercises be repeated 8 to 15 times and if the individual
Elderly persons can strengthen their upper begins to feel stronger after some time, they can
and lower body by lifting weights or using alternate legs while performing this exercise.
weight lifting machines. In the beginning of a Arm raises strengthen shoulder muscles and
weight lifting regimen, weights can be performed by sitting in
that can be effortlessly lifted a chair with the arms facing the
five times should be used. When side of the body and raising both
this routine becomes too easy, arms to the shoulder height. This
the same set of weights should position is held for one second
be lifted five times for two sets. and then the arms are lowered
The routine can be increased back down to the individual’s
periodically until the individual side. Arm raises can be repeated
can do 15 continuous repetitions. 8 to 15 times.
When the individual can lift the weight 5 times Lower back strength is also important
for 15 repetitions, the size of the weights can be for elderly persons because back pain is a
increased. This type of strength symptom that often occurs when
training can be performed for people begin to age. Having a
30 to 40 minutes, 2 or 3 times a strong back makes it easier for
week. the elderly to stand up from a
There are several strengthening sitting position, get into and out
exercises that can be performed of a car, pick up objects, move
at home. Plantar flexion is around and work in the yard.
an exercise that strengthens ankle and Back muscles can be strengthened by sitting
calf muscles. To perform this exercise the upright in a seat with the feet placed flat on
individual slowly raises their body so that the floor, arms bent and relaxed, then pulling
they are standing on their tiptoes and holds the shoulders back as far as possible. Another
this position for one second. This exercise can exercise that strengthens back muscles can be
211
performed by lying on the floor and placing a arms, shoulders, back, chest, stomach, thighs
pillow or cushion under the hips. The arms are and calves. Shoulder rotations are easy to
placed at the sides and the legs are straight. perform and are often recommended. First,
The head and feet are slightly the individual lies flat on the
lifted off of the floor at the same floor with their head placed
time and held for one second. The on a pillow. The palms are
individual can relax for a moment placed face down and the
and then repeat the exercise. elbows are bent so that the
Stretching Exercises arms are forming an angle.
The muscles and joints This position is held for 10 to 30 seconds
of elderly persons are and then the arms are rotated so that the
often inflexible, stiff and inflamed. In order palms are facing upward and held again for 10
to avoid unnecessary injuries and lessen the to 30 seconds. This exercise can be repeated
three to five times.

1
Calves and ankles can also be easily stretched
by standing in front of a wall, fully extending
the hands and then placing them on the wall.

2
pain that is caused by inflammation, stretching
exercises should be performed throughout
the week, especially before strength training.
In fact, warm-ups and cool-downs should

The individual then moves one of their legs
involve 5 to 15 minutes of stretching before
backwards while keeping their foot and heel
strength exercises are performed. Elderly
pressed against the floor. This position is held
persons should make sure they stretch their
for 10 to 30 seconds, then the knee is bent
212
and the leg is brought back to its original stabilizer muscles in the upper and lower
position. This stretch is performed again with parts of the body that are normally not active.
the opposite leg and the entire exercise is After a period of time, the individual learns
repeated three to five times. Elderly persons how to stabilize their body and maintain
should work closely with a personal trainer to their balance on top of the half-ball. This form
make sure stretches are performed of exercise also improves agility
correctly and that posture is (needed to avoid falling), increases
maintained throughout the stretch. the ease at which an elderly
Balance Exercises person can move and enhances
By helping older individuals their reaction time in case of an
maintain posture and mobility, emergency. Simple balance training
balance exercises have been shown on a Bosu can greatly improve an
to prevent injuries that are typically elderly individual’s quality of life
caused from falling. In addition, elderly by increasing their mobility and reducing
persons who can maintain their balance also injuries typically caused from falling down.
retain their independence by In every case, it is important for
reducing their need for a walker, elderly persons to remember
wheelchair or assistance when that the best way to reduce the
it comes to moving around. In symptoms of aging is by staying
order to enhance an elderly person’s ability to active, even if they cannot exercise two or
maintain their balance, trainers usually focus three times a week.
on increasing the individual’s core muscle

Safety Precautions
strength.
Sarcopenia, a loss of muscle mass and
One commonly used method of improving
strength and a decline of muscle tissue, also
balance involves the use of a Bosu balance
occurs in people as they age. Experts suggest
trainer. This is an exercise ball that has been
that muscle mass decreases approximately
cut in half (half-ball) that engages small
4% each decade from ages 25 to 50. Aerobic
213
fitness, which normally increases the amount periodically undergoing a medical examination
of oxygen that is delivered to muscles, is also and working under a trainer’s supervision. The
doctor will ensure the patient is not putting too

Active Inactive
much strain on the body and the trainer will
ensure the exercises performed accommodate
the client’s current level of fitness. In addition,
elderly persons who have chronic conditions
should consider the role their condition plays
in their ability to exercise safely in order to
hindered as people age. This may reduce avoid unnecessary injuries. These persons
one’s mobility and alter daily activities. Joints should be sure to consult regularly with
become stiffer, which often their doctor and personal
leads to a higher risk of trainer. If the individual
injuries. Each year, more begins to experience chest
than 300,000 people are pain, shortness of breath
hospitalized for broken hips or lightheadedness while
caused by falls. exercising, they should stop
Recently, more and more and contact their doctor.
scientists claim that the complications of

Youths
aging can be avoided or become less severe if
Children, teenagers and adolescents may
people remain active as they age. Older adults,
often think they do not really need physical
regardless of age, should make sure time is
education classes or aerobic exercises to keep
devoted to exercising on a regular basis. Even
in shape, but inactive young people are just as
exercising one or two times a week is more
susceptible to health problems as adults who
healthy and beneficial than being inactive.
are inactive. In fact, a large number of children
However, elderly persons should constantly
and youths are at risk for developing coronary
be aware of their level of physical fitness by
artery disease (heart disease), type 2 diabetes,
214
high blood pressure, high girls and 4 out of 10 boys
cholesterol and even heart are not engaging in physical
attacks because of inactivity activity for a minimum of
and consuming unhealthy one hour a day, which is
foods. Overweight persons recommended by health
increase their chances of care professionals. Training
developing such conditions when their weight programs and classes that educate children
continues to increase, so it is good advice for and young people about how to get into
even young people to manage their weight and shape or stay in shape will begin to lower the
physical activity. currently increasing obesity rates.
Surveys performed over recent years

Training Programs and
suggest that the majority of obese children
Supervision
and youths are overweight due to an absence
Training programs are beneficial tools
of physical activities in their daily routine
that can be used to combat obesity. They are
and an unhealthy diet. Years
sometimes conducted in school
ago, children, youths and adults
for students or information is
alike used to walk or cycle to
given to parents seeking ways to
school or work and play sports
help their child reach their ideal
regularly. Nowadays, people
weight and optimal physical
travel mainly by car and children
fitness level. Training programs
are transported to school by
for parents should include ways
their parents or by school buses.
that their child’s activity level and
In the afternoons when kids
eating habits can be monitored and
return from school, they typically sit in front
improved. Training programs and supervision
of the television or computer for several
also entail physical education, which means
hours before going to bed. According to a U.S.
making sure children are engaging regularly in
National Diet and Nutrition Survey, 6 out of 10
recreational activities. It is also important that
215
children and youths are supervised while they
are exercising or playing sports, since a lack of
concentration or playing during training can
lead to unnecessary accidents and injuries.
Training programs should offer students Preventing and Controlling

a variety of options. Children and youths Childhood Obesity
have different personalities and will often Preventing and controlling obesity involves
prefer various types of exercises and sports. introducing a healthy and well-balanced diet
Parents, teachers and trainers should pay to an obese child or youth that is overweight.
close attention to behavioral patterns

Fats, Oils & Sweets
USE SPARINGLY
when a child or youth is engaging in
Meat, Poultry, Fish,
Milk, Yogurt &
recreational activities. When individuals Cheese Group
Dry Beans, Eggs &
Nuts Group
2-3 SERVINGS
2-3 SERVINGS
are performing an activity or sport they
Vegetable Group Fruit Group
3-5 SERVINGS 2-4 SERVINGS
do not like or find difficult, they may
Bread, Cereal, Rice &
Pasta Group
become less motivated and will not reap 6-11 SERVINGS
the health benefits that performing a sport

Fatty foods like chips, hotdogs and hamburgers
they are enthusiastic about can provide them.
should be replaced with fruits, vegetables and
Allow youths to try a number of activities to
starchy foods such as potatoes, pasta and
find the exercise or sport that is right for them
rice. In addition, sodas and other carbonated
and encourage them to engage in this activity
drinks should be replaced with fruit juice, milk
on a regular basis.
216
and water. Controlling obesity also involves parents. Parents can also make recreational
improving eating habits. For example, if a activities fun by going to amusement parks,
parent and their child are used to eating meals riding bikes, swimming, etc. Avoid inactivity
at random times during the day, regular eating by reducing the amount of time the child or
intervals can be implemented with healthy youth is allowed to watch television or play on
snack foods between meals. Eating while Health

Education
Family/
watching television should also be avoided Community Physical
Involvement Education
because the child will, more than likely, not
move around once they have finished eating.

Health
Health
Promotion
If consuming fast food during the week is the for Staff
Services
normal routine, try to encourage the parents
to implement a family night when the whole Healthy Nutrition

School Services
Environment
family cooks healthy foods together. Counseling,
Psychological, &
Social Services
Safety Precautions
the computer. Inactivity can also be avoided by
For children and youths who were
making sure children engage in activities that
previously inactive, doctors recommend that
are appealing to them and give them a sense of
an easy exercise be chosen and the intensity
satisfaction. One may also consider rewarding
of physical activity be gradually increased.
children and youths for maintaining healthy
Walking for approximately one hour a day is
eating habits and being active during the week
one of the easiest approaches to becoming
by buying them a small gift, taking them to
physically active. If a child’s school or the
the cinema or by another means that shows
shopping center is not very far from home,
them you are proud of the progress they have
parents should encourage walking instead of
made.
going by car. Taking children to a park regularly
and playing sports with them also encourages Injured Persons

children to become more active and shows Physically active people who have recently
that physical fitness is important to their been injured may think they have to stop
217
exercising until they have fully recovered, and if a doctor recommends that a person
but this is not always true. According to the do so. Putting weight on injured parts of the
type of injury you have, performing certain body (e.g., a sprained ankle or broken bone)
exercises under the supervision of a medical directly after an accident can lead to a chronic
professional or physical therapist can speed condition or chronic pain. However, after a
up the recovery time. certain amount of time a
However, it is important to doctor may suggest specific
only perform exercises that exercises to strengthen the
a doctor recommends and do injured area. In fact, not
so under close supervision doing these exercises could
to avoid further injury. This prolong the recovery period.
is particularly good news When individuals begin
for people who have recently torn a ligament performing exercises that involve injured
or strained a muscle and thought they would body parts, they should pay close attention
have to sit at home or at their desk all day for to body warning signs. Some people tend to
the next couple of weeks. An injured individual push themselves when they are exercising—
should speak with their doctor about whether for example, forcing one’s self to do just one
they can exercise and what kind of exercise more sit-up even if they are beginning to
can be performed while they are recovering. feel pain. For injured individuals, this can
In most cases, people who were already active Cumulative Injury Cycle
only need to change certain parts of their

Tissue Trauma Muscle Imbalance
normal exercise regimen.
Exercising with an Injury

Altered Neuromuscular
Inflammation
Exercising with an injury should only be Control
considered if the injured part of the body
has been given some time to begin healing

Muscle Spasm Adhesions
218
be quite harmful. When individuals start to prevented if a person avoids overtraining. If
feel increased pain in an injured region or muscles and joints are overworked, they are
in other parts of the body, they should try a more susceptible to becoming damaged and
different exercise or stop exercising. This will less able to protect their connective tissues,
prevent further damage to the injured region. which increases the risk of damaging cartilage,
Following a doctor’s instructions is important bones, ligaments and tendons. Training should
but listening to individual body signals also be performed throughout the week and at
aids the recovery process. regular intervals with recovery periods in
between workouts. In addition, focusing on

Exercising after an Injury
strengthening all of the body’s muscle groups
Once a person has fully recovered from an
will avoid muscle imbalances by reducing the
injury, they should educate themselves about
need for overworked muscles to compensate
how to avoid further
for weaker inactive muscles.
injuries or re-injuring
the same area. One Exercises to Perform and Avoid

of the best ways Exercises that put direct pressure on the
to prevent future injured area should be avoided for some time.
injuries is by learning For example, if a person has a knee or foot
to maintain balance injury, they should avoid running or riding
and flexibility. This a bike. Instead, this person can concentrate
can be done at home or under the supervision on upper body strength while recuperating.
of a trained professional. It is important to Their workout regimen can be modified to
make sure the personal trainer or physical include exercises that can be performed while
therapist has been informed about the recent sitting or lying down. The same idea should
injury or previous injuries before beginning a be applied when the person has an injury in
new workout regimen. Tight muscles can lead the upper part of the body, such as an elbow
to imbalances in the body and this can cause or shoulder, by concentrating on the body’s
accidents and injuries. Injuries can also be lower regions. Yoga and Pilates are often
219
recommended for people who are recovering will depend on the specific type of injury. It is
from an injury. These exercises are easy on better to take things too slow than to risk re-
muscles and joints (e.g., in the hands and feet) injury or create a chronic condition.
and typically improve balance, flexibility and

Persons with Specific Medical
posture. Before starting one of these courses,
Conditions
the instructor should be informed about the
injury. If these exercises will be carried out Arthritis

at home, the individual should speak with a Arthritis is an inflammatory condition
doctor or physical therapist before beginning affecting the joints of the body and afflicts a
the exercise. Swimming and water aerobics Arthritis

(Degenerative Joint Disease/Osteoarthritis)
Three Examples
are typically good workouts for people who
have strained muscles or broken bones in Metacarpals

Carpals Degeneration of
Phalanges Joint Surfaces
their legs or feet. The use of a pull-buoy is Hand
especially helpful, as placing this device

Degeneration of
Joint Surfaces
Pelvis Pelvis
between the thighs allows the lower part of Head
Neck
Hip
the body to float and forces the upper regions
Femur Femur
to do all of the work. In every case, an injured Side View Degeneration of

Joint Surfaces
Quadriceps
person should speak with a doctor or physical Femur Femur

Patella
Knee
therapist about the best time Tibia
Patella
Tibia
Cartilage Covered
Joint Surfaces
and types of exercises that
should be performed. majority of older persons. Aging is often
associated with degeneration of the

Safety Precautions
functional ability of the body. However,
It is very important to know
arthritis does not just occur in the aging.
as much as possible about a
Collectively affecting about 15% of the
client’s injury and to work closely with the
general population, arthritis is one of the most
doctor on developing a workout regimen.
prevalent chronic conditions in the U.S.
The exact precautions a trainer needs to take
220
Cartilage
Worn Out
arthritis, when other methods do not prove
Bone
Bone
Erosion
effective, surgery could be necessary.
Swollen
Cartilage Synovial
Synovial
Fluid
Membrane
In terms of exercise training, fitness
Osteoarthritis Normal Bone Rheumatoid Arthritis
professionals should always be aware of the
Arthritis is separated into two major groups— major types of arthritis and determine whether
osteoarthritis and rheumatoid arthritis. their client is arthritic. The progress of arthritic
Osteoarthritis is due to the degeneration of clients in exercise training programs should be
cartilage in the joints. This ultimately creates closely monitored. Any movement that leads
a wearing of the bone surfaces where to persistent pain for more than
they come in contact and leads to an hour following exercise should
inflammation and pain. The most be noted. A good way to manage
common areas where people develop arthritis is to be aware of what types
osteoarthritis are in the hands, knees, of activities lead to joint aggravation.
hips and spine. The second major type These exercises should be modified
of arthritis is rheumatoid arthritis, or eliminated from the routine.
an autoimmune joint disease. In this They often involve high intensity
case, the immune system attacks the exercises or ones that involve a
tissues of the joints or organs. This high number of repetitions. People
too leads to pain and stiffness and the with osteoarthritis usually have
loss of joint integrity in multiple joint areas, a decrease in strength and proprioception,
most commonly in the hands, feet, wrists and which leads to postural alignment issues and
knees. decreased ability to balance while standing.
Managing Arthritis Other training considerations include
The major ways people with arthritis manage morning stiffness and lowering of the maximal
their arthritis is proper rest, exercise, a good oxygen uptake due to decreased exercise
diet and medication. Splints or braces can also ability.
help to lower arthritic pain. In cases of chronic
221
If a client is under the supervision of a fitness through inactivity due to muscle atrophy and
professional for exercise training, both parties lack of flexibility of the joint tissue. Therefore,
should be aware of medications being taken inactivity is often associated with the
(e.g., acetaminophen, NSAIDs, corticosteroids) perpetuation of the chronic pain cycle. Rather,
as pain relievers to manage this condition. For there should be a balance of activity and
example, corticosteroids rest. Consistent exercise
can lead to osteoporosis, Understanding can have some great
a condition characterized Arthritis Facts benefits for clients with
by a decrease in bone arthritis. Research in
density. This condition can hinder certain sports medicine reports have demonstrated
training routines because it causes arthritic that long-term strength training, including
flare-ups and therefore affects the client’s proprioceptive training, can provide some
exercise tolerance. immediate and prolonged relief to arthritic
Also, this medication is known to increase patients. The decrease in the symptoms
Recreation
body mass, anemia and gastrointestinal of arthritis is primarily due to the
bleeding. Aerobic Exercise increase in muscle strength gained
Types of Exercise for Arthritis from exercise training. Literature

Muscle Strengthening
It used to be a common also supports the benefits of
practice to avoid any type of Range of Motion and Stretching

isometric strength training
strenuous exercise if the because strength can be
individual suffered from arthritis. The reason developed in joints with little to no movement,
for this former misconception is that a lack so it is less likely to inflame joints. People
of activity and complete rest was thought to with arthritis are advised to participate in
have the most benefit in managing arthritis. structured exercise routines and work with
However, research studies show that this is their trainer in the design of a personalized
not the case. Joint pain and stiffness associated program to help restore their functional
with arthritis can actually be heightened mobility. If a trainer cannot be consulted, then
222
a strong increase in daily activities can also be or elastic bands to create resistance. Correct
beneficial. body position when using weights is crucial
Three types of exercises that are best for to avoid muscle tear and more joint swelling.
arthritic people include range of motion Low impact, water-based exercise works
exercises (e.g., stretching and well because the body’s buoyancy
dance) to maintain normal joint reduces stress on hips, knees and

Strengthening
movement and relieve stiffness; spine, areas primarily affected
strengthening (e.g., weight by arthritis. The water should be
training and water exercises) to about 83-88°F to be soothing to

Aerobics/Heart and Lung Health
increase muscle strength, which the joints. Some beneficial modes
helps support and protect joints; of basic endurance exercises that
and endurance exercises (e.g., should be conducted include
swimming and cycling) to improve stationary cycling and distance

Range of Motion
cardiovascular fitness, control swimming. They should be
weight and improve overall bodily function. preceded by extended warm-ups and include
Range of motion exercises (E.G., dance, special considerations to exercise intensity
aerobics and rowing), which decrease risk of and duration.
orthopedic complications, can be enjoyable Osteoarthritis

Feelings of
and therefore, increase exercise compliance.

helplessness,
hopelessness
or depression Regain
Chronic Control
Exercise programs with range of motion focus Disability
(long term)
Pain
can include anything from walking around the Loss of joint

function
Find
Activities
you can take part in
Learning (e.g. t’ai chi, yoga)
block, taking a yoga class or playing a low- about
osteoarthritis
Sleep
key game like golf. However, it is important Pain Relief Problems
through medication get help
(if it is not helping, from your doctor
to work only the pain-free range of motion see your doctor) Controlled
Exercise
(weight or resistance
exercise for joint stability,
that one can exhibit. In the case of strength and cardiovascular

exercise for overall
fitness or weight loss)
training, weight training can be conducted

In rheumatoid arthritis, the joint structure
with small free weights, exercise machines
of the body is damaged through the wearing
223
away of cartilage as a result of autoimmune
Lungs
Airway
degeneration. Improving muscle strength Mucus
Smooth muscle
cells constrict airway
and flexibility through a properly designed
training routine can complement the use of
medication, rest and diet to manage this type Cells release cytokines,
triggering inflammation
and airway constriction
of arthritis.
NKT Cell
Th2 Cell
Asthma
kind, duration and frequency of the exercise
There are more than 10 million Americans
to be performed. It can also establish when
that suffer from asthma or asthma-like
and where the client will exercise.
symptoms, such as shortness of
It might be advantageous to work
breath, coughing, headaches and
with the client’s doctor to learn
abdominal pain. Exercising correctly
more about the client’s condition.
can be helpful for asthmatic clients
An asthma management team can
by reducing their vulnerability to
help determine the most beneficial
asthma triggers such as pollutants,
training program for the client.
allergies and cold/dry air. Exercise can also
It is very important that a client have the
reduce shortness of breath or dyspnea, which
asthma under control. This can be accomplished
is common among this population.
mainly by using inhaled or oral drugs.
Therefore, it is important that
Some clients may use inhalers that
personal trainers understand how to
can decrease the chance of having an
deal with people affected by asthma
attack up to 2 hours after doing so if
in order to avoid complications.
this action is taken approximately
Preparing for Exercise 15 to 30 minutes before exercise.
Before setting up an exercise program, the Clients should also try to prevent interaction
client should finish an asthma screening form with variables that contribute to asthmatic
which can be used to figure out the appropriate symptoms.
224
If this technique is used, the following steps
can be taken:
1. The technique should be discussed with
the client’s physician.
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.

Proper warm-up
and cool-down 5. The client should work to 70-85% of the
may prevent or
reduce the normal heart rate.
incidence of When to Avoid Exercise
exercise-induced
asthma. All exercise should stop when the client
experiences an asthma attack. The following

The client may also consider exercising
steps should be taken:
to try and induce an asthma attack with
1. Place the client in an upright position.
mild symptoms. This may be especially
2. Unfasten any tight or restraining clothing.
advantageous if the client is an athlete. After the
3. Ask the client where their medication is
first attack, there is a lower chance of another
and allow the client to self-administer. It is
one occurring and this period is referred to
important to note that the personal trainer
as the refractory period. Depending on the
should have the knowledge or permission
individual, this period can occur from half an
to administer the medicine or should not
hour to three hours after the initial asthma
do it at all.
attack.
225
4. Should symptoms persist for half an hour allergies can be activated by certain triggers.
or more, medical assistance should be There are certain medications that can bring
requested immediately. about EIA, and clients
An asthma attack can be should speak to their doctor
brought on during exercise about which medications
and this is known as exercise- can do this. They should
induced asthma (EIA). learn more about the side
It is present in children, effects to medicine they are
adolescents and young adults who frequently currently taking and how it can be influenced
work out. This condition can be induced if the by exercise.
client exercises constantly at 70% of aerobic

Diabetes Mellitus
capacity for a minimum of five minutes. It can
Exercise can potentially reduce the risk of
happen either in the first 6 to 12 minutes or last
diabetes mellitus and help manage diabetes.
5 to 10 minutes of exercise.
There are two types of
Therefore, longer periods
diabetes mellitus (type 1
of exercise consistent with
and type 2) and personal
Diabetes
certain sports should be Mellitus
trainers should familiarize
limited or avoided.
themselves with the different
EIA can also be avoided Inappropriate Dietary Habits
Inheritance
Obesity
Dyslipoproteinemia
types. Diabetes mellitus
by exercising in the proper Cigarette Smoking Lack of Exercise
Hypertension is a condition in which a
Psychological Profile and Pattern of Behavior
weather conditions or Viral Infections
Immune Reaction person has high glucose in
locations. Clients should
their blood. Glucose is the
exercise caution when the
primary fuel for our bodies and the process of
air is cold or dry. They should also limit exercise
converting glucose into energy occurs within a
when they have a cold or viral infection. Clients
cell. This process is regulated by the hormone
who suffer from asthma allergies should not
insulin, which is secreted by the pancreas. The
exercise in outdoor locations where these
226
difference between type 1 and type 2 diabetes As with many chronic illnesses, being active
mellitus is seen at the molecular level. and maintaining health is believed to help
In type 1 diabetes mellitus, a person’s decrease the risk of obtaining type 2 diabetes
pancreas malfunctions and starts to lose mellitus, along with good eating habits.
the ability to secrete insulin. When a person Exercise is beneficial for people with either
with type 1 diabetes mellitus eats a meal, type 1 or type 2 diabetes mellitus. Some
the pancreas does not secrete enough or any people with type 2 diabetes mellitus can
insulin. Without insulin, glucose cannot gain manage their own diabetes with exercise and
entry into the cells and thus glucose eating without needing medication.
accumulates in the blood, which can In the next section, we will discuss
elicit many dangerous outcomes. the benefits of exercising in terms
People with type 1 diabetes mellitus of reducing the risk for diabetes or
can inject insulin that mimics their how it can manage diabetes.
own insulin, which is lacking, so Benefits and Risks of Exercising
that they can lead a mostly normal The majority of evidence from
life. People with type 2 diabetes current research suggests that there
mellitus have a different malfunction. These is a positive effect of exercise on diabetes
people typically have normal insulin levels; mellitus, especially cardiovascular exercise.
however, for a reason yet to be understood, Exercise is beneficial to those individuals with
their cells stop responding to the insulin. diabetes mellitus because it burns calories
This essentially blocks glucose from entering and can therefore help lower blood glucose.
the cell, thus causing the person to have high Burning extra calories can come from many
blood glucose levels. different sources, such as taking stairs or
Some research has shown that chronic parking further away at work or the store. A
overeating, which can lead to being overweight, cardiorespiratory workout of walking briskly
along with a sedentary lifestyle, can increase or a mild jog is a great way to manage diabetes
the risk of developing type 2 diabetes mellitus. or to help reduce the risk of getting type 2
227
diabetes mellitus. Studies have shown that as aware of any associated risks and be sure to
little as a 5% reduction in weight is enough to ask if their doctors advised them that it was
prevent type 2 diabetes mellitus. Along with acceptable to try to manage their diabetes
keeping diabetes in check or reducing the risk without medication. One symptom of diabetes
of developing it, exercising also helps to stave is called neuropathy—this condition occurs
off other chronic diseases, such as high blood when diabetes has damaged nerves in the
pressure or cardiovascular disease. extremities and it renders the client unable to

Benefits & Risks of Exercising with Diabetes in feel pain. For example, if a diabetic client with
the Elderly
Benefits Risks neuropathy gets a blister, it will go unnoticed,
Increased exercise tolerance Sudden cardiac death
and this could lead to an undetected and
Increased glucose tolerance Injuries to the feet and joints
Increased maximal O2 Hypoglycemia unmanaged infection, which will often lead
consumption
Increased muscle strength to amputation. Trainers must be very careful
Increased muscle mass
and knowledgeable when it comes to diabetic
Improved lipid profile
Improved sense of well-being clients. For these clients, you may recommend
Decreased blood pressure water exercises, since walking or running may
Decreased body fat
put too much strain on their feet and legs.
There are some risks that personal trainers Also, heavy weight lifting is not recommended
must be aware of if a client has diabetes. for a client with diabetes, as they already have
Taking a good initial assessment should a lot of pressure on the vessels within the
reveal this chronic condition, eyes. That is why exercise-
along with the medications a Heavy weight lifting is induced lower blood pressure
not recommended for a
diabetic client is taking. The client with diabetes, as they helps with diabetes, as it
already have a lot of pressure
trainer will also need to know on the vessels within the eyes. aids in decreasing vessel
if the diabetic is trying to use pressure. Another important
the workout being designed as a means to consideration is to be mindful of medications
manage the diabetes. Fulfilling clients’ goals they are taking, which are designed to lower
is important, but trainers also need to be blood glucose. When they exercise, they are
228
further lowering their blood glucose—this is also important in maintaining a healthy
could lead to hypoglycemia (low blood weight, as excess glucose is stored in fat tissue
glucose) and can result in fainting. Some as triglycerides. As little as a 5-10% weight loss
medications can also cause hypoglycemia on can eliminate type 2 diabetes mellitus in some
their own; therefore, it is important to know
what medications clients are taking and the
mechanism of those medications. Also, ensure
a glucose meter is handy and keep a sugary

Physical Activity
Dietary Management Blood Pressure Control
snack on hand in case of this problem. Do not
give a diabetic client any food prior to checking

Diabetes
glucose levels because, if the glucose level is
Blood Sugar Check
Control Foot Care Practices
already high, the situation will worsen.
Exercise Can Help Control Diabetes
Exercise helps to control diabetes mellitus
by burning more calories, which utilizes Stress Management Proper Medication Use
Dental Care & Hygiene
more glucose than if a person were sedentary.
Additionally, exercise has been shown to people. Unfortunately, people who suffer from
increase the cells’ ability to utilize glucose type 1 diabetes mellitus will always be insulin
as well as increase the function of insulin. dependent, but a good exercise program can
Increasing cardiovascular output also reduces aid in their longevity and quality of life. Again,
blood pressure and, as stated earlier, one effect exercise has a beneficial and broad-spectrum
of diabetes mellitus is that it can cause blood effect on overall health.
vessels to constrict (especially in the eye). Types of Exercises for Diabetics
Exercising can also lower LDL (bad cholesterol) There are several safe exercises for diabetics.
and raise HDL (good cholesterol). Lowering The only exercises unsafe for diabetics are
cholesterol has been shown to help control heavy weight lifting and any other exercise that
diabetes mellitus. Lowering triglycerides would cause a lot of straining. Most diabetics
229
will suffer from blood vessel constriction in should determine if the client has neuropathy,
the eye and trainers want to minimize this as this will be important in determining the
side effect as much as possible. Walking and workout regimen. No straining exercises,
such as heavy lifting or high resistance bands,

Vigorous
should be used. Strength training is acceptable
and building muscle is an excellent way to burn
more calories at rest; however, ensure it is not

Moderate
overdone. It may be wise to purchase a glucose
meter and keep glucose strips, prickers and
gloves readily available to test blood glucose

Light
levels if necessary.
Personal trainers will frequently encounter
clients with many different chronic illnesses.
light jogging are great exercises for healthy

Before
diabetics. If the client is experiencing numbing
 Include 5 minute
warm up After
or tingling in the extremities, the trainer  Check blood  Include 5
sugar minute cool
should recommend a swimming regimen or down
 Check blood
water aerobic type exercise. They can also do sugar
stretching, yoga or mild weight lifting and, if
they feel capable, a stationary bike may also
be an option.
Precautions
Personal trainers should know if clients’
physicians have approved them for a workout Diabetes mellitus is quite prevalent and it
regimen. Trainer should ask what medications is likely that a trainer will eventually have
they are taking and if they have type 1 or type a client with this disorder. It is therefore
2 diabetes mellitus. In addition, the trainer important that trainers be aware of the general
230
precautions and details of type 1 versus type medication. Diastolic pressure, which occurs
2 diabetes mellitus and the types of exercises when the heart is dilating (expanding) and
appropriate for this demographic of client. relaxing, typically remains constant or drops
slightly during exercise due to increased blood

Hypertension
flow. Some individuals exhibit an increase of
High blood pressure (hypertension)
diastolic pressure that is approximately 10
or a dramatic increase in blood pressure
mmHg or higher.
occasionally occurs during exercise. A
In contrast to exercise-induced
study involving athletes with
hypertension, in many persons
mild hypertension, whose ages
regular exercise lowers high blood
ranged from 55 to 75, showed
pressure and reduces the risk of
a correlation between exercise-
developing heart disease. In fact,
induced hypertension and an
an inactive lifestyle is one of the
inhibited ability of blood vessels
major causes for heart disease and
to increase in size while exercises
obesity. Regular exercise can also improve
were being performed. Normally, when people
circulation and increase the body’s utilization
exercise, blood flow increases and blood
of oxygen by strengthening the heart and
vessels dilate. The inability of blood vessels to
cardiovascular system. In addition, regular
dilate places more pressure on the heart and,
as a result, increases blood pressure. Exercise-

Normal Hypertensive
induced hypertension usually leads to a Heart Heart
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

Thickening in
by a doctor and probably controlled with Walls of Ventricles
231
exercise increases one’s energy level and monitor while exercising is also recommended
endurance while reducing fatigue, shortness for people with hypertension. This allows these
of breath and heart failure symptoms. individuals to determine if they are pushing
themselves too hard or if the activity needs to

Monitoring Blood Pressure
be changed. If a rapid or irregular heartbeat
People who have a history of hypertension,
(heart palpitations) develops during exercise,
or know the condition runs in their family,
the individual should rest by sitting for a few
should consult a doctor before beginning an
minutes and then check the pulse
exercise regimen. Once
again. If the pulse remains higher
the individual starts a
than 100 beats per minute or
routine, that individual
the heartbeat is still
should review the
irregular, a doctor
exercise plan with a
should be contacted.
doctor on a regular
When the individual
basis. Factors that
Hypertension is is not exercising,
should be discussed with a consistently high
blood pressure of at lifting and pushing
doctor include: how much least 140 (systolic)
heavy objects should be avoided, as well
exercise can be performed over 90 (diastolic).
as household activities such as mowing,
daily, the types of exercises
scrubbing, shoveling or raking.
that should be performed, activities that should
be avoided, when to take medication (e.g., Types of Exercises for Persons

before or after exercising) and how often one’s with Hypertension
pulse should be measured during exercise. Exercises for Persons with Hypertension
Typically, doctors and trainers recommend that • Stretching exercises
hypertension patients gradually increase the ▪▪ Slowly lengthen muscles
amount of aerobic exercise that is performed Yoga (include warm-up and
to approximately 20 or 30 minutes, at least cool-down)
3 times a week. The use of a portable heart
232
• Cardiovascular/aerobic exercises Cardiovascular/aerobic exercise is physical
▪▪ Benefits the heart activity that incorporates the use of large
Jogging/walking, cycling, golf, muscle groups and provides many benefits
swimming, etc. for the heart. Cardiovascular exercise
• Strengthening exercises improves circulation and the use of oxygen
▪▪ Improves muscle tone and mass, by strengthening the heart and lungs. When
endurance performed on a regular basis, cardiovascular
Walking, taking stairs, etc. exercise leads to improved breathing during
Exercises for persons with hypertension exercise, decreases the heart rate and
are divided into three groups: stretching, reduces high blood pressure. Recommended
cardiovascular/aerobic exercise and cardiovascular exercises include: jumping
strengthening exercises. Stretching involves rope, jogging, walking, cycling (e.g., outdoors or
slowly lengthening the body’s stationary), rowing or canoeing,
muscles. Performing specific Stretching involves cross-country skiing, skating,

slowly lengthening
stretch routines for the arms and the body‘s muscles. water aerobics, golf, fishing
legs before and after exercising and swimming. Strengthening
prepares muscles for the activity while exercises involve repetitive muscle
reducing the risk of injuries and muscle strains. contractions which improve muscle tone and
A warm-up and cool-down of 5 to 10 minutes increase muscle mass. Strong muscles also
is normally recommended. The cool-down is increase one’s endurance, allowing individuals
especially important because blood pressure to perform more challenging exercise routines
medication often causes a significant decrease for extended periods of time. Taking the stairs
in blood pressure after exercise or if an activity instead of the elevator is a form of strength
is abruptly interrupted. To avoid this, the cool- training, as well as, getting off the bus one or
down period should be at least 10 minutes but two stops early and walking the remainder
longer if possible. Stretching also increases an of the way. For individuals who drive to work
individual’s flexibility and range of motion. daily, parking at the far end of the lot and
Yoga is a good form of stretching. walking to the building also builds strength.
233
Exercise should be interrupted or avoided if should use light weights and not overexert
the following symptoms occur: themselves. Youths will benefit from exercise
• Dizziness and enjoy the process more if they are given
• Lightheadedness several options from which to choose. People
• Chest pain with recent injuries need to protect their
• Weakness injury but work to strengthen it at the same
• Irregular swelling or weight gain time. And those people with specific medical
• Pressure in the jaw, neck, chest or conditions need to work closely with their
shoulders doctor when developing a workout regimen.
If any of these symptoms persist for more Trainers need to listen to clients to gather
than a couple minutes after the activity is as much information as possible about their
discontinued, a doctor or emergency medical specific situations and be prepared to consult
team should be contacted immediately. with their doctors on which exercises are
Knowing how to avoid asthma triggers appropriate and which exercises should be
and properly prepare for exercise can help avoided.
asthmatic clients reap its many benefits.

Review Questions
Summary 1. Pregnant women in their second trimester
In general, special consideration needs to should avoid lying on their backs while
be given to individuals within these special performing exercises. True or False?_______
populations. Depending on clients’ unique _ _______________________________________________
situations, workout regimens need to be 2. Which of the following activities is NOT
tailored to both protect them from further recommended for a pregnant woman?
complications and help them become stronger. a) Pilates
Pregnant women need to be aware of the b) Light/low impact aerobics
impact of exercise not only on themselves but c) Long distance running
also on their growing baby. Elderly persons d) Swimming
234
3. List three types of exercises that are 8. Type 2 diabetes mellitus can be managed
beneficial for elderly persons._ _____________ with diet and exercise. True or False?______
_ _______________________________________________ _ _______________________________________________
_ _______________________________________________ 9. High blood pressure is referred to as ______
4. What are some reasons for the current _ _______________________________________________.
increase in childhood obesity?______________ 10. Name three types of exercises that are
_ _______________________________________________ beneficial for persons with high blood
_ _______________________________________________ pressure.______________________________________
5. When can exercise-induced asthma (EIA) _ _______________________________________________
occur during exercise? _ _______________________________________________
a) During the first 6-12 minutes of Answers

exercise 1. True.
b) During the last 5-10 minutes of 2. c) Long distance running.
exercise 3. Walking, dancing, swimming, light-to-
c) It can only happen after exercising for moderate weight training.
more than 30 minutes 4. There is the absence of physical activity in
d) Both A and B the daily routine of today’s youth and they
6. Which part of the body is typically NOT are participating in an unhealthy diet.
affected when an individual suffers from 5. d) Both a & b.
osteoarthritis? 6. b) Back.
a) Knees 7. Pancreas.
b) Back 8. True.
c) Hips 9. Hypertension.
d) Spine 10. Any three of these—yoga, jogging, taking
7. Type 1 diabetes mellitus is caused by a the stairs, walking, cycling, golf and
failure of what organ?_ ______________________ swimming.
235
postpartum. American Journal of Obstetrics
References
and Gynecology. 1991;164:883-87.
Bell R, Palma S. Antenatal exercise and birth
Gaudin P, Leguen-Guegan S, Allenat B, Baillet
weight. Australian and New Zealand
A, Grange L, Juvin R. Is dynamic exercise
Journal of Obstetrics and Gynecology.
beneficial in patients with rheumatoid
2000;40(1):70-73.
arthritis? Joint Bone Spine. 2008;75(1):11-
Berger L, Klein C, Commandeur M. Evaluation
17.
of the immediate and midterm effects of
Klaus D. Management of Hypertension in
mobilization in hot spa water on static and
Actively Exercising Patients: Implications
dynamic balance in elderly subjects. Ann
for Drug Selection. Drugs. 1989;37(2):212-
Readapt Med Phys. 2008;51(2):84-95.
18.
Blackham J, Garry JP, Cummings DM,
Ning Y, Williams MA, Dempsey JC, Sorensen
Russell RG, Dealleaume L. Does regular
TK, Frederick IO, Luthy DA. Correlates
exercise reduce the pain and stiffness of
of recreational physical activity in early
osteoarthritis? Journal of Family Practice.
pregnancy. Journal of Maternal Fetal
2008;57(7):476-77.
Neonatal Medicine. 2003;13(6):385-93.
Bowman AJ, Clayton RH, Murray A, Reed JW,
Plasqui G. The role of physical activity in
Subhan MF, Ford GA. Baroreflex function in
rheumatoid arthritis. Physiology and
sedentary and endurance-trained elderly
Behavior. 2008;94(2):270-75.
people. Age Ageing. 1997;26(4):289-94.
Portegijs E, Kallinen M, Rantanen T, Heinonen
Christiansen CL. The effects of hip and ankle
A, Sihvonen S, Alen M, Kiviranta I, Sipilä
stretching on gait function of older people.
S. Effects of resistance training on lower-
Archives of Physical Medical Rehabilitation.
extremity impairments in older people
2008;89(8):1421-28.
with hip fracture. Archives of Physical and
Clark SL, Cotton DB, Pivarnik JM, Lee W, Hankins
Medical Rehabilitation. 2008;(9):1667-74.
GD, Benedetti TJ, Phelan JP. Position change
Qi L, Hu FB, Hu G. Genes, environment and
and central hemodynamic profile during
interactions in prevention of type 2
normal third-trimester pregnancy and
236
diabetes: A focus on physical activity Stewart KJ, Sung J, Silber HA, Fleg JL, Kelemen
and lifestyle changes. Current Molecular MD, Turner KL, Bacher AC, Dobrosielski
Medicine. 2008;8(6): 519-32. DA, DeRegis JR, Shapiro EP, Ouyang P.
Simonsick EM, Newman AB, Visser M, Exaggerated Exercise Blood Pressure
Goodpaster B, Kritchevsky SB, Rubin S, is Related to Impaired Endothelial
Nevitt MC, Harris TB. Mobility limitation Vasodilatory Function. American Journal of
in self-described well-functioning older Hypertension. 2004;17(4):314-20.
adults: importance of endurance walk Wang TJ, Belza B, Elaine Thompson F, Whitney
testing. The Journals of Gerontology. Series JD, Bennett K. Effects of aquatic exercise
A, Biological Sciences and Medical Sciences. on flexibility, strength and aerobic fitness
2008;63(8):841-47. in adults with osteoarthritis of the hip
Snapp CA, Donaldson SK. Gestational diabetes or knee. Journal of Advanced Nursing.
mellitus: physical exercise and health 2007;57(2):141-52.
outcomes. Biological Research for Nursing. Weker H. Simple obesity in children: A study
2008;10(2):145-55. on the role of nutritional factors. Med
Stathi A, Simey P. Quality of life in the Fourth Wieku Rozwoj. 2006;10(1):3-191.
Age: exercise experiences of nursing home
residents. Journal of Aging and Physical
Activity. 2007;15(3):272-86.
237
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
requirements. However, knowing when to
O
Introduction to Nutrition
eat and what to eat at each meal is the key to
ne of the most important aspects
the client achieving fitness and training goals.
of designing a complete personal
Keep in mind, however, that exercise increases
program for a client is advice on
the rate at which calories are burned; however,
proper nutrition. Regardless of a
only 40% of the potential energy in food is
client’s goals for personal fitness and training,
converted into energy; the other 60% is lost
the fundamentals of a proper diet do not
as heat. The rate of sweating increases in
change. In fact, a training regimen combined
the body’s attempt to lower
with proper nutrition will
Weight Maintenance its temperature. Because of
enhance the client’s health Weight Gain Weight Loss
this, frequent hydration is
and performance, help
an important component of
fight disease and infection,
Food Intake Energy Expenditure
proper nutrition in order to
increase energy and reduce
maintain the body’s water
total body fat. It is the job of
content and replace any fluid
the personal trainer to be
lost as sweat.
armed with information on
For athletes and physically active adults,
proper nutrition as a means of counteracting
each meal should consist of 60-65% of the
the popularity of fad diets and the “lose weight
calories from carbohydrates, specifically
quickly” mentality.
complex carbohydrates, 15% from lean
The relationship between physical activity
protein and 10% from fat. Carbohydrates,
and caloric intake is a simple one: eat fewer
which are converted to the forms glucose and
calories than you burn and you will lose
glycogen, are the body’s primary source of
weight; eat more calories than what you
instant energy and longer term energy storage,
expend and you will gain weight. All of life’s
respectively. Additionally, carbohydrates
processes require the energy provided
are required to burn fat; without a sufficient
by food and exercise only increases these
quantity of carbohydrates, a person will not
240
effectively lose body fat. Protein is required to that the client requires at least 1,500 calories
build and repair body tissues and structures. It per day. Next, estimate the calories expended
is also used in the process of for scheduled exercise and
synthesizing hormones and The Eatwell Plate

Use the eatwell plate to help you get the balance right. It shows
training. For easy activities,
how much of what you eat should come from each food group.
hemoglobin, and is the body’s Fruits and

Vegetables
Breads, Pastas
and Potatoes
a person will expend around
alternative source of energy 3-5 calories per minute. For
if there is an insufficient moderate activity, assign
source of carbohydrates. Meat, Fish

and Alternatives
Milk and
Dairy Foods
6-10 calories per minute
Foods containing fat
Fats are also an important and, for strenuous activity,

and foods containing
sugar
aspect of a proper nutrition estimate 11-15 calories per
regimen and should not be feared. Fats are minute. To calculate the calories used for
needed for the proper absorption of many scheduled training, multiply the number of
vitamins, minerals and supplements, and they minutes spent in that activity (do not count
function as the long-term energy storage for time spent resting and recovering) by the
the body. assigned calories burned per minute for that
level of intensity.
Recommended Caloric Intake
For example, if a client participated in a normal
Although a client should not become
40-minute strength training session, then the
obsessive over daily calorie intake, it is helpful
trainer calculates that the client expended
to establish caloric intake requirements. There
approximately 240 calories [because (6.8
are two simple ways to do this: determine a
METs x 3.5 x 50 kg)/200=6 calories/minute]
client’s resting metabolic rate (RMR) and lean
for that session. Next the trainer estimates
body weight (LBW). The resting metabolic rate
the time spent in activity outside of scheduled
is the amount of energy needed to sustain the
exercise. For a sedentary person, add 20-40%
body at rest and is determined by multiplying
of the RMR; for a moderately active person,
the body weight by 10. For example, if a client
add 40-60% of the RMR; and for a very active
weighs 150 pounds, the RMR is 1,500, meaning
241
person add 60-80% of the RMR. A moderately pounds, indicating that the client’s bones,
active client weighing 150 pounds requires muscle and soft tissue weigh 117 pounds.
750 calories for daily activity: 150 lbs – 33 lbs body fat = 117 lbs LBW
(150 lbs x 10 = 1500 RMR) x (lean body fat weight )
50% moderate activity = To determine the lower range of your
750 moderate daily activity calories client‘s calorie intake, multiply her LBW
To determine the total calorie requirement by 16. This client requires at least 1,872
per day, add the RMR plus the formal calories per day. To find the upper limit of
exercise plus the daily activity: the calorie intake, add 500 calories, which
1,500 RMR calories + 240 formal exercise for this client would equal 2,372 calories
calories 750 activity calories = 2,490 total per day.
calories required per day 117 LBW x 16 = 1872
The other method to determine daily calorie lower range of calorie intake
requirements for a client is to estimate the (117 LBW x 16) + 500 = 2372
client’s lean body weight (LBW). To use this upper limit of calorie intake
method, a trainer must know the client’s Notice that there is a slight difference in
body fat percentage, which is multiplied by daily calorie requirements between the two
the client’s weight to determine the body fat methods. The RMR
weight. determination can
For example, a client weighing 150 pounds be higher by up
with a 22% body fat percentage has a body to 1,000 calories
fat weight of 33 pounds of body fat. since it takes into
150 lbs x 22% body fat = 33 lbs body fat account scheduled
Next, the trainer determines the client’s and nonscheduled
lean body fat weight by subtracting the training. Regardless of the method used,
body fat from the total weight. For this however, it is important to remember that this
client, the lean body weight would be 117 is an estimate. If a client begins to gain fat and
242
the goal is to lose fat, it may be necessary to a client may want to consume high calorie
adjust calorie intake. Additionally, many factors shakes or other dietary supplements, wrongly
can influence daily energy requirements. The thinking that the calories will be turned into
resting metabolic rate and daily activity will muscle. Unfortunately, all extra energy that is
use most of the available energy per day. The not used, regardless of the form, is stored as
rest of the energy that is used is determined fat.
by such factors as sex, activity level, weight, The goal for nutrition is to have a client in
body composition and age. an energy balance, consuming and burning an
Many clients will be interested in how to put equal amount of calories. Many studies now
on muscle while simultaneously reducing body suggest that the best way to achieve energy
fat—unfortunately, they often turn to diets balance is to spread the intake of calories evenly
where they dramatically over the course of the day by

The goal for nutrition is to have
lower total energy intake. a client in an energy balance, eating small, frequent meals,
This practice is actually consuming and burning an equal rather than three large meals
amount of calories.
counterproductive because separated by long time gaps.
they will burn into their lean body mass. This practice has been shown to have many
This will reduce their total muscle mass and benefits, including maintaining metabolic rate
decrease their metabolic rate, the rate at and blood sugar level, decreasing body fat and
which they burn calories. The result of a lower increasing lean body mass, and improving
metabolic rate is usually an increase in body performance. Additionally, energy deficits can
weight (from an increase in body fat) due to the be better managed or possibly eliminated by
body’s inability to effectively burn the calories spreading calorie intake evenly over the entire
that are consumed. Conversely, many people day. Problems caused by energy deficits, which
will turn to eating a high amount of protein; can be most evident early in the day or after
however, a high-protein diet does not amount intense training, include the following: an
to more muscle mass because muscles are inability to maintain energy stores (affecting
unable to store excess protein. Additionally, endurance), an inability to maintain lean
243
muscle mass and metabolic rate, and an form of glycogen) in the muscles and liver.
increased risk of injury due to both muscle A client should avoid meals high in fat and
and mental fatigue. protein immediately prior to activity. If the
planned activity will be shorter than an hour,

Nutrition for Working Out
eating foods such as breads and pasta should
Not only is it important for a client to
be sufficient. However, if the activity will last
eat small frequent meals throughout the
longer than an hour, foods with lower glycemic
day that contain the correct proportion of
indexes, such as bananas and oatmeal, are
carbohydrates, protein and fats, it is also
recommended because they provide sustained
important to determine what a client will eat
energy.
before, during and after the workout. Although
For short workouts (less than 30 minutes), it
the timing and type of nutrition to suggest
is usually unnecessary for a client to eat during
to a client has been determined by science,
the activity. However, for light to moderate
all people are different
intensity exercise, most
and this regimen may It is important that a client eat before
participating in physical activity to people can tolerate small
take experimentation to maintain constant blood sugar levels
amounts of plain food and
determine what works for and prevent early fatigue.
this may increase their
each individual client.
performance. For activities lasting longer than
Although eating before a workout or
60 minutes, maintaining a sufficient fluid and
competition can cause stomach discomfort and
carbohydrate supply becomes a challenge.
diarrhea, it is important that a client eat before
For fluids, a client’s sweat loss should match
participating in physical activity to maintain
their fluid intake. To determine if fluids are
constant blood sugar levels and prevent early
being adequately replenished, weigh the
fatigue. Following a few guidelines can help
client before, during and after long, vigorous
eliminate any possible discomfort. First, a
workouts. Ingesting enough carbohydrates is
client should be consuming a low-fat, high
also important to maintain blood sugar levels
carbohydrate diet daily. This will help ensure
and ensure endurance for long workouts.
that there are adequate energy stores (in the
244
Every hour of endurance exercise requires Proper nutrition is extremely important for
approximately 100-300 carbohydrate calories a person’s health and performance. Although
or about 0.5-0.8 grams of the trainer and client should

Sample Label for
Macaroni and Cheese
carbohydrate per pound of body Nutrition Facts

Serving Size 1 cup (228g)
both be aware of what the client
Start Here Servings Per Container 2
weight. is eating, the process does not

Amount Per Serving
Calories 250 Calories from Fat 110

% Daily Value*
Total Fat 12g 18% Quick Guide
Limit these Saturated Fat 3g 15%
to % DV
The recovery diet is an often Nutrients Trans Fat 1.5g
Cholesterol 30mg 10%
5% or less
is low
have to be complex. The trainer
Sodium 470mg 20%
Total Carbohydrate 31g 10% 20% or more
Dietary Fiber 0g 0% is high
overlooked but extremely Sugars 5g
Protein 5g
can monitor the client’s eating
Get Enough Vitamin A 4%
of these Vitamin C 2%
important component of the Nutrients Calcium

Iron
20%
4%
habits for several weeks by
* Percent Daily Values are based on a 2,000 calorie diet.
Your Daily Values may be higher or lower depending on
your calorie needs:
client’s performance on days having the client keep a food

Calories: 2,000 2,500
Footnote Total Fat

Sat Fat
Less than
Less than
65g
20g
80g
25g
Cholesterol Less than 300mg 300mg
Sodium Less than 2,400mg 2,400mg
Total Carbohydrate 300g 375g
Dietary Fiber 25g 30g
following training. The priorities journal. Additionally, trainers
are carbohydrate and fluid replacement. After can help clients learn to read food labels to
exercise, a client should begin to immediately determine how many grams of carbohydrate,
replace fluid loss by drinking water (possibly fat and protein they are consuming per day.
sports drinks if severely dehydrated) and by It may also be helpful to suggest that clients
eating food with high buy a food scale so they

The recovery diet is an often
water content. After overlooked but extremely important can accurately measure
stopping the activity, component of the client’s performance serving sizes. After the
on days following training.
the first major intake trainer and client have
of food should be approximately no less determined a regimen for exercise nutrition,
than 15 minutes and no more than 2 hours. it will still require periodic adjustments to
It should consist of about 300 calories of ensure that the client is performing as well as
carbohydrate-rich foods such as bananas. It is possible.
also recommended that protein, such as that There are six essential classes of nutrients
provided by lean meats and low-fat milk, be a the body needs to function properly. The first
part of the recovery meal. Protein helps shuttle is carbohydrates, the body’s primary fuel
blood glucose to muscles to replenish glycogen sources. Fat is the second—despite popular
stores and is needed for cell and tissue repair belief, the body does need fat to transport
following a workout. vitamins A, D, E and K. The third class of
245
nutrients is proteins, which help to keep milk, for instance, the galactose is absorbed
our bodies supplied with the eight essential and transported to the liver where enzymes
amino acids. The next is vitamins. Vitamins in the liver convert galactose (or any other
work as coenzymes to aid the many enzymatic carbohydrate) into glucose for the body to use.
processes occurring in the body at any given Any excess glucose is converted into glycogen,
moment. The fifth is minerals, such as zinc which is the storage molecule made from
and iron, which function as cofactors for many glucose. Glycogen is stored in the liver. When the
biological processes. Without iron, the body body needs it, the liver converts the glycogen
could not transport oxygen to any tissues. back to glucose for use. For any active person,
The last but not least is water. The body needs carbohydrates are the number one source of
water, plain and simple. energy because they are the metabolized the
fastest. Fat is the slowest to be metabolized and

Carbohydrates
protein is somewhere in the middle; therefore a
Carbohydrates are chains of sugars held
good balance of all three is necessary.
together by chemical bonds. Sugars are also
Carbohydrates have received
known as saccharides. There are
HO a bad reputation in recent years
five monosaccharides, or single
HO
HO
O
HO
OH OHO O
HO
a1.6 bond
due to diets such as the Atkins
sugars,thatarethebuildingblocks
O
OHO
OH
O
OH O HO O HO O
and South Beach Diet. However,

O
HO
O
OHO OHO OHO O
OHO OH OH OH
OH
for carbohydrates. Three of the

HO
OH
HO a1.4 bond
O O
not all carbohydrates are bad,

OH
HO
HO
O
best-known monosaccharides
O
OH
and a good understanding of

OH HO
O
are: glucose, fructose and

this is key to any client who is
galactose (milk sugar). The body
trying to improve overall health.
can absorb several different
Carbohydrates are more than just
types of monosaccharides and
sugar.Complexcarbohydrateslike
disaccharides (simple sugars
the fiber found in fruits, vegetables, cereals and
made up of two monosaccharides, like sucrose
whole grains are important energy sources for
and lactose); however, it can only use glucose
the body. Fiber is also important for maintaining
as a form of energy. When someone drinks
246
the health and function of the digestive system as
Recommended Carbohydrate
well as for weight control. Trainers should make
Intake
sure clients fully understand food groups and
A food pyramid shows that the suggested
classifications before they start omitting food
foundation for any dietary plan is
items from their diets. A good understanding of
carbohydrates. In general, the abundance of
food labels is important.
calories should come from carbohydrates.
So what is the difference between simple
carbohydrates and complex carbohydrates? My

Food
The term complex carbohydrate simply Pyramid
Fa
ts
Fa
ts
means that the source is primarily made
Steps
Me
from monosaccharides, disaccharides or
lk
Mi
ats
To
s
polysaccharides. In general, monosaccharides
ble
A
Fru
eta
its
g
Ve
Healthy
and disaccharides are considered simple. An
Gr
ain
ain
Body
Gr
s
example of a simple carbohydrate would be
a soda, which is made from high fructose corn Dietary guidelines currently recommend
syrup (fructose is a monosaccharide). Breads that 40-60% of daily calories come from
made from bleached flour are also considered carbohydrates—for an active person, 60% is
simple carbohydrates. Care should be taken with probably best. Carbohydrates are the main
wheat bread: if the labeling does not state 100% fuel of muscles. Many people think that
whole wheat or other whole grains, it is not a increasing the amount of protein will increase
complex carbohydrate and therefore no better their muscle size. Protein is important after a
than white bread. An apple is also a complex strenuous workout because the amino acids
carbohydrate. It has fructose (or fruit sugar), in protein are used to help repair and renew
but it is plant material that contains cellulose, muscles; however, during a workout, the body
which is a polysaccharide. Vegetables are is using carbohydrates for fuel.
polysaccharides and thus considered complex. Of course, exercise physiology is not that
simple, as fat is also being used at low levels
247
during training. In reality, a combination of Potatoes, for example, are considered more
fat and carbohydrates are used during any of a starch (carbohydrate) than a vegetable.
workout. While carbohydrates are used to Broccoli is another vegetable, but its
fuel the body when the body is at work, fat carbohydrates come from its high content of
is the main source of fuel when the body is cellulose. The body lacks the enzyme to break
at rest or during low levels of exercise. The down cellulose, making broccoli a good source
problem is that most American diets contain of fiber and low in calories. We cannot digest
an overabundance of fat. A person should the majority of the vegetable, but we get many
be eating 200-300 grams of carbohydrates nutrients in the form of vitamins and minerals;
based on a 2000 calories/day diet. There are therefore, broccoli is a high-density food for
4 calories in every gram of carbohydrate or this reason.
protein, and there are 9 calories per every While it is not bad to occasionally eat a candy
gram of fat. bar, the majority of carbohydrate calories
should come from foods that are nutritionally

Types of Carbohydrates
dense. A personal trainer will be asked all
Not surprisingly, a candy bar, which is mostly
sorts of questions regarding health, fitness
sugar and fat, is not the same as an apple or
and nutrition, so it is important
an orange. The fruit is more
to have an understanding of the
nutritionally dense because, The body lacks the enzyme
to break down cellulose. basics of nutrition. Most people
while it also has sugar, it has
trying to lose weight want to
fiber and vitamins that are
omit food groups or extremely limit an entire
also good for the body. If an individual is just
nutrient class. The advice should be that fad
counting calories, some candy bars may seem
diets do not work in the long run. Instead,
similar to some fruits. A banana, for example,
clients should educate themselves on the six
is a high carbohydrate fruit and may have the
classes of nutrients the body needs for proper
same calories as a candy bar, but the banana is
function. It is very important when trying to
more nutritious. Vegetables contain very little
achieve or maintain a healthy standard of
sugar but can still be high in carbohydrates.
248
living to include maintaining proper weight after a meal of mostly simple carbohydrates.
and muscle mass. This is believed to happen because digestion

GI occurs so fast that the result is a huge spike in
Classification Range Examples
most fruit and vegetables insulin, which is responsible for transporting
(except potatoes, water-
55 or less melon), grainy breads, pasta, glucose into the cells. A huge sugar spike means
Low GI legumes/pulses, milk, products
extremely low in carbohydrates
(fish, eggs, meat, nuts, oils) a “crash” will follow, leaving the individual
whole wheat products, brown
Medium GI 56-69 rice, basmati rice, orange feeling sluggish. This is also believed to be
sweet potato, table sugar
corn flakes, baked potato, one of the leading causes in type II diabetes.
watermelon, some white rices
High GI 70-99 (e.g., jasmine), croissant, white A person eating in this fashion is constantly
bread, candy, cereal
100 straight glucose cycling between this spiked insulin and then
Most people have heard about the glycemic a huge drop. The cells stop responding to the
index and personal trainers are undoubtedly insulin stimulus and stop letting the glucose
going to be asked about it by clients. The from the high carbohydrate meals into the
glycemic index is a ranking cells. The result is high glucose

A huge sugar spike means a
of carbohydrates based “crash” will follow, leaving the in the blood, also known as
individual feeling sluggish.
on their simplicity; simple diabetes. Type II diabetes is
carbohydrates have a higher GI and vice versa. different than type I because, in type I, there
When a person consumes a carbohydrate- is a defect in the production of insulin—this
rich meal, digestive enzymes break down is usually a genetic defect and has nothing to
the carbohydrates starting in the mouth. do with how the person eats. This is also why
Digestion continues in the stomach; however, type II diabetes is a gradual process: it takes
the majority of carbohydrate digestion occurs time for the cells to finally stop responding.
in the small intestines. The glycemic index was designed to help
The simpler the sugar, the easier and faster reduce type II diabetes by giving people a
the breakdown of that carbohydrate is going means to label a food as either a good or
to occur. The idea behind simple sugars being bad carbohydrate. The lower the GI for a
“bad” derives from studies showing a “crash” particular food, the better it is because the
249
insulin released will be gradual since the body caffeinated and carbonated drinks on workout
will take longer to break down a complex days. Studies have shown that for every hour
carbohydrate than a simple carbohydrate. A of endurance workout (cardio), a person needs
personal trainer should also advise a client 100-300 carbohydrate calories. Trainers
that no foods need to be totally eliminated. should recommend that, approximately three
Once a food is omitted, it becomes that much hours before clients work out, they should eat a
more alluring. Clients should allow themselves high carbohydrate meal equivalent to what will
to still enjoy an occasional ice cream or candy, be needed for their workout. They can have a
just not every day. A dietary plan followed 60- small snack right before, such as crackers and
70% of the time is still successful. Many clients juice, if they like. Preferably, some of the meal
will think if they “cheat” on should come from foods with

A personal trainer should also
their diet one day, there is no advise a client that no foods a low glycemic index, which
need to be totally eliminated.
use working out or following will keep them feeling fuller
the plan for the rest of the day. This is not the longer and help to avoid any “crashing” due to
case so trainers should advise them to forget insulin spiking. After their workout, trainers
the slip-up and keep moving forward. One may want to suggest a slightly higher protein
Friday night binge or skipped workout is not meal to help repair any muscle damage from
failure. Trainers need to keep clients, as well their session. On non-workout days, they
as themselves, positive. should try to stay within their recommended
caloric intake; 40-60% of their daily calories

Carbohydrates for Working Out
should be coming from carbohydrates.
As already stated, an extremely athletic
person should be consuming 60% of calories Alcohol as a Carbohydrate?

from carbohydrates. Fluids are also important Many people enjoy a beer or wine at the
in order to stay hydrated throughout the end of their day to help them relax. Clients
day; however, clients should try to not drink may wonder if this is hurting or slowing their
copious amount of water a few hours before or progress or how alcohol factors into their
during their workout. They should try to avoid daily caloric intake and overall nutrition.
250
Contrary to popular belief, alcohol is not companies have tried decreasing the amount
a carbohydrate. It contains carbohydrates of carbohydrates in beer in order to lower
because it is generated from various grains calories without lowering alcohol content.
which are themselves carbohydrates. However, The focus on lowering carbohydrates has
there are very few residual carbohydrates left given the general public the impression that
over from the processes of making alcohol. alcohol is a carbohydrate, while in actuality it
To be more specific, beer and wine are made has more calories than carbohydrates and is
through a process of fermentation so these not a carbohydrate. If trainers are asked this
types of alcohol contain a small amount of question, the response to give is that alcohol
carbohydrates. However, liquor such as whiskey is not a carbohydrate nor is it converted into
or vodka is made from a distillation process a carbohydrate, and it has more calories than
which leaves nothing but the ethanol. Another a carbohydrate. Another important fact about
important aspect of alcohol is Alcohol has more calories alcohol is that it is a diuretic,
that despite what most people than carbohydrates and which means that it blocks
is not a carbohydrate.
hear, the breakdown products the hormone responsible for
are not sugar. When alcohol of any sort is keeping water in the body and will cause the
consumed, it is metabolized in the liver by person to excrete more urine than normal.
an enzyme called alcohol dehydrogenase, Also, alcoholic drinks are often laden with
and that enzyme breaks alcohol down into a sugary mixtures, such as margaritas and
chemical called acetate. Acetate is not a sugar daiquiris, that are high in simple sugars and
and thus not a carbohydrate. that are essentially empty calories. Beer or
Alcohol does have a lot of calories. Next to wine is a much better alternative.
fat, it has the most: 7 calories for every gram of

Fats
alcohol. If a person is trying to lose weight, it is
Fats, or lipids as they are commonly referred
important to decrease the amount of alcohol
to in nutritional circles, are an important part
because it is very calorie dense but provides
of the diet. It is essential that personal trainers
virtually no nutritional value. This is why beer
and clients understand the role of particular
251
fats in the body in order to include them in the provide over double the amount of calories per
diet in the most beneficial way. Many people gram than protein or carbohydrates; 9 calories
have either a fear of eating fat and avoid it versus 4 calories. Because fats are so energy
altogether or a misguided belief that athletes dense, they should be eaten wisely. When
can benefit from a high-fat diet for increased calorie requirements for a person increase,
performance. It is generally accepted that as they do during a training schedule, their
neither a very low fat nor a very high fat diet fat requirement also increases. It is advisable
is ultimately beneficial for active individuals. to make sure that when food consumption
A balanced diet with between 25-30% of a is increased in order to increase calories, fat
person’s daily calories coming from fat is ideal intake stays in the same ratio. High-fat, low-
for maintaining a healthy weight, keeping carbohydrate diets, which are very popular
up bodily energy levels among people currently,

A balanced diet with between
and maintaining metabolic 25-30% of a person‘s daily calories are generally thought to be
coming from fat is ideal for
functions. Those who aim inappropriate for athletes
maintaining a healthy weight.
to lose body fat as part of seeking to increase their
their workout goals may restrict fats to as low energy output because of the potential to starve
as about 10% of their daily calories; however, the body of energy from carbohydrates.
limiting one’s intake to lower than this is not It is important to understand the role of
advisable due to the important role of fats in fats in the transportation of vitamins around
the body. the body. Many essential vitamins cannot
be utilized by the body without the fats that

The Role of Fats in the Body
provide the medium for them to enter the
Most athletes understand that the body
body’s cells. Physically active adults will often
relies primarily on carbohydrates as an
gain benefits from carefully supplementing
immediate source of energy. Fats, however, are
with fat-soluble vitamins (A, D, E and K) and
also very important in the release of energy
essential fatty acids. These vitamins act as
to the muscles of the body. They are the most
anti-oxidants, helping to repair the damaged
concentrated energy source in the body and
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cells and tissue in the body that are a normal break down can also help prevent people from
result of working out. Healthy fats in the diet overeating.
ensure that these vitamins are of the most The cells that make up all of the body’s
benefit to clients. organs and tissues, including the muscles,
Hormones are extremely important require fats to help send and receive signals
chemicals in the body. They regulate many from other cells. This is especially important
different body systems and have a large effect in the brain, where fatty acid chains assist
on energy levels and the building of muscle messages to cross synapses as the neurons
tissue. In order for the body to manufacture fire. New studies also stress the importance of
these important regulatory “brown fat” in signaling cells
hormones, it must have fats. The cells that make up all of the to create muscle tissue, which
body’s organs and tissues,
Fats form the precursors, or including the muscles, require is essential for the human
fats to help send and receive
first steps, that allow the body signals from other cells. body and especially those of
to make what it needs. athletes.
Nerve fibers in the body transmit messages A complex mixture of nutrients, minerals and
to muscles and organs via electrical impulses. vitamins must pass in and out of cells through
Fats are used by the body to compose a myelin the cell membranes in order to be used by the
sheath which coats these nerve fibers and body. Lipid molecules are able to control this
allows the messages to move around the body process, ensuring the body is able to extract
without difficulty. what it needs for optimal functioning from the
Many people who make the loss of body fat foods eaten.
a goal of their exercise program may complain Fats not only act as a physical buffer for the
that they do not feel full or satisfied after a well- organs, protecting them if the body suffers a
balanced meal. Fats play a role in helping to blow or a fall, but more importantly, they form
provide this feeling. They stay in the stomach a kind of barrier around the organs, protecting
longer and therefore create the sense of feeling them from disease organisms and toxins until
fuller for a longer period of time. The ability they can be removed from the body.
of the fat molecule to require a longer time to
253
Fish oil supplements are readily available for
Types of Fats
those who find it difficult or unpalatable to eat
Fat molecules are referred to as fatty
fish once or twice a week as recommended
acids. They are essentially long chains of
to meet the body’s need for EPA and DHA
hydrocarbons (longer than a typical acid)
omega-3 fatty acids.
with a carboxyl group on the end. There are
many different kinds of fatty acids that vary Triglycerides

slightly in the numbers and composition of The “normal” fats that we eat are composed
their hydrocarbons. of three fatty acid chains bonded together with

H
H
glycerol. These are known as triglycerides
and an excess of these molecules can cause

OH H
A free fatty acid
H H
HO
Cholesterol fatty build up around the body. The types

H
A triglyceride
of fatty acids that make up these molecules
P
determine the properties of the particular
HO N*
H
A phospholipid
fats. For example, whether a fat is a solid or a
Some of the most beneficial types of fats liquid at room temperature or whether or not
are known collectively as omega-3 fatty acids. it saturates, is determined by the particular
These fatty acids assist in brain function acid chains that make up the triglycerides.
and are important for the health of the heart Some studies show that an increased intake
and the joints. There are three main types of of medium-chain triglycerides (MCT) may be
omega-3 fatty acids: Docosahexaenoic acid a good way for athletes to positively increase
(DHA), Eicosapentaenoic acid (EPA) and their caloric intake, but these studies are not
Alpha-linolenic acid (ALA). conclusive.
EPA and DHA are found primarily in fatty

Unsaturated Fats
fish like sardines and salmon, while ALA is
These fats have certain hydrogen atoms
commonly found in vegetable oils, avocados
missing from their carbon/hydrogen chains,
and walnuts. The body converts ALA to EPA
forcing the carbons to make a double bond.
and DHA in order to use it for cellular functions.
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For this reason, these fats are liquid at room disease. Most studies conclude that eating less
temperature. Those with one double bond hydrogenated fats will likely decrease LDL
are referred to as mono-unsaturated fats. levels. Many prepared foods, like cakes and
Examples are olive oil and canola oil. Fats chips, are made with trans fats because they
with double carbon bonds are referred to are inexpensive to use in the processing of
as poly-unsaturated. Many researchers foods.
and nutritionists recommend that mono-

Saturated Fats
unsaturates should make up a large
These fats have every bond filled with a
proportion of the fats consumed by a healthy,
hydrogen atom and are, therefore, termed
active person. It should be noted, however,
“saturated” or “filled up.” They are solid
that current research shows that unsaturated
at room temperature and have received
fats should not be heated, as this changes the
considerable negative attention because
properties of the oil and makes them act more
of the link between their consumption and
like a trans fat in the body.
increased blood cholesterol levels and heart
Trans Fats disease. Because they are both saturated
Trans fats refer to a group of unsaturated fats and solid, they are more likely to deposit in
that are normally liquid at room temperature the walls of the arteries, creating blockages.
but have been “hydrogenated” Recent studies have shown,

Trans fats are difficult for
in order to make them solid. however, that because of their
the body to metabolize and
This process is used, for are associated with health chemical composition, these
problems like high cholesterol
example, to turn vegetable and heart disease. fats may not be as bad for the
oils into margarine. The body as originally thought
fat is heated to a high temperature to break and cooking with butter, a saturated fat, is
the double bonds and attach hydrogen to now preferred over margarine among many
them. Trans fats are difficult for the body to nutrition scientists. Although eating butter
metabolize and are associated with health and other saturated fats, such as those found
problems like high cholesterol and heart in red meats, should be limited, these fats are
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currently preferred by health professionals cholesterol levels have been linked to heart
over trans fats. Part of the reason is that the disease in many individuals. Raising levels of
molecules that form a saturated fat are more “good” cholesterol, or HDL, in the blood can
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
easily recognized and processed by the body help to lower the LDL. Foods that raise HDL
than the physically-altered molecules of trans cholesterol include those high in omega-3
fats. fatty acids, high-fiber foods like oat bran and
lentils, and oils like olive oil and canola oil.

Cholesterol
The amount of cholesterol and fat found in Problems with Fats
people’s diets is directly related to the amount
Metabolic Syndrome
of cholesterol circulating in their blood.
This is a group of symptoms that includes
Studies have shown that eating foods high in
obesity, insulin resistance and cardiovascular
saturated fats (e.g., butter) or trans fats (e.g.,
problems. Overeating in general and eating
margarine) increase the amount of “bad”
a diet high in saturated or trans fats can
cholesterol, or LDL, in the blood. High LDL
contribute to this syndrome. A simple way to
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help protect against this combination of health factors all play a role in storing excess fat in
problems is to keep the polyunsaturated/ the body is important when making dietary
saturated fat ratio of the diet in a healthy and exercise recommendations.
range. Balancing fats with carbohydrates and

Insulin Resistance
protein, as well as eating plenty of fiber, can
Insulin resistance is a condition that
also protect against developing this deadly
increases a person’s risk of developing diabetes
combination.
or heart disease. Storing excess fat increases a
Obesity person’s risk of developing insulin resistance
Fat molecules in excess of what is needed because fat in the body interferes with the
by the body form large droplets, or globules, ability of the muscles to use insulin properly.
that clump together and Studies suggest that there is a

Consuming more than 30%
form adipose tissue, or of calories from fat slows clear connection between excess
metabolism and contributes
white fat. This fat collects to the depositing of dietary fat and the inability to use insulin
in the body’s “problem fat in stores in the body. properly.
areas” and it is difficult for

Heart Disease
the body to burn these fatty deposits because
Saturated fats have long been connected to
they are not well supplied with blood, which
problems with heart muscle function. Arteries
carries the hormones that assist in the process
that supply the heart with blood become
of burning white fat.
hardened and clogged from the build-up of
Consuming more than 30% of calories
fats, which negatively affects their ability
from fat slows metabolism and contributes
to function properly. High LDL cholesterol
to the depositing of dietary fat in stores in
levels, as well as the stress on the heart from
the body. Obesity is not simply a result of
supplying excess body tissue with blood, can
the overconsumption of fat. There are many
also contribute to problems with proper heart
environmental, physical and social factors
functioning.
that contribute to a person’s likelihood of
becoming obese. Understanding that these
257
Fat Requirements Protein
Different people have different fat Proteins are large molecules made up of
requirements. Those who have high cholesterol, individual amino acids linked together by a
who are obese or who are suffering from other peptide bond, similar to pearls on a necklace.
conditions, such as high blood pressure or heart The amino acids are arranged in a
disease, will need to pay very careful attention specific sequence that folds into particular
to the types of fats they eat to best control 3-dimensional structures to yield a specific
their conditions. Most people can benefit functional protein. Proteins have a number
from a diet lower in saturated fat and higher of functions in the body, including building
in unsaturated fat, with care taken to avoid and repairing tissue, synthesizing hormones
partially hydrogenated oils and other enzymes and

Primary Protein Structure
or trans fats and attention functioning as an energy

is sequence of a chain of amino acids
given to include good Amino Acids

source for the body in
Phe
sources of omega-3 fatty Amino Group

Leu
Ser
Cys
the event of insufficient
NH2
acids. A good way to avoid H C

R
COOH
Acidic
Carboxyl
carbohydrate levels. Good
Group
R Group
the consumption of “bad” sources of protein include

Amino Acid
and unwanted fats is to avoid processed and meats, eggs, legumes, nuts and dairy products
prepared foods. If clients prepare their own such as low-fat milk and cheese.
foods, they will be better able to control the There are 20 different amino acids and they
type and amount of fats they ingest. Fats are can be divided into two main classes: essential
an important component of a healthy diet and and non-essential. Essential amino acids are
essential to an active and optimally-functioning those that cannot be synthesized by the body
metabolism. It is not necessary to be obsessed and must be obtained by food or supplements.
with fat consumption but understanding the These include leucine, isoleucine, valine,
functions of fat in the body will help personal lysine, threonine, tryptophan, methionine,
trainers better advise clients about their phenylalanine, histidine and arginine. The last
individual dietary needs. two amino acids are termed semi-essential as
258
they are produced at levels too low to sustain begin to break the peptide bonds between
growth, especially in children. The non- the amino acids, releasing short polypeptide
essential amino acids are alanine, asparagine, (protein) chains and individual amino acids.
aspartic acid, cysteine, glutamic acid, glycine, In the small intestines, the polypeptides are
proline, serine and tyrosine. These amino further broken into chains of two to three
acids are synthesized by the body in sufficient amino acids. The resulting dipeptides and
amounts using fats and carbohydrates as tripeptides are absorbed through the cells
building block precursors. lining the small intestines and are further cut
into individual amino acids which then enter

Protein Digestion
the bloodstream. They then travel to the liver
In order to build protein in the body, the
and other tissues for protein synthesis.
ingested protein must first be broken down
Not all protein-rich foods are able to
into its individual amino acids through the
equally satisfy the body’s need for amino
process of digestion. Where the amino acids
acids. When determining the quality of a
end up after digestion will depend on the needs
protein, physiologists examine the amino
of the body. If too little protein is consumed,
acid content, the digestibility of the protein
the body will begin to burn lean muscle mass.
and its bioavailability, as well as the ability of
Excess protein is not stored in the muscles
the body to incorporate that protein’s amino
for muscle building; it is instead converted to
acids into its own tissues. There are several
fat or carbohydrate and then stored, or it is
methods to determine these values, such as
excreted in urine.
Salivary the protein efficiency ratio
Digestion of proteins begins
Glands
(PER), which examines the

in the stomach where harsh
ability of the amino acids
The liver regulates the Protein digestion is begun in
distribution of amino acids the stomach by hydrochlorine
to the rest of the body. acid and the enzyme pepsin.
hydrochloric acid causes

Liver
to be incorporated into
the protein to denature or Absorbed amino acids
enter the blood and travel
to the liver.
Pancreas
Stomach Protein-digesting enzymes are
secreted from the pancreas
into the small intestine.
tissues by measuring muscle

unfold. This unfolding allows
Final digestion of dipeptides
and tripeptides to amino acids
The small intestine is the
major site of protein growth. However, the values
proteases (enzymes that cut
occurs inside the intestine. digestion.
A little amount of dietary

protein is lost in the
feces. were determined for lab
proteins) such as pepsin to
259
rats, which may have different amino acid who is not taking the supplement. However,
requirements than humans. excess protein is not stored for later use in the
Biological Value of Some Protein-Rich Foods

muscles; any unused amino acids
are stored as fat or are excreted
Biological
Met Phe
Value
+ + from the body. One advantage,
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 though, of consuming foods with a
Milk, human 1,1 1,4 1,0 1,0 1,1 1,6 1,0 1,0 0,9 0,95
high BV is that a person’s amino acid
Milk, cow 1,1 1,3 1,0 0,9 0,7 1,3 1,3 0,9 1,1 0,90
Muscle, beef 0,8 0,9 0,7 0,9 0,9 0,9 1,4 0,7 1,6 0,76
requirement can be met with less
Soybeans 1,0 0,9 0,8 0,8 0,6 1,3 1,1 1,0 1,4 0,75 total protein, thus a person may be
Rice 0,8 0,9 0,9 0,8 0,9 1,2 0,5 1,2 0,8 0,75
able to cut calories from his diet if the
Wheat 0,6 0,8 0,6 0,7 0,8 1,1 0,4 0,8 1,0 0,67
Potatoes 0,6 1,1 0,8 1,3 0,6 1,9 1,4 0,8 1,1 0,67
goal is to lose weight. Conversely, if
Oats 0,8 0,8 0,8 0,7 0,6 1,2 0,6 1,0 1,1 0,66 one consumes low-BV foods, more
Corn 1,0 1,7 0,8 0,7 1,1 0,5 0,4 1,0 1,0 0,60
protein will be needed to satisfy
Source: McGilvery, Biochemistry, 1970
the amino acid requirement. The
Historically, protein quality was determined
shortcomings of using BV is that it does not
by measuring the biological value (BV), which
include factors that affect digestion of protein
measures nitrogen incorporation from digested
and it measures the maximum potential of
proteins. Proteins with a higher BV score
amino acid incorporation and not an actual
contain a ratio of different amino acids that are
value.
most suited for the needs of the human body.
The current preferred method to determine
For example, a chicken egg has a BV of 94 while
protein quality is referred to as the protein
beef has a BV of 76. Unfortunately, BV content
digestibility corrected amino acid score, or
is an idea that is often misused, especially by
PDCAAS. This method determines the content
marketers of protein supplements. They try
of amino acids of certain proteins based on the
to sell the idea that if someone who is already
actual amino acid needs of children between
consuming adequate protein takes a high-
the ages of two and five (an age group that
BV supplement, then that person will build
is considered to be the most nutritionally-
muscle to a greater degree than someone
260
demanding). This method is not without its lean muscle mass from being consumed for
flaws. PDCAAS measures the amount of protein energy during long runs, which will have
present in feces and compares that to what an overall detrimental effect on endurance
is eaten. The result is the amount of protein abilities. Protein requirements increase
is utilized by the body. However, most of the as total energy or calorie intake decreases
protein that reaches the colon is consumed overall. When there is an insufficient supply
by bacteria and would not be present in the of carbohydrates available for energy, the
feces. According to measures by the PDCAAS body will instead use amino acids as its
method, it would appear that protein has been primary energy source. Additionally, children,
digested and used by the body, when in fact it pregnant and breastfeeding mothers and
has not. those recovering from trauma or surgery have
an increased need for protein in their diets.

Factors that Affect Protein
However, consuming too much protein if
Requirements
part of a high-calorie diet will cause the excess
The primary uses for amino acids in the body
protein to be stored as fat rather than used
are the anabolic processes, such as building
for muscle building. High-protein fad diets
muscle mass. Therefore, it is not surprising
that propose cutting down or eliminating
that athletes have a higher requirement for
carbohydrates as a way to
protein than a sedentary
Consuming too much protein lose weight can lead to the
population. Having a sufficient if part of a high-calorie diet
will cause the excess protein development of metabolic
supply of amino acids to be stored as fat rather than
ketosis that, if severe enough,
enhances protein synthesis used for muscle building.
can lead to coma and death.
for muscle building during
High protein diets have also been thought to
anaerobic activities and for muscle recovery
increase blood lipid levels and blood pressure,
and repair afterwards. Endurance athletes
which can increase the risk for cardiovascular
also have a need for increased protein intake.
disease. High protein diets may stress the
For example, marathoners may not want to
kidneys and, in extreme cases, this can lead
“bulk up,” but having extra protein prevents
261
to kidney failure. Additionally, high protein When we exercise we use many different
diets can lead to calcium loss from bones, muscles. Each muscle generates heat when in
which can be extremely dangerous for older, motion and that heat translates into an overall
female clients because it increases their risk higher body temperature. The body starts to
of osteoporosis. Although athletes and those perspire to regulate temperature. When we
individuals who regularly exercise need a sweat our body loses valuable nutrients that
slight increase in protein over the rest of the can increase the chance of muscle cramps and
population, it is important to stress a balanced injury. Replacing fluids throughout exercise
diet when advising clients on nutrition. Too is vital to productive training and overall
much of anything is not a good idea and that health. Sweat is mostly water but the other
also goes for protein. mineral content proportions can vary from
individual to individual. The minerals present

Proper Hydration
in sweat are: calcium, sodium, potassium,
The function of water in the human body
magnesium, and trace amounts of copper,
is extensive and should be repeatedly
iron, chromium, nickel,
emphasized to any athlete. Regulates body
Moistens tissues
temperature zinc and lead. The amount
Water makes up about 50% such as those in
the mouth, eyes
and nose Lubricates joints
of each is tied to how often
of a woman’s total body
the individual exercises and
weight and about 60% in
Protects body
organs and
to that individual’s ability
men. Water is responsible
Lessens the burden
tissues on the kidneys and
liver by flushing out
waste products to dissipate heat, which
for digestion, sweating Helps prevent
constipation
can depend on individual
to maintain temperature
Helps dissolve
minerals and
Carries nutrients
and oxygen to acclimation to climate.
regulation, lubricating other nutrients
to make them
cells
accessible to
the body The process of sweating
tissues and joints and is
is actually controlled
especially important for
in the brain. The skin is one receptor that
the elimination of waste. When adding extra
sends information to the brain but the
physical activity such as moderate exercise,
core temperature is the main catalyst that
the need for water grows.
262
stimulates sweating. Sweating is actually a concentrations of electrolytes in the blood.
twofold process. The sweat on skin evaporates, When training, the electrolyte level begins
cooling the skin, but the actual act of sweating to change because of loss via sweating. Each
cools the core temperature in the body. drop of sweat takes water and electrolytes
Replacing fluid lost through sweating is one out of the body. Replacing electrolytes is vital
of the most important elements of effective to hydration during exercise so that the body
training. It is important that has all the necessary tools to

Electrolytes carry electrical
hydration happens before, impulses, such as muscle communicate and regulate
contractions and nerve
during and after exercise. If temperature. Sports drinks
impulses, to other cells.
a client begins exercising in often contain electrolytes
a dehydrated state, it is impossible to catch such as potassium or sodium chloride and
up. To help avoid dehydration and its many have become a popular water replacement,
complications, drink 15 fluid ounces of water especially for elite athletes. Are sports drinks
or sports drinks 2 to 3 hours before exercising a more effective means of hydration?
and then 10 fluid ounces again 10-15 minutes

Sports Drinks vs. Water
prior to the activity.
Looking at the differences between sports
Electrolytes are positively and negatively
drinks and water can aid clients in the decision
charged ions. A common electrolyte is
as to which is a better choice for their hydration.
known as sodium chloride, which is table
Water is often free or low-cost, which makes it
salt. Other electrolytes are potassium,
a more cost-effective means of hydrating, but
calcium, magnesium, phosphate and sulfate.
the lack of flavor can make it a bit boring. This
Electrolytes have a vital function throughout
can be easily altered by adding lemon to water
the body. They carry electrical impulses,
or purchasing flavored water Sports drinks
such as muscle contractions and nerve
come in a variety of flavors that may tend to
impulses, to other cells. This function is most
prompt more drinking because the taste is
important to the heart, nerves and muscles.
more enjoyable. The real difference between
The kidneys are responsible for maintaining
sports drinks and water is the electrolyte
263
content. Sports drinks are formulated with
Signs of Dehydration
sodium, potassium and a healthy dose of
When individuals are not getting enough to
carbohydrates to enhance energy supply. The
drink, their body will begin to tell them through
sodium can also lift and maintain the sodium
a variety of symptoms. If these symptoms
balance in the blood, which will keep more fluid
are ignored, they can grow worse and, in the
in the system, whereas water will stimulate
worst case scenario dehydration, they can
the kidneys to turn on urine production.
lead to death. At the first sign of dehydration,
For a variety of reasons the sugar content
it is vital that any athlete stop, hydrate and
in sports drinks can be an issue for some
then gauge if activity should be continued. It
athletes. Luckily, manufacturers have begun
can be difficult to get enough fluid in or for the
to produce sugar free or low sugar sports
body to hydrate quickly enough for an athlete
drinks. Often the choice between sports
to continue. If an athlete is
drinks and water depends on
If an athlete is even moderately even moderately dehydrated
the individual and the type dehydrated it can take many
hours for them to consume it can take many hours for
of exercise or training being enough fluid to safely continue
them to consume enough
performed. Someone taking their training.
fluid to safely continue their
a brisk 30 minute walk will
training. The first signs of mild to moderate
do fine with a bottle of water, while an elite
dehydration are:
athlete vigorously training over a period of
• Sticky, dry mouth
hours will need the extra ingredients found
• Fatigue
in sports drinks to regulate electrolytes and
• Headache
enable necessary hydration without overdoing
• Lightheadedness or dizziness
it. For these intensely training athletes, often
• Muscle weakness
the best course of action is a combination of
At the first sign of these mild to moderate
sports drinks and water before, during and
dehydration symptoms, athletes should stop,
after their workout.
drink a sports drink and some water and
discontinue exercise. It is unlikely they will
264
be able to “catch up” their hydration level to they need to drink water, but during exercise it
safely continue training. Children have higher cannot be relied upon as an adequate reminder.
metabolic rates and require more fluid than Hydration must occur before, during and after
an adult, regardless of their smaller size. Their physical needs during training. In addition,
kidneys are not able to conserve fluid as well there is a condition called hyponatremia,
as their adult counterparts so they must be which is water intoxication. This condition
closely monitored to avoid dehydration. results in a dilution of salt or sodium in the
Severe dehydration symptoms include: body. Athletes may experience this if they
• Very dry mouth drink too much water without also drinking a
• Extreme thirst sports drink with necessary electrolytes. This
• Rapid heartbeat is the primary reason why sports drinks are an
• Confusion and irritability important addition to any training program.
• Sunken eyes A U.S. Army study found that “dehydration
• Cessation of sweating in excess of 2% of body weight consistently
• Fever impairs aerobic exercise performance.” This
In the most extreme, cases dehydration can study goes on to warn of the dangers of
cause fainting and unconsciousness. One of the hyponatremia from hyper -hydrating before,
best indicators of dehydration A U.S. Army study found that during or after exercise. Only
is urine color. Amber colored “dehydration in excess of 2% elite athletes with access to
of body weight consistently
or dark yellow urine is a impairs aerobic exercise qualified health professionals
performance.”
sign of dehydration. Clear or to monitor them should
light colored urine demonstrates adequate experiment with hydration levels at any kind
hydration. of extreme.
Thirst is a natural indicator to hydrate the

Hydration to Maximize Training
body but unfortunately it is not always the
Athletes who know how to fuel their bodies
best indicator. During normal daily activities
with nutrition and hydration are able to do
people can trust thirst to remind them when
more for longer periods of time. They will
265
begin to understand the level of hydration they every 15 minutes. The carbohydrate count of
need throughout their training. But a personal the sports drink should be no more than 8%.
trainer must emphasize the need for hydration A simple way to re-hydrate after exercise is to
on a daily basis and not just during exercise. weigh before and after training and then drink
Everyone benefits from adequate hydration 20 fluid ounces for every pound lost. Athletes
but an athlete who begins training with any need to replenish glycogen stores by ingesting
kind of hydration deficit will quickly learn that a 4-1 ratio of carbohydrates to protein within
it is difficult if not impossible to recover from 2 hours of training.
that deficit. A 2008 University of Connecticut study looked
The optimum level of hydration is the same at the effects of hydration and its connection
for every human being. Athletes, however, are to muscle damage. Studying different levels
unique: their ultimate level of hydration in physically

The carbohydrate count of
depends on the intensity of the sports drink should be compatible study participants
no more than 8%.
exercise or training, climate, showed that the optimal state
altitude and the conditioning of the athlete. of hydration to protect athletes from injury is
The American College of Sports Medicine an euhydrated state, or normal state of body
recommends that athletes who exercise for water content. They found that this allowed
60 minutes or more at high intensity include athletes to “maximize endogenous hormonal,
sports drinks in their regimen. The drink should mechanical and metabolic benefits.”
include approximately 100 calories per 8 While there is a school of thought that elite
ounces to meet athletes’ calorie needs. General athletes can “hyper-hydrate” before working
recommendations for athletes performing a out, most sports science experts are coming
moderate training or exercise session include to agree that an average athlete should start
drinking 20 fluid ounces about 3 hours before out at a normal hydration level, maintain it
exercise, 8 fluid ounces every 15 minutes throughout, and hydrate adequately to recover
throughout exercise and, if exercising for an for optimum results and safety.
hour or more, 8 fluid ounces of a sports drink
266
and training that will be performed to
Supplements
adequately choose the supplements that will
In an attempt to gain a competitive edge in
give the best results.
sports performance or to ensure the maximum
effect of sports training, people often resort Types of Supplements

to supplements. Supplementation is a legal Creatine
and popular way to support physically Creatine is a nitrogenous amine and natural
active individuals. Athletes seek means to dietary constituent of animal foods. It is
improve their performance beyond training normally found in animal flesh, especially
alone. Often, supplements are used to obtain those animals that are physically active.
adequate calorie intake, resynthesize energy Primary food sources of creatine are fish and
and increase tolerance in training. Other red meat; thus, vegetarians may have lower
major goals in using supplements are the use serum concentrations of creatine. Creatine
of energy efficiently with quick recovery and absorption is highest after carbohydrate intake.
the enhancement of physical Creatine is not an essential

Hundreds of dietary supplements
power or the ability to have been marketed in the form nutrient since adequate
of protein shakes, powders,
produce energy specifically amounts can be synthesized
energy bars and sports drinks.
for athletic performance. by the body. Normally,
Additionally, noncompetitive athletes and creatine is synthesized from the amino acids
fitness enthusiasts are turning to supplements methionine, glycine and arginine by the liver,
to lose weight, add muscle mass, prevent kidney and pancreas to be used anaerobically
injury, relieve pain and alleviate stress. as a fuel. Since only approximately 2 grams
Hundreds of dietary supplements have are needed for daily activities, it must be
been marketed in the form of protein shakes, constantly resynthesized for use because
powders, energy bars and sports drinks. only a limited amount of creatine is stored for
Certain supplements are beneficial to certain several seconds for activity.
people under certain circumstances so it is Creatine participates in the production and
important to determine the extent of exercise maintenance of ATP and therefore plays an
267
important role in cellular energy production. marked with high intensity. Benefits of
Creatine regenerates ATP in skeletal muscle in creatine may also be due to the person’s ability
the form of phosphocreatine (PCr). PCr gives to increase strength from harder training and
up its phosphate to facilitate ATP synthesis. maintain strength and power for repeated
Normally, the amount of ATP available for short-duration movements. If this is the case,
use by the muscle is very small so it must be creatine may not be beneficial for sedentary
made continuously. Creatine phosphate (CP) persons. Creatine supplements are used
is one of the three pathways used for the extensively in resistance-exercise training and
production of ATP by muscle fibers. The high- are marketed as a body-building and strength-
energy phosphate from CP is transferred to boosting aid. Resistance training is known
re-phosphorylate ATP from ADP by creatine to stress the ATP-CP energy system and it is
kinase. This rapid reaction is conducted in one the primary energy system for this type of
enzymatic step but is limited by the amount of training.
stored creatine or PCr in free muscle. The most common regimen for
Creatine is one of the most popular and supplementation follows a 2 phase cycle.
well-known supplements used by athletes. The first phase, or loading phase, consists of
Many professional sports teams taking about 20-25g/day for

Creatine is one of the
actually supply creatine to most popular and 5-10 days. After the loading
well-known supplements
their athletes. Supplementation phase, the maintenance phase
used by athletes.
is thought to elevate muscle is utilized to sustain a beneficial
creatine stores. Additionally, creatine increases amount in the body. The maintenance phase
the amount of water that each muscle cells is of variable length and usually consists
hold—thus it increases the size of the muscle of taking 2-5g/day. Intake of supplemental
and therefore power outputs. creatine can increase muscle creatine levels
Research has shown that creatine for several weeks. Only longer periods of
monohydrate supplementation may improve supplementation help in training and shorter
athletic performance in activities that are periods do not enhance exercise performance.
268
It is important to note that creatine has not been lead to imbalances in metabolism, so it is wise
thoroughly tested for safety so it may be wise to monitor usage of amino acid supplements.
to avoid usage of creatine supplementation Glutamine
if energy consumption is adequate. Creatine Glutamine is a 5-carbon compound with
supplements can be associated with weight two nitrogen groups. An amide derivative
gain so anyone taking them should be of the amino acid, glutamine, is converted to
advised. its natural form in tissues of the liver, brain,
Amino Acid Supplements kidney, skeletal muscle and intestine. Food
The 20 amino acids are the basic building sources include foods rich in protein, such
blocks for protein and therefore build cellular as milk and meat, and plant foods, such as
tissue. Each of these amino acids has unique spinach, parsley and cabbage.
metabolic properties in human physiology. Glutamine is the most common amino acid in
Amino acid supplements containing one muscle and plasma. It accounts for about 10%
or more amino acids are popular as sports of the amino acid content in muscle protein
enhancers. These amino acid supplements and upwards of 50% of the amino acids
have been promoted on the market with claims released from muscle during exercise stress.
that these products are more Glutamine provides nitrogen and

Glutamine is the most
rapidly digested and absorbed common amino acid in carbon molecules for synthesis
muscle and plasma.
than protein obtained from food. of macromolecules and energy
The claim is that amino acid supplements can production. It also neutralizes cortisol, a
inhibit muscle loss, maintain immune system steroid hormone that induces catabolism
function and promote glucose/glycogen and accompanies strenuous exercise. Under
metabolism. However, evidence for the athletic certain physiological conditions (e.g., injuries,
benefits of isolated amino acids is mixed. It has infections and extreme stress), glutamine
been found that large intakes of some single stores in the muscles can be depleted and
amino acids may interfere with absorption and supplementation becomes necessary to
269
maintain adequate concentrations in the body. decrease in body fat. Arginine is also thought
Lasting fatigue is often also associated with to be involved in several other physiological
low plasma glutamine levels. Glutamine is also areas of interest to athletes, including creatine
important for athletes in terms of recovery synthesis, release of insulin and removal of
and healing, and thus glutamine is considered toxic ammonia. Besides oral supplements,
an indispensable amino acid during stress. athletes often inject large amounts of arginine,
Glutamine supplements are currently which may cause a temporary rise in growth
available as L-glutamine and are in the hormone levels.
form of individual supplements or protein Branched-Chain Amino Acids (BCAA)
supplements. Usually, supplements are taken Branched-chain amino acids (BCAA)
several hours before or after food to prevent include leucine, isoleucine and valine. These
interaction with regular dietary amino acids. amino acids have been hypothesized to help
Arginine in resistance-training by
Besides oral supplements,
Arginine is a conditionally improving endurance exercise
athletes often inject large
essential amino acid and one amounts of arginine, which performance. BCAAs are
may cause a temporary rise in
of the most commonly used growth hormone levels. important nitrogen sources
amino acid supplements for for alanine, which is converted
sports training due to its postulated stimulatory to glucose as a fuel source. Importantly,
effects on human growth hormone (HGH) BCAAs compete with tryptophan for entry
production. Others hypothesize that arginine into the brain and can thus prevent fatigue.
stimulates the release of HGH by increasing The central fatigue hypothesis suggests that
upstream hormones that act on this endocrine an increase of serotonin in the brain impairs
pathway. It is well-known that this growth the function of the central nervous system
hormone produces anabolic effects, including during bouts of prolonged exercise and can
the stimulation of protein and nucleic acid then hinder sports performance. This increase
synthesis in the skeletal muscle. This also in serotonin synthesis is ultimately due to
leads to an increase in muscle mass and a the elevated levels of tryptophan, which is a
270
precursor of serotonin. Thus, hindering levels of training, one should not consume caffeine or
of tryptophan by BCAA is thought to prevent other stimulants for at least 30 minutes prior
the onset of fatigue. to exercise. Overstimulation with caffeine can
Caffeine cause insomnia, restlessness, anxiety, high
Caffeine is the most widely consumed blood pressure and headaches.
psychoactive drug used worldwide. Caffeine is Caffeine is believed to be useful in
a central nervous system stimulant and often improving endurance by increasing effective
increases both adrenaline and noradrenaline fat metabolism during exercise. It may also
concentration after ingestion. The main work by enhancing exercise capacity and
sources of caffeine are coffee, tea and cocoa recovery from fatigue if exhaustion normally
products. Additionally, it is contained in many ensues after 30-60 minutes, since this is when
energy drinks. there is a peak plasma concentration. This
The benefits of using caffeine as an ergogenic is especially true for exercises like cycling
aid is that it is inexpensive and has little to no and swimming. Caffeine can improve aerobic
adverse health effects. A high endurance during short-term,

The benefits of using caffeine
rate of tolerance is associated as an ergogenic aid is that it is extreme exercise, increase
inexpensive and has little to no
with caffeine usage, which fat oxidation and decrease
adverse health effects.
then leads to reduced dose the perception of pain, all
effects. More caffeine is then needed to get the which can allow for more intensity in athletic
same benefits as before. At high doses, caffeine performance. Recently, caffeine has been
can be used as a diuretic, which also increases shown to decrease plasma potassium levels.
the chance for dehydration. One should never This is important because during exercise,
increase the consumption of caffeine before potassium is transported out of muscle
exercise for this reason and because caffeine cells, leading to a decrease in muscular force
can increase heart rate. But if caffeine is output. For supplementation, caffeine can also
consumed normally, the same amount can be be obtained from herbal sources with high
ingested since adaptation of caffeine occurs. If content, like guarana and kola nut.
heart measurements are being taken as a part
271
Conjugated Linoleic Acid (CLA) Instead of long carbon chains like regular fats,
Conjugated linoleic acid (CLA) is the MCT oils have much shorter carbon chains
collective name given to a group of linoleic and can therefore be digested, transported
acids, the parent compound of the omega-6 and metabolized quicker and easier. Medium
group of unsaturated fatty acids. An isomer chain triglycerides are also not stored like
of linoleic acid, CLA is an essential fatty acid traditional fats but are directly used for energy
and must be provided in consumed food. It is through oxidation by the liver or in peripheral
mostly found in corn, sunflower, peanut and tissue. Additionally, MCT oils are metabolized
soy oils. The CLA used for supplements are more as a carbohydrate than as a fat, but have
from these oils but can also be found naturally a higher energy density.
in dairy products and beef. Supplements with MCT oils are used as
CLA is primarily marketed as a weight-loss muscle builders and as an energy source.
and muscle-building supplement. However, MCT oils are used to increase total intake of
there is no real clinical evidence to support calories in athletes who need high energy
CLA supplementation. Because of these effects, for sports performance. They are thought to
CLA is thought to prevent improve athletic performance

MCT oils are synthetically
muscle wasting and improves derived dietary fats processed because these oils can enter
from coconut oil.
body composition. The typical the mitochondria without
recommended dosage is 3-6 g/day. carnitine, unlike other fats and they also help
Medium Chain Triglycerides (MCT Oil) conserve muscle stores of carbohydrates.
Medium chain triglycerides or MCT oils, are Improvement in muscular development and
a class of lipids made from saturated fatty increases in the loss of body fat from enhanced
acids 6-12 carbons in length. MCT oils are metabolic rate are other benefits of MCT oils.
synthetically derived dietary fats processed Also hypothetically MCT can aid in recovery
from coconut oil. These oils were initially from injury by adding more calories that
formulated for people who were unable to spare lean muscle without becoming body fat
digest regular fat since they are less viscous. if excess fat is ingested. If taken, doses should
272
be monitored because large amounts may be liquor is okay, as long as it is not the bulk of
associated with gastrointestinal disturbances their calories and not consumed on a daily
like intestinal cramping. basis.
Fats are also an important part of the

Summary
daily diet. They serve many functions in the
In summary, the majority of a person’s
body, including allowing vitamins to move
calories should come from carbohydrates. Your
throughout the cells, protecting nerve fibers,
client should be aware that the best sources of
providing the building blocks for hormones
carbohydrates are fruits and vegetables, which
and supplying a concentrated source of
also contain vitamins and minerals. Simple
energy. About 30% of a healthy person’s daily
sugars, such as table sugar or high fructose corn
calories should come from fat. Following a
syrup, should be avoided. Clients should eat a
fat-restricted diet (less than 10% of daily
high-carbohydrate meal with a good variety
calories) can lead to problems with the body’s
of complex carbohydrates approximately 3
metabolic functioning. Too much fat in the
hours prior to a workout and then consume
diet (more than 35% of daily calories) can
an additional small snack of crackers right
also cause problems, such as increasing the
before the workout. A follow-up meal higher
chances of obesity and heart disease. Lipids
in protein after the workout is important to
are composed of long acid-chain molecules
provide the necessary amino acids to help
bonded together to form different kinds of fats.
repair and refresh the muscles. The glycemic
Unsaturated fats, like olive oil, are generally
index is a good reference for those concerned
better for the body’s health. Saturated fats,
with eating too many carbohydrates. Personal
like butter, should be limited because of
trainers should never recommend that clients
their links with heart disease. Some fats, like
omit carbohydrates from their diet, not even
omega-3 fatty acids found in oily fish, can help
for a couple of weeks. The muscles rely on
the body function more optimally and reduce
carbohydrates to get the necessary glucose as
cholesterol and the chances of heart disease.
their fuel. Moderation is also good advice to
Other fats, like partially-hydrogenated oils or
give a client. Candy, ice cream or beer/wine/
273
trans fats, are detrimental to health because to lose weight, sugar free ones are the best
they raise cholesterol levels. Depending on option.
their current health status and their weight loss When clients feel their diet is not providing
goals, people have different fat requirements. enough nutrients, they may turn to
However, too little or too much fat—i.e., any supplements. While it is always best to attempt
extreme—is not advisable for most people. to get nutrition from food, it is sometimes
The proper addition of protein to the diet difficult and supplements can help fill in the
is yet another aspect of good nutrition. gaps. There are several types of supplements
Ingestion of protein provides the body with available and great care should be taken to
the amino acids it needs to perform several discuss the risks and benefits of the specific
bodily functions. Lean meats, eggs, nuts, dairy supplement a client is considering.
products and legumes are all good sources of Nutrition is very important for any active
protein and should be incorporated into every person. It is the body’s source of fuel—it is what
meal. However, clients should be informed that keeps people going, what supplies the energy
if too much protein is ingested, it will not be for everything they do. Good nutrition will
stored as protein and instead will be stored as maintain bodily functions, such as breathing,
fat. This fact is often unknown to clients who and internal processes, such as maintaining
are attempting to follow the popular high- heart and brain function, all of which require
protein, low-carbohydrate diets. energy. Just to stay alive, the body is equipped
Hydration is a crucial aspect of nutrition with a certain amount of calories it needs and
and must be maintained during workouts by this is dictated by hormones released from the
the intake of plenty of water. Sports drinks are thyroid gland. Maintaining proper nutrition is
usually an unnecessary source of calories and important in all aspects of good health. A good
sugar, which is fine for athletes training for balance between carbohydrates, protein and
hours vigorously but may inhibit weight loss fat will provide clients with the best possible
in clients trying to lose weight. If sports drinks nutrition, and trainers that learn about the
are preferred for hydrating clients that want most popular supplements can help advise
274
clients when certain elements are missing in 5. Eating hydrogenated fats can
their clients’ diets. _ __________________________________ LDL levels.
6. The current method to determine the

Review Questions
amount of protein in food is referred to as
1. The glycemic index is a ranking of
the PDCAAS. True/False ____________________
_ __________________ based on their simplicity.
7. When there is an insufficient supply of
2. Dietary guidelines currently recommend
carbohydrates available for energy, the
20-30% of your daily calories come from
body will instead use ________________________
carbohydrates. True or False? ______________
as its primary energy source.
3. Fat is necessary for the body in order to:
a) Sugar
a) Help us feel satiated
b) Amino acids
b) Transport vitamins A and D
c) Creatine
c) Protect nerve fibers
d) Fat
d) Form hormones
e) All of the above
e) All of the above
8. Creatine is an essential nutrient. True or
4. Fat is important as a bodily energy source
False?_ ________________________________________
because:
9. Caffeine can:
a) It is converted more efficiently than
a) Improve aerobic endurance during
carbohydrates
short-term, extreme exercise
b) It provides more than double the
b) Increase fat oxidation
calories per gram than other energy
c) Decrease the perception of pain
sources
d) Allow for more intensity in athletic
c) It can be eaten in unlimited quantities
performance
without excess storage
e) All of the above
d) It is the body’s primary source of
10. When should you advise your clients to
energy
hydrate? ______________________________________
e) All of the above
_ _______________________________________________
275
Grunewald KK, Bailey RS. Commercially
Answers
marketed supplements for bodybuilding
1. Carbohydrates.
athletes. Sports Medicine. 1993;15(2):90-
2. False.
103.
3. e) All of the above.
Hoffman JR, Falvo MJ. Protein-Which is
4. b) It provides more than double the calories
Best? Journal of Sports Science Medicine.
per gram than other energy sources.
2004;3:118-30.
5. Increase.
Hu FB, Willett WC. Optimal Diets for
6. True.
Prevention of Coronary Heart Disease.
7. b) Amino acids.
JAMA. 2002;288:2569-78.
8. False.
Jenkinson DM, Harbert AJ. Supplements
and sports. American Family Physician.
10. Before, during and after exercise.
2008;78(9):1039-46.
References Juhn M. Popular sports supplements
Bloomer RJ. The role of nutritional and ergogenic aids. Sports Medicine.
supplements in the prevention and 2003;33(12):921-39.
treatment of resistance exercise-induced Lattavo A, Kopperud A, Rogers PD. Creatine
skeletal muscle injury. Sports Medicine. and other supplements. Pediatric Clinics of
2007;37(6):519-32. North America. 2007;54(4):735-60.
Brosnan JT, Brosnan ME. Creatine: endogenous Lichtenstein AH, Kennedy E, Barrier P, Danford
metabolite, dietary and therapeutic D, Ernst ND, Grundy SM, Leveille GA, Van
supplement. Annual Review in Nutrition. Horn L, Williams CL, Booth SL. Dietary fat
2007;27:241-61. consumption and health. Nutrition Reviews.
Graham TE. Caffeine, coffee and ephedrine: 1998;56(5 Pt 2):S3-19.
impact on exercise performance and Montain SJ. Hydration recommendations for
metabolism. Canadian Journal of Applied sport. Current Sports Medicine Reports.
Physiology. 2001;26 Suppl:S103-19. 2008;7(4):187-92.
276
Mozaffarian D, Ascherio A, Hu FB, Stampfer MJ, Schaafsma G. The protein digestibility-
Willett WC, Siscovick DS, Rimm EB. Interplay corrected amino acid score. Journal of
between different polyunsaturated fatty Nutrition. 2000;130(7):1865S-67S.
acids and risk of coronary heart disease in Tseng YH, Kokkotou E, Schulz TJ, Huang TL,
men. Circulation. 2005;111:157-64. Winnay JN, Taniguchi CM, Tran TT, Suzuki
Paddon-Jones D, Borsheim E, Wolfe RR. R, Espinoza DO, Yamamoto Y, Ahrens MJ,
Potential ergogenic effects of arginine Dudley AT, Norris AW, Kulkarni RN, Kahn
and creatine supplementation. Journal CR. New role of bone morphogenetic
of Nutrition. 2004;134(10 Suppl):2888S- protein 7 in brown adipogenesis and energy
94S. expenditure. Nature. 2008;454:1000-04.
Persky AM, Rawson ES. Safety of creatine Yamamoto LM, Judelson DA, Farrell MJ, Lee
supplementation. Subcellular Biochemistry. EC, Armstrong LE, Casa DJ, Kraemer WJ,
2007;46:275-89. Volek JS, Maresh CM. Effects of hydration
Phillips GC. Glutamine: the nonessential amino state and resistance exercise on markers
acid for performance enhancement. Current of muscle damage. Journal of Strength and
Sports Medicine Reports. 2007;6(4):265- Conditioning Research. 2008;22(5):1387-
68. 93.
277
Chapter 10: Legal/Business
Topics Covered
Legal Issues
Slip and Fall
Equipment Usage
Supplements
Sexual Harassment
Personal Trainer Qualifications
Emergency Response
Confidentiality
Risk Management
Proper Education Expanding Your Business
Appropriate Training for Each Client Organizing Your Business
Limiting Liability Through Avoidance, The Business Plan
Retention, Reduction and Transfer The Budget
Proper Conduct Establishing Policies
Proper Training Area Clients
Documentation Advertisement
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
entering into the activities set forth by
A
Legal Issues
their trainers
s rewarding as it can be to
• Negligence—Failure to comply with
work as a personal trainer
known standards
and positively impact a client’s
• Waiver—A document signed by clients
health and fitness, there are
that they are knowingly participating
some legal issues to be considered. Personal
in activities that may cause them an
trainers must understand their role when
injury and that they are waiving
it comes to putting clients at
legal action should injury occur
risk for injury. Trainers have to
• Risk Management—Processes
do everything in their power to
in place to ensure the least
ensure their clients’ safety through
amount of harm will come to
proper technique and proper
clients. Essentially being proactive
spotting, by not overexerting them
by following safety procedures,
and by ensuring that the workout
properly informing clients
environment is safe. There are
of risk and having all proper
some legal terminologies trainer should know
documentation completed prior to any
and below is a list and a brief detail of their
activities
definition.
• Tort Law—Regulates civil wrong-
• Contract Law—Regulates laws that
doing
govern individuals who enter into a
Clients have a right to a safe environment
contract
whether their trainer is working for a fitness
• Duty of Care—The responsibility one
facility or independently. Ensuring the client‘s
has to protect another from harm,
safety is the trainer’s duty. Hazards must
especially in a service-oriented client
be taken care of or proper warning must be
relationship
given. Do not allow a client to workout with
• Informed Consent—Ensuring clients
faulty equipment. Personal trainers should
understand they are voluntarily
280
have a plan as to what workout EXERCISE MANUAL an unsafe situation. Last and
areas clients are going to be using, most importantly, trainer
so it is wise to make a routine of Your should use common sense.
checking that equipment prior to

Healthy Body Every year clients make
clients’ sessions. Make sure the legal claims against personal
area being used for a workout is trainers. This section will
clean of any liquids or hazards. briefly discuss some of these
In a fitness facility environment and how risk management
there are many potential hazards A Manual for your Mind and Body comes into play when trying to
which can harm a client. Make sure there are

T i p s o n e a t i n g h e a l t h y a n d
avoid these situations and, most importantly,
f e e l i n g y o u r b e s t !
no water bottles lying around that could be a avoid injury to clients. Below is the list of the
potential tripping hazard. Any fluid not cleaned most common claims against personal trainers,
up can also cause slippage as compiled by insurance companies:
of hands or a slip and fall.

Assess
Towels left behind can also Risk
lead to accidental injury. Monitor &

Plan
Policies &
Evaluate
Both the trainer and the Controls
client must be cautious of Implement

Safeguards
bodily fluids—left behind
towels can be a source

• Slip and Fall
of bacteria or infectious disease. If possible,
• Equipment Usage
sanitize equipment before a client uses it.
• Supplements
There are so many potential risks that a client
• Sexual Harassment
can encounter under a trainer’s supervision
• Proper Qualifications
that they cannot all be eliminated; however,
• Emergency Response
personal trainers that are aware of their duties
• Client Confidentiality
to ensure clients’ safety will quickly recognize
281
worn do not fit properly or are inappropriate
Slip and Fall
for working out, the trainer should bring
Slipping and falling
it to the client’s attention. Clothing that is
that led to injury
restrictive or too loose can also cause a slip
was the number
and fall, so once again, trainers need to make
one complaint of
the client aware. If a trainer deems a situation
clients against their
or environment unsafe, the trainer should not
personal trainer. As
continue because in the end, the trainer will
stated previously,
be held liable by the employer at the least
ensuring a safe environment is key to clients.
and also possibly by the client. Clients should
This can be accomplished by being diligent
be advised of requirements from day one of
about routines. When first starting out, it is
training: proper shoes and attire are a must.
easy to develop habits, so trainer must try to
Clients need to be informed that if compliance
make sure the habits developed are good ones.
is not met, their session cannot proceed for
Make it a habit to check a client‘s workout
their own safety.
environment prior to a session in order to
Another good habit for trainers to adopt is
decrease the chance that the client may have a
documenting a slip and fall immediately after
slip and fall incident. Obviously a fitness facility
the incident and writing down the
is very dynamic, but if a trainer
circumstances. As time passes and
has checked a client‘s areas
the story is retold, information
prior to use, any out of place
may be mistakenly added or taken
items should be very apparent
out. If trainers write details
as the workout progresses
down immediately, there is a
from station to station.
better chance at resolving the
Personal trainers need to
issue quickly. Most facilities
become very observant as part
have their own incident report documents
of their risk management technique. Review a
and trainer notes will help to put as much
client’s attire and if, for example, the shoes being
282
detail into the report as possible. Another a must. Instead of asking clients if they know
recommendation is that trainers log their how to use the equipment, trainers should
precheck of equipment with the date, time and take the initiative to just show them. This will
condition of the specific piece of equipment keep clients from stating incorrectly that they
checked. This may seem time consuming know how and give trainers the opportunity
and tedious, but it is better to have too much to demonstrate both proper setup and use of
information than not enough. the equipment.
Trainers need to periodically check and
document the equipment maintenance
record. They may want
to inform clients of this
documentation if they
feel it may be important.
Equipment Usage There are many pieces of
Improper use of equipment is the second equipment that trainer
most reported injury claim against personal and clients will use and
trainers. As such, personal trainers need to all situations cannot be covered, but the two
ensure clients know main safety rules for equipment usage are
how to use equipment proper set up and usage. It is also essential
before they begin a that all working equipment, whether it be
designated activity. resistance bands or high tech machines, be
Many times clients in good condition. All equipment should be
will say they know inspected for safety.
how to use a particular machine even though

Supplements
they have never used it. Fitness equipment
Supplement usage can be a sensitive subject
seems intuitive but, in reality, some of it is quite
for some people and will most likely depend
complicated to set up, and proper technique is
on the trainer’s own personal beliefs, as
283
there is no law governing what a own notes versus simply giving
personal trainer can recommend clients questionnaires to fill
or sell to a client in terms of out. Also, trainers should not
supplementation. As a general recommend supplements that
rule, it is not recommended that trainers sell they would not take themselves or that they
or advise clients on any supplement. With do not know what the active ingredients are
that being stated, some personal trainers sell and what they do.
supplements or the company There are also illegal

What is Ephedrine?
or fitness facility they work substances that are
Ephedra Dangers
for sells them. This aspect Side Effects
available for a clients,
Injury Cases
of personal training may be such as human growth
Lack of FDA Regulation
part of a job description. This hormone or anabolic
Deceptive Marketing
is where education regarding steroids. Trainers may get
Contact Lawyers
what is being sold becomes approached with inquiries
Heart Attack, Stroke
and Death Cases
of the utmost importance. about how to obtain such
There have been liability cases where items. We cannot stress enough for trainers not
personal trainers and the facilities they work to get involved in this area of supplementation,
for have been held accountable for selling as it is illegal and highly dangerous. Personal
supplements containing ephedra to a client. trainers should advocate a healthy road to
In one case, the client had hypertension fitness and stress the importance of hard
and, since ephedra raises blood pressure by work. Becoming fit
increasing heart rate, the client died. As stated is not an overnight
throughout this literature, it is absolutely process and a pill
essential that trainers take a detailed initial will not get a client
assessment that includes any chronic illnesses there. The fact that a
a client has and what medications are being client has sought out a personal trainer means
taken. Trainers need to be involved and take that client is ready to make the necessary
284
changes in daily life. These are the aspects not be afraid to ask this question. They should
that trainers should stress and they should do inform clients that, at times, touching may
everything in their power to deter someone be necessary and ask them how comfortable
from trying to obtain results through the use they are with this. Another aspect of sexual
of illegal substances. Again documentation harassment can develop when a trainer and
is key. Personal trainers should report any client develop a personal relationship. As
attempt at seeking these items to a supervisor; stated before, a personal trainer is sometimes
even if nothing comes of it, the trainer will be in an intimate situation with a client and
absolved of any wrongdoing. if a relationship develops, it is
unacceptable, inappropriate and

Sexual Harassment
unprofessional. Also, there may
Another sensitive subject is sexual
be certain backlashes once the
harassment. Personal trainers are
relationship ends. It is best to end
in intimate situations with clients.
the professional relationship if a
Some clients will understand this
personal relationship develops with
and others may misconstrue or be
a client. Most fitness facilities will
uncomfortable with the amount of
not tolerate this behavior.
touching that may occur. This was the third
Sexual harassment is a claim that often arises
highest claim made to insurance companies
because one person’s idea of what is acceptable
against personal trainers. Sexual harassment
is not the same as another person’s. It is hard
comes in all forms—male to female, male to
to prove and usually rests on the credibility of
male or female to female.
the persons involved. The best way to avoid
Some people are just
any incidence that can be perceived as sexual
not comfortable being
harassment is to not touch the client. Trainers
touched by an unfamiliar
can demonstrate to clients how particular
person. A good initial
maneuvers should be conducted by positioning
assessment can address
a “barrier” between the client and the trainer;
this; so trainers should
285
i.e., a trainer could “touch” personal trainers do not hold the credentials
the client with an object, advertised. Importantly, trainers should not
such as a ball. Trainer should overstate qualifications and should keep
also avoid private settings certifications handy, as it is the right of any
where the situation has only client who may ask to see credentials. People
the two parties as witnesses. pay for a service from trainers or providers
When doing body fat measurements, where on their behalf and they expect to get what
touching is required and expected, trainers they pay for. If a trainer is not certified and the
should have another personal trainer present facility is claiming that the trainer is, it is up to
and document who that person is in case the trainer to set the record straight because
there is any question later. Because sexual this is misrepresentation on behalf of both the
harassment is in the eyes of the person being facility and the trainer, and it is grounds for
“harassed,” the best thing to do is to leave legal action should a client wish to take it that
no question, which can be done by avoiding far.
touching. If spotting or touching is required, Another area regarding personal trainer
trainers can use a prop (e.g., a ball), to avoid qualifications is claiming to work with a
direct contact. specific demographic such as elderly people.
If a facility advertises this service and the

Personal Trainer Qualifications
personal trainer assigned to these clients
Personal trainer qualifications deal more
does not have the appropriate certifications
with a fitness facility than individual personal
to serve this population, the liability is put
trainers. Those reading this literature are
on the personal trainer. If a trainer wants to
on their way to becoming

work with a special needs
certified personal trainers.

Credentials group, such as the elderly or

Some clients will claim that This certifies that
John Doe those afflicted with arthritis,

a particular fitness facility has passed the Personal Trainer program.
07/08/09
the trainer needs to get the
staffs improperly certified Jane Smith B�� J��e�
Jane Smith

Bob Jones
proper training needed. The

personal trainers or that the
286
bottom line is for trainers not to overstate These are also certifications that a client
qualifications or allow their employers to has a right to ask about and see upon
overstate their credentials and to obtain any request. A trainer does not want to be in the
additional training required to serve special position of having to explain to a client and/
populations. or employer why certifications are not up
to date. Documentation is also important in

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

arises and the trainer should be familiar Confidentiality is one of the most important
with this procedure. CPR, first aid and AED aspects of personal training. A client is sharing
certifications must be renewed and trainer very personal information with a trainer
should keep track of when their certifications at any given time. It is up to the trainer to
expire so they can keep them up to date. maintain professionalism and not discuss or
287
When in Doubt...REPORT
Risk Management
IT!
HOME
Click Her e to Re p ort It! Risk management simply means the

P r o p e r r e p o r t i ng of t h e f a c t i s cr u c i a l wh i l e l e a v i n g o u t a n y
b i a s e d o p i n i o n s of t h e i n c i d e n t . Mo s t f ac i l i t i e s h a ve t h e i r own
i n t e r n a l f or m f o r i n c i d e n t r e p or t s, s o m ak e s u r e yo u
avoidance of liability in the event that
f a m i l i a r i ze yo u r s e l f w i t h t h em . I f yo u ar e a n i n d i vi d u a l
p e r s o n a l t r a i n e r n o t wo r k i ng f o r a f a c i l i t y, yo u c a n g e n e r at e
something goes wrong. There are certain
o n e of yo u r o wn t o k e e p o n h a n d i n c a se s o m et h i ng h a p p e ns .
S o m e t i m e t hr o ug h ou t yo u r p er s o n a l t r a in i n g c ar e e r yo u a r e
g o i ng t o b e f ac e d wi t h a n e m er g e n c y r es p o n s e s i t u at i o n a nd steps a personal trainer can follow to reduce

yo u m a y b e r eq u i r ed t o r e n d er l if e s a vi n g a i d t o a n
i n d i vi d u a l .
the chances of liability when some mishap
gossip about any information that is given in Four Elements of Risk Management
a professional setting. A client may be hesitant
to disclose details about a condition, which Plan

(what, when, how)
Monitor and
can hinder progress or cause injury. It is not Report
(know what’s
Assess
(identify and analyse)
happening)
necessary, but a trainer may want to become Handle

(mitigate the risk)
HIPAA compliant. HIPAA (Health Insurance
Portability & Accountability Act) is a 2003 law A continuous interlocked process—not an event
passed by Congress which states that health occurs. Despite taking as many precautions as
care professionals possible and following all the rules, accidents
are not allowed to will happen. Trainers are in a business of
release personal serving people. The fact that people will
health information get hurt and people will be unsatisfied is
of clients to third unavoidable. What steps can personal trainers
parties. While a trainer is not classified as a take or what risk management can be put into
health care professional, it is wise to let a client place that can protect them, their job and their
know that the trainer understands and abides certification when something bad happens?
by HIPAA. A client might then be more at ease Although this is not an enjoyable topic, it is
in disclosing any ailments or medications that important that a personal trainer understands
may affect training, which will help the trainer how to minimize liability.
tailor a more effective workout. A good initial Risk can be managed through:
assessment should include a confidentiality • Proper Education
agreement. • Appropriate Training for Each Client
288
• Limiting Liability Through Avoidance, the anterior cruciate ligament (ACL) is not
Retention, Reduction and Transfer good, but a good trainer knows where it is
• Proper Conduct located, what movements could result in its
• Proper Training Area injury and what tests are done to confirm any
• Documentation injury. Most clients will not have a clue about
anatomy and physiology, but they expect that

Proper Education
their personal trainer will. A wise move for a
Becoming a personal trainer only requires
trainer is to invest in a good anatomy book and
completing the certification process. If
study basic anatomical structure and typical
individuals are serious about personal
sports injuries.
Appropriate Training for Each

THE EXERCISE COUNCIL
THIS CERTIFICATE SHOWS THAT
Lucy Adams
has passed The Exercise Council’s certification program and is a
Client
Certified Personal Trainer
Certificate given this 9th day of July, 2009
Every client a personal trainer will have will
be different, so the trainer should tailor the

Ty Nelson
Ty Nelson, President
workout to the client. Knowing clients and
training, they will strive to obtain a higher their needs will greatly reduce their chances
degree in some sort of exercise physiology Build a Workout
area. The more education a trainer has, the

MEET T HE PERSON AL T R AI NERS CONT ACT US
Welcome To Build A Workout

less likely that trainer will make avoidable Click on a button below to begin building your new workout!
Beginner Workout
mistakes. Common sense indicates that diet Intermediate Workout
and exercise will gain fitness, so what is a

Advanced Workout
personal trainer bringing to the table? The Next Event >

Build a W orkout W orkshop.
more education a personal trainer has, the less

of injury and therefore will limit the trainer’s
likely any highly educated client is to question
liability. If a client has back problems, the
actions. A good understanding of anatomy and
trainer should avoid any exercises that could
physiology is extremely important. What are
further exacerbate the problem. Remember,
common injuries? Most people know tearing
289
not every problem is going to be physical. risks and protecting their job and certifications.
Some people have physiological or chronic Certifications are easy to initially obtain but
illnesses, such as high blood pressure or heart are usually difficult to reinstate, so personal
conditions. Again, it is a personal trainer’s job trainers want to protect their certifications as
to know this, and the trainer cannot make a much as possible. Liability can be limited by
client with heart problems run miles at a time. following four steps:
The personal trainer should make sure any • Avoidance
client who is under the care of a physician for • Retention
any condition has a signed release form from • Reduction RISK

that doctor stating it is okay to participate in • Transfer
a physical fitness routine. The bottom line is, Avoidance
take the time to personalize clients’ workouts Avoidance simply means to avoid any
to meet their needs. Trainers should not allow dangerous action that will lead to a raised
clients to do exercises that will exacerbate risk for injury. Undoubtedly, clients want to
any injury. Clients expect personal trainers be challenged and personal trainers want to
to remember things, so it may be a good idea provide this, but not at any cost. For example,
to review a new client’s information prior to maybe a client prefers outdoor activities
a session until the trainer becomes familiar versus a gym setting. While this is fine, a trainer
with the history. This practice will help the should not take a client cycling or running on
trainer to avoid making “dumb” mistakes that busy streets. Instead, the choice should be a
may lead to injury. park or designated path where there is less
likelihood injury.
Limiting Liability through
Retention
Avoidance, Retention, Reduction
Retention of clients is great way to avoid
and Transfer
liability because there is a sense of loyalty
Limiting liability is not meant to teach
felt by clients they have developed a good
tricks to avoid any wrong doing. It is meant to
professional relationship with their trainers.
increase client safety while reducing trainers’
290
Clients are less likely to pursue any action if in return, but it is peace of mind and the
trainers have retained them for an extended assurance of coverage for any mishap that
period of time. may occur.
Reduction
Proper Conduct
Within any profession, guidelines are
Behaving in a professional manner,
constantly changing and some are mandated
especially in a customer service field like
while others are not. Trainers
personal training, is a must.
are likely to be aware of some Professional
Conduct Having a crude sense of humor
mandates, but they should take Decisions
or making inappropriate jokes
the responsibility to keep up with
can lead to unwanted outcomes even though
all of them. Familiarizing oneself with annual
no harm is meant. The best practice of risk
changes will greatly reduce liability, especially
management is simply not to do it. Remember,
when changes affect more of the legal aspect of
sexual harassment is on a continuum, so what
personal training versus the practical aspect.
a trainer may deem appropriate may not be in
Transfer
the eyes of others and may leave the trainer
The most recommended way to transfer
having to offer an explanation in an awkward
legal liability is to obtain liability insurance.
situation. A trainer can also be on the receiving
This type of insurance requires a fee, which
end, which the trainer will want to report
provides trainers with services, just as with
and document and potentially end services
health or car insurance. Some of these services
with that individual. Most importantly, acting
include legal representation and any fines
professionally can greatly reduce the risk of
set forth by court proceedings. While annual
any reprimand.
costs will never exceed the annual liability, it
is well worth the cost should an event happen Proper Training Area
that requires paying a large amount of money As discussed earlier, a safe training area is the
if found liable. Just as with any insurance, personal trainer’s responsibility and checking
what goes in is not usually what comes back areas prior to training will decrease incidences
291
of injury. Also, if the trainer and client are injury, if the trainer
training in a non-traditional area, such as those properly annotated
not located in a fitness facility, the trainer must that the equipment
make sure the environment is appropriate. or the area was
Places like parks are an appropriate setting. checked and can show documentation of
Trainers do not want to take clients to a place that check, as well as proving a history of this
where they will feel uncomfortable. Trainers practice, the trainer is at much less risk. Most
should use good judgment and common sense, personal trainers will not take the time to
and they should also be cautious of settings check an area, let alone document their check,
that are too intimate or private. A fitness but trainers should make it a habit from day
facility is actually the best, most appropriate one. They should keep a small notebook with
place to train. Should a client request another the date, time and client number. It is wise
place, the trainer should use good judgment to never use names when writing informal
when agreeing, which will reduce liability for documentation. When trainers have to fill
any wrongdoing. Some employers will not out incident reports, they use as many details
allow off-site training, so the trainer needs to as possible, and they simply state facts, not
know the policy on this issue. opinions. Documentation is a good practice for
risk management because it allows a record
of events when they actually occurred. If an
individual is asked to recall something, even
the next day, key events are often forgotten.
Personal trainers should always document
anything they think may be of importance.
Documentation Selling Your Services

No matter what the occurrence, proper One of the most important
documentation can greatly assist the trainer goals in creating a business is
if a client takes legal action. In the case of an obtaining and keeping clients.
292
Getting potential clients in a business can be steps. First, decide the purpose of the website
achieved many ways. Develop a name for the and include information, graphics, videos and
business through various marketing strategies relevant links. Second, begin to develop the
to help expand it successfully. page by figuring out an appropriate domain
name that will attract potential clients and

Marketing Your Business
choose a reliable Internet Service Provider
In this technology-driven age, computers
to register the name. Make the website
are a convenient and popular information
interactive and include the
search tool. When trainers work
intended information. The more
for established businesses, they
visual and interesting (including
can work on individualizing
quizzes, polls, ways to calculate
themselves from other workers.
BMI, etc.), the more successful it
This can be accomplished by
will become. Remember to update
forming an introductory
the site with current facts and
packet for clients filled with STAY
FIT! articles so clients will benefit
needed information. Creating
from the latest changes in
an identity can help a trainer
health and fitness. There
get noticed at work or can help
is lots of competition from
if the decision is made to open
other websites, so visiting
a private business in the future.
them can help in obtaining
Trainers considering opening
information. Links relating to
their own business can learn
health and fitness websites can
practical skills from their current employer:
also be attached. Finally, the website should
interviewing, hiring, sales, organization and
be launched in order to ensure continued
time management are some important skills
success. Getting clients to visit the website
for business owners.
and spreading its existence through word-of-
Websites
mouth can help the business expand.
A website is an excellent advertising tool.
Constructing a website can be done in three
293
Business Cards and Brochures contact information, mission statement (if
Besides developing a website, there are business has one)
other ways of marketing the business. 2. Back Page: contact information, promotions
Personal trainers should develop a consistent or special deals, positive client feedback
logo, color and design to appear on all of 3. Inside: qualifications and experience of
their business materials and have business personal trainers, more information about
cards available and accessible to clients. the company and owner, brief explanation
The cards should emphasize qualifications and general benefits of fitness training,
and necessary contact information without services and programs offered
appearing too crowded. Create brochures and 4. Proper targeting to intended clientele
place them by business cards to attract clients. 5. Easy to read, clear layout, limiting word
The brochures should include information on crowding
benefits not offered by other health centers, 6. Accurate facts and updates when needed
the purpose of the business and the services Steps for Successful Marketing
of personal trainers. It can sometimes replace Selling services requires knowledge of
and be less costly than the client introductory marketing and how to use it successfully.
packet. It mainly consists of research to keep the
business up-to-date and is not costly or
difficult to accomplish. Selling services can be
accomplished with the following steps:

Power Fitness
see what we can do for you...
1. Identify needs: Find a need that the current
marketplace has not fulfilled.

Bill Jameson
2. Conduct Research: Collect facts related to

Personal Trainer
555-123-4567
that need.
3. Satisfy: Make a service that fulfills the

A useful brochure should contain the
need.
following information:
4. Promote: Showcase the service to clients
1. Front page: logo, business name,
so they are aware of the ability of the
credentials of the personal trainer(s),
business to satisfy the need.
294
5. Distribute: Use advertisements and other 2. Highlight a client’s positive results (with
information to let clients know about the client’s permission) through different
services. sources.
6. Acquire new business: Make sales and try 3. Offer gift certificates or discounts.
to keep clients’ commitments. 4. Mail postcards
When marketing a business, becoming or items with the
involved in community activities can be very company’s contact
advantageous. Involvement is inexpensive information.
and useful for individuals who own their own 5. Develop a line of products like t-shirts,
business. Participating in community or public caps, gym bags, etc., with the company’s
speaking events related to fitness training is a name
great way to appeal to the media and sell the 6. Promote ads through local TV and radio
business. If there is a local newspaper or TV stations and newspaper.
station at the event, highlighting the benefits 7. Offer clients and other professionals
of a business can be useful and less expensive benefits for referring the company’s
than placing an ad. services.
Determining the Cost of Your

Service
Pricing is based on a variety of factors. Think
about the salaries of employees and taxes that
have to be paid to the government. Also take into
account the telephone, uniforms, equipment,

Additional Ideas for Marketing Your
supplies and liability insurance. Consider the
Business
pricing after completing the following 10-step
Other ways to sell your services include:
assessment. It is based on setting up a reliable
1. Create a periodical newsletter and
annual income by answering some questions
distribute it through mail, email, fax and
and doing some math.
websites.
295
1. Determine an annual income, which is the how long it will take to contact those
12-month salary you require. clients each week.
7. Divide the number from #6 by 5 weekdays
to determine how many clients to contact
per day.
8. Consider the number from #7 and decide
how many clients can be contacted every
hour depending on the trainer’s daily

2. Figure out how much income will be
schedule.
earned weekly (divide wanted annual
9. Keep a file of new contact information
income by 50 instead of 52 to take into
for all clients so they can be contacted
account vacations, sick days, etc.).
for personal sales by showing them a few
3. Next, figure out how many clients and
exercises.
sessions are needed weekly to achieve
10. Follow-up with clients by sending a thank
the weekly income (divide wanted weekly
you card and contact them about a week
income by amount earned per session and
after that to talk about things to do during
divide the number of paid sessions by the
the next appointment.
number of clients).
There are several elements to
4. Determine the closing
Use clients‘ feedback as running a successful business.
percentage by dividing the a guide to improve the
business in the future. Commit to clients by staying
number of people interested
professional and dependable.
in a sale by the number who
Take the initiative to create a program
actually signed up.
suitable for clients. Use clients’ feedback as a
5. Set a realistic timeframe within which the
guide to improve the business in the future. A
number of new desired clients needed to
trainer should always be ready to change the
fulfill the weekly amount will actually sign
program to better suit a client’s needs. Having
up.
the ability to keep a professional disposition
6. Divide the number of new desired clients
when providing services, collecting money or
by the closing percentage and determine
296
listening to complaints can help the business and can explain the importance of fitness
run smoothly. training, which will help clients trust them.
Clients can see when a person is enthusiastic

Retaining Clients
and willing to help them. They are more likely
One of the most important goals in a business
to stay at a health club with individuals they
should be to produce a profit. However, health
know are beneficial to them. Clients assess
and fitness professionals should also focus
professionalism by what they hear and see
on getting and retaining clients. When this is
from trainers. It is necessary to dress keenly
accomplished, there is a long-term partnership
and always be free to communicate with
between both which can be fruitful and
clients. Trainers should not be preoccupied
profitable.
with computers, leaning against furniture or
READ—Rapport, Empathy, keep clients waiting. They should also have a

Assessment and Development friendly tone of voice and make eye contact
Because there are a when addressing clients.
variety of places for people For empathy, trainers
to exercise, excelling in should strive to understand
customer service is essential the thought process behind
to rise above the competition. actions. Motivation helps
This can be accomplished people make decisions. It is

4 kinds of motivation
by improving rapport, Positive best to understand a client’s
Motivation towards a goal
empathy, assessment and intentions in personal

“Write this report “I really want to
and you get a write this
+
Someone wants you to do it
development (READ). When bonus.”

* report!” training by asking a few
You want to do it
Extrinsic
Intrinsic
forming a rapport with clients, questions. Trainers should
confidence, enthusiasm and “Write this

report or you’re
“I really don’t
want to write
ask which goals clients are
fired!”
* this report!”
*
professionalism are very trying to accomplish and
Negative +
important. When trainers are * These three
don’t work—
Motivation away from something
Only this
one creates discuss the importance of
and yet positive,
companies sustainable
motivation.
confident, they are friendly keep using
them. reaching them. They should
297
find out how long their clients have been trying best course action. The time of day, medical
to achieve the goals and any past obstacles that conditions and other factors should be taken
prevented them from reaching them. Knowing into account.
the motivation behind wanting to workout can

Customer Service
help in forming an exercise routine.
The following is a list of useful guidelines for
During the initial assessment, the trainer
customer service:
should ask the client questions to
1. Always make time to
find out more about the client’s
greet club members (even if
requirements, which can help the
off shift).
client feel more engaged in the
2. Exhibit a welcoming and
training program. Questions should
professional attitude.
be nondirective ones, which require
3. Treat each question with careful
an answer more expanded than yes or no.
consideration.
Understanding the most important needs
4. Express ideas with clear verbal
of the client can help trainers figure out the
communication and body language.
best ways to accomplish their clients’ goals.
5. Be enthusiastic to hear complaints and
Directive questions, in turn, result in a yes or
deal with them accordingly.
no answer, which can be useful in reassuring
Many trainers need to
a client’s responses to other
realize the benefits and
questions. For example, a
advantages they have to
trainer can paraphrase what
offer a client. Clients want
the client has just said and
trainers who can explain
ask the client to verify.
how personal training
A trainer should develop
can help their lives. They
individualized programs
want someone to give
by taking into account the client’s needs and
them proper guidance during an exercise to
goals. This should help trainers realize the
make sure it is safe and effective. A trainer
298
needs to find a way to fit conveniently into a 9. Pay attention to client’s concerns.
client’s schedule. Upgrading the intensity in 10. Keep each session interesting in order to
exercise levels can give experienced clients keep clients coming back.
a refreshing new challenge. Trainers should

Key Points for Success
also be prepared to work with special needs
Finding and keeping a clientele is a process.
populations, such as people with long-term
First, trainers should be aware of their
illnesses or injuries. In order to satisfy a client
qualifications. They should assess whether or
population, try the following:
not they are educated to deal with different
1. Have a client introductory
HEALTHCARE NETWORKING FOR HEALTH CARE PROFESSIONALS
packet ready that contains
credentials and qualifications.
2. Be certified in CPR & other

age or special needs populations. In assessing
first aid training.
a client initially, if a trainer is uncomfortable
3. Become a member in professional
about any information, it is better to let that
organizations to show clients an interest
client train with someone else. Being ill-
in and dedication to the profession.
equipped to deal with a certain client can lead
4. Develop a fitness program based on the
to losing that client and others if the reputation
client’s medical history, needs and goals.
of the business is harmed. Networking with
5. Have knowledge of nutrition, which can be
health care professionals and those associated
advantageous to clients.
with personal training can help in recruiting
6. Seek help from other professionals when
clients. A trainer can get in contact with doctors,
needed.
physical therapists, nutritionists and dieticians
7. Keep up to date on business policies
and leave business cards or brochures with
concerning bills, liability insurance, etc.
them if possible. In making these contacts, a
8. Make safety a priority and practice
trainer needs to make sure to exhibit maturity
warming up, cooling down and using
and a professional appearance.
equipment properly.
299
Avoid actions that could potentially 3. Train off-site: Switch workout
lose clients, such as failing to places from inside to outside to add
follow-up with them. They may lose more variety to routines.
confidence trainers that are unable 4. Get to know the client: Knowing
to answer questions or lead them in more about a client’s hobbies and
the right direction to find answers. interests may fortify the relationship
Clients look forward to follow-ups between the trainer and client.
and comments on their progress. Trainers 5. Use effective ways to get and keep clients.
need to make sure to have time to complete Mailing clients does carry some cost
current appointments before recruiting and can recruit only a few clients out of
new clients. It may be advantageous to hire the hundreds of letters sent. If this is a
additional employees when taking on more preferred method, letters need to be sent
clients. Take time and consideration when to a targeted client population. A useful
expanding a business. way to attract clients is to have current
There are a variety of ways to invest more clients refer them. Referrals are free but
time with a client including: can only be successful if trainers provide
1. Take interest in the client outside the incentives and helpful reminders to make
training area: Trainers can talk to a client’s referrals. Remind clients that referrals are
health care professional if requested or the main way of expanding business and
necessary or watch the client engage in ask them for recommendations to their
physical activity. friends and family. Using this method with
2. Become well-rounded: Read a variety of close clients can make referrals a reliable
newspapers, magazines or articles not way to attracting new clients.
necessarily related to health and fitness.

Referrals
Clients come from different career levels
Although some trainers maybe uncomfortable
and being well-rounded may help trainers
with approaching clients to make referrals,
relate to them more easily.
there are a few things they should keep in mind.
300
Most clients will understand the importance and needs and suggest convenient ways to
of expanding a business and acquiring new fit training into the client’s schedule.
clients. Long-term clients 7. Prepare an outline of the
are usually pleased by their exercises planned and useful
current trainer and will have information if the client commits to
no problem speaking about training.
the benefits of personal training. 8. Review policies and fees to find what is
After a referral is made, trainers should do best suited for the client.
the following to turn potential clients into new 9. Have the confidence to ask a potential
clients: client to sign up for training.
1. Mail a client introductory packet to the 10. After completing the introductory meeting,
potential new client. follow-up to close the sale if the client has
2. Call to arrange an introductory meeting; not already signed up.
do not wait for the new client to call you.

Other Incentives
3. Pay attention to the client’s history and
There are several things that can be done to
disposition to discuss how personal
attract new clients. Provide clients with trial
training can be advantageous to them.
offer coupons or the option
4. Listen to the client
attentively by using eye

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to give training a try and may
said.
continue once they realize the benefits. If a
5. Assess the client’s goals to better
client was referred, remember to follow-up
understand how to successfully achieve
with the potential new member and thank
them.
the client who did the referral. Participate in
6. Close the deal by summarizing what the
public speaking events related to training to
client has just discussed regarding goals
promote services. Those listening may commit
301
to the services or pass on information about
Expanding Your Business
the business. Send thank you notes to clients
Being a personal trainer is what an individual
or other professionals when appropriate.
makes of it. Some people are content with
Non-Compete Clauses working for an organization such as a fitness
EMPLOYEE NON-COMPETE AGREEMENT

center, while others opt to work as a contractor,
For good consideration and as an inducement for_________________

perhaps working for a company who contracts
(Company) to employ_________________________(Employee), the undersigned Employee
hereby agrees not to directly or indirectly compete with the business of the Company and its
successors and assigns during the period of employment and for a period of _____ years
following termination of employment and notwithstanding the cause or reason for termination. out the training services. Many personal
The term "not compete" as used herein shall mean that the Employee shall not own, manage,
operate, consult or to be employee in a business substantially similar to or competitive with the
present business of the Company or such other business activity in which the Company may
substantially engage during the term of employment.
trainers want to make a business out of their
The Employee acknowledges that the Company shall or may in reliance of this
agreement provide Employee access to trade secrets, customers and other confidential data and
good will. Employee agrees to retain said information as confidential and not to use said training by seeking their own clients and
information on his or her own behalf or disclose same to any third party.
This agreement shall be binding upon and inure to the benefit of the parties, their
successors, assigns, and personal representatives. negotiating their own prices. This next section
Signed this _____ day of ________________________ 20____.
_______________________________________
Company
focuses on those who wish to start their own
_______________________________________
Employee
business or be hired as a contractor.
Sometimes health clubs or businesses First the basics. Some terminology to become
require a contractual non-compete clause to familiar with are the terms sole proprietor,
be signed by trainers before working. This individual contractor, partnership, corporation
is done in the hopes of preventing trainers and S-corporation. Prospective owners must
from leaving and taking clients with them. decide which category best fits their needs.
However, this contract is very challenging to

Organizing Your Business
enforce in court. Should this happen, clients
Sole Proprietor
will usually follow a trainer they have been
The trainer is the sole owner/operator of the
working with rather than start over with
business. Usually it only requires a license from
another trainer. If a trainer has a business and
the particular state/
employs fellow trainers, it is best to strengthen
local government in
the relationship between the parties to avoid
which the business
future conflicts rather than relying on the non-
will be located. This
compete clause.
is the least expensive
302
and most simple business model. There a trainer receives payment from the person/
few negatives to this type of proprietorship. company that contracted them out. The
One is the large amount of money that must downside is that the personal trainer has little
be available up front in order to start up the flexibility in negotiating salary, as it is usually
business. Another is that the personal liability predetermined and set by the hiring individual
always falls back on the sole proprietor. All or company.
legalities or IRS dealings are considered one Partnership
and the same for the sole proprietor, meaning A partnership is an agreement between
there is no separation of personal versus more than one individual entering into
business situations, as there is only one a business. There may be
owner. formal documentation of the
Independent Contractor partnership, which is usually
This is an individual who provides handled by an attorney. The
his services on a hired-out basis for partners may also enter into
another company or individual. Being an informal agreement. This is
not recommended because if problems arise,
proving verbal agreements can be difficult.
If the parties are not planning to enter into
a formal agreement, they should at least get
the agreeing terms in writing and signed by
all parties. Federal or state governments do
not tightly regulate partnerships. A pitfall to
a partnership is that liability is placed on all

an independent contractor allows personal
partners regardless of fault. An advantage is
trainers to work at multiple locations and
that startup expenses can be shared and all
the freedom to make their own schedule. The
parties will bring their own expertise to the
services provided are not directly paid to the
business.
personal trainer by the client. The personal
303
Corporation asset loss and limits the risk of the individuals
A corporation is a true involved. In a corporation, usually the owner

Power Fitness
business entity and must Corporation or owners are taxed on their business as well
abide by federal, state and local regulations as their salaries, seemingly being double taxed.
set forth for corporations. Unlike sole However, with an S-Corporation this does not
proprietorships or partnerships where liability happen. It gives the owners the freedom to
rests in the owners’ hands, a corporation distribute dividends as they choose. Basically,
is a legal entity of its own. Managers and the big difference is how the business is
owners are not necessarily legally responsible classified with the IRS and thus how taxes are
in liability situations. Corporations are handled.

Business Type Comparison Chart
governed by charters and bylaws. Investors
Type of
Business Definition Advantages Disadvantages
usually encumber the startup expenses of a Sole Business owned Work for yourself Start-up expenses
Proprietorship by one person & and personal
corporation. Transfer of ownership is much the operating
license is obtained
accountability due
to any debt
from the state/local
easier than with other types of business city in which the
business resides
Independent A personal trainer Set schedules, Health club may
models. Contractor who is paid by variety of locations, determine amount
health clubs in ex- paid per session paid for services
change for personal
S-Corporation training services
Partnership Business owned by Compilation of Can be accountable
An S-corporation combines the advantages 2+ people informally financial resources for partner‘s failures
or by contract & talent
of all three types of business models and Corporation Formal business Investors have Costs, regulation
ruled by a contract limited liability
& bylaws; separate
from owners &
C Corporation S Corporation managers
$100 Earnings & Profits $100 Earnings & Profits
Corporation treated Limited risk, no
S Corporation as proprietorship or double taxation
$100 E & P Minus
$100 Salary
$100 Net Income
Taxed at 35% = $35
partnership
Deduction = $0 Net after tax is $65
Net Income available as $0 Tax
100% 100%
(No Tax) Dividend (California has
1.5% tax)
Salary 1 Owner Dividends 1 Owner
$100 x 35%
Tax Rate = $35 Tax.
Net to Owner is $65
$65 x 15% = $9.75.
Net to Owner is
$55.25 $100 x 35%
The Business Plan
Tax Rate = $35 Tax.
Once a decision is made to have a business, the

Net to Owner is $65
$65 $55.25
1. Salary Distribution does not include any withholding calculations in order

to keep the example simple. owner’s first priority is to make a business plan.
2. The Dividend Distribution assumes that the corporate level tax is paid
before distribution to shareholder (this illustrates the effect of the double
The
taxation concept).
This should include plans Business
Plan
is usually the best alternative for a small for the budget, established
business. It protects the owners from personal policies for employees and
304
clients, advertisements and profits. Writing If so, owners would have to ensure all
out or making a list of all pertinent processes trainers employed took a proper HIPAA
and costs will help with organization as well course.)
as preparation for potential hurdles. Monies earned:
a) Determine a per session amount—see

The Budget
profits section.
Owners can make categories 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
b) Insurances
$ Budg
et
the arrangement be a baseline with the
potential for performance-based raises
c) Equipment or will the pay be based on experience,
d) Taxes or a combination of both? As an
e) Electricity, phone, water, office supplies, employer, the owner should establish
etc. how salaries will be determined and
f) Travel have it in writing.
Monies required for annual training: b) Will health insurance be offered to
a) Certifications employees? As of right now, small
b) Specialized training (i.e., for people

ns
with disabilities)
io
ectat
c) Mandated training (This may come up GET

exp
PRODUCTIVE
lish
without notice such as when laws that

tab
Es
govern areas may overlap. For example, p

lo
ve
d de ge
health care information privacy is nd
an wle
rsta d kno
d
Unde a n
skills
regulated by the HIPAA act. As of now,
personal trainers do not have to be businesses are not required to offer
HIPAA compliant, but this may change. health insurance to their employees
305
by law; however, owners should be have more specialized training. If
prepared for this to change in case the company is not prepared to offer
there is a requirement to do so in the proper training to individuals who may
future. need specialized training, resources
c) How many full-time, part-time or should be able for the company’s
independent contractors will be hired trainers to refer these clients to
and be on the payroll? known trainers that do offer
This is important specialized training. In these
when trying to budget cases, however, it is important
expenses. that these clients understand
d) How will vacation, the company is not refusing
personal time, sick to train them but instead
time be handled? It is better to have considers it wise to encourage them to
established guidelines versus just use a trained specialist.
“winging it.” Employees need structure b) How will clients be charged? Will it be
and conflict among them will be by the session or by the hour? Prices
better avoided if there are established should be competitive.
guidelines. c) What forms of payment will be
accepted? There are three major forms

Clients
of payment—cash, check or debit/credit
a) What sort of clients will services be
card. If debit/credit card payments are
offered to? This is not meant to exclude
accepted, the company may also wish
any demographic, but to avoid liability.
to offer automatic deduction. Many
Owners must make sure they are
clients view this as convenient and
qualified to provide services to people
it will assure that payments will be
who may require special training. For
delivered on time, every month.
example, people who have physical
d) If a client is late to a session, are they
disabilities may require a trainer to
allowed to make up the time?
306
e) If a client is going on vacation, should such as honesty and integrity. Every person is
their sessions carry over? different and holds various values to varying
Having clear guidelines governing employee degrees, but if the owner lays out the design
and client policies is the best way to run and show clients and employees, they will
a successful business. These lists are not better understand the type of business person
exhaustive or all-inclusive but allow examples that the owner is trying to be.
of ideas on what to ask. When guidelines are

Advertisement
preset there is less likely to be confusion in the
A good advertisement will be the key to a
future. Policies should always be written in a
successful business.
contract style document that will be signed by
a) How much do can be spent? In the
the employee or client signifying agreement
beginning (at least the first year),
to the guidelines set forth. It is a good idea
the owner should budget more for
to go to several similar businesses and get
advertising. If potential clients do not
ideas in terms of how they run their business
know about the company, how can they
Business
Guidelines
seek its services?
b) What type of advertising will be used?
After determining how much to spend,

policywise because they are likely to be up-
this is the second most important area
to-date with all of the current regulations.
for focus. There are so many avenues
Owners must also make sure that guidelines
to explore for advertising: the Internet,
are compliant with current federal,
radio, television, flyers and
state and local regulations. IT is a
billboards are the most
good idea to outline the business in a
popular.
mission statement style that highlights
c) The Internet is where
key points as to the philosophy upon
most people find their
which it will be operated. Include the
information in today’s world.
vision and important characteristics,
An owner should strongly
307
consider hiring someone to generate and firm’s flyers or business cards and
maintain a website. The ideal website they reciprocate. Reach out to other
will include the mission statement, any local businesses like health stores,
specialized skills the trainers may have, especially ones that are locally owned
an appointment scheduler, pricing and and operated. Owners can also set up
contact information. incentive programs where a free lunch
d) The radio is also a good place to is given for every five customers they
advertise, but homework needs to refer.
be done to figure out g) Billboards may sound

Make sure money is not being
what local stations are wasted on a demographic that old-fashioned, but they still
the most popular and is not likely to become the work. People driving by still
company’s clientele.
which are affiliated look at billboards.
with the clientele being sought. It h) Who will be targeted? Knowing whom
is possible to get sponsorships if to target can be tricky. Everyone
employees are wearing the station would like to be in shape and have the
logo in exchange for advertisement. Be luxury of having a personal trainer for
creative and explore all avenues. guidance but realistically not everyone
e) Television is also a great place to can afford one. Make sure money is not
advertise but can be very expensive. being wasted on a demographic that
Again, local channels are the ideal is not likely to become the company’s
place to advertise, but timing can be an clientele. Wherever the business
issue in terms of cost. Chose wisely if location is, the owner needs to examine
selecting television. the area carefully and decide who
f) Old fashioned flyers still work and are might be likely to want and afford the
relatively cheap. Partnering up with services.
other businesses around is a great i) Where will the target market be?
way to distribute flyers. The company Owners do not want to market in a
can offer to set up a place for other place that is not likely to gain new
308
clients. Every city is different and it bills. In order to determine pricing,
is important to pick the place wisely. the owner needs to do some case
Smaller cities are not likely to give studies. What are the most successful
much clientele. Success will be based personal training businesses in the
the your skills to market and sell the area charging? What are the mediocre
company’s service. After all, there will ones charging?
be competition in the personal training b) Next, comparisons need to be made
business,, so the owner must figure between what the firm’s prices are for
out what makes the business better/ services and what competitors prices
different than the others. That is what are for those services, and then make
the marketing and advertising needs to prices equal to those of competitors
portray. that most closely match the firm’s
offerings. It is likely that a potential

Profits
client has been other places
a) How much money
and if prices seem higher than
does the owner want
competitors, the firm needs
the company to make?
to be able to explain why. This
In the first year, and
is why casing competition is
maybe even the first
important and why an owner should
few years, the goal is to not be in the
highlight what makes the company
red (negative); furthermore, breaking
and its training better/different in
even is good and being in the black
advertisements. Pricing varies from
(positive) is excellent. It is important
state to state, city to city and company
that a good budget is in place to know
to company. Only the owner can set the
what expenses are and what amount
pricing based on the area and business.
needs to be made. Pricing must be set
However, charging inflated prices to
such that the firm is competitive but
make ends meet is not going to work
also makes enough money to pay the
309
and people will see right through personal training, a personal trainer is
that. Startup money is vital; an owner responsible for many legal issues. It is
needs to make sure sufficient funds are important to understand all legal issues and
available to sustain the business for responsibilities so they can be accurately
the first year. In order to save money, addressed. They can include issues of
minimal hiring should be done until it negligence or not fulfilling duty, of failure
is determined that the business has the to provide emergency support and of not
clientele to sustain more employees. gaining the appropriate informed consent.
The last thing an owner wants to do In addition, they can include tort law or legal
is have to let someone go because too rights between individuals in relation to
many people were hired. An owner civil injuries. Ensuring appropriate exercise
can be the best personal trainer, but regimes for clients is a simple way to avoid
bad business practices are a sure way any legal problems.
to guarantee failure. If a trainer does Additionally, many personal trainers
not feel business savvy, education on operate out of their own facilities and within
running a small business via books or their own knowledge of personal training. In
extra classes is a good option. Taking these situations, it is important to understand
on this endeavor is very challenging any potential legal action that can be
and knowing and admitting what one brought against the personal trainer. This is
does not know can only help. There important to not only protect the client but
are multitudes of ways to help gain the also the personal trainer. Risk management
knowledge that may be lacking, so an through proper education, training, extensive
individual should not be afraid to use documentation and practicing limited liability
them. can all be used to completely avoid or greatly
reduce the chances of liability in case of

Summary
wrongdoing.
Because of the intensive work and complex
Personal trainers should also be well-versed
interactions with clients associated with
in business aspects of their profession. It is
310
important to have a sound business model in 4. Liability can be reduced by the following:
order to grow cliental and maximize profits. a) Avoidance
The use of technology to create websites and b) Retention
business cards, identifying current marketplace c) Reduction
needs and offering discounts are all important d) Transfer
marketing strategies used to grow a business. e) All of the above
READ (rapport, empathy, assessment and 5. List four components of a good website.
development) can help a personal trainer a) _ ___________________________________________
connect with clients and excel in customer b) _ ___________________________________________
service. There are many different levels to c) _ ___________________________________________
organized business, with sole proprietorship d) _ ___________________________________________
being the simplest and commonest practice 6. When considering customer service, the
of securing a business. However, getting into acronym, READ, stands for:
business with others in a partnership or a a) Rapport, Encouragement, Assessment
bigger corporation are other possibilities. and Development
b) Reduction, Empathy, Assessment and

Review Questions
Development
1. What is the most common complaint made
c) Rapport, Empathy, Assessment,
by clients against their personal trainer?__
Development
_ _______________________________________________
7. In order to become a personal trainer, an
_ _______________________________________________
individual needs to obtain a bachelor’s
2. As a personal trainer, you are required by
degree in Personal Training from an
law to follow the HIPAA regulations. True
accredited institution. True or False?_ _____
or False?______________________________________
8. Name the difference between a corporation
3. Explain how a trainer would deal with a
and an S-corporation.________________________
client who has a specific condition that the
_ _______________________________________________
trainer has not been certified to handle. _ _
_ _______________________________________________
_ _______________________________________________
_ _______________________________________________
311
9. What are the components of a Business name to generate and drive the business;
Plan? interactive content (e.g., quizzes, polls, ways
a) _ ___________________________________________ to calculate BMI); up-to-date information.
b) _ ___________________________________________ 6. c) Rapport, Empathy, Assessment,
c) _ ___________________________________________ Development.
d) _ ___________________________________________ 7. False.
10. You should check the________________________ 8. A corporation is a true business entity
_ ______________________website to ensure that and must abide by federal, state and local
the online certification program chosen is regulations set forth for corporations.
accredited. An S-corporation is usually the best
alternative for a small business. It protects

Answers
the owners from personal asset loss and
1. Slipping and falling that led to injury is the
limits the risk of the individuals involved.
number one complaint of clients against
In a corporation, usually the owner or
their personal trainer.
owners are taxed on their business as well
2. False, but that may change in the future.
as their salaries, seemingly being double
3. Personal trainers need to ensure that they
taxed; however, with an S-Corporation this
receive the proper additional training and
does not happen. It gives the owners the
certification for special needs groups.
freedom to distribute dividends as they
However, if the trainer cannot achieve the
choose. Basically, the big difference is how
necessary certification in a timely manner,
the business is classified with the IRS and
the trainer should refer the special needs
thus how taxes are handled.
client to another trainer certified in the
9. Budget, established policies for employees
appropriate area.
and clients, advertisements and profits.
10. National Organization for Competency
5. Any of the following: a purpose; graphics
Assurance at www.noca.org.
and relevant links to other health and
fitness sites; an appropriate domain
312
Melton DI, Katula JA, Mustian KM. The current
References
state of personal training: an industry
Eickhoff-Shemek JM, White CJ. The legal
perspective of personal trainers in a small
aspects: Internet personal training and/or
Southeast community. Journal of Strength
coaching: what are the legal issues? ACSM’S
Conditioning Research. 2008;22(3):883-
Health & Fitness Journal. 2005;9(3):29-31.
89.
Goldman E, Couzelia P. The business side of
Robinson EM, Graham LB, Bauer MA. The
wellness coaching. ACSM’S Health & Fitness
National Strength and Conditioning
Journal. 2007;11(5):38-39.
Association is the preferred certification
Malek MH, Nalbone DP, Berger DE, Coburn JW.
for personal training employment in
Importance of health science education for
southeastern Massachusetts. Journal
personal fitness trainers. Journal of Strength
of Strength Conditioning Research.
Conditioning Research. 2002;16(1):19-24.
2006;20(2):450-51.
Manley RS, O‘Brien KM, Samuels S. Fitness
instructors’ recognition of eating disorders
and attendant ethical/liability issues.
Eating Disorders. 2008;16(2):103-16.
313

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ACT

Personal Trainer Certification

copyright © 2009 ACT Certification

Chapter 3: Client Assessment..................................................... 67

How Thorough Should Each Initial Assessment Be?.............................88

Chapter 4: Introduction to Designing Programs........................... 97

Chapter 5: Flexibility................................................................. 125

Types of Warm-Ups........................................................................... 128

Warm-Ups and Stretching................................................................. 129

Types of Flexibility............................................................................. 131

Stretching Techniques....................................................................... 134

Chapter 6: Program Design Elements........................................ 151

Chapter 7: Warning Signs.......................................................... 183

Chapter 8: Special Populations................................................. 203

Injured Persons................................................................................. 217

Chapter 10: Legal/Business....................................................... 279

factors which are known to important for physical

This stimulation of nerve cell study of the body’s responses

types of learning. This exercise-induced individual roles during exercise performance

prevent depression. exercise. All these factors should be taken

not enhance the normal functioning of the respiratory system.

immune system, exercise does strengthen it

these stimuli (motor function). and another cell type. A

The messages are relayed back synapse is just a tiny empty

parts of the body. Neuron

The neuron is the functional cells. Within these synapses,

unit of the nervous system neurotransmitters, the

and the merging of these cells, major chemical messengers

communication to and from receiving cells located after

the neuron. A neuron’s main NEURON Dendrites

component is a cell body, or receiving cell, called a receptor,

organelles important to the act on the signal in the desired

A long branch called the axon Node of

projects out of the soma and Myelin Sheath

feeds information through the end location. For example, a

from other neurons of the nervous system.

system (PNS). The brain and the spinal cord,

a long tubular continuation of the brain,

are collectively known as the CNS. This is

the source of conscious

their signals. total weight. The cerebrum is divided into left

send signals from the spinal cord

signals from areas of the body to Cerebral Cortex

containing nerve cells. of internal organs and therefore controls

diencephalon, which includes glands important

for the release or regulation of hormones. The Somatic ACh*

and is similar in function to the cerebrum but

Autonomic Motor Neuron

*ACh or NE: contraction of smooth or cardiac muscle, stimulation

for the control of visual and auditory reflexes,

heart rate, blood pressure and breathing. The

Peripheral Nervous System usually slow down bodily functions in rest

The PNS is further divided into the voluntary conditions.

improve performance and decrease the risk

Skeletal System the sites where movement due to muscle

The major function of the skeletal system is contraction takes place.

bodily movement. The skeletal movement. Our bones provide

system also helps in producing us with two primary functions

blood and storing minerals for during movement: support and

skeletal system determines our system for soft tissues. Posture

stature and the positioning of is an essential component of

our bones determines our shape the support system provided

and size. by our bones and is essential