Monthly Archives: September 2013

Fighting Diabetes with Exercise and Nutrition

Presented below is a sanitized case file of a client of mine with Type 2 Diabetes (T2D) and the results achieved between 1 July 2013 to 11 Sept. 2013  The clients permission was granted prior posting and no names are named.

Acronyms:  CHOL: Total Cholesterol      TRIG: Triglycerides      LDL: Low Density Lipoprotein ( aka Bad Cholesterol)     V-LDL: Very Low Density Lipoprotein     HDL: HIgh Density Lipoprotien (aka Good Cholesterol)    A1C:  Hemoglobin A1C / Glycated Hemoglobin    GLU:  Glucose

Client Basic Stats:  64 y.o African American Male, HT/WT: 66in/167lbs (167cm/75.74kg) GIRTH: 37.5in (95.25cm) circumference around the navel.

Quality Control:  All measurements taken by myself using the same measuring equipment, on a bi-monthly basis at the same approximate time.  All labs taken by clients primary care facility.

Exercise Rx: Client attended three 30 minute resistance training sessions weekly followed by 30 minutes of aerobic training on commercial fitness equipment.  Clients programming was based largely on the standards set by the American College of Sports Medicine (ACSM) position on training individuals with T2D. Slight deviation was required to attend to clients upper body muscle imbalances.

Diet Rx:  Following the approval of the clients diabetes nutrition counselor and physician, the client began a 90 day strict vegan diet. SIDE NOTE: I went vegetarian during this period as a show of support.  Truth be told, I had a harder time adjusting to it than the client did.

PRE- ExRx/ Diet Labs                                                          Results!

28 May, 2013                       Reference Range                  11 Sep, 2013

AIC:         11.1                      4.8 – 5.9                                        6.3                     39% reduction

GlU:         272                       70 – 126                                        135                   50% reduction

CHOL:      197                       0 – 199                                          131                   32% reduction

TRIG:        119                      0 – 199                                           71                     40% reduction

LDL:         116                       0 – 130                                            56                    51% reduction

V-LDL:     23.8                         0 -80                                             14.2                 40% reduction

HDL:        57                            7 – 55                                            61                   6.5% improvement

Client additionally lost 2in (5cm) off his abdominal circumference and averaged 2lbs (.9 kg) weight loss per week for a total of 10lbs (4.54kg.)

Personal Trainers that Rock!

Now that I have finished my week long rant on Trainers that Suck, I have decided to end the week on a positive note.  Below are some of the signs that your trainer rocks!

But before I get to the feel good stuff, one Trainers that Suck parting shot is required…

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One can almost hear the 70’s porn music being cued.

The Creepy Patented Moves Trainer.   Yes, movies and soap operas have featured this guy.  Yes, they really exist (stereotypes exist for a reason.)  No, this is not a very good representation of reality.

OK…on to the good stuff!

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Your trainer is an educated and experienced professional (and acts like one!)  Trainers holding a college degree in an Exercise or Nutrition related science, or trainers with degrees in other fields having ample experience in fitness have demonstrated a degree of commitment that further separate them from the pack.

Non-degree holding, but highly dedicated trainers might have practical experience that far outweighs their degree holding counterparts.

Trainers of either ilk holding the more expensive and difficult to obtain credentials may, or may not be a better trainer than those with cheaper and easier credentials, but have demonstrated greater financial commitment and put in far more work to obtain their credentials.

Education and experience aside, if the trainer acts like a jacka$$ then they belong in the Trainers that suck blog series.

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This cute Pug managed to become a “certified personal trainer” through an online fly-by-night company.

 Your trainer has reputable credentials.  Aside from, or in addition to their formal education, your trainer holds one or more credential from the following major accredited organizations within the United States:  American Council on Exercise (ACE), American College of Sports Medicine (ACSM), National Academy of Sports Medicine (NASM) or the National Strength and Conditioning Association (NSCA.)  Furthermore, your trainer is up to date on their CPR/AED and First Aid certifications.

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A technically perfect squat.

Your trainer can explain things functionally, athletically, scientifically or in lay terms.  It has been my experience that clients like to know why they are doing what they are doing.  Just because the client is not asking questions does not prevent you from providing a little background information to them.  They might be embarrassed to ask.

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Your trainer actually cares about your results.  The first session with your trainer may not be an actual training session.  It is preferable that your first session be an assessment of your health history, goals and current measurements.  Assessments can also include, but are not limited to:

– Movement Screens / Postural Assessment

– Strength/Cardio/Flexibility tests

– Joint ROM reading

– Pharmocology Review

– Current Diet review

– Lifestyle Q&A

– Past training history (if applicable)

– Sport Needs (Sport specific clients)

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I wasn’t sure if it was me or my 7 for all Mankind jeans that made my pelvis look anteriorly rotated.

 In my current practice, my clients’ first assessment takes approximately an hour depending on complexity.  This is followed by several hours of research prior to developing the case file and three and six month training programs.

Depending on your unique needs, your trainer tracks your performance gains/ physical improvements accordingly.  In general, weight/girth should be checked at least monthly and performance improvements being noted per workout unless you are on a lengthy rehab program.

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Maybe not elevator music, but certainly not 70’s porn music either.

Your trainer gets to know YOUNot only is this a BIG PART of the initial assessment, it is something that naturally occurs during your training time together.  Your trainer need not be your best pal.  Matter of fact some trainers prefer to keep things cordial but professional, while others treat you as a family member they can lovingly dispense burpees and thrusters to.

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Your trainer holds safety as the top priority.  In my opinion this is non-negotiable.  Trainers:  Although it lacks the sexiness of winning a bodybuilding title, the prestige of a college degree or the bragging rights of holding particularly difficult certifications, being known as the trainer with common sense and a sense of caution when needed is a good thing that $ can’t buy (but can rent for 30-50min sessions.)  Honestly, would you want to be known as the trainer that gets people hurt? 

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Your trainer will call you out on your BS.  Clients:  Even the lesser attentive trainers know you are eating more / working out less than you tell us.   Trainers: You are in the unique position of being the hired help that actually is in charge of your boss.  The third and fourth rules of leadership: (3) Enforce the Rules. (4) Play the Part.

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Batman knows what to do with a shake weight,

Your trainer is effective, and sticks to things that work.  Your trainer does not hop on every bandwagon; they do not necessarily follow the pack and they are able to apply their training philosophies in varying degrees to their clientele, regardless of diversity.  They achieve results in clients with differing needs by tailoring their training system to meet the clients’ needs.  Furthermore, your trainer continually educates themselves and seeks to improve their skill set.

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Your trainer rocks if they are consistent, professional,dependable and certified.  They need not be Swiss, super expensive or flashy.

Your trainer is consistent, professional and dependable.  This is non-negotiable.

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Your trainer isn’t a one-trick pony. (Unless you hired a one-trick pony on purpose) The ideal trainer holds a variety of skill sets, although they may prefer to specialize in 1-2 of them.  If the trainers’ specialization(s) are in line with your goals then you stand a fine chance of success.  I do not recommend a trainer seek to become a “Jack of all trades.”  I suggest that after establishing a solid foundation (education and experience) the trainer find their passion within this diverse field and pursue it with all effort.   It is entirely reasonable that trainers’ interests will change over the years, or even according to client base and this is perfectly normal.

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Personal Trainers that suck (Part 6- The Hits keep coming)

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“You’re going to take all that weight on your neck. Then you’re going to jam your legs down and hyper-extend your ankles, and then shoot back up and lock your knees in place.”

The Dissociation Disorder trainer.  I’m not talking about the trainers that prescribe  “old school” type exercises (you know deadlift, pull-ups, push-ups, squats etc.) I’m talking about the trainers that are prescribing exercises/ techniques that have been medically and scientifically proven as ineffective,or outright dangerous, but were popular during the trainers heyday.  A fine set of examples would include the behind the neck lat-pull-down, refusing to go down to 90 degrees on a squat and bouncing the bench press bar off of your chest.

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These trainers may/may not have a dissociation disorder but they are certainly chrono-challenged.

The “you do ALL of the work” trainer.   As in you rack/re-rack your own weights, you log your lifts, you get your own water bottle, you locate your props etc.  Trainers: I’m not saying you need to kiss the clients butt, but  a little customer service is a good thing, I assure you.  What’s next, are you going to have them spot themselves?

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The “I’m taking a snack break while you workout” trainer.  Yes, I have seen independent trainers eat in front of their clients.  In this case, it was a plastic container of pasta and chicken breast.  I have seen gym trainers chug Diet Dr. Pepper in front of their client as well.  Even worse on both counts, the trainers were sitting on their butts while the client was on a machine pushing around weight with terrible form.  (Yes, it is possible to train on machines with poor form.)

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“Bro…this hurts!, my shoulder is killing me!”

“Just jerk it down harder”

The Ignore the Pain trainer.  I’m not talking about  pain that you (a) walked in with or (b) Muscle soreness from your last workout / WOD.    I’m talking about the pain caused by the effort required to move something heavy repeatedly.  A good trainer will be able to handle the sudden change in plans, possibly figure out the cause, enact a back-up plan and/or refer you to a medical professional if needed.  Then again a good trainer would have had an eye on your form and not put you in a position where things got to that point.  Like life itself, things can and will happen.  A workout is going fine, the weight is perfectly within reason, form is spot-on and then the unexpected happens and your body sends out a warning sign.  Neither you, nor your trainer could have predicted it.  Best option is to halt the exercise, reassess the situation, proceed with caution at a lighter weight or replace exercise completely.  Seek medical advice.

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The Ineffective Method trainer.   If your goals are to increase overall muscle mass or to lose weight, and your trainer has you training on multiple isolation exercises without prescribing any of the bigger multi-joint/multi-muscle actions then they are doing you a disservice.

They are however making their job a lot easier.  How much coaching is really required to learn how to do a machine bicep curl?

Worst of the worst:  I saw a trainer put an obese female client through the following workout:  5 minute walk on the treadmill at 0 incline, Hammer Strength Preacher Curl,a high curl machine with both arms, then one arm at a time and then a standing cable curl set with lousy form.  For trainers reading this blog, I will add that the client didn’t appear to have any problems moving around and her client screening sheet indicated no physical/medical issues other than obesity.

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The Preacher curl performed with a straight barbell.

The next exercises  were 2 sets of what seemed to be 100 light reps on the seated hip add/abductor machine.  The workout was finished on a weighted crunch bench doing15 minutes of partial range crunches.

Here  is what the workout amounted to:

5 minutes of assisted walking on a flat service, 3 exercises hitting the same relatively little muscle in a singular plane of motion (2 performed in a sitting position, which burns less calories than standing, 1 in a leaning position and 1 in a standing position.)

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The seated adductor/abductor machines (the close or open your leg machine) can cause strain on the spine and creates tension along the IT band, which can further throw the knee cap out of alignment.  It is also a machine that doesn’t replicate any sort of motion you do in real life.

Crunches (for the purpose of building abdominal muscle) are not the most effective means as they miss the transverse abdominus muscles and stress the lower back and neck.  For the purpose of trimming the waistline they are ineffective due to the fact that spot targeting fat is impossible.

Personal Trainers that suck (Part 5)

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The Always has you warm up for 5-10 minutes walking on the treadmill trainer.  The trainer is off the hook if you showed up early and decided to get a few minutes on the cardio equipment.  The trainers that have you walk for 5 minutes on a treadmill before working on your chest/tricep muscles are wasting time on a “warm-up” that prepares the wrong systems for work.  I’m 99.999% sure that is NOT the way they warm-up.  It is however a great way to kill a few minutes off your session or sneak in a bathroom break/snack break, text/tweet/FB post.

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“This stretches your legs  (and gives me a chance to deactivate my glutes)”

The Doesn’t know how to stretch muscles beyond the ones you learned how to stretch in gym class trainer.  This indicates several possible things: 

(1) The trainer skipped the anatomy section of their certification process (not likely)

(2) The trainer doesn’t see value in flexibility training (possible, especially in younger/limited skills trainers

(3) The trainer hasn’t evolved.

(4) The trainer doesn’t care.

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The BS’s with other trainers during your session trainer.  BS…not consult on something that is directly related to you, or related to the safety of someone else around you.

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The BS’s with other gym go’ers during your session trainer.  Once again, this has been known to happen. 

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The Salesman/Trainer Trainer.   Pushing you into upgrading personal training contracts, upgrades, buying shake weights, purchasing supplements and anything else with all the tact of a telemarketer.

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“Don’t be a wuss!  Are you a wuss? No? Fine! Prove it…look at the weight and tell it to Come at Me Bro!…DO IT!!! DO IT NOWWWWWW!!!!!”

The Bully Trainer.  This was the guy that made fun of you in high school, now he/she is in charge of putting you through exercises. 

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The Bully trainers female counterpart is The Mean Girl trainer.

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The D-Bag Trainer.  This is the one that spends more time telling you how great they are and checking themselves in the mirror frequently.

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The Ringmaster Trainer.  They LOVE getting you on that BOSU ball to perform all sorts of single leg tricks with weights.  (Exception: You are training to become a juggler that specializes in performing at sea in high waves.)  Balance training itself is not a bad thing, it is when it is the ONLY thing that you are doing that have a problem.

Personal trainers that suck (Part 4, just back from the gym edition)

More of the worst!

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The Danger is my middle name trainer.   The things they will put clients through never fails to both amaze, and frighten me.   Tonight for example, I observed a trainer try to make a 50+ year old lady hop up onto aerobics steps.  Although it was only two-steps high, a fall for an elderly person is never a good thing…and fall she did, on her butt (low back injury you say?)    Maybe the trainer didn’t know any better, maybe they trainer….who is far younger and athletic… could perform the technique without any problem, maybe the trainer is training the lady in very basic parkour, maybe the trainer was making stuff up on the spot.

 That’s a lot of maybes.  One thing I do know for certain, the trainer was hired off the floor and doesn’t appear to have any experience training elderly clients.

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“Man…Pookie….Bro!…those fat burners your trainer hooked you up with have got you looking shredded!….and ashy…here bro…I have some supps my trainer sold me that will keep you classy, never ashy!”

 The always pushing supplements.  Unless the trainer also happen to also be a registered dietitian they have NO business pushing supplements.  Even registered dietitians cannot say with 100% certainty how a supplement may/may not effect you, especially if you are taking medications.

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“Wait…isn’t there supposed to be something written on here?”

The doesn’t give his/her contact information trainer.   Sounds sort of like they don’t  care about you or don’t want you to bother them doesn’t it?  It sounds that way because it IS that way.   Seriously, in what other situation does a person whom you intend to conduct business with NOT give you their number after they have yours?

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The “So what do you want to work on today?” trainer”  In my opinion, the only acceptable time this term can be used is if there are only a limited number of agreed upon sessions.  For long-term clients, I regard this statement as your trainer killing their own credibility as a supposed expert in the field of personal training.  Furthermore, I can guarantee any workout that was delivered in this manner will be either (a) Made up on the spot or (B) Be rather generic and tailored to your particular need.  

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The has no short-mid-long-term plan trainer.  (1)   Decent trainers think 3-6 months in advance with some going as far as twelve months.  (2)   Great trainers think about the lifetime of the client. 

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“Looks like a good time to post a status on Facebook…need a self-pic too!”

 The Texts/Facebooks/Tweets/E-mails during your session trainer.  Once again, this shouldn’t require much explanation.  What could possibly be so important during your paid for time that an electronic communication couldn’t wait 30-60 minutes? 

 

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“Ok Bro…hold it right there…..be back in a sec!”

The leaves without justifiable reason while supposedly training you trainer.  Yes, there have been examples of trainers walking off “I’ll be right back” and not coming back with a weight/prop/instructional material.  Matter of fact, I’ve heard of this happening twice lately (albeit at different times and different gyms.) 

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“Spot!…SPOT!!!!! Sh..Shhh…Shhiiii…ugggggghh”

 

Personal Trainers that suck (Part 3)

No CE Rx     or      CE Rx

The No corrective exercise/Too much corrective exercise trainer.  This can go several ways:  (1) The trainer does not know anything about corrective exercise and is too lazy to look it up or doesn’t see any value in it.  (2) The trainer does know corrective exercise and fancies themselves as a physical therapist.  Fellow trainers, I believe that there is indeed a balance between none and too much.

Physio

The I’ve got the solution for your Corrective Exercise needs trainer.  The trainer has rehabilitated themselves to some degree, possibly quite successfully, and believes that alone qualifies them to prescribe corrective exercise for you.  Not always a bad thing, but this falls way too close to a one size fits all mentality and exceeding the scope of ability and credentials for me.    I pulled out a tooth of mine when I was 6, I don’t think that qualifies me to practice amateur dentistry.

Spotters

“4..5..You got it bro…9…13…yeah buddy…27..Hells yes…1973”

The Inattentive trainer.  This shouldn’t require explanation, but the fact is your trainer IS responsible for your safety during your session.  Extra negative points assigned if you trainer was hired off the floor and lacks CPR/AED/First Aid qualifications.

 Idiot Guide to Weights

Thankfully this edition comes with photos, after all not everyone has time to spend on stupid things like descriptions or procedures.

The No certification/formal education/on-going education trainer.  You may have a trainer with a broad level of knowledge, yet no papers to back it up…or a trainer with papers and no practical experience.  Personally I would want an educated and credentialed trainer with experience in training others that have the same/similar needs as myself.  Just like I would like a legitimate professional in any other field.

 CPRDoingItWrong

I thought cracked ribs were the worst thing that could happen to me from successful CPR, turns out involuntary gender reassignment is the worst thing.  I’ve got a fiver that say’s the other person inhales instead of exhales as well.

The I’m not CPR/AED/First Aid certified trainer.   Ask to see proof.  If it can’t be produced then do not proceed until it can.   All major credentialing agencies REQUIRE aforementioned certification from a reputable provider (I.E. Not an online course) BEFORE a candidate can sit for their examinations.  A few will allow you to take the test, but will not mail your certificate until you forward a copy of your CPR/AED qualification.   To maintain certification, certified trainers are to complete a certain amount of continuing education credits and maintain CPR/AED qualification.  Some trainers will let their qualifications/credentials lapse, which begs the question (for me at least) what else are they letting lapse?

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“I thought you had that one bro!….How was I supposed to know overhead lifts would turn you into a little girl?  What do you mean you have a bad rotator cuff?….oh wait, you did tell me you had a bad rotator cuff didn’t you?

 The I have no liability insurance trainer.  Independent trainers only, staff trainers are covered by their gym but can elect to purchase additional coverage.  Ask to see proof.  If it can’t be produced then do not proceed until it can.

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I often wondered why a T.G.A.T I worked with always wore a jacket during PT sessions.  Despite his claim of being in a bulking phase I never once saw him eat.  Saw him drink plenty of Monster Energy drinks, but never eat.

The “That guy’s a Trainer?” trainer (aka the Fat Trainer.) Power Lifting coaches, Strongman Event coaches and Striking Padman coaches are exempt.  I am also personally exempting trainers that were previously much fatter and are passing on their dieting/ exercise knowledge to others in the same predicament they went through.  I am talking about your standard personal trainers who dole out workout, dietary and nutrition advice.

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Know-it-all’s come in all shapes, I just thought this was a funny pic.

The other “That guy’s a Trainer?” trainer (aka the no muscles at all trainer.)  I’m exempting the lean physique trainers, the flyweight class combat athletes, gymnasts, speed trainers and smaller sized CrossFit coaches….this is the outright skinny guys that can’t move things that weigh more than they do.

Personal Trainers that Suck (Part 2- The rant continues)

 

Single tool

“All I has is my hammer, but I can use it for cardio, resistance. joint care and flexibility!”

The Singular type of training trainer.   Applicable to commercial gym staff.  Independent trainers can elect to specialize in a singular type of training.  This is a trainer that has a very limited/specified skill set, yet thinks his/her method can be applied to everyone equally, or in the case of a multi-skilled trainer…he/she believes a singular method is the BEST way to service all.  Often that singular method is a current fad.

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“Hand me those shake-weights so I can realllllllly blast my kegels...want to make them babies burn!”

If the trainer specializes in bodybuilding then they are best suited for clients that are fit, or near fit that want to pursue bodybuilding.  If the trainer believes a bodybuilding-specific  method can also serve athletic strength and conditioning needs, inclusive fitness for the handicapped  or rehabilitative corrective exercise needs  then they are sorely mistaken.

The Singular workout routine.  Usually the only tool available to a singular skilled trainer, but this is not always the case….it could simply be that your trainer is…..

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I need to get my hands on some of these!

 

 The Lazy A$$ trainer.  Easy to spot, every place they take their client has something nearby to sit down on, or lean against while counting out your reps.  Granted, there are certain exercises where spotting requires the trainer to sit down and observe you, but those are fairly limited and I can all but guarantee those are not the exercises the trainer is using since they are usually technically complex moves that require demonstration and explanation.

Fit and not so fit

“OK so you’re nearly 30 years older than me, have more than twice my bodyfat, have not exercised since the late 90’s, have diabetes and high cholesterol, a bad knee, a strained lumbar and no tan whatsoever….welll….we are both guys, so I’ll have you do the program I do…it will be cool.”

The Trains you the way they train trainer.  Usually the method the Singular Type of Training Trainer, Lazy A$$ trainer or the Hired off the floor trainer.  The trainers method may have worked wonders for them….you however are a different person entirely.

The No type of screening trainer.  Not covering of your medical history, goals, current nutrition, performing movement screens,  conducting bodyfat composition or researching your prescription medications for exercise induced side-effects is a SERIOUS warning sign.  

(A) The trainer doesn’t know how to screen or what questions to ask.

(B) The trainer doesn’t think screens are important.

(C) The trainer doesn’t care.

(D) All the above, and wouldn’t think to/wouldn’t know when to refer you to a medical professional.

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“I have this program at home that will be perfect for you!  If you follow this program 3x per week for 6….make that 12 months you might be ready for the treadmill!”

 The Going nowhere slowly trainer.  Essentially you perform the same workout for very long  periods of time.  No switching of exercises, progression of resistance or protocols.  Under certain exceptions this is perfectly acceptable, namely for lengthy rehab clients,those with very poor motor control skills, cognitive issues or medical conditions.   I would further regard this as acceptable if the client does not train very frequently and misses too many sessions.

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(Voice of trainer on the far left)  “C’mon Bro..Lightweight Baby! Lightweight!

The Going nowhere way to fast trainer.  Insisting on progression when regression is clearly called for.  Not sure where the trainer is going with this.  If you are struggling with certain movements/weights and the trainer simply adds more complexity and weight to the situation, are they thinking that this will solve things?

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The Machines only training trainer.  Unless your club is equipped without any form of free-weight, your trainer is only creating only local hypertrophy of your muscles.  They are also making their job a lot easier since the machine doesn’t require spotting and they don’t have to fetch weights nor do much in the way of correcting your form.  Matter of fact, they can sit down, count out reps and get in a Facebook post or two.