Note: This is
a continuation of the 12/6/06 FitBit.
All exercise
prescription begins with a thorough PAR-Q and
HHQ. These documents will give you the starting
point for your client’s fitness assessment.
This is an essential first step for all clients
and any and all dysfunctions the client may
experience. Low Back Pain is highly variable
and will require you to customize your client’s
exercise prescription for each individual.
The overall goal of
Low Back Pain exercise prescription is to
strengthen all the supporting muscles, tendons,
ligaments, and other tissues and promote tissue
regeneration of the dysfunctional areas.
General
Recommendations for Exercise for Low Back Pain
(these recommendations are reprinted from the
Exercise Management textbook from the IFPA
Exercise Management Certification Course):
EXERCISE MODE
• Aerobic fitness
lessens risk of low back pain and enhances
recovery after injury.
• A variety of
abdominal exercises is suggested.
• Muscular warm-up
before and cool-down after exercise is
essential.
EXERCISE
FREQUENCY AND INTENSITY
• Daily exercise of
spine stabilizers, muscle flexibility, and joint
ROM is recommended.
• Muscular endurance
is more important than muscular strength.
• Individualize
program by nature of injury, fitness level,
exercise history, and goals.
• Start at low
intensity and progress gradually.
PRECAUTIONS
• Emphasis should be
placed on developing or regaining functional
capacity and on injury prevention.
• Avoid compression
(e.g., hyperextension, free weights).
• Avoid twisting in
flexed or extended positions.
• Maintain neutral
lordosis (natural curve of spine) during all
exercises.
• Stop exercise if
pain is present.
• Consult a medical
practitioner or physiotherapist for persistent
pain.
The Three Phases
of Exercise Prescription:
Phase 1:
This phase focuses
on motor control and muscle coordination
exercises that train the spine stabilizers to
provide support for the back without stress.
Calisthenics and other postural exercises (i.e.,
with a Swiss Ball) can be performed daily.
Stability/functional exercises should be
selected based on the client’s ability and
comfort (remember GPO). Phase 1 can begin
immediately.
Phase 2:
Begins within the
first 2 weeks after onset of pain. The goal of
Phase 2 is to build cardiovascular endurance
through low-impact or weight-supported,
moderate-intensity exercise. This can be
achieved through walking, aquaerobics, swimming,
stationary cycling, etc. Remember GPO, start
low-intensity, and gradually progress toward
higher intensities. Continue using stability
exercises according to GPO.
Phase 3:
Includes exercises
for muscular strength, endurance, and
flexibility. Wait a minimum of 2 weeks after
the onset of pain (4 weeks or more, depending on
the degree of pain). Strength and flexibility
exercises should be used to increase spinal
stability and function. Flexibility and
strength exercises must not load the spine. Use
the “Cat-Camel” and “Seated Low Back Stretch”
within the pain-free ROM for your client.
Muscular endurance
is much more important than pure strength for
Low Back Pain exercise prescription. Personal
Fitness Trainers should use relatively high
repetition ranges, above 10 RM, during personal
fitness training sessions.
Abdominal curl-ups,
or “crunches” are far safer and more effective
than sit-ups. Use a variety of crunch positions
and ROM to develop all the abdominals. Focus on
good form, keeping the head neutral and chin
AWAY from chest, keep the stomach sucked in, and
use complete exhalation on the concentric motion
to activate all the abdominals, including the
transverse abdominis.
Low-to-moderate-intensity exercises for the
spine stabilizers to improve ROM are most
effective if performed daily. Exercises for
cardiovascular endurance may be performed 3 to 7
times per week. Exercises for muscular
endurance may be performed 2 to 3 times per
week.
Unfortunately, exercise by itself may not be
enough to eliminate chronic Low Back Pain. The
client’s doctor may prescribe bed rest,
medication, massage, manipulation, weight loss,
postural retraining, and surgery.
Do not overlook the
value of acupuncture; a good Chinese Medicine
Doctor can be worth their weight in gold and
tremendous, near-miraculous relief from Low Back
Pain, if they are skilled at their craft.
Best regards,
Jim Bell, PhD
CEO
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IFPA Exercise Management
Certification Course
Successful completion of this course
leads to the designation:
IFPA-Certified in Exercise Management
The IFPA Exercise Management
Certification Course offers a complete, user-friendly
program for developing strategies for fitness and
exercise management that meets the needs of every
personal training client, from healthy, elite-level
athletes to clients with physical, pathological, social,
or psychological limitations.
This course provides an
interdisciplinary approach to developing, prescribing,
and delivering high-quality fitness and exercise
programs. In this course, you will explore how to
individualize fitness programs to encourage more people
to participate in regular physical activity and enjoy
the many health benefits. With 67% of the population
currently (as of 6/2006) categorized as morbidly obese,
obese, or overweight, the exercise management techniques
you will learn in this course are absolutely essential
in order to safely and effectively train these
special populations.
Even more critical is to
master the exercise management techniques provided in
this course. This will allow you to safely and
effectively manage the additional special population
groups, such as those with metabolic syndromes, which consist of
glucose intolerance, hypercholesterolemia, hypertension,
certain cancers, various cardiovascular and
cardio-respiratory diseases and more, all resulting from
the current Obesity Epidemic. Furthermore, the Obesity
Epidemic has created both a Diabetes Epidemic and a
Cancer Epidemic.
If you are a serious fitness
professional and desire to help more people, or if you crave
more knowledge and understanding of the personal
fitness training career, then this course is for you.
The goals
of this course are to help you:
1. Overcome the challenges
of encouraging people to become and remain active.
2. Develop programs
consistent with each person’s goals and capabilities.
3. Promote and maintain
successful physical activity programming in diverse
settings and situations.
4. Develop the professional
skills needed to manage exercise facilities and
employees.
5. Provide the knowledge,
skills, and abilities you need to work safely and
effectively with numerous special populations groups,
including: clients with cardiovascular,
cardio-respiratory, and metabolic diseases such as heart
disease, stroke, diabetes, obesity, hypercholesterolemia,
hypertension, COPD, PAOD, CF, asthma, low back pain,
arthritis, osteoporosis, cerebral palsy, spinal cord
injury, acquired brain injury, MS, Parkinson’s Disease,
chronic fatigue syndrome, and more.
The text is included and provides
excellent case studies to clearly illustrate key
concepts and terms in practical application scenarios
based on real-life experiences. Plus, glossaries at the
end of each chapter and at the back of the text keep
terms within easy reach and make referencing during
study quick and easy.
The study questions and real-life
activities in the text are great tools for independent
study. They’ll encourage you to seek further
information, develop practical skills, and observe
professional practice with first-hand insight. You’ll
also find suggested readings divided between cited
references and additional resources that will give you
the edge when studying topics in more depth and help you
along in your journey to becoming a “Master of Your
Craft”!
Successful completion of this course
will give you the knowledge and tools you need to help
the
young or old, healthy or infirm, develop and maintain
physically active lifestyles.
As with all IFPA Courses, text, exam,
and study guide are included along with your diploma when
you successfully complete the course. The IFPA Exercise
Management Certification Course will give you 24 CECs
toward re-certification.
Cost: $599.00
Christmas Special: save $200.00….ONLY
$399.00 until January 1, 2007!
James
T. Bell, PhD is the
founder and CEO of the International Fitness
Professionals Association, IFPA.
More
Books from Jim Bell, PhD
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