Illness and injuries

Question 1

Lordosis

Answer 1

Lordosis: An increased anterior lumbar curve with an associated tilting of the pelvis. This typically leads to tension on the spine, which could result in low-back pain.

Question 2

Kyphosis

Answer 2

An increased posterior thoracic curve with associated rounded shoulders, depressed chest, and forward-head posture with neck hyperextension.

Question 3

posterior pelvic tilt

Answer 3

Caused when Rectus abdominis and hamstrings are tight. rectus abdominis will pull up on the front of the pelvis, while the hamstrings will pull down on the back of the pelvis. This would keep the pelvis in a position of posterior tilt during standing posture.

Question 4

What is a diabetic client MOST likely to experience if he or she takes too much insulin prior to an exercise session?

Answer 4

Hypoglycemia (low blood glucose) Why? Insulin causes glucose to move from the circulatory system into the working cells. Exercise has an insulin-like effect, resulting in increased glucose uptake by the cells as well. Therefore, if a client takes too much insulin prior to exercise, the client would have two factors (insulin and exercise) that would be facilitating increased glucose uptake by the cells. This will cause a drop in blood glucose, potentially leading to low blood glucose, or hypoglycemia.

Question 5

If heels off ground when doing bend and lift movement, what does it mean?

Answer 5

If heels off ground: plantarflexors (calfs) too tight

Question 6

If If knees bend inward when doing bend and lift movement, what does it mean?

Answer 6

If knees bend inward: Hip adductors, tensor fascia latae are tight. Glut under active.

Question 7

You notice that in his regular standing position, he exhibits a posture in which his shoulders are rounded forward and the backs of his hands face forward when he is standing in a relaxed manner. What is the MOST likely cause of this postural deviation?

Answer 7

indicative of shortened pectorals and latissimus dorsi, as well as overstretched and potentially weakened scapular retractors and shoulder external rotators that passively allow the shoulders to fall forward into internal rotation.

Question 8

What exercises would be MOST appropriate to include in a client’s initial exercise program if he has postural issues due to a lack of range of motion (ROM) in hip extension?

Answer 8

Half-kneeling triplanar stretch Why? A lack of ROM in hip extension is generally due to tight hip flexors. The half-kneeling triplanar stretch of the hip flexors improves mobility in all three planes without compromising lumbar stability. ACE Personal Trainer Manual (5th ed.), pages 284-285

Question 9

What muscles tightness can cause internal shoulder rotation ROM is limited?

Answer 9

The infraspinatus and teres minor are primary external shoulder rotators; if they are tight, they will limit internal shoulder rotation. ACE Personal Trainer Manual (5th ed.), page 184

Question 10

Carrie indicates that she has been diagnosed with “tennis elbow.” Which of the following anatomical structures is MOST affected by this condition?

Answer 10

The lateral epicondyle of the humerus Why? “Tennis elbow” is a common name for lateral epicondylitis, or inflammation of the wrist extensor tendons at their origin on the lateral epicondyle of the humerus. ACE Personal Trainer Manual (5th ed.), pages 581-582

Question 11

For “scapular winging.” Which of the following muscles should be of PRIMARY focus in his resistance-training program, as it is most likely weak and contributing to this postural deviation?

Answer 11

Serratus anterior Why? Weakness in the serratus anterior can result in an inability of these scapular muscles to hold the medial border of the scapula in place against the ribs. This is known as scapular “winging” and results in instability in the scapulothoracic joint that can lead to instability and injury in the shoulder girdle and/or shoulder joint. Personal trainers who see scapular winging should help the clients strengthen the serratus anterior, as well as the rhomboids, which are also often weak with scapular winging. In addition, trainers should help clients learn how to “pack” their scapulae by retracting and depressing the scapulae. ACE Personal Trainer Manual (5th ed.), pages 160-162

Question 12

Which exercise is CONTRAINDICATED for a client with a history of shoulder impingement syndrome?

Answer 12

Overhead barbell press in the frontal plane Why? This response is correct, as individuals with shoulder injuries, or undergoing post-rehabilitation from shoulder injuries, should modify overhead activities. For example, the overhead press can be modified to use dumbbells with the arms moving in the scapular plane without fully extending the elbows. This takes the shoulder out of the abducted and externally rotated position seen during the overhead barbell press in the frontal plane. ACE Personal Trainer Manual (5th ed.), pages 377 & 579-580

Question 13

What will happen if hip flexor, iliopsoas and rectus fermoris are tight during Thomas Test?

Answer 13

Test if hip flexor, iliopsoas and rectus fermoris are tight. If lowered thigh not touch table and knee does not flex to 80 degress: primary hip flexor muslces are tight If lowered thigh not touch table, knee does flex to 80 degress: iliopsoas is tight If lowered thigh touches table, knee does not flex to 80 degrees: rectus fermoris is tight ACE PT manual 5th edition p.179 https://www.youtube.com/watch?v=Ieu-t3vwbqI

Question 14

What should client do who is currently taking diuretic medication for hypertension. Which of the following recommendations is MOST appropriate?

Answer 14

Consume fluids before, during, and after exercise Why? This response is the most appropriate because diuretic medications increase the excretion of water and electrolytes through the kidneys. This decreases blood volume and can predispose an exerciser to dehydration. Therefore, adequate fluid intake before, during, and after exercise is important. ACE Personal Trainer Manual (5th ed.), pages 133 & 518-520

Question 15

Which sets of muscles and muscle groups should be the PRIMARY focus of a flexibility program designed to address this client’s kyphosis deviation?

Answer 15

Shoulder adductors and serratus anterior Why? This answer is correct, as kyphosis posture is associated with tight shoulder adductors (pectoralis major) and tight scapular abductors (serratus anterior) which pull the scapular into protraction. ACE Personal Trainer Manual (5th ed.), page 162

Question 16

What is sciatica?

Answer 16

Sciatica refers to back pain caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the lower back that spreads to the hip, buttocks, and leg. https://www.webmd.com/back-pain/ss/slideshow-visual-guide-to-sciatica

Question 17

Common issues identified during Bend and lift screen

Answer 17

squats - don’t tell client techniques common issues: 1. inward knees 2. arched back 3. heels lifted

Question 18

What does palms face backward when hands are positioned at the sides indicate?

Answer 18

internal (medial) rotation of the humrus and/ or scapular protraction

Question 19

an inability to lay the back of the right thigh completely flat on the table during the thomas test indicate?

Answer 19

tightness of the right iliopsoas, which is preventing the hip from rotating posteriorly and inhibiting the thigh from being able to touch the table

Question 20

normal length of the hamstrings in the passive straight-leg (PSL) test indicated when the raised leg archives >= how many degrees of movement before the pelvis rotates posteriorly?

Answer 20

80 degrees

Question 21

Ability to externally rotate the forearms ? degrees to touch the mat indicates good mobility in INTERNAL (medial) ROTATORS?

Answer 21

90 degrees

Question 22

Ability to internally rotate the forearms ? degrees towards the mat indicates good mobility in EXTERNAL (lateral) ROTATORS?

Answer 22

70 degrees

Question 23

Scapular winging during the shoulder push stabilisation screen would MOST likely be due to ______

Answer 23

scapulothoracic joint sttability

Question 24

The coupling relationship between tight __________ and __________ is defined as the lower-cross syndrome (LCS).

Answer 24

Hip flexors; erector spinae

Tight or overdominant hip flexors are generally coupled with tight erector spinae muscles, producing an anterior pelvic tilt. This coupling relationship between tight hip flexors and erector spinae is defined as the lower-cross syndrome.

A posterior pelvic tilt is caused by tightness in the rectus abdominis and hamstrings.

Question 25

Anterior pelvic tilt indicates…

Answer 25

Tight or overdominant hip flexors are generally coupled with tight erector spinae muscles. AKA Lower-cross syndrome (LCS).

muscles suspected to be lengthened: hamstrings, recturs abdominis

Question 26

posterior pelvic tilt indicates… (butt towards the front)

Answer 26

tightness in the rectus abdominis and hamstrings.

muscles suspected to be lengthened: hip flexors, erectors spinae

Question 27

An elevated shoulder may present with an overdeveloped or tight ___________, while a depressed shoulder may present with more forward rounding of the _______.

Answer 27

upper trapezius muscle
scapula

Question 28

During the hurdle step screen, you observe that the client exhibits an anterior pelvic tilt with a forward torso lean. What muscles should you suspect of being underactive or weak?

Answer 28

Rectus abdominis and hip extensors

If a client exhibits an anterior tilt with a forward torso lean, he or she likely has overactive or tight stance-leg hip flexors and underactive or weak rectus abdominis and hip extensors.

Question 29

Your client or class participant is experiencing some pain in her low back when performing abdominal exercises. Which of the following imbalances could potentially cause this condition?

Answer 29

Tightness in the iliopsoas

Why?

Because of its origin at the lumbar spine, iliopsoas tightness can result in lordosis, which can cause low-back pain, particularly during the second half of a sit-up and with prolonged periods of sitting. To correct the anterior pelvic tilt position associated with lumbar lordosis, focus on strengthening the abdominal and hip extensor muscles, while stretching the hip flexors and spine extensors.

ACE Essentials of Exercise Science, p. 116, 128-129

Question 30

You notice a client or class participant is running “flat-footed.” You can hear her foot slap the treadmill with every step. What muscles can you suspect to be weak?

Answer 30

Dorsiflexors

Why?

When acting concentrically, the muscles of the lower leg produce dorsiflexion of the ankle, and work together during walking and running to eccentrically lower the foot to the ground with control. Without the eccentric action of the dorsiflexor muscles as dynamic shock absorbers, the foot would slap the ground with each stride or impact.

Question 31

Physical capacity decrease with age. Non- training adults lose ____kg of muscle tissue per decade

Answer 31

2.3kg

Question 32

muscles have been shown to shorten when held passively in shortened psition in as few as ____

Answer 32

two to four weeks

p.266

Question 33

How much muscle an adult can gain in 3 months with basic strength training program?

Answer 33

3 pounds/ 1.4kg muscle

Question 35

What is Sarcopenia?

Answer 35

Sarcopenia is the degenerative loss of skeletal muscle mass (0.5–1% loss per year after the age of 50), quality, and strength associated with aging.Sarcopenia is a component of the frailty syndrome. It is often a component of cachexia.

Question 36

Transient hypertrophy

Answer 36

The increase in size of muscle is referred to as hypertrophy. The ‘pump’ one feels from a single exercise bout is referred to as transient hypertrophy. This short term effect is attributable to the fluid accumulation, from blood plasma, in the intracellular and interstitial spaces of the muscle.

Question 37

If an individual has tight hip flexors, what condition can occur in the lumbar spine?

Answer 37

Because of its origin at the lumbar spine, tight hip flexors can result in passive hyperextension of the lumbar spine, which is known as lordosis.

ACE Essentials of Exercise Science, p. 118

Question 38

A client who just found out she is pregnant asks what foods to eat to increase her intake of folic acid. What would be the BEST response?

Answer 38

Green leafy vegetables, organ meats, dried peas, beans, and lentils

Why?

These foods are the best sources of folate, or folic acid. Citrus fruits, berries, and vegetables are good sources of vitamin C; green leafy vegetables, fruit, dairy, and grain products are good sources of vitamin K; and milk, liver, eggs, and peanuts are good sources of choline.