The Show Up Fitness Podcast
Join Chris Hitchko, author of 'How to Become A Successful Personal Trainer' VOL 2 and CEO of Show Up Fitness as he guides personal trainers towards success.
90% of personal trainers quit within 12-months in the USA, 18-months in the UK, Show Up Fitness is helping change those statistics. The Show Up Fitness CPT is one of the fastest growing PT certifications in the world with partnerships with over 500-gyms including Life Time Fitness, Equinox, Genesis, EoS, and numerous other elite partnerships.
This podcast focuses on refining trade, business, and people skills to help trainers excel in the fitness industry. Discover effective client programming, revenue generation, medical professional networking, and elite assessment strategies.
Learn how to become a successful Show Up Fitness CPT at www.showupfitness.com. Send your questions to Chris on Instagram @showupfitness or via email at info@showupfitness.com."
The Show Up Fitness Podcast
How to program for an elderly client (70+ yrs young)
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Falls among the elderly cost our healthcare system over $50 billion annually—a staggering figure made even more heartbreaking when you realize many are preventable through proper strength training. Yet the fitness industry continues pushing ineffective "gentle" approaches that fail to provide adequate stimulus for meaningful adaptation.
This episode dismantles outdated training myths for older adults and presents a comprehensive framework for designing strength programs that truly address the physiological changes of aging: sarcopenia (loss of muscle mass) and dynopenia (loss of power). Using a 70-year-old retired professor as our case study, we walk through exactly how to assess, design, and progressively overload a training program that builds functional strength where it matters most.
You'll discover why motor unit recruitment through appropriate loading strategies is essential for bone remodeling—specifically, resistance training with weights that challenge clients in the 8-10 repetition range. We explain why popular balance training methods using unstable surfaces fail to produce optimal results compared to properly designed unilateral strength exercises that challenge stability in the frontal plane.
The episode provides a detailed three-day-per-week program with specific exercises, sets, reps, and progressions that can be immediately implemented with older clients. You'll learn assessment strategies that evaluate relevant movements like sit-to-stand rather than irrelevant ones like overhead squat, and understand how to incorporate cognitive challenges that stimulate brain-derived neurotrophic factor for improved neuroplasticity.
Beyond program design, we address crucial considerations like increased protein needs for seniors and practical coaching strategies that build confidence while challenging clients appropriately. This evidence-based approach doesn't just improve fitness metrics—it preserves independence and quality of l
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Welcome to the Show Up Fitness Podcast, where great personal trainers are made. We are changing the fitness industry, one qualified trainer at a time, with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showupfitnesscom. Also, make sure to check out my book how to Become a Successful Personal Trainer. Don't forget to subscribe, rate and review. Have a great day and keep showing up. Howdy y'all. Welcome back to the show Fitness Podcast.
Speaker 1:Today we're going to help you design a program for a 70-year-young hunk who wants to get stronger, not been exercising regularly? Retired professor, what would that program look like? Before we get into this program, we're going to take a look at some statistics. As we age, what happens, some terminology. So let's begin with the systems of the human body. Most textbooks would probably tell you there's 11, with the nervous system, skeletal system, muscular system, endocrine, integumentary which is your skin, digestive, pulmonary or respiratory, cardiac, urinary everyone's favorite reproduction, as well as the lymphatic system. But then there's three kind of subcategories under the nervous system the vestibular system and proprioception, which play a huge role when it comes to balance, and then the enteric system, which is called the second brain, the communication between your gut and your brain and what's taking place there. You're inflamed, your gut health that's for another podcast, but these 14 systems are really important and the four that I'm really going to take a look at are going to be balance, which is going to be the inner ear, the vestibular system we're looking at the three small bones in the ear, the incus, malus and stapes. There are these circular canals that tell the body where and what is happening with balance. Proprioception is what's happening with your joints and your muscles, and the communication from the sensory standpoint and vision is really important when it comes to balance.
Speaker 1:But the one that we don't talk enough about is strength. You're going to see online people doing a bunch of weird shit on BOSU balls. Can that help with balance? Sure, if you take someone who's inactive and you put them on a BOSU ball, they could improve. But what happens if you were to get them stronger unilaterally? So anytime when we design a program for an individual, you have to take a step back and go through the needs analysis what are the demands, what are the systems that need to be challenged? How's our strength, how's our balance? What are some things that we can test beforehand? So we got to eliminate red flags. Definitely very important to do an assessment, a PAR-Q physical activity readiness questionnaire. Check out their blood pressure. I would definitely do a grip strength so you can show them the standards of where they're at and where they need to be, because as we age, the two important things that you're going to come across is sarcopenia, which is the loss of muscle mass due to age, and dynopenia, which is the loss of power due to age.
Speaker 1:There's a great podcast from Dr Kramer, my professor at the University of Connecticut, and he does a podcast with Eric Cressy. I was at UConn when Eric was getting his master's, doing his dissertation, and he did a great study on 10 weeks looking at unstable surface training versus stable surface training for athletes, and him and Dr Kramer have a great conversation. This is about a year or two ago and Dr Kramer talks about the fundamentals of movement and how important it is for trainers to know what the size principle is. I will do a podcast on this one another time. But the size principle isn't even in the ACE or ISA or NASM textbook. This is the fundamentals coming from maybe one of the most iconic exercise physiologists ever on this planet, and these textbooks don't even have it. So you need to understand what the size principle is and it's about motor unit recruitment and threshold. So we have type one, type two muscle fibers. High threshold motor units are going to be those fast twitch which are going to be recruited when you do things that are fast, explosive to volitional fatigue and when you lift heavy.
Speaker 1:And when I say heavy it's really important to understand less than 10 reps because that's what's needed to stimulate your bones for remodeling. If we're lifting light weights or if we're just doing balance training, we're not strengthening our bones and we're not going to induce optimal hypertrophy. Tension is the most important factor there. So obviously you're not going down to a six to eight rep max on their first session. You need to assess the individual and see where they're at. There's plenty of individuals in their seventies and eighties who are capable right now to do a one rep max. For this case example that we're dissecting for the next month in August part of the SUF CPT we're going through the Frank avatar so we have a picture of him. I'll post this on social media and you can see what he looks like. So you're going to gather a ton of information from that assessment in what you're going to be implementing for the workouts and the exercise selection.
Speaker 1:So before I tackle this workout, let's dig a little deeper into that size principle. So our type one muscle fibers are slow twitch, our type two are fast twitch. Recruit those suckers first. It's a spectrum. I wrote an article for stackcom. You can type in size principal Chris Hitchco and I go and give a little fun analogy with Darth Vader and the emperor controlling the stormtroopers where, say, 70 of the stormtroopers are type one, 30 are type two.
Speaker 1:And what happens with neuromuscular synchronization and raising your hand In the beginning? If I were to ask people to raise their hand there's a hundred people in a room the synchronization isn't going to be very good. That's what happens when we begin to strength train. The adaptation takes some time, the neuromuscular recruitment. That's why we want to start out with lower loads, lighter weights, really focus on proper form, so we optimize that synchronization. After anywhere from two to six weeks, depending on the individual and how often you're exercising, the recruitment will be optimized and then hypertrophy will start kicking in. That's why it's so important to tell your clients that don't expect a ton of gains with a capital G the first couple months, because it's really just your body learning how to move optimally.
Speaker 1:I'm not going to be doing an overhead squat assessment or any of that bullshit. It's 2025 and people are still doing that. It's crazy because it's not specific to the individual. When was the last time you think Mr Frank right here puts his hands above his head and squats down to a table? No, it's not specific. What do we need to do to stimulate bone remodeling? We need to load the tissue.
Speaker 1:So this overhead squat assessment that a lot of people are doing doesn't play a role for optimal programming. So we don't do that. What I'm going to do is I'm going to assess him, learn about his goals, ask great questions and after about 15 to 30 minutes, I'm going to go see how he moves. We're going to look at the movement patterns how does he squat, how does he push, how does he pull, what's his unilateral strength look like and then I'm going to find an appropriate exercise that I can then begin to overload week by week, month to month, and that's progressive overload. That's the cover of my book, volume two. If you haven't read it, you're missing out, because we help you design programs for these types of individuals, as the second volume has a lot more with programming, how to get clients and everything else.
Speaker 1:But you need to look at the individual. We're not just throwing random assessments at people because of their age. So when I get an inquiry form from someone who's a little older and deconditioned, my mind is going to start looking at the statistics of what happens. As we age, we are more likely to fall. The CDC report, I think, last year, over $50 billion of medical costs from falls. A lot of these are preventable if we had the foundation for strength, but we don't. We stop exercising as we age. It's too late so we're not going to do it, or we're doing classes that are just body weight or sitting down to a chair. Yes, we have to meet the client where they're at, but we need to progress them. A lot of the elderly programs that I see are not stimulating enough for optimal adaptation from the neural standpoint or the muscular standpoint. So I'm going to take you through what that would look like after the assessment Day one.
Speaker 1:The assessment part with a workout is a workout. My assessment quote unquote with those bunny ears in the air is a workout. I'm going to do CCA. I do CCA on everyone. That is my assessment. So what do you think Frank has done regularly? He sits down and gets up. So I want to look at him sitting down and getting up. I'm going to have him do maybe five to eight reps, check them out. I'm going to give some tactile cueing. We want our big toe and little toe and heel to be on the ground at all times. Let's drive our knee out, not so excessive. Where knee varus happens and you lose one of those foot placements I want it to track through the toes, ideally. If it's a little externally rotated, that's fine. He may not have the optimal dorsiflexion, so maybe we need to put some wedges behind his heels or let's throw a weight out in front of him. That's one of my go-tos. You may go to a TRX, which is fine.
Speaker 1:I like to do what the client is doing regularly and he guarantee he sits down into a rocking chair or his recliner and then he gets up. So I want to mimic that and give a little bit of load. And that's again why I do not do the overhead squat assessment, because he doesn't stand up from his recliner with his hands over his head. So why would we test him on something that I know for a fact he's going to fail and suck at. That's fear-based training. I'm very pro-movement.
Speaker 1:I'm going to give him a two and a half or five pound plate, put it out in front of him and have him stand up. See how he does it for eight to 10 reps. We're not going to volitional fatigue. I'm keeping a lot in the tank One to two sets, two to three, depending on how he's doing. So if we did a squat pattern there, I'm going to move into an upper body pattern. Let's do some bar pushups. I'm going to keep the bar pretty high, like what most of us would probably squat with, and I'm going to have him do some pushups. Teach optimal centration of the shoulder by tucking his elbows down. Ideally, the posterior part of your elbow or the olocronum process should be coming back behind the body with the front part or anterior part of the elbow pointing forward. I don't want to be a T, I want to be more like an arrow and I'm going to see how he does these pushups and then I'm going to get into some planks.
Speaker 1:Now, this is the strategy that I implement with elderly people. Again, you have to make sure it's appropriate, based on the assessment and your warmup. My warmup is typically the same for most individuals. I want to see how their balance is. So can he stand on one leg and bring his knee to his chest? Can he pull his ankle to his butt? I'm going to be right there with my forearm if you need support or some type of squat rack that he could put his hand on. Can he open up his hips so put his hand on? What about a deep squat with some rotations? I'm going to progress the warmup based on how he performs there.
Speaker 1:If the first rep he pulls his knee to his chest and he really needs my support and he cannot do that, then I'm going to modify. It's all based on what his capabilities are. Maybe he has better balance because he was a runner in the past, which brings me into some soft tissue work. That I would do because in our case example here Frank has some cranky knees. So I would do an adductor magnus release. See how that feels.
Speaker 1:But as we age we're going to be more prone to bruising and he probably doesn't have that much muscle size, as you can see with the avatar, so we're not pressing that hard bringing him up to a 10. Just get the discomfort to maybe four or five. Teach him to breathe through it. Then I'll have him stand up and see how his knees feel and I guarantee you his knees are going to be feeling a lot better. So when we get into the warmup his knees feel better and that's already a huge benefit for you as the trainer, because he sees value in wow, you helped my knees feel better that quickly and I've been having this discomfort for the last 10, 15 years, that quickly and I've been having this discomfort for the last 10, 15 years. So as I analyze his warmup very simple I'm checking out his balance, essentially to see could I potentially do a lunge? And I guarantee you probably can't. That's why I don't like the lunge as a movement pattern.
Speaker 1:It's called unilateral because I would work into unilateral probably the second or third circuit as I have here, because he's probably doing a lot more squatting versus unilateral stuff. Walking up and down the stairs, you will learn, if he has a two-story house, what is challenging for him. But that's how most people break a hip walking down the stairs. They don't know how to decelerate, so we have to plan our foot stabilize in the frontal plane, where we don't have the strength and then we fall. These are things that we're going to work on on a regular basis, so, as I said prior, the first CCA would be a squat into a push into a plank.
Speaker 1:I strategically did that, though, because I want him to be up and then work down to the ground and then work on getting back up, and I'm going to challenge his capacity to remember how he did that. Great job, frank. I'm going to help him up after the planks. Did you know how you got up right there? He's going to give me a weird fish eye and be like what do you mean? Get back down there and get back up, frank, real quick. Tell me how you got up. Talk through it. I put my left knee up, I put my right hand down, and then he was standing up. Maybe he needed my support, maybe he didn't. Awesome job, frank.
Speaker 1:This time I want you to get back down there and I want you to do it the opposite, and it's really neat to see that cognitive phase of learning, because he's going to be struggling to think how he has to move the other way, because if he's 70 plus years young, how many times has he done it the same way? We have that cognitive phase of learning where you have the deer in the headlights and you have a fixed stare. I love that. The brain is learning. It's really going to adapt to that stressor. The associative phase of learning is you could talk through it. So if he's able to get up very easily and talk to me about how he did it and he's not struggling, I need to challenge him a little bit more to bring him back to that cognitive phase of learning. That autonomic is just very simple. It's like walking in the park. There's no thought that goes into it, which is good to a certain degree. But I want to throw some challenges so we get him back into that cognitive phase of learning.
Speaker 1:Based on my observations on that first round, I'm going to do another one and then I may do a third, pinning on how he's doing. Then we're going to do a glute bridge for the second CCA into a half kneeling banded row. So now we're doing a hinge pattern into a pole, into some band walks. So he's on the ground. Now he has to get up, like tying his shoes. He's going to have to put the bands on his knees and walk back and forth. You may have to use one of the rubbery elastic ones, because the typical hip bands may be too aggressive for him. See how he moves Two to three rounds, eight to 10 reps, not going to volitional fatigue, and that third one.
Speaker 1:What have we done so far? Use your brain here. We've squatted, we've hinged, we've pushed, we've pulled. What else do we need to check off? Let's do a unilateral, let's do a shoulder and let's challenge his core again. So we're going to do a step up into a half kneeling banded press.
Speaker 1:I really like the half kneeling because he has to stabilize in the frontal plane and the hips are so important for knee and ankle health and we typically do not challenge them, just the hip by itself. When we squat, you have hip extension, knee extension, but they're working bilaterally. So if you had a two pound dumbbell or a five pound dumbbell, I want you to grab both ends. When you do a squat, your hips are working together. If you take one of your hands off, the hand that's holding the dumbbell has to work a lot harder. That's what's happening when we do a unilateral step up. Control the eccentric six to eight reps, depending on how he's doing. If he's huffing and puffing, maybe we'll only do three to five.
Speaker 1:Then we go into that half kneeling banded press. I'm going to be behind him with the band at my foot anchoring it down while he presses about to 130 degrees of shoulder flexion. Most people are not going to have 160 plus, as we should, so we'll work up to it. If I had him do a military press from the get go, probably going to have some rib flare, anterior pelvic tilt and just not optimal for now. But I would want to see what his movement looks like. Can he put his hands above his head? I will screen appropriately to see if he can touch his opposite scapula. Those are the four screens that we teach within our soft tissue mobilization certification to see if it's something we can work with or if we need to refer out to our team DPT.
Speaker 1:That last exercise we're going to do is a payoff hold and I'm going to see how he stabilizes in the frontal plane. So he's standing up. He's going to a half kneeling. We're doing a pale off hold. Maybe we do it half kneeling, maybe we do it tall kneeling. You make that decision based on how he's doing.
Speaker 1:That's my first workout and my assessment. I put them into one. So the next time that he comes back I'm going to see how he's feeling. Make sure to give him some homework of consuming a good amount of protein. Talk to him about creatine. These are all things that we should be consuming regularly. But muscle protein synthesis the sensitivity as we age increases. So what that means is when he's in his 20s, 20, 25 grams of protein is going to be enough to stimulate muscle protein synthesis, but as we age, it may creep up to 30 or 35. So if he's not getting the requisite protein that his body needs, he's going to be really, really sore the next day. I don't want him to be so sore where he has DOMS and he doesn't want to come back and work out. That's going to suck because that's a full body workout. But notice, the load wasn't 10 reps to max. We're doing a lot of body weight stuff. We're using bands. We're going to minimize the soreness. But I want him to consume a couple meals of 25 to 30 grams and then report back to me and we'll work out non-consecutive days.
Speaker 1:So on Wednesday or the second time he comes back in, ask him how he's doing, get into a warmup. Soft tissue for the knee. Now we're going to do some banded stuff. We'll do some rows and some banded presses, some payoffs. Maybe we do some mirroring with some jumps. So I'm going to lift my arms up like a jumping jack and then I'm going to put my arms behind my body and then we're just going to jump a couple inches off the ground. See how he does with that. That's going to help with the prevention or reversal of dynopenia. The load after a month it's going to help with sarcopenia. So we want to target both of those.
Speaker 1:Reverting back to the size principle, we need that type two motor unit recruitment but we have to create a really good foundation. We're working with local muscular endurance, so 10 plus reps, but we're not going to volitional fatigue because of the soreness factor. So after that warmup we're going to get into some side step ups. So we bring that last CCA from day one and now we put it into the first circuit for the CCA. On day one we did pushups. Now we're going to do a row let's introduce a TRX row and then we're going to do a bird dog Notice how we're standing and then we end off with the accessory on the ground. Two to three rounds of that Second CCA. We'll do some modified RDLs.
Speaker 1:Maybe we need to increase the height because he lacks dorsiflexion or he's probably just going to struggle with the hinge pattern. So give some great cues. Like you're trying to push your dresser with your butt, maybe you need to put a foam roller behind him to teach his hips going back without the knees migrating forward. And then we're going to go back into a bar push-up like we did on day one. But now if he really kicked major ass on that first day, maybe you want to have him lift the leg out. Or he does a push-up and then he comes back up and he lifts the leg up.
Speaker 1:Working with auditory cueing Really important to challenge tactile, auditorial, visual, because that's all going to help improve his balance. And let's do an airplane where we get him on the ground and he's in a lunge position but he's just going to see if he can lift the leg up to balance in the frontal plane, really challenging the glute med in the frontal plane. The anterior fibers of the glute max, the sartorius, gracilis and TFL, which are all biarticulate that start at the hip but come down to the knee, are going to be taken out of the equation. So this is a really great hip stabilizing exercise. Two to three rounds of that that last circuit. We're going to do a sit to stand. So he's sitting on a bench. I'm having him stand up as fast as he can See how he does with that. Maybe you throw in some clapping or snapping or a couple reps. You have him close his eyes. See how he does with that visual auditory stimulus. Now let's try a seated overhead press. If he did well on day one with the half kneeling banded press, let's try a seated overhead press. We probably need to tuck his elbow more into that scapular plane of motion, but overhead pressing is really important and I think that would be a great thing to incorporate.
Speaker 1:On day two, let's do some side planks. So on day one we did anterior planking. Now we're going to do lateral planking. Two to three rounds of that. That's day two. Day three which would be probably on Friday or non-consecutive, so five days out, but this will be the third workout let's do some goblet squats to see how he does. Maybe we need to put a wedge behind his feet and then we're going to do a TRX row again into some dead bugs. Day one, we planked. Day two, we did some bird dogs. Now we're going to do some dead bugs. We started in the squat position. The accessory for the last one. We're going to do a dead bug on the ground. Two to three rounds of that.
Speaker 1:For the second CCA we're going to start with a glute bridge, which we did on day one. Then we're going to do a med ball press. Give them a three to five pound med ball. That's going to get that higher threshold motor unit recruitment. Pass it to me as hard as you can there, frank. That a boy good. And then you throw it back to him.
Speaker 1:Tracking objects in the air is really important for BDNF, brain derived neurotropic factor. That's the neuroplasticity protein hormone. That's really awesome when you have to track things. It's going to be released. So I'm going to throw it to him in the sagittal plane right to him. But then, if he's doing well, I might throw it more over his right shoulder or down a little bit to have him react to where the ball is going. And then we're going to do some med ball rotations. He's going to be on the ground in a lunge position. He rotates and throws it to me. I'm not throwing him a fastball back where it's going to jack up his low back or anything like that. We want it to be controlled. But when he throws and rotates because the other days we did side planks and we did some payoffs. If you feel it's appropriate, get some rotation in there.
Speaker 1:That last circuit for the week we're going to do a single leg RDL. So I'd have his hand on a beam or a dowel or on my forearm and we're just working on single leg hinging. See how he does for eight to 10 reps. If he doesn't need any support, I would have him do it without the beam or my arm, but I'm there to help, support and spot him if he were to lose his balance. That's the value of the trainer. I'm not sitting on my phone counting the reps out or on my iPad five feet away. I'm right there giving him the comfort, knowing that he's safe. Let's go into a seated med ball press. Prior he was doing a standing push. Now we have him sit down. It's going to be more of an arc, so we're going to get the shoulder recruitment and let's do some planks at the end. That's the whole week of workouts.
Speaker 1:If you want to see the full month email info at showupfitnesscom, throw this into your story. We will send this back to you. You'll look at how we progress from day one to day 12, which would be training three times with you for entire month, and the progressions that we're going to incorporate. To give you a little teaser, that last workout of the month we're going to get into a safety bar squat. We'll be doing split stance, rowing, more reactive dead bugs. Let's throw some hip thrusts in there, single arm pressing.
Speaker 1:So you see, from the beginning it's more band to get a feel for where you're at. And then we progress into heavier loads, because that's where the bone mineral density is going to increase. We need at least six months of at least 70%. What that means is volitional fatigue 10 to 12 reps. 10 reps would technically be 75. 12 reps would be right around 70. That's the stimulus needed to volitional fatigue for the bones to get stronger On a cellular level. That's the osteoclasts breaking down. The bone Osteoblasts will be building up. Frank needs to be drinking his milk on a daily basis to strengthen his bones. But he's not going to have strong bones if he's not resistance training and overloading appropriately. So we will get into more compound lifts stimulating his system. Get down to eight to 10 reps Now, continuing that for the next six months. He will increase his muscle mass, he will improve his balance, he will increase his bone mineral density.
Speaker 1:These are all things that are going to help prevent a fall. Our society as we age, we do not challenge people the way they should be. If we're just doing BOSU ball walks and silly step-ups to a hold without the load, it's not optimal for adaptation. If you want to throw some BOSU ball stuff in there or an Eric's pad, that's fine. Do it as an accessory, but make sure you're there for support If he were to fall. Worst case scenario you're not there and he falls and breaks a hip. How are you going to feel? Because you could have just had him stand on one leg without the stupid device. What is your reasoning for that? It was fun. It's going to improve his balance. As we said earlier, balance is going to improve by challenging the vestibular system, proprioception that's where your body is in space and getting stronger. Having him close his eyes the visual aspect. You can do all that stuff very safely and eliminate the falls. So if you go to some type of unstable device, you better be very confident that they can perform it properly and they're not going to fall and hurt themselves.
Speaker 1:Let us know what you think of today's program. We teach trainers online in person. Our next in-person two-month internship is going to be October 6th, santa Monica, atlanta. We're online. We have weekend seminars. We're going to be in Beaverton, oregon, outside of Portland, the 26th and 27th of September. The hands-on learning and mentorship is what changes the game. Have a great day y'all. Remember big biceps are better than small ones, and keep showing up.