I have a new client who wants me to draw up a training program for her. She is 30 years old, 160 centimeters tall, 79.4 kilograms and 37.5 percent body fat. She has a family history of diabetes, cancer and heart disease. She does not want to do resistance training as she says she has high cortisol levels and the resistance training makes her pump up and grow muscle too quickly. I'm not sure what she wants from me but could this be Cushing’s disease? She has been training for a while, but would it be a good idea to get a full doctor’s exam or report done? Can the resistance training make her swell or grow because of the cortisol because I always thought cortisol was catibolic? Some insight would be appreciated.
I have a couple of questions for you before I get into this question, which is a great one:
- I always tell my students to do their research so they know their client. Sounds like you have done yours. But clients come in to learn from us (that is what she wants from you), so meet her at her level so she can benefit. As well, do you think clients just come to us for that reason? No! They come to us so we can learn from them. So take this opportunity to learn from your client. So what do you think she “wants” from you?
- As well, never second guess your gut feeling with what you know or what you want to do with a client. This is your intuition, and when you doubt it, you doubt yourself.
The question is, where to start? The bottom line is you cannot base your treatment program on symptoms. Otherwise, you will just be a “holistic trainer” following the allopathic approach. Have you assessed your client in the areas of sleep, digestion, stressors, fluids and intake, food (quality and quantity) and detoxification systems? Some great resources for this are www.mercola.com, “How to Eat, Move and Be Healthy!” by Paul Chek and/or “The Cortisol Connection” by Talbott. All of these will allow you to periodize and individualize your client’s treatment program.
When the body is stressed, many things happen. One important thing that happens is the H-P-A-T-G-G (Hypothalamus, Pituitary, Adrenal, Thyroid, Gut and Gonad) axises are turned on. The body releases hormones and cortisol, which help regulate BP, blood sugar and help to fight stress/inflammation. Over time, if we don’t come back to homeostasis because of lack of adaption to the stressors in our lives, the adrenal glands have to work over time. This in turn slows down our metabolism, we become catabolic, end up with a hormones imbalance (Pregnenolone Steal = Pregnenolone is a precursor to progesterone, cortisol and DHEA which DHEA is a precursor to estrogens and testosterone. When over time, we have to keep up with producing cortisol to cope with stress, the body steals Pregnenolone to overproduce cortisol. Reference www.biohealthinfo.com for more in depth information), as well as end up with a gut dysfunction (secondary to the adrenal glands producing immunocytes = SIgA to protect the gut).
So if your client is overweight, might be insulin resistant, has high body fat and is being bombarded with the “many faces of stress in their life,” and she claims to feel pumped up from working out, the pumped up feeling in my opinion is inflammation if anything. This could be joint, arterial, venous, respiratory, the detoxification system and so forth. But you can still exercise someone who has a high physiological load, such as this client. You want to make sure that the goals are as follows:
- Balance the biological oscillators in the body (brain, heart and gut)
- Balance toxicity levels in the body
- Help with immune support
- Emotional well being: depression, anxiety and anger
- Help with acute pain
- Assist with malnourishment (most Americans are overfed and undernourished!)
- Harvesting energy within the body
- Tuning biological oscillators
- Consciousness shift in healing and health maintenance over time
Intensity Zone (weight to be used):
- 0%-40% intensity - You can base this off RM (reps, BW or exact weight to be used)
- Breathing exercises such as yoga or qi gong
- Teaching your client how to breath
- Incorporating Feldenkrais movements, Alexander Techniques, cycling, rowing, swimming, hiking, etc. into her daily life
- Exercise that falls within the client’s postural needs and skill level and does not put any more stress on her body than she already has. With high physiological load clients, anaerobic work does wonders to increase their GH levels, not cortisol levels. But keep it within their intensity parameters.
- You can see most of these are with minimal to no load. Any extra load will just put more fuel into the fire of sympathetic stress.
For more information on the above, attend any course by Paul Chek or Charles Poliquin.
Here are my recommendations:
- Work with this client within her physiological load.
- Refer out for some nutrition and lifestyle assessments and education to meet her needs.
- Refer out to www.biodia.com in order to get the Adrenal Stress Profile (#201).
- With clients such as this, you can see that nutrition and lifestyle at this point will out weigh her need for exercise.