Thanks Mike so much for taking time to reply.
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Think about teaching her how to move correctly in addition to prescribing exercises. For example, observe how she climbs stairs - teach her how to properly activate her glutes. Teach her how to engage her trunk muscles - read Stu McGill's stuff on bracing.
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I work w/a kinesiology grad and am sure I can borrow Stu McGill's info from my co-worker...thanks.
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It souds like your client is motivated - that's always a good thing...
- It's also a good thing that she has no apparent musculoskeletal issues - is that right? Just be cautious with body weight exercises as you want to keep her injury-free.
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She is very motivated and had no apparent musculoskeletal issues...yes very careful
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On cardio - great that she can walk those distances - does she have other options to complement the walking? Something orthopedically-friendly would be a good adjunct exercise. Also, try playing with the intensity a bit if she can handle it.
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For the strength portion we do circuits and I do vary the intensity during the workout. For cardio: she can use the elliptical in the gym. I have had her do basic intervals on the treadmill using the incline for playing w/ intensity. Other than that what other ortho-friendly cardio can you suggest? I am not a fan of swimming for fat-loss.
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Nutrition: What is she doing diet-wise?
Motivation/inspiration: How do you plan on helping keep her inspired? It's easy to be gung ho in the beginning but things can easily go off track. Does she have relapse plans? Does she fill out a food log? Does she have realistic short-term goals that are lifestyle-based as well as scale weight based?
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Diet is her big problem (of course!) She is seeing an RD who my client says is fat and is not connecting well w/ her. I gave her basic info (eating every 2.5 hours, small protein based meals, non processed foods,etc.) and she has been following my lead more than the RD. She knows her eating is psychological and has an appointment w/ a psychologist to address these issues. I am hoping the psych will have her log her food, and create a relapse plan for her. Yes - her short term goals are there...she is on the right track and very realistic.
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Why is losing weight important to her? What is she doing to control her environment? Does she have support other than you?
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She wants to get back to a normal size as she is pre-diabetic and just turned 40. She is tired of living in the big body she has now and wants to be fit and healthy for her family. Her kids are a tremendous support as are family, friends and neighbors. Controlling the environment is an issue...I need to speak to her about this.
Thanks again Mike...any other success stories or comments are greatly appreciated!
Anne