1). Assess, Assess, Assess
This should be a general rule of thumb when it comes to all clients but I find my assessment sheet becomes more cluttered with writing when it comes to my adult "athletes". Years of wear and tear lead to a number of injuries and pathologies that often go unnoticed or written off as simply a result of "old age." The fact is nobody should be in pain and everybody's dysfunction can be resolved either by me or a more skilled clinician.
It seems like every adult client that I get makes me play my least favorite game entitled "Find My Pain and Dysfunction." It goes like this.... The health and injury history form comes back glowing. No history of pain or injury in sight. I say "Wow, no aches, pains or injuries ever!?!? Write down anything you can think of big or small I have to know!" They answer, "No, I'm healthy and ready to go!" Common sense tells me this is next to impossible and in my head I think "Well, here we go again..."
More often than not, only about 10 minutes into an assessment, I find out about that shoulder injury from high school hockey when you got buried into the boards. To which they often say "Yeah it's not a big deal, I just can't lift my arm over my head, I've just got a lot of miles" If not that, it is the chronic low back pain that they didn't think was worth mentioning. This is why assessment is so important. To them "It's just old age" to you it's pain and dysfunction that needs to be dealt with.
Here is what I do:
• Watch: How do they walk, move, sit, stand etc.. Are they rubbing their shoulder or low back as you go through the movements?
• FMS: This should be the standard of movement for all humans. Follow the formula and stick to principles and it will lead you to your corrections. Remember if there is pain here the score is 0. Refer to a medical professional or go to the SFMA if you are qualified.
• Table Assessments: Go here to help confirm your findings in the former. Check things like hip mobility, ankle mobility, hip strength, shoulder ROM. This can be a great way to clarify some of things you may already think that you are seeing through the screen.
• Have an "Assessment Workout": After the aforementioned assessments I put all my new clients through a standard "assessment workout." This works out great as I usually have 30 minutes left after my initial assessments are done. I use this as an opportunity to take another look at all of the major patterns assuming I don't see a red light somewhere in the FMS. Furthermore, I can see how move through a linear movement warm-up and can get a general idea of their overall fitness level by watching their general fatigue. Now, I can see the client's general coordination and get a glimpse of their conditioning levels in addition to their movement limitations.
Now we know their limitations and where we need to lay some groundwork before we start really training certain patterns. You can see your red, green and yellow lights. Program your corrective work where it's needed and start training everything else. If nothing else remember these two things "If it hurts, don't do it." and "Pain = Referral"
2). Full-Out Assault on Soft Tissue Quality
By far the number one need for all adult trainees that I see is improved soft-tissue quality. Everybody that comes in seems to be jacked up somewhere. We do self-myofascial release and mobility work and stretching of some variety everyday. All my clients are familiar with the roller, lacrosse ball, and tiger tail whether they like it or not. This does not mean dig in every inch of the body. It means tack and dig with purpose. Teach your clients what their problem areas are, how to attack them and why it is important. I have a confession to make: I still believe in static stretching. Now I know it won't work in all situations. A lot of people are "locked long" and all the stretching in the world won't loosen them up. That being said I have a lot of adults who are simply tight. I've seen remarkable improvement in hip mobility with a little bit of soft tissue work combined with contract/relax and static stretching. If you know that they are tight and short somewhere then stretch them. See if it helps. If it doesn't help, go back to the drawing board. Once again, the FMS should give you the guidelines to figure this out.
In addition to all of this, make sure your clients hydrated. We know hydration improves soft-tissue quality. Keeping proper hydration will ensure that their tissues don't more matted and nasty than they already are.
3). Explosives and Plyometrics: The Right Way
We've all heard the research before. As we age beyond our twenties we begin to lose our ability to produce force at an alarming rate. More specifically we see a loss in reactivity as well as the ability to create explosive power. So is it in our best interest in try to promote reactivity and explosiveness in our aging clients right?!? Well yes, but with the right implements. We have to think about "explosiveness and reactivity" in relative terms. What is a plyometric for a 50-year-old adult? It might just be a ladder drill not a continuous 45* bound or depth drop to hurdle jump. You get what I'm saying? They don't need bounding all over they simply need to be moving reactively and stabilizing their landing as much as THEIR body allows.
As far as building explosive power goes, I'm all for KB swings for adult clients who clear the assessments but they probably don't need to do Olympic lifts. If their patterns don't clear have them use the shuttle jump or jump squat. My clients do medicine ball throws everyday combined with one of the aforementioned implements. These can lead to a great training effect with far less chance of injury.
I think plyometric and explosive work is necessary for adult personal training clients. We should be training adults to be powerful and reactive so long as we choose the correct means. It comes down to what is explosive in relative terms not absolute terms.
4). Build/Maintain Muscle Mass and Joint Mobility
Everyone knows that as we age we fight the battle against atrophy. As we head north of thirty and beyond it is my belief that we should literally be in a fight to the death to maintain our lean body mass. In addition to muscle atrophy we also tend to see a loss of joint mobility in our joints in which need them most (Big Toe/Ankle/Hip/T-Spine). Our western lifestyle combined with the natural biology of aging makes for double whammy of sorts when it comes to our body breaking down. Failing to battle these two elements will leave us high and dry, making daily function a severe challenge.
Well how do we fight it...??
Enter Dan John, Legend.
The need to battle this loss of function in aging populations was something greatly reinforced to me by Dan John when he came to speak at MBSC for our winter seminar. Dan stressed that the battle against aging is won by increasing lean body mass combined with increasing mobility in the proper places.
Dan brought attention to Janda's Upper and Lower Crossed Syndromes, as it should be a basis for training everybody.
In summary, we have "tonic" muscles that are generally prone to tightness and shortness and are in need of flexibility and mobility in their associated joint as well as "phasic" muscles that are often weak and inhibited and need activation, strength and hypertrophy to provide stability. Lets take a look at some of the list.
Phasic
• Rhomboids
• Lower Trapezius
• Gluteus Maximus, Medius, Minimus (Dan said the best sign of virtility is a muscular butt!)
• Deep Neck Flexors
Tonic
• TFL/ITB
• Pectoralis Major/Minor
• Upper Trapezius
• Rectus Femoris
• Quadratus Luborum
This is not all of them but you get the point. Stretch what needs to be stretched and get more mobile. Strengthen what needs to be strengthened and build some lean body mass. Increased mobility means more functional range of motion during daily life and probably less pain. Increased LBM usually means faster metabolism, less body fat and improved visual appearance. Ask yourself, "What middle aged person doesn't need all of these things?"
5). Locomotion
As far as goals concerning body composition and truly functional core strength I don't think you get more bang for your buck out of any exercise than you do with carry variations. (I know this is also Dan John inspired. What can I say he is a legend.)? Once we progress to carries from exercises like planks and press-outs I like to program them as much as possible for a couple reasons.
• They provide a great demand in core strength combined with locomotion making them a metabolic challenge in addition to a core exercise.
• For the average person, back injury comes from picking up, putting things down and carrying things improperly. Carry variations teach you how to do all three of those things correctly if you coach them right. They provide a core demand that these adult athletes can carry over more consciously to daily life.
Along with providing a truly "functional"(there is that dirty word again) core demand, these exercises provide a full-body muscle engagement during locomotion. So not only do we engage proper core sequencing but we also get locomotion at the same time. This is a win-win for gaining muscle mass, burning fat and fighting the upper-lower crossed. Programming carries CORRECTLY provides for a full body muscle builder, fat burner and posture improver all in one.
6). Single Leg Work
Single leg work is my predominate mechanism for training the lower body in my adult PT clients. The ability to spare the back and train the legs is priceless when working with aging clients since the majority of which have some history of low pack pain.
Rear-Foot Elevated Split Squats, Single Leg Squats, Single Leg Deadlift and Skater Squats are my primary lower body lifts of choice. They allow me to train the posterior and anterior musculature of the lower body effectively without increasing the chance for low back injury.
With that being said, I have not totally abandoned bi-lateral lower body strength work with my adult clients. All my clients learn to BW/Goblet Squat properly as well perform the hip hinge in some capacity provided they clear the screen. Those without a history of chronic back pain, who show me they have the prerequisite stability and mobility to deadlift, will do so. I think the squat and hip hinge is crucial pattern that needs to be trained if we have the ability to do so.
7). Condition, Condition, Condition
Since the number one goal of all my adult clientele is living longer, healthier lives, improvement of cardiovascular health and body composition is paramount. There is not a day that goes by when my adults come into train that we don't get some form of high-intensity work in through some medium. Here are some of the different approaches I take to conditioning a during the last half of our work out...
Metabolic Circuits for time or reps: 30 on/30 or 10 reps of each or something similar.
• Goblet Squat • Farmer Carry • Push-Up • TRX Row • DB Curl and Press
Heavy Sled Pushes:
• Partner 1- 20 yards down/back -- 6-10 reps
Airdyne Bike Rides:
Time Intervals: 15/45, 20/40, 30/30: 6-10x
Distance Sprints: .2 miles, .3 miles, .5 miles: For multiple reps
Long Distance Rides: 3-5 miles: For best time possible
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