Exercise Technique

Question 1

Fundamentals of Exercise Technique

Answer 1

• Well-designed fitness programs should follow a progressive system that integrates all forms of exercise: resistance/weight training, cardiovascular, flexibility, core and balance training, plyometrics training, and SAP training.
• Proper exercise technique is key to building muscle strength and endurance while minimizing injury. Focus should be on proper form and breathing techniques before adding a difficult weight load. The more controlled the exercise reps, the better quality the workout.
• Proper breathing helps control core activation, rep tempo, and range of motion. In rested position, one should inhale through the nose which inflates the diaphragm and exhale through the mouth while exerting the muscle into power position. Then repeat the inhale to control the release back to resting position and so on, until all reps are complete in the set.
• Valsalva breathing maneuver — advanced lifters focused on heavy loads might adopt this technique, which uses a forceful exhalation pushed through a tight airway causing decreased blow flow. Most feel this type of breathing during heavy lifting (particularly barbell deadlifts, squats, chest press) supports the low back, reducing injury risk. However, this technique lowers one’s heart rate and blood pressure, which can lead to dizziness and fainting.
• Maintaining a neutrally aligned body position is another vital component in exercise technique. Good form and posturing will minimize injury risk and isolate the correct muscle groups when an exercise is performed. PTs’ primary goals should include giving feedback on form during sessions.
• The following are the elements of a neutral standing body position:
  1. head straight
  2. chin back
  3. legs at hip-width apart or slightly wider
  4. shoulders relaxed and straight
  5. palms facing the midline of the body (thumbs forward)
  6. pelvis tucked in
  7. navel pulled toward the spine (activates core)
  8. knees soft
  9. toes straight forward
• A client’s potential postural muscle imbalances might have the following body position inefficiencies:
  1. head and chin forward
  2. palms facing posteriorly
  3. shoulders jutting forward (thoracic kyphosis 胸椎後禿)
  4. hips tilting upward (lumbar lordosis 腰椎前禿)
  5. legs too wide or too narrow
  6. lateral or proximal toe positioning
• Proper body form in the semi-supine position should include:
  1. laying on back
  2. five points of contact: head, shoulders, glutes, right foot, left food.
• Along with proper body positioning, another way to isolate muscle groups with efficiency is using different types of grips while lifting barbells, dumbbells, and kettlebells, and while using weight machines.
• Bodybuilding can be very difficult on the body, because many lifters perform most exercises to their sticking point (年制點), where form is heavily compromised. Advanced clients may want to train to get past this sticking point; a proper program design focusing on form, spotting, and breathing can help with this.
• Exercises can be classified into categories to help fitness professionals pick the right types of exercise for different fitness levels - either by muscle type recruitment or whether the kinetic chain is working from a fixed position.
• Core exercises recruit multiple large muscle groups (e.g. the legs, back, or chest) and multiple joint motions at a time. Core exercise can be:
  1. structural — posture-centered and load bearing (e.g. barbell deadlift)
  2. power-based — more reactive and explosive (e.g. medicine ball slam)
• Assistance exercise typically activate smaller muscle groups (e.g. arms, calves, and neck) and single joint motions. These types of exercises tend to be used for rehabilitative purposes because they focus on one muscle group and joint motion at a time.
• The body’s 3 systems - the nervous, muscular, and skeletal systems - need to work in synergy to complete the kinetic chain, making for the most effective and efficient workout.
• Closed Kinetic Chain — When the hands/feet are planted in a fixed position (e.g. in a pull-up or squat), we consider these Closed Kinetic Chain exercises; planting the limbs closes the chain of motion.
• Like core exercises, closed chain exercises engage both Type I (postural muscles) and Type II (power muscles) muscle groups for a more complex workout and more efficient caloric expenditure.
• Open Kinetic Chain - Like assistance exercises, open kinetic chain exercises isolate one muscle group at a time. A machine leg extension or dumbbell biceps curl allows hand or foot movement, keeping the chain open.

Question 2

Warm-Up and Cooldown Protocols

Answer 2

• Warm-ups should be based on the client’s fitness assessment and should contain both full-body conditioning and targeted exercise.
• The primary goal of a warm-up should be to increase the range of motion before resistance training allowing for proper neuromuscular efficiency.
• Several benefits of warming up the body prior to the exercise, including:
  1. Aiding in correcting muscle imbalances
  2. Increasing joint range of motion, while relieving joint stress
  3. Reducing muscle tension
  4. Improving response of muscle/joint connectors, or the tendons
  5. Improving mind/muscle recruitment efficiency
  6. Improving overall body function
• An effective warm-up should last at least 10 minutes at 30-60% exertion, or low to moderate intensity, depending on a client’s fitness level. Someone who is new to exercise or deconditioned may need to spend more time on a warm-up due to postural correction through stretching or poor cardiorespiratory endurance.
  1. One should start with a general cardiovascular warm-up (e.g. using a treadmill/other cardio machine, jumping rope, performing body weight exercises - jumping jacks or high knees). This will help elevate body temperature and provide a general warm-up for all muscles of the body, which is necessary before any stretching begins.
  2. After the body is warm, the client should be directed to briefly stretch the muscles they will be using in their workout. If the client has a muscle imbalance (e.g. shortened hamstring muscles), be sure to give him special attention with SMR (self-myofascial release 自我基金模式放) or static stretching, or both, to ensure proper form throughout the duration of his exercise session.
  3. End the warm-up with dynamic stretching to targe the muscle groups the client will be focusing on during his workout session. These stretches should require more exertion (65-75%) than the general warm-up. (As the client improves his cardio endurance, he can use these types of exercises in lieu of standard cardio machines. Performing several dynamic stretch exercises in a circuit can provide effective heart elevation and efficient muscle activation for a warm-up (e.g. butt kickers or prisoner squats for the lower limbs, arm circles and medicine ball chop/lifts for the upper limbs).
• A cooldown will benefit the body because it:
  1. Promotes flexibility
  2. Removes waste products via the blood
  3. Alleviates potential for muscle soreness
  4. Avoid dizziness or fainting
  5. Provides a mental relief after exercise stress
• Cooldown protocols should follow a similar pattern to the warm-up and should last about 10 mins.
  1. Start with cardio at a low level (that will aid in slowly reducing back to a resting level while still moving).
  2. Go immediately into a few targeted static stretches.
  3. Finish the cooldown session with SMR.
• RAMP — to remember how to warm up a client use RAMP for her routine.
  1. Raise your body temp (typically some sort of cardio training).
  2. Activate key muscle groups.
  3. Mobilize joints and joint receptors (tendons).
  4. Potentiate (增強) or increase the power of muscle groups or workout type one is performing (e.g. reactive training for sports, power training for weight lifting).

Question 3

Flexibility and Stretching Exercises
Self-Myofascial Release (SMR 自我筋膜釋放)
Exercises
Static Stretching Exercises
Dynamic Stretching Exercises
PNF Stretching Exercises (Proprioceptive Neuromuscular Facilitation 本體感覺神經肌肉促進法)

Answer 3

Flexibility — easily defined in the fitness world as the full range of motion in one’s joint or the mobility of one’s muscles for easy joint motion.
* Stretching should have a multifaceted approach to help correct muscle imbalance and improve proper muscle and tendon elasticity and function.
* SMR (self-myofascial release or foam rolling) — a good way to target any muscles that may be overactive or have apparent knots in the muscle fibers; initiate autogenic inhibition within the muscle sensors called the Golgi tendon organs. These organs eventually release their tension once stimulated by the pressure the foam roller puts on them, causing them to relax and increase range of motion in the overactive fiber.
1. There are different densities of foam roller depending on the client’s sensitivity to pressure, and other implements that can be used for SMR (e.g. tennis balls, medicine balls, roller bars, textured rollers), but foam roller are the most popular and accessible.
2. Special populations (e.g. people with heart failure, bleeding disorders, organ failure, blood clots, contagious skin disorders, or open wounds) should avoid SMR.
3. In general, these exercises should be performed by rolling over the tender spot for 30-60 secs, depending on the clients’ pain tolerance.
* SMR Exercises:
1. SMR Gastrocnemius/Soleus (Calf)
2. SMR Iliotibial (IT) Band 髂見戴
3. SMR Adductors (Inner Thigh)
4. SMR Piriformis 梨狀肌
5. SMR Hamstring
6. SMR Latissimus Dorsi (Large Back Muscles)
7. SMR Thoracic Spine (Mid Back)
* Like SMR, static stretching causes autogenic inhibition in the muscle spindles and Golgi tendon organs. To protect the muscles from injury, these sensors will relax and allow lengthening in the muscle fibers.
* The static stretches should be held at the muscle’s point of slight discomfort for 30 secs. It’s best to do at least 2 sets of static stretches, so the muscles being relaxed can extend their range of motion in the 2nd set.
* Static Stretching Exercises:
1. Look Right and Left
2. Neck Flexion (區區/向前) and Extension (伸展/向後)
3. Straight Arms Behind Back
4. Seated Lean Back
5. Behind-Neck Stretch
6. Cross Arms in Front of Chest
7. Arms Straight Above Head
8. Spinal Twist
9. Semi-Leg Straddle
10. Forward Lunge
11. Supine Knee Flex
12. Side Bend
13. Side Quadriceps Stretch
14. Sitting Toe Touch
15. Straddle Stretch
16. Butterfly
17. Wall Calf Stretch
* Dynamic stretching exercises use force production and body momentum to activate a full range of motion and are ideal for warming up the body parts about to be used during a workout.
* Dynamic Stretching Exercises:
1. Arm Swings
2. Lunge Walk
3. Walking Knee Lift
4. Forward Lunge with Elbow Instep
5. Heel-to-Toe Walk
6. Walking Over and Under
7. Inverted Hamstring
8. Straight-Leg March
* PNF (Proprioceptive Neuromuscular Facilitation) Stretching exercises are an assisted stretching technique typically used in clinical or athletic environments. These PNF stretches utilize a combination of static stretching and isometric contraction to increase range of motion and aid in muscle rehabilitation, while keeping the injury risk low. This technique is beneficial for increasing range of motion quickly.
* PNF Stretching Exercises:
1. PNF Gastrocnemius (Calf) Stretch
2. PNF Hamstring Stretch
3. PNF Piriformis Stretch
4. PNF Biceps Femoris Stretch
5. PNF Chest Stretch

Question 4

Resistance Training
Resistance Machines
Free Weight Training and Exercises
Spotting

Answer 4

• Resistance Training (Strength Training) — a type of exercise that recruits muscle growth through resistance provides exponential health benefits to the body by:
  1. increasing bone, tendon, and ligament strength
  2. improving metabolism
  3. increasing cardiac health
• Effective resistance programs should include a progressive system allowing for the body to build strength from a solid foundation, with proper form and core strength, including 3 steps:
  1. Stabilization
  1.1. focus on building strength through core training, controlled instability, lighter loads and higher rep counts.
  1.2. focus on decreasing body fat and improving muscle endurance.
  2. Strength
  2.1. focus less on stability training and more on prime mover strength training through increased weight load and synergistic muscle group recruitment.
  2.2. focus on building lean body mass and joint strength by lifting heavier loads with more sets and less reps.
  3. Power
  3.1. focus on muscle speed and strength/force production.
  3.2. incorporate supersets of lighter explosive exercises with a higher rep count. This will challenge the muscles to work speed and strength together.
• Resistance Machines:
  1. Cam and pulley machines — use a combination of the body’s concentric and eccentric forces, friction from the pulleys, and weight loaded to dictate the speed of the machines and range of motion.
  1.1. Cam machines help lock the position of the body in place so one can isolate specific muscle groups, which is beneficial to improving form.
  1.2. Pulley machines allow the body to activate secondary muscle groups because the user must use more of their body to maintain proper form.
  2. Air and hydraulic machines — provide a fixed amount of resistance through a specific range of motion, so no matter how fast move, the resistance stays the same.
  3. Suspension training — allows users to leverage their own body weight for resistance to focus more on core activation and balance training while targeting other muscle groups. While body weight limits strength production, suspension training offers a very efficient training technique for increasing neuromuscular efficiency, tendon strength, and flexibility.
  4. Shoulder Press
  5. Triceps Pushdown
  6. Pec Deck
  7. Vertical Chest Press
  8. Abdominal Crunch
  9. Lateral Pulldown
  10. Seater Row
  11. Low Pulley Seated Row
  12. Hip Sled (Leg Press)
  13. Seated Leg Extension
  14. Seated Leg Curl
  15. Standing Calf Raise
  16. Seated Calf Raise
• Fee Weight Training — use gravity to force the body into concentric and eccentric motion to counteract and control the weight. Free weights typically are considered dumbbells and barbells; however, kettlebells, sandbags, and resistance tubes are becoming increasingly popular functional fitness tools because of their versatility and power maneuvers.
  1. Barbell Biceps Curl
  2. Hammer Curl
  3. Lateral Shoulder Raise
  4. Lying Barbell Triceps Extension
  5. Flat Barbell Bench Press
  6. Dumbbell Bench Press
  7. Wrist Curl
  8. Wrist Extension
  9. Flat Dumbbell Fly
  10. Incline Dumbbell Fly
  11. Bent-Over Row
  12. One-Arm Dumbbell Row
  13. Back Loaded Squat
  14. Front Load Squat
  15. Forward Step Lunge
  16. Step-Up
  17. Good Morning
  18. Deadlift
  19. Stiff-Leg Deadlift
  20. Romanian Deadlift
  21. Seated Barbell Shoulder Press
  22. Upright Row
  23. Push Press
  24. Push Jerk
  25. Power Clean
  26. Power Snatch
• Spotting — supporting another person to ensure safety while he/she lifts a heavy weight. Only allow spotting if a user is not sacrificing form to lift the weight or if the spotter is needed to help support the weight. The spotter should not be lifting a substantial portion of the weight.
• General body placement for a spotter should contain a wide stagger stance where one foot is in front of the other one; knees are soft to ensure a quick reaction in case the lifter goes into failure.

Question 5

Core Stability and Balance Training
Exercises

Answer 5

• Core Muscle Group — the muscles that initiate trunk rotation (or waist rotation) are considered the core muscle group which is the body’s center of gravity and starting point for all movement.
• Core muscle group controls posture, acceleration, and deceleration of movement and is an integral part of injury prevention. Weak core functionality can be the primary source of most muscle imbalances.
• A common misconception is that the abdominal muscles solely comprise the core. However, the core’s anatomy contains abdominal and hip muscles (lumbo-pelvic-hip complex, LPHC) and the thoracic and cervical spine muscles.
• Proprioception is an individual’s ability to sense where his/her body is in space.
• Core Training goes hand in hand with Balance Training, allowing clients to increase their proprioceptive ability, or sense of where their body is positioned in a space.
• Core Training uses controlled instability to build proprioception and balance. Standing on one leg or sitting on a stability ball while performing a simple exercise will increase core stabilization and postural strength. Having a client stand on one leg while closing her eyes is a good way to assess her proprioception.
• Core Stability and Balance Training Exercises:
  1. Plank
  2. Bird Dog
  3. Bridge (progression: single-leg bridge)
  4. Abdominal Crunch (progression: full sit-up)
  5. Bent Knee Sit-Up (progression: full sit-up)
  6. Reverse Crunches (progression: straighten the legs completely)
  7. Ball Crunches (regression: abdominal crunch)
  8. Cable Rotations
  9. Soccer Throw
  10. Rotation Chest Pass
  11. Medicine Ball Pullover Throw (regression: ball crunches)
  12. Single-Leg Balance (progression: close the eyes)
  13. Single-Leg Balance and Reach (regression: single-leg balance)
  14. Single-Leg Windmill (regression: single-leg deadlift)
  15. Single-Leg Squat (regression: single-leg balance and reach)
  16. Single-Leg Deadlift (regression: single-leg squat)
  17. Lunge to Balance (regression: single-leg balance and reach)
  18. Single-Leg Box Hop-Up (regression: step up to balance)
  19. Single-Leg Box Hop-Down
  20. Multiplanar Single-Leg Hop (regression: lunge without the hop)

Question 6

Speed, Agility, and Quickness (迅速)
SAQ Exercises
Speed and Overspeed (超速) Training

Answer 6

• Speed, Agility, and Quickness (SAQ) — these 3 components can also be considered reactive training. SAQ training preps the body and mind to react quickly to everyday scenarios. SAQ training can benefit the body by strengthening the connecting tissue of the muscles.
  1. Speed — the body’s ability to move in one direction as quickly as possible.
  2. Agility — bursts of movement starting, stopping, or changing the direction of the body.
  3. Quickness — the body’s ability to react to a cue that propels the change.
  4. These can be included as cardio training for advanced clients. It takes a great deal of strength, stability, and balance to perform these exercises properly. Use caution when adding these exercises to a program to minimize injury risk.
• SAQ Exercises:
  1. Fast Feet
  2. A-Skip
  3. Cone Drills: 5-10-5 Drill
  4. Cone Drills: T-Drill
  5. Cone Drills: Star Drill
  6. Cone Drills: Box Drill
  7. Cone Drills: Z-Drill
  8. Agility Ladder Drills: Ali Shuffle
  9. Agility Ladder Drills: Ickey Shuffle
  10. Agility Ladder Drills: In and Out
  (11 & 12 — Speed and Overspeed Training)
  11. Resisted Sprinting
  12. Assisted Sprinting
• Shuffles — small lateral hops; Backpedaling — running backwards; Carioca Shuffles (aka grapevines) — crisscrossing the feet forward and back while moving from side to side.

Question 7

Plyometric Training (衝擊性訓練)
Exercises

Answer 7

• Plyometric Training (aka Power Training) — focuses on building the body’s strength through maximum force production in the minimum amount of time.
• While SAQ training can also be considered part of the reactive training continuum, plyometric training primarily focuses on explosive movement in a full range of motion; SAP training keeps the exercise compact.
• Plyometric training recruits multiple muscle groups and require significant proprioceptive ability and core control. It’s imperative the client be in the power level of training to perform these exercises appropriately to minimize risk of injury.
• Plyometric Training Exercises:
  1. Squat Jump
  2. Double-Leg Box Jump
  3. Single-Leg Box Jump
  4. Lateral Box Jump
  5. Alternate-Leg Push-Off
  6. Multiplanar Jumps
  7. Butt Kicks
  8. Tuck Jumps (七蓋暴跳)
  9. Box Run Steps
  10. Ice Skaters 冰華埠
  11. Single-Leg Tuck Jump
  12. Double-Leg Vertical Jump
  13. Front Barrier Hop
  14. 4-Hurdle Drill
  15. Power Skip 強力蹦跳
  16. Backward Skip
  17. Single Arm Alternate-Leg Bound (單臂交替腿要 — 跳遠的跑步動作)
  18. Double Arm Alternate-Leg Bound
  19. Depth Jump (大部分沒有2nd box)
  20. Single-Leg Depth Jump
  21. Depth Jump with Lateral Movement
  22. Chest Pass
  23. Two-Handed Overhead Throw
  24. Power Drop

Question 8

Aerobic or Cardiorespiratory Endurance Training

Answer 8

• Aerobic or Cardiorespiratory (Cardio) Training emphasizes inducing stress to the cardiorespiratory system, so almost any activity can be considered a form of aerobic training, but usually any load-bearing activity is not considered aerobic-centered training.
• Aerobic training will benefit any person, regardless of his/her fitness level. Aerobic training can decrease fatigue, anxiety, hypertension, obesity, and coronary artery disease, while increasing general body performance, immunity, glucose tolerance, and an overall sense of well-being.
• Fat Burning only occurs when more energy is being expended than consumed.
• Cardio equipment:
  1. Treadmills (most common)
  2. Stationary and Recumbent (reclined seat) Bicycles (Some populations with knee issues or who cannot walk with proper posturing should be encouraged to try a stationary bicycle).
  3. Elliptical Trainers (lower impact on the joints even though they facilitate a range of motion similar to running).
  4. Stair Climber (Stair Stepper) — considered more advanced and provide a great challenge for those at higher fitness levels.
  5. Rowing Machine — offers a full body and core challenge as well as a very tough cardio workout.
  6. Arm Bike — probably the most obscure of cardio machines, but it does provide a targeted workout for those doing upper body exercises or those who cannot use their legs for cardio training.
  7. Jump Rope — the most portable piece of cardio equipment (except the human body), also believed to be the most efficient type of cardio training, requiring both coordination and body control.
  8. Walking
  9. Jogging
  10. Running/Sprinting — if a client is not landing softly on her feet, if her shoulders and head are hunched forward, or if her knees are drawing inward or toes are pointing outward, she should slow down or even regress to a lower impact form of cardio training.
  11. Swimming — a viable option for populations suffering from joint injury or other problems that make walking or running difficult. Those who cannot swim can use kickboards.