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Injuries Chronic & Acute

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Old 06-21-2006, 05:34 AM   #1
Ralph Garcia
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I’d like to recommend crossfit to someone, but am not familiar with how to train someone who is:

1. 60 years old and

2. Suffered a pretty bad stroke about 3-4 years ago.

The extent of personal training I have is teaching/leading karate classes to kids between 4 to 17 years old. The kids were healthy, fit and could usually take on whatever workout I would throw at them. I’d really like to help this friend with crossfit, but I also do not want to further harm him by inducing another stroke via the metcon-type workouts.

The stroke did leave some permanent damage to one side of his body. However, he has no joint or mobility problems. Also, his weight is pretty good considering his height and age. And, though he’s never really followed a formal workout routine, he stays active by playing golf (he’s pretty good at it). I’m comfortable with slowly teaching and tailoring the moves for him and putting him through some basic calisthenics. Beyond that I’m not sure where to go or how to introduce some metcon WODs.

Does anyone have any suggestions or advice? At this point, would crossfit help to strengthen his heart?

(Lynne, I hope this is the appropriate message board to post this)

-Ralph
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Old 06-21-2006, 07:40 AM   #2
Jerimiah Childress
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Robb Wolf, would probably be the best guy to talk to about this, I know he is working on a DVD for scaling Crossfit to Rehab scenarios. I would say from what I know I would recommend his diet is spot on very strict. As far as exercise goes I would not even think about metcon for a while, I would be focusing on getting the basic movements to where he can perform each of the basics(squat, pullup, deadlift, pushup, etc.) with top notch form, and then push toward doing the warm-up without difficulty. When he can perform the warm-up and still do something else, then I would start thinking about some metcon stuff. I would be real strict though about doing lots and lots of reps in the ramp up. Anybody coming to crossfit is going to have to ramp up, but his is going to be very long and very low grade.
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Old 06-21-2006, 08:50 AM   #3
Elliot Royce
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I wouldn't touch it with a ten foot pole without a specific clearance from his doctor. We're talking about strenuous exercise and you are more at risk when exercising for heart attack and stroke. The benefits of exercise come after the exercise and outweigh the risk of the exercise itself for most people (NY Times just ran an article on this yesterday). But for people with illnesses, that isn't necessarily the case.

Do you really want to be sued by this guy's family if he dies while under your training?
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Old 06-21-2006, 11:56 AM   #4
Lincoln Brigham
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I have a 65 year-old client with valve regurgitation, an aneurysm, and significant angina. The angina is chronic and despite the other heart issues the cause has not yet been determined. His work capacity through Crossfit has improved tremendously. When he started he usually could not get through the warmups. After a month or so he could. Then he started progressing to getting through the entire workouts, that took a few months. Now he can get through the workouts (most days) and is now improving his scores and work output. His previous workout regime (brisk walking) was showing a black-box result over time of reduced work capacity and other measures of fitness along with increased bouts of angina.

The key is dialog - you must talk with the client and establish a baseline of acceptable exertion. This dialog includes any doctor's reports. (My client has passed a doctor's treadmill test and has been cleared to exercise up to the onset of angina.) Interval training - like many of the Crossfit WODs - has been shown to be highly effective and SAFE for cardiac patients. However, the expected level of exertion must be scaled appropriately. If you run him through Fight Gone Bad, that's fine. Just don't expect a score of 350 with loads of 95 lbs.. More like 50 with 20 lb loads. Or maybe less, whatever they can manage. Pacing in proportion to the client's current fitness is key. My client is constantly reminded to pace himself. Strategies and tips for improving performance through pacing is discussed (i.e. the score will be lousy if he goes too fast at the start and crashes.) A cardiac patient's fitness and work capacity is going to be the lowest of any of your clients, that's the bottom line. Focus on long-range improvement and not absolute work performance. Scale, scale, scale the workouts down and progress from there.

(Message edited by lincoln on June 21, 2006)
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Old 06-21-2006, 08:35 PM   #5
Erik Preston
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Lincoln, you continue to amaze me with your dedication to training, and valuable input on the board. You surely must know that it reaches far beyond the Sedona horizon. Just wanted you to know this, from out here in Philadelphia.
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Old 06-21-2006, 08:57 PM   #6
Lincoln Brigham
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:blush:

My client is out of town this week to see his cardiac specialist. Last time the doc put him on nitroglycerine just to see what happened. Mostly it made him feel like crap. We'll see what news this latest doctor's visit brings.
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Old 06-22-2006, 05:11 AM   #7
Ralph Garcia
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Thank you for the input. I'll definitely employ a slow approach to first teaching the movements and slowly progressing through warm-up and eventually the workouts.
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