P.R.F.C.T. Techniques: Upper Extremity Bias

In this video, we will combine the last 3 exercises into a non-stop circuit.  I will show you the Long Device Lateral Thrust, Persian Mil Drumming, and Persian Mil Squat Overhead Tap.  For the sake of time, each will be performed for 15 seconds and repeated twice.  You may perform each technique for 15, 30, 45 or 60 seconds before moving on to the next technique.  This combo is great for grip, forearm strength, shoulder/scapular stability, core stability, coordination, etc...  Check out previous posts for further descriptions of each technique.  Great for clients in the later recovery stages of hand, wrist, elbow, or shoulder injuries.

http://www.youtube.com/watch?v=dBUrmq0k59w

How Hard Should I Push My Client???

If you are working with a client who has one or more pre-existing medical or orthopedic conditions, you may be nervous when progressing him or her.  How aggressive should you be? 

Here are a few things to keep in mind when advancing your client.

1)Is their diagnosis recent or long standing?

You must find out whether the condition is acute (days old), subacute (weeks old) or chronic (months old).  If it is acute, you should be cautious, and advance intensity slowly.  If chronic, you may be more aggressive.

2) What is your client's reactivity?

Ask yourself: "Does a little activity causes a great deal of pain?"  If so, you need to modify.

3)Is the problem an inflammatory or mechanical issue?

Acute inflammation may present as red, swollen, hot.  It is usually better with activity due to the "moving around" of inflammatory chemicals.  Chronic inflammation presents with no resting pain, but may be worse with activity.  Is the activity you are performing creating more inflammation, rather than "flushing out" the inflammatory agents? With Mechanical issues, pain increases with activity and is better with rest.  However, there is no redness, swelling, or warmth.  If you adjust the mechanics, does the pain diminish?

4) What is the seriousness or severity of the condition? 

Is it a serious pathology that may worsen upon increased activity (Multiple Sclerosis, torn tendon/ligament, etc...)

So these are a few things to keep in mind when initiating a progression in your client's program.   They will help with your client's health and comfort level, his/her confidence level in you, the longevity of your relationship with your client, the speed of your client's recovery, and his/her return to a healthy fitness lifestyle.

"Red Flags" for Special Population Clients

When initiating sessions with special populations, many of them will come to you with an extensive past medical history.  They may be on medication for heart problems, diabetes, high blood pressure, cancer, etc... Although you should give each of your clients your undivided attention, you must pay particular attention to what these more "medically compromised" clients report to you.  Here are some "Red Flags" you must be aware of in order to maintain the safety of your clients.  If a client complains of any of the following, do not tell them to "brush it off!"  Refer him/her back to their physician before continuing your sessions.

RED FLAGS:
1)Complains of intense, unremitting pain
2)Pain is unaffected by medication or change in position
3)Complains of intense night pain
4)Complains of intense pain with no history of prior injury
5)Complains of intense spasms

Detailed Pain Assessment

When a new client begins working with you, he or she may come to you experiencing pain in one or more areas.  During your initial assessment, an easy way to formulate a detailed pain assessment is as simple as remembering O-P-Q-R-S-T.  If you know your alphabet, you can do this assessment.

"O" stands for onset of symptoms - when did the symptoms start? Is it an acute, subacute or chronic condition? Was it a slow or sudden onset?
"P" stands for properties of symptoms - What makes your symptoms better or worse?
"Q" stands for quality of symptoms - Type of pain...dull ache, sharp stabbing, shooting, etc...
"R" stands for radiating - Is it local or diffuse?
"S" stands for score - How does the pain rate on a scale from 0-10 where 0 is nothing and 10 is "get me to the emergency room!"
"T" stands for timing of symptoms - Is it constant or intermittent?

Answering these questions during an initial assessment and on subsequent sessions will provide you with a guidance system on whether your client is improving or not.  It will also help you to advise your client on what activities may be beneficial and which are detrimental.

P.R.F.C.T. Techniques: Mil Squat Overhead Tap

Today's P.R.F.C.T. Technique can be incorporated into any fitness or post rehab fitness routine. 

http://www.youtube.com/watch?v=UIn1kaDIu08

The benefits are as follows:
1.  Grip Strength: Controlling the uneven weight distribution of the Mil Device taxes your grip and forearm strength especially upon changing the grip position from a lateral bias to medial bias 

2. Shoulder/Scapula Strength:  The lateral raise itself focuses on the lateral deltoid muscle.  Controlling the "awkward" Mil device challenges your scapular stabilizers as you perform the lateral raise

3.  Lower Extremities: The squat portion strengthens your legs in order to assist in any squatting motion.  The squat is a functional every day movement required by everyone, so you want to maintain strength and efficiency

4. Core: Elevating your arms while descending/ascending from a squat requires a strong foundation or core to maintain control and stability of your trunk

5.  Coordination:  Some people can not chew gum and walk at the same time.  Squatting, while moving your arms with bilaterally weighted objects will definitely help with your coordination

Who will benefit from this:
Any client who needs to strengthen his forearm/hand, knee, hip, ankle, shoulder and/or requires strengthening in the overhead reaching/lifting actions due to his occupation or recreation