Chapter 13

Training in All Planes of Motion

A common mistake made in the fitness industry is to develop exercise programs that overly emphasize the sagittal plane of motion (front-to-back motions) and neglect exercises in the frontal (side-to-side motions) and transverse planes (rotational motions). The advantage to the body working in all three planes of motion is the enhancement of muscle recruitment. For example, the posterior fibers of the gluteus medius concentrically perform hip abduction and hip external rotation. As such, to effectively target all muscle fibers of the gluteus medius, the client must perform a variety of movements at the hips (abduction, external rotation). In other words, simply performing common hip extension exercises (e.g., squats, lunges) does not effectively target the gluteus medius muscles.

Integrated Training Principles

According to the Merriam-Webster dictionary (2019), to integrate means to "form, coordinate, or blend into a functioning or unified whole. As an example, fitness professionals can opt out of heavy squatting to accommodate a client who was recently released from physical therapy due to a knee injury. Instead, the fitness professional can substitute core and balance drills to make that training session more tailored to their client's needs and abilities. When fitness professionals take an integrated approach to exercise, their programs become well balanced while reducing boredom and can maximize results

Acute Variables

Also known as exercise training variables, determine the amount of stress placed on the body and ultimately the physical adaptations that occur, such as increased strength, endurance, weight loss, or muscle gain. Acute variables can be viewed as all the building blocks that are used to design an exercise program, which include repetitions, sets, training intensity, repetition tempo, rest intervals, training volume, training frequency, training duration, exercise selection, and exercise order. The most fundamental components of an integrated training program because they determine the amount of stress placed on the body during an exercise session. Properly manipulating acute variables will help the fitness professional elicit optimal performance from their clients while reducing the risk of injury

Plyometric (Reactive) Training

Also known as reactive or jump training. A fallacy exists that plyometric exercises are only appropriate for athletes. However, plyometric training can be a safe and effective mode of exercise for many populations, since it is a form of exercise characterized by the expression of muscular power (Mansur et al., 2018). Yet, variations of plyometric training exist to accommodate clients of differing skill and fitness levels. Plyometric training does not require many exercises or a high amount of volume, especially if it is completed prior to a resistance training session. In addition, a plyometric training session may be completed on different days in which the volume and amount of exercises can be increased for a greater stimulus. Plyometric exercise improves the stretch-shortening cycle, which enhances a client's ability to move explosively.

Balance Training

Balance is the ability of a person to maintain, achieve, or restore a specific state of balance without falling (Callesen et al., 2018). Balance training is a method that can create better movement patterns for all clients and reduce the occurrence of falls in the elderly (Gschwind et al., 2013) and ankle sprains for athletes (Bellows & Wong, 2018; McGuine & Keene, 2006). Balance training is used for improving postural control by challenging the alignment of the body's center of gravity with regard to the base of support (Lesinski et al., 2015). The more control the body is able to maintain, the more opportunities abound to incorporate more challenging movements into most exercise sessions. This holds true for any age of a client, and while it does benefit the elderly immensely, it should not be diminished in those who are considered younger.

Phase 5 Example Supersets

Body Part 1.) Chest 2.) Back 3.) Shoulders 4.) Leg Strength-Focused Exercise 1.) Bench press 2.) Lat pulldown 3.) Dumbbell shoulder press 4.) Barbell squat Power-Focused Exercise 1.) Medicine ball chest pass 2.) Medicine ball soccer throw 3.) Front medicine ball oblique throw 4.) Squat jump

Example Supersets

Body Part 1.) Chest 2.) Back 3.) Shoulders 4.) Legs Strength-Focused Exercise 1.) Bench press 2.) Seated cable row 3.) Shoulder press machine 4.) Barbell squat Stabilization-Focused Exercise 1.) Push-up 2.) Standing cable row 3.) Single-leg dumbbell overhead press 4.) Single-leg squat

Fundamental Movement Patterns

Common and essential movements performed in daily life and are involved in exercise motions within a training session. A necessity for all fitness professionals to demonstrate and teach to their clients. Fitness professionals must ensure their clients' mastery of these movement patterns to minimize injury risk and increase exercise effectiveness. Most exercises involve at least one of these movement patterns; though more movement patterns exist, and many of these patterns can be combined into a single exercise: 1. Squatting 2. Hip hinge 3. Pulling motions 4. Pushing motions 5. Vertical pressing Designing exercise programs based on movement patterns may provide enhanced adaptations when compared to isolated resistance training, such as enhancing neuromuscular coordination and athleticism. A movement pattern exercise design can include many variations. For example, the individual may choose pushing patterns on Monday, pulling patterns on Tuesday, squatting and hip hinging on Wednesdays, and vertical pressing on Thursdays. There are almost limitless possibilities.

Benefits of Cardiorespiratory Training

Decreased resting heart rate and blood pressure Increased stroke volume and cardiac output Improved gas exchange, decreased airway resistance, and improved oxygen uptake Decreased blood flow resistance and increased blood volume Improved blood lipid profile/chemistry Improved blood flow back to the heart via veins

Phase 3 Muscular Development Training

Designed for individuals who have the goal of maximal muscle growth (such as bodybuilders). This phase of training can use a variety of resistance training exercises and methods to elicit a maximal response in muscle growth. This form of training can also benefit those seeking to lose body fat while maintaining lean muscle mass (Cava et al., 2017). Because the goal of this phase of training is primarily muscular hypertrophy, the fitness professional will want to increase the volume (lots of sets) and intensity (using moderate to heavy weight) of the program. This phase is optional depending on the goals of the client, because some clients do not wish to achieve high levels of muscular growth, such as endurance athletes. However, this phase is very popular among fitness enthusiasts seeking to reduce body fat and improve muscle tone.

Phase 1 Stabilization Training

Designed to teach optimal movement patterns (e.g., pushing, pulling, pressing, squatting, hip hinging) and to help clients become familiar with various modes of exercise. In addition, this phase of training creates optimal levels of joint and core stabilization and postural control. focuses on exercises and movements that enhance muscular endurance, joint ROM, joint and core stability, and muscular coordination. It requires slow and controlled movements, relatively light loads, and meticulous attention to proper posture and exercise technique. In the early implementation of this phase, fitness professionals should focus a great deal of energy on honing and perfecting proper movement patterns and introducing clients to a variety of exercise modalities. The goal is to improve the client's ability to move in a biomechanically correct manner to reduce the risk of injury, which may have the added benefit of increasing client adherence to the exercise program. Clients are more likely to stick with an exercise program if they feel confident in their abilities. Once movement patterns have been addressed, exercises can be progressed by introducing a greater challenge to the balance and stabilization systems of the body versus simply increasing the load. For example, a client may begin by performing a push-up and then progress by performing the same exercise using a stability ball. This progression requires additional activation from the nervous system and the stabilizing muscles of the shoulders and trunk to maintain optimal posture while performing the exercise. Not only addresses the existing structural deficiencies, it may also provide a superior way to alter body composition (reduce body fat) because all the exercises can be performed in a circuit fashion, using short rest periods along with a high number of repetitions. By performing exercises in a controlled yet unstable environment, the body is forced to recruit more muscles to stabilize itself. In doing so, more calories are potentially expended, especially when performed in succession with minimal rest

Strength

Emphasis is to maintain stabilization endurance while increasing overall muscular strength. This is also the level of training to which an individual will progress if their goals are hypertrophy (increasing muscle size) or maximal strength (lifting heavy loads). The strength level in the OPT model consists of three phases: Phase 2 Strength Endurance Training, Phase 3 Muscular Development Training, and Phase 4 Maximal Strength Training.

Benefits of Core Training

Enhanced posture and spinal health Better bodily function for activities of daily living and on-the-job movements Increased balance, stabilization, and coordination of the kinetic chain Minimized or resolved low-back pain conditions or symptoms Improved skill-related movements and power (i.e., swinging a racket or golf club)

Phase 2 Strength Endurance Training

Goal is to enhance stabilization endurance while increasing prime mover strength. These two adaptations are accomplished by performing two exercises in a superset sequence, back-to-back without rest, with similar joint dynamics (Table 13-9). The first exercise is a traditional strength exercise performed in a stable environment (such as a bench press), whereas the second exercise is a stabilization-focused exercise performed in a less stable (yet controllable) environment (such as a stability ball push-up). The principle behind this method is to predominantly work the prime movers in the first exercise to elicit prime mover strength. This is immediately followed with an exercise that challenges stability and postural control. This produces an increase in muscular endurance, joint stability, and ideal posture.

Phase 5 Power Training

Goal of Phase 5 Power Training is to increase maximal strength and rate of force production. This phase of training is important for improving velocity of movement and athleticism. The premise behind this phase of training is the execution of a traditional strength exercise (with a heavy load) superset with a power-focused (high-velocity) exercise of similar joint dynamics (Table 13-10). This form of training, also known as complex training, has been shown to improve sprint and vertical jump performance

Benefits of SAQ Training

Improved performance for top speed, change of direction, and rate of acceleration/deceleration Improved health-related physical fitness Enhanced response time to a stimulus or better reaction time Improved technical skills in sprinting and change of direction mechanics

Goals of Stabilization Training

Improving movement patterns and exercise technique Improving muscle imbalances Improving joint ROM and flexibility Improving stabilization of the core musculature and peripheral joints Preventing tissue overload by preparing muscles, tendons, ligaments, and joints for the upcoming imposed demands of training Improving overall cardiorespiratory conditioning

Benefits of Plyometric Training

Increased bone mineral density and decreased risk of bone/joint injuries Improved soft tissue (ligaments, tendons, cartilage) strength and decreased risk of injury Increased metabolic expenditure for improved weight management and/or weight loss Increased strength and power for athletes and general population Improved muscle contractions and nervous system synchronization Improved performance or game play for athletes of all levels

Benefits of Resistance Training

Increased endurance, strength, and power Increased muscular hypertrophy Improved weight management and enhanced weight-loss efforts Improved resting metabolic rate, resting heart rate, and blood pressure Improved coordination and athleticism Decreased risk of injury due to strength of all soft tissues (ligaments, tendons, cartilage, and muscle fibers)

Benefits of Flexibility Training

Increased joint ROM Possible decrease in muscle soreness Potential for a reduction in injury risk

Progressive Overload

Increasing the intensity or volume of exercise programs using a systematic and gradual approach.

Training in a Systematic and Progressive Fashion

Like a house, the body must also have a solid foundation of fitness before embarking on an intense training regimen. It is illogical and potentially dangerous for a fitness professional to recommend exercises that are too advanced or physically demanding for their clients. It may also cause frustration and reduce a client's own self-efficacy. Fitness professionals should guide their clients to first build a solid foundation that includes appropriate levels of aerobic and muscular endurance, joint mobility and stability, and core strength. This is best accomplished by using a systematic and progressive approach to program design. If an exercise program is progressive and systematic, using a progressive overload approach, the body sufficiently adapts to the new demands placed on it and consequently becomes stronger and more resilient. Conversely, skipping steps may do more harm than good.

Training Based on Assessment Results

Programming efforts should focus on the assessments conducted by the fitness professional prior to their client's initial workout. Appropriately conducted assessments are needed to develop a baseline value for different exercises that will be completed in the exercise program. Also, the detection of muscle imbalances, postural abnormalities, and other health concerns can reveal necessary information about a potential client. The fitness professional can then gain an accurate portrayal of the client to develop the proper movement patterns for the new exercise program. this process separates generic physical activity from systematic and progressive exercise programs, which is important because a lack of assessment can lead to ineffective exercise selection and programming strategies by the Certified Personal Trainer

Benefits of Integrated Training for Clients

Psychological benefits, such as stress relief, improved mood, and improved sleep Physiological benefits, such as improved cardiovascular, respiratory, and endocrine (hormone) functionality Body composition benefits, such as fat loss and increased lean muscle mass Performance benefits, such as increased flexibility, endurance, strength, and power

Benefits of Balance Training

Reduced risk of falls Reduced risk of ankle sprains Improvements in landing mechanics (which may reduce risk of anterior cruciate ligament injury) Improvements in lower-extremity muscular strength Improvements in proprioception and body awareness Improvements in agility-based outcomes in athletes Stronger hip musculature (e.g., gluteal complex) and lower extremities

Resistance Training

Resistance training can promote marked increases in muscle strength and hypertrophy, with improvements in these outcome measures seen irrespective of age and gender (Schoenfeld et al., 2016b). In addition, resistance training has shown to be an effective mode of exercise to improve bone density and muscular strength and enhance cardiovascular health (Garber et al., 2011; Hart & Buck, 2019; Westcott, 2012). Moreover, resistance training plays a fundamental role in improving athletic performance and rehabilitation from musculoskeletal injury (Kristensen & Franklyn-Miller, 2012; Vesci et al., 2017). Lastly, resistance exercise is an effective method for increasing lean body mass and reducing body fat, especially when it is combined with proper dietary measures. The role of resistance training in an integrated training program cannot be overemphasized, and fitness professionals must be well-versed in its benefits. In addition, fitness professionals must be skilled at designing and implementing resistance training protocols for a variety of clients, including youths, athletes, elderly, pre- and postnatal parents, and weight-loss clients

Skipping Steps Versus a Progressive and Systematic Plan

Skipping Steps 1. Possible increased risk of injury 2. Potential client frustration because of inability to correctly perform exercises 3. Client's goals may be delayed more than expected or may not be achieved 4. Lack of measurement and tracking; unable to track client success 5. Inconsistent exercise programming Progressive and Systematic 1. Decreased risk of injury or overtraining 2. Increased client adherence to the exercise program 3. Clients more likely to achieve goals 4. Ability to track client successes and setbacks 5. Consistent exercise programming with progressive overload

Speed, Agility, and Quickness Training

Speed, agility, and quickness (SAQ) training is another form of exercise that can be misconstrued as something fit just for athletic purposes. Like plyometrics, these drills can all be modified to be beneficial for most types of clients. SAQ training is a system of progressive exercises and instruction aimed at developing fundamental motor abilities to enhance the capability of individuals to be more skillful at faster speeds and with greater precision (Chandrakumar & Ramesh, 2015). The movement patterns used can also be of great assistance in preventing falls and increasing agility, reaction time, sprinting velocity, and lower-body power. SAQ training is similar to explosive jump, or plyometric training, but the idea is to propel the body as quickly as possible, to accelerate and decelerate as fast as possible, or to change directions with ease and speed changes. Like plyometrics, SAQ exercises can be completed as their own workout or combined into an integrated training session

Posture Goals for Trainers

The aim of the fitness professional is to create progressive and systematic exercise programs that inherently maintain or correct posture to reduce injury risk, enhance the client's physical health, and allow for a more enjoyable exercise experience. If a systematic and progressive approach is applied, many physical enhancements will occur, such as increased flexibility, endurance, strength, and power. Improving posture is another physical enhancement that occurs when using a systematic approach to program design. When programming for optimal posture, the fitness professional will use appropriate flexibility and strengthening techniques to help correct muscle imbalances and include unilateral/bilateral and anterior/posterior exercises to create symmetry between right/left and front/back sides of the body

Core Training

The core musculature includes those of the trunk and pelvis that are responsible for spinal and pelvic stability. These muscles also generate or transfer energy from the core to the extremities. Core stability is the ability to control the position and motion of the trunk over the pelvis and legs for optimal production, transfer, and control of force and motion (Manchado et al., 2017). Exercises aimed at enhancing functionality of the core musculature and core stability are considered part of core training. Core training is sometimes misconstrued and only associated with the anterior abdominal region of the body, such as the rectus abdominis (i.e., six-pack muscle). In other words, individuals may believe crunches and sit-ups are lone core exercises. Fortunately, many movements can be completed using a variety of exercises that work all three different planes of motion as well as many muscle groups, including the obliques, low-back, and gluteal complex.

Range of Motion (ROM)

The degree to which specific joints or body segments can move; often measured in degrees. Clients are often plagued by muscle imbalance, poor posture, or joint restrictions. As a consequence, ROM at certain joints can become restricted, which limits movement and may lead to injury. For example, limitations in hip mobility have been implicated in hip, spine, and lower extremity dysfunction

Range of Motion Goals for Trainers

The fitness professional must understand that restrictions of a particular ROM may occur because a prior injury may have caused scar tissue to form, which changes the mechanics of the joint. Ultimately, clients may have to work within specific constraints and use caution to avoid causing further injury to that area. On the other hand, an individual who does not have a limited ROM should work through all ROMs to maximize exercise adaptations. Training for optimal ROM requires patience by both the client and fitness professional because many factors come into play when dealing with the appropriate range for every person.

Cardiorespiratory Training

The number one cause of death around the world is heart disease (World Health Organization, 2018). To combat this issue, cardiorespiratory training is a cornerstone of improvement for heart and lung functionality (Conraads et al., 2015). Cardiorespiratory training refers to the capacity of respiratory and cardiovascular systems to provide muscles with oxygen during sustained and/or intense exercise (Lin et al., 2015). Typical forms of cardiorespiratory exercise include walking, jogging, running, cycling, biking, swimming, rowing, and sports competition. In most cases, cardiorespiratory training is a critical component of an integrated training program. However, the mode, duration, and intensity of cardiorespiratory exercise will be dependent on the client's health, wellness, and performance goals

Posture

The relative disposition of the body parts in relation to the physical position, such as standing, lying down, and sitting. Maintaining ideal posture places the client's body in the most optimal state to perform movement patterns safely and effectively. However, maintaining ideal posture is a difficult challenge, especially as people age and have developed compensatory movement patterns and faulty static postures

Training Volume

The sum of the repetitions performed in a given set during each training session, multiplied by the resistance used.

Rest Interval

The time taken to recuperate between sets.

The OPT Model

To help Certified Personal Trainers design safe and effective training programs based on the client's individual needs, NASM recommends using a structured, scientifically based program design model. The training program should be a methodical approach to improve physical and performance adaptations. The best way to achieve consistent, superior results is to follow a structured, periodized training program (Rhea et al., 2003; Williams et al., 2017). Evidence also exists that an integrated program that includes flexibility; core; balance; plyometric; speed, agility, and quickness; resistance; and cardiorespiratory training can decrease injury and improve performance (Distefano et al., 2013). As such, NASM created an evidenced-based training system known as the Optimum Performance Training (OPT) model. The OPT model was conceptualized as a training program for a society that has more structural imbalances and susceptibility to injury than ever before. It is a process of programming that systematically progresses any client to any fitness or sport-performance goal. The OPT model is based on the scientific rationale of human movement science and uses the principles of integrated training discussed throughout this chapter.

Phase 4 Maximal Strength Training

Works toward the goal of maximal prime mover strength by lifting heavy loads. In other words, in this phase of training the client will opt for exclusively heavy weights when performing resistance training exercises. This phase of training is common for strength athletes, such as those who compete in powerlifting or strongman competitions and others who require maximal strength (i.e., shot-putters, rugby athletes, American football linemen). Because the goal is to increase maximal strength capabilities, individuals must be accustomed to resistance training. This is an advanced form of exercise that is optional, depending on the goals of the client.

Integrated Training

a concept that combines all forms of exercise into one system: flexibility; cardiorespiratory; core; balance; plyometric; speed, agility, and quickness; and resistance training. It is an all-inclusive approach to exercise that can lead to improvements in overall health, wellness, and athletic performance.

Flexibility Training

flexibility training involves different types of stretching techniques to improve tissue extensibility, which allows the body to move freely without being hindered. The National Academy of Sports Medicine (NASM) recommends using a variety of stretching options in a systematic fashion to elicit optimal results. These stretching techniques include self-myofascial techniques, such as foam rolling, static stretching, active stretching, and dynamic stretching

Stabilization

focuses on two main adaptations: improving movement patterns and enhancing stabilization. By doing so, it prepares the body for the demands of higher levels of training that may follow. This period is crucial for all beginners (Saeterbakken et al., 2016). It is also necessary to cycle back through this level after periods of strength and power training to maintain a high degree of core and joint stability. In addition, it allows the body to actively rest from more intense bouts of training

Benefits of Integrated Training for Fitness Professionals

integrated training programs incorporating different types of training in a multiplanar fashion are more optimal than isolated resistance training programs. Areas of improvement were found in movement quality, speed and agility, strength, endurance, flexibility, and power. This does not mean that isolated training is ineffective, but when the fitness professional intends to provide the greatest changes to their clients, integrated training improves more variables than isolated training. Research has indicated that a multidimensional, or integrated, training approach can provide a greater effectiveness to an exercise program than an isolated resistance program (Reilly et al., 2009). This indicates that if the fitness professional implements an integrated approach, the client can benefit to a higher extent by incorporating more variables aimed at creating specific results based on client goals, needs, and abilities. However, it is important to note that integrated training principles involve more than a variety of exercises. Additional principles that must be observed include training in a systematic and progressive fashion, training fundamental movement patterns, training with optimal posture, training for optimal range of motion, training in all planes and motion, manipulating acute variables (e.g., sets, reps, and rest periods), and designing exercise programs based on assessment results.

Power

should only be entered after successful completion of the stabilization and strength levels—unless the client is well-conditioned, exhibits adequate joint and core stability, and is familiar with power forms of exercise. This level of training emphasizes the development of speed and power

OPT Model Levels of Training

stabilization, strength, and power (Figure 13-3), which are subdivided into five phases. It is imperative that fitness professionals understand the scientific rationale behind each level and each individual phase of training so they can properly use the OPT model. These five are Stabilization Endurance, Strength Endurance, Muscular Development, Muscular Strength, and Power.