Session 11 | Functional and Integrated Training

Session 11 | Functional and IntegratedTraining

© Australian Institute of Fitness 1 / 35

SETTING THE SCENEThe term ‘integrated programming’ is a relatively recent concept that has been introduced into thefitness industry and its definition varies according to the source. In its broadest meaning, it refersto integrating all the different types of training into one program to assist a client to reach theirgoals. This training can include flexibility, cardiovascular, core, balance, power and resistancetraining. You might say that you already do this to some degree.

For this session, our take on integrated training focuses on movements that combine elements ofbalance, stability, strength and power in a progressive manner with an emphasis on correct motorpatterning and recruitment. These integrated movements often involve contributions from theupper and lower body in their execution. Many of these movements involve pathways where thebody moves through combinations of planes. The expression ‘multiplanar’ is used to describe amovement where more than one plane is involved. A client performing a bicep curl performs themovement exclusively in the sagittal plane. A client performing a high to low cable woodchopmoves through the transverse, sagittal and frontal planes during the movement.


Myofacial Sling Systems

The key to our interpretation of integrated exercises is the application of the myofascial slingsystems. The concept of myofascial slings comes from the work carried out by Andry Vleemingand others, and the findings reveal that the body is all connected via certain lines, which you willlearn about in this session. As such, the body works as one integrated and coordinated unit,hence the term integration.

This knowledge has been applied by allied health professionals such as physiotherapists, andconditioning coaches in their quest for optimal human performance, and personal trainers to helpclients develop functional capacity.

As a personal trainer, our exercise prescription needs to match the requirementsof our clients. Many clients will not have the fundamental movement patterns ormuscle synergies required to perform more demanding exercises safely. Theconcept of progression allows us to develop the key motor patterns and musclesynergies required step-by-step. Imagine a ladder where the lower rungsrepresent the most basic muscle activations and motor patterns required for a skillprogression and the upper rungs represent the high end of the skill in terms offorce, complexity and challenge. A prudent personal trainer will always ensurethat the lower runs of the ladder are achieved first prior to allowing the client to ‘climb further upthe ladder’. As a PT, one of your prime roles in individualising programs is to add rungs wherenecessary.

To truly apply the concept of integrated training, you need to have a deep understanding ofanatomy and appreciate that all anatomy is well... connected...via connective tissue. As you mayhave experienced, when one body part ‘packs it in’, it often affects other body parts. With thisknowledge, screening and programming takes on a more holistic approach.

Snapshot

Integrated training involves the elements of balance, stability, strength, power, and maycombine ‘multiplanar’ upper and lower body movementsFunctional training involves individualised exercises that reflect the demands of the sporting,recreational, occupational and activities of daily living for an individual client


Let's Look at Movement

As a personal trainer, how you view movement will largely determine how you train a client.There are lots of ways to look at a muscle. For example, the gluteus maximus can be seen as abig muscle that originates at the ilium, sacrum and coccyx, inserts on the femur and has theaction of hip extension.

Viewed from a different perspective, gluteus maximus has a central role in force closure of thesacroiliac joint. In this role gluteus maximus is a key contributor to pelvic stability and control.

Gluteus maximus also plays a role in enhancing hip joint congruence by helping to give the headof the femur its best fit into the acetabulum. A well-positioned femoral head provides a moreeffective mechano-receptor signal from the articular receptors in the hip joint cartilage, thusimproving proprioception.


Fascia

Fascia was introduced in your Fitness Instructor course. Our entirebody is covered in fascia. It is the background material that providesthe scaffolding for all musculoskeletal structures. In fact, muscle andfascia are interrelated. The outside covering of muscle, the epimysium,is made of fascia. The connective tissue contained within thesarcomere of a muscle is also fascia. Fascia is used to partition thebundles of muscle fibres within the muscle belly. As the muscle nearsits tendon the fascia becomes more prolific. The tendon itself is fascialtissue. Fascia is strong and somewhat elastic and is therefore able tostore force, release force and transfer force.

The thoraco-lumbar fascia (TLF) is a comprehensive array of fascia that is located posteriorlyaround primarily the lumbar and thoracic areas. It consists of a number of layers that surround thepsoas major, quadratus lumborum and erector spinae muscles and contributes greatly to thestability of the trunk.

The fibres of the thoraco-lumbar fascia cross the midline following a diagonal path from the ribson one side toward the iliac crest on the other. The fibres intertwine, creating a substantial fascialcomplex that is able to create links between muscles and allow force to be distributed andtransferred. The transversus abdominis muscle attaches posteriorly to the TLF. This allowstransversus abdominis to influence many of the deep contributors to spinal stability via theircollective relationship to the TLF.

Besides its boney attachments, the gluteus maximus also has a major fascial attachment to thethoraco-lumbar fascia (TLF). The fibre direction of the TLF crosses the midline and allows thegluteus maximus on the right (R) to attach to the TLF and continue a fibre line diagonally uptoward the left (L) where it acts as a major attachment for latissimus dorsi on the (L).

This means that via fascial attachments, gluteus maximus is able to operate functionally withlatissimus dorsi on the opposite side. Myofascial continuity is a term given to a combination ofmuscle and fascia that allows muscles to exert influence beyond their boney attachments andisolated joint actions. In the myofascial continuity described above, the thoraco-lumbar fasciaallows force to be stored elastically and shared between the two muscles. This relationshipallows force from the lower body to be sling-shotted to the upper body and vice versa.


Coach Tip


THE SCIENCE BEHIND SLINGSOur everyday movements utilise the stretch, recoil and support provided by the myofascia thatsurrounds and links certain muscles. These structures form what we call myofascial slingsystems and we naturally use the advantages of the ‘sling’ such as the elastic properties ofmyofascia, to improve sporting performance (throwing, running, jumping etc). In a rehab settingwe focus on building the neuromuscular connection between the muscles of the sling thereforepromoting stability. Hence knowledge of slings in the context of strength and conditioning,rehabilitation and to improve function is crucial.

It’s all about force

The relationship between muscles and their connecting fascia allows force to be transferredacross multiple body segments. This effectively allows load sharing between muscles. Theconnected relationship also provides muscles, tendons and fascia along the myofascialcontinuity with the ability to store and release elastic energy. We will discuss this further when weexplore plyometric and power training in another session.

The functional movement patterns involved in sport, recreation, occupation and everyday life areoften multiplanar. Many of these movement patterns involve rotation. Many of the patterns areperformed under load. The connectedness between muscles and fascia can allow us to safelyand effectively program exercises that can improve the efficiency and execution of these patternsin our clients.

Let’s explore the myofascial sling systems to discover how they work in practice.


Upper Body Muscle Review

You should already have a good understanding of the major muscle groups and are encouragedto keep adding to your knowledge of anatomy. The images below provide detail on both deepand superficial musculature of the upper body.



Lower Body Muscle Review

The images below provide detail on both deep and superficial musculature of the lower body andwill help your understanding of the sling systems.



POSTERIOR OBLIQUE SLING (POS)The myofascial relationship between gluteus maximus, the thoraco-lumbar fascia and latissimusdorsi is known as the posterior oblique sling (POS).

To engage the posterior oblique sling, the gluteus maximus and the opposite latissimus dorsineed to be loaded.

Following are examples of conditioning exercises for the posterior oblique sling for you topractice and perfect.


POS Exercises

To engage the posterior oblique sling, the gluteus maximus and the opposite latissimus dorsineed to be loaded. A basic exercise to link these muscles is the supine ball bridge roll and amore advanced exercise is the unilateral low cable pull – see below.

Supine Ball Bridge Roll

This exercise is a progression from a supine ball bridge. In this ‘roll’ variation, gluteus maximus ismost active with the knees at 900 and the heels loaded. This exercise brings the glute/lat dorsilink into a sling arrangement where the glute gets loaded on the side that is rolled toward and theopposite lat dorsi becomes a static rotator/extensor to maintain trunk position. Transversusabdominis (TA) needs to be actively recruited and monitored by the personal trainer. An activeTA will maintain a high degree of fascial tension for stability. This exercise primes the posterioroblique sling for rotational loading.

Rotating low cable pull

In this exercise the front leg needs to be fully loaded (i.e., minimal weight on the back foot) toensure that gluteus maximus is appropriately engaged. The oblique sling operating in thisposition allows the gluteus maximus to contribute to latissimus dorsi force production. Thisarrangement sets the foundation for posterior rotational work.


ANTERIOR OBLIQUE SLING (AOS)The anterior oblique sling (AOS) is a myofascial continuity that transfers force from one side tothe other anteriorly. The anterior oblique sling links the external oblique on one side with theopposite internal oblique via the linea alba and continues on to incorporate the adductor musclegroup via the anterior pelvic fascia.

The anterior oblique sling is heavily involved in throwing and unilateral pushing activities. Toengage the anterior oblique sling, ensure that the trunk rotates toward the front leg.

Useful exercises to activate the sling relationship follow for you to practice and perfect.


AOS Exercises

The anterior oblique sling is heavily involved in throwing and unilateral pushing activities. Toengage the anterior oblique sling, ensure that the trunk rotates toward the front leg.

Supine diagonal pullover

Lie on your back and start with a traditional pullover with a light bar (as shown).

Progress the exercise and extend the leg on the opposite side to the direction that the bar istravelling – this will place emphasis on the anterior oblique sling. Execute this exercise with aslow down-phase (e.g., 3-5 seconds). Breathing out on the way down ensures a more definitivecontribution from the abs. This exercise sets up the force platform relationships for the functionalwork to follow.

Double to single cable rotating press

This exercise relates to punching, throwing and hitting patterns. The emphasis is on the secondhalf of the movement. Initiate the exercise with a pivot off the rear foot and two arm pull to thechest. There is controlled momentum building at this stage of the movement. There is a fast,explosive pivot and single punch-drive in the second half of the up-phase.


LATERAL SLING (LS)The lateral sling is a myofascial continuity incorporating the gluteus medius, gluteus minimus,tensor fascia latae and the iliotibial band. It is augmented functionally by the contra-lateralquadratus lumborum. The lateral sling is essential for controlling lateral horizontal pelvic shift andis especially relevant in activities such as walking, running and changing direction.

The lateral sling is most fully engaged in single-leg loaded exercises where the foot is on theground (closed chain).

Following are some examples of conditioning exercises for the lateral sling for you to practiceand perfect.


Lateral Ball Hold

This exercise focuses gluteus medius and minimus in their roles as hip stabilisers and positionalsynergists for the knee. In this exercise, push the Swiss ball firmly into the wall via the distal thighin an athletic sprint position. Emphasis is on the support leg in terms of knee alignment. The kneeon the support leg is held in about 150 flexion. Ensure neutral spine and pelvis.


Cable Hip Abduction

This exercise focuses the lateral sling on the support leg. In this exercise, keep the heel of theswinging leg off the ground throughout and pull the foot no more than one shoe length intoabduction. This exercise is a progression from the lateral ball hold.


Lateral Step Drop

This exercise challenges dynamic control in the lateral sling. The client leapssideways off the step and lands in an athletic stance on the outside leg. Thelanding should be controlled and incorporate an eccentric yield of the hip, kneeand ankle. The goal is to exhibit minimal lateral shift through the pelvis on landingand ensure that the knee lines up with the toes as the stable end point.


Lateral Ball Slam and Slide

This exercise combines the lateral sling with the anterior oblique sling. The client stands in astraddle position with the medicine ball raised high to one side. Slam the ball hard toward theopposite foot and shuffle to catch the ball on the rise. Aim for the movement to be rhythmical byutilising the deceleration and pre-stretch at the top to set up the next slam to the other side.


POSTERIOR LONGITUDINAL SLING (PLS)The posterior longitudinal sling is a myofascial continuity between the biceps femoris muscle ofthe hamstring group, the sacrotuberous ligament of the pelvis, the erector spinae muscle and thedeep layers of the thoraco-lumbar fascia.

Exercises that involve combined hip extension and trunk extension engage the posteriorlongitudinal sling.

Following are examples of conditioning exercises for the posterior longitudinal sling for you topractice and perfect.


Prone Back Extension

This is a basic exercise that links the muscles involved in the posterior longitudinal sling. Tomore fully engage the synergy between erector spinae and hamstrings, flex the knees slightly sothat the feet are off the ground and extend the hips slightly during trunk extension in the upphase.


Deadlift - Low Load

The posterior longitudinal sling system comes into play most in the top portion of the deadlift dueto the length-tension dynamics of the hamstring portion of the sling. The symmetrical nature oflower limb positioning and loading in the deadlift also allows the posterior oblique sling to beutilised. When the posterior oblique slings are working bilaterally they cancel out rotation andbecome powerful extensors of the hip and trunk.


Deadlift to Front Raise - Low Load

In the up-phase of a pronated deadlift use the momentum generated from the initial part of the liftto combine into a front raise as the bar passes the knees. The front raise continues through fullrange to finish in the overhead position. In the down phase hold the trunk and lower body stableuntil the bar hits the thighs at the bottom of the front raise before continuing the down-phase ofthe deadlift back to the floor.


Power Jump

At the bottom of the jump ensure that the trunk and hips are in flexion and that the client swingsthe arms to explosively drive upwards.


PROGRAMMING SUGGESTIONSSo now that you have the science behind slings, you might now realise that you may well have infact been incorporating these exercises into your own training... congratulations! Usually theseexercises become firm favourites because they are great to perform – they feel natural and it’soften easier to move the load. That is because we are training the body in the way it wasdesigned to move!

So you have been unconsciously using slings – how do we now consciously introduceintegrated training into programs?

First of all, we suggest that you don’t suddenly change every exercise to suit the slings systems.Secondly, you and your clients need to be ready to perform these exercises, as many of theseare considered advanced. Remember the elements of difficulty – the more elements, the harderthe exercise.

If you have been performing lunges and unilateral row exercises separately, for example, start tocombine these – not only is this more functional but is also time-efficient. Once you havemastered the typical linear movements in most gym programs, start to introduce unilateralprogressions and rotational movement patterns.

By now, you should be able to see how these exercises would fit into an exercise progression –make your programming goal to bring on gradual changes to introduce exercises for the key slingsystems discussed.

Remember the rules we learnt for strength development training programs such as large beforesmall muscle groups, and complex before simple movements. While these rules have a place instrength training, when we design programs for integrated training, we use a different approach.To achieve the integrated movement, it is important to prime the central nervous system toimprove the synergistic relationship in the movement hence smaller muscles involved in a sub-skill of the target movement pattern may be introduced first.


Rules for Integrated Training

Specific rules for exercise order exist when establishing basic motor patterning for skilldevelopment. Rules of skill development are part-practice to whole-practice. A significantdifference is the inclusion of an exercise as a precursor to the target movement pattern you wishto use to achieve the goal in mind such as strength, endurance or power.

Gym Instructors vs Personal Trainers

Gym instructors generally do not have the luxury of spending one-on-one timewith clients like personal trainers do; hence the exercise prescription in gymprograms of basic, compound exercises is appropriate.

Personal trainers however, spend considerable time with clients over weeksof training to firstly learn their strengths and weaknesses, and secondly, beable to introduce the concept of integration training. So what is this?

Remember the rungs of the ladder. Our concept of integrated training is to work with progressionsfrom activation to part-practice of a skill through to whole-practice of a skill. In other words, weprime the nervous system initially to improve the overall performance of the target movementpattern. We make sure we are proficient at the lower rungs of the ladder before we climb higher.

Let’s apply this concept of part to whole practice to a lunge

Part-practice involves breaking the skill (lunge) into its component parts (sub-skills) e.g., lateralpelvic control with appropriate knee alignment is required in the lifting phase of a lunge so wecould use a lateral fitball hold as the sub-skill prior to performing the lunge. This allows thecomponent parts of the skill to be more effectively integrated into the nervous system.


Find, Fire, Fatigue (FFF)

FFF is a user-friendly system to practically apply integrated training.

FFF WHAT? HOW? Example for PowerFind Locate the

muscles withinthe relevantsling

Usually an isolated and/or isometric exerciseto activate relevant muscles

Back extension toactivate muscles ofthe longitudinal sling

Fire ‘Switch’ thesemuscles on

Specific low load exercises at 15-20 reprange to ‘prime’ the nervous system followedby 60 second rest

Low load deadlift

Fatigue Work/fatiguethese muscles

Whole body exercise / target movementpattern where you gradually increase ROMand intensity (load, speed, power) as required

Power jump

Find exercise - back extension

Fire exercise - low load deadlift

Fatigue exercise - power jump


In the fatigue stage, you ideally want to utilise the elastic properties of the fascia to optimisestretch and recoil, power and stability.


Coach Tip


Progressions

These sample progressions use FFF and indicate where a typical client would start so they youcan build the skills and capacity to perform the target exercise. As a personal trainer, you must besatisfied that a client has adequate control through each step of the progression. Remember thatthe client needs to earn the right to progress by demonstrating good control.

It is worthwhile performing the full progression over a number of sessions to ensure that the clientgets the feel of the movement and relates the key components in their nervous system. A trainershould ensure low load on these exercises using a 15 -20 repetition range until they are satisfiedthat the client has the necessary posture, timing and coordination to perform the target skillconsistently.

Posterior oblique sling

Ball bridgeSupine ball bridge rollStanding single low cable pull with opposite foot forwardStanding single low cable pull through rotation

Anterior oblique sling

Barbell pull overDiagonal barbell pullover with contralateral leg extensionCable double hand pull to chest through rotationSingle cable press in standing with contralateral leg forwardDouble to single rotational pull to press

Lateral sling

Lateral ball holdCable hip abductionLateral box dropLateral ball slam and slide

Posterior longitudinal sling

Prone back extensionDeadliftDeadlift to front raise (finish overhead)Power jump


YOUR TURN | SLING INTO ACTIONThis Your Turn consists of a series of questions and/or activities to consolidate yourunderstanding of slings. Visit your Your Turn Diary to complete.


Your Turn | Functional Training Client

Many personal trainers build a business around the notion of 'functional training' using theconcepts of slings or fascial trains. The programming is considered more advanced due to:

the application of the sciencethe practical skills required to break down a movement and piece it together (part to wholepractice) clients being more familiar with 'traditional' gym exercises/equipment and hence need morecueing and guidance with innovative equipment and 'new' movements.

The good news is that you are probably already using many of these 'functional' exercises. Thegoal is to now consciously apply the concepts behind functional and integrated training into clientprogramming and put into practice. This type of training is ideal in either an indoor or outdoorenvironment.

You will need a client which we will call your functional training client. Visit your Your Turn Diary.


ROUND UPTo truly understand integrated training and to appreciate how it can assist functional movementpatterns, you have to put it into practice; to feel the integration; to load and unload and …. Get agreat workout.

Main concepts in the session follow:

The science behind slingsPosterior oblique slingAnterior oblique slingLateral slingPosterior longitudinal sling

Programming suggestionsProgressions


REFERENCESThe following resources were used in the compilation of this material:

Dalcourt, M., Exploring the Fascial System, Part 2, 2010, www.ptonthenet.com

Dalcourt, M., Isolation to Integration Training? Part 2, 2006, viewed at www.ptonthenet.com

Myers, T.W., Exploring the Fascial System, Part 1, 2010, viewed at www.ptonthenet.com

Myers, T.W. Anatomy Trains, Second Edition. (2009). Churchill Livingstone Elsevier (also atAnatomyTrains.com)

Vleeming, A., Force Couples: The Muscular Slings, viewed athttp://dance.gmu.edu/sites/default/files/files/Spring_2012/210_Forced_Couples.pdf


http://dance.gmu.edu/sites/default/files/files/Spring_2012/210_Forced_Couples.pdf

Session 11 | Functional and Integrated Training

Documents