F1 For the unfit

So my stepdad wanted to start to workout. He is a GolfPro,chainsmoker and hasnt exercised in 30 years. Has been in several car crashes and has an array of back and shoulder problems. After some hill sprints (3*7s) he was at the point of nearly fainting. We did some F1 after and due to his big stomach he couldnt do the PE1 of the SLS, he however did the PE2 instead and all the other exercises of today went well (MnPe1/SLPe1 and some weights) as well as their IM. The reason Im posting is: is it okay to skip exercises he cant do due to his injuries/body state? And are there any thing to keep in mind especially due to him being overweight and having injuries in his shoulder and back?

Thanks

It is great that he wants to exercise with you;

However, it would be even better if he would also clean up his diet, and address his addiction.

Maybe it would be a good idea for him to get medically checked and get a green light from his physician.

As far as skipping exercises are concerned, maybe he should still attempt every time to do the ones he cannot yet perform until he can, then add a couple of sets of the progression that he can perform?

That will give him something to aim for, and yet get a workout out of his session.

People with more experience will chime in too.

Have you considered some of the scaling methods discussed in other threads to help with the deck squat? A raised surface and or a small weight for counter-balance may enable him to get over his feet enough? Maybe allowing him to have his knees apart initially will provide some space for better hip angle and get him into a deeper bottom position.

Not sure about hill sprints for an out-of-shape, overweight, injured chain-smoker for a first workout!?

Depends on the nature of the injuries - whether they can be improved with mobility/strength work, or are the type that are a genuine and permanent limitation.

Once he gets into a regular exercise habit, he's naturally going to feel a lot more positive regards his eating/smoking. It's a big change for him, and trying to create/alter too many habits all at once is usually a show-stopper. There's are some studies showing that in some ways willpower is rather like a muscle - It gets tired, but can be strengthened.

George Launchbury said:

(...) Not sure about hill sprints for an out-of-shape, overweight, injured chain-smoker for a first workout!?

LOL, indeed!

If he survives, for sure he is good to go!

George Launchbury said:

Have you considered some of the scaling methods discussed in other threads to help with the deck squat? A raised surface and or a small weight for counter-balance may enable him to get over his feet enough? Maybe allowing him to have his knees apart initially will provide some space for better hip angle and get him into a deeper bottom position.

 

Not sure about hill sprints for an out-of-shape, overweight, injured chain-smoker for a first workout!?

 

Depends on the nature of the injuries - whether they can be improved with mobility/strength work, or are the type that are a genuine and permanent limitation.

 

Once he gets into a regular exercise habit, he's naturally going to feel a lot more positive regards his eating/smoking. It's a big change for him, and trying to create/alter too many habits all at once is usually a show-stopper. There's are some studies showing that in some ways willpower is rather like a muscle - It gets tired, but can be strengthened.

In retrospect, it wasnt the best first workout idea I have had, however I just didnt realize how low his fitness level was until I saw it.

Ill look into the alternative solutions for the Deck Squat, however i really do doubt that he needs it.

About the injuries, I will post details in an hour or so when he gets back, because Im not familiar with them. I know he has troubles with his rotator cuff etc. 

His Diet isnt that bad to be honest, he probably came off as obese in the OP, he eats the same stuff I eat, however up to 2 months ago he would also drink green smoothies which helped him alot. The trouble is he eats a lot of junk, gummibears,coke etc. However hes willing to stop with that stuff. 

I think that after 2 months of working out he will feel much better, and may have even lost some fat.

FredInChina said:

It is great that he wants to exercise with you;

However, it would be even better if he would also clean up his diet, and address his addiction.

 

Maybe it would be a good idea for him to get medically checked and get a green light from his physician.

 

As far as skipping exercises are concerned, maybe he should still attempt every time to do the ones he cannot yet perform until he can, then add a couple of sets of the progression that he can perform?

That will give him something to aim for, and yet get a workout out of his session.

 

People with more experience will chime in too.

Exactly, he is working on both. 

We could go to our physician, however he was lately at a Chiropractor who gave him the green light. 

Your idea of the revisiting the exercises is very good, i like it. 

Thanks to everybody

It is not wise to skip exercises. If a person finds the introductory exercises difficult you can use the mobility exercises as their main work. For this individual this is probably the best focus for now. Go slow and address weaknesses. If there is something specific post back here and we can try to address it without compromising anything.

Robmob said:

Exactly, he is working on both. 

 

We could go to our physician, however he was lately at a Chiropractor who gave him the green light. 

 

Your idea of the revisiting the exercises is very good, i like it. 

 

Thanks to everybody

You are fracking kidding me!!!

A chiro has no business giving someone a medical clearance for exercise. That comes from his GP or cardiologist, not anyone else. Chiros don't evaluate the entire health picture. Good chiros are great, and can absolutely say "Hey, your elbow's fine now, go play ball again" but to tell someone in your step-father's condition that he is ok to exercise is absolutely unacceptable. If he gave a blanket medical clearance you should sue that guy for malpractice, that is outside his scope of practice.

With your stepdad's exercise and smoking history, it is fairly certain that he has some level of cardiovascular disease, so it's important to scale his exercise slowly. It's all fun and games until he has a heart attack, and then he's too busy dying to enjoy the rest of the workout.

Dropping the junk food would be outstanding, and so would quitting smoking, but take it one step at a time. Tossing everything cold turkey will probably be too much for him to handle, but if he CAN do that then he should. If not, start with whatever he's the most open to quitting first.

For his cardiovascular exercise, he really needs a stress test. Only an MD can order that. You really should go in, tell them what the experience was, and ask for a prescription for a stress test so that you know what your step-father's current functional capacity is, whether or not he has any underlying heart conditions that may limit his safe exercise abilities, and get an exercise prescription so that he knows how to progress.

High intensity stuff increases blood pressure, which stretches blood vessels. That's a recipe for breaking a plaque loose in someone like your step-father, and that's what causes strokes, pulmonary embolisms, and heart attacks. Which one it is depends on where stuff gets stuck... Please be careful, and go get the right evaluations.

With a little patience and a good exercise prescription, your stepfather can absolutely make incredible progress, and probably safely achieve a level of health and fitness that WILL allow him to do hill sprints with you.

Joshua Naterman said:

 

For his cardiovascular exercise, he really needs a stress test. Only an MD can order that. You really should go in, tell them what the experience was, and ask for a prescription for a stress test so that you know what your step-father's current functional capacity is, whether or not he has any underlying heart conditions that may limit his safe exercise abilities, and get an exercise prescription so that he knows how to progress.

 

High intensity stuff increases blood pressure, which stretches blood vessels. That's a recipe for breaking a plaque loose in someone like your step-father, and that's what causes strokes, pulmonary embolisms, and heart attacks. Which one it is depends on where stuff gets stuck... Please be careful, and go get the right evaluations.

 

This is a rare topic which I am actually qualified to comment on. I've been a practicing paramedic for years and practicing EMS in some form for almost 15 years. While I've found the scenarios Josh lists above to be very rare, the effects are catastrophic. I've only seen 3 or 4 exercise induced heart attacks in my career, but the results tend to be very bad. Perhaps that's because the body is already in a stressed state when the heart attack begins.

As I said, they are rare, but only last year I saw exercise induce a heart attack in a 40-year-old firefighter. He was generally healthy but for those damned plaques. The heart attack killed him and seeing the dead body of my friend on the firehouse floor was one of the most terrifying moments of my life. Fortunately we resuscitated him successfully. That's luck, not skill and I wouldn't suggest anyone bank on it. Despite the miracle stories on TV most cardiac arrest victims die. I tell this story only to make sure that you press him to do this before you do anything. 

As for the chiro, either your stepfather misunderstood him or the chiro was acting very irresponsibly. I'm more qualified than a chiro to make such a judgement and my schooling totaled about the same as that required to get a barber's license in most states. I have no strong opinions on chiros one way or the other but I'd say that being cleared by your chiro is about as meaningful as being cleared by the lady who checks out your groceries. Maybe it's more like asking a police officer to rescue a cat from a tree.

He needs to see a physician and do some sort of stress test. They favor the fairly gentle sub-maximals now so it will probably last less than 10 minutes and won't even hurt.

I know heart attacks, strokes and the like seem unlikely but they do, in fact, happen. 

As far as deck squats go, have you considered starting him on say, standard squats?

Hello there, 

Excuse me for not replying in the last couple of days. Also excuse my shortcoming in saying that the Chiro gave him the green light, it was physically wise, due to a back problem he had. 

Talking to him he revealed that he had a complete check up a few months ago, and everything is fine so far, nor is there a heart disease. About the stress check, we have to look for one here, since I live in the Canary Islands, which is kind of remote of everything. However we will look into it. Since we know of a cardiologist here. 

I wont do hill sprints with him until I see him fitter, this is basically my first time that I have told anybody what to do fitness wise, so there where going to be mistakes. 

He's going to get started with some very light cardio which my martial arts instructor will pick out, since he is a bit knowledgable in the topic of unfit individuals. 

And about the deck squats, we are going to try to do some of the variations where he comes off something higher, and yes, we have been doing normal squats. 

And thank you very much for your concern, I really feel like I should have thought of this better.

Daniel Burnham said:

It is not wise to skip exercises. If a person finds the introductory exercises difficult you can use the mobility exercises as their main work. For this individual this is probably the best focus for now. Go slow and address weaknesses. If there is something specific post back here and we can try to address it without compromising anything.

Daniel makes and extremely good point here. For the deconditioned mobility work is often very difficult for them, it is a workout not just mobility. He needs to feel good after training, not defeated.

Indeed.

If you want guidance on how to help your step-dad scale his cardio, you can consult the ACSM guidelines. They will guide you quite well in helping him make the transition from an out-of-shape old man to a reasonably fit older guy who is ready for more intense cardiovascular training.

If you look at ACSM strength training guidelines, which again are aimed at taking someone from poor condition to decent (not taking a reasonably decent athlete and making them into an Olympian) you will see the recommendation of starting with 1-2 sets of 8-12 reps on 8-10 exercises  and scaling them up to 3 sets of 8-12 reps over a ~3-4 month period.

As Nic and Daniel stated, you can use the mobility work that is included in F1, along with the lowest level exercises to basically create this exact structure.

If I were you, for your step-dad I would start with Week 1 of F1 and take around 12-16 weeks to build up to week 7-9. If he can tolerate the 3 sets, that's excellent. I would probably keep the first 6 weeks of his training at 3 sets, which is kind of how this scaling would go.

It is important to remember two things:

1) His tissues are stiffer than yours, and therefore easier to injure. It takes time for them to become more resilient, so take progression with him slower than progression for you.

2) He needs to be having his protein in 30g pulses. 15g of protein isn't going to do much of anything for him, so if he gets 6 servings of 15g of protein he's going to see very poor results, while you would see pretty decent results. Older people (50-60+), for whatever reason, need to get the 30g serving size of protein. If they do, they have very similar protein synthesis responses to younger people. If not, they won't see anywhere near the gains that they really SHOULD see.

Remember those two things, apply them with him, and tell us about the good results!

As far as SLS/PE1 goes, maybe start him on spinal rocks to begin with.

I could do a pistol before I could squat with my feet together, so I can understand why he would be having difficulty with the move.

What are spinal rocks?

FredInChina said:

What are spinal rocks?

Basically the "deck" part of the squat.

Noted, thank you

mmm said:

This is a rare topic which I am actually qualified to comment on. I've been a practicing paramedic for years and practicing EMS in some form for almost 15 years. While I've found the scenarios Josh lists above to be very rare, the effects are catastrophic. I've only seen 3 or 4 exercise induced heart attacks in my career, but the results tend to be very bad. Perhaps that's because the body is already in a stressed state when the heart attack begins.

 

As I said, they are rare, but only last year I saw exercise induce a heart attack in a 40-year-old firefighter. He was generally healthy but for those damned plaques. The heart attack killed him and seeing the dead body of my friend on the firehouse floor was one of the most terrifying moments of my life. Fortunately we resuscitated him successfully. That's luck, not skill and I wouldn't suggest anyone bank on it. Despite the miracle stories on TV most cardiac arrest victims die. I tell this story only to make sure that you press him to do this before you do anything. 

 

As for the chiro, either your stepfather misunderstood him or the chiro was acting very irresponsibly. I'm more qualified than a chiro to make such a judgement and my schooling totaled about the same as that required to get a barber's license in most states. I have no strong opinions on chiros one way or the other but I'd say that being cleared by your chiro is about as meaningful as being cleared by the lady who checks out your groceries. Maybe it's more like asking a police officer to rescue a cat from a tree.

 

He needs to see a physician and do some sort of stress test. They favor the fairly gentle sub-maximals now so it will probably last less than 10 minutes and won't even hurt.

 

I know heart attacks, strokes and the like seem unlikely but they do, in fact, happen. 

that is scary. can doing a stress test let me know what degree of plaque i could have in my body? I've dealt with angina before but could not determine if it was due to a sternum injury i sustained when i was around 10-12yrs old or due to all the junk food i ate until around High School. I've never suffered an angina like pain while training F1, especially in the upper body portion of the exercises, but I have in the past and immediately discontinued moving until I caught my breath and felt myself move from that panicked "wtf is this horrible feeling in my chest?" to just sitting and chilling out for a while. 

KeilaniG said:

that is scary. can doing a stress test let me know what degree of plaque i could have in my body? I've dealt with angina before but could not determine if it was due to a sternum injury i sustained when i was around 10-12yrs old or due to all the junk food i ate until around High School. I've never suffered an angina like pain while training F1, especially in the upper body portion of the exercises, but I have in the past and immediately discontinued moving until I caught my breath and felt myself move from that panicked "wtf is this horrible feeling in my chest?" to just sitting and chilling out for a while. 

I'M NOT A DOCTOR AND YOU SHOULD DISCUSS THIS WITH A DOC THE NEXT TIME YOU SEE ONE. (end disclaimer)

A stress test uses an EKG to give an idea about how well the heart is functioning. An EKG basically a "video" of how the electricity is moving through the heart. If the electricity is using the right "roads" and traveling at the right speed, it's good. It doesn't give a picture of what kind of plaques are built up in your vessels. 

It can give hints. In someone your stepdad's age, for example, plaques have lined the blood vessels. The heart has to work harder to move blood and in some cases, the plaques may have blocked the supply of blood to the heart muslce. In these cases, the heart's electricity has to take different "roads". We can see that in an EKG.

There are better tests to measure that, however. There are some methods using sound (similar to sonograms used for looking at fetus'). There are really fancy tests in which they go into the the vessels with a tiny camera and look around.

I"M NOT A DOCTOR but I can tell you that you probably don't need to worry too much. Generally folks your age don't die of heart attacks unless they have existing heart disease. As I remember, you've been a pretty active guy and this helps keep the pipes clean, even with a bad diet. Additionally, the plaques build up slowly, over decades. If I recall you're a pretty young guy... you've barely been on the earth long enough to be at risk for this.

There are, of course exceptions. These days some people eat so horribly from the moment they're born and lay around playing video games and watching TV. They are morbidly obese and they die young. These folks aren't generally spending their time on GST website and you're not in the category.

The other possible factor is an existing heart problem. It's possible that you have some sort of freak congienital (read: "born with") disease but it's pretty unlikely. Chances are it would have showed up by now. There are very rare cases of these going undiagnosed, but they're pretty uncommon.

There are many causes of angina. It can be caused by stress. It can be caused by muscle pulls. It is famously caused by anxiety. The most common cause, in my experience, is indigestion. In short, there are a lot of things that might have caused your angina and most of them are harmless.

I think you should rest easy, but bring it up with your doctor the next time you see him. Again I'm only speaking broadly. The stuff I've written should only be seen as general information, not an answer about your specific case. To get a real answer you'd need 1) to see a physician 2) to receive a thorough exam 3) to complete any follow up tests.

If it hasn't bothered you with your current training, however, I see no reason you should stop training or hit a panic button.

No matter what your stress test says, you can still have a stroke tomorrow morning.

FredInChina said:

No matter what your stress test says, you can still have a stroke tomorrow morning.

Dirty boy