CSEP-Certified Certified Personal Trainer (CSEP-CPT) CPT) Musculoskeletal Prescription

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1 CSEP-Certified Certified Personal Trainer (CSEP-CPT) CPT) Musculoskeletal Prescription 1

2 Exercise Prescription for Improving Muscular Strength & Endurance Key Concepts:

3 Key Training Principles Specificity principle» Strength improvements are specific to the muscle group trained Progressive overload principle» Achieved by changing INTENSITY, duration, frequency, recovery 3

4 Training Adaptations Neural & Cellular Skeletal Muscle Adaptations» number of contractile proteins (myofibrils) - protein synthesis; protein breakdown» Number of muscle fibres DOES NOT INCREASE» Fast twitch fibres are most responsive to a strength stimulus» Connective tissue adapts 4

5 Training Adaptations First 8-10 weeks» Rapid increase in strength due to neural adaptations» No difference in rate of progression b/w males and females 10 weeks +» Continued strength gains mostly due to cellular adaptations» Greater hypertrophy in males due to testosterone 5

6 Results Depends on initial strength level, training program, genetic factors Usually takes 8-12 weeks of training to see significant strength gains 6

7 Males, Females and Strength Muscle quality is similar between genders Males have greater number and larger muscle fibres Males & females show similar % change in strength 7

8 Designing Your Training Program Purpose of program Identify muscle groups to be exercised Order of exercises Determine appropriate starting loads Set guidelines for progressively overloading muscle groups 8

9 General intensity classification for resistance activities Intensity Classification Resistance Activities (%1RM) Very Light Effort <30 Light Effort Moderate Effort Hard Effort Very Hard Effort >84 Maximal Effort 100 9

10 Dynamic Training Prescription Basics Frequency Intensity Time Type days/week %1-RM repetitions, sets specific exercises; equipment NOTE: training volume = sets * reps * weight lifted 10

11 Typical Strength Prescription (Key Concept 4.17) Moderate weight: 50-69% 1-RM Multiple sets: 1-2 Moderate repetitions: 8-12 Moderate rest b/w sets: minimum 3 min Number of exercises:

12 Frequency 48 hrs rest b/w each muscle group workout 2-3 days / wk is optimal Time constraints & advanced lifters may split routines (i.e., upper body 1 day, lower body next day) 12

13 Sets Optimal number of sets is controversial 1 set may achieve similar strength benefits as 3 sets in novice lifters Health benefits are achieved with sets Advanced lifters may perform multiple sets 13

14 Progressions Goal = 1-2 sets of 8-12 reps Progressions made every 1-2 wks for adults (and 2-4 weeks in the elderly) The increases in resistance load should be gradual (e.g. a 5% change). Example perform 1 set of 8 reps PROGRESSION: number of reps to 12 (1 set) PROGRESSION: number of sets to 2; drop reps to 8 PROGRESSION: number of reps to 12 (2 sets) PROGRESSION: load by 5%; drop reps to 8 (2 sets)» 5% or ~5 lbs upper body, ~10 lbs lower body PROGRESSION: number of reps to 12 (2 sets) load by 5%; drop reps to 8 and so on 14

15 Guidelines for Rest Between Sets Multi-joint exercises w/ heavy loads & using a large muscle mass 2-3 min Smaller muscle mass Muscle endurance Power 1-2 min 1-2 min 4-5 min 15

16 Exercise Order At least 1 exercise per major muscle group Usually recommend large muscle groups 1st Alternate upper body/lower body exercises to maximize recovery Alternate agonist/antagonist exercises 16

17 Exercises Body Segment Type Exercise Prime Movers/Synergists 1 Hip & thighs Multijoint Lunge Gluteus maximus, hamstrings, quadriceps 2 Chest Multijoint Bench press Pectoralis major, triceps brachii 3 Upper & mid back Multijoint Lat pull-down 4 Legs Single joint Leg extension 5 Shoulders & upper arms Multijoint Upright row 6 Lower back Multijoint 7 Upper arms Single joint Back extension Triceps push-down Latissimus dorsi, teres major, pectoralis major, trapezius, rhomboids Quadriceps femoris Deltoid, supraspinatus, pectoralis major Erector spinae Triceps brachii 8 Legs Single joint Leg curl Hamstrings 9 Upper arms Single joint Arm curl Biceps brachii, brachialis 10 Abdomen Single joint Trunk curl Rectus abdominus 17

18 Body Segment Basic Techniques for CPT Resistance Training Exercises 1 Hip & thighs Multijoint Lunge 2 Chest Multijoint 3 Upper & mid back Type Exercise Prime Movers Multijoint Bench press Lat pulldown Glut max, hamstrings, quadriceps Pec major, triceps Lat dorsi, teres major, pec major, trap, rhomboids Technique Use body weight only, dumbbells, bar Forward mvmnt: exaggerated step with lead leg with torso erect & perpendicular throughout. Plant lead foot on floor pointing forward (or slightly in) & let trailing knee slightly flex. Allow lead hip & knee to slowly flex keeping knee directly over lead foot. Lower trailing knee until 3-5 cm above floor. Backward mvmnt: forcefully push off floor with lead leg and maintain torso position. Alternate legs Supine position on bench with upper/lower back, both feet, and head in contact with bench Closed, pronated grip Grip slightly wider than shoulder-width Downward phase: lower bar to chest (~ nipple level). Keep wrists rigid & directly above elbows Upward phase: push bar until elbows extended with wrists rigid & directly above elbows Closed, pronated grip on bar Grip is wider than shoulder-width Seated, facing machine Lean torso back & keep torso in position throughout mvmnt Downward phase: bar to upper chest Upward phase: elbows slowly extend to starting position 18

19 Basic Techniques for CPT Resistance Training Exercises Body Segment Type Exercise Prime Movers Technique 4 Legs Single joint Leg extension 5 Shoulders & upper arms Multijoint 6 Lower back Multijoint Upright row Back extension Quadriceps femoris Mid deltoid, trapezius Erector spinae Back against pad Ankles in contact with foot roller pad Legs parallel Align knees with axis of machine Upward mvmnt: extend knees keeping torso erect & back against pad. Hips & buttocks should not lift off seat and knees should not lock out. Downward mvmnt: allow knees to slowly flex keeping back against pad Closed, pronated grip Grip narrow than shoulder-width Feet shoulder-width Upward phase: pull bar up along ab & chest toward chin keeping knees & torso in same position. At top position, elbows are higher than wrists and even with (or above) shoulders Downward phase: bar lowers slowly to beginning position. Follow CPAFLA back extension technique 19

20 Basic Techniques for CPT Resistance Training Exercises Body Segment Type Exercise Prime Movers Technique 7 Upper arms Single joint Triceps push-down Triceps brachii Closed, pronated grip Grip is 6-12 inches wide Feet shoulder-width, knees slightly flexed, body close to machine to allow cable to hang straight down. Move bar to position upper arms against side of torso & flex elbows to position forearms perpendicular to floor or slightly higher Downward phase: push bar until elbows are extended keeping torso erect & upper arms stationary. Upward phase: allow elbows to slowly flex. 8 Legs Single joint Leg curl Hamstrings 9 Upper arms Single joint Arm curl Biceps brachii, brachialis Closed, supinated grip Grip is shoulder width Upward phase: flex elbows through ROM Downward phase: elbows slowly extend 10 Abdomen Single joint Curl Rectus abdominus Follow CPAFLA partial curl-up technique 20

21 Equipment Machines Free weights Tubing Body weight Soup cans 21

22 Lifting Techniques Warm-up/cool-down» Light aerobic exercise for a minimum of 5 min» Perform a warm-up set (light load, high reps) Perform exercise through full ROM» 1-2 for concentric & eccentric phases of the lift Breathe normally throughout ROM.» Brief breath hold is normal and not contraindicated!!! - Haykowsky et al. Med Sci Sports Exerc 35(1): 65-8,

23 Types of Training - Circuit Can improve strength, endurance, & aerobic fitness 2-3 sets of stations / circuit Passive or active rest between exercises Pros & cons? 23

24 ACSM & CSEP Muscular Strength Guidelines for Healthy Adults F 2 days/week I 1-2 set of 8-12 reps T 8-10 exercises T major muscle groups 24

25 Adaptations to FITT Prescription Over 60 yrs and/or more frail individuals» 1 set of reps» progressions every 2-4 wks Deconditioned person» 30-40% 1-RM for upper body» 50-60% 1-RM for lower body 25

26 New to Exercise (i.e., precontemplator, contemplator, preparation, relapse) Regular Exerciser (i.e., preparation, action, relapse) M-S fitness (CPAFLA) predicted 1-RM (Heyward): NI poor fair or good fair or avg intensity (%1-RM) upper: 30-40% 1-RM lower: 50-60% 1-RM 50-70% 1-RM frequency/ volume 1 set reps 1-2 days/wk 1 set 8-12 reps 2 days/wk NOTES: rate of progression is rate of progression is every 2-4 wks in elderly or every 1-2 wks 2006 Version 2.0 deconditioned CSEP - CPT M-S Prescription 26

27 New to Exercise (i.e., precontemplator, contemplator, preparation, relapse) Regular Exerciser (i.e., preparation, action, relapse) M-S fitness (CPAFLA) predicted 1-RM (Heyward): good or v. good avg or good v. good or excellent good or excellent intensity (%1-RM) 70-80% 1-RM 70-80% 1-RM frequency/ volume 2-3 sets 8-12 reps 2-3 days/wk 2-3 sets 8-12 reps 2-3 days/wk NOTES: rate of progression is every 1-2 wks see ACSM paper progression models for resistance training for advanced programming 27

28 FITT for Flexibility F I T T : 2 to 7 days / week : just below pain threshold : 10 to 30 seconds per static stretch; 4 reps : PNF: 6 sec contraction, sec assisted stretch : regular stretching, yoga, T ai Chi, gardening» stretch slowly and smoothly - NO BOUNCING 28

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