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  1. #1
    Venison Warrior Footballa_19's Avatar
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    Client with heart defects

    hey guys, I just got a new client today, and she has tachycardia. I have had clients with this before so I am not too worried. The real issue is that she also has VSD (hole in the heart), and this is a first for me. She is a very high risk client, but her doctor has given her clearance to exercise, and even get pregnant. Anyone else had a client like this? I love training unique clients like this, but any input would be awesome.
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  2. #2
    Registered User PeteratCastle's Avatar
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    Did the doctor recommend particular exercises? Quite a few of them will do. Some of them will also specifically say "but not to do any isometric exercises with the client" as it puts the heart under too much strain.

    I would really get that info from her doc before doing anything. Maybe even worth getting in touch with the doc, I don't know if that's allowed in the US I've only had 1 client with issues and just spoke to her GP without any problems in the UK (Obv with the clients permissiona nd she informed the GP it was OK to speak to me)

    If he signs her off completely you can just train her the normal way but will have to keep a close eye on her during exercise.
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  3. #3
    Venison Warrior Footballa_19's Avatar
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    Thanks pete, I know isometric exercises are def off the agenda. I'll be the first one to say this one is a little outside the scope of my knowledge so I agree I better just talk to the doc. i am also gonna talk to some of the GP's I keep in my close circle of professionals for times like this. One of the best decisions I ever made. I'll let ya know how it goes for anyones future reference.
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  4. #4
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    Yeah would be cool if you could let us know what they come back with. TBH, I think this is outside every PT's scope so would be great to see what the general advice is for someone with issues like this.
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  5. #5
    Venison Warrior Footballa_19's Avatar
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    Hey guys, I have finally figured out this program for the most part and figured I would share. Upon doing some research I came across 4 articles that studied the effects of HIIT on patients recovering from heart disease and defects. The results showed significant improvement in cardiovascular response from patients undergoing HIIT cardio, from patients doing continual training. Increases in stroke volume, lowering of resting heart rates, and better overall cardiac output were all seen in the HIIT patients. Since she has a hole in her heart, I have decided to go with a shotgun approach, and hope that by increasing her stroke volume, I can bring more oxygen into the ventricle than before, and even more over time. I might lose more, but hopefully it isn't enough to overcompensate for the new increased amounts coming in. Obviously by lowering her heart rate we can aid in helping her tachycardia as well. I also have chosen to go with full body exercises, and have advised her to keep up on her aerobic cardio on days she isn't with me.

    This program was cleared by her cardiologist when I sent it to him. I am hoping it will work out well. I am always interested in seeing if plans like this will work, by doing the research it takes to get some answers and find new ways of training people. If anyone wants the articles, let me know and i'll see if I can get em to you. Thanks guys.
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  6. #6
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    Interesting and cool. HIIT for someone with a hole in their heart? Never woulda thunk it. Thanks.
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  7. #7
    Registered User rancid_theclash's Avatar
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    aren't most compounds Isometric (erector spinae, abs, etc.) ?? So she wouldn't be able to do those??
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    Originally Posted by rancid_theclash View Post
    aren't most compounds Isometric (erector spinae, abs, etc.) ?? So she wouldn't be able to do those??
    I think you need to look up what isometric means.
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  9. #9
    Registered User rancid_theclash's Avatar
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    Originally Posted by WoofieNugget View Post
    I think you need to look up what isometric means.
    huh???

    http://en.wikipedia.org/wiki/Isometric_exercise


    Also, this from http://www.livestrong.com/article/41...#ixzz2LeGsEyqS
    Erector Spinae
    "Although you may not think of the squat as a back exercise, the erector spinae muscle group contracts isometrically -- without shortening and lengthening -- during both the downward-movement and upward-movement phases of the exercise. The erector spinae group includes the iliocostalis, longissimus and spinalis muscles that span the length of your back on both sides of your spine, attaching to various structures therein. Although the muscles don't contract concentrically or eccentrically when you perform the squat, they are the primary spine extensors and also assist with lateral, or sideways, spine flexion and torso rotation ranges of motion."

    etc. etc. etc.
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    I would get written instructions from the Doctor on what she can and can't do. Have the Doctor sign it. It may come back to you if you don't CYA.
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    I can understand where you guys are coming from. I have an email with his signature, but not a physical one. I see your point rancid, and from what he told me, he said to just keep her moving. He suggested step up onto boxes with a db press as an example. Although this would be isometric on the core, I am guessing there must be a different effect on the heart. I haven't seen any research on that subject. That would be a cool study to examine, core isometric effect vs extremity isometric effect on the heart.
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    Originally Posted by rancid_theclash View Post
    aren't most compounds Isometric (erector spinae, abs, etc.) ?? So she wouldn't be able to do those??
    When he, the doc, says to avoid isometric exercise I think he means to avoid things that keep her static. Like a plank or something.

    You could argue that no compound exercise is isometric, or any exercise for that matter if you want to get really nitty-gritty about it, because each exercise requires some form of flexing (concentric) and relaxing (eccentric). You could also argue that all exercises are isometric or, rather, that they have an isometric component to them. I am just rambling and word-playing now but I think you get my point.
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  13. #13
    Venison Warrior Footballa_19's Avatar
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    Originally Posted by LostLlama View Post
    When he, the doc, says to avoid isometric exercise I think he means to avoid things that keep her static. Like a plank or something.

    .
    This is what I gathered from his email. I believe that anyone could argue that every exercise has an isometric contraction in the phase between concentric and eccentric. This makes sense to me though, because the majority of people do not know how to breathe when exercising. 99% of my clients are "gut" breathers when they start my program. They rely so heavily on stomach breathing, that when in an isometric exercise they "brace" their core to create stabilization, which makes them hold their breath while still performing the exercise. That creates a lot of stress on the cardiovascular system by forcing the heart to work harder for a less amount of O2. This brings up a good point. Correct breathing is a staple for a person to be able to get 100% out of their workouts. I teach all my clients to chest breathe by making them contract their diaphragm and then try to breathe while bracing. It's funny how hard this can be for some people. controlling intra-abdominal pressure by doing this has many benefits. It trains the diaphragm and transverse abdominals to be stronger, creates better stability in the hips, and of course more efficient oxygen uptake. I might even go so far to say that if one was properly trained enough, and had the right cardiovascular conditiong, they could overcome any stress on the heart during an isometric exercise. Just my 2 cents since I was on the topic.
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  14. #14
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    Originally Posted by LostLlama View Post
    When he, the doc, says to avoid isometric exercise I think he means to avoid things that keep her static. Like a plank or something.
    Oh ok , In this context Isometric meant something like plank or dead hang aha I hear ya now
    Originally Posted by Footballa_19 View Post
    I can understand where you guys are coming from. I have an email with his signature, but not a physical one. I see your point rancid, and from what he told me, he said to just keep her moving. He suggested step up onto boxes with a db press as an example. Although this would be isometric on the core, I am guessing there must be a different effect on the heart. I haven't seen any research on that subject. That would be a cool study to examine, core isometric effect vs extremity isometric effect on the heart.
    lol that if they did such a study, the results would have been great to post in this thread LOL

    lol cheers guys
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