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From PEKN 4P22 D02 2012 Group 01

Group # 1 Brier House bh09cg Brittany Beamer bb09ua Michael Mok mm09xi Kristen Maiden km08oa

Contents 1 Initial Consultation with LS 2 Initial Pre-Fitness Assessment Plan 3 Pre-Fitness Assessments Performed with LS 4 Training Goals 5 Fitness Meeting #1 (Testing Stage) 6 Fitness Meeting #2 7 Fitness Meeting #3 8 Fitness Meeting #4 9 Fitness Meeting #5 10 Fitness Meeting #6 11 Group Meeting/New Routine 12 Fitness Meeting #7 13 Fitness Meeting #8 14 Fitness Meeting #9 15 Fitness Meeting #10 16 Physiotherapy Results 17 Fitness Meeting #11 18 Post-Fitness Assessments Performed with L.S. 19 New Program Summary/Continuation

[edit] Initial Consultation with LS

Date: September 27, 2012 @ 5:30pm
Attended by Brittany and Brier

What is your age?

• 45

What is your occcupation?

• Financial Planner/Part-time Lecturer/Editor

What is your availability during the week?

• Mondays at 2/Thursdays at 3

What are your personal aspects of his life? (wife, kids, animals etc.)

• Enjoys sports
• Completed a triathlon 8 years ago
• Prior to injuries: Enjoyed running on trails
• Enjoys set workout routines
• Stays active as much as possible

What are your goals/What do you expect to get from this?

• Get back into a set routine in the gym
• Maintain current muscle mass
• Goal weight 225 lbs.

Do you have any fears/apprehensions of the program/of us?

• Re-injure previous injuries

What are your expectations at the end/expectations from us?

• Keep it exciting
• Stretch/warm-up very important part of routine
• No sitting still
• Reach goals
• Try new exercising techniques (ie. exercise ball/core)
• Maintain muscle mass not build more

Are there any pre existing medical conditions/injuries?

• Complete right knee meniscus tear (had surgery 4 years ago)
• Baker's Cyst (right knee)
• Plantar Fasciitis- both feet (not severe enough to hinder activity)
• Left shoulder: Supraspinatus tear 2 years ago
• Lower back injury when younger

Are there any medications that we should be aware of?

• No medications currently
• Had a cortisone shot in right foot previously
• Goes to physiotherapy, chiropractor, doctor before prescribed medication

• Go through PAR-Q
• -PAR-Q: OK

What was your previous training history? Was it positive or negative?

• Prior to injuries: 2 hour exercise routines
• Enjoys exercising-all positive experiences

How often are you physically active? What do you enjoy doing?

• Enjoys soccer, hockey, running, mountain biking
• Active as much as possible

Do you have any personal preferences in activities/workouts or ones you'd like us to avoid?

• Enjoys leg Press
• Likes to keep active
• Gets bored if sitting/waiting too long
• Dislikes squats
• Wants a set routine
• Enjoys weights/bike
• 2 days a week for program

Is there any other information that you feel would be relevant?

• Right hand dominant

[edit] Initial Pre-Fitness Assessment Plan

Mock-up Plan 
Developed by Brier, Brittany, Kristen & Michael 

Cardiovascular Testing

• -Cooper 12 minute run (if he is willing to do so)
  • Equipment: Stopwatch & Track
  • The client will start out on a track (helps to measure distance) and will complete as many laps of that track as possible in 12 minutes. He can run or walk all of it or alternate between the two during this time. There will be examiners (2 group members) standing at a fixed point on the track to monitor both time and laps completed.
    • OR
• -Modified Cooper 12 min test on stationary bike
  • Equipment: Stationary Bike with distance monitor
  • The client will place himself on a stationary bike and peddle (once again at his own pace) and try to complete the greatest distance in 12 minutes (Distance will be recorded from bike.
• Distance and VO²max score will be compared from the beginning of this plan to the end but also to norms [1]
• Equation to calculate VO² Max: (Distance covered in metres - 504.9) ÷ 44.73

Flexibility

• -Goniometry of Hip, Knee, Ankle, Shoulder
  • Equipment: Goniometer, table/floor with mat
  • 2 group members will use a goniometer to measure angles and the range of motion of the joints that have been previously injured to compare them to the related non-injured joints. Reference of proper procedure [2]

Strength Testing

• -Manual Muscle Test
  • Equipment: Chair
  • Knee extension/flexion, Shoulder Abduction/Adduction, Extension & Flexion
  • These joints/muscle groups will be tested manually by 2 group members to make sure previous injuries have not caused a large difference in strength between the two sides of the body. It is also useful to test if any old injuries are reoccurring ones.
• -Core Muscle Strength and Stability Plank Test
  • Equipment: Yoga Mat, Stopwatch
  • The client will begin by laying on a mat in the prone position, he will then lift himself into a plank position with his feet on the floor and elbows bent. He will hold this for 30 seconds, he will then lift the right arm off the ground for 15 seconds, return it and lift the left arm for 15 seconds, the legs will follow respectively for 15 seconds as well. Group members will watch for swaying, shaking etc and also if the whole sequence is completed. These observations will be written down and compared to the assessment at the end of this term with our client. (reference for plank test: [3])

[edit] Pre-Fitness Assessments Performed with LS

Date: October 11, 2012 @ 3pm 
Attended by Kristen and Michael

Cardiovascular Assessment

• Cooper 12 Minute Run
  • Ran 11.5 laps in 12 minutes
  • 1 lap = 200m , therefore he ran 2300m
  • Calculated VO²max = 40.12
  • Above average rating

Flexibility Assessment

• Values found using the goniometer (Note: the right side is listed first)
• Shoulder
  • Abduction (0-155 and 0-135)
  • Flexion (0-160 and 0-160)
  • Extension (160-0 and 160-0)

• Hip
  • Flexion(with bent knee)(0-106 and 0-109)
  • Abduction (0-36 and 0-30)
  • Adduction (0-77 and 0-65)

• Knee
  • Flexion (0-126 and 0-129)
  • Extension (126-0 and 129-0)

• Ankle
  • Dorsiflexion (0-20 and 0-30)
  • Plantar Flexion (0-60 and 0-75)
  • Inversion (0-20 and 0-20)
  • Eversion (0-15 and 0-20)

• There were no significant differences between the flexibility found in the right side vs. the left side of the body in general but it should be noted that due to the injury he suffered in his left supraspinatus muscle (which is responsible mainly for shoulder abduction) his left shoulder had slightly less ROM in respect to abduction.

Strength Assessment

• Manual Muscle Tests
  • These were used to assess the strength in both the shoulder and the knee joints. In the shoulder we tested flexion/ extension and adduction/ abduction. In the knee joint, flexion and extension were tested. There were no major differences within the right and left sides of the body and no notable weakness in any muscle group.

• The Stability Plank Test
  • Was used in order to gain a general idea of his current overall core strength. He was able to complete the entirety of both assessments. During the first test we noted only slight shaking while alternating arms were lifted off the ground. When nearing the end of the first assessment his body was more wobbly/shaky but he was still able to remain in the proper plank position in order to fully complete the test. The second part of the Stability Plank Test we noted much more shaking than before when the alternating arm and leg were raised but he was still able to finish this test completely as well. Based on this we are able to estimate that he has slightly above average core strength but there is still room for improvement in this area.

• Based on all the information we gathered in this initial assessment we can make 2 positive conclusions, 1: That LS is in good/above average shape for a man of his age and 2: that his injuries/inflictions do not limit his physical activity/exercise ability to any real extent. Of course we will still approach certain exercises with caution and avoid too much weight bearing but he is in good enough shape to enter into a normal regimented circuit training design.

[edit] Training Goals

• 1. Maintain cardiovascular fitness through circuit training within our five to six week time frame. We can measure this by doing the 12 Minute Run in our final training session.

• 2. Increase core strength by progressively working on planks and stability ball exercises. We are able to measure the progress at the end of our training sessions by re-using the plank test with an increased time frame. We can look for improvements in the overall performance and technique between the two assessments.

• 3. Increase flexibility within the shoulder joint by utilizing stretching exercises. Progress can be observed through comparisons of the goniometer measurements of the shoulder joint from the first and last flexibility assessments. There should be a noticable increase in range of motion following our training program.

[edit] Fitness Meeting #1 (Testing Stage)

Date: October 15, 2012 @2pm
Attended by Brier and Brittany 

• Our initial plan is to develop a circuit for LS complete 2 times (sets), with approximately 6-8 exercises per set. However for the inital fitness meeting we plan to develop a whole bunch of exercises for each large muscle group and have LS chose which ones he prefers most and also based on the ones we feel he will benefit the most from.

Dynamic Stretching

• Straight Leg Kicks (10 reps per leg)

• • While standing straight, bring one leg out in front of you and kick upwards slowly until you feel a tug
  • Arms can be extend to the side for balance if needed
  • Complete 10 reps then switch legs and repeat

• Arm Swings (10 reps per arm)

• • While standing straight, swing one arm diagonally across the body in front of the other arm and back out to the side
  • Complete 10 reps and repeat with opposite arm

• Toe Touch (8 reps per side)

• • From a standing position, swing one arm downwards towards the opposite foot (touch if able) then return to standing position
  • Without hesitation, swing opposite arm downwards towards the new opposite foot then return again to standing position
  • Repeat this routine 8 reps for each side (16 total)

Warm-up

• Stationary Bicycle
  • 5-8 minutes
  • small resistance

Routine:

Ball Push-Up

• 1. Lie face down with exercise ball at chest.
• 2. Walk forward with your hands until the ball is resting on your shins.
• 3. Place hands shoulder width apart.
• 4. Flex elbows so your body lowers to the floor.
• 5. Extend elbows so your body is parallel to the floor.
• 6. Repeat.
  • We asked LS to raise one leg as the push-up is being completed to add difficulty
  • 14 reps/1 set

Ball Jackknife

• 1. Start in the push-up position.
• 2. Keeping your back straight, contract your abdominal muscles.
• 3. Bend your knees to pull the exercise ball toward your chest.
• 4. Return to push-up position.
• 5. Repeat
  • 14 reps/1 set

Leg Press

• 1. Load machine with appropriate weight.
• 2. Place feet on the middle of the platform, shoulder width apart (knees should form 90° angle).
• 3. Contract the abdominal muscles and push platform with heels and forefoot by extending your knee (heels remain flat).
• 4. Push platform until knees are almost fully extended (do not fully extend knees).
• 5. Return platform back to starting position (knees and legs forming 90°).
• 6. Repeat.
  • 14 reps/1 set

Stationary Bicycle

• small resistance
• more for speed
  • 3 minute bouts

*Ball Table Top

• 1. Place knees on ground and place your forearms on the exercise ball (elbows at 90° and back straight).
• 2. Raise knees off of the ground by rolling the ball forward with your forearms.
• 3. Fully extend knees and pause.
• 4. Return to starting position.
• 5. Repeat.
  • 14 reps/1 set

Ball Chest Fly

• 1.Lie on your back and place your shoulder blades on top of the exercise ball.
• 2. Back is extended and your knees are at 90° angles.
• 3. Hold dumbbells out to each side of your body.
• 4. Keeping elbows slightly bent, pull weights above head.
• 5. Return to starting position.
• 6. Repeat.
  • 12 reps/1 set

Monster Walk

• 1. Loop a resistance band around your legs (just above the ankle).
• 2. Crouch down into a squat with feet shoulder width apart.
• 3. Take a few short steps forward (alternating between the left and right leg).
• 4. After completion of the forward steps, take a few short steps forward.
• 5. Repeat on each side.
  • 14 reps (7 steps forward/7steps backward)/1 set

Stationary Bicycle

• same as above

Lateral Raise

• 1. Begin by standing with your feet shoulder width apart holding a dumbbell in each hand (palms facing inward).
• 2. Bend knees slightly.
• 3. Lift weights slowly, keeping back straight.
• 4. Raise weight until your arms are parallel to floor.
• 5. Lower weights to the side of your body and repeat.
  • 14 reps/1 set

Seated Cable Row

• 1. Sit at a seated row cable machine.
• 2. Extend arms to hold attachments with both hands (palms facing inward).
• 3. Keeping your back straight, flex your elbows to pull the handles towards your navel (do not lean backwards).
• 4. Extend elbows to return to starting position.
• 5. Repeat.
  • 14 reps/1 set

Ball Wall Squat

• 1. Place the exercise ball at the small of your back.
• 2. Stand shoulder width apart.
• 3. Bend your knees to a 90° angle (the ball will roll along your back).
• 4. Push down on your heels to extend knees into starting position.
• 5. Repeat.
  • 14 reps/1 set

Plank

• 1. Begin with your knees and forearms touching the ground.
• 2. Extend your knees so that your back is straight and your toes are holding you up.
• 3. Keep back straight and your bottom down.
• 4. Hold.
• 5. Repeat.
  • To add difficulty, we asked LS to raise each leg while performing the plank
    • L.S. started with 15 seconds for each position

Stationary Bicycle

• same as above

This routine would be repeated twice

Cool Down

• • 5 min walk around track or on bike (slowly decreasing pace)

Static Stretching

• Shoulder Stretch Cross Over

• • Take one arm and cross it over your body towards the opposite arm
  • Using the hand of the opposite arm apply slight pressure behind the elbow until there's a pull without pain
  • Hold for 30 seconds

• Quadricep Stretch

• • While standing, bring one ankle towards the hamstrings and grasp with hand
  • Gently pull upwards with arm until you feel a slight tug
  • Hold for 30 seconds

• Hamstring Stretch

• • While sitting with legs straight out in front of you, lean forward and reach towards your toes (grab if able)
  • A possible modification is to bend leg in towards you and stretch down towards the straight leg
  • Hold for 30 seconds

[edit] Fitness Meeting #2

Date: October 18, 2012 @ 3pm
Attended by Kristen and Michael 

Notes of Circuit

• LS was coming in from a ten minute trail run when we met him today, therefore we went straight into some dynamic stretches rather than having him bike as a warm up.

Within the First Round of the Ciruit:

• LS struggled near the end of the plank test
  • We ended up doing the plank for a minute and a half with alternating raising each arm and leg, as well as opposite arm and leg for 15 seconds each.
• The first circuit was completed within 30 minutes

Within the Second Round of the Circuit:

• Too much swinging motion during the lateral raise (noticable difference from the first circuit)
• By the end of the workout he was unable to fully complete the plank

General Notes:

• LS mentioned that he had previously donated blood this morning which may have caused him to fatigue quicker
• Experienced shoulder pain during the final plank, no pain anywhere else
• After LS finished our circuit he was planning on biking for 45 minutes
• We asked on a scale of 1 (easy)-10 (hard) how he would rate our program, he rated it an 8
• Enjoyed the fact that the circuit kept him constantly moving

[edit] Fitness Meeting #3

Date: October 22, 2012 @ 2pm
Attended by Brier and Brittany 

NOTES of Circuit

• LS chose to run outside again for his warm up and then we went straight into dynamic stretches followed by the first set of the circuit.

Within the First Round of the Circuit

• He performed all the exercises well, he needed some correcting on the table top form but the rest was done properly.
• He was still struggling with the plank test at the end of the first circuit

Within the Second Round of the Circuit

• We could notice him shaking a bit more throughout this circuit and seemed to be a bit more tired when moving between exercises but still kept up the pace
• He was unable to properly do the plank at the end and requested that we change the first 15s to only 10s per arm/leg and add in another core exercise to make up for this
  • Medicine Ball Crunch Twist

• 1. Begin by sitting on the ground, legs extended right in front of you.
• 2. Lean back and raise legs off the ground.
• 3. Contract core muscles.
• 4. Move the medicine ball to each side of your body by twisting your upper body.
  • When the medicine ball goes to each side, that is 1 complete repetition of the exercise.
• 5. Repeat.
• 12 reps/1 set

General Notes

• He said he enjoyed the workout and liked when we rode the bike with him and talked because it made the time go by quicker
• He complained of shoulder pain, not in his injured shoulder, after doing the planks which led to our slight alterations in the program and adding a medicine ball twist exercise to still work his core
• Did 45 min on the stationary bike after the circuit workout as well for his added cardio

[edit] Fitness Meeting #4

Date: October 29, 2012 @ 2pm
Attended By Brier and Brittany 

NOTE : THURSDAYS WORKOUT MISSED DUE TO LS HAVING A FAMILY EMERGENCY

Notes on Circuit

• LS began as usual with a ten minute warm up on the bike followed by the stretches
• We've noticed his table top exercise strength has gotten much better and he doesn't shake as much while performing it
• Increased the resistance band for the monster walk from a green to a blue (almost strongest resistance)
• The modification in the plank has shown to be very effective since he can fully perform the last plank of the circuit

General Notes

• No shoulder pain reported after during full circuit and mentioned he liked the new medicine ball exercise we added in to make up for reduction in time for the plank
• LS noted that he found the monster walk more effective with the stronger resistance and tend to enjoy it more

[edit] Fitness Meeting #5

Date: November 1, 2012 @ 3pm
Attended by Kristen and Michael

NOTES on Circuit

• LS began his workout with a ten minute ride on the stationary bike at a low-moderate intensity followed by some dynamic stretches.
• We inquired about any joint pains within his knees or shoulders since his shoulder was sore the last time we saw him. He reported to have no pains in the beginning and thought the previous cause may have been from the plank exercises which called for the alternating legs to be raised since he was off balance.
• He mentioned that the biking portion of the circuit was more relaxing than the other exercises which means we may need to motivate him to increase his speed or the resistance used during the cardio exercises.
• Throughout the core exercises that were performed we noticed that LS seemed much more stable than the previous time that we worked with him (which was about two weeks ago).
• Each circuit took about 40 minutes to complete, which is slightly longer than before due to our added biking and core exercise.

General Notes

• Again, LS will be biking for about 30 minutes following our circuit workout.
• He requested for us to add in an exercise to target his biceps since we have not targeted this muscle so far.

[edit] Fitness Meeting #6

Date: November 5, 2012 @ 2pm
Attended by Brier and Brittany 

Notes on Circuit

• All stability ball exercises have largely improved in terms of balance and overall strength when performing them, he is less shaky and reports that they have become easier to perform
• He began to get tired near the end of the second round of the circuit but still performed his plank fully and carried out all exercises
• Increased weights he used during chest fly from 27 lbs to 30 lbs

General Notes

• LS had eaten close to when we worked out, contributing to him feel sluggish near the end of the second round
• Had some pain between his scapulae but said it was there before hand due to sleeping position the night before

[edit] Group Meeting/New Routine

Date: November 7, 2012 @ 10am
Attended by Brier, Brittany, and Kristen

New Routine

Warm-Up

• Stationary Bicycle for 5 minutes

Biceps Curl with Bar

• 1. Stand with feet shoulder width apart with knees slightly flexed.
• 2. Slowly raise the weighted bar toward you shoulders by flexing the elbow.
• 3. Keep elbows positioned at both sides of the body.
• 4. Slowly return bar to resting position.
• 5. Repeat.
  • 14 reps/1 set

Triceps Dips

• 1. Sit close to a bench, where your buttocks is right in front of the bench.
• 2. Extend arms to hold yourself up off the bench.
• 3. Slowly lower your body down to the ground (do not exceed a 90 degree angle at your elbow).
• 4. Slowly raise body to starting position.
• 5. Repeat.
  • 14 reps/1 set

Jackknife with Medicine Ball and Bosu

• 1. Start in the push-up position with ankles on top of stability ball and your hands on the bosu.
• 2. Keeping your back straight, contract your abdominal muscles.
• 3. Bend your knees to pull the exercise ball toward your chest.
• 4. Return to push-up position.
• 5. Repeat
  • 12 reps/1 set

Leg Press

• 1. Load machine with appropriate weight.
• 2. Place feet on the middle of the platform, shoulder width apart (knees should form 90° angle).
• 3. Contract the abdominal muscles and push platform with heels and forefoot by extending your knee (heels remain flat).
• 4. Push platform until knees are almost fully extended (do not fully extend knees).
• 5. Return platform back to starting position (knees and legs forming 90°).
• 6. Repeat.
  • 14 reps/1 set

Calf Raise

• 1. Stand on raised platform on the toes (feet shoulder width apart).
• 2. Raise your body by lifting your toes.
• 3. Hold position for 1-3 seconds.
• 4. Return to resting position.
• 5. Repeat.
  • 14 reps/1 set

Run

• client will run 2 laps around the track

Lateral Raise

• 1. Begin by standing with your feet shoulder width apart holding a dumbbell in each hand (palms facing inward).
• 2. Bend knees slightly.
• 3. Lift weights slowly, keeping back straight.
• 4. Raise weight until your arms are parallel to floor.
• 5. Lower weights to the side of your body and repeat.
  • 12 reps/1 set

Seated Cable Row

• 1. Sit at a seated row cable machine.
• 2. Extend arms to hold attachments with both hands (palms facing inward).
• 3. Keeping your back straight, flex your elbows to pull the handles towards your navel (do not lean backwards).
• 4. Extend elbows to return to starting position.
• 5. Repeat.
  • 14 reps/1 set

Ball Chest Fly

• 1.Lie on your back and place your shoulder blades on top of the exercise ball.
• 2. Back is extended and your knees are at 90° angles.
• 3. Hold dumbbells out to each side of your body.
• 4. Keeping elbows slightly bent, pull weights above head.
• 5. Return to starting position.
• 6. Repeat.
  • 12 reps/1 set

Run

• client will run 2 laps around the track

Medicine Ball Burpee

• 1. Stand shoulder width apart with arms raised above head holding a medicine ball.
• 2. Jump straight up.
• 3. Land in a squatting position.
• 4. Quickly, move into a push-up position.
• 5. Perform a push-up (where your hand are on the medicine ball instead of the ground).
• 6. Return to standing position with medicine ball above your head.
  • This would be 1 complete burpee
• 7. Repeat the jump, squat, push-up positions.
  • 12 reps/1 set

Ball Pike-Ups

• 1. Begin in a plank position with your ankles on top of a stability ball.
• 2. Slowly, roll the stability ball towards your arms.
• 3. Your buttocks will be raised in the air.
• 4. Slowly return to plank position.
• 5. Repeat.
  • 12 reps/1 set

Plank

• 1. Begin with your knees and forearms touching the ground.
• 2. Extend your knees so that your back is straight and your toes are holding you up.
• 3. Keep back straight and your bottom down.
• 4. Hold.
• 5. Repeat.
  • To add difficulty, we asked LS to raise each leg/arm/alternating sides while performing the plank
  • L.S. held each position for 8-10 seconds

Medicine Ball Crunch Twist

• 1. Begin by sitting on the ground, legs extended right in front of you.
• 2. Lean back and raise legs off the ground.
• 3. Contract core muscles.
• 4. Move the medicine ball to each side of your body by twisting your upper body.
  • When the medicine ball goes to each side, that is 1 complete repetition of the exercise.
• 5. Repeat.
  • 12 reps/1 set

Run

• client will run 2 laps around the track

• The modifications were made due to the fact that our client wanted a change in the other circuit

*Our client will go through this new circuit twice, like the prior circuit.

[edit] Fitness Meeting #7

Date: November 8, 2012 @ 3pm
Attended by Kristen and Michael 

Notes of Circuit

• LS was coming in from a fifteen minute warm-up on the stationary bike when we met him today, therefore we went straight into the circuit exercises.
• Equipments: Bosu, Medicine balls (6 lbs and 3 lbs), Stability ball, 2 sets of weights: 17.5 lbs and 30 lbs.

Within the First Round of the Circuit:

• All the weight exercises were completed little difficulty.
• After the Medicine Ball Burpee exercise, LS was sweating a lot and felt the exercise was really tough.
• During Jackknife with medicine ball and bosu and Ball Pike-ups, LS had some trouble keeping his exercise position.
• Plank exercise was changed to 10 seconds because LS felt it was tough

Within the Second Round of the Circuit:

• During the lateral raise, the arms were not kept straight.
• Assistance was given during the jackknife exercise to initiate his starting exercise position.
• Was not able to fully complete the plank exercise. Due to feeling of throwing up and fatigue.
• Had to walk for half of the 2 laps run at the end of the circuit.
• Had more small breaks in between exercise due to fatigue.
• Plank exercise was changed to 10 seconds because LS felt it was tough

General Notes:

• LS mentioned that he had a big meal (chicken salad) for lunch at 1:30pm before he came to exercise. This caused discomforts and occasional "burps" during the circuit. There are times when he had to stop from exercise for a few moments relieve the "burping".
• LS dislikes the Heel Walking with weights, as the movement felt awkward.
• Experienced shoulder pain during the final plank any time when he has to life one of his legs. This may be due to LS's tendency to lean on the supporting arm when lifting his legs. No pain anywhere else.
• After LS finished our circuit he was planning on stretching out his calf, as he felt tightness.
• We asked on a scale of 1 (easiest)-10 (hardest) how he would rate our program, he rated it a 9. The new exercises for the core strength was quite tough, but he really enjoyed the training.
• He had no problem with weight exercises and running.
• Enjoyed the new tough core strength exercises to push him harder.
• Total time: ~56 minutes.
• Requested a small change in the order of exercise, to move the Jackknife exercise to the first half of the circuit. He felt the Burpee, Jackknife, and Ball pike-ups were the toughest exercises in the circuit, and that to do them all side-by-side is tough.

[edit] Fitness Meeting #8

Attended By: Brier & Brittany 
Date: November 12,2012 

First Round of the Circuit

• LS chose to do his warm up on the stationary bike once again and then we went into stretches and began the circuit
• The first section of the circuit before the first run had been changed, the jacknife had been moved from the end of the circuit up to the beginning section just after tricep dips to reduce to amount of core exercises at the end
• LS didn't say anything about this at first but once the circuit was done he told us how much he appreciated it and it made the end section much more bearable
• It was noted when he did the jackknife that he was struggling to keep the bosu stable at first to be able to perform it properly but as the reps went on he found better balance and his form improved
• We noticed he was struggling more with the plank than he did last week and reduced his time to only 8 seconds due to his favoring of his left arm

Second Round of the Circuit

• We offered him a little break to recover after all the intense core at the end but he said he wanted to keep going right away
• We noticed during the second bicep curl set that he seems to overcompensate for his left shoulder being a bit weaker by grasping the bar tighter with that arm and causing the bar to not be kept straight
• The zone was particularly busy today so LS had to wait a minute to get the seated cable row machine but we kept up a good pace throughout the rest
• He performed all the core exercises rather well considering how tough they are to do back to back, but he said he liked how challenging they were

General Notes

• LS said he was very happy with the new routine especially since the jackknife made it more possible to keep up the pace at the end of the circuit
• He seemed to be much more tired at the end but he said he enjoyed it cause this new circuit really pushed him
• LS thought his shoulder was a little more sore today cause of the way he slept, not due to his injury
• Total Time: 1 hour (with warm-up and finishing run)

[edit] Fitness Meeting #9

Attended By: Kristen & Michael
Date: November 15,2012 @ 3pm

General Notes

• LS notified us right away that he had been having pain in his right arm all day and did not want to perform the lateral raise exercise. He said that he had a feeling of numbness in his right hand and forearm.
• We continuously questioned him about his shoulder after each upper body exercise to make sure that we would not hurt it more by performing our exercises.

First Round of the Circuit

• LS was on the stationary bike when we met him this afternoon so we went straight into the circuit exercises.
• During the Bosu Ball Jackknife we noted more instability than normal (which we believe to be caused somewhat by his sore shoulder, however he assured us this exercise was not hurting him)
• We skipped the Lateral Raise completely since the motion during this exercise caused him pain.
• During the Ball Chest Fly exercise LS had a pinching pain near the medial border of the right scapula as he horizontally abducted his arms. Since he informed us of shoulder pain before beginning the routine we grabbed slightly lighter weights to place less stress on the right arm and shoulder.

Second Round of the Circuit

• We made a few modifications within the second round in order to ensure that LS would not cause further harm to his shoulder.
• The bosu ball was completely removed from the Jackknife exercise so that LS would be more stable while performing the motion.
• Instead of the Lateral Raise we included a Frontal Raise exercise using only a 10lb weight with 15 repetitions. We tested out this motion before LS actually performed the exercise and he had no pain at all. This exercise was substituted in order to still gain a shoulder strengthening exercise without causing pain to the client.

Substituted Exercise used today:

Frontal Raise

• 1. Begin by standing with your feet shoulder width apart holding a dumbbell in each hand (palms facing backwards).
• 2. Bend knees slightly.
• 3. Lift weights forward slowly, keeping back straight.
• 4. Raise weight until your arms are parallel to floor.
• 5. Lower weights to the side of your body and repeat.

[edit] Fitness Meeting #10

Attended By: Brittany and Brier
Date: November 19,2012 @ 2pm

• L.S. cancelled today's scheduled workout
  • He was experiencing pain on his right arm and his back and stated he did not want to injure himself more/cause more pain
  • L.S. was scheduled to see a physiotherapist on Tuesday November 20 to discuss his problem areas
    • Will e-mail results of physiotherapist meeting to group
• Waiting on results to continue exercise program

[edit] Physiotherapy Results

• L.S. stated that his physiotherapist saw no problems in his shoulder or back, probably just due to overuse
• He did notice issues in his MCL however but nothing serious
• L.S. was given permission to go ahead as usual with his workouts and other physical activities
• He will meet with Michael and Kristen on Thursday as planned

[edit] Fitness Meeting #11

Attended By: Kristen and Michael
Date: November 22,2012 @ 3pm

General Notes

• We questioned LS about his physiotherapy visit to make sure that he was able to go through his workout with us. We continuously asked him about any pain or discomfort after each exercise was completed.
• He mentioned that he may have a slight sprain in his MCL, but was allowed to exercise. He told us that he had tenderness only when he touched this area and not during movements. We gave him the option of biking rather than running in hopes to not cause pain to the area but he decided it was okay for him to be running.
• Another thing his physiotherapist noted was that his lat muscles may be a little inflammed. LS did say he had tightness in these muscles but he did not report any pain. We made sure that he was not pushiing himself to hard with our circuit and attempted to lower the weights during the Seated Row machine. LS decided to stay at his normal amount of weight lifted for this exercise.

Circuit Notes

• During the Ball Chest Fly exercise the weights were lowered to 25lbs in order to avoid overworking. We noted that he tended to bend his elbows during this exercise to compensate and protect his shoulder joint. He did not have any pain during this exercise.
• We re-added the Lateral Raise into his routine because he did not experience any discomfort while performing the motion today.
• However, during the plank LS did not experience shoulder pain. He tends to twist his body, leaning mostly on one shoulder which we feel is a major cause of this problem. We tried to make alterations to the exercise and have him keep both arms down in hopes of decreasing the twisting motion, but he decided to continue.

[edit] Post-Fitness Assessments Performed with L.S.

Date: November 26 @ 2 p.m.
Attended by Brittany and Brier

Cardiovascular Assessment

• Cooper 12 Minute Run
  • Ran 11 laps in 12 minutes
  • 1 lap= 200m
  • Therefore, LS ran 2200m
  • Calculated VO²max: 37.90 mls/kg/min
    • Above Average Rating

Flexibility Assessment

• Values found using the goniometer (Note: the right side is listed first)
• Shoulder
  • Abduction (0-180 and 0-176)
  • Flexion (0-175 and 0-170)
  • Extension (175-0 and 170-0)

• Hip
  • Flexion (0-105 and 0-110)
  • Adduction (0-55 and 0-40)
  • Adduction (0-55 and 0-50)

• Knee
  • Flexion (0-120 and 0-125)
  • Extension (120-0 and 125-0)

• Ankle
  • Dorsiflexion (0-17 and 0-16)
  • Plantar Flexion (0-43 and 0-40)
  • Inversion (0-20 and 0-23)
  • Eversion (0-23 and 0-22)

NOTES:

• The shoulder assessment improved from the pre-fitness assessment
  • The post-fitness assessment shoulder ranges were closer to the 'normal' ranges
  • Normal shoulder ranges
    • Shoulder abduction 0-180
    • Shoulder flexion 0-180
    • Shoulder extension 180-0
• L.S. increased his shoulder abduction by 25 degrees on the right side and 41 degrees on the left
• L.S. increased his shoulder flexion by 15 degrees on the right side and 10 degrees on the left
• L.S. increased his shoulder extension by 15 degress on the right side and 10 degrees on the left
  • This is important due to the fact that L.S. has had a shoulder injury, so his flexibility has increased slightly in his injured shoulder

Strength Assessment

Manual Muscle Tests

• Shoulder flexion, extension, adduction and abduction were all tested
• Knee flexion and extension were tested as well
  • L.S. scored a 5 on all of the tested areas
  • There were no notable weaknesses in any of these areas

The Stability Plank Test

• The plank test was used to determine if L.S.'s overall core strength has improved from the pre-fitness assessment test
• L.S. was able to complete the entirety of the assessment
  • We gave the option of decreasing the time due to his pain in his shoulder in previous weeks, however L.S. opted to complete 15 seconds at each stage of the plank test
• L.S. remained in proper plank position the whole test
• There was notable shaking at the last segment (raising his right arm and left leg), however, comparing this to his pre-fitness assessment, the shaking was minimal
• L.S. is above average in the strength category due to the fact that he scored all 5's during the Manual Muscle Test and he reduced his shaking during the Plank Test

Overall Achievements:

• Prior injuries did not seem to limit L.S's performance at any point
• L.S. is above average for physical fitness for a man his age
• Shoulder flexibility has increased greatly compared to the pre-fitness assessment
  • IMPORTANCE: previous shoulder injury
• Plank test improved greatly-less shaking and proper form throughout
  • Improved his core strength throughout fitness meetings
• Despite current injuries (mcl injury), L.S. was able to maintain his cardiovascular fitness from pre-test to post-test
• L.S. reached all of his fitness goals by the end of the semester!

[edit] New Program Summary/Continuation

We provided LS with the following:

• Results
  • Results from the inital fitness assessment
  • Results from the post-fitness assessment
• New Goals
  • Increase time doing the plank exercise (from 8 seconds to 12 seconds)
  • Try new cardiovascular exercises (i.e. swimming)
  • Try new stability ball/bosu exercises
    • Keep routine exciting!
• Exercise Routine
  • Follow exercises given by group (LS was given both circuits which included pictures and descriptions of exercises)
  • When program becomes too easy:
    • Switch in new exercises
    • Increase weight/reps
• New Exercises (As examples)
• Butt Lift

• Ball Pass

• Squats on Bosu

• Stability Ball Knee Drives on Bosu