Fortunately, exercise seems to have a positive effect on bone mass throughout the adult years. Most studies of the relationship between exercise and bone mineral density have been conducted in women because they have a greater risk of suffering a bone fracture with age in comparison to men.

The studies suggest that whether you walk, jog, or run, these weight-bearing exercises tend to have a positive impact on bone mass.

And this seems to be true for women before and after menopause. Progressive resistance training using lifts that load the hip and back may be even more effective for building bone mineral density in premenopausal and postmenopausal women.

In young women, progressive resistance training and running both produced an increased bone mineral density in the lower back. And although men haven't been adequately tested to date, similar beneficial effects of exercise are anticipated.

The key message from these studies is that weight-bearing exercise and progressive resistance training can help to protect the health and strength of your bones, regardless of your age and gender.

For adults, the American College of Sports Medicine recommends a combination of weight-bearing exercise virtually every day, along with progressive resistance exercise times per week. So the good news is that all the exercise you're doing can stimulate the building of stronger bones.

The bad news is that certain athletes have low bone mass or sports osteopenia. And unfortunately, this is all too commonly diagnosed in female athletes. As a consequence, they are at high risk for stress fractures during exercise.

A stress fracture is a partial or complete break in the bone. It's caused by the bone's inability to withstand repeated stress of a non-violent nature, such as running. Stress fractures occur because microscopic damage in the bone accumulates and is not adequately repaired by the remodeling process.

An increase in the load on a bone can cause a stress fracture. In addition, factors that interfere with bone remodeling and repair, or those that decrease bone strength, are culprits. The question is, if exercise is such a positive stimulus for making bones stronger, why do some athletes have low bone mineral density and weak bones?

It turns out that calorie intake is a critical factor in how strong your bones are. Some athletes, particularly women involved in endurance sports such as running, or sports where being lean is considered ideal, such as dancing and gymnastics, restrict their intake of calories while still training and competing at a high level.

The body adapts to the calorie shortfall, and these athletes may have very stable body weights, despite consuming a low level of calories.

But the physiologic cost is high. The precious calories consumed end up preferentially used to meet the daily energy demands of training and competing.

Unfortunately, this means there aren't enough calories left over to fully support other normal physiologic functions. One casualty of consuming too few calories is reproductive function.

Often, these athletes stop ovulating and stop having their normal monthly menstrual periods. While at first glance that may seem like a welcome convenience, the effect on bone is devastating.

Menstrual periods stop because hormones that are involved in reproduction, such as estrogen, are in short supply when the body is lacking in calories. However, just as in menopause, when you take away the inhibiting effects of estrogen on cells that break down bone, suddenly bone resorption far outpaces bone formation.

As the number of missed menstrual cycles accumulates, bone mineral density continues to decline, leading to weaker bones. In fact, physically active women with menstrual irregularities have 2—4 times the risk of stress fractures than women with regular periods. Also, women who suffer from stress fractures are more likely to suffer debilitating and painful osteoporotic fractures later in life.

Moreover, the current thinking is that the loss of bone mass due to low calorie consumption leading to missed menstrual cycles can't be reversed later. So it's a problem that needs to be identified quickly, and resolved sooner, rather than later.

The medical term for the cessation of menstrual periods in women of reproductive age is amenorrhea , and unfortunately it is a condition that seems to be disturbingly common in certain female athletes. Thus, the data suggest that certain female athletes are at very high risk for a condition that is silently but inexorably undermining the health of their bones.

If you're a woman engaged in a sport where it's a competitive advantage to be lean, it's important to be aware that you are at risk for consuming too few calories to support normal physiologic function.

Remember, you may be able to compete successfully and your weight might even be stable, but that doesn't mean you have enough calories available to support other important physiological functions needed for long-term health. Your calorie shortage may be inadvertent. After all, as an athlete, your primary focus is probably on consuming enough carbs each day to replenish depleted glycogen stores so that you can keep up with the demands of training and competing.

And of course you pay attention to calories, because no one wants to lug around more body weight than is necessary. But if your periods have become irregular or have stopped altogether, it is important to understand that you've crossed an unhealthy threshold, and that your bones are suffering the consequences with each period missed.

Fortunately, normal menstruation and reproduction can be restored by increasing your available calories, and this can reestablish the normal bone remodeling process. So the first order of business is to increase the availability of calories. Do this by either upping your intake of calories, decreasing your exercise, or a combination of both.

Whichever approach you take to making more calories available to support normal physiologic function, stick with it until your regular periods resume and they continue while you are training and competing. In addition to freeing up calories, make sure that you're supplying the other key nutrients needed to support optimal bone remodeling, including calcium, vitamin D, and protein.

According to the American College of Sports Medicine, adequate daily amounts of these bone-building nutrients include 1,, mg calcium and IU of vitamin D. Good sources of both calcium and vitamin D are dairy products. For example, an 8-oz glass of milk provides about mg calcium and IU vitamin D.

A 6-oz tub of yogurt provides about mg of calcium and 80 IU vitamin D. Other calcium-rich dairy products include cheeses, cottage cheese, frozen yogurt, and ice cream. If you're looking for a non-dairy source of calcium, tofu provides about mg calcium in a 3-oz serving.

Also, if your intake of dairy foods is restricted, supplements of calcium and vitamin D may be necessary to consistently achieve optimal intakes for bone health. The daily recommendation for protein to support strong bones is 0.

This equates to about grams of protein daily for a pound kg athlete. Most athletes consume this amount of protein, although vegetarians may need to be extra diligent in ensuring that their protein intake is adequate.

Finally, other nutrients important in the bone remodeling process include vitamin C, vitamin K, zinc, copper, and manganese. Thus, consuming a variety of foods will help to ensure an adequate supply of the full range of nutrients needed for healthy bones.

Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP. American College of Sports Medicine Position Stand. The Female Athlete Triad. Med Sci Sports Exerc ; Nichols DL, Sanborn CF, Essery EV. Bone density and young athletic women. Sports Med ; Kerr D, Khan K, Bennell K.

Bone, exercise and nutrition. In: Burke L, Deakin V. Clinical Sports Nutrition. McGraw-Hill, ; Skip to main content Skip to navigation.

Rotating the arms externally. Hyperextending the low back. Pinching the shoulder blades together. Pointing the thumbs up. Which of the following reflects stabilization progression correctly?

Wobble board to foam pad. Balance disc to BOSU ball. Foam pad to sport beam. BOSU ball to balance disc.

What is another term for the preparatory period in a traditional periodization model? Neuromuscular adaptation. Anatomic adaptation. How should the order of exercises be chosen for a client's workout program?

Exercises should be prioritized by stabilization, strength, and then power. Exercises should be prioritized according to the individual's needs and training objectives. Exercises should be prioritized by power, strength, and then stabilization.

Exercises should be prioritized according to what the individual dislikes the most. What is the repetition range in the stabilization endurance phase of the Optimum Performance Training OPT model? In which of the following phases of the Optimum Training Performance OPT model would a client benefit most from performing timed holds?

Phase 5. Phase 4. Phase 3. Phase 1. When referring to the Optimum Performance Training OPT model, all of the following phases make up the strength component except:. Strength endurance. Maximal strength. NASM has developed a template that provides health and fitness professionals with specific guidelines for creating an individualized program.

All of the following components should be listed on a client's program except:. Resistance training. Client's height and weight.

Core training. Client's goal. To help a client safely progress through to hypertrophy training, which of the following phases of the Optimum Performance Training OPT model should be completed first? Dynamic strength. What might upper extremity exercise result in for an individual with lung disease?

Decreased muscular performance. Hypertrophied neck muscles. Muscle wasting. Onset of dyspnea earlier than usual. All of the following are causes of restrictive lung disease except:. A neuromuscular disease. Fractured ribs. Assessments using estimated heart rate max HRmax.

Assessments involving a Valsalva maneuver. Assessments using predicted maximal heart rate. Assessments using the talk test. If a client exhibits dyspnea during exercise, which of the following should take place? Immediately cease exercise and have them eat a simple carbohydrate snack.

Immediately cease exercise and call Have the client take longer rest breaks and train with reduced loads. Have the client lie down on the ground with their feet elevated. The trainer pays a fee to a health club in order to train clients. The trainer is paid an hourly wage with benefits.

The trainer owns a facility and is responsible for facility ordinances. The trainer must travel and use portable equipment. Yes, sexual harassment can occur with people of the same sex, and women can be harassers. No, sexual harassment can occur with people of the same sex, but women cannot be harassers.

No, sexual harassment cannot occur with people of the same sex, and women cannot be harassers. No, sexual harassment cannot occur with people of the same sex, although women can be harassers. How should the trainer contact a potential client after asking them for their contact information?

Call the potential client 2 to 3 days later. Approach the client at their next gym appearance. Email the client a few days after meeting with them. Mail a handwritten card within 24 hours.

When a potential client says yes to a personal training package, when should their first appointment be scheduled? Within 2 weeks. Within 48 hours.

Within 24 hours. Within 1 week. In which situation does a personal trainer have a percentage of their session fees taken? When working as an independent contractor for a commercial fitness club.

When working as a full-time employee for a commercial fitness club. When owning a facility. When providing in-home personal training services. All of the following are examples of good customer service except:. Offering members a towel or some water. Giving advice to an individual who declined help.

Making eye contact and smiling. Introducing yourself by name. Goal setting. Positive self-talk. Process goals can be predictively achieved, and product goals may or may not be achieved. Process goals give the client something to work toward, and product goals are something to do in the moment.

Process goals can always be achieved, and product goals are rarely achieved. Process goals are only achieved with careful assessment, and product goals are simple to achieve. Parents may try to make exercise unpleasant for their children.

Parents lead by example, and their views on exercise are often passed down to their children. Parents can make their children exercise. Parents can tell their children to exercise, which will result in the children's consistency.

Set Modest Accessible Restricted Temperate. Sensible Measurable Appropriate Rational Thorough. Specific Measurable Attainable Realistic Timely. Significant Material Assessable Reachable Thoughtful. The trainer and client should agree that the goal is achievable.

The client should create the goal based on their desire for a certain outcome. The trainer and client should agree that the goal is important. The trainer should create the goal based on what is beneficial for the client. When discussing SMART goals, how would the "attainable" component be described?

It means the goal is challenging but reasonably accessible. It means the goal is easy to attain. It means the client will definitely succeed. It means it is possible that the goal can be achieved.

When overtraining occurs, which hormone is typically present in the bloodstream? Growth hormone. In order to fulfill the R of the goal-setting SMART acronym, what does an individual need to do?

Make sure the goal can actually be achieved. Make the goal challenging, but not extreme. Establish a way the goal can be quantified. Decide on a specific date of completion. Why should a personal trainer ask permission of a client before educating them?

Permission allows the trainer to fully speak their mind and share details of training. A trainer should never share information with anyone without permission. The client is paying for training and a thorough fitness training plan, not education.

It improves the trainer-client relationship by reducing the imposing image of the trainer. All of the following are potential side effects of elevated cortisol levels except:.

Increased body fat specifically abdominal fat. Decreased breathing rate. Breakdown of muscle tissue. Decreased fat utilization. Continue educating them concerning the benefits of exercise. Discuss progress and suggest changes to the training plan. Discuss the best program for them.

Clarify misconceptions about exercise. Inside the myofibrils of muscle tissue, which two types of contractile myofilaments can be found? Sarcoplasm and plasma. Actin and myosin. Tropomyosin and troponin. Agonist and synergist.

A motor neuron and the muscle fibers it innervates is known as a n :. Motor unit. Action potential. It lengthens. It stays the same. It shortens. It awaits an electrical impulse from the CNS. The process of electrical impulses sliding from the CNS down the axon of the neuron, thus releasing neurotransmitters to initiate muscle contraction.

The process of neural stimulation creating a muscle contraction. Troponin providing binding sites along the actin filament for both calcium and tropomyosin when a muscle needs to contract. How thick and thin filaments within the sarcomere move past one another, resulting in shortened muscle and force production.

When doing a waist circumference measurement, where does the measuring tape rest? Directly above the bottom of the rib cage. Directly below the navel, in line with the top of the iliac crest. At the narrowest point of the waist, below the rib cage and just above the top of the iliac crest.

At the widest part of the waist, below the iliac crest. In pronation distortion syndrome, all of the following are shortened muscles except:. Anterior tibialis. Hip flexor complex. In upper crossed syndrome, which of the following altered joint mechanics is present?

Decreased cervical extension. Increased scapular protraction. Increased shoulder rotation. Increased shoulder extension. Which group represents injuries that are potentially caused by pronation distortion syndrome? Headaches, biceps tendonitis, rotator cuff impingement, thoracic outlet syndrome.

Plantar fasciitis, hamstring complex strain, biceps tendonitis, thoracic outlet syndrome. Plantar fasciitis, shin splints, patellar tendonitis, low back pain.

What is the recommended body fat percentage range for a year-old woman? All of the following are skinfold measurement sites used with the Durnin formula except:.

During a stretch, which of the following is happening to sarcomeres within the muscle? The sarcomeres lengthen. The sarcomeres contract. The sarcomeres shorten. The sarcomeres stay the same length. Skeletal muscle. Joint capsules. Pacinian corpuscles. They are capable of creating energy from both aerobic and anaerobic metabolism in nearly equal amounts.

They can produce the most speed and strength. They contain the most mitochondria, myoglobin, and capillaries. They can provide the most stabilization force without fatiguing as quickly. In regard to working with the internal obliques, what is the main muscular role of the transverse abdominis?

To assist in trunk flexion. To facilitate contralateral rotation. To isometrically stabilize the lumbo-pelvic-hip complex. To facilitate lateral flexion. Which of the following balance exercises is a balance-stabilization exercise? Single-leg throw and catch.

Single-leg squat. Single-leg squat touchdown. Single-leg Romanian deadlift. What is the most common form mistake during the back extension exercise? Bending the knees.

Retracting and depressing the shoulder blades. Lying prone instead of supine. By simulating stable and safe environments. By challenging the muscles of the local stabilization system. By challenging the muscles of the core to activate and protect the spine. By simulating unstable yet controllable environments.

Which of the following assessments is a suitable replacement for the single-leg squat assessment? Overhead squat assessment. Inline lunge assessment. Stork balance test. Single-leg balance assessment.

Which of the following is an accurate list of the kinetic chain checkpoints? Foot and ankle, Knee, Lumbo-pelvic-hip complex, Elbows, Head and cervical spine.

Foot and ankle, Knee, Lumbo-pelvic-hip complex, Shoulders, Head and cervical spine. Foot and ankle, Knee, Lumbo-pelvic-hip complex, Shoulders, Wrists. Toes, Knee, Lumbo-pelvic-hip complex, Shoulders, Head and cervical spine.

Which movement compensation is indicated in an overhead squat assessment? Scapular protraction. Knee adduction. Shoulder elevation.

Cervical extension. Stabilization level and power level. Stabilization level and strength level. Strength level and power level. Stabilization level, strength level, and power level. Which of the following is an example of a balance-strength exercise?

Multiplanar box jump. Multiplanar step-up to balance. Single-leg lift and chop. Multiplanar hop with stabilization.

Which of the following cues is important to remember during a single-leg Romanian deadlift? Slowly squat as if sitting in a chair. Retract the shoulder blades. Reach all the way to the floor.

Avoid hunching over. Single-leg box hop-down. Lunge to balance. Single-leg hip rotation. The ability to balance while walking in a straight line. The ability to change direction without falling while moving on unstable surfaces.

The ability to stay in balance on an unstable surface. The ability to maintain stabilization during walking lunges. Which of the following is a common form mistake during the single-leg lift and chop?

Lifting in a diagonal pattern instead of straight ahead. Having the feet too close together. The knee of the balance leg not tracking in line with the toes. Lifting the medicine ball up too high. What makes "multiplanar single-leg box hop-down with stabilization" a balance-power exercise?

It utilizes multiple planes of motion and requires full range of motion. It requires stabilization in the jump from a platform down to the floor.

It requires dynamic control in the mid-range of the motion, with multiplanar movement. It utilizes multiple planes of motion and requires force production followed by stabilization.

How often should an overweight or obese person participate in cardiorespiratory exercise? At least 5 days per week. At what intensity should a pregnant woman exercise during aerobic exercise?

All of the following exercises are appropriate for a pregnant client except:. Overhead squat. Ball cobra. Single-leg balance. For effective weight loss, how many calories should an obese client expend per session?

How many sets and repetitions should an initial resistance training program prescribe for individuals with high blood pressure? Which of the following blood pressure measurements is considered hypertensive?

All of the following are acute variables for balance-stabilization training except:. Number of sets. Rest frequency. Static and dynamic. Postural and dynamic. Combination of static and dynamic. Static and active-isolated.

How long should an individual with coronary heart disease be asymptomatic before engaging in a resistance training program? At least three months. At least one month.

At least four months. At least six months. For older adults, what is the recommended intensity for resistance training? All of the following movement assessments are recommended for youth training except:. Single-leg stance. One-repetition maximum strength assessment.

Push-up assessment. All of the following are low-impact forms of cardiorespiratory exercise except:. Water aerobics. Stair climbing. VO2 peak is higher than in adults body weight adjusted.

Sweat rate is consistently higher than in adults. Glycolytic enzymes are lower than in adults. Submaximal oxygen demand is lower than in adults.