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CSEP - CPT M-S Theory2006 Version 2.0 1

CSEP-Certified Personal TrainerCSEP-Certified Personal Trainer(CSEP-CPT)(CSEP-CPT)

Musculoskeletal Fitness Theory


Basic AnatomyBasic AnatomyKey Concepts: 3.23-3.25Key Concepts: 3.23-3.25


Force & LeversForce & Levers

• 1st class» seesaw» muscles that extend neck

• 2nd class» loaded wheelbarrow» plantar flexion force at the expense of

speed & distance

• 3rd class» flexion at elbow speed & distance at the

expense of force

R

F AF

R

F

AF

R

F

AF


Fascicle OrganizationFascicle Organization


Parallel MusclesParallel Muscles

• Fascicles are parallel to long axis

• Most muscles in body

• Functional characteristics similar to individual m. fibre

• Entire m. shortens by same amount


Convergent musclesConvergent muscles

• Fibres come together (spread out) to a common attachment site

• Ex: pectoralis major m.

• Direction of pull can be changed by stimulating different fibres of m.

• Less strength than parallel m. of same size


Pennate M.Pennate M.

• 1+ tendons run through body of muscles & fascicles form an oblique angle to tendon

• Contain more m. fibres than a parallel m. of same size generates ______ tension

» Unipennate» Bipennate» Multipennate


Primary ActionsPrimary Actions

• Prime mover (agonist)» Contraction is responsible for movement

• Synergist» Assists prime mover

• Antagonist » Oppose action of agonist» Tension adjusted to control speed of agonist


Assessment of Muscular Assessment of Muscular StrengthStrengthKey Concepts: 4.16Key Concepts: 4.16


DefinitionsDefinitions

• Muscular strength: peak force or torque developed during a maximal voluntary contraction (MVC)

• Muscular power: rate at which mechanical work is performed

» Maximal amount of force one can exert in the least amount of time (force/time)

• Muscular endurance: ability to exert sub-maximal force repeatedly, or sustain a static contraction without fatigue


Force GenerationForce Generation

• Ability of a muscle or muscle group to generate force depends on » Size of muscle » Type of contraction» Number of muscle fibres activated» Ability of nervous system to activate muscle fibres» MOTIVATION of the client!

• Strength potential is limited by genetics» Number of fast-twitch fibres


Why Test Strength & Why Test Strength & Power?Power?

• To develop profile of client • To monitor training progress• To monitor the rehabilitation of injuries• To assess health status• ????


Gender & AgingGender & Aging

• Men typically have greater muscle mass and cross-sectional area than women

• Rate and pattern of strength development and decline in age are similar for both genders

• Peak strength: females late teens and males during their 20s.


Gender & Aging: StrengthGender & Aging: Strength

• Decline in strength begins at age 45 to 50 and progresses at a rate of 12-15% per decade

• 25-40% of muscular strength is lost by the 6th or 7th decade

• Large portion of the decreased strength in old age is due to muscle atrophy

• Women tend to have a higher percentage loss of strength than men


Gender & Aging: StrengthGender & Aging: Strength

• Grip Strength: Good indication of overall muscular strength» Early screening of populations to identify those at higher risk

for physical disability related to low muscle strength» Cutoff score of 21.0 kg – minimum level of old-age grip

strength» Individuals with scores close to this value are 8X the risk of

developing muscular strength disabilities» Good indicator of high and low levels of health status

Warburton et al. Can J Appl Physiol 26(2): 217-237, 2001. Warburton et al. Can J Appl Physiol 26(2): 161-216, 2001.


Theoretical relationship Theoretical relationship between musculoskeletal between musculoskeletal fitness and independence fitness and independence across the lifespan. across the lifespan.

Mu

scu

losk

elet

al F

itn

ess

10 20 30 40 50 60 70 80

Disability

Independent Living

0

Age (yr)

Threshold for Dependence

Warburton et al. CMAJ 2006


Gender & Aging: Muscular Gender & Aging: Muscular EnduranceEndurance

• Loss in endurance with aging is also significant• Peak partial curl-up scores: 13-15 yr• Peak back extensor endurance scores: 20-29 yr• Average performance for endurance tests

(push-ups, partial curl-ups and back extensor endurance) decline dramatically through to 60-69 yr range


Gender & Aging: Muscular Gender & Aging: Muscular EnduranceEndurance

• Push-ups and partial curl-ups are less significant predictors of overall musculoskeletal health in comparison to grip strength for both genders

• Males: Push-ups and grip strength are the strongest discriminators between high and low health

• Females: Grip strength and sit & reach are the strongest discriminators between high and low health» Payne et al. Can J Appl Physiol 25(2): 114-126, 2000.


Gender & Aging: PowerGender & Aging: Power

• Greater loss in power with aging compared to muscular strength & endurance

• Maybe due to the loss in FT fibres• Women have lower leg extensor power than

men• Gender differences begin in the teens and

continue throughout life


Musculoskeletal FitnessMusculoskeletal Fitness

in MSF with age is not solely due to age itself but to physical inactivity and/or chronic disease

• Strength training can offset the loss in muscular strength and muscle mass associated with aging

• Improves the ability to perform activities of daily living, improve bone health and reduce the risk of falling


Strength TestingStrength Testing

• When choosing a strength test consider:» Client’s goals » Specificity» Equipment » Upper & lower body strength measure, and

abdominal endurance

• Always ensure subject is warmed up & familiar with all equipment

• Keep motivation consistent!!!!


Absolute or Relative Absolute or Relative Strength?Strength?

• Absolute strength = MVC (in Newtons or kg)– MVC = maximum voluntary contraction

• Relative strength = MVC / body mass


Isotonic ContractionsIsotonic Contractions

• Concentric contraction» Muscle shortens during tension development» Weight is lifted

• Eccentric contraction» Muscle lengthens during tension development» Weight is lowered» Able to generate higher forces» Greater risk for injury

• What is the maximal weight that can be lifted during a concentric contraction?


1-RM1-RM

• Maximal amount that can be lifted in one complete repetition with proper technique

• Can be used to rate health status, establish exercise prescription workloads, and/or monitor a resistance training program

• Limitations of 1-RM test» Injury » Technique » Economy of test

• Outside of the Scope of Practice of a CSEP-CPT!Outside of the Scope of Practice of a CSEP-CPT!


Predicting 1-RMPredicting 1-RM

• Muscular endurance is directly related to muscular strength

• THEREFORE, 1-RM can be predicted without performing a maximal lift

• Usually 6 to 10-RM test


Submaximal Predicted 1-RMSubmaximal Predicted 1-RMSingle SetSingle Set

• Warm up at 40-60% of estimated 1-RM for 5-10 reps

• Stretch during 1 min rest period

• 1 set of 10 reps at 60-80% of estimated 1-RM» >10 reps completed, then client gets a 3-5 min rest

• Increase weight client attempts up to 10 reps


Predicted 1-RM (Baechle Predicted 1-RM (Baechle & Earle)& Earle)

• determine %1-RM from # of reps completed

• divide weight lifted by % 1-RM

EXAMPLE: client performed 8 repetitions of 100 lbs

Reps Completed

% 1-RM

1 100

2 95

3 93

4 90

5 87

6 85

7 83

8 80

9 77

10 75

8 repetitions = 80% 1-RM1-RM = 100 lbs lifted/.80 1-RM = 125 lbs


PRACTICE!PRACTICE!

• Groups of 3-4• 1 person client; 1 acts as appraiser; 1

observes• Calculate results for different muscle groups


Muscle BalanceMuscle Balance

• A strength imbalance between opposing muscle groups may compromise joint stability & increase risk of injury

• Muscle balance ratios differ between muscle groups

• Crude index can be obtained by comparing 1-RM

Muscle Groups Ratio

Hip extensors/ flexors 1:1

Elbow extensors/ flexors 1:1

Trunk extensors/ flexors 1:1

Ankle inverters/ everters 1:1

Shoulder flexors/ extensors 2:3

Knee extensors/ flexors 3:2

Shoulder internal/ external rotators

3:2

Plantarflexion/ dorsiflexion 3:1

Strength Comparison

Right & left side 10-15%

Upper to lower body 40-60%


Sources of ErrorSources of Error

• Client

• Equipment

• Technician Skill

• Environment


Exercise Prescription for Exercise Prescription for Improving Muscular Strength & Improving Muscular Strength & EnduranceEnduranceKey Concepts: 4.17 – 4.18Key Concepts: 4.17 – 4.18


Key Training PrinciplesKey Training Principles

• Specificity principle» Strength improvements are specific to the muscle

group trained

• Progressive overload principle» Achieved by changing INTENSITY, duration,

frequency, recovery


FlexibilityFlexibilityKey Concepts: 4.19Key Concepts: 4.19


FlexibilityFlexibility

• Ability of a joint (or series of joints) to move through a full ROM» Specific to the joint» Dependent on morphological factors» Ball-and-socket joints (hip/shoulder) have greater

flexibility than hinge joints (elbow/knee)» Muscle-tendon factors can impact flexibility» Also related to age & type of activity performed


AssessmentAssessment

• Direct methods» Goniometer, Leighton flexometer

• Indirect methods» Linear measurements - i.e., sit and reach

• Pros/cons of each?

• All flexibility measurements are dependent on the skill of the fitness appraiser!


Benefits of Adequate Benefits of Adequate FlexibilityFlexibility

• Improved performance (?)

• Helps with proper posture

• Reduces stiffness and soreness from unaccustomed activity

• Minimizes risk of back injury


Types of StretchingTypes of Stretching

• Ballistic - bouncing and jerking movements at extreme ROM or point of discomfort» bad bad bad» remember the muscle spindle!

• Static positions - position is held for a period of time at extreme ROM

• Partner Assisted (Proprioceptive neuromuscular facilitation (PNF)) - induces muscle relaxation through spinal reflex mechanisms» remember the GTO & reciprocal inhibition!


PNFPNF

• Contract-relax method based on reciprocal inhibition» Isometric contraction of antagonist

Induces a reflex facilitation & contraction of agonist suppresses the contractile activity in the antagonist during static stretch phase

Also, stimulates Golgi tendon organs reflex relaxation of same muscle group


Partner-Assisted Partner-Assisted TechniqueTechnique

• Contract-relaxStretch muscleIsometric contraction of muscle group being

stretched (5-6 s)Slow static stretch (10-30 sec)


CPAFLACPAFLAStretching Routine TipsStretching Routine Tips

• Stretch slowly and smoothly• Avoid bouncing and jerking• Use gentle continuous movement or stretch-

and-hold techniques• Breathe naturally• Static stretching - start with several reps of 10-

30s hold and then progress to fewer reps and longer duration

• Avoid exercises that hurt or feel wrong

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