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Old 11-04-2010, 06:51 AM   #41
Beau Bryant
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

[quote=Trevor Shaw;861640]Ahmik,
Muscluar imbalances do not exist most of the time? What about the countless studies and information provided by Liebenson, McGill, Lewit and Janda on that exact topic? Do upper and lower cross syndromes not exist? Do weak lower trapezius and rhomboid muslces, or deep neck flexors (longus capitus and colli) not pre-dispose athletes (in particular) to upper cervical and levator scap sprain / strain?
Here is one paper with multiple sites discussing imbalances if you have any interest. Also, texts by any of those authors will provide more than enough information on everything I previously expressed concern about.
(WSFS) http://www.dynamicchiropractic.com/m...e.php?id=38083

Of course it exists. I think where many are starting to make a great divide is in the way we address these problems. When people get fixated on these imbalances they begin to isolate them to address them. We can debate all day long and in the end we will both probably get the end result. Some of us just happen to think that the best way to address an imbalance may not be with a glute bridge. It may just be with a properly executed squat, loaded light enough to enforce the properly executed squat (which was properly coached), and progressive loading during full movement ensuring mechanics are kept.

This topic would be better discussed in person but I see your point, I just happen to think there may be a more efficient way to get to the end.

I have my CSCS and honestly, the more interaction I have with other strength and conditioning professionals the more I come to realize what a mess it is out there within the profession S&C community.

I think most of these problems are due to people inabilities to 1. understand the movements and 2. coach the proper execution of those movements.

Good discussion
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Old 11-04-2010, 12:25 PM   #42
Beau Bryant
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

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Originally Posted by Trevor Shaw View Post

Bryan,
As for the long haul, I would love to see someone step up and mandate licensure for trainers. Licensure would guarenteed the person coaching you had at least some baseline knowlege of the body other than squat = good and bicep curls are a waste of time. This would easily weed out uneducated trainers who for lack of a better term don't know rat sh** from a rice crispy. (Appologies for the poor attempt at comic relief). Licensure would also allow people who havent earned a bachelors degree in a related field to take "required" equivalent classroom time to meet the demands set by the licensing board. If this ever happened I'd be one of the first in line to spend the money and take the test.
Last post on this subject for me.

Any reasonable person who wants to read the text book can pass the NSCA CSCS exam pretty easily. I can see no way for that exam to give any more credibility to the holder personally.

When I attended the USAW cert I was surrounded by more than a few CSCS strength coaches from mostly the college and high school S&C setting and it was an eye opener to just how little they knew about the Olympic lifts and their inability to teach them.

When I went to Rippetoe's SS coaching cert (the new one) I was amazed at the level of coaching that went on there, not just by the instructors but by the students themselves. Not many "professional" strength coaches there.

The level of practical knowledge being passed during instruction and held by attendees was night and day between the two events.

I just don't see how having trainers licensed by a governing body will improve anything, the NCSA can't do it within the CSCS community. How would we expect another governing body do it?
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Old 11-05-2010, 09:20 AM   #43
Katherine Derbyshire
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

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Originally Posted by Trevor Shaw View Post
As for the long haul, I would love to see someone step up and mandate licensure for trainers. Licensure would guarenteed the person coaching you had at least some baseline knowlege of the body other than squat = good and bicep curls are a waste of time. This would easily weed out uneducated trainers who for lack of a better term don't know rat sh** from a rice crispy. (Appologies for the poor attempt at comic relief). Licensure would also allow people who havent earned a bachelors degree in a related field to take "required" equivalent classroom time to meet the demands set by the licensing board. If this ever happened I'd be one of the first in line to spend the money and take the test.
Please define "trainer" for the purposes of this proposed license.

People who might forseeably get swept up in such a requirement include everyone from a guy coaching his son's Little League team to a traditional martial arts instructor. I assume (hope!) that isn't what you want, but the suggestion is a non-starter until you explain who should/would be covered.

Katherine
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Old 11-05-2010, 01:08 PM   #44
Mike Neill
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

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Originally Posted by Katherine Derbyshire View Post
Please define "trainer" for the purposes of this proposed license.

People who might forseeably get swept up in such a requirement include everyone from a guy coaching his son's Little League team to a traditional martial arts instructor. I assume (hope!) that isn't what you want, but the suggestion is a non-starter until you explain who should/would be covered
In addition to defining who's in and who's out is the issue of what is the level of need for licensure.

When the gov't gets into the act of certifying that some people are legal to do certain things, it should be in reaction to an objective need. This is usually identified by a pattern of problems, failures, abuse, deaths, injuries - really bad problems that show gov't intervention is required in order to forestall a greater public harm. If the problem is "that trainer is incompetent because he says squatting below parallel is bad for you", that hardly rises to the level requiring trainer licenses. It's incompetence + a large-scale pattern of serious harm to the public.

Too often special-interest groups push legislatures to enact licensing requirements only to protect turf and exclude competition.

I'm getting sick and tired of an avalanches of new laws every year that make more activities illegal or limited or needing a fee to pursue. If there's a need, OK, but what passes for 'need' gets lower and lower every season.
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Old 11-05-2010, 01:22 PM   #45
Mike Neill
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

Sorry, I got hung up on the word 'license.'

A license is something issued by a gov't with force of law behind it. The discussion has been more about certification by one or another governing body, which can only allow or deny a person the right to say they have a qual issued by that body. The NSCS (for example) can't fine me or close my business if I am an incompetent trainer, they can only deny my right to advertise that I have their cert.

Big difference but I glossed it over.
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Old 11-05-2010, 03:14 PM   #46
Lincoln Brigham
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

It's been made clear from previous attempts to legislate licensing for fitness trainers that several exemptions are almost certain to be given. School sports coaches for one would be exempt, which ironic considering that schoolage sports probably constitutes the largest contributor to injuries. In Maine for example, a high school football coach only need to pass the $40 UM/MCSC/Maine Coaching Eligibility Course (approximately 10-15 hours), a basic first aid class, and CPR/AED. That's pretty thin, if you ask me. Subjects such as "dealing with the media" are key parts of the curricula.
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Old 11-09-2010, 02:37 PM   #47
William F. Burgess
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

I go swimming in the morning at our towns top prep high school. The kind with lots of money and well equipped sporting facilities. As I walk through the athletic building to get to the pool, there is a poster on the wall with the title "Certified Athletic Trainer vs. Personal Trainer". It outlines the main differences, the most distict being the requirement for a BS in some sports related maor vs. no formal education at all required.

I gather from the discussion that some don't really put a lot of stock in the degreed trainer types. As someone with a formal education(in engineering, not sports related) I am kind of biased towards those with the formal education.

The one and only life science course I had to take for my degree was Human Anatomy. It was intensive. I learned a lot about the basic systems of the human body in a formal sense. There were weekly quizzes that required quite a bit of studying to pass. We dissected quite a few specimens as well(fetal pigs because the systems are remarkably similar to a human). It was not an easy A by any means. Yet this was an first year level course at a Community College.

Just going off the top of my head as to what a degreed trainer might need to know I came up with : Know every muscle tendon and ligament and every insertion point by name, Know every function of previously stated muscle/tendon/ligament and how forces are applied for each movement, know endocrine responses of the body and basic chemistry required to understand, know the layout of the nervous system and how it can be compromised by injury...the list goes on and on, but basically what I am saying is lots and lots of studying to really know these subjects. Too much to learn in a weekend cert. for sure.
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Old 07-29-2011, 06:36 AM   #48
Alberto Da Silva
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

This is an extremely interesting thread. I would like to say Dr Jones and Dr Shaw thank you for all the information. Since this discussion has become so intense allow me to add a few of my own opinions. Also I'll list my experiences and background so you can judge my credibility as well.

I feel that the only reason Rhabdo has become such a big thing in the CrossFit community is because Coach Glassman was honest enough to address the issue before it became a problem. I absolutely agree that Rhabdo is seen way more often in many other sports and military related PT than it is in Crossfit. I have not been part of a "Box" yet, I follow the main site WOD but I say this from my own experience.

From 1996 - 2000 I was a High School wrestler. Our Coach had two PHD’s. The man was and still is a walking book. One of his PHD's is in Health the other is in History. During my first year alone we had 10 people drop from the team for various injuries that would not heal during the season. Some of those injuries were Rhabdo. How it happen? Well practice started at 2:15pm and went on some nights till 7pm. Between running up and down all nine stories of our school, weight lifting, wrestling, running some more, and then some more wrestling we had all kinds of injuries. The only thing that qualified this man to coach was the fact that he was an awesome wrestler in his high school and college days. His mentality was "you need to endure and those that can't get cut". I had a fun 4 years and sustained some injuries that my coach said "just work it out, it will be fine" and thirteen years later I'm still working it out and it is still not fine.

After a while I ended up working at a local fitness center in NYC. I was a "salesman" at the place. I was surrounded by "fitness guru's" that charged people way more money than should be allowed by law to do something that every person should know how to do from childhood. These of course were the guys with all the papers to back their knowledge. After a while, without any schooling I began to train people and had very good results. Until this day I have zero injuries under my belt. (Of course this is not the point of me telling you this.) One day at the gym one of these certified trainers gave their client a heart attack. I would like to think that I'm smart enough to see the signs that my client has had enough. I mean some of my clients were very old and did have heart problems, which is why they were in the gym in the first place.

Between the times I left High School and joined the USAF in 2005. I taught small kids and some autistic kids how to rollerblade as a part time job. On and off I still worked as a "trainer" and I also practice BJJ. I did other things too but they are not related to fitness or teaching/coaching so I won’t mention them.

Joined the military and again I saw a bunch of injuries related to training that I had not seen since High School. During basic training all these injuries were labeled "heat injuries". Funny thing was I went to basic in the winter and there was only one day in San Antonio that actually got hot while I was in basic. The other time it rained and it was cold. Still a large number of trainees in our squadron ended up in medical for these "heat injuries". Same thing as in the high school coach mentality we would push or run till we dropped.

Once I became "permanent party", I was once again forced to participate in these horrific PT sessions that really provided nothing for anyone. To make this already long post a little shorter let’s just say this also produced several injuries at least once a month someone was injured or disabled to the point of requiring surgery because of our prescribed fitness program and their PTL’s (physical fitness leaders). Did I mention this program is designed by some guy that got paid way too much money, talks a smooth talk and has a bunch of papers and titles behind his name?

To make a long story short I ended up running several fitness sessions for the entire squadron. Some loved it, many complained (because they actually worked) and no one got hurt. This got the attention of my superiors and I ended up being the official person to get the "fat boys" fit again. And I’ve been doing that now for the last 3 years. This is before I had even heard of CrossFit; I was working on functional and a natural form of fitness.

I started Crossfit on my own in Jan 2011. I've done every WOD since my day one and I have not been injured. I spent the entire first month doing everything scaled down to avoid injuries and rhabdo. I spend every free moment educating myself in either Crossfit or BJJ. Am I not fit to become Level I Cert and train people in Crossfit? Which I hope to do once I get back home from this deployment and get certified.

What I'm saying is that each individual trainer is going to be different. I could have spent the last ten years in school and know every fancy name for all the bones and muscle systems in our body. But that won't do anything for my approach in how I teach a skill to someone who doesn't have the knowledge I posses. No amount of school can make someone a good teacher/instructor/coach that comes from experience and personality. Don't get me wrong school has its place in everything we do, but it isn't an end-all, beat-all answer to a problem. I agree with Dr. Shaw in that more knowledge would only make people smarter, but I also agree with Dr. Jones in that books won't make good trainers. However, the true Murphy's Law in this case will be in the clients. Clients want good service, being a trainer requires a level of care for each person you train. A good trainer has to know when a person is not 100%, a good trainer has to know when to push someone a little bit more but not over the edge. These things can't be found in a book, every person is different and only experience can teach these things.

Also please don't take my 2 cents the wrong way. I know I may seem negative towards trainers backed by big associations but that is not true. I only mentioned those to drive the point that books don't make a person an expert. There are many good trainers out there with plenty of school backing the same as there are many good trainers out there with no school backing. The trainer reputation and clients should be the judge of his/her skill.

Going back to the Rhabdo issue. I'm no scientist but I think this can be completely avoided with knowledge and an extensive onramp program. I was already in good shape (by normal standards) when I started CrossFit and still I took a full month before I felt confident enough to go head-on a WOD. If people can be taught to listen to their bodies, slow down today so you can hit it hard tomorrow and hydrate this issue would likely go away. The thing is most people who start a fitness program are out of shape to push them too early is to invite injury and problems. I would rather lose training partner because I put them through 20 sessions of skill building, than to lose a training partner because I made them hit it too quick, too hard, too soon.
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Old 07-29-2011, 11:17 AM   #49
Steven Low
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

I did a writeup a while back on this which may be useful to some

wfs
http://www.eatmoveimprove.com/2010/0...habdomyolysis/
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Old 02-05-2012, 02:01 PM   #50
Pär Larsson
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Re: Top 10 Ways to Avoid Giving a Client Rhabdo

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Originally Posted by Steven Low View Post
I did a writeup a while back on this which may be useful to some

wfs
http://www.eatmoveimprove.com/2010/0...habdomyolysis/
Thanks man, that was useful, especially the part about "Cindy" and "Michael".

After getting my CF Level 1 back in 2008 I have so far only seen one case, and that was this week.

Tue: 10-min "Cindy" (indoors with A/C) for people new to Law Enforcement, little prior physical training, one severely overweight person in the class, some kids straight out of college with no intense training (physical or mental) experience, rest a bunch of former Marines. Un-CF-certified (pretty sure, not confirmed yet) LEO defensive tactics instructor says do as many rounds as you can, don't stop completely but drink water if you need to, put your feet on the wall and push yourself up to the bar if you can't do regular pullups. Turns on music and yells "Go!"

Highly motivated 23-year-old college softball player that hadn't done much serious training since 2009 (gym membership, running), was strong enough to do 2 sets of 5 pullups, then did another 8-ish (?) rounds with feet on wall, didn't stop because she didn't want the class to get in trouble. Was hydrated. Very sore arms that day, trouble holding a gun on the firing range. Only forearms were sore all week, but no problems with other physical drills (basic fighting). Finally went to health unit on Friday, now on 2nd day in hospital with CPK down from high of 80 000.

I'm a student in her (soon to be former) class and admittedly should have caught it and said something, but thought it'd be ok since it wasn't negatives/fully eccentric, workout was cut in half, hydration was encouraged - and not out in the heat.

Problems:
  1. No ramp-up period before Cindy.
  2. Music + intensity + people who have never been yelled at
  3. Formerly very athletic person who's still strong but hasn't gone hard for 2.5 years
  4. Feet on wall for pullups = assisted, allowed her to keep going after she should have been forced to stop
  5. Lack of information to students about having to do pullups in training.
  6. An environment where students are told the instructor is always right, do what they say, never stop, never quit, keep up with the class or everyone suffers or you lose your job or can't go on.

Last edited by Pär Larsson : 02-05-2012 at 02:07 PM.
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