Paul Smith

Client Background
Paul Smith started personal training with me in February 2005. He is 5'9", a 53-year-old male and started at 185 lbs. Paul has had previous injuries to his right shoulder and left elbow and he has a tendency to develop tendonitis in those areas. He has had low back problems, due to a previous herniated disks (L4-L5 / L5-S1). He also has Addison's Disease in which he takes replacement medication for Cortisol and Aldosterone production. Paul had a great interest in bodybuilding and has had over 10 years of previous weight training experience.

Problems To Be Solved
Paul had previous weight training experience and wanted the motivation to be pushed in order to make the greatest gains in the least amount of time. He was used to mild vigorous exercise and expressed a desire for a transformation in terms of his physique. His primary goals were to lose bodyfat in order to obtain a 32" waistline. His secondary goals were to increase muscle mass throughout his legs, arms, and chest, while reducing pain in his right shoulder, left elbow and lower back. One of my goals for Paul was to increase his mental effort to improve his intensity of effort.

Plan of Action
I collected Paul's health history and had him fill out a questionnaire in order to access his health and fitness goals. I collected his baseline assessment information (resting heart rate, blood pressure, height, weight, and body composition) to calculate his starting point, as well as having pre-history data to look back on and assess future progress. I planned on collecting Paul's assessment information periodically to determine his health and fitness-related progress.

I started Paul on Full-Body Routine (Break-In Period) in order to slowly acclimate him back to weight training. We targeted mainly on multi-joint exercises, focusing on proper form and slow rep cadence. He performed 2-3 sets per exercise and 8-12 reps using a 4/4-rep cadence. His workouts included the following exercises: Leg Press, Calf Raises, Chest Press, Pec Deck, Overhead Press, Pulldowns, Seated Row, Bicep Curls, and Tricep Pushdowns. We progressively increased his intensity from moderate to high as the weeks progressed. He trained twice per week and rested approximately 3-4 days between workouts. His other rest days included bouts of cardiovascular training. He performed 2-3 days of moderate intensity cardio using the Elliptical Cross Trainer (EFX) for approximately 20-30 minutes.

Paul Smith's Program (Break-In Period Routine) consisted of:
Warm-up: 3-4 minutes walking on treadmill
Leg Press
Calf Raises
Chest Press
Pec Deck
Pulldowns
Seated Row
Overhead Press
Bicep Curls
Tricep Pushdowns
Cool-down: 3-4 min walking on treadmill

The Break-In Period Full-Body Routine lasted 2 weeks. Paul's intensity level was increasing with each workout, and so I switched him over to an Upper-Lower Split Routine. This routine was incorporated to allow him to train more intensely with a limited number of exercises, while allowing him additional recovery. He performed 1-2 sets per exercise, focusing on attaining muscular fatigue using a 4/4-rep cadence at approximately 60-75 sec tension time. His workouts included the following exercises: Upper Body - Pec Deck, Chest Press, Pulldowns, Seated Row, Bicep Curls, and Tricep Pushdowns; Lower Body - Leg Press, Leg Extensions, Leg Curls, and Calf Raises. He started training to muscular fatigue (MF) during this period, in which we consistently observed strength increases in every workout. He still trained twice per week and rested approximately 3-4 days between workouts. His other rest days included bouts of cardiovascular training. He performed 2-3 days of moderate intensity cardio using the Elliptical Cross Trainer (EFX) for approximately 20-30 minutes.

Upper Body (warm-up/ cool-down: 3-4 min of walking on treadmill)
Pec Deck
Chest Press
Pulldowns
Seated Row
Bicep Curls or Tricep Pushdowns (alternate each workout)

Lower Body (warm-up/ cool-down: 3-4 min of walking on treadmill)
Leg Press
Leg Extensions
Leg Curl (Seated or Prone)
Calf Raises

Routine: The Upper-Lower Split Routine lasted approximately 6 weeks. Paul's intensity level was off the charts and continuing to increase every workout. In an effort to allow him to focus on additional exercises while keeping his overall volume low, I switched him to a Push-Pull-Lower Body Routine. This routine was incorporated to allow him to train very intensely, while incorporating a few new exercises within his routine and allowing him additional systemic recovery. His workouts remained every 3-4 days. However, each body part received approximately 10-11 days rest before being trained again. His workouts included the following exercises: Push - Pec Deck, Chest Press, Overhead Press, Pushdowns; Pull - Pulldowns, Seated Row, and Bicep Curls; Lower Body - Leg Press, Leg Extensions, Leg Curls, and Calf Raises.

Intensity: High intensity training was obtained with every set to MF. After reaching MF, he would periodically perform partial reps for an additional 10 sec. This intensity variable was used approximately half of his sets during this workout. Paul responded very well to partial reps after reaching momentary MF.

Cadence: 4/4 (1/1 pauses in the contracted and stretch positions)

Time Under Tension: 60-75 seconds. We maintained training with a 60-75 sec TUT, as Paul responded very well to this time frame the best. I concluded that Paul's overall fiber-type was predominately mixed or intermediate in nature. We have planned a fiber-type test for the beginning of 2006 in an effort to pinpoint TUT ranges for every muscle group.

Duration: He still trained twice per week resting approximately 3-4 days between workouts, while training each body part once every 10-11 days. His other rest days included bouts of cardiovascular training. He performed 2-3 days of moderate to high intensity cardio using the Elliptical Cross Trainer (EFX) for approx. 20-30 minutes. He slowly incorporated high intensity bouts of cardiovascular training using interval training of 2-min moderate, 1-min of high intensity, until he reached duration of approximately 20 minutes.

Nutrition: I had Paul perform a 5-day food dairy, listing what he ate and drank for 5 consecutive days. He calculated the caloric values of all what he wrote down and weighed himself before and after the 5-day span. We then calculated his maintenance caloric balance using his data from the food diary. We structured a food plan using 3 meals per day and approx 1-2 additional snacks throughout the day. This food plan worked well with Paul's work schedule. Paul became more aware of what he ate on a daily basis, as well as how to budget his calories throughout the day. If Paul eats out and overeats during a meal, he is aware that he can subtract calories in another meal that day to maintain his caloric budget for the day.

Monthly Progress

Strength: He trained to MF on each and every set during this period. Frequently, we would observe strength increases on every set of his workouts. Paul typically motivates himself and now requires little direct motivation from me. He is learning to generate most of his mental and physical effort from self-motivation, which is accomplishing one of my major goals for him. Lastly, the pain in Paul's left elbow and right shoulder completely disappeared and the pain in his lower back has reduced as well.

Cardio: Paul's endurance has improved significantly with the additional cardio sessions, as well as introducing high-intensity interval training into his overall program. His resting heart rate has decreased from approximately 75 bpm to 51 bpm.

Body fat: Paul experienced a 10-pound weight loss during his first month. He went from 185 lbs to 175 lbs, which resulted in a leaner look throughout his physique. Paul has reduced his overall body fat from approximately 30% to 24% and has reduced his waist size from a 40" waist to a 34" waist. Paul was pleased to see his waist size reducing, as well as overall body fat. It was quite exciting seeing Paul's improvements throughout the weeks working with him. I saw more confidence in him, as well as a more extroverted attitude. As a fitness professional, seeing not only physical improvements, but also mental and emotional improvements is what makes my job so worthwhile and gives me a sense of self-fulfillment. Great job Paul - keep up the good work and healthy lifestyle!!!

The photo set below is from March 2005 and June 2005.

Strength Results

Body Part	Exercise	% Strength Increase
Chest	Chest Press @ 220	133%
	Pec Deck @ 140	100%
Back	Pulldowns @ 140	133%
	Seated Row @ 110	57%
Delts	Overhead Press @ 150	25%
Triceps	Triceps Push @ 65	63%
Biceps	Biceps Curls @ 95	58%
Quads	Leg Press @ 360	50%
	Leg Ext @ 160	167%
Hams	Seated Leg Curls @ 150	200%
Calves	Calf Raises @ 270	93%

Client's Comments

History: Growing up, I was very thin. When I graduated from high school, I weighed 105 pounds at 5'10". As an adult, I vacillated between 125 and 135 pounds. I had no energy, no stamina. Although I tried everything I could, I just could not gain weight-that is until I ended up with Addison's Disease (a complete dysfunction of the outer cortex of the adrenal glands) in 1986. When I started taking cortisol to replace what I didn't produce, I gained 45 pounds the first month and ended up at the end of 6 months weighing in at 190 pounds. Needless to say, despite weight training, most of that weight was fat.

Moving to Springfield, Missouri, in 1987, I continued my search for the right supplement, the right training program to meet my unrealistic goals fed to me by popular bodybuilding mags. This led me to join various gyms with promises that were too good to be true. I eventually joined Cox Fitness Center where I periodically was monitored and encouraged. However, in the last year, I experienced several health problems that prevented me from working out regularly.

Training: At the end of 2004, I began weight training again. I made absolutely no progress. After three months, the fitness center director recommended hiring a personal trainer to get me over my slump and help me set and meet realistic goals. I contracted with Chuck Rainey, who introduced me to high intensity training.

After evaluating my fitness level, Chuck put me on a twice a week regimen. I train once a week with Chuck and once by myself, using three separate workouts-legs, chest/shoulders/triceps, and back/biceps). He impressed on me the importance of giving everything I've got during high intensity training. He stressed that the number of reps is not important, but strict form, slow reps, and going to failure within a "time-under-tension" of about a minute.

He also encouraged me to continue cardio training using high intensity philosophy. By using no-impact training machines, like the elliptical fitness cross trainer, I have found I can generally do this two to three times a week on non-weight-training days.

Results and Benefits: During the months that I have been training with Chuck I have seen some significant progress in strength gains and fat loss-although my weight has remained pretty much the same after an initial 15-pound weight loss in the first month (175 lbs). I have not yet gained the size I hope to eventually have, but I do feel much better about my progress toward more realistic goals that I am making than I have about training in a long time. I also feel good about how the decrease in fat has given me a leaner look.

In addition, I have experienced some unexpected health benefits. I had tendonitis in my left elbow and right and left shoulders that were not going away despite cortisone injections, rest, and rehab. However, the pain is completely gone from both my left elbow and right shoulder, and has reduced in my left shoulder.

Currently, I am being treated for a herniated disc in my lower back. High intensity training, although not eliminating the problem, has caused a reduction in the pain levels on the days that I train. (This is strictly anecdotal and not a recommendation for high intensity training to reduce the pain caused by a herniated disc.)

In addition, my resting pulse rate has decreased from about 75 bpm to 51 bpm (my blood pressure is regulated by medication that keeps it up at 120/65).

After a lifetime of unrealistic physique goals, I still vacillate over what is realistic and what I can really accomplish. With the high intensity weight training program and the encouragement I receive from my personal trainer, Chuck Rainey, I am beginning to see the changes in my physique that I have wanted my entire life. This has pumped up my self-esteem and confidence, and made me feel a whole lot better about myself, and what I can accomplish.

Sincerely,
Paul Smith