The program I find myself using for most clients is a typical Macrocycle and Microcycle of training using the NSCA standards and guidelines:
The first thing I do is the assessments – I use the Functional Movement Screen (FMS).
My first concern and goal with people is to fix any imbalance and asymmetry of the body. This is done in the first phase of working out. I usually start with foam roll training, stretches, body weight exercises and I have clients perform body weight exercises for a count of 15-20 reps. It’s also the muscle endurance phase, so when I switch them to using free weights I use 12-15 reps per exercise. A beginner would only perform a little of each muscle group in a workout day until they are ready to progress into more of a split routine. Once I feel the person has muscle endurance, form, posture, and muscle balances they can move on to the hypertrophy phase.
During hypertophy I simply add some weight and perform 6-12 reps. The first few weeks is about 10-12 reps and then it progresses to 8-10 followed by 6-8 at the end of the phase. The sets may also increase along with the weight. The split routine also may change to cause overload as well. During this phase muscle mass should be gained as well as some strength. Once certain goals are obtained the client should be ready for the strength phase.
Strength is 1-5 reps with 2-5 minutes rest because it is mainly using testosterone in the phospogen system. Fat loss and whatnot is not much a concern in this phase but only pure strength. It is wise to be patient and wait for ATP and Creatine stores to recover rather than perform another set before that. I mainly perform 1-5 reps for the large multi-joint exercises such as bench press, squat, and dead-lift. As for some shoulders, arms, calves, etc I perform 6-8 reps. You do not want to do 3 rep bicep curls. This phase may last about 6 weeks. I do about 5 sets of 5 the first week, 5 sets of 4 week two, 5 sets of 3 week 3, and then I start mixing it on week 2. I am gradually aiming to get my highest max possible on week 5-6. During this phase I also look for weaknesses such as unilateral strength, eccentric strength, and stopping points. After the strength phase I go right to Power Training which is also the same reps and recovery as Strength Training however it is explosive.
The warm up for each phase consists of Core muscle work. I like clients to perform planks, side bridges, and glut bridges in all phases. For a new client I focus on plank form and endurance in the endurance phase. During hypertophy I have the client perform a plank for 30-60 seconds with weight on the low back.
Even though there is a system, each client gets a personal program.
The first kettlebell maneuver I teach my clients is the swing. It is the most common kettlebell exercise. The swing should be viewed as the foundation exercise and I like to see clients master the swing before other kettlebell exercises are introduced.
Once clients can perform the 2-handed swing, this is a typical progression I teach my clients in the office:
One-Arm Swing. Grasp the handle with one hand in overhand grip with slight elbow bend. Position feet slightly wider than hip width, and assume athletic stance. Upper body should be upright, with chest lifted and shoulder blades retracted. Free arm should be out to side of body. Rotate body slightly, allowing kettlebell to hang between legs. Initiate swing by rocking hips (versus using shoulders to lift bell). Raise bell upward with momentum, and give forceful hip thrust at top of movement. Bell should go no higher than eye level, with bell pointed away from body at end of arm. Allow gravity to bring bell downward in controlled manner. Keep spine at neutral, rather than rounded, at bottom of movement. Perform 10 repetitions in each hand.
One-Arm Alternating Swing. Repeat steps above (one-arm swing), but switch to other hand at top of movement. Perform 10 repetitions in each hand.
Around-the-Body Pass (at waist level). Grasp handle with both hands in overhand grip with slight elbow bend. Position feet slightly wider than hip width apart, and assume athletic stance. Upper body should be upright, with chest lifted and shoulder blades retracted. Release one hand from bell, allowing opposite hand to bring bell behind body. Free hand should grasp bell at back of body and complete the rotation. Grasp kettlebell firmly to avoid dropping it. After 10 repetitions in one direction, repeat 10 reps in the opposite direction.
Figure Eight (between the legs). Grasp handle with right hand in overhand grip with slight elbow bend. Position feet slightly wider than hip width apart, and assume athletic stance. Upper body should be upright, with chest lifted and shoulder blades retracted. Left arm should be out to side and ready to accept kettlebell. Begin movement by handing bell from right hand to left hand through legs from front of body to back. Left hand then brings bell around from back of body to front of body. Continue this figure-eight pattern by passing bell through legs again from left hand to right hand. After desired number of repetitions, repeat in opposite direction.
These exercises provide a good cardio and fat-loss workout, creating a great foundation for other exercises. After a full-body warm-up, perform each exercise for approximately 30 seconds or 10 reps. Do one exercise after another and rest at the end. Repeat the circuit 2 or 3 times depending on your condition and the amount of time you have to train.
For a one-on-one in-depth kettlebell session, please call my office at 310-473-2911.
An article on the core by Dr. Jeffrey Tucker
I am a patient of Dr. S (chiropractor) and have had chronic
achilles tendonitis for at least 10 yrs. Recently icing and stretching
has not been effective to decrease inflamation in the L foot in
particular. I have been going to PT for the past month receiving
iontophoresis with dexamethasone treatments. I do get some burning on the skin and it has taken about 6 treatments to see and feel about a 60% improvement. However , as soon as I do even mild use of the left foot with weight bearing, it flares up to previous levels.
I am curious as to whether hot or cold laser therapy would help this
condition. Do you think laser therapy would help and what type…hot
or cold? Any advise, information, opinions are welcome from you.
THANK YOU very much for your time.
RESPONSE FROM DR. TUCKER
It is a challenge managing chronic Achilles tendon injuries. The warm laser can help heal the in-growth of new nerves and blood vessels which are known to be sensitive to pain chemicals. As part of my rehab protocol for Achilles problems I use the following:
•Alfredson’s heel-drop exercise
In 1998 a Swedish orthopaedic surgeon published excellent results for a group of patients with Achilles tendinosis who undertook a specific 12-week eccentric calf loading rehabilitation program. The subjects all experienced a dramatic reduction in pain, a significant increase in calf strength and returned to full running.
The client stands on the bottom step of a staircase, facing inwards, hands lightly supporting at either side. The forefoot of the affected leg is placed on the edge of the step. The client lowers their body down by dropping the heel of the affected leg over the edge, with control; then places the foot of the non-affected leg on the step to raise the body back up to the starting point. If this proves too difficult, or if both Achilles are affected, it is possible to raise back up on two legs (thereby sharing the concentric load) and coming down on a single leg (this is the “2 up, 1 down” concept).
•Perform 3 x 15 eccentric heel drops with the knee straight and 3 x 15 repetitions with the knee bent, repeated twice daily.
More recent studies have found that eccentric loading increases collagen deposition in tendinotic tendons, suggesting a healing response. Perhaps of greater significance is the apparent disappearance of the vascular in-growth in people who respond favourably to loading and it is possible that the effectiveness of the program is due to the direct effect on pain rather than tendon healing or an increase in calf muscle strength.
Balance training programs are essential as part of the rehab for Achilles.
Regarding the warm laser, I think it would be very helpful & effective.