July 1, 2017 Ben Jackson

Case Study

Client: Janice Kestenberg

  • Female
  • Diagnosed with osteoporosis in 2015
  • Trained for 1.5 years and reduced to Osteopenia

Key focus:

  • Posture
  • Muscle activation
  • Breathing
  • Hip hinge
  • Walking

I started training Janice at the beginning of 2016, when she came to me to help manage her osteoporosis and get her on the right track, to improve quality of life. The first step in my process is an osteo-screening, where I assess body mechanics such as hinging, waking, squatting, balance, and a full core assessment.

Homework is a huge component in my training. Eliminating bad habits and creating new habits takes time and dedication. This is where I tie in my exercise training with every day activities. For example; if you are at home and you need to pick up a full laundry basket, how should you pick it up? Hip hinge!! Keeping a neutral spine without rounding the back. Now how often do you think of these things? It’s my job to make my client aware of these situations and to strengthen the body to withstand everyday activities without injury.

My osteoporosis program consists of 3 components: muscle activation / resistance training, balance, and posture mechanics. The first three months with Janice had high focus on strengthening and protecting the lumbar spine, with a significantly high T-score in the lumbar region made it a top priority in my programming. The other major focus was walking posture and balance. Understanding the mechanics of the body during a walking pattern is essential in every day life, yet a simple exercise and assessment tool like the “Sneaky Walk” challenges not only my osteoporosis clients but my more athletic clients too.

After the 3 months, Janice’s overall posture and awareness of her body significantly changed, therefore implementing more resistance training was necessary. Although most of my resistance training involves Therabands, cable pulley system allows my clients to access a few more lbs in need of proper progression and activation of the muscle fibres. With resistance training the muscle “tugs” on the nine creating cells called Osteoblasts which build bone!

The final step is “maintaining” the posture mechanics and the strength we just built up. Retracing your steps and implementing regression / posture programs is vital in this process. A blend of the basics with a variety of challenging but safe exercises. With Janice, she has 2 posture days, 1 osteo day: hip hinge focus, 1 osteo day: core and balance, and finally 1 stretching and mobility day. Walking is highly encouraged as well! This would comprise of one week and would continue this program anywhere from 4-6 weeks.

 

Example of a program for Janice January 2016:

  1. T-spine mobility on floor. Set up on the floor in your side, knees inline with hips, feet under knees / 6-8 reps
  2. Cat camel (on hands and knees) hyper-extension and flexion … Make it fluid / 8 reps per side

Exercises

  • A1- TVA core contraction (on back) with belly breathe – 3 sets x 12 reps
  • A2- bird dog (hands and knees- shoulders packed, Glute squeeze, core tight) 3 sets x 4 cycles
  • B1- sneaky walk – 3 sets x 4 lengths
  • B2- potty squat bw – 3 sets x 12 reps (3 seconds down, 1 second hold at bottom, 1 second up)
  • C1- external Rotation on bench 3-5lbs 3×12 (4sec down, 1 sec up)
  • C2- hip hinge 3 sets x 12 reps (feel stretch in the back of the legs by pushing your butt back)
  • D- kneeling cable Paloff press 5lbs 2×30-45 seconds

My passion for training those who need reconditioning and rehabilitation exercises began when I broke my ankle in a high school hockey game. Experiencing the rehabilitation process first hand truly sparked my learning and I eventually graduated from Acadia University with a bachelor in Kinesiology (2013). My passion drove me to my first job as a Kinesiologist at Physio Fitness in Riverview NB, 3 months out of university.  At Physio Fitness I worked under Sharon Steeves, physiotherapist and on the board of osteoporosis Canada. She has conducted Bone Fit classes at her facility. I was trained, mentored and educated by Sharron Steeves which ultimately led me to become the lead instructor for the program. Throughout my time I was able to train over 30 individuals with osteoporosis, 95% being woman, with a high rate of success and positive results.

Another passion of mine happens to be golf. I’ve been playing since the age of 4, and competitively from ages 8-18. I had the pleasure of working in the Pro Shop at Osprey Ridge Golf Club and assisting the Head Professional Jared Lohnes in Jr Clinics ages 6-18. I have since blended my passion for golf with exercise, creating methodical training programs that target specific muscles being used during the golf swing. If you have seen me around the gym I have been working with some clients specifically for this type of training!

Understanding how the human body functions at a rehabilitative and functional level has helped me progress my training for everyday individuals. Learning the basics…properly. I am a huge believer in posture and bending, training for every day life activities. Everything we do in the gym is associated with a movement or situation outside the gym. Quality of life is paramount. I truly enjoy training my clients and seeing progress not just physically but state of mind.

My methodologies for training are composed of posture mechanics with emphasis on isolation and muscle activation. Simply put, I want my clients to be focused on posture not just inside the gym but outside too.  I am a strong believer in delivering quality of movement and body awareness drills for my clients so that they understand the complexity and importance of the human body. Educating my clients so they understand what muscle they are using and WHY is paramount in training.

Starting from the feet up has been my approach to training for almost 3 years. For every client, I have them doing rehabilitation and corrective drills to correct foot position and weight displacement during rest and movement. I explain to my clients that there’s a “domino effect” once the foot mechanics and strength are poor or are not utilized. The knees become unstable, followed by the hips and up … A dangerous chain reaction.

My corrective training is mostly comprised of body weight and Theraband resistance drills, with a high focus on inner core work follow by external core.