In Part I of this article series we explored the importance of creating a Unique Identity (UID) and the influence it will have on your personal and professional goals. In the second installment of this series I will share with you several developmental tips that have allowed me to successfully help many of my clients in addition to assisting in my own professional development.
It seems that more and more trainers are giving in to the temptation of training their clients using a “recipe approach” rather than creating individualized programs based on each client’s individual needs. These trainers have fallen into the rut of training each client using the same exercises, same rep ranges and even the same rest periods! The good news is you can climb your way out of that rut and I intend to help you accomplish that by sharing some of the strategies that have helped me over the years.
STOP GUESSING AND START ASSESSING!
If you accomplished the objective of Part I of this article series, you have a unique identity or are in the process of developing one. As many of you will soon realize, with the development of your UID comes specific needs and challenges by your clients. Therefore if you claim a specific UID yet continue to practice as a general practitioner or trainer, chances are high that you will reach a point at which you will stunt your personal and professional growth as well your client base.
As your clients’ needs become more specific and your marketing efforts focus on your new UID, you must make sure that your assessment skills become equally focused to keep up with your clients. The only way to ensure that your rate of professional development exceeds the rate or your clients’ complexities, is to accomplish the following educational objectives:
- Master the basics of a Universal / Holistic approach to assessment, education and exercise.
- Master assessment skills that are specific to your client’s unique challenges or conditions.
Let’s take a look at each of these vital objectives one at a time.
MASTERING THE BASICS OF A HOLISTIC APPROACH
When I was a younger I learned how to repair engines in trade school. There I learned the three things that must always be present before any engine can run - Fuel, Ignition, and Compression. It does not matter how much of an expert someone is at setting the timing an engine if the basics of fuel delivery aren’t understood. Similarly, it makes no difference how good someone is at ignition and fuel delivery systems if compression and how to assess it are not understood
The same principles can be applied to the human body and can help to explain why we have such a poor success rate with traditional medical approaches! Consider this: All engines need fuel, ignition and compression to run. The human body needs adequate levels of fuel, hydration, and requires air for the combustion of its fuel. Even though there are many other items deemed necessary for human function, such as sunlight, space to move and physiological stressors, for the sake of this article these items will simply be viewed as improvements to quality of life.
Why is this little tid bit of information so important? Most of you reading this article are in the exercise profession – you induce stress for a living! Some of the stresses encountered by your clients are mental, physical, chemical, hormonal, structural and nutritional. This is important to understand because today’s exercise industry is being bombarded with clients that are ill equipped to handle additional stressors in their lives. In addition to being poorly nourished, structurally imbalanced and psychologically stressed out, many clients are coping with chronic injuries! This point is well backed by EFI Total Gym (San Diego, CA), who as far back as 1997 conducted phone interviews with 1000 personal trainers asking them if they were working with one or more clients suffering from some kind of chronic pain. Every single trainer (100%) stated that at least one of his or her clients was suffering from chronic pain!
So where does this leave us? It forces us to step back and realize that regardless of the specific problem or diagnosis a client presents us with, until their basic needs are met, there will be no benefits gained from specific assessment other than a superficial, palliative, short-term gain. Famous Naturopathic Physician, Bill Timmins (Founder, BioHealth Diagnostics www.biodia.com), calls these basic needs the Foundation Principles. In fact, Dr. Timmins encourages anyone using the BioHealth system to first begin treatment of client or patient by first addressing the Foundation Principles.
While attending a BioHealth Diagnostics seminar I asked Dr. Timmins what percentage of people he felt going to doctors would recover from their ailment if they simply adhered to the foundation principles he prescribes in his Foundation Health program. His belief is that it is about 90%. This is an important statement, which I have clinically validated many times over. It is obvious that, just as an engine will not run unless it’s basic needs are met, if a human being’s basic needs are not me it will not work correctly no matter how hard you try!
BASIC NEEDS and FOUNDATIONAL HEALTH PRINCIPLES
As simplistic as it may seem, the topic of basic needs and foundational health principles is vast and has many repercussions if not followed! In fact, much of my four-year certification program in Holistic Health and Corrective Exercise is spent learning how to address the basic needs of clients. To keep this article focus on your success as a practitioner and not on the actual assessment procedures involved in restoring foundational health, I would like to address the these principles with brevity, leaving you with suggested reading sources to expand your knowledge to a greater depth.
Water composes around 75% of the human body and approximately 85% of the human brain. There are a vast number of disease processes and problems that result directly from chronic dehydration. In fact, F. Batmanghelidj, MD suggests that heartburn, rheumatoid pain, back pain, angial pain, headaches and leg pain while walking are all potential symptoms of dehydration which are often alleviated by proper hydration.
In his book, “Your Body’s Many Cries For Water”, Dr. Batmanghelidj states that the brain, which only weighs 1/50th of one’s body weight, receives 18-20% of circulation. He further states that should ones level of hydration in the central nervous system drop 1% there will be noticeable loss of brain function (1). After reading Dr. Batmanghelidj’s book, it became evident to me that proper hydration could address many of the problems that people are seeking a doctors assistance. (For more information on this resource, see www.watercure.com)
Hydration is also critical for vital physiological functions such as digestion, elimination, detoxification and to the ability to perform physical work. If the body is not adequately hydrated, our ability to thermoregulate is disrupted, which leads to early onset fatigue, loss of motor control and an increased chance of injury. Unfortunately, many exercise professionals either encourage the use of or watch their clients consume fruit juices, caned soda beverages, or any number of chemical concoctions misrepresented as being healthy! In reality, most of these drinks can dehydrate the body and may decrease performance. Additionally, many of these beverages are sweetened with artificial chemicals, which are not only neuro-toxic, but also send false messages to the brain regarding calorie consumption. Believed to be one of the reasons for the vast problem with obesity today, artificial sweeteners cause your brain to tell you to look for food to compensate for the deficit between what it thought you ate (sugar), and what you actually ate (chemicals)!
You’ve all heard, “You are what you eat.” Looking at this from another perspective, “You are what you didn’t eat!” The first statement suggests that we can only be as good as the food we consume because it provides the raw materials for cellular regeneration and healing of our body. The second statement indicates that we can only be as good as what you’ve eaten, therefore, if we do not eat high quality proteins, fats and carbohydrates, we can only be made of low quality proteins, fats and carbohydrates!
Having spent my entire career rehabilitating orthopedic injuries and conditioning athletes, I can assure you that those on poor diets either do not recover from injury or have a hard time reaching their rehabilitative or conditioning goals. Although there are thousands of diet books available each claiming to have the “answer” to our societal woes, there are tens of thousands of people that have tried one or more of these books and achieved zero results, or even become worse!
The only book I have ever found that takes an understandable, logical approach toward diet is The Metabolic Typing Diet by William L. Wolcott, with Trish Fahey. One of the many great features of this book is that it takes into consideration key factors such as racial/ethnic background, biochemical individuality, blood type, western philosophy, eastern philosophy, and more.
Having used Wolcott’s principles of metabolic typing for nine years, I can tell you with great confidence that when combined with the other Foundation Health Principles, many people have spontaneous resolution of their problems. Though it may be hard to believe, they say things like, “You know, I haven’t had a headache in over a week,” or, “I’m not sure why, but my chronic ear infection has been gone for the last month,” or, “Have you noticed that the swelling around my knee is gone even though we are training harder than before?!”
This book is just one example of how to address Foundational Health Principles with your clients. As trainers you are not allowed to diagnose, treat disease or practice medicine without a license. However, using books like the ones I have mentioned will allow you to make informed recommendations to your clients that may help them tremendously. You will be coaching your client on how to provide their body with optimal nutrients and clean water intake, which may help their body heal itself - something no doctor or therapist can do for them!
Bill Wolcott’s organization, Health Excel, has additional training above and beyond the information found in his book, but I can assure you that positive results are possible by using the questionnaire in chapter six of his book. Once you do this and apply the results of the questionnaire to the principles relevant to you or your client’s metabolic type, it will help your client’s body heal itself and afford you maximum opportunity to help them achieve their goals. Visit www.healthexcel.com for more information on Health Excel, “The Metabolic Typing Diet,” or for a number of interesting articles on this subject. In future articles, I will expose you to many other food-related concerns with regard to ecology and biological terrain.
There are more physiological stressors today than any other time in history. Today, we live in a highly-caffeinated world full of air travel, late night entertainment and shift work that goes well into the night. The fact is we were not designed to withstand these stressors night after night, week after week and month after month, if at all!
Our body is very sensitive to circadian rhythms (24-hour cycle). Our hormonal system, nervous system and immune system are all heavily influenced by circadian rhythms. If you are seeking long-term resolution to your client’s problems, addressing circadian rhythm disturbance should be viewed as a priority in any assessment protocol or corrective procedure. Though it is well known that sleep provides numerous benefits for us, less well known is the importance of the times we sleep every night. In his seminars, Bill Timmins, ND states that between the 10:00pm and 2:00am, the body focuses on physical regeneration while between 2:00am and 6:00am the body focuses its healing energies on psychogenic repair.
Using this information, it becomes easy to identify why clients who are routinely going to bed at midnight or later, are suffering from chronic musculoskeletal pain that no doctor has been able to fix. Simply having these people make the commitment to get to bed by 10:00pm-10:30pm can makes a huge difference in their lives by allowing the body adequate time to heal. It’s not a “be-all-and-end-all” solution, but I’ve seen it help a number of times.
Clients with chronic headaches, neurological and/or hormonal disorders often suffer from sleep disturbances between 2:00am – 6:00am. This may be due to a number of factors such as being awoken by a significant other that comes home from work early in the morning, being a new parent having to repeatedly check on their newborn throughout the night, or their diet may be the cause of disrupted sleep patterns! At the C.H.E.K Institute, we have had numerous cases of clients who were eating stimulants such as chocolate or vanilla ice cream, drinking coffee, espresso, and/or sports drinks at night. Such items are laden with stimulants such as sugar and caffeine which, when consumed within three hours of bedtime, raise cortisol levels, antagonize the release of melatonin and disrupt the body’s ability to achieve a deep sleep.
These are all examples of circadian rhythm disruption that can easily precipitate chronic musculoskeletal injury as well as produce a barrage of seemingly unrelated hormonal and neurological symptoms. Other examples of imbalanced physiology resulting from sleep deprivation are memory problems, disturbed thyroid function and an impaired ability to make insulin and use glucose in men, to name just a few (2)!
Not knowing any better, the client continues to run from doctor to doctor. The medical professional, doing what he/she is trained to do, usually provides the client with any number of drugs from their ever growing arsenal of pharmaceutical reserves. The client is then faced with the task of processing and detoxifying these pills, which creates even more work for the already over worked liver, not to mention the array of side effects that comes with each medication!
For more information on the basics of circadian stressors and their effects on the body, refer to the Articles section of my web site, and read Chris Maund’s C.H.E.K Certification thesis entitled Sleep, Biological Rhythms and Electromagnetic Fields: Implications For The Corrective and High Performance Exercise Kinesiologist.
Few people would argue that breathing is one of the most important aspects of human life! However, it is likely that many of your clients do not breathe properly. The two most common problems are a rapid respiratory rate and overuse of the chest during the inhalation cycle. In the later of these two there is inadequate downward travel of the diaphragm, inadequate expansion of the abdominal wall and inadequate expansion of the rib cage resulting in an alteration of blood-gas mixtures which favors the action of calcium and can result in muscle cramping.
Poor respiratory performance is usually related to several factors, such as:
- Poor posture
- Emotional stress
- Bad die
- Poor examples of how to breathe from parents
Because many people are exposed to at least one of the above factors, the inability to breathe properly is a common clinical finding. I have personally found many people who have breathing dysfunctions in the presence of pain and dysfunction in the head, neck, jaw, shoulder and arm regions. There may be an additional visceral dysfunction related to poor breathing habits as well. The diaphragm is a major player in the circulation of lymph and blood through your internal organs, in addition to its role in keeping the organs mobile. When the respiratory apparatus is dysfunctional, the chance of developing visceral ptosis is elevated as is the chances of becoming constipated. This is just one way incorrect breathing will diminish the body’s ability to eliminate toxins.
Knowing this, just think of all the drugs that could be eliminated and conditions that could be relieved by simply identifying a breathing disorder in your client and teaching them how to breathe properly. And, you don’t need to be an expert at breathing to make a difference. You only need to study a good book or two and you will learn to help many people feel better and help them achieve their goals. A great little book to assist you in better understanding the breathing process which has many useful breathing exercises and techniques is Breathe To Succeed In All Aspects Of Your Life by Tania Clifton-Smith. Give it a read instead of watching TV for a few days!
It is important to realize, as demonstrated in Figure 1, that all systems of the body are fully integrated with one another. There is no such thing as a hydration problem without a change in the hormonal, neurological, circulatory, digestive, or eliminative systems of the body. The key point I’m making is that the foundation systems, which serve as catalysts to all the other systems, must be restored to optimal function prior to attempting to treat problems that appear to be isolated.
The body summates nociceptive (pain) input, which in addition to stress, determines the physiological load on the body. In an attempt to minimize load on any given physiological system, the body will shuttle excessive stimuli to a facilitated circuit or to a region (system) with less physiological load. As indicated above, excessive stimuli coming in via any of the major physiological systems will automatically increase the overall physiological load on the body. The appearance of symptoms in any other given system is an indication that the level of stimulus was great enough to cross the line of homeostasis, resulting in “excess physiological load.” Excess physiological load may manifest itself as pain or aberrant physiology in any body system or systems.
To highlight my point, consider the man (Figure 2) with an orange tree in his back yard. Upon finding an unusual growth on one of his orange trees, he consults a medical doctor, who tells him that the growth is cancer. When asked what he should do about it, the medical doctor states, “I can easily remove the cancerous growth for you surgically!” With visions of a scalpel cutting into his lovely orange tree, he opts to get a second opinion and calls a gardener.
The gardener takes one look at the tree and states “this form of growth is commonly the result of a soil deficiency.” The gardener suggests taking soil samples and running tests to correct any deficiency. He states that such unusual growths are not uncommon when a tree is malnourished and that once the trace minerals and microorganisms in the soil are at optimal levels, the growth will begin to disappear. The gardener makes suggestions as to how much water to give the tree as well as other general maintenance tips, and tells the man the tree should be back to normal within less than a year.
The medical doctor located a specific problem and offered an appropriate response to what he felt was the problem. The question I have for you is, how many of your clients are taking drugs, have had surgery and/or are living a less than optimal life because they did not do some basic gardening before opting for a more radical approach to alleviate their symptoms?
KNOW YOUR CLIENT
In 1989 I attended a conference in Vancouver British Columbia, Canada titled “Muscles, Nerves and Joints – Chicken or the Egg?” It was at that conference that C. Chan Gunn, MD gave a fantastic lecture on the treatment of chronic musculoskeletal pain, during which he described man’s reptilian reflexes.
Dr. Gunn showed that in each human being there is the brain of a reptile. In essence it is our brain stem, which is the oldest part of our brain from a phylogenetic perspective. Dr. Gunn explained that each of us still exhibits the reflexive behavior of a reptile and he used the example of a lizard. A lizard’s first concern is security, which is why after a lizard awakes it looks around to make sure it is safe before proceeding to do anything else. After the security needs are met, a lizard will then actively seek out its second need, food. Finally, after a lizard feels secure and has food, it will then entertain its third concern, procreation.
Dr. Gunn showed us that as human beings, anytime we are threatened by what may be called a breach of our reptilian reflexes, we react with a stress response. I have applied Dr. Gunn’s work to my patient practice since 1989 and have seen over and over again that he was absolutely correct in his observations. The way you can use this wisdom is to always pay attention to what your clients tell you about their financial situation and their home life. For example, someone with a breach of the first reptilian reflex will be in the fight-or-flight state, otherwise known as a state of sympathetic dominance. This may result because they can’t afford to pay their mortgage, their rent or because something else is encroaching upon the safety of their home.
A breach of the second reptilian reflex in modern man is often demonstrated as an eating disorder. The client is either eating too much, too little, or is addicted to certain foods because they act as a pacifier during stressful times.
Finally, a breach of the third reptilian reflex occurs when there is a problem with one’s sex life. A number of situations are possible. Some people may not be receiving adequate amounts of sex to maintain equilibrium for themselves. Other people may be in a dysfunctional relationship where there is sex but no love involved. Lastly, people may be engaging in sexual acts that produce conflict with their beliefs. Any and all of these can cause a breech in one’s reptilian reflexes.
Realize that each time you breach such a reflex, it produces a stress response in the body. If you breach two, it produces a greater stress response, and if someone breaches all three they will exhibit a significant stress response.
This is critical for you to observe and understand regardless of whether you are a trainer, physiotherapist, chiropractor or otherwise, because these reflexes produce stress at the core level of human existence. When you consider that exercise is stress, and that those breaching one or more of the reptilian reflexes are already going to be stressed beyond a physiological ideal, you must carefully consider how much exercise (stress!) you administer. Some of the bodily changes that occur in response to a breach in reptilian reflexes include changes in body posture, breathing patterns, tissue quality, hormonal function and sleep pattern disruption!
How many of you had one or more clients come to mind as you were reading this? Is there a correlation between how many reptilian reflexes they are breaching and the number of specialists they are seeing? Is there a correlation between the number of reptilian reflexes being breached and the number of chronic ailments they have?
I have only begun to skim the surface and to fully utilize this information requires much more training. Much of this information is included in the third year of my certification program, but there is immediate application for those of you that are reading this article. Begin by paying attention to what your clients are telling you!
Realize that the more stressed they are internally, the more carefully you have to be about adding stress to their life with an exercise program. I strongly suggest that the more reptilian reflexes you see being breached, the more careful you are about the following:
- Exercise volume
- Exercise intensity
- Exercise complexity
· Balance between fun exercise requiring little cognitive process (i.e. jogging along the beach or going for a hike) and more technical exercise sessions in the gym.
· Time commitment required of any exercise program relative to the level of stress in your client’s life. Be cognizant of their time availability and design a program that suits their needs, not one that suits your needs!
With this in mind, consider how many of the clients fitting the above description are running from doctor to doctor, consume chemical agents that further toxify their body, and are masking the real issue. I strongly suggest that when you see reptilian reflex breaches, breaches that are causing obvious stress to your client, realize that this person may have deep seeded issues that are far greater than what you can assist with and they may need to be referred to a qualified psychologist or councilor specializing in the particular issue they are dealing with. If your client’s issues continue, they may have an ongoing relationship with injuries and ill health that will potentially be made worse by an exercise program if it is not designed with the utmost of care and therapeutic intent.
THE SPECIFIC ASSESSMENT
By now it should be evident that there is no point in entertaining a specific assessment if the foundation principles have not been attended to. This does not imply that you should not perform a specific assessment until all foundation principles have run their course and the client has failed to make progress. I am simply implying that there is no sense in performing a specific assessment and designing an exercise or treatment protocol until the client is fully educated in the basic, foundational principles and how to apply them to their lives. I strongly suggest adhering to foundational principles for at least two months before attempting any regimen directed at a specific problem. As Dr. Timmins stated, 9 out of 10 people will heal themselves if just given the right environment by addressing foundation principles!
One exception to what I am proposing here is any case where a client has acute pain or indicators of a serious or life threatening pathology. An example of acute pain requiring specific assessment is if a client experiences pain shooting down their leg or experiences numbness in an extremity during activity. The inability to abduct an eye would be an example of another serious dysfunction requiring specific assessment. In either case, unless you are trained in specific assessments, it will be vital that you refer to a medical professional who can screen the client. This will also serve to protect you from injuring them in the gym, which can be a high-stress environment from many physiological perspectives.
The performance of a specific assessment of the body with regard to the exercise professional will share many of the same characteristics used by the medical and allied health care professions. This is to be expected being that we are assessing key systems of the body (circulatory, neurological, musculoskeletal) similar to how someone who is trying to fix their car must assess the relevant systems (cooling, electrical, ignition).
What Are We Looking For?
Specific assessments are related to specific problems. For example, if you have a client that has pain while squatting, you must determine why. To perform a specific assessment, some of the many things that you will need skills to assess are:
- Nervous system function
- Circulatory system function
- Hormonal system function
- Musculoskeletal structures
- Active movements
- Passive movements
- Stress tests
- Soft tissue palpation
- Medical history
- History of current and past injury
- Exercise history
- Psychological profile
- Visceral function
This form of assessment requires extensive skills that are not generally taught by organizations certifying personal trainers. The C.H.E.K Certification does teach a comprehensive array of specific assessments, although the C.H.E.K Certification program is multidisciplinary and takes the average student four years to complete.
One of the best books for the personal trainer who has mastered the basics and is ready to study specific assessment techniques is Orthopedic Physical Assessment, 2nd Ed. by Dave Magee (W.B. Saunders Co. 1992). This book will assist you in better determining which of your clients you are likely to be successful in coaching toward their goals.
Now that you have chosen your Unique Identity and are no doubt marketing your services in that specific arena, you will begin to see an escalation in the challenges presented to you as your skills develop. Remembering that the body is the best healer of all, and that all we need do in 90% of cases is provide basic needs using foundational principles, you will not only save your own time but you will save your clients an indefinite sum of time and money!
In my opinion, the biggest part of being successful in the exercise and rehabilitation professions is what motivational guru Tony Robbins calls “CANI,” which stands for “Constant And Never Ending Improvement.” Because the universe seems to be sensitive to our personal growth and development, providing us greater and greater challenges as we learn more, it is important that we strive to achieve consistent personal growth in all levels of development!
You will find that when you are in a state of constant, progressive growth, you stay stimulated at a deep level. You will have a deep sense of happiness and satisfaction that you are doing your best. Like a flower that grows toward the sun each day, a little bit at a time, but getting more beautiful as it matures. You will find that to get to the next level of your ultimate success plan, you must have this deep inner stimulation and satisfaction to stay motivated, turned on and in a peak state - the topic of my next article!
- Batmanghelidj, F., MD. Your Body's Many Cries For Water. Global Health Solutions, Inc., Falls Church, VA, 1997.
- Smolensky M, Lamberg L. The Body Clock Guide to Better Health: How to Use Your Body's Natural Clock to Fight Illness and Achieve Maximal Health. New York, NY: Henry Holt & Co, Inc; 2000.