Programs & Assessments Essentials of Integrated Training - Part 9 by Mike Clark | Date Released : 18 Mar 2003 0 comments Print Close In order to be safe, effective and productive, all trainers must be competent at designing resistance training programs for a variety of clients. This entails the proper utilization of scientific concepts, exercises and acute variables structured in a progressive manner. For many trainers this can become a daunting task when trying to figure out where to begin and how to specifically modify programming variables for particular clients. However, when using a structured, scientifically based programming model, it becomes as easy as “cut-n-paste” on your computer. And let’s face it, the less time we have to spend designing a program, the more time we have for applying it with our clientele. This makes us happy trainers and a happy trainer means a happy client. Let’s spend some time now looking what program design is and what it should do, then we’ll review the programming model developed by the National Academy of Sports Medicine (NASM) termed Optimum Performance Training™ (OPT™). WHAT IS PROGRAM DESIGN? “Program Design” simply means creating a purposeful system or plan to achieve a goal. The key words here are “purposeful system”. The “purpose” of a resistance training program is to provide a path for the client to achieve their goal. This involves understanding the physiological adaptations that must take place, the necessary bio-motor abilities to address (i.e. flexibility, core, balance, power, strength, etc.), the acute variables necessary, the right exercise selection and how to specifically manipulate all of these components over time to ensure a safe and effective progression. That is a lot of information for a trainer to process especially when they don’t have to. If a trainer, however, has a “system” than they can follow that system and simply plug in the needed information. This is what the OPT™ model provides a trainer. THE OPT™ MODEL The OPT™ model (Figure 1) is a scientifically based progressive system of applying acute variables and exercise selection to achieve specific goals.1 In essence, the OPT™ model provides the answers to every trainer’s needs – how to create a purposeful system or plan to achieve any goal, what adaptations to address and how, what acute variables to use when and for how long and what exercises best address each adaptation. Looking at Figure 1, we see that there are essentially three major physiological adaptations (stages) that take place relative to resistance training. The adaptation of “hypertrophy” falls more predominantly within the “strength” stage and is therefore, not given a specific stage in this version of the OPT ™ model. The first stage is “Stabilization”, second is “Strength” and third is ‘Power”. Figure 1. The OPT™ Model. STABILIZATION TRAINING Stabilization is often overlooked and misunderstood by many health and fitness professionals. This adaptation requires high repetition schemes with low to moderate volume and intensity to challenge the stabilizing muscles of the body which are predominantly type I or endurance based muscle fibers (Figure 2).1-,2,3 Figure 2. Stabilization Training Acute Variables *4/2/2 – refers to 4 second eccentric, 2 second isometric and 2 second concentric muscle actions. The higher repetition schemes utilized in this stage also help to increase vascularization of tissues for better recovery and prepare the connective tissues of the body that are not as readily repaired as muscle following resistance training (i.e. tendons and ligaments).4,5 In an Integrated Training model, exercises in this level of training are selected to increase the proprioceptive demand placed on the body. In other words, by performing exercises in a more unstable manner (only to the level that a client can control), the nervous system is forced to adapt by increasing its intrinsic stabilization. This form of training has been shown to be extremely effective for increasing neuromuscular coordination and efficiency in healthy6 elderly7 and unhealthy populations.8,9-10 Another important component of unstable training is that it may help to ensure action-specific strength adaptations such as standing on one leg to kick a ball, walk up stairs or simply walk.11 Example exercise selections for this stage of training include the use of a Ball Dumbbell Chest Press (Figure 3) or a Standing Cable Chest Press (Figure 4) instead of a Chest Press machine (please refer to the PTontheNET.com Library of Exercises for detailed descriptions of these exercises). These types of exercises have been suggested as increasing the stabilization demand placed upon the core. 1,6,11 Figure 3. Ball DB Chest Press Figure 4. Standing Cable Chest press STRENGTH TRAINING Strength is typically the level of training that most trainers and clients start. However, much of today’s clientele is really not properly prepared for the demands placed upon the body in this stage (sets reps, intensity, etc.) of training due to lack of joint stabilization strength as noted by their postural imbalances. In a progressive training model however, a client is systematically prepared to meet the demands that should be placed upon the body at this level of training. The Strength phase of training allows for increases in volume, intensity and force production to enhance the preparation of a client for the higher force demands of their daily or sporting activities.3,11-12,13 Here eccentric, isometric and concentric muscle actions are emphasized with progressing speeds of contraction to maximize better force production. Stabilization Strength/Endurance, Hypertrophy, Strength/Maximal Strength (Power) adaptations are the focus in this level of training as suggested by the acute variables seen in Table 2. Figure 5. Strength Training Acute Variables *(Str) = Strength exercise; (S) = Stabilization exercise Exercises that are used in this level of training are more stable/traditional in comparison to the stabilization level of training, and include exercises such as bench press (Figure 6) and squats (Figure 7) (refer to PTontheNET.com Exercise Library for detailed descriptions) Figure 6. Bench Press Figure 7. Squats Phase 3 – Stabilization Equivalent Training Stabilization equivalent training is a hybrid form of training used by NASM to promote increased stabilization endurance for maximal joint and core stabilization as well as hypertrophy and strength. This form of training entails the use of super-setting techniques where a more stable exercise such as a bench press is immediately followed (super-set) with a stabilization exercise with similar biomechanical motion such as a standing cable chest press (Figure 8). Thus for every set of an exercise/body part performed according to the acute variables, there are actually two exercises or two sets being performed. High amounts of volume can be generated in this phase of training.1 Figure 8. SET Exercise Example for Chest POWER TRAINING Power forms of training are usually not pursued in the fitness environment, but have a very viable and purposeful place. Power is simply defined as force x velocity.14 Therefore, any increase in either force and/or velocity is will produce an increase in power. This is accomplished by either increasing the load (force) as in progressive strength training or increasing the speed with which you move a load (velocity). Power training allows for increased rate of force production through increasing the number of motor units activated, the synchrony between them and the speed at which they are excited. 15,16,17-18 This allows for better force production in daily and sporting events.3,11,12,-13 Table 3 provides acute variable selection parameters for power training. Don’t let the intensities confuse you. The 85-100% refers to the intensity for traditional strength training exercises and increases power by increasing the FORCE side of the power equation (force x velocity). The 30-45% intensity is used for “speed” exercise such as speed squats where the squats are performed as fast as possible with this low load. The 10% (up to 10%) intensity is used for medicine ball training that will require the throwing or release of a medicine ball. These last two forms of training effect the VELOCITY side of the power equation (force x velocity). By using either heavier weights (approximately 60-90% depending on body part) with explosive movement and/or low resistance with a high velocity you can produce high power outputs.19 Table 3. Power Training Acute Variables *RM = Repetition Maximum; MB = if using a medicine ball; (P) = power exercise Exercises used in this level of training range from the traditional exercises seen in Figures 6 and 7 to explosive medicine ball exercises such as Medicine Ball Chest Pass (Figure 9) and Medicine Ball Pullover Throw (Figure 10). As a side note, any of the Olympic lifts may be used in the Strength and Power levels of training if you use these lifts in your workout routine. Figure 9. Medicine Ball Chest Pass Figure 10. Medicine Ball Pullover Throw Phase 6 – Elastic Equivalent Training Elastic eqiuvalent training, also known as complex training, is a hybrid style of power training designed to maximize rate of force production. This phase of training entails the use of a super-setting technique where a more traditional strength exercise such as a bench press is followed by a high velocity/plyometric exercise with a similar biomechanical motion such as a medicine ball chest pass (Figure 11).1,20 Figure 11. EET Exercise Example for Chest CONCLUSION Program design is a systematic scheme for planned progression. It must provide a method to your madness specifically organizing the desired adaptations to follow the physiological principles of the human body. It is imperative that a properly designed program address all necessary adaptations of flexibility, core stabilization, balance, reactive (power) and strength. An example template used by NASM is seen in Figure 12 and allows for proper organization of each workout (see also the PTontheNET.com Create-a-Program feature for integrated program templates online). If a person is extremely strong (maximal strength) yet has very poor core strength, they will be unable to realize all of their strength as their platform (the core) will not be able to withstand the forces applied to it. This leads to compensation and overuse injuries21,22,23 Similarly, if a person does not have appropriate flexibility they will acquire muscle imbalances and this will lead to compensation and injury as well.24,25,26 *CST=Core; NST=Balance; RNT=Reactive The OPT™ model provides a structure that allows you to systematically progress any client to any goal regardless of their initial ability level.1 It details all the necessary components of a program (flexibility, core stabilization, balance, reactive and strength) and shows you what exercises to use at right time, what acute variables are needed for the specific adaptation you require and how to safely progress each component collectively with the others over time. For more information on how to use this simplistic programming model and template or if you are already familiar with them and are ready for advanced application, please contact NASM at www.nasm.org REFERENCES Clark MA, Corn RJ. Optimum performance training for the fitness professional. Thousand Oaks, CA: National Academy of Sports Medicine; 2001 Kraemer WJ et al. Progression models for resistance training for healthy adults. Med Sci Sports Exerc 2002;34(2):364-80. Bompa TO. Periodization of strength: The new wave in strength training. Toronto, ON: Verita Publishing Inc.; 1993 Nordin M, Lorenz T, Campello M. Biomechanics of tendons and ligaments. Chapter 4. In Nordin M, Franklel VH (eds.). Basic biomechanics of the musculoskeletal system. 3 rd edition. Philadelphia: Lippincott Williams & Wilkins; 2001. Kannus P. Structure of the tendon connective tissue. Scand J Med Sci Sports 2000; 10(6):312-20 Heitkamp HC, Horstmann T, MayerF, Weller J, Dickhuth HH. Gain in Strength and Muscular Balance After Balance Training. Int J Sports Med 2001;22:285-90. Wolf B, Feys H. Weerdt De, van der Meer J, Noom M, Aufdemkampe G, Noom M. Effect of a physical therapeutic intervention for balance problems in the elderly: a single-blind, randomized, controlled multicentre trial. Clin Rehab 2001:15(6):624-36. Fitzgerald GK, Childs JD, Ridge TM, Irrgang JJ. Agility and perturbation training for a physically active individual with knee osteoarthritis. Phys Ther 2002;82(4):372-82. Luoto S, Aalto H, Taimela S, Hurri H, Pyykko I, Alaranta H. One footed and externally disturbed two footed postural control in patients with chronic low back pain and health control subjects. A controlled study with follow-up. Spine 1998 Oct 1; 23(19): 2081-9. Borsa PA, Lephart SM, Kocher MS, Lephart SP. Functional assessment and rehabilitation of shoulder proprioception for glenohumeral instability. J Sports Rehab 1994;3:84-104. Behm DG, Anderson K, Curnew RS. Muscle force and activation under stable and unstable conditions. J Strength Cond Res 2002;16(3):416-22. Poliquin C: The Poliquin Principles; Successful Methods for Strength and Mass Development. Dayton Writers Group. Napa, CA 1997. Siff MC, Verkhoshansky YV: Supertraining; Special Strength Training for Sporting Excellence. Strength Coach Inc. Painesville, OH 1997 Enoka RM. Neuromechanics of human movement. 3rd edition. Champaign, IL: Human Kinetics; 2002. Sale, DG, MacDougall JD, Upton AR, McComas AJ. Effect of strength training upon motorneuron excitability in man. Med Sci Sports Exerc 1983; 15(1):57-62. Sale, D.G. Neural adaptation to resistance training. Medicine and Science in Sports and Exercise. 20(5): S135-S145, 1988. Milner-Brown HS, Stein RB, Yemm R. Changes in firing rate of human motor units during linearly changing voluntary contractions. J Physiol 1973; 230:371-390. Hakkinen K, Komi PV. Electromyographic changes during strength training and detraining. Med Sci Sports Exerc 1983;15(6):455-60. Baker D. Selecting the appropriate exercises and loads for speed-strength development. Strength Cond Coach 1995;3(2):8-16. Ebben WP, Watts PB. A review of combined weight training and plyometric training modes: Complex training. Strength and Cond 1998;20(5):18-27. Hodges PW, Richardson CA. Neuromotor dysfunction of the trunk musculature in low back pain patients. In: Proceedings of the international congress of the world confederation of physical therapists. Washington, DC; 1995. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine 1996;21(22):2640-50. Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther 1997;77:132-4. Alter MJ. Science of flexibility. Second Edition. Champaign, IL: Human Kinetics; 1996 Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther Abstract Oct 1997;77(10):1090-96. Chaitow L: Muscle Energy Techniques. New York, Churchill Livingstone, 1997 Back to top About the author: Mike Clark Since 2000, Mike Clark has spearheaded the National Academy of Sports Medicine’s renewed commitment to the health-and-fitness industry through the development of a revolutionary educational continuum and the implementation of a state-of-the-art training and teaching facility. The author of two textbooks, nine educational monographs and more than 35 textbook chapters and peer-reviewed articles in the areas of sports medicine, sports performance and integrated manual therapy, Clark served as the director of the Optimum Performance Training™ (OPT) program at Physiotherapy Associates in Tempe, AZ, between 1997 and 2000. There, Clark and his team rehabilitated, reconditioned and trained hundreds of professional and Olympic athletes. Clark also served as team physical therapist for Olympic teams during the 1996 and 2000 games. Between 1995 and 1997, Clark served as director of Peak Performance Physical Therapy and Sports Medicine in Oshkosh, WI. Clark holds master’s degrees in human-movement science and sports medicine from the University of North Carolina-Chapel Hill. He achieved physical therapy and bachelor’s degrees in exercise and sports science from the University of Wisconsin-LaCrosse. Currently eligible to sit for the NATA-BOC Examination (ATC), Clark is also a doctoral candidate. Professional memberships and certifications include American Physical Therapy Association, Orthopedic Physical Therapy Association, Sports Physical Therapy Association, National Athletic Trainers Association, National Strength and Conditioning Association and the National Academy of Sports Medicine. Clark and his wife Melissa, a 2000 Olympian (pole vault) and previous American record holder, reside in Wood Ranch, CA. 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