Hello! We are back from a two-month-long hiatus! Great to be back with you all again.
Since my last article, I’ve started my final year in medical school and am now preparing to apply for residency in Physical Medicine and Rehabilitation… aka Physiatry. It’s been a busy few months and it’ll continue to be busy throughout the year, but I’m more than ready to start writing again. My goal for the summer and fall is to pump out at least one article a month minimum. Following residency applications, I will be able to get back to a more frequent writing schedule.
Thank you so much for your continued support - I truly appreciate it!
- Ty
We’ve heard slogans like “Exercise is Medicine,” and we all certainly know that exercise is “good for us,” yet so many people don’t exercise. Why? I’m sure there are many reasons, but with this article I wish to start a new series addressing one of the main reasons: paralysis by plentitude.
There are so many options and so MUCH information on exercising, how to exercise, what you should do, what you shouldn’t do - etc etc etc - that it gets to be OVERWHELMING. A person becomes paralyzed by a plentitude of information. It’s my goal here to cut through the noise… to give a basic overview of how to develop your own exercise program, delving into different goals and concepts, how it connects to medicine and your health, all while building a sample program that you can feel free to use!
Disclaimer – This article also assumes that you have the basics of health down pat (sleep, steps, sunshine, food, etc). Additionally, this article is not meant to be a comprehensive deep-dive into the nuances of different styles of programming and what not. This article seeks to offer a template from which to build your own exercise program that is scalable. To give you the tools, knowledge, and conceptual understanding necessary to succeed. To start a series of articles examining goal-setting and program creation… There is more than one way to skin a cat… this is but one of those ways
Before we start, a question to ask - why should you listen to me?
Before medical school, I got my degree in exercise physiology (which I lovingly refer to as "jock science") and was a strength coach for seven years. Working with a variety of people over the course of my career, from professional athletes in Frisco, TX, to regular folk (like you and me) in Milwaukee, WI, I had the great privilege of helping many people better their lives and reach their goals. I’m currently working as an online personal trainer while in school, but I'm no longer accepting new clients. Exercise has always been an integral part of my life… which is a story for another time.
Ok, let’s get on with it.
Here’s young Tyler in Texas… seems he brought the Wisconsin weather with him.
The K.I.S.S. Principle
As a strength coach, and generally in my everyday life, I am a strong proponent of the K.I.S.S. Principle. Every morning I wake up, look at the person in the mirror, and tell them to Keep It Simple, Stupid… (not really). However, simplicity is an important lens through which to explore exercise programming – “simple” consistently applied over time = improvement.
When I say simple, I’m not referring to our understanding of exercise. It certainly can be boiled down to “see heavy thing, lift heavy thing,” or “go run up that hill,” but it’s much more than that. Like the great physicist and teacher Richard Feynman said – “If you can’t explain it simply, you don’t understand it well enough.” Comprehension and Understanding are best exemplified as complicated concepts applied and explained simply.
Using the lens of “simple,” effort must be poured into the foundation of our program - its structure… its bones… as in the strongest houses are built on rock and not sand. If our foundation is strong, the rest will follow… so let’s build our foundation.
With our KISS principle as a guide, we must organize our program’s vision and direction. What are we trying to achieve? How will we know if we’ve achieved it? This then coms in the form of different qualities of movement. From this point of view, we can produce three total qualities summed up in the following: move smooth, move strong, move all day long. Improvements in measurements of these qualities will be how we know we are achieving our health and fitness goals.
“Move smooth” refers to neuromuscular development and technique… aka how “well” a person moves. “Move strong” refers to musculoskeletal development… aka how strong you are. And finally, “move all day long” refers to cardiovascular development… aka endurance and heart health! These are the main facets of athletic development and general fitness. It’s improvements in these qualities we are shooting for. The goal now, with our exercise program, is to balance these three categories.
Say you want to strength train three times per week. You’re just looking to get fit again and you’ve got no more than 45 minutes to do it because you’re busy, have kids, etc. To build the program structure, we must focus primarily on the “move smooth” quality. This refers mostly to exercise selection, program direction, and is addressed in a strength training program.
Imagine three empty blocks. Now stack them on top of each other. This is the skeleton of the program. The top block (…or “Block 1”) is where you’ll place your first “main” exercise, which is your main movement emphasis for the day. Block 2 (the middle block) is where you’ll place your second “main” movement. And Block 3 is reserved for everything you didn’t do within the theme of the workout for that day.
Each Block has room for 3 exercises. Your first 2 blocks will contain the main movement followed by two supplementary exercises: one exercise that focuses on stability and the other on mobility. These supplementary exercises support your performance during the main movement (more on that another time).
Movin’ Smooooth
Now that we have our structure, we must know how many different ways our body can move so we can flush out our program.
You can push and pull with both your upper body and your lower body. Pushing and pulling with your upper body is pretty self explanatory - e.g. a pushup or pullup. With your lower body, you can generally think in terms of squat and hinge for pushing and pulling. A squat is considered a lower body “push” and a deadlift is considered a lower body “pull.”
Oh, and you can rotate! Don’t forget to rotate.
There are some exercises that don’t fit neatly into this schema. For instance, a Turkish get up would be hard to categorize like this. Additionally, an Olympic lift (e.g. snatch, clean, and/or jerk) would be difficult as well.
And that’s it. Let’s get some examples on the board…
Examples:
Lower Body
Upper Body
Rotate
Anti-Rotation
Rotation
These are our main categories of movement; a guide to refer to when selecting exercises. From here, we must organize them further into sub-categories for the purpose of building balance, harmony, and as comprehensive foundation for our program as possible. These sub-categories include “dominance and direction,” “open vs closed chain,” and “joints involved.”
Definitions:
Direction and Dominance —> Direction is exactly what you think it is. For pushing and pulling, it’s important to specify whether the movement is horizontal (like a bench press) or vertical (like an overhead press). When rotating, you can also choose which direction you rotate (Horizontal, Low-High, or High-Low) as well as specifying rotation or anti-rotation (like a Palloff Press). Dominance refers to lower body movements. For squatting and hinging - aka lower body push and pull - it’s important to note which joint is managing the most stress; e.g. hip-dominant (like a Glute Bridge or RDL) or knee-dominant (like a Squat or Lunge). There is some leeway between these terms, for example, a Kettlebell swing is a hinge movement and hip-dominant but would be considered a lower body push. Same as the barbell hip thrust.
Open vs Closed Chain —> The Kinetic chain is a topic that deserves its own post. Briefly, it is an engineering concept (first developed by Franz Reuleaux) that was later applied to the body. It states that the body can be understood as a series of rigid segments (bones) connected by joints. These linkages allow for one joint to influence another down the chain. Like when cracking a whip, you apply some force to the handle of the whip, that force is propagated down the whip until it’s multiplied and released at the end of the whip. Applied to the body - when Hank Aaron hits a homerun, the force necessary to do so begins in his feet, is multiplied by his hips, and is transferred to the end of the baseball bat. Within this framework, an exercise can be either “open chain” or “closed chain.” To categorize exercises, we must think in terms of fixed and fluid: one joint will be fixed and the other will move relative to it… aka fluid. In open chain exercises, the distal segment (the segment furthest from your torso) moves on the proximal segment (the segment closest to your torso). An example would be a bench press, where your hands and wrists move in space and your shoulders stay fixed in relation to them. In a closed chain exercise, the proximal segment moves on the distal segment (proximal is fluid, distal is fixed). An example here would be a pushup: it’s categorized as an “upper body push” like the bench press, however the shoulders move in space and your hands/wrists are fixed to the ground.
Generally speaking, a main lower body movement will be closed chain because our feet spend most of their time putting force into the ground (e.g. picking something up, jumping). And a main upper body movement will be open chain because our arms make most of their impact out in space (e.g. throwing a ball, reaching for the top shelf). This isn’t to say legs never move in an open chain manner (e.g. throwing a kick) or that arms never move in a closed chain manner (e.g. crawling), but just to point out that life has its preferences…
Joints Involved —> And finally we must note how many joints are involved in an exercise. A compound movement refers to an exercise where two or more joints are involved (e.g. Squat, Barbell Row). An isolation movement refers to an exercise where just one joint is involved (e.g. Bicep Curl, Leg Extension). Compound movements are much better for strength and movement pattern development, as you can lift more weight much more safely because more than one joint equals more muscles stimulated. Isolation movements, like the leg extension, should NOT be completed with heavy loads. The risk-to-reward ratio is way too high. Additionally, one can choose to use both limbs in a movement or just one, as is the case with a dumbbell bench press. It can be bilateral (where two limbs are used) or unilateral (where one limb is used).
Examples:
Lower Body
Knee-Dominant
Closed chain
Compound and bilateral
Hip-Dominant
Closed chain
Compound and unilateral
Knee-Dominant
Open chain
Isolation and bilateral
Here’s an example of exercise selection visualized as a conveyor belt. As you run through the belt, you’ll notice not all combinations are compatible. For example, it would be nonsensical to create an Upper Push exercise that was organized into Vertical, Closed, and Isolation sub-categories…
Putting it all together
That’s enough information for now, I think! We have our parameters (3 times/week, less than 45 minutes a session) and our direction. Below is a sample program I whipped up, let’s examine it with our newfound programming knowledge.
What is “A” and “B”?
These indicated specific workouts. “A Day” refers to the workout on the left. “B Day” refers to the right. Each days has its own theme: A = lower push/upper pull and B = lower pull/upper push. Each workout follows that theme.
These are only two sessions, but we want to strength train 3x/wk?
In the name of simplicity, you will alternate workouts each week. For example - Week 1 - A/B/A; Week 2 - B/A/B; Week 3 - A/B/A and so on.
What about balance?
On a weekly scale, further balance will be achieved through conditioning and cardio workouts (“move all day long” - beyond the aim of this article) as well as set/rep schemes for each exercise (“move strong” - also beyond the aim of this article). Additionally, balance is built into the program through supplementary exercises (e.g. “Banded Clamshell,” or “Side Plank w/Rotation”) and the warmup for each workout day. Deeper examination of supplementary exercises and the warmup is beyond the aim of this article.
What about balance within the workout itself?
Each exercise follows the day’s theme. Let’s look at the A day. Back Squat and Lat Pulldown are the days main exercises, and each follows the “Lower Push/Upper Pull” theme. Turning to Block 3, we see “Kettlebell Swing,” “Inverted Row,” and “Palloff Press.” We know that Palloff press checks off our rotation requirement, but what of the others? The kettlebell swing also follows the Lower Push theme, but is hip-dominant. The Back Squat is a lower push, but is knee-dominant. How about the upper pull theme? The Lat pulldown is a vertical pull, open-chain movement. The Inverted Row is a horizontal pull, closed-chain movement.
How about progression?
This something we will touch on in later articles, regarding movement (move smooth), strength (move strong), and conditioning progression (move all day long).
In Conclusion
Just to recap, we learned in this article how to build a program and how to select exercises in a way that is measurable, logical, and scalable! Future articles will further examine movement progression via supplementary exercises and warmups. Additionally, set/rep schemes for strength development and conditioning for cardiovascular development will be discussed.
Stay tuned and get moving!
I love all this knowledge you have shared. I don't know how to apply this in moderation for an OLD lady
HA!! I like the things I learned at rehab when I had knee surgery. Still do those from time to time. Guess I have gotten lazy . I will try to keep doing those and then incorporate some of your techniques and knowledge of how the body should move. Right now I have an issue with my lower back and upper legs. Hate going to the chiroprator all the time. He does give me relief but it doesn't last. Probably beause I don't exercise enough.Anyway Thank you for the interesting blog.