When Kim tried to describe her condition during our initial meeting, I was discovering an entirely new world. Being familiar and experience in training Clients with more common conditions such as hypertension, obesity, fibromyalgia, Chronic Fatigue, and Metabolic Syndrome, Kim’s condition was new to me, and turned out to be more complex challenge I am typically hoping to be involved with.
After some research on the condition, Kim & I both well understood the diverse & unpredictable nature and effects of the Postural Tachycardia Syndrome (POTS), the restrictive guidelines on training intensities, type, and frequencies, the amount of intense monitoring and reporting to the team of healthcare professionals. All these obstacles were going to influences on Kim’s Training, progression and Potential Results. Nevertheless, we shook hands and embark on this exciting journey.
In this case, it is not simply the challenge of Client’ new condition that got my attention, what actually won me over was Kim’s unique positive spirit, high-level motivation, and the ground breaking journey Kim was initiating. I jumped to the opportunity to be the Personal Fitness Trainer, that could guide her. My challenge consists of creating results-based appropriate and safe training programs for Kim by carefully merging my knowledge and experience in training Body Builders Clients and Clients with Special Conditions.
The restrictive training guidelines included respect included, long progressive warm up, and cool downs, focus on core and lower body exercises, upright positions, Isotonic contractions (concentric/eccentric; no isometric (holds) contractions allowed); Long rest periods between sets to name a few. To ensure a positive training experience for Kim, based on her high sensitivity to environmental conditions, each session needs to be pre-set with proper dimmed lighting, fresh room temperature, and schedule sessions during less noisy and busy time of day.
The only true consistency with Kim’s condition is the fact that it is absolutely inconsistent! Every session is based on how Kim is feeling at the moment, which dictate the intensity and volume that can be used, which is not always following progression from week to week. As her trainer, my focus is essential directed to how she respond to the training by reading her verbal and non-verbal communication. Because of this unpredictability, it is best to prepare a few training scenarios ahead of time.
As it turns out, Kim represents the Exception to the Exceptional! As we progressed Kim’s training, it became evident that she would and could benefit from upper body toning exercises, which greatly contributed to her overall re-conditioning and body sculpting. We carefully monitor Kim’s response to the training intensities and frequencies to ensure appropriateness of her program. The main purpose is to improve Kim’s muscular strength and endurance, increase her lean mass towards a more competitive stage-ready body composition without creating any negative effects on her health.
The full battery of lower body resistance exercises are part of Kim’s training routine: body weight and front loaded squats, full lunge matrix, Romanian deadlifts, Calf Presses, Toe raises. Upper body exercises consists of standing Cable low rows, Resistance tubing pec and reverse Flies, front & side deltoid raises while core exercises include Barbell Torso Twist and lateral Flexions, TRX standing Abdominal Crunches.
As sessions progressed, so did Kim’s tolerance to lactate build up, allowing progression in workload and repetitions as well as the complexity of the exercises.
Part of Kim’s Weekly routine include 1-2 modified yoga 30 min sessions per week as well as 2-3 sessions of 30 minutes of aerobic cardio overload (intensity within 50-70% Heart Rate Reserve - Rate of Perceived Exertion 2-5 /10).
Kim is focused on her training, and maintaining holistic balance are great contributors to her progression. Both Kim and I are conscious that we have to make the best of the “Good Days”, in the event of “Not So Good Days" . To our advantage, it seems that the unpredictable effects of the POTS have not affected Kim’s ability to add on Muscle Mass, which could be attributed to the consistency and adherence to a structured, appropriate safe exercise routine, optimum nutritional habits and appropriate rests between workouts.
Probably the most positive contributing effect to Kim’s progression is her relentlessly positive stamina, her dedication to excellence, and focus on the set objectives. Despite the vertigo episodes, insomnia, light headedness, general fatigue, palpitations, nausea, Kim is training at home and showing up at her training session with the discipline and ethics of the Olympic Athlete. I am personally inspired, humbled and honoured to be participating in Kim’s Project.
I believe in her ability to achieve the personal fitness objectives as well we her determination to show how engaging in a safe, appropriate supervised training exercise regiment can positively contribute to the self-esteem, general health and long- term quality of life of people diagnosed with POTS.
Sylvain Cyr - Elite Personal Trainer - Certified ACE, ACSM, BCRPA, NSCA