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I am a woman in her 40s, and my exercising has been routinely punctuated by a variety of significant injuries and ailments that have put a crimp in my activities and exercising. I have spent years in physical therapy and am trying to recover from a back problem. I tend to go too fast and try too hard to regain my fitness and end up just causing more problems.
I need someone who has a strong background in biomechanics, injury and physical therapy; and one who understands the angst of an aging tomboy who can set me on a healthy path. What questions do I ask?
This represents a number of very good questions. How do you keep momentum after injury? How long do you rest after injury? How do you come back in a way you don't aggravate the injury or hurt something else because you're compensating? And how do you know that trainer knows what he or she is doing?
The simple answer is listen to your body first and evaluate the trainer before you listen to him or her. Don't do anything that doesn't feel right. The best trainer can't get inside your body or your head.
Fabio Comana, of the American Council on Exercise, believes that the woman's injury problems are probably due to biomechanical and muscular compensations and deficiencies arising from the earlier injuries. She appears to understand, he says, that the body is a series of interconnected links (kinetic chains), not individual muscles working in isolation. Knowing that is half the battle. Incomplete rehabilitation can leave the body in a compromised and compensated position.
"When injured, we tend to compensate our movements as the body discovers the path of least resistance to avoid further pain," he says. "Ironically, repetitious action of this kind can be detrimental as the body may force muscles to alter their normal function and assume different roles than originally intended. That will probably change their resting length, making them now tight or weak. This, in turn, alters the mechanics of the joint, rendering it more vulnerable to injury. Repetitious compensation may even develop new motor programs in the brain, teaching us to move this way subconsciously."
Take inventory. How have you injured yourself in the past? Identify muscle and joint imbalances. Undergo fundamental and functional movement tests to identify what compensations your body may be making. Participate in progressive and corrective exercises, including core activation and stabilization before moving on to strengthening the core. Return to traditional weight training gradually. Integrate core training into functional training that mimics your daily life. If it's applicable, include sports-specific training.
"While several trainers are well-versed in these areas and should be interviewed to their experience, another possibility is finding a physical therapist who is also trained as a personal trainer," Comana says. "Expertise may come at a premium. Another viable option is through your physician and locating a facility that offers both that may be covered under health insurance."
Monica Donald and Steven Stanfield, who run Studio 122 in Seattle, suggest the reader (and others) follow this advice when selecting a trainer:
-Know the trainer's philosophy. Is it "no pain, no gain"? If so, move on.
-Does the trainer understand anatomy, stay up-to-date? Does the trainer think big-picture? Does he or she know nutrition?
-The reader should consider working with an expert in functional exercise, which emphasizes balance and coordination and develops strength and skills you use in everyday life.
-Your trainer should assess your posture, core strength, range of motion and nutritional balance (including hydration).
-Interview multiple trainers and know the cost. It usually costs between $60 and $100 an hour. But don't always let price sway your decision. Who certified him or her? And when? Calling their references is a must, but trust your intuition, too.
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FIT BIT
Personal training industry-wide standards are lacking, but here are links to established organizations:
www.acsm.org (American College of Sports Medicine)
www.acefitness.org (American Council on Exercise)
www.afaa.com (Aerobics and Fitness Association of America)
www.nsca.com (National Strength and Conditioning Association)
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(Richard Seven is a Pacific Northwest magazine writer at The Seattle Times. Send questions on workouts, equipment or nutrition to him at: Pacific Northwest magazine, The Seattle Times, P.O. Box 70, Seattle, WA 98111, or e-mail rseven(at)seattletimes.com. Past columns can be found at http://www.seattletimes.com/onfitness/)
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(c) 2006, The Seattle Times. Distributed by Knight Ridder/Tribune News Service.
