You are working with a client who has hypertension and has been cleared by her physician for exercise. Which of the following would be most appropriate for her initial resistance-training program?
a. mostly bodyweight exercises with isometric contractions held initially for 10-15 seconds, working up to 30 seconds
b. two sets of 8-12 repetitions on 8-10 exercises addressing all major muscle groups using mostly cables and dumbbells at an intensity of 70-80% 1 RM
c. one set of 6-8 repetitions performed on 8-10 selectorized machines to address all major muscle groups at an intensity of 80-85% 1 RM
d. circuit training consisting of 8-10 exercises using mostly tubing and bodyweight performed one time for 12-16 repetitions at 60-70% 1 RM
E none of the above. I start all clients with foundation movements without load to analyze their ROM and the effects of their habitual movement patterns and postures on their biomechanics. The foundation movements are performed as the initial workout program. Loads and multijoint movements are introduced and progressed as tolerated, regressed as needed. Often I find movement issues and imbalances that need to be corrected/eliminated before loads can be applied. I do this with all new clients, from physical therapy referrals to college athletes. I have to know how clients move before I can introduce loads effectively. Once I have this information, I can usually move clients toward their goals much more quickly.
As an example, if I have a client that overpronates the feet, it could be very harmful in the long term to add a load such as squats before the client is able to control the amount of pronation at the feet/ankles. Or say I have a basketball player with limited mobility/stability the hips/ankles. It would be in their best interest to limit their use of high speed stops, change of direction, and starts until the necessary mobility and stability are gained. Many people/athletes don’t realize they have movement issues until they get injured exceeding the limits of their mobility/stability. In either case, taking the time to correct these clients’ issues first will make anything they do safer and more productive.