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YMCA Level 2 Certificate in Gym Instructing (603/2767/4)

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Anatomy and physiology for exercise and fitness instructors Manual

Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Contents

Section 1: Structure and function of the circulatory system ..................................................... 8 Location and function of the heart .............................................................................................. 8 Structure of the heart .................................................................................................................. 8 How blood moves through the four chambers of the heart ....................................................... 9 Systemic and pulmonary circulation .......................................................................................... 10 Structure and functions of blood vessels................................................................................... 11 Blood pressure (BP) .................................................................................................................... 12 Implications of hypertension and hypotension on exercise participation ................................ 13 Section 2: Structure and function of the respiratory system ................................................... 18 Structure and components lungs ............................................................................................... 18 Function of the lungs ................................................................................................................. 18 Location of the lungs .................................................................................................................. 18 Gaseous exchange of oxygen and carbon dioxide in the lungs ................................................. 19 Main muscles involved in breathing .......................................................................................... 20 Passage of air through the respiratory tract .............................................................................. 21 Section 3: Structure and function of the skeleton .................................................................. 25 Functions of the skeleton........................................................................................................... 25 The axial and appendicular skeleton ......................................................................................... 26 The pectoral girdle ..................................................................................................................... 27 The pelvic, or hip girdle .............................................................................................................. 28 The vertebral column, or spine .................................................................................................. 28 Classification of bones ............................................................................................................... 33 Structure of long bone ............................................................................................................... 36 Stages of bone growth ............................................................................................................... 37 Factors affecting bone growth and remodelling ....................................................................... 37 Section 4: Joints in the skeleton ............................................................................................. 41 Anatomy and physiology for exercise and fitness instructors | Manual | Version 1.0 © YMCA Awards 2018 3

Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Classification of joints ................................................................................................................ 41 Structure of synovial joints ........................................................................................................ 42 Anatomical terminology ............................................................................................................ 44 Joints and their movements ...................................................................................................... 45 Section 5: Muscular system .................................................................................................... 49 Types of muscle tissue ............................................................................................................... 49 Structure of skeletal muscle ...................................................................................................... 49 Function of skeletal muscle ....................................................................................................... 50 Name and location of major skeletal muscles ........................................................................... 51 Structure and function of the pelvic floor muscles ................................................................... 52 Types of muscle contraction ...................................................................................................... 53 Delayed onset muscle soreness ................................................................................................. 54 The influence of gravity on muscle contraction ........................................................................ 54 Levers and biomechanics ........................................................................................................... 54 Valsalva effect ............................................................................................................................ 55 Muscle actions ........................................................................................................................... 55 Types of muscle attachments .................................................................................................... 56 Joint actions brought about by specific muscle actions ............................................................ 56 Skeletal muscle fibre types and their characteristics ................................................................ 64 Section 6: Life‐course of the musculoskeletal system and its implications for special populations exercise .............................................................................................................. 67 Young people (13–18 age range) ............................................................................................... 67 Older people (50 plus) ............................................................................................................... 69 Ante and‐Post natal ................................................................................................................... 71 Section 7: Structure and function of the digestive system ...................................................... 75 The digestive process ................................................................................................................. 75 Role of fibre in the digestive process ......................................................................................... 77 Timescales for the digestive process ......................................................................................... 78 Importance of fluid intake in the digestive process .................................................................. 78 Section 8: Energy systems and their relation to exercise ........................................................ 81 Anatomy and physiology for exercise and fitness instructors | Manual | Version 1.0 © YMCA Awards 2018 4

Anatomy and physiology for exercise and fitness instructors (K/616/7823)

What is energy? ......................................................................................................................... 82 Use of the three energy systems during exercise ...................................................................... 83 Fuel use for energy .................................................................................................................... 85 Section 9: Nervous system and its relation to exercise ........................................................... 88 Central nervous system (CNS) .................................................................................................... 88 Peripheral nervous system (PNS) ............................................................................................... 88 Nerve impulses ........................................................................................................................... 89 Motor neurons ........................................................................................................................... 91 Effects of exercise on neuromuscular connections and motor skills ........................................ 92 Points to discuss ......................................................................................................................... 94

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Section 3: Structure and function of the skeleton Functions of the skeleton The framework of the human body is constructed of bones, joints and cartilage and is called the skeletal system. The skeleton has five main functions. Movement – the skeleton provides a series of independently movable long bones that act as levers. Muscles attach via tendons to these bones and when they contract, they pull on the bones/levers, causing movement. Bones also act as the attachment for ligaments which stabilise joints. Storage – bones serve as storage areas for mineral salts, such as calcium and magnesium phosphate, both of which are essential for bone growth and health. Bone owes its hardness (i.e. compression strength) to these mineral deposits. A deficiency in these minerals can contribute to the bones becoming weaker and brittle (a condition known as osteoporosis). Protection – the skeleton protects the delicate internal structures and vital organs. For example, the skull protects the brain, the ribcage protects the heart and lungs, the vertebral column protects the spinal cord that runs down the middle of it and the pelvis protects the abdominal and reproductive organs. Shape/structure/framework – the skeleton gives the body its characteristic shape and provides a framework for attachment of muscles to the body. Production – the bone marrow that is contained within certain bones constantly produces red and white blood cells along with platelets which are needed for blood to clot. Red blood cells contain haemoglobin, which facilitates gaseous exchange i.e. the exchange of oxygen and carbon dioxide. White blood cells are dedicated to defending the body against infection, disease and foreign materials.

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

The axial and appendicular skeleton The skeleton is divided into two parts: Axial skeleton (un‐shaded area in right‐hand image) – consists of the skull/cranium, ribs, sternum and spine (including cervical vertebrae, thoracic vertebrae, lumbar vertebrae, sacral vertebrae and coccyx).

Appendicular skeleton (un‐shaded area in the right‐hand image) – consists of upper and lower limbs, plus the bones forming the ‘girdles’, which connect the limbs to the axial skeleton. These girdles are the pelvic (hip) girdle and the pectoral (shoulder) girdle. Bones in the appendicular skeleton include 

scapula



ilium



clavicle



ischium



humerus



pubis



ulna



femur



radius



patella



carpals



tibia



metacarpals



fibula



phalanges



tarsals



metatarsals

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

The pectoral girdle

The pectoral, or shoulder, girdle is composed of a double set of two bones on the right and left sides of the body. The clavicles are slender, doubly curved long bones that run horizontally across the upper chest and can be felt just below the neck. Each clavicle articulates with a scapula in a gliding synovial joint at the shoulder. They also articulate with the sternum in the chest to form a synovial saddle joint which has a cartilaginous disc that absorbs considerable stress (e.g. when falling on the shoulder). In fact, this joint is so strong that the clavicle itself is much more likely to break than the joint dislocate. The scapulae are roughly triangular‐shaped, thin flat bones that partly cover the back of ribs 2–7. The posterior surface of each scapula has a raised ridge along its length that ends in a large bony process called the acromion process. This articulates with the clavicle and is called the acromioclavicular joint (AC joint). It can be felt at the top of the shoulder and is the point of contact of each scapula with the rest of the central skeleton. Each scapula is anchored in place by the many muscles of the back and shoulder joint, giving incredible mobility to the whole shoulder girdle and the associated upper limbs. The diagram shows that there is a depression – the glenoid cavity – laterally at the top of the scapula. This forms the socket that the head of the humerus fits into, forming a synovial ball and socket joint.

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

The pelvic, or hip girdle

The pelvic girdle has the same function as the shoulder girdle; however, because the pelvis supports the weight‐bearing lower limbs, this joint must provide greater stability. The trade‐off for this stability is a reduced range of motion (ROM), particularly at the ball and socket hip joint, when compared with the ball and socket joint at the shoulder. The female pelvis is a slightly different shape than the male pelvis. This is the most significant difference between the skeletons of women and men. The female skeleton is designed primarily to allow for childbirth, so the hole in the middle of the pelvic bones is slightly wider than the male and the gap filled by the cartilage of the pubis symphysis is also bigger. While the alignment of the female pelvis is necessary for childbirth, it is not the best alignment for performing exercises involving the legs. This is because a wide pelvis makes the position of the hip joints wide, which makes the femurs slope inwards to compensate. This wider pelvis and alignment of the knees may cause the knees to roll inwards during some exercises. This angle between the hip joints and the knees is often referred to as the ‘Q angle’. In contrast, the narrower male pelvis allows more vertical femurs – an alignment that is much more efficient for leg exercises.

The vertebral column, or spine The spine is the main foundation or starting point in the framework of the body. The head sits on top of this column and the ribs surround it, protecting the organs inside. The shoulder girdles are suspended from this framework and lead into the arms. At the bottom of the spine is the pelvis, which leads down to the lower limbs. The vertebral column is made up of individual bones called vertebrae. The names of the vertebrae indicate their location along the length of the vertebral column. There are 33 vertebrae in total.

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Anatomy of the spine The spine is a flexible structure that affords the following movements: 

flexion and extension



rotation



lateral flexion and lateral extension.

Sections of the spine and their movements The various sections of the spine produce the following movements in varying degrees: 

cervical – the most mobile part of the spine



thoracic – less mobile than the cervical spine



lumbar – very limited range of movement



sacral – no movement possible



coccyx – no movement possible.

Each vertebra has a hole in the body of the bone to allow the spinal cord to pass through. One of the central roles of the bones of the vertebral column is to protect the spinal cord. In between each vertebral body lies an intervertebral disc (we have super‐imposed a disc in the right‐hand picture). In the middle of each intervertebral disc is a soft, jelly‐like nucleus. As well as preventing the vertebrae from rubbing against each other, this disc also acts as a shock‐absorber against the impact of daily activities.

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Optimal posture A ‘normal’ spine has four natural curves named after the vertebrae that form them. These curves centre the skull over the rest of the body, enabling a person to walk more easily and maintain an upright posture. They also reduce the amount of impact through the skeleton by dispersing shock and protecting the brain from shock waves that occur from movement. The natural curved shape of the spine is often referred to as neutral spine alignment and is the optimal alignment for good posture.

Postural deviations Genetics and lifestyle factors can cause curvature of the spine to become exaggerated or excessive, which gives a distorted appearance to an individual’s posture. This, in turn, may lead to additional problems and symptoms, in the form of stiffness, tenderness, back pain and a lack of mobility. Factors relating to spine curvature include: 

fashion (e.g. high heels): this can cause shortening of the calf muscles, hamstrings and increased curvature of the lower spine (lordosis)



work/school (e.g. poor positioning of work desk and chair, driving, poor positioning while operating a checkout or computer, carrying heavy bags): these activities can stretch the upper back muscles and shorten the upper chest muscles, which leads to an increased ‘hunch’ or kyphosis



emotional state: lack of confidence, stress, low self‐esteem, etc may affect the way an individual holds their posture



sport: sports such as golf, tennis or rowing may lead to over development of certain muscle groups on one side of the body, thereby affecting posture



hereditary conditions: conditions such as scoliosis may be inherited, as may other conditions that affect muscles (e.g. muscular dystrophy)



injuries: soft tissue strains and sprains may lead to changes in posture. The development of scar tissue may reduce flexibility of muscles and range of movement, leading to postural changes



age: growth spurt, puberty, the menopause and osteoporosis can all affect connective tissue and bone structure, which may affect posture



pregnancy: the weight of the baby, increasing body size and relaxing of spinal ligaments can lead to an exaggeration of spinal curvature during pregnancy

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

disability: some factors of an individual’s disability can lead to poor posture



obesity: distribution of body fat on certain parts of the body and increasing body size can affect the shape of the spine.

Any exaggerated curvatures of the spine are referred to as hyper‐kyphosis, hyper‐lordosis or scoliosis, depending on the direction of the curve. Each condition is characterised by a distinct spinal curvature. Hyper‐lordosis is an exaggerated inward curvature of the lumbar spine that gives the lower back a hollowed appearance and can sometimes make the buttocks appear more prominent. Lordosis can be caused by poor posture, and can also be brought about by development problems during childhood or pregnancy. A number of muscles are affected by lordosis. These muscles include: 

erector spinae (shortened)



gluteus maximus (lengthened)



hamstrings (usually overactive to substitute for weaker gluteals)



hip flexors (shortened)



transverse abdominis (weakened)



rectus abdominis (lengthened).

Hyper‐kyphosis is when an individual has an exaggerated rounding or hump in the thoracic vertebrae, giving a slouched appearance, often with the head jutting forwards. This may result from a variety of causes, such as: 

genetics



lifestyle factors that have led to bad posture (e.g. sitting for long periods of time with bad posture in front of a computer)



structural deformity of the spine that may occur at birth (a congenital defect) or as a result of degenerative disease, such as arthritis or prolapsed discs.



Whatever the cause of the kyphosis, the result is excessively shortened or lengthened muscles in the front and back of the upper body. The main muscles affected include:



pectorals (shortened)



trapezius (lower and middle sections lengthened, upper section shortened)

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

rhomboids (lengthened).

Scoliosis is a lateral, or sideways, curvature of the spine. When observed from the front or the back it gives the appearance of an S‐ shape, rather than a straight line. Some of the bones in the spine may also rotate slightly, giving the appearance of unevenness in the waist or the shoulder. Scoliosis is most commonly caused by a congenital defect (i.e. something one is born with), but at times it can result from poor posture. This type of posture is not easy to correct and requires working with a specialist such as a physiotherapist, rather than an exercise instructor.

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Classification of bones Bones are classified by their shape. There are 5 types of bones in the human body. These are long bones, short bones, flat bones, irregular bones and sesamoid bones.

Long Bones Long bones are some of the longest bones in the body, such as the Femur, Humerus and Tibia but are also some of the smallest including the Metacarpals, Metatarsals and Phalanges.

Femur

Humerus

Tibia

The classification of a long bone includes having a body which is longer than it is wide, with growth plates (epiphysis) at either end, having a hard outer surface of compact bone and a spongy inner known as cancellous bone containing bone marrow. Both ends of the bone are covered in hyaline cartilage to help protect the bone and aid shock absorption

Short Bones Short bones are defined as being approximately as wide as they are long and have a primary function of providing support and stability with little movement. Examples of short bones are the Carpals and Tarsals ‐ the wrist and foot bones. They consist of only a thin layer of compact, hard bone with cancellous bone on the inside along with relatively large amounts of bone marrow.

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Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Flat bones Flat bones are as they sound, strong, flat plates of bone with the main function of providing protection to the body’s vital organs and being a base for muscular attachment. The classic example of a flat bone is the Scapula (shoulder blade). The Sternum (breast bone), Cranium (skull), os coxae (hip bone) Pelvis and Ribs are also classified as flat bones. Anterior and posterior surfaces are formed of compact bone to provide strength for protection with the centre consisting of cancellous (spongy) bone and varying amounts of bone marrow. In adults, the highest number of red blood cells are formed in flat bones.

Irregular Bones These are bones in the body which do not fall into any other category, due to their non‐uniform shape. Good examples of these are the Vertebrae, Sacrum and Mandible (lower jaw).

They primarily consist of cancellous bone, with a thin outer layer of compact bone. Anatomy and physiology for exercise and fitness instructors | Manual | Version 1.0 © YMCA Awards 2018 34

Anatomy and physiology for exercise and fitness instructors (K/616/7823)

Sesamoid Bones Sesamoid bones are usually short or irregular bones, embedded in a tendon. The most obvious example of this is the Patella (knee cap) which sits within the Patella or Quadriceps tendon. Other sesamoid bones are the Pisiform (smallest of the Carpals) and the two small bones at the base of the 1st Metatarsal. Sesamoid bones are usually present in a tendon where it passes over a joint which serves to protect the tendon.

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Structure of long bone Bone is a living tissue with its own blood supply and is constantly being reshaped and remodelled. A long bone comprises: 

epiphysis – the ends of the bone, made of cancellous bone which is spongy tissue designed to withstand compression forces



diaphysis – shaft of the bone, made of compact bone which is dense and very strong



periosteum – a hard, protective fibrous sheath around the bone (but not over the ends). It contains a rich supply of blood vessels that brings nutrients for bone cells and takes away waste matter



epiphyseal plates (growth plates) – these separate the shaft from the ends of the bone. These are the areas of growing tissue in children and adolescents and are the weakest areas of the growing skeleton. When growth is complete, the growth plates close and are replaced with solid bone. They remain vulnerable to damage until this time



medullary cavity (middle of the bone) – this contains red and yellow bone marrow (site of production of red and white blood cells and platelets)



capillaries – supply blood to all parts of the bone



hyaline/articular cartilage – covers the top of each epiphysis. It is tough and smooth and helps to reduce friction between the bones, as well as providing shock absorption for the joint. Periosteum

Epiphysis Bone cavity (containing bone marrow) Compact Bone Diaphysis Capillaries

Spongy Bone

Growth Plate (not visible)

Epiphysis Including weight‐bearing exercise as part of a programme for those vulnerable to bone thinning (such as the older adult, after periods of inactivity and those with disabilities) can increase bone density and offset some of the bone changes that come with old age and other conditions. It is worth noting that

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Providing a positive customer experience in the exercise environment Manual

Providing a positive customer experience in the exercise environment (M/616/7824)

Contents

Section 1: Customer needs and expectations ..........................................................................7 Internal customers ....................................................................................................................... 8 External customers ...................................................................................................................... 8 Customer wants and needs .......................................................................................................13 Section 2: The principles of customer service........................................................................ 17 Providing excellent customer service ........................................................................................ 17 Customer retention.................................................................................................................... 18 Section 3: Customer engagement ......................................................................................... 22 Verbal communication ...............................................................................................................22 Customer service in the exercise environment .........................................................................31 Section 4: Professionalism in the health and fitness sector ................................................... 35 The Register of Exercise Professionals (REPs)............................................................................35 The Chartered Institute for the Management of Sport and Physical Activity (CIMSPA) ...........37 The World Health Organization (WHO) ..................................................................................... 38 National Institute for Health and Care Excellence (NICE) .......................................................... 38 American College of Sports Medicine (ACSM) ...........................................................................39 Equality and diversity .................................................................................................................39 Duty of care and professional boundaries .................................................................................41 Keeping knowledge and skills up to date .................................................................................. 42 Opportunities and requirements for career progression in the exercise environment............43 Section 5: Health and safety in the exercise environment ..................................................... 46 Preparing and maintaining the exercise environment .............................................................. 46 Section 6: Operational and legislative procedures within the exercise environment ............. 51 Legal and regulatory requirements for health and safety in an exercise environment ............51 Types of emergencies that may occur in an exercise environment ..........................................52 Following emergency procedures calmly and correctly ............................................................ 56 Providing a positive customer experience in the exercise environment | Manual | Version 1.0 ÂŠ YMCA Awards 2018 3

Providing a positive customer experience in the exercise environment (M/616/7824)

Maintaining safety of people involved in typical emergencies .................................................56 Key health and safety recording documents .............................................................................58 Security procedures within a health and fitness environment .................................................60 Section 7: Controlling risks in a health and fitness environment ............................................ 64 Hazards in a fitness environment .............................................................................................. 64 1.

Facilities .............................................................................................................................. 64

Equipment .......................................................................................................................... 65

Working practices within facilities...................................................................................... 67

Client behaviour .................................................................................................................67

5. Security...................................................................................................................................69 Risk assessments ........................................................................................................................ 70 Section 8: Safeguarding children and vulnerable adults ........................................................ 76 Legislation relating to safeguarding the welfare of children and vulnerable adults .................76 Responsibilities and limitations of an instructor in regard to safeguarding children and vulnerable adults ....................................................................................................................... 79 Types of abuse an instructor may encounter ............................................................................80 Procedures to follow to protect oneself from accusations of abuse ........................................84 Statutory agencies responsible for safeguarding children and vulnerable adults .................... 84 When to contact statutory agencies.......................................................................................... 85 Maintaining confidentiality of information relating to possible abuse .....................................85 Section 9: Business processes to support the health and fitness environment ....................... 88 Components of financial planning in the health and fitness environment ............................... 88 Responsibilities for income tax and National Insurance ........................................................... 91 Supporting â&#x20AC;&#x2DC;product offersâ&#x20AC;&#x2122; within a health and fitness environment ......................................93 Use of social media in the health and fitness environment ...................................................... 95 Setting up a social media/digital profile for the health and fitness environment .................... 95 Points to discuss ......................................................................................................................... 97

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Providing a positive customer experience in the exercise environment (M/616/7824)

Section 1: Customer needs and expectations The fitness industry is a service industry, and it is imperative that instructors look after their customers accordingly. The industry is very competitive, so how the customer perceives their experience is vital.

An enhanced customer experience is important for several reasons: 

It improves the instructor’s reputation



It improves the reputation of their organisation



It gives the instructor and their organisation a professional image



It helps with customer retention



It provides potential referrals (friends and family)



It helps the client to achieve their goals.

Customer service generally involves two people – the service provider, or instructor, and the customer. A customer is described as any individual or organisation that is the user of the provider’s products, services and/or information. To offer a high level of customer service, it is necessary to have a genuine interest in people and enjoy interacting with them. How the provider delivers customer service is as important as knowing how to teach a safe and effective exercise session. Good customer service is a challenge that involves balancing the customer’s wants and needs with the interests of the business.

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Providing a positive customer experience in the exercise environment (M/616/7824)

Customer service The number one rule is: Every instructor represents their own company! Whether self-employed or employed, there is no distinction between the instructor and the company from a customer’s perspective. If an instructor treats the customer well, the company has treated them well.

Types of customers Customers come in many guises and consist of: 

Internal customers



External customers

Internal customers Internal customers are described as anyone within the organisation involved in the delivery or supply of a product, service or information. An internal customer can be another instructor or another department (e.g. the sales department or anyone involved in providing products or services to the external customer).

External customers These customers include the public wanting to use and pay for the facilities. These include: 

those wanting a product, service, information or advice



potential customers



people wishing to complain



visitors



specialist groups such as older adults, children and teenagers, people with disabilities, antenatal women



other professionals whose services may be used (e.g. physiotherapists).

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Customers will visit a health and fitness facility for many different reasons and they may only visit one part of a facility, for example:

Gym

Leisure

Studio

Sports

Pool

Clubs

Within each health and fitness facility there will be a range of products and services on offer. Examples may include:

Retail products

Services

Refreshments

Inductions to the exercise facility

Nutritional supplements

Personal training or coaching sessions

Sports and fitness clothing

Group exercise classes

Sports and fitness equipment

Sports massage

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Providing a positive customer experience in the exercise environment (M/616/7824)

Mini-project List all the reasons someone may attend a health and fitness facility and what sort of services or products they may require. Consider an organisation that you know well. Why do the customers go there? List all the reasons you can think of below:

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Providing a positive customer experience in the exercise environment (M/616/7824)

The ‘customer journey’ The customer journey refers to the stages customers travel through in their relationship with a specific brand or organisation. This can also be called the ‘customer experience’ or the ‘customer engagement cycle’. For example, a customer may make an initial search for a health and fitness facility on the internet, then they may look at the organisation’s website and may telephone to find out more information or just pop in. By looking at the customer experiences at each individual touch point within an organisation, it is possible to pinpoint where improvements to customer service can be made. A customer touch point can also be called a ‘point of contact’. A customer touch point describes the points of interaction between a customer and a product, service or brand and this can be before, during and after a customer visits a health and fitness facility. To the customers of a health and fitness facility the instructors and all the staff within the organisation are the organisation’s touch points. Collectively, touch points form the foundation of a customer’s perception of the organisation and enable them to make decisions about an organisation and its offerings. This is why it is so important for the customer to have a positive experience at every touch point. Better customer experiences lead to better results for both the customer and the organisation which leads to improved sales and greater customer loyalty.

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Providing a positive customer experience in the exercise environment (M/616/7824)

Mini-project Consider a customer who wants to use an exercise and fitness facility for the first time. What is their customer journey and where are the touch points?

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Providing a positive customer experience in the exercise environment (M/616/7824)

Customer wants and needs What is the difference between a customer’s wants and a customer’s needs? A customer’s wants are usually quite narrow. A want is a desire for a specific product or service to satisfy the underlying need. A customer’s needs are usually very broad. A need is a basic requirement that individuals wish to satisfy. For example: Customers need to eat when they are hungry. What they want to eat and in what kind of environment can vary enormously. For some, eating at the local café meets the need to satisfy hunger. For others, a microwaved ready-meal meets the need. Some customers are never satisfied unless their food comes served with a bottle of fine wine. Customers’ wants tend to be shaped by social and cultural forces, the media and marketing activities of businesses. The success of any organisation depends on providing an excellent customer service experience and ensuring that their specific and individual needs are met. If these needs are identified and met customers will want to return to the facility. Meeting customer needs doesn’t just mean matching them to the right product or service, it means giving them a positive customer experience every time they use the facility.

The customer comes first! Instructors should remember these five simple points.

Customers are human beings with feelings and needs like our own, not cold statistics.

Customers are doing us a favour when they call; we are not doing them a favour by answering.

Customers are not an interruption of work; they are the purpose of it.

Customers are not dependent on us; we are dependent on them.

Customers are people who bring us their wants; it is our job to satisfy those wants.

Customers are the lifeblood of any organisation and business is dependent upon them. It is commonly stated, “The customer is always right.” The importance of this statement is frequently misunderstood and is perhaps best summed up with the acronym RIGHT.

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Providing a positive customer experience in the exercise environment (M/616/7824)

RIGHT

Respect

There should be mutual respect between the instructor and the customer. It is important to remember that every customer has the potential to increase or decrease the organisation’s business.

Indispensable

All customers are an indispensable part of the business and need to be able to feel a part of it. Asking for feedback on a product or service not only helps make improvements, but makes the customer feel part of the process. A sense of belonging can be conveyed in many ways (e.g. thank you cards, company newsletters, discounted prices and fun events).

Greeted

All customers expect their presence to be acknowledged. Greet each customer promptly so that he or she feels as welcome as a guest in your home (e.g. at Disneyworld, every person who visits is called a guest).

Helped

It is important that instructors have a thorough knowledge of their organisation’s products and services, so it can easily be passed on to the customer. Instructors may have to research information to meet individual needs. Knowledge is a tool to offer exceptional customer service.

Thanked

Whether customers take up a product or service or not, they should always be thanked for their interest. Customer service research indicates that if we receive good service, we tell an average of 9–12 people. When we receive poor service, we tell up to 20 people. If customer service is really poor, 91% of customers won’t come back. Always bear in mind that customers may not need products or services on offer today but they might need them tomorrow.

As mentioned above, asking for customer feedback is extremely important. This could be feedback on their wants, needs or on your customer service delivery. Gathering feedback is extremely valuable and will ensure the organisation continues to improve its customer service offering. All organisations should give their customers the opportunity to make suggestions, comments or complaints about its services and facilities. These can be positive or negative, but both give the organisation the opportunity to improve. There are numerous ways to collect feedback from customers and some of these include: 



Social media



Website reviews



Text reviews



Focus groups



Comment cards/comment box

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

Evaluation forms



Direct mail survey



Questionnaires



Face-to-face (just ask!)

Once feedback has been gathered it is important to really listen to the feedback and be clear about what is being said. It may be that further confirmation is needed to understand the ‘bigger picture’. It is essential to record and process customer feedback in line with the organisation’s procedures. Always thank customers for giving feedback and offer solutions where possible and if not explain why a solution is not possible. Customers should always feel that any feedback is valuable to the organisation and that their views will be listened to and acted upon. Ideally, customers should always receive a personal reply to their comments or feedback. Feedback should be addressed in every instance and shared with the relevant staff and other customers (if appropriate). Feedback can be used when training staff to standardise and improve customer service standards.

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REVISION: TEST YOURSELF Questions: 1. What types of customers attend health and fitness facilities? 2. What is the difference between an internal and an external customer. 3. What is a customer ‘touch point’? 4. List five services or products a customer may require when attending a health and fitness facility. 5. What is the difference between a customer’s wants and needs? 6. List four ways of collecting feedback from your customers. Write your answers here: 1.

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Lifestyle and health awareness management Manual

Lifestyle and health awareness management (K/616/7949)

Contents

Section 1: Promoting a healthy lifestyle.................................................................................. 6 The implications of obesity .......................................................................................................... 8 Identifying individual client needs ............................................................................................. 12 Section 2: Healthy eating ..................................................................................................... 15 Professional role boundaries ..................................................................................................... 15 National food guide ................................................................................................................... 15 Hydration ................................................................................................................................... 17 Food labelling ............................................................................................................................. 18 How much food do we need to eat? ......................................................................................... 18 The energy balance equation .................................................................................................... 19 The health risks of a poor diet ................................................................................................... 23 The risks of excess caffeine ........................................................................................................ 26 The risks of excess alcohol ......................................................................................................... 26 Section 3: Supporting clients to adhere to exercise ............................................................... 30 Barriers to exercise .................................................................................................................... 30 Responding to clientâ&#x20AC;&#x2122;s barriers .................................................................................................. 33 Motivation and adherence ........................................................................................................ 33 Extrinsic and intrinsic motivation .............................................................................................. 34 Additional factors to consider.................................................................................................... 35 Social support............................................................................................................................. 36 Theories and concepts of behaviour change ............................................................................. 37 Using technology to promote lifestyle and behavioural change ............................................... 45 Points to discuss ......................................................................................................................... 49

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Section 1: Promoting a healthy lifestyle The benefits of a healthy lifestyle The lifestyle choices that individuals make and the health behaviours they follow in their daily life and across their lifespan can have an impact on their current and future health and the likelihood of them suffering from lifestyle-related conditions such as obesity or cardiovascular disease.

The behaviours that offer the greatest potential to improve health and reduce problems associated with chronic health conditions include: 

Increasing activity levels. Sedentary living increases the risk of cardiovascular disease (CVD). Being active increases the efficiency of the cardiovascular system and helps to maintain healthier cholesterol levels and blood pressure which are CVD risks.



Giving up smoking. Smoking is one of the key lifestyle factors that can contribute to CVD. It damages the lining of the arteries and causes a build-up of atheroma (fatty substance) which narrows the arteries.



Reducing alcohol misuse. Alcohol is a depressant – it initially makes you feel good and relaxed but then lowers mood.



Healthy eating (emphasising increased fruit and vegetable consumption). A poor diet can increase the risk of CVD. A high intake of processed foods containing trans fats and sugar can lead to a narrowing of the arteries. Some foods and drinks can have a negative effect on mental health. Caffeine and sugar are examples of stimulants which temporarily elevate mood.



Stress management. Being active helps to manage stress and improve mood. Activity can be a distraction to negative thinking patterns and time away from life stresses. It also releases chemicals, such as endorphins, which contribute to a feel-good factor.



Improving sleep quality. Sleep is essential for good physical and mental health. Lack of sleep leads to tiredness and lethargy and may exacerbate symptoms of depression and anxiety.

Small positive changes to any of these health behaviours can lead to significant increases in life expectancy.

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Unhealthy lifestyle choices can reduce the quality and quantity of years lived. These unhealthy choices are contributory factors for many chronic health conditions, including cancer, chronic obstructive pulmonary disease (COPD), obesity, diabetes, osteoporosis, liver cirrhosis, CVD (hypertension, CHD and stroke), some mental health conditions and many other conditions. Being physically inactive and leading a sedentary lifestyle is reported to have an impact on health and wellbeing equivalent to that of smoking. Diseases of inactivity are called hypo-kinetic diseases and are a primary cause of death in the UK. Inactivity increases the risk of: 

CVD (high blood pressure, high cholesterol, stroke, CHD)



musculoskeletal conditions (osteoporosis, low back pain)



mental health conditions (depression and anxiety)



obesity



type 2 diabetes.

Individuals who are active and lead healthy lifestyle will experience benefits in many areas of their life.

Benefits of an active, healthy lifestyle Physiological benefits Improve all body systems (muscular, skeletal, cardiovascular)

Reduced risk of back pain

Stronger heart muscle

Stronger muscles, improved strength

Reduction in ‘bad’ cholesterol

Improvement in functional capacity

Improved circulation

Strengthened immune system

Normalising blood pressure

Improved sleep

Improved bone density

Reduced risk of developing some chronic diseases

Psychological benefits Improved self-esteem

Quality of life

Improved self-confidence

Overall sense of wellbeing

Reduced stress levels

Improved sense of purpose and achievement

Reduced anxiety

Improved concentration

Lower risk of depression

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Social benefits Helps with the management of chronic health conditions

Reduced social isolation

Reduced risk of premature death

Make new friends

Reduced risk of developing diseases

Sharing an active hobby with others

Less risk of falls in older adults

Trying new activities

Weight loss/weight management

Joining groups and clubs

The implications of obesity The terms ‘overweight’ and ‘obesity’ are used to describe excess body fat.

Obesity definition Obesity is defined as ‘abnormal or excessive fat accumulation that may impair health’. Obesity results from an imbalance between energy intake and energy expenditure. Many factors can influence this, including lifestyle, genetics, medical conditions and medication. The environment has a major influence on the decisions people make about their lifestyle.

Obesogenic environments Obesogenic environments are places, often urban, that encourage unhealthy eating and inactivity. Cars, TVs, computers, desk jobs, high-calorie food and clever food marketing all contribute to inactivity and overeating. Long working hours and desk-bound jobs limit opportunities for activity during the working day. Obesity is classified by the assessment of Body Mass Index (BMI), which is the chosen form for most clinical standards. More recently, research has suggested that waist circumference has a closer association with morbidity and mortality. At present, however, waist measurements are not routinely taken although more health practitioners are doing so. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in metres.

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Classification

BMI

Overweight

25–29.9 kg/m2

Obesity l

30–34.9 kg/m2

Obesity ll

35–39.9 kg/m2

Obesity lll

Greater than or equal to 40 kg/m2

The prevalence of obesity is increasing: in the UK 26% of all men and women are obese (BMI 30 kg/m2 or more) and 68% of men and 58% of women are overweight or obese (BMI 25 kg/m2 or more) (www.cks.nice.org.uk). Obesity levels in the UK have more than trebled in the last 30 years and, on current estimates, more than half the population could be obese by 2050 (www.nhs.uk). Obesity is associated with an increased risk of developing a number of chronic diseases and conditions including:              

Type 2 diabetes Coronary heart disease Hypertension and stroke Asthma Depression Metabolic syndrome Certain cancers Gallbladder disease Osteoarthritis and back pain Breathlessness Reduced mobility Psychological problems Poor quality of life Most of the complications of obesity can be reduced by weight loss.

Obesity is a particular risk for the cluster of diseases that have become known as metabolic syndrome – type 2 diabetes, hypertension and dyslipidaemia – and is strongly linked to an increased risk of cardiovascular disease.

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Communicating the benefits of a healthy lifestyle There are a variety of ways an instructor can communicate the benefits of a healthy lifestyle to clients: 

Approach clients with relevant healthy lifestyle information that would benefit them.



Use current research, creating handouts and newsletters for clients and information boards in the facility



Lead information sessions or seminars for clients on the benefits of making lifestyle & behaviour changes.



Determine what information is relevant to the client, using details of client communications and information collected.



Provide credible information to the client that is relevant to them, their goals and aspirations.



Signpost clients to relevant products and services that may increase their capability or opportunity to make lifestyle & behaviour changes.



Explain how to include everyday physical activities as part of a client’s lifestyle to complement exercise sessions.

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Mini-project Describe another way in which you would communicate the health benefits of an active lifestyle to your clients.

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Identifying individual client needs During a consultation with a client it is helpful to carry out lifestyle questioning to gain an insight into a client’s health behaviours. This can be done by talking to the client in a face-to-face interview or asking the client to complete a lifestyle questionnaire. This can be completed alongside the PAR-Q medical questionnaire. If an instructor felt that some areas of the client’s lifestyle needed additional support that was out of their scope of practice, they could refer the client to another professional for further advice regarding health and wellbeing. Reasons for referral could include: 

Limitations of the instructor or doubt



Seeking further information relating to client needs



Obtaining medical clearance due to illness, health changes or health risk, for example if the client had combined risk factors, such as obesity with high blood pressure and was sedentary



Alternative professional services that may be more appropriate or support the client’s need.

The types of health and exercise professionals and services that can support a client to change their lifestyle behaviours are included in the table below:

Health and exercise professionals and services Alcohol and smoking cessation and support services

Alternative therapy practitioners

Chiropractor/osteopath/physiot herapist

Counselling services, mental health support

Dietitian

Exercise referral instructors/schemes

Self-help groups

Specialist instructors (e.g. for low back pain, cardiac rehabilitation, falls prevention, mental health, obesity and diabetes)

Sports massage therapist/sports therapists

Other qualified instructors (e.g. t’ai chi, yoga, Pilates, water-based class, walking/running group)

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REVISION: TEST YOURSELF Questions: 1. What are the benefits of a healthy and active lifestyle on the cardiovascular system? 2. What are the benefits of a healthy and active lifestyle on the skeletal system? 3. What are the benefits of a healthy and active lifestyle on the muscular system? 4. Name three health behaviours that have the greatest effect on health. 5. Describe three health benefits of physical activity. 6. Describe two ways an instructor can communicate the benefits of physical activity to their clients. 7. Describe one reason why you would refer a client to another professional and explain who you would refer them to. Write your answers here: 1.

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Gym-based programme planning and preparation Manual

Gym-based programme planning and preparation (D/616/7950)

Contents Section 1: Collecting information from clients ........................................................................8 Communicating with clients with differing needs .......................................................................8 Methods of collecting client information .................................................................................... 9 Fitness testing ............................................................................................................................ 14 Deferral/delay of exercise and medical referral ........................................................................16 Risk stratification ....................................................................................................................... 18 Section 2: Supporting behaviour change ............................................................................... 21 Theory of planned behaviour ....................................................................................................21 Health belief model.................................................................................................................... 22 Health locus of control ...............................................................................................................22 Social cognitive theory ...............................................................................................................23 Section 3: The principles of training ...................................................................................... 27 Progressive principle .................................................................................................................. 28 Specificity principle .................................................................................................................... 28 Reversibility principle .................................................................................................................29 Exercise intensity and heart rate ............................................................................................... 31 Section 4: Components of fitness ......................................................................................... 37 Cardiovascular fitness ................................................................................................................37 Muscular fitness ......................................................................................................................... 41 Flexibility ....................................................................................................................................47 Motor fitness.............................................................................................................................. 53 General considerations for working with younger, older and ante/post-natal individuals ......56 Section 5: Session structure.................................................................................................. 63 Warm-up ....................................................................................................................................63 Main workout section â&#x20AC;&#x201C; cardiovascular training methods ........................................................ 73

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Main workout section â&#x20AC;&#x201C; resistance training methods ............................................................... 80 Cool down ..................................................................................................................................92 Section 6: Gym equipment ................................................................................................... 99 Safe use of the space and equipment in the gym environment................................................99 Cardiovascular machines ...........................................................................................................99 Fixed resistance training equipment .......................................................................................116 Free weights .............................................................................................................................134 Body weight exercises..............................................................................................................159 Points to discuss .......................................................................................................................168

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Section 4: Components of fitness This section will look at the theory and guidelines for activity for cardiovascular fitness, muscular fitness, flexibility and motor fitness. Each section is aimed at apparently healthy individuals and provides additional information and guidance for young and older people.

What is cardiovascular fitness? Cardiovascular fitness is often referred to as stamina, endurance, cardiorespiratory fitness (heart and lungs) or aerobic fitness. The lungs take in oxygen, the heart and circulation transport oxygen, and the muscles use the oxygen. Therefore, cardiovascular fitness is a measure of the efficiency of all of these systems. Cardiovascular exercise can be defined as any activity that is rhythmic in nature, continuous and using large muscle groups under low to moderate tension over an extended period of time. This type of exercise is frequently referred to as ‘aerobic exercise’. Some common exercises of this type include walking, cycling, swimming and jogging.

Maximum oxygen uptake A measure of the ability of the body ability to take in, transport and utilise oxygen is ‘maximum oxygen uptake’ (called VO2 max). Maximum oxygen uptake involves the measurement of oxygen, carbon dioxide and the volume of expired air during maximal exercise, normally assessed under laboratory conditions.

Cardiovascular fitness The ACSM recommend the guidelines below for improving the heart and lung capacity to deliver oxygen to the working muscles and to achieve health and fitness benefits. This range is broad to reflect that unfit or deconditioned individuals may achieve a training effect at the lower end of the range, while those that are already physically active require higher intensities to further improve their fitness.

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ACSM guidelines to achieve and maintain health and fitness benefits Frequency

3–5 days per week

Intensity

57–94% Max HR, moderate and vigorous intensity

Time

20–90 minutes

Type

Rhythmic aerobic activity that involves large muscle groups

Source: ACSM Guidelines for Exercise Testing and Prescription (8th Edition) These guidelines are a guide for an apparently healthy adult. There will be situations in which they do not apply because of individual characteristics, such as health status, physical ability, age or athletic performance goals.

The long-term benefits of cardiovascular training Long-term, moderate levels of cardiovascular fitness can provide protection against many major medical problems, such as heart disease, stroke, high blood pressure and high blood cholesterol, some cancers and type 2 diabetes. In addition, this can also provide additional benefits, including reducing or controlling body fat, easing of daily tasks, greater independence and quality of life, and improved selfconfidence and body image. Regular training over a period of time causes the body to make the following physiological adaptations over the long term: 

Lungs – Training causes the lungs to take in more oxygen, making the lungs more efficient. Rather than the lungs growing bigger, the body simply utilises more of the available lung tissue that is already present. This means that at any one time, more air can be sucked into the lungs, thus more oxygen is available to be exchanged into the blood system for carbon dioxide. The breathing process becomes more efficient, as the respiratory muscles get trained and can continue to work aerobically for longer periods of time or at higher levels of exercise intensity.



Heart – In response to regular CV training, the left ventricle increases in volume and its muscular wall becomes stronger. The stroke volume of the heart increases, which means that each time the heart beats a greater volume of blood is pumped out of the left ventricle into the aorta to be sent around the body. This may be accompanied by a lower resting heart rate because the same amount of blood can be pumped out in one minute with fewer beats. In the same context, for any given level of exercise intensity, more blood can be pumped out of the heart each minute (i.e. the cardiac output increases).



Circulatory efficiency – With training, arteries and veins become better at delivering oxygen and removing waste products. There is an increase in the number of blood capillaries within the

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body, in part due to the manufacture of new blood vessels and in part due to previously dormant vessels being used. This extra ‘capillarisation’ occurs in and around muscle tissue; consequently, the delivery of freshly oxygenated blood to the working area is improved. There is a similar increase in capillarisation in and around the lungs and also the heart, which allows both of these organs to function more efficiently for longer. 

Blood – To transport more oxygen around the body, there is an increase in both the blood volume and the number of red blood cells in which oxygen is carried.



Fats – As cardiovascular exercise promotes fat metabolism, there is an important health benefit related to the way in which fats are transported around the bloodstream. Fats are carried in the blood, combined with proteins as lipo-protein (lipids is another name for fats). The lipo-proteins that have a high proportion of fat compared to protein are known as low density lipo-proteins (LDL), as fat is much less dense than protein. Conversely, lipo-proteins that have a higher proportion of protein to fats are known as high density lipo-proteins (HDL). The LDLs tend to stick to the blood vessel walls during transportation, and this may lead to an accumulation of fat deposits, which cause a blockage in the blood vessel (atherosclerosis or atheroma). Regular cardiovascular exercise improves the blood fat profile by causing more of the fat to be carried as HDL rather than LDL.



Blood pressure – As a result of this extra capillarisation, there are more avenues through which blood can flow. This means that the actual pressure of blood flow along any one vessel may be lower than before the aerobic adaptations occurred and overall blood pressure may be reduced.



Skeleton – Cardiovascular training that has a degree of impact can provide benefits to the skeletal system. The stress of the muscles pulling on the bones stimulates the activity of the osteoblasts to lay down new bone. This strengthens the bones, providing protection against osteoporosis (bone thinning). Connective tissue such as ligaments and tendons also benefit by becoming stronger, thereby improving the stability of the joints. Non-weight-bearing aerobic activities, such as cycling or swimming, will not have the same level of effect on bone density.



Muscles – Within the muscles, training causes an increase in both the number and size of mitochondria. There is also an increase in the amount of aerobic enzyme activity, and together this results in the muscles being capable of utilising more oxygen and fat at any given time. The muscles can continue to produce energy aerobically for longer, or at somewhat higher intensities of exercise. As a result, at a given exercise intensity, less lactic acid will be produced and so fatigue will be offset for longer.

Special populations and cardiovascular training Young people Younger people need to work harder than adults during aerobic activity to supply the muscles with the amount of oxygen they are burning. They are not well equipped to tolerate anaerobic exercise and therefore respond best to interval and fartlek training (a type of interval training using speed play) which are more suitable to their energy system development.

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Younger people tend to heat up and cool down faster than adults due to an inferior and underdeveloped cooling mechanism. Young people don’t carry as much water in their body and can dehydrate during activities more easily. Heart rate training with young people can be tricky; it is safer and more effective to use the RPE scale, talk test and visual observation.

Older people Older adults tend to tire more easily and are less able to maintain their maximum pace than younger people. There is a decrease of 30% in the efficiency of the cardiovascular system between the ages of 30–70 years. Older adults have a lower tolerance to lactic acid, need longer to recover and can overheat rapidly. Some individuals may also have age-related increased blood pressure. When moving from one position to another, in particular from lying to standing, older adults may experience dizziness. Therefore, position changes should be made slowly to allow time for the blood to redistribute. Loss of flexibility in the rib cage leads to increased frequency of breathing (shallow and fast). There is also a reduced ability for exchange of gases, leading to breathlessness. Due to the changes in the bones and joints associated with ageing, continuous high-impact cardiovascular activities should be avoided, as these can damage the joints.

Ante-natal During pregnancy, the cardiovascular system changes as hormonal signals initiate relaxation and decreased responsiveness in most smooth muscle cells in a woman’s blood vessels. These hormonal changes result in an increase in the elasticity and volume of the entire circulatory system. During pregnancy, the blood flow shifts away from internal organs to give muscles, lungs and heart more oxygen. However, because of this, if exercise is too strenuous, oxygen flow to the uterus can be restricted which can be dangerous. Traditional heart rate-based methods to measure intensity are not appropriate because heart rate response is so changeable during pregnancy. Instead the ‘RPE’ (ratings of perceived exertion) scale should be used to monitor intensity. However, increased blood flow and a higher metabolic rate during pregnancy means a woman may get overheated much faster than they normally would which may have an effect on the babies development. When exercising, it is important to watch out for signs such as excessive sweating, nausea, dizziness and shortness of breath. Fluids should be taken in regularly. General recommendations are that cardiovascular exercise should consist of any activity that uses large muscle groups in a continuous rhythmic manner (e.g. walking, hiking, jogging/running, aerobic dance, swimming, cycling, rowing and dancing). Dangerous activities should be avoided. Warm –ups and cool downs to prevent the pooling of blood become even more important.

Post-natal Physiological changes during pregnancy persist four to six weeks postpartum; therefore, pre-pregnancy exercise routines should be resumed gradually based on the woman’s physical capabilities. The initial goal of exercise (within the first six weeks) should be the following:

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

Beginning slowly and increasing gradually, avoiding longer-duration or high intensity training.



Avoiding excessive fatigue and dehydration



Stopping to evaluate if exercise hurts



Stopping exercise and seeking medical evaluation if experiencing heavy bleeding.

Muscular fitness Muscular fitness is of fundamental importance to everyday life and necessary for the maintenance of an independent lifestyle. Many individuals do not have enough strength in their dominant leg to exert a force required to lift 50% of their body weight. Consequently, a simple task, such rising from a chair, would be difficult without using the arms to assist in standing up. Muscular fitness can determine an individual’s mobility, work performance and ability to enjoy leisure activities.

Muscular strength and muscular endurance Muscular strength Muscular strength refers to the maximal tension or force that is produced by a muscle or muscle group. Absolute strength is usually measured by determining how much weight can be lifted in a single effort. This can be expressed as the 1 repetition maximum (1 RM). To improve muscular strength, training intensity should be high and the number of repetitions of each lift or movement should be kept relatively low. This is expressed as: •

Very high resistance x low repetitions

•

75% (or above) of 1 RM x low repetitions (1–10)

Muscular endurance Muscular endurance refers to the ability of a muscle, or muscle group, to exert sub-maximal forces against a resistance over an extended period of time. To improve muscular endurance, training intensity should be low to moderate and the number of repetitions kept relatively high. It is expressed as:

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•

Low to moderate intensity x high repetitions

•

40–60% of 1 RM x high repetitions (15–25)

Muscular strength and endurance can also be effectively trained in a studio or sports hall, or outside of the gym by using exercise bands or body weight exercises such as press-ups, squats and abdominal curls. Body weight exercises like these can be easily adapted for strength or endurance by increasing the lever length or changing the body position or the angle of the movement. The usual rule for muscular strength and endurance training is to perform exercise with a slow and controlled technique, keeping the muscles under tension. An exercise performed at a faster pace will develop power. This may be important when training for certain sports.

Power Power is defined as: force x speed. A jumping squat, performed at speed, is an example of an exercise that will effectively develop power.

The muscular strength and endurance continuum The relative intensity of any given exercise can be placed on a continuum according to an individual’s muscular fitness. This continuum ranges from pure strength at one end to muscular endurance at the other. For example, as you move away from the strength end, the gains in muscular strength diminish and the gains in muscular endurance increase. To put this in simple terms, an individual who can only perform five full press-ups would be working towards improving muscular strength, whereas an individual who can perform 30 full press-ups would be working towards muscular endurance. Everyday tasks require varying degrees of muscular effort. Some may lean more towards strength (e.g. lifting a wardrobe or carrying a heavy bag of shopping), whereas others may be more endurance-based (e.g. digging the garden, or washing clothes by hand).

Muscular strength and endurance continuum 1–8 reps

8–12 reps

12–25 reps

Strength

Strength and endurance

Endurance

Heavy resistance

Light resistance

CP energy system

LA/O2 system

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Fast-twitch muscle fibres

Type llb

Type lla

Slow-twitch muscle fibres

Changes in a muscle are specific to the stimulus placed upon it (the SAID principle). If the stimulus is of low intensity and towards the endurance end of the continuum, then the changes will improve endurance capabilities. If the stimulus is very high in intensity, then the changes will improve strength capabilities. When a client trains on this continuum, the resistance must be sufficient to overload the muscles, otherwise no improvements will occur.

When training with body weight, it is important to take a more ‘scientific’ approach by altering the body position, lever length or exercise angle to achieve the desired strength or endurance goal. For example, the shorter lever is closer to the pivot point, thereby decreasing the exercise intensity. Conversely, the longer lever is further away from the pivot point, thereby increasing the exercise intensity. Gravity and body position also affect exercise intensity. For example, performing a standing squat in which the whole body is being used against gravity is more intense than a lying leg lift in which the leg only is being used as the resistance without the influence of gravity.

Muscular response to strength training Over a period of time, long-term strength training brings about physiological changes within the muscle that occur due to the specific stress placed on it. The muscle adapts to enable it to meet these new physical demands. Strength training largely utilises fast-twitch muscle fibres and is primarily fuelled by the phosphocreatine energy system. Therefore, this system will adapt and increase its efficiency. This type of training causes microscopic tears to the contractile proteins, actin and myosin filaments in the muscle fibres. Providing there is adequate rest and nutrition following training, it is thought that the repair process results in extra contractile proteins being laid down, increasing muscle size and strength. The increase in muscle size is referred to as ‘muscular hypertrophy’. As the muscles become stronger, they will start to burn more calories. However, muscular hypertrophy is not permanent. With muscle disuse (cessation of training or disuse due to an injury or disability), muscular atrophy occurs (reduction or wasting of the muscle fibres). Connective tissues become stronger. Adaptations to ligaments make the joints more stable, and the pulling effects of the tendons on the bones can result in increased bone density at the site of muscle attachment.

Adaptations of the nervous system, or neuromuscular adaptations, can also include improved synchronisation of motor unit firing and improved ability to recruit motor units to enable a person to match the strength elicited by electrical stimulation. This adaptation explains the rapid gains in strength that often occur in the first few weeks of strength training without any increase in muscle size.

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Delayed onset muscle soreness (DOMS)

DOMS Strength training puts stress on the connective tissues and muscular structure of the body. It can produce micro-tears in the tissues, resulting in pain, soreness, stiffness and inflammation. Delayed onset muscle soreness (DOMS) describes muscle pain, soreness or stiffness that is felt 12–72 hours after exercise. This is particularly the case at the beginning of a new exercise programme, after a change in sports activities, or after an increase in the duration or intensity of exercise or activity. DOMS should not be confused with the muscle discomfort experienced immediately following severe physical stress due to increased carbon dioxide in the muscles. Eccentric training is a method of training that allows a person to push his or her muscles past their normal point of failure. It allows one to lift, eccentrically (the lowering/negative phase of an exercise), 30–40% more resistance than the concentric (lifting/positive phase of an exercise). However, this is much more demanding on your muscles and produces a high level of muscle damage in the form of micro-tears. It is a method of training that carries the highest risk of DOMS and is not suitable for the deconditioned individual.

Muscular response to endurance training Long-term endurance training brings about its own specific physiological changes within the muscle that occur due to the stress placed on it. The resultant adaptations differ from those that occur following strength training. Endurance training largely utilises slow-twitch muscle fibres and is primarily fuelled by the lactic acid energy system. This system will adapt and increase in efficiency. It is the gradual accumulation of lactic acid in the muscle that leads to fatigue, as the sliding filament process of muscle contraction is inhibited. To offset this fatigue and improve muscle endurance, it is necessary to improve the supply of oxygen to the muscle, and the muscle’s ability to use this oxygen, reducing the build-up of lactic acid. The supply of oxygen is improved by an increase in blood capillaries in and around the muscle, as well as an increase in both the number and size of mitochondria in the muscle. This type of training maintains muscle mass, which is often referred to as muscle tone. As the muscles become more toned, they will start to burn more calories. Changes to the nervous system or neuromuscular changes will also occur. In the middle of the continuum, at 8–12 reps, both strength and endurance will be training in equal balance. This makes it an ideal range for individuals who want to train for general fitness and health benefits. The ACSM recommends the following guidelines for improving muscular fitness.

ACSM guidelines for improving muscular fitness

Gym-based programme planning and preparation (D/616/7950)

Frequency

2–3 times per week *2–4 sets at 8–12 repetitions, with a rest interval of 2–4 minutes between sets.

Intensity For older adults and the deconditioned, 1 or more sets of 10–15 repetitions Time

60 minutes

Type

Whole-body, multiple joint exercises for the major muscle groups. Free weights, resistance machines, body weight, etc

Source: ACSM Guidelines for Exercise Testing and Prescription (8th Edition)

*The number of sets, reps and rests can be manipulated to accommodate specific muscular strength or muscular endurance training goals

Benefits of resistance training Numerous studies have shown that muscular fitness training produces many benefits for all ages and both genders. These include: 

Increased bone density – Studies have shown that women over the age of 35 can lose about 1% of bone mass per year, a figure that tends to be significantly increased after the menopause. Regular muscular fitness training has been shown to increase bone mineral content. For example, one study found that women who performed resistance training twice a week for a year significantly increased their bone density. Regular muscular fitness training reduces the risk of osteoporosis and bone fractures in later life.

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Increased metabolic rate and calorie expenditure – Long-term resistance training has been shown to increase the resting metabolic rate (i.e. the energy required to maintain the functioning of the body at rest). This helps to reduce body fat and control body weight.

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Decreased blood pressure – Regular muscular fitness training has been shown to reduce both systolic and diastolic blood pressure.

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Decreased blood cholesterol – Numerous studies have shown that regular muscular fitness training can improve the blood cholesterol profile.

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Improved self-image – Changes in muscle tone, shape and size can contribute greatly to enhanced self-image.

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Daily activities – Activities such as lifting children, carrying heavy shopping bags and standing up from a chair become easier.

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Decreased risk of injury – Increased mobility and stability of the joints and stronger muscles and connective tissue result in a stronger body. A stronger body and core are better able to avoid or resist injuries and knocks from falls or other physical activities.

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

Improved core stability – The core includes the back, pelvis and shoulder girdle. Improving the ability of the core, or trunk, to support your everyday functional activities enables the muscles and joints to perform at their safest and most effective position. Typical exercises for this include the plank, crunches, oblique crunches and back extension. Core stability is the ability to move the limbs (arms and legs) while maintaining correct alignment of the spine.

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Improved posture – Employing functional, push–pull type muscular strength and endurance training can help to correct muscular imbalances, which can lead to postural problems.

To improve posture, there must be an appropriate choice of exercises; this could involve strengthening weak muscles and stretching tight ones. For example, if a client has an increased curvature of the upper back, they may benefit from strengthening the rhomboids and mid trapezius and stretching the pectorals. This combination of strengthening and stretching could counteract the stooped position often associated with sitting and working at a desk all day. A client with an increased arching of the lower back will usually benefit from exercises to strengthen the abdominals and gluteus maximus muscles and stretch the hip flexors. This combination may counteract the excessive curve in the lower back and bring the spine into a more neutral alignment.

Special populations and muscular strength and endurance training Young people Weight-bearing exercise for young people and children is an important feature of their development. It is important to remember that weight-bearing exercises that employ the appropriate repetitions and resistance stimulate bone growth. Very high intensity strength training for young people and children should be avoided, as it may damage bone and the growth plates. Note that muscle growth does not keep up with bone growth.

Older people With age, the metabolic rate tends to decrease. This decrease is largely thought to be due to the loss of muscle tissue (particularly fast-twitch muscle fibres), which is more a product of inactivity than ageing. Regular resistance training is an excellent way to preserve muscle mass, prevent a reduction in metabolic rate and avoid putting on weight (fat) with age. Regular muscular fitness training reduces the risk of osteoporosis and bone fractures in later life and can reduce the frequency and severity of falls and fractures.

Ante-natal The average weight gain during pregnancy is 25-45 pounds, which increases force across joints of the body. This may cause increased joint discomfort, especially in the back, pelvis, hips and legs as the woman’s centre of gravity move upward and outward. A woman should therefore listen to any discomfort and modify exercises accordingly and be aware of becoming more easily unbalanced. It may be helpful to focus on some resistance-based exercises that can help with posture and stability.

Gym-based programme planning and preparation (D/616/7950)

As mentioned earlier, Supine positions should be avoided as much as possible during rest and exercise as they can result in obstruction of venous return, and therefore decreased cardiac output. Motionless standing is associated with a significant decrease in cardiac output; therefore, this should be avoided. General recommendations for muscular strength and resistance training are to work with low weights and perform multiple repetitions through a dynamic, controlled range of motion. Repetitive isometric or heavy-resistance weight-lifting should be avoided, as well as any exercises that require the Valsalva maneuver (breath holding), which would increase abdominal pressure. Core exercises that heavily load the abdominals should also be avoided.

Post-natal As mentioned earlier, because of the physiological changes occurring during pregnancy lasting up to six weeks post-partum, return to muscular strength and endurance training should be gradual. The initial focus should be for a woman to obtain personal time and redevelop a sense of control, starting gradually. Pelvic floor, postural and stability-based exercise should be encouraged. If the woman has â&#x20AC;&#x2DC;diastasis rectiâ&#x20AC;&#x2122; (abdominal separation), exercises such as ccrunches, sit-ups, oblique (twists) combined with crunches; anything that places strain on the abdominals such as straight leg lifts or holds from lying on the back should be avoided. Exercises that focus on alignment and engaging transverse abdominus can, however, help.

Flexibility

Flexibility is a measure of the maximum possible range of movement (ROM) around a specific joint or set of joints. Most individuals only become aware of flexibility as they get older or if they participate in activities in which its presence or absence affects their performance (e.g. yoga or Pilates). However, lack of flexibility at any age will make the body stiff, less mobile and restrict everyday movements.

Flexibility is probably the most underrated component of physical fitness, yet there is a wide range of health-related benefits to be gained from a regular stretching programme. Flexible joints and muscles contribute to the maintenance of correct posture and joint alignment. This aspect of physical fitness should be included at the end of every exercise session, when the muscles are at their warmest.

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Gym-based programme delivery and professional instruction Manual

Gym-based programme delivery and professional instruction (H/616/7951)

Contents Section 1: Goal setting ...........................................................................................................6 Recap on goal setting ...................................................................................................................6 Record keeping ............................................................................................................................ 8 Section 2: Safe and effective instruction ............................................................................... 10 Professional conduct .................................................................................................................. 10 Preparation ................................................................................................................................ 12 The learning process .................................................................................................................. 13 Whole-part-whole ...................................................................................................................... 15 Guidelines for teaching a warm up and CV workout .................................................................15 Exercise correction ..................................................................................................................... 16 Guidelines for teaching a muscular strength and endurance component ................................ 17 Safe guidelines for teaching a post-workout stretch .................................................................18 Guidelines for teaching gym inductions .................................................................................... 19 Guidelines for evaluation ...........................................................................................................23 Points to discuss ......................................................................................................................... 27 Appendix 1 - ACSM risk stratification.................................................................................... 30 Appendix 1 - Irwin and Morgan risk stratification tool .......................................................... 31 LOW RISK ....................................................................................................................................31 MEDIUM RISK ............................................................................................................................. 32 HIGH RISK ...................................................................................................................................34

Gym-based programme delivery and professional instruction | Manual |Version 1.0 ÂŠ YMCA Awards 2018

Gym-based programme delivery and professional instruction (H/616/7951)

Section 2: Safe and effective instruction Professional conduct Instructors should demonstrate professional conduct at all times. The moment the instructor walks into their place of work they should be aware of the image they portray. The job of the instructor involves talking to current and potential customers, centre staff, managers and coordinators. First impressions are always important as are communication skills. Demonstrating equal opportunities and customer care skills inside and outside of the gym shows a professional approach. Everyone should feel welcomed and supported by the instructor. Instructors should also be aware of all relevant procedures relating to the care of their clients, such as fire evacuation, first aid and other emergency procedures. Before instructing a planned session, the instructor will need to engage clients from the outset using effective communication (including active listening skills) to help the client feel welcome and at ease. The following instructor attributes and skills are essential to make a good impression on the client.

Professional appearance The majority of gyms provide a uniform for their staff. This makes employees recognisable and looks professional. Instructors should dress according to the organisation’s dress code. Instructors should also be aware of personal hygiene (hair, jewellery) and cleanliness.

Positive attitude The instructor needs to be seen as having a positive attitude towards life and work. Customers do not want to hear how bad the instructor’s day has been or how tired they are. The instructor needs to convey fitness and wellbeing. It is also essential that an instructor displays positive behaviours to make a good impression – standing tall or sitting appropriately – not slumping or using closed body-language and not chewing gum or chatting to other staff.

Customer focus An instructor should always have an approachable manner with a customer focus (natural empathy). An instructor should show that they care about a customers’ problems and be polite and helpful at all times. Customers should be treated with respect, fairness and honesty at all times.

Effective communication skills This includes effective verbal, non-verbal, listening skills and questioning skills. The instructor should also display positive body-language and mannerisms. A key role of the instructor is to be able to communicate essential information effectively. Clients need to know: 

how to operate and use all equipment safely

Gym-based programme delivery and professional instruction (H/616/7951)



how to perform exercises correctly including, CV and resistance machines, free weights, warmup and cool-down exercises

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how to adapt the exercise to meet their needs.

Instructors can communicate this information: 

visually, through demonstrations and use of body language (e.g. pointing to show the correct alignment of a specific joint area)



verbally, through instructions, teaching points, suggesting alternatives and encouragement

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through teaching positions.

To instruct in a safe and effective manner, the following skills will need to be utilised: 

Demonstration and explanation – The instructor should be able to perform and explain exercises with good technique. The instructor should give clear and concise explanations for equipment and exercises, avoiding jargon and unnecessary terminology at all times.



Teaching position – Choose positions where technique can be observed from various angles. Instructors should explain the purpose of observations and ensure that observation methods suit individual clients (consider any nervous clients). Mirrors can enable the instructor to see the clients. The instructor will also need to consider environmental constraints, such as lack of space plus the position of the client (standing or seated) to ensure appropriate teaching positions are taken.



Observation – This involves closely looking at alignment of the joints and watching for any signs of discomfort. The client’s performance should be closely monitored using methods of intensity monitoring (e.g. talk test, RPE, heart rate) and an instructor should recognise and respond to any signs of overexertion.



Reinforcement – Keep the participant focused on good exercise technique by repeating key teaching points. During the session an instructor should check client understanding at regular intervals using effective communication methods. Ask open-ended questions that encourage the client to speak at length and use active-listening to create rapport. An instructor should offer praise/positive reinforcement as well as correction.

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Correction – Instructors must be able to correct individuals to ensure that they are exercising both safely and effectively.

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Asking for feedback – Gauge from the participant whether the exercise is effective. An appropriate explanation should have stated the aim of the exercise which allows the participant to provide effective feedback specific to the goal.

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Motivation – Create a motivational atmosphere by being approachable and friendly, by varying voice tone, using open and energetic body language and by offering simple encouragement. Vary your teaching approach and style according to the client’s visual and verbal feedback. Create a positive environment that motivates and encourages client/s to achieve their desired goals.

Gym-based programme delivery and professional instruction (H/616/7951)

The following areas should be implemented to ensure a safe and effective session.

Preparation New clients must be welcomed and encouraged to work at their own level. Prior to starting any session, it is important that the instructor is aware of the participant’s wellbeing. Newcomers must be screened for experience, motivation and injuries. A general verbal check or screening must also take place to ascertain whether regular attendees are suffering illness, are pregnant or have any new injuries. The current PAR-Q should also be checked regularly for any recent changes. It is also vital to check that the client is wearing appropriate clothing and shoes for the session. The environment in which the session is to take place should be checked for cleanliness, and availability and condition of equipment. Similarly, at the end of the session, the environment should be left in a good condition for subsequent users. An instructor should advise on emergency exit points, fire alarm procedure, assembly points, security procedures and any planned evacuations.

Session overview An overview of the session should be explained to the client including the aims and objectives of the session and how it links to the client’s goals. An instructor should provide a brief explanation to the client of what to expect, so they can mentally prepare for the session. The client should also be given an opportunity to ask questions. The instructor should give the client a brief overview of the planned warm up, cardiovascular machines, resistance machines, free weights, use of any other apparatus, any body weight and functional exercises, flexibility, and cool downs.

Ending the session An instructor should allow enough time to end the session according to the client’s level of experience, fitness level, intensity of workout and temperature/environmental conditions. After the session the instructor should give the client an accurate summary of the session, to include strengths, areas for development, and praise and positive reinforcement. At the end of a session the client should be given an opportunity to reflect on the session, ask questions, provide feedback to the instructor and identify further needs. An instructor should ensure that the client understands how to continue their programme of gym-based exercise without direct supervision and this should include clarification on their understanding of their programme and time scales involved. The client should know where to find and how to complete their programme card. They should also be told where to find help and who to contact if they experience difficulties, along with your availability to support them through their programme. The environment should be left in an acceptable safe, clean and tidy condition ready for other users. An instructor should do this by returning equipment to its correct storage space, wiping down equipment and reporting any maintenance issues. Gym-based programme delivery and professional instruction | Manual | Version 1.0 © YMCA Awards 2018 12

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The learning process An instructor will often spend a lot of time planning the content of their session. They know the content inside out and have rehearsed the teaching points. By delivery time they are convinced that nothing could possibly go wrong, and then for some reason the client is confused or doesn’t respond to the teaching. As instructors it is important to realise that teaching does not always result in learning. Different people learn in different ways. Some can take information in, understand it and use it, whilst others need to spend time digesting the information; they may need to be shown something several times before they are in a position to master a skill or understand the theory. A client will need both time and practice to develop new specific skills to perform a new exercise. To learn effectively, two-way communication needs to be developed between the instructor and the client. As part of the teaching and learning process the client will need the opportunity to ask questions. The instructor will need to gain feedback (visual and verbal) to check learning has been achieved. This will ensure the teaching and learning process has been successful. To aid in the learning process, it is necessary for instructors to recognise the stages of learning through which the client progresses when learning a new skill. This process can relate to the learning of correct technique and alignment, as well as following complex instructions. There are three main stages: cognitive, motor (or associative) and automatic (or autonomous).

Cognitive This is the initial phase of skill development. It is where the client finds out what they are expected to do. At this stage, they will be less coordinated and unfamiliar with the exercise or movement pattern. They may also tire easily as concentration levels will need to be high. It is essential at this stage not to overload the individual with too much information. In addition, the exploratory nature of this stage will mean that errors are made. To ensure learning at this stage is effective, instructors should ensure that: 

each skill is broken down into simple components

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adequate practice time is allowed at each stage and movement patterns are repeated to reinforce learning

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demonstration of each specific aspect of the movement is provided

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explanations and clear instructions regarding each stage of the exercise or movement pattern are provided

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specific feedback is given so that errors are recognised and corrected

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motivation and encouragement are provided to individual learners.

Gym-based programme delivery and professional instruction (H/616/7951)

Motor (associative) Many clients stay at this stage of learning for a long period of time. They are increasingly able to recognise mistakes, make comparatively fewer errors and are able to make some of the necessary adjustments to improve technique. Although clients are able to link movement patterns together, their movement is often slower and more deliberate, and concentration levels are high. To ensure effective learning at this stage, instructors should ensure that: 

practice is encouraged to reinforce the learning of the exercise pattern and timing of sequences

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specific feedback is given to improve performance

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positive reinforcement is provided regarding skills being performed correctly

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repetition is allowed until the movement is correct and effortless, and before additional aspects of the movement pattern are added

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demonstration and explanation can be used to assist with the correction of errors

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motivation and encouragement are provided throughout.

Automatic (autonomous) At this stage of learning, clients will have developed their reaction time, be able to move faster and perform multiple actions. They can also maintain a higher degree of accuracy in their movement, with reduced anxiety over their performance. Movements are less cognitive and are performed more automatically. However, to maintain the level of skill it is still necessary to return to earlier stages of learning on occasions. At these stages, the instructor should: 

provide positive reinforcement of correct patterns

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identify and rectify mistakes immediately

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focus on the more detailed aspects of the skill

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use further demonstration and explanation to help with development of finer aspects of the movement/skill

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motivate and encourage to promote adherence.

It is worth noting that it is harder to correct a client if the skill has not been learnt correctly or if bad habits are formed. The movement behaviour would have to be unlearned for it to be learned again effectively. It is important for the instructor to consider the learning cycle and where their clients may be in the cycle. Some people will need to be shown something over and over again if they are in the cognitive stage. They may master a skill on a few occasions but because high concentration levels are required mistakes reoccur. It is important not to assume more advanced clients need less teaching; if correct technique was not taught and reinforced effectively in the motor stage, they will have learnt incorrect techniques and bad habits would be difficult to rectify.

Gym-based programme delivery and professional instruction (H/616/7951)

Whole-part-whole Complicated exercises can also be taught using an approach called ‘whole-part-whole’. A good example of this is teaching the clean. First the instructor demonstrates the whole clean so the client has a clear picture of what they are aiming for. Then the instructor breaks down the movement into parts, teaching each one, then adding the next one and linking them together. For the clean the parts might be: 

Deadlift



Upright row and raise onto toes

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Receive

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Return.

Finally, all of the parts are then seamlessly merged together to produce the whole lift.

Guidelines for teaching a warm up and CV workout Teaching a CV session requires a considerable degree of organisational skill. The following guidelines aim to assist the instructor in teaching and organising successful CV sessions. The prompt IDEA is often used to aid the introduction and teaching of CV machines:

IDEA example – treadmill running The treadmill Introduce the machine

Name the body system and muscles working

Demonstrate the exercise

Explain the exercise

Primarily a CV exercise (heart, lungs and circulation) with muscular endurance in the tibialis anterior, gastrocnemius, soleus, quadriceps, hamstrings and hip flexors.

Demonstrate the console setup and exercise action, move the client to view exercise technique from different angles and explain the exercise giving key teaching points.

Talk the individual through the console setup and into the start position.

Activity

Talk them through performing the exercise by giving coaching points and observing and correcting technique. Ask questions to see how individuals feel. Talk them through finishing the exercise. Gym-based programme delivery and professional instruction | Manual |Version 1.0 © YMCA Awards 2018

Gym-based programme delivery and professional instruction (H/616/7951)

An alternative method is to talk the client into position whilst demonstrating. This is an appropriate method for individuals who have some experience but who are not skilful or confident enough to exercise without guidance.

Exercise correction The key task for the instructor is to ensure that individuals are exercising effectively. This often necessitates suggesting minor adjustments to an individual’s technique for maximum effectiveness. For instance, an individual might be performing a lunge exercise with small strides and simply prompting them to work through the full range of motion – taking larger strides forward and bringing the rear knee closer to the floor – the effectiveness of the exercise will be significantly improved. When correcting an individual’s exercise technique, the instructor needs to consider the following:

Verbal correction and demonstration Use the teaching points or show them how you would like them to perform the exercise. Alternatively, show them what they are doing wrong and how you would like the exercise to be performed. If an individual is still struggling to perform the exercise safely after this, offer them a related alternative exercise. Try not to be too intrusive, and respect the individual’s personal space. However, it is important that the client is coached into correct technique by verbal or visual instruction and correction.

Hands-on correction Some individuals may be offended if they feel their personal space has been invaded. Whenever possible, correct technique verbally. However, if you feel that touching the client will aid learning and improve exercise technique, it is vital that you ask permission first. This ensures no one will misconstrue the situation and avoids embarrassment.

Feedback and support After the session is a good time to reinforce specific points, especially if it is known that the participant may have a future training session without the instructor’s close observation. It is an appropriate time to discuss how they can maximise their performance on certain exercises.

Motivation Whilst varying the exercises, content and the type of approach are key motivational factors over the long term, within any given session, the instructor needs to consider creating an energetic and motivational atmosphere. There are no set rules on how to create an enjoyable atmosphere and it will somewhat depend on the client’s preference. An instructor’s behaviour and personality both have a strong impact on whether the clients have fun during their gym session. Being outwardly enthusiastic, positive, approachable and friendly can go a long way to help make a session enjoyable. Keeping clients satisfied is essential in maintaining their commitment and one simple tip is to ask them, “What would make this session more enjoyable and fun for you?” Use their feedback to enhance the quality and enjoyment of future sessions.

Gym-based programme delivery and professional instruction (H/616/7951)

Whilst there are no set rules on motivation, there are a number of distinct turn-offs, such as teaching the entire session using a monotone and flat voice, adopting a ‘military’ approach, or leaving long gaps of silence whilst the client is exercising, and not reinforcing or praising the client’s performance.

Keep the clients focused on their exercise goals 

Remember: clients look to you for support, inspiration and encouragement to reach their goals.

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Use positive feedback.

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Find something positive about an individual’s exercise performance and point it out. If his or her exercise technique has improved, tell them.

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Use reinforcement.

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Keep the clients focused on good exercise technique by reinforcing the key teaching points at regular intervals. This helps the clients to concentrate on maintaining good form and avoids the tendency to resort to poor techniques when working hard.

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Be optimistic and enthusiastic about the workout.

Guidelines for teaching a muscular strength and endurance component The following guidelines aim to assist the instructor in teaching a muscular strength and endurance component. The prompt NAMSIT (OR NAMSET) is often used to aid the teaching of free weight and fixed resistance machine exercises.

Name:

Name the exercise

Area:

Identify the area of the body being exercised

Muscle(s):

Identify the muscles being worked

Silent:

Give a silent demonstration of the exercise, allowing for close observation of technique

Instruct:

Instruct/explain the actual technique and alignment of the exercise. Outline only the major instructional points of the exercise as you, the instructor, perform the exercise

Teach:

Allow the participant to practice the exercise. Whilst they are performing, teaching skills must be demonstrated.

Gym-based programme delivery and professional instruction (H/616/7951)

The instructor needs to ensure they can be seen by the client whilst teaching and be in a position where they can be heard. It is equally important that the instructor can observe the client throughout the workout. When working with heavy weights instructors need to position themselves where they can perform safe spotting.

Observation As with the CV machines it is vital the instructor can maintain all round observation of the client so that errors in exercise technique can be identified and corrected. This requires walking around a participant who is using fixed resistance machines or performing free weight exercises.

Exercise demonstration Demonstrating several exercises within a session can be time-consuming and possibly boring for the participant. They want to be doing rather than watching. A simple teaching strategy to overcome this problem is to demonstrate the exercise whilst encouraging the participant to practice at the same time. More experienced clients could be coached directly into the correct exercise position without demonstrating the exercise. Both approaches provide an opportunity to observe performance, identify and correct technique, offer alternative exercise options, and allow time for the reinforcement of key teaching points. Explain the purpose of the exercise to the clients. Take the opportunity whilst demonstrating or teaching the exercise to educate clients about the exercise benefits and the muscles used.

Exercise correction The key point here is to consider the clientâ&#x20AC;&#x2122;s self-esteem. The emphasis needs to be on mastering technique and not highlighting their poor technique to possible observers. This can dent a clientâ&#x20AC;&#x2122;s confidence and make them feel self-conscious.

Safe guidelines for teaching a post-workout stretch Areas to consider in the post stretch and relaxation are as follows.

Pace of delivery Instructions can be given at a slower pace; clients can be given more time to relax and assume comfortable stretch positions.

Teaching position, observation and correction As with all sections of the session, it is important to ensure correct technique and alignment in the postworkout stretch. For comfort and effectiveness of developmental stretches many exercises will be performed on the floor. The instructor should not stand over the participant as it can feel intimidating. It is important that the instructor comes down to the same level as the participant when appropriate.

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Teaching points To ensure correct alignment and technique the client needs to have each exercise explained to them clearly. Teaching points are used for safety and effectiveness to tell the client how to perform an exercise rather than simply what to do. The following points are important to recognise and adhere to for customer care: 

Encourage clients to ask questions to promote confidence.

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Use questions to request feedback from clients. Use a variety of open questions (questions that require more than a single word answer) and closed questions (questions that only need a oneword answer e.g. yes or no).

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Explain the purpose of the exercise/activity.

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Recognise the need for regular checks to establish how clients are feeling.

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Recognise the importance of encouraging clients to work towards their own goals and discouraging group competition.

Guidelines for teaching gym inductions A major part of the gym instructor’s job is to induct new members to the gym environment. Whether it be a private club or local authority site, it is important all users are safe in the environment. The induction is often the first contact that a new member has with the health club. The impression they gain at this stage will have a profound effect on their views and opinions of the company and its staff. If a good relationship can be established at the outset, it makes it much easier for all of the instructors to do their job in the future. For example, it can be awkward for gym staff to approach members who are training with poor technique and offer them correction. However, if new members are told during the induction that this may happen, it makes it easier for instructors to speak to a member. A member will also be more likely to accept the advice, rather than ignoring it or taking offence.

Setting ground rules The induction is a useful time to explain rules, such as health and safety guidelines, dress code, using towels to wipe down machines, sharing equipment, clearing away free weights, etc.

Communication skills During an induction an instructor will need to apply all of the communication skills they have learnt previously. Effective communication during an induction will involve adapting communication style, attitude and response to suit customers and their specific needs. The instructor will need to be professional and adhere to the organisation’s code of conduct (specific greetings/procedures) showing good manners, appropriate language and a friendly attitude. An instructor may need to adapt their communication and behaviour for different types of customers, including children, young people, adults, older people, people with disabilities or those who have English as a second language.

Gym-based programme delivery and professional instruction (H/616/7951)

Some gyms have a policy of offering one-to-one inductions whilst others show members around the gym in small groups. An individual induction tends to give better customer service than the group approach, but does require more gym staff to be on duty, and thus incurs a cost. Individual attention allows the client to select exercise options based upon their activity preferences and gives them time to learn the exercises and ask questions regarding their exercise goals; in other words, the induction can be tailored to suit the member’s individual needs. Group inductions require fewer staff, but do not offer quite the same degree of customer service. The management should agree a limit in any one induction to maintain quality. Groups of three to five people are fine. Groups of 5–10 are harder to manage, and although still possible, they’re not recommended. Groups with more than 10 clients make it difficult for individuals to hear and see the instructor; people may be reluctant to ask questions. Group inductions also need different teaching skills compared to individual ones, if they are to be managed effectively. For example, with a one-to-one, the member can practice after demonstrating one piece of equipment. With a group, a good approach is to introduce several pieces of equipment and then get the group to practice the exercises in the form of a simple circuit. This enables them to learn the skills and allows the instructor to observe their performance, reinforce good technique and correct unsafe technique if necessary.

What should be included in an induction? In an ideal world, every piece of equipment in the health club would be included in an induction. However, this is rarely feasible because of the time and money involved, and because new members understandably want to make use of the facilities as soon as possible. If they are told they have to attend five hours of compulsory induction, they will probably feel that this is excessive and join a different fitness facility. A compromise therefore has to be found between what is ideal, and what can be done in a reasonable time and for reasonable cost. Instructors have a duty of care to ensure that members know how to use machines safely. Decisions need to be made about what has to be included, and what can be omitted. The following is usually included within a typical induction: 

Screening form (PAR-Q)

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Venue rules and health and safety information

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Advice on warming up and cooling down

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Advice on safe and effective stretches

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Demonstration and practice of selected CV machines and resistance machines/free-weights

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Demonstration and practice of basic abdominal/core exercises on the mat

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Advice on training intensity, duration, resistance, sets, reps, etc.

YMCA Awards is one of the UKâ&#x20AC;&#x2122;s leading health, fitness and wellbeing specific awarding organisations. It offers training centres and learners across the world a diverse suite of qualifications, from introductory (Level 1) to advanced levels (Level 4). YMCA Awards issues over 30,500 qualification certificates a year, helping learners in the UK and overseas to launch and progress their careers in the active leisure sector. To view YMCA Awardsâ&#x20AC;&#x2122; full range of qualifications please visit www.ymcaawards.co.uk.