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International Sports Sciences Association The World Leader in Fitness Education and Certification — Since 1988

FITNESS: THE COMPLETE GUIDE OFFICIAL TEXT FOR ISSA’S CERTIFIED FITNESS TRAINER PROGRAM

www.ISSAonline.edu

Frederick C. Hatfield, PhD

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CONTRIBUTORS Frederick C. Hatfield, PhD, MSS Sal Arria, DC, MSS Karl Knopf, EdD Michael Yessis, PhD James A. Petersen, PhD Daniel Gastelu, MS, MFS Charles Staley, BS, MFS Patrick S. Gamboa, BS, MSS

REVIEWERS Thomas D. Fahey, EdD Jane Frederick, MA, MFS Doug Holt, BS, MFS, CSCS

EDITORS Michelle Basta Boubion, BA, NSCA-CPT Maura Weber, BA Managing Editor, Muscle & Fitness Hers Magazine Beth Saltz, MPH

GRAPHICS AND ILLUSTRATION Sarah McDonough, Art Director Karen Williams, Formatting and Photography (Strength) Samantha Hird, Photography (Flexibility) Alex Gundersen, Illustrator

Fitness: The Complete Guide (Edition 8.6.6) 10 9 8 7 6 5

Official Course Text for: International Sports Sciences Association’s Certified Fitness Trainer Program Copyright © 2009 TXu1-157-866 International Sports Sciences Association. All rights reserved. No part of this work may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage or retrieval system, except as may be expressly permitted by 1976 Copyright Act or in writing by the Publisher. Direct all correspondence, permissions requests, and inquiries to: International Sports Sciences Association 1015 Mark Avenue • Carpinteria, CA 93013 1.805.745.8111 • www.ISSAonline.edu

DISCLAIMER OF WARRANTY This study guide is informational only. The data and information contained herein are based upon information from various published as well as unpublished sources and merely represents training, health and nutrition literature and practice as summarized by the authors and editors. The publisher of this study guide makes no warranties, expressed or implied, regarding the currency, completeness or scientific accuracy of this information, nor does it warrant the fitness of the information for any particular purpose. The information is not intended for use in connection with the sale of any product. Any claims or presentations regarding any specific products or brand names are strictly the responsibility of the product owners or manufacturers. This summary of information from unpublished sources, books, research journals and articles is not intended to replace the advice or attention of health care professionals. It is not intended to direct their behavior or replace their independent professional judgement. If you have a problem with your health, or before you embark on any health, fitness or sports training programs, seek clearance from a qualified health care professional.

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AUTHOR

ABOUT THE AUTHOR Frederick C. Hatfield, MSS, PhD, is Co-founder and President of the ISSA. Dr. Hatfield, (aka “Dr. Squat”) won the World Championships three times in the sport of powerlifting, and performed a competitive squat with 1014 pounds at a body weight of 255 pounds (more weight than anyone in history had ever lifted in competition). Dr. Hatfield’s former positions include an assistant professorship at the University of Wisconsin (Madison) and Senior Vice President and Director of Research and Development for Weider Health and Fitness, Incorporated. Dr. Hatfield was honored by Southern Connecticut State University when they presented him with the 1991 Alumni Citation Award. He has written over 60 books (including several best-sellers) and hundreds of articles in the general areas of sports training, fitness, bodybuilding, and performance nutrition. He has been coach and training consultant for several world-ranked and professional athletes, sports governing bodies and professional teams worldwide. Dr. Hatfield qualified for the 1998 World Championships in Olympic Lifting and competed in the Masters Division.

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TABLE OF CONTENTS Nutrition, 446

Introduction, 1 Anatomy and Physiology,

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Metabolism, 10 Basic Anatomy and Physiology, 30 Muscle Anatomy and Physiology, 72

Weighing the Truth on Exercise and Nutrition, 450 The Basics of Sound Nutrition, 462 Estimating Caloric Needs,

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Kinesiology and Biomechanics, 122

The ISSA Zig-Zag Approach to Muscle Gain and Fat Loss, 518

Kinesiology of Exercise, 126

Fad Diets and Nutrition, 528

Biomechanical Concepts of Exercise, 140

Supplementation, 536

Musculoskeletal Deviations, 154

Injury and Disease, 576

Muscle Mechanics, 166

Exercise and Older Adults, 580

Health and Physical Fitness, 184

Exercise and Adaptive Fitness, 588

Strength, 188

Exercise and Our Youth, 594

Cardiovascular Training Theory, 294

Exercise and Hypertension, 598

Flexibility, 320

Exercise and Diabetes, 604

Body Composition, 338

Exercise and Arthritis, 610

Program Development, 358

Exercise and Coronary Heart Disease, 616

Program Development, 360

Exercise and Pregnancy, 622

Basic Assessment of Fitness Participants, 370

Exercise and Asthma, 628

Training Principles, 390

Exercise and Sports Medicine in the Trenches, 634

Periodization, 408 Determining Training Loads, 426

Basic First Aid, 672

References, 683 Glossary, 701 Index, 721

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INTRODUCTION Anatomy and Physiology Kinesiology and Biomechanics Health and Physical Fitness Program Development Nutrition Injury and Disease

INTRODUCTION

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INTRODUCTION

THE WHO, WHAT, WHY, AND HOW OF

PERSONAL TRAINING

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THE WHO, WHAT, WHY, AND HOW OF PERSONAL TRAINING I n t e r n a t i o n a l

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INTRODUCTION

PERSONAL TRAINING The fitness industry, as we know it today, is a multi-billion dollar industry. Personal training is its ever-growing offspring. While the roots of personal training are difficult to pinpoint (its origin is credited to the 1950s) one could contend that the roots of personal training date back to the beginning of recorded history. While the profession or terminology associated with personal training was not yet in existence, the concept of optimal health, which is the basis behind the profession, was already being touted by ancient philosophers. Around 400 B.C., Hippocrates wrote: “Eating alone will not keep a man well: he must also take exercise. For food and exercise, while possessing opposite qualities, yet work together to produce health . . . and it is necessary, as it appears, to discern the power of various exercises, both natural exercises and artificial, to know which of them tends to increase flesh and which to lessen it; and not only this, but also to proportion exercise to bulk of food, to the constitution of the patient, to the age of the individual . . .”

Of all of our nation’s leaders, President Theodore Roosevelt was one of the strongest — physically and mentally. However, he did not start that way. As a child, Roosevelt was small for his age and quite sickly. He had debilitating asthma, poor eyesight and was extremely thin. When he was twelve years old his father told him, “You have the mind, but you have not the body, and without the help of the body the mind cannot go as far as it should. You must make the body.”

Theodore Roosevelt began spending every day building his body as well as his mind. He worked out with weights, hiked, hunted, rowed, and boxed. History can attest: Theodore Roosevelt’s strength in mind and body contributed to his strength as the leader of our nation. Another great leader of our nation was President John Fitzgerald Kennedy. Kennedy, like Roosevelt, acknowledged the benefits of physical activity for optimal health. “Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.”

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WHO WANTS PERSONAL TRAINING? Since 1998, the number of Americans belonging to health clubs has grown twenty-three percent or seven million members according to the 2002 IHRSA/ASD Health Club Trend Report. Health club membership among children under eighteen years of age has jumped by one-hundred-and-eight-seven percent since 1987. The number of clients considering personal training services continues to grow. The American Sports Data Inc., a company that specializes in sports and fitness research since 1983, projected that 4,021,000 people in the United States alone paid for personal training services in 1998. The survey revealed the following: • Three out of five clients are women. • Clients report an average of 18 sessions with a trainer. • Clients pay an average fee of $34.00 per session. • Average household income of clients:

WHO IS A PERSONAL TRAINER? The profession of personal training is a relatively new field, which continues to expand and redefine itself its boundaries. Prior to the early 1980s, no minimal requirements existed to qualify or identify one as a personal trainer. Those who engaged in training were still an esoteric group. Many learned about training solely through personal experiences in the gym. Recognizing the need for standardization and credibility, Dr. Sal Arria and Dr. Fred Hatfield pioneered a personal fitness training program to merge gym experience with practical and applied sciences. Today a personal fitness trainer can be defined as an individual who educates and trains clients in the performance of safe and appropriate exercises to effectively lead their clients to optimal health. Personal trainers can be either self-employed or employed by health clubs, physicians’ offices, physical therapy clinics, wellness centers, hospitals, rehabilitation facilities and private studios.

Under $25,000

18%

$25,000 - $49,999

20%

$50,000 - $74,999

20%

$75,000 and up

42%

• Average sessions used in 12 months: 1–6

47%

7 – 11

12%

12 – 24

11%

25 – 49

8%

50 +

11%

Not Reported

11%

• Number of sessions clients used by age: 6 – 11 years old

22 sessions

12 –17

26 sessions

18 – 34

15 sessions

35 – 54

14 sessions

55 +

24 sessions

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INTRODUCTION These statistics support the growing trend and need for personal training services. While those 4,021,000 individuals who purchased personal training services are sold on the need for personal training, why is personal training a necessity?

WHY PERSONAL TRAINING IS NECESSARY? The Office of the Surgeon General released its Report on Physical Activity and Health in 1996. The report strongly supports the role of physical activity for good health and prevention of major health problems. The National Institutes of Health released a Consensus Statement on the importance of physical activity for cardiovascular health. The Healthy People 2000 objectives list physical activity and fitness as the first of twenty-two priority areas. The American Heart Association included physical inactivity and low fitness levels as primary risk factors along with smoking hypertension and high cholesterol. On the federal side, two health club-related bills stand out for possible passage in 2004. The IMPACT Act (Improved Nutrition and Physical Activity), approved by Congress before its last break, provides $250 million in grants for eligible organizations to help address the obesity problem. Grants would be available to provide health services for improved nutrition, increased physical activity and obesity prevention. The Senate approved the bill (S. 1172) in December 2003 and the House will take up the bill (H.R. 716) in 2004.

ture of almost $3,000 for every individual in the entire population. Regrettably, this financial commitment neither has shown signs of abating, nor has it produced totally acceptable results with regard to treating a wide variety of chronic health problems.

Unfortunately even with the resounding benefits of physical activity and fitness being touted and reported, America is currently undergoing an obesity epidemic with twenty-five percent of Americans still remaining sedentary. This would equate to one out of four Americans still being sedentary. To make matters worse, the federal resources and funds for physical activity have lagged far behind other aspects of health. Health and physical education in our schools are a low priority and are often the first programs to be cut in schools.

Attempts to identify the factors which have been major contributions to this virtual epidemic of medical problems have produced a litany of probable reasons why such a large number of individuals are so apparently unhealthy; poor eating habits, a sedentary lifestyle, stress, poor health habits (i.e., smoking), ad infinitum. At the same time, a number of studies have been undertaken to identify what, if anything, can be done to diminish either the number or the severity of medical problems affecting the public. These studies have provided considerable evidence that exercise has substantial medicinal benefits for individuals of all ages.

Consider the following as well. Americans spend more than $600 billion dollars annually for health care. This meteoric figure translates into an expendi-

Two of the most widely publicized efforts to investigate the possible relationship between exercise and disease were longitudinal studies, each of which

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4 Any listing of the medical problems and health-related conditions that can be at least partially treated and controlled by exercise would be extensive. Among the most significant of these health concerns and the manner in which exercise is thought to help alleviate each condition are the following: • Allergies. Exercise is one of the body’s most efficient ways to control nasal congestion (and the accompanying discomfort of restricted nasal blood flow).

involved more than 10,000 subjects. Several years ago, in a renowned study of 17,000 Harvard graduates, Ralph Paffenbarger, MD, found that men who expended approximately 300 calories a day; the equivalent of walking briskly for 45 minutes, reduced their death rates from all causes by an extraordinary 28% and lived an average of more than two years longer than their sedentary classmates. A more recent study conducted by Steven Blair, PED, of the Institute of Aerobics Research in Dallas documented the fact that a relatively modest amount of exercise has a significant effect on the mortality rate of both men and women. The higher the fitness level, the lower the death rate (after the data was adjusted for age differences between subjects in this eight-year investigation of 13,344 individuals). An analysis of the extensive data yielded by both studies suggests one inescapable conclusion … exercise is medicine! Accepting the premise that regular exercise can play a key role in reducing your risk of medical problems and in decreasing your ultimate costs for health care is critical. Despite the vast number of individuals who lead a sedentary lifestyle, the need for and the value of exercising on a regular basis is an irrefutable fact of life (and death). For example, Paffenbarger concluded after a detailed review of the results of his long-term investigation that not exercising had the equivalent impact on your health as smoking one and one-half packs of cigarettes a day. Fortunately, with few exceptions, most people are too sensible to ever consider ravaging their health by smoking excessively. Unfortunately, many of these same people fail to recognize the extraordinary benefits of exercise in the prevention of medical problems.

• Angina. Regular aerobic exercise dilates vessels, increasing blood flow — thereby improving the body’s ability to extract oxygen from the bloodstream. • Anxiety. Exercise triggers the release of mood-altering chemicals in the brain. • Arthritis. By forcing a skeletal joint to move, exercise induces the manufacture of synovial fluid, helps to distribute it over the cartilage and forces it to circulate throughout the joint space. • Back Pain. Exercise helps to both strengthen the abdominal muscles and the lower back extensor muscles and stretch the hamstring muscles. • Bursitis and Tendonitis. Exercise can strengthen the tendons — enabling them to handle greater loads without being injured. • Cancer. Exercise helps maintain ideal bodyweight and helps keep body fat to a minimum. • Carpal Tunnel Syndrome. Exercise helps build up the muscles in the wrists and forearms — thereby reducing the stress on arms, elbows and hands. • Cholesterol. Exercise helps to raise HDL (the “good” cholesterol) levels in the blood and lower LDL (the undesirable lipoprotein) levels. • Constipation. Exercise helps strengthen the abdominal muscles, thereby making it easier to pass a stool. • Depression. Exercise helps speed metabolism and deliver more oxygen to the brain;

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INTRODUCTION the improved level of circulation in the brain tends to enhance your mood. • Diabetes. Exercise helps lower excess blood sugar levels, strengthen muscles and heart, improve circulation, and reduce stress. • Fatigue. Exercise can help alleviate the fatigue-causing effects of stress, poor circulation and blood oxygenation, bad posture, and poor breathing habits. • Glaucoma. Exercise helps relieve intraocular hypertension — the pressure buildup on the eyeball that heralds the onset of glaucoma. • Headaches. Exercise helps force the brain to secrete more of the body’s opiate-like, pain-dampening chemicals (e.g., endorphins and enkephalins). • Heart Disease. Exercise helps promote many changes that collectively lower the risk of heart disease — a decrease in body fat, a decrease in LDL, an increase in the efficiency of the heart and lungs, a decrease in blood pressure and a lowered heart rate. • High Blood Pressure. Exercise reduces the level of stress-related chemicals in the bloodstream that constrict arteries and veins, increases the release of endorphins, raises the level of HDL in the bloodstream, lowers resting heart rate (over time), improves the responsiveness of blood vessels (over time), and helps reduce blood pressure through bodyweight maintenance. • Insomnia. Exercise helps reduce muscular tension and stress. • Intermittent Claudication. Exercise helps improve peripheral circulation and increases pain tolerance. • Knee Problems. Exercise helps strengthen the structures attendant to the knee — muscles, tendons and ligaments — thereby facilitating the ability of the knee to withstand stress. • Lung Disease. Exercise helps strengthen the muscles associated with breathing and helps boost the oxygen level in the blood.

• Memory Problems. Exercise helps to improve cognitive ability by increasing the blood and oxygen flow to the brain. • Menstrual Problems and PMS. Exercise helps to control the hormonal imbalances often associated with PMS by increasing the release of beta-endorphins. • Osteoporosis. Exercise promotes bone density — thereby lowering an individual’s risk of suffering a bone fracture. • Overweight Problems. Exercise is an appetite suppressant. It also increases metabolic rate, burns fat, increases lean muscle mass and improves self-esteem. • Varicose Veins. Exercise can help control the level of discomfort caused by existing varicose veins and help prevent getting any additional varicose veins.

Are the positive effects that result from exercising regularly worth the required effort? Absolutely. Should you make exercise an integral part of your daily regimen? Of course, you should. In countless ways, your life may depend on it. The meteoric rise of health care and health problems makes your success as a personal trainer predictable.

Implications for Certified Fitness Trainer Professionals The need for personal training services continues to grow. As future ISSA fitness professionals it is imper-

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6 ative that we keep up with the ever-changing and evolving recommendations for health and physical fitness that have a direct application for fitness programs and exercise recommendations. With the emergence of the latest technologies information regarding health and fitness is easily accessible. However, because of the nature of the media’s use of vague and brief headlines in conjunction with radio and TV sound bites that provide only limited, confusing and often conflicting recommendations, it is important that we can help our clients, friends and family members put each new study or report in proper perspective. Personal trainers today are committed to a long-term career in health and fitness and are increasing their knowledge through additional courses in post-rehabilitation, corporate wellness, youth fitness, senior fitness, and pre and post-natal specializations to better serve their clients in achieving and living the fitness lifestyle. As you can see, we as personal trainers have an inherent responsibility to positively shaping and influencing the health and fitness attitudes of those around us and it is our hope that individually and collectively we can bring health and fitness to the masses and make the dream of optimal health a reality for all.

WHAT SHOULD A PERSONAL TRAINER KNOW? As the industry continues to expand its boundaries and the realm of scientific knowledge concerning the human response and adaptation to exercise continues to grow, it is essential that personal fitness trainers are competent in: • Exercise Programming • Exercise Physiology • Functional Anatomy and Biomechanics

the aforementioned areas as well as the knowledge of muscular, cardiopulmonary and metabolic adaptations. These adaptations are known as the training effect. The “training effect” is our body’s adaptation to the learned and expected stress imposed by physical activity. Our bodies begin to change at the cellular level, allowing more energy to be released with less oxygen. Your heart and capillaries become stronger and more dispersed in order to allow a more efficient flow of oxygen and nutrients. Your muscles, tendons and bones involved with this activity also strengthen to accommodate a better proficiency at performing this activity. In time your body releases unnecessary fat from its frame and your stride and gait become more efficient. Your resting heat rate and blood pressure drop. These adaptations can be achieved through an educated trainer who can develop an appropriate fitness and health plan. The plan must include the basic principles of fitness training: overload, specificity, individual differences, reversibility, periodization, rest, over-training, and stimulus variability. The plan requires a thorough understanding of the major muscles of the body and how they work and an understanding of metabolism; how the body converts food energy into other forms of energy the body can use at rest and during exercise. Additionally, we must learn about the function and regulation of the lungs, heart, blood vessels, hormones, brain, and nerves, as well as the weight control and temperature regulation systems at rest and during exercise. Once we have the knowledge and support to develop a comprehensive, individualized and periodized plans that effectively produce the training effect, then we will be able to effectively draw our friends, family members and future clients into the fitness lifestyle and optimal health.

• Nutrition and Weight Management

ISSA CODE OF ETHICS AND STANDARDS

• Basic Emergency Procedures and Safety

Principles and Purposes

• Program Administration

Upon receipt of the ISSA Certificate, members become, in effect, de facto representatives of the leader in the fitness certification industry, and as such are expected to conduct themselves according to the highest standards of honor, ethics and professional behavior at all times. These principles are

• Assessments and Fitness Testing

• Human Behavior/Motivation

Our ability as fitness professionals to educate and effectively draw our clients into the fitness lifestyle and optimal health comes from a plan that is based in

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INTRODUCTION intended to aid ISSA members in their goal to provide the highest quality of service possible to their clients and the community.

Academic Standards Requirements for Graduation 1. Certification will not be issued to any student/member who does not successfully complete or meet all pertinent qualifications or has not achieved passing scores on the relevant ISSA examinations. 2. Certification will not be issued to any client/member unless they have successfully completed CPR training as evidenced by a current and valid CPR card. 3. Certification will not be issued until all fees are paid in full.

Professional Standards ISSA members will: 1. Serve clients with integrity, competence, objectivity and impartiality, always putting the clients’ needs, interests and requests ahead of his/her own. Members must always strive for client satisfaction. 2. Recognize the value of continuing education by upgrading and improving their knowledge and skills on an annual or semiannual basis. Members must keep abreast of relevant changes in all aspects of exercise programming theory and techniques. 3. Not knowingly endanger his or her clients or put his or her clients at risk. Unless they have allied health care licenses, members must stay within the realm of exercise training and lifestyle counseling with clients. Clients with special medical conditions must be referred to proper medical professionals. 4. Never attempt to diagnose an injury or any other medical or health-related condition. 5. Never prescribe or dispense any kind of medication whatsoever (including over-thecounter medications) to anyone. 6. Never attempt to treat any health condition or injury under any circumstance whatsoever (except as standard first aid or CPR procedure may require).

7. Never recommend exercise for anyone with a known medical problem without first obtaining clearance to do so and/or instructions from the attending qualified medical professional. 8. Ensure that CPR certification and knowledge of first aid procedures is current. 9. Work towards the ultimate goal of helping clients become more self-sufficient over time, reducing the number of supervised training sessions. 10. Respect client confidentiality. All client information and records of client cases may not be released without written release from the client. 11. Charge fees that are reasonable, legitimate and commensurate with services delivered and the responsibility accepted. All additional fees and services must be disclosed to clients in advance. 12. Adhere to the highest standards of accuracy and truth in all dealings with clients, and will not advertise their services in a deceptive manner. 13. Not get intimately involved with their clients. Minimize problems by always maintaining a professional demeanor, not becoming overly friendly with clients, particularly of the opposite sex, and documenting training sessions, evaluations, and training programs. We cannot overemphasize this point: Be a professional and do not get involved with clients!

Dr. Sal Arria and Dr. Fred Hatfield had a vision to pioneer a personal fitness trainer program that would merge in-gym experience with practical and applied sciences more than fifteen years ago to share the benefits of the fitness lifestyle with the masses. As the profession continues to grow and expand it boundaries, for the ISSA trainer of today and the ISSA trainer of tomorrow education and support is vital. It is the hope and vision of the ISSA that through this course text and the support provided by the entire ISSA staff, our trainers will be well rounded and more educated than in the past and will be knowledgeable on exercise and how it relates to optimal health and fitness.

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ANATOMYand PHYSIOLOGY