FPM (Precision Programming)

Learning Objective 

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate the concepts:

• Inactivity as a significant driver of disability.
• Providing a positive experience with movement as the key to changing behavior.
• The squat & lunge as health span biomarkers.
• Traditional pathology narratives grounded in an overly biomedical/biomechanical approach (i.e., “wear & tear”) tend to make people over-protective.
• How the status quo in the health professions often manages people away from load resulting in under-preparation

In this hour, we discuss and cover the following:

• The relationship between muscle atrophy, loss of muscle strength, falls, fractures, and frailty.
• You will learn to focus on the activity intolerances related to symptoms rather than pain.
• Discover how the silver lining (“gift of injury”) of MSK (Musculoskeletal) pain can shed light on the fact that we are older sooner (increased diabetes, obesity, etc.)
• We discuss how movement is medicine and why personal trainers should be included in the healthcare system.
• Learn how to shift the focus from people’s expectations about learning the cause of their pain to the upstream factors they can change.
• Learn how the “tyranny of the visit” can lead to over-protection rather than empowering self-management.
• Discover the role of graded exposures to feared stimuli in the recovery process.
• We will discuss the W.H.O.(World Health Organization) P.A.G.s (Physical Activity Guidelines) and the role of gamification for “guiding by the side” in constraints-based motor learning.
• Find out when technical proficiency matters and how to detect the signs of over-protective beliefs/behaviors.
• Learn how the assessment aims to identify baselines where improvement can occur in the shortest time possible.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate the concepts:

• There is a relationship between muscle atrophy, loss of muscle strength, falls, fractures, and frailty.
• One should focus on activity intolerances related to symptoms rather than pain.
• There is a silver lining (“gift of injury”) of MSK (Musculoskeletal) pain that sheds light on the fact that we are older sooner (increased diabetes, obesity, etc.)
• Movement is medicine, and personal trainers should be included in the health care plan of care.
• One should shift the focus from people’s expectations about learning the cause of their pain to upstream factors they can change.
• Beware the “tyranny of the visit” that leads to over-protection rather than empowering self-management.
• Consider the role of graded exposure to feared stimuli in recovery.
• Consider recommending the W.H.O. (World Health Organization) P.A.G.s (Physical Activity Guidelines) as a minimum care plan.
• Use gamification for “guiding by the side” in constraints-based motor learning.
• Keep technical proficiency in perspective.
• Watch for the signs of over-protective beliefs/behaviors.
• Ensure your assessment aims to identify baselines where improvement can occur in the shortest possible time.

In this hour, we discuss and cover the following:

• Why a 5-Part Fundamental Movement Literacy Screen is an ideal movement prep (afferent/foot; thermogenic; mobility; pillar; E.S.R. – Energy Storage & Release)
• We describe why a Gap Analysis is a key to person-centered programming and adaptation requires graded exposures.
• We review the principle “It’s not the load that breaks you down, but the load you’re not prepared for.”
• We consider the “Talk Test,” how to use the Rating of Perceived exertion (RPE) scale and Reps in Reserve (R.I.R.).
• We describe a way to rate pain with the Traffic Light – green, yellow, red (uncomfortable, uncertain, unacceptable, or intolerable)
• We discuss Movement Agnosticism and the principle, “First move well, then move often.”
• We present the concept, Guide by the side, as an antidote to creating conscious movers in the pursuit of “corrective” movement patterns and why load is the essential ingredient in restoring mobility.
• We create a Functional Dashboard of baseline floor issues to create a precision program.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate concepts and techniques that include:

• You will be able to apply a 5-Part Fundamental Movement Literacy Screen for movement preparation.
• Apply a Gap Analysis as the key to person-centered programming.
• Use graded exposures to produce adaptation.
• Apply the principle; “It’s not the load that breaks you down but the load you’re unprepared for.”
• Use the “Talk Test,” Rating of Perceived exertion (RPE) scale, and Reps in Reserve (R.I.R.) to produce the best results.
• Rate pain with the Traffic Light – green, yellow, red (uncomfortable, uncertain, unacceptable, or intolerable)
• Use movement agnosticism and apply the concept; “First move well, then move often.”
• You will be able to Guide By the Side as an antidote to creating conscious movers in the pursuit of “corrective” movement patterns.
• Use “load” as the essential ingredient in restoring mobility.
• Create a Functional Dashboard of baseline floor issues to create a precision program.

In this hour, we discuss and cover the following:

• A step-by-step 5-part movement prep skills. We explain why we coach the setup more than the exercise and discuss why landing drills precede plyometrics.
• We explain the key to determining the box height for depth jumps and how to categorize any test or exercise as painful, dysfunctional, or acceptable.
• We explain why the Movement Prep is the prerequisite and should “bleed into” lifting or playing a sport.
• Finally, we discuss why general locomotor skills are a prerequisite for more specific sport-specific skills.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts, including:

• Be able to coach a step-by-step 5-part movement prep set of skills.
• Coach the setup more than the exercise in your programs and how to use landing drills before plyometrics.
• You will be able to determine the best box height for depth jumps and categorize any test or exercise as painful, dysfunctional, or acceptable.
• You will use the Movement Prep as the prerequisite and “bleed into” lifting or playing a sport.
• You will start to use general locomotor skills as a prerequisite for more specific sport-specific skills.

In this hour, we discuss and cover the following:

• How to find and recommend a 5-10 RM (Rep Max) with 1-2 RIR for progressive resistance training exercises.
• We consider options besides intensity and volume in our programming – tempo and time under tension parameters.
• We discuss Agnosticism, the view that absolute truth or ultimate certainty is unattainable, and why the tool you use in the gym doesn’t matter as long as the goal is clear.
• We consider why we are chasing adaptation and how mild pain or discomfort is OK.
• We discuss how to find a safe starting place and why the primary question should be, are you giving people a positive experience with movement and progressing them to the hardest thing they do well.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts, including:

• How to find a 5-10 RM and 1-2 RIR for progressive resistance training exercises.
• How to apply programming options besides Intensity and Volume – specifically, Tempo and Time Under Tension parameters.
• Why the tool you use doesn’t matter so long as the goal is clear.
• You will understand why we are chasing adaptation and use that concept for better outcomes.
• You will be able to start using the phrase; Is it tolerable rather than rating pain with the numeric Visual Analog Scale (0-10).
• You will know how to determine the safe starting place and find it easier to create effective programs because you understand that the primary question is, are you giving people a positive experience with movement and progressing them to the hardest thing they do well

In this hour, we discuss and cover the following:

• The continuum from Movement Prep to General Physical Preparation (GPP) and Specialized Physical Preparation.
• We discuss RPE 5-8 and why the true strength is making the hard easy.
• We explain how to lower a client’s biological age.
• Why R.I.R. is the key to adaptation.
• We discuss the language of strength and RPE.
• We describe how to use a Traffic light analogy to re-conceptualize discomfort as something to be put in the rearview mirror.
• How predictive processing leads to people embodying their past negative experiences with pain into their present, thus expecting activity to be painful and hurt to equal harm.
• We describe how an excessive focus on biomechanics can interfere with training by making people conscious movers and over-protective, so they don’t get sufficient exposure to necessary stress stimuli to cause adaptation.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts, including:

• How to incorporate the continuum from Movement Prep, General Physical Preparation (GPP), and Specialized Physical Preparation into your programs.
• Your programs will embrace the idea that true strength is making the hard easy (RPE 5-8)
• You will be able to motivate clients by explaining how they can lower their biological age.
• You will be able to apply R.I.R. as the key to programming with sufficient stress stimuli to cause a positive adaptation.
• You will understand the language of strength and RPE.
• You will learn how to teach clients or patients a traffic light analogy where discomfort can be re-conceptualized as something tolerable rather than assuming every hurt equals harm.
• By turning activity from foe to friend, we put disabling pain in the rearview mirror and are empowered to return to valued life activities.

In this hour, we discuss and cover the following:

• How training gamification can be used to improve consistency and exercise participation.
• We discuss person-centered communication, the validation of lived experience, and empathetic listening.
• We discuss the debrief, the role of social support, behavioral economics, and “soft nudges” in coaching.
• Why we cannot predict the future and how accepting and navigating uncertainty is essential.
• We discuss the Person-Centered profile template and share a case presentation.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts, including:

• How to employ training gamification, person-centered communication, and lived-experience validation.
• You will be able to use empathetic listening with clients/patients, utilize a debrief, and provide social support.
• You will have additional tools from behavioral economics, such as using “soft nudges” with behavioral guardrails.
• You will be able to educate people that our inability to predict timelines is uncertain but that landmarks are key, operational rehab criteria on the rehab journey.
• You will be able to create a Person-Centered profile template and see a case presentation that uses the same approach and methods taught in your course.

In this hour, we discuss and cover the following:

• The Nocebo effects and how they affect our client/patient.
• We discuss the relationship between and value of communication, collaboration, context, and connecting the dots between the team members and the clinician-coach community.
• We discuss a communication debrief and the value of listen – affirm – validate – motivational interviewing.
• We consider the likelihood of an over-diagnosis and how to explain that hurt doesn’t equal harm and activity isn’t dangerous.
• We discuss the concept that words can hurt and the dangers of labels.
• Finally, we present practical techniques such as hinge and hip lock training.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts:

• You will start considering the danger of a nocebo effect when coaching.
• You will have a greater appreciation of the value of communication, collaboration, and context and how a key to offering client-centered (service) is to connect the dots from their story to our game plan.
• You will be able to start using a communication – debrief with clients.
• Your motivational interviewing skill will improve, making you better equipped to listen – affirm, and validate as you coach.
• You will understand the pitfalls of over-diagnosis.
• You will be able to reassure clients that hurt doesn’t equal harm and activity isn’t dangerous.
• You will understand how words can hurt, making you less likely to apply disabling, fear-producing labels.
• You will better understand and be more able to coach specific techniques such as hinge and hip lock training.

In this hour, we discuss and cover the following:

• How to coach sprint training for acceleration
• How lateral pelvic stability is assessed and optimized for running.
• We cover why the forward lean and stumble reflex are essential Key Performance Indicators of training acceleration.
• How running economy benefits from foundational athletic development.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate specific techniques and concepts, including:

• How to coach sprint training for acceleration and lateral pelvic stability for running optimization.
• You will have a greater ability to coach the forward lean.
• You will be able to design exercises to train the stumble reflex in progressions of the famous wall drills.

In this hour, we discuss and cover the following:

• Skill transfer and residual adaptation.
• We cover linear acceleration drills and the role of the fixed tibia.
• Fatigue resistance as a critical goal of coaching.
• Bottoms-up linear to lateral acceleration
• Timelines vs. landmarks.
• Derek Hansen on front side sprint mechanics
• Injury prevention vs. promotion
• Evidence-based but not recipe driven.
• The why behind individualization vs. cookie-cutter formulas
• And finally, accepting uncertainty

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate certain techniques and concepts, including:

• Skill Transfer & Residual Adaptation
• Linear acceleration drills – the role of the fixed tibia
• Fatigue resistance as a key goal of coaching
• Bottoms up linear to lateral acceleration
• Derek Hansen on front side sprint mechanics
• Timelines vs. Landmarks
• Injury prevention vs. promotion
• Evidence-based but not recipe driven.
• The why behind individualization vs. cookie-cutter formulas
• Accepting uncertainty

iIn this hour from Reload, his clinic-gym, Dr. Ryan Chow presents a Lived Experience Profile Template. His presentation is an excellent summary of the principles and framework we use for problem-solving. It is an example of a systematic approach that doesn’t follow a single system or method. Instead, you’ll see proof of concepts of a person-centered, principle-based approach allowing you to use any “systems” or “methods” you already know and use. What is unique about FPM is that we’re agile and, as Dr. Lewit taught, “not a slave of any methods, since the methods should serve the goals.”

 You’ll see Ryan’s thought processes for his progressions and how he keeps it client-centered and focused on the goals of the person in front of him. Along the way, you will see how he listens to the person’s story, finds a safe starting place, gives a positive experience with movement, and finally progresses them by finding the hardest thing they do well that is linked to their capacity shortfall and activity demands.

Learning Objective

Upon completion of this hour, you will be able to provide clients or patients with better-designed rehabilitative programs that incorporate techniques and concepts that include:

• CC, O, A.I., Activity History, Goals, PMHX, Concerns, B.F., MS
• 1 R.M. is equal to your A.I.
• Feet: ground interface
• Thermogenic: fitness screen
• Active Mobility: toes, hips, T-spine
• Pillar Prep: Glute/Abdominal/Groin/Quads activation
• Energy storage & release
• Self-Care Rx: Finding the safe starting point: No guarded movements, facial grimacing, lack of technical proficiency, loss of concentric velocity.
• Self-Care Rx: Feel target tissue to give a positive experience with movement.
• Validate self-care Rx with test/re-test.
• Frequency: like Advil.
• Volume & Intensity can be audited with the test of mechanical sensitivity (M.S.) to determine Self-Care Rx dosage.
• The Teach Back Test