Recently, I had the honor and privilege of participating in Amelie’s 2nd grade “job fair,” where my job as physical therapist was put under the microscope of 100+ second grade students. I had an absolute blast spending an afternoon with these kids and can’t thank my daughter enough for allowing me to participate! I would also like to take this moment to apologize to my mom for depriving her of said opportunity when I was in elementary school – sorry Mom!
My two biggest takeaways from this experience were the following:
2nd grade students are obsessed with the age of adults. Every class asked, “How old are you?” and, to a student, responded “Wow!” when I told them my age.
2nd grade students will drill you down with follow up questions and/or blank stares until you explain in a manner that suits them – they are masters of the “Keep it Simple” approach.
“ Keep reading to the end to find out my responses to these questions…
This experience got me thinking about how I can help my community better understand one of my major roles as a physical therapist, how to heal through movement.
This blog post is meant to help you better understand the following:
The “why?” of an exercise program
Key parameters of a foundational exercise plan
How to select performance metrics to assess progress within the program
Plus—stay tuned for a follow up blog post where I’ll provide insights into some intermediate steps to spice up your exercise plan.
Begin with “Why”
Each of us will have a personalized answer to “why exercise?” but my physical therapist answer is to better handle the physical stresses we encounter each day.
Physical stress can best be handled when we possess a balance of the following attributes:
Mobility – The ability to move your body freely and easily, through as large a range of motion as possible.
Stability – Demonstrating body control positionally and through movement (especially in end ranges). Stability = ownership of the position and movement.
Strength – The ability to produce greater amounts of force using one’s body weight or external weights (ie db, bb, machines, cables).
Endurance – The ability to sustain activity over a prolonged period.
Power – The ability to produce force as quickly as possible.
As described in Mobility + Stability = Prelude to Athletic Performance, my preference is to begin with mobility and stability as the foundation. With regards to mobility/stability, I want to demonstrate a combination of global proficiency (think 7-year-old gymnast that can twist and turn her body in every direction and demonstrate control of these positions) and specific proficiency (I can squat through a full range of motion with control).
When selecting performance metrics, choose wisely (that is, what’s important to you).
My preference? I want my patients and clients to be able to get up and down from the ground with ease, squat/hinge/lunge proficiently, get their arms fully overhead, and perform some version of a push up/pull up/ring row.
Ground Transfer Examples
https://www.youtube.com/shorts/7lB32lxYdZg
https://www.youtube.com/shorts/AOufBECo0QM
https://www.youtube.com/shorts/s1-SPIZXo8Y
Overhead Mobility Test
https://www.youtube.com/watch?v=NkuJp-zMtvc&list=PLtbxeURCQnLJVzDAT5i6jAXekUi1CJ977&index=3
Track your progress using videos with an aim to move through larger ranges of motion with less assistance. Progress is often incremental, and the videos allow for feedback and help you better identify incremental improvements.
Strength1-3
Whether you are looking for a program for optimal aging or looking to improve body composition, at any stage of life, the following approach can be utilized as a starting blueprint.
Foundation of strength exercises:
1. Pick 8-10 different exercises for the entire body
Use this sample list to get ideas:
Upper Body Pull
Pull Ups
Horizontal Row
Upper Body Push
Push Up
Overhead Press
Lower Body Hinge
Bridge
Deadlift
Lower Body Squat
Squat
Hack Squat
Lower Body Split Leg
Lunge
Step Up
2. Do 1-3 sets for each exercise
For untrained populations (if you haven’t trained before or recently) do 1 set. For trained populations or lower body exercises, do multiple sets.
3. Do 8-12 repetitions per set
This rep range combines and increases strength, endurance, and power.
4. Establish your 10 rep maximum
Your “working weight” should be 60-80% of this number. Older adults (> 65 years) should start at 30-40% and progress towards 60-80% over time.
If you are not able to identify your current repetition maximum, use the rating of perceived exertion (RPE) scale below. RPE is a validated tool to effectively dose exercise intensity.
5. Utilize the superset format
If you’re performing multiple sets of an exercise, alternate between two exercises for each set. Select an upper body and a lower body movement as an exercise pair, which will allow one body region to rest while the other works.
Here’s an example superset:
Superset 1: Squat 8 reps and immediately perform horizontal rows for 8 reps.
Rest: 60 seconds
Superset 2: Squat 8 reps and immediately perform seated rows for 8 reps.
6. Rest intervals 30-60 seconds between sets
For older adults, rest 60-180 seconds.
7. Train each major muscle group 2-3x per week
This frequency builds strength while giving your body and nervous system an appropriate amount of time to recover.
8. Work your training program for a minimum of 6 weeks
9. Aim to progress: 3-10% per week
This number may fluctuate based on your total volume (workouts, reps, sets, weights, durations, …) of work
But how do you assess progress?
Track any of the metrics above and look for change. For example, on day 1 of the program you could perform 5 pull ups. After 6 weeks, you can perform 7 pull ups.
Go strength train, note the changes and progress, and keep it up!
Endurance3-5
Endurance training is an important tool to improve cardiovascular health and improve submaximal and maximal activity performance (aka: do the things you want or need to do, longer).
The World Health Organization and American College of Sports Medicine state that adults (of all ages) should engage in 150 minutes of moderate or 75 minutes of vigorous-intensity aerobic activity, weekly.
The good news? You pick the exercise modality.
Whatever type of activity suits your interests and your body’s current capabilities is fair game. Examples include walking, running, cycling, rowing, stair climbing, swimming, dancing to Disney songs (take a guess which example my daughter provided).
Remember, you can measure effort using a Rating of Perceived Exertion (RPE) which sits on a scale of 0 (least) to 10 (most).
Moderate and vigorous intensity activity can be defined as follows:
Moderate = RPE 3-4
Vigorous = RPE 5-7
How do you assess progress?
Test your submaximal aerobic capacity with a 30-45 minute continuous activity (using cycling as an example). Track your distance, while maintaining an RPE in the 5-7 range.
Test your maximal aerobic capacity with one of the following tests:
2000 m row
1.5 mile run for time
12-minute max distance run
The intent for each of these tests is a 10/10 on the RPE scale.
Power
Power is an intermediate attribute and I’ll cover it in more detail in the next blog post in this series.
Good news though, by training to improve strength (force production), you are also improving one of the major attributes of power (force).
Start with a foundational period of building movement confidence (stability) and force production (strength) and this will set you up for success to start adding the speed component in future iterations of your training program.
Conclusion
With exercise—as with most things—consistency is the secret ingredient and the superpower. Take the foundational principles described above and apply them to the exercises that are most meaningful and most enjoyable to you. If you are consistently showing up, you will find that the exercises get easier. And when that time comes, nudge up the intensity.
Keep showing up for your exercise sessions so that one day, when prompted, you can confidently proclaim to a class of 2nd graders that you are young enough to beat them in a race.
Bonus: My answers to the two burning questions of 2nd grade students
What’s my age?
Old enough to have a head full of grey hair and young enough to beat you in a race
What is a physical therapist?
A mechanic for the human body
ACSM. Progression models in resistance training for healthy adults. MSSE. 41(3):687-708, 2019.
George Davies – A Master Clinician's Approach to Advanced Concepts in Examination and Treatment of the Shoulder Complex – 2016.
Izquierdo M, et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-853.
Lagally KM, Robertson RJ. Construct validity of the OMNI resistance exercise scale. J Strength Cond Res. 2006;20:252–256.
