16 Week Client

Portfolio

03/28/2018

Client: Cortney Welch

Trainer: Chelsea Nagel
Part 1:
Client Information:
Name Cortney Welch

Age 21 years old

Weight 142.5 lbs

Height 5’6”

Right Leg Length 95 cm

Hand Length 17 cm

Tibial Length 44 cm

Smart Goals:
→ Improve symmetry on both sides of the body within 12 weeks using ROM tests to
measure this.
→ Improve splits on each side by 5% each week.
Part 2:
Resting Values:
Blood Pressure 100/70 mmHg

Heart Rate 51 bpm

Metabolic Rate 1489.5

BMI 22.4 kg/m2

Waist/Hip Ratio 0.679487

Body Fat % BIA → 19.2%

SECA → 22.4%
Skinfold → 21.7%
Interpretation:
Cortney’s blood pressure is considered normal. BMI of 22.4 with a waist girth less than
88 cm is at least risk, but waist girth greater than 88 cm is at an increased risk. Cortney has a
waist girth of 67 cm. She would be put into the category of least risk.
Cortney’s Waist/Hip ratio is less than 0.71; therefore, she is at low risk. Cortney’s body
fat % ranges between the lean and leaner than average depending on what system you are using.
I noted all three tests we used, and it helps see that the tests can differ with results. When we
retest, I would note which test we used the second time and compare it to the same system used.

ROM:
Right Left

Ely’s Test 121° 134°

Thomas Test + +

Ober’s Test - +

Seated Hip IR 21° 22°

Seated Hip ER 43° 41°

Knee to Wall (ankle) 10 cm 10 cm

Shoulder Flexion 173° 175°

Supine Shoulder IR 45° 60°

Supine Shoulder ER 90° 90°

Interpretation:
Thomas test was positive on both the right and left sides, because the lower thigh lifted
off the table while letting the lower back touch the table. A positive test is a sign for a tight
iliopsoas. If we used a foam roller to roll out her iliopsoas, her lower thigh is less likely to lift off
the table during this test.
Ober’s test was negative on the right side meaning the leg did adduct beyond neutral. On
the left side it was tested positive, because the tensor fascia latae and IT band are tight. The leg
did not adduct beyond neutral. With a tight tensor fascia latae and IT band, we could roll them
out using a foam roller to help.
Ely’s test shows the knee should bend to 135° or touch the butt, but on the right side the
leg is 14° away from where it should be. The left leg is 1° away from where it should be.
Looking at the two scores, the right knee is not as mobile as the left, and that would have to be
worked on. Rectus femoris could be tight in the right leg; therefore, she could do some rolling
and see if that fixes the problem.
Seated hip external rotation should be between 45-50°, and Cortney's external was only a
couple degrees off from that. I am not concerned with external rotation for her hips.
Seated hip internal rotation should be between 35-45°. Cortney’s hip internal rotation is
14-24° away from where it should be. External rotation was better than internal by far. In this
case, I would focus more on improving internal hip rotation. I would have her do the 90/90°
stretch to hit both external and internal, but then I would have her do more internal movement
snacks every other day.
Normal ranges for knee to wall range of motion would be between 10-12 cm and Cortney
hit 10 cm for both ankles. I wouldn’t worry about her ankle range of motion with these scores.
Cortney’s range of motion for shoulder flexion is within normal ranges. It is closer to the
high end of the range too. I wouldn’t worry about her shoulder flexion. Comparing both sides,
they are only two degrees off too so this isn’t alarming.
Cortney’s external range of motion of the shoulder is within limits, and both sides is at
the same degree so I wouldn’t be concerned.
For internal shoulder rotation, it should be between 70-80°, but Cortney is at 45° and 60°.
Her right side is alarming just comparing that side to normal values, because it is 25-35° off from
normal range. Left side is only 10-20° off from normal range, but still not within range.
Comparing the left side to the right, I am concerned. They are far off from each other meaning
her left side has more internal rotation ability than her right. She would need to work her right
side up to her left and then do stretches to get both of them up to normal ranges. If she leaves
them uneven it could lead to injuries.

FMS:
Test Raw Score Final Score Comments
 Deep Squat 2 2 Needed the heel raise to perform
movement.

Hurdle Step L-2 | R-2 2 Ankle turned to get over the bar on
the right.
Alignment was lost between hips,
knees, and ankles on the left side.

Inline Lunge L-3 | R-3 3

Shoulder Mobility L-2 | R-3 2 Left hand was within hand & a half

Active Straight-Leg Raise L-3 | R-3 3

Trunk Stability Push Up 2 2 Move thumb to clavicle level.

Rotary Stability L-2 | R-2 2 Could not do the same side arm and
leg.

Total 16

Interpretation:
When looking through all of the scores, the only one that majorly sticks out to me is the
shoulder mobility. For the shoulder mobility, the right hand scored a 3 and the left hand scored a
2. I noted the left hand was within a hand and a half. Left shoulder is not as mobile as the right
side in this case. I would start her with rolling out the left shoulder and chest area. I would even
have her do wall angels to get the shoulders moving together. After I fixed the shoulder mobility,
I would start incorporating mobility movements into her workout every other day to start fixing
the 2s she scored on FMS.
Anaerobic Power:
Wingate Revolutions

0-5 12

5-10 8

10-15 10

15-20 8

20-25 6

25-30 6

Wingate Mean Power 441 J/sec

Wingate Fatigue Index 50%

Switch Mat Test 20.1 inches

Interpretation:
Cortney’s wingate mean power compared to the normal ranges, she lands in the 85-90%.
Her anaerobic power is not a concern to me with these results.
I looked at data for a vertical jump to compare her switch mat test results, too. In the
chart, I could compare her results to healthy non athlete, recreational athlete, and competitive
athlete. Her results landed above all three of them. She got a 20.1 inches, while competitive
athlete data got a highest of 18.5 inches for women.
Aerobic Capacity:
Metabolic Cart - Bike HR (bpm) RPE

50 W 126 7

100 W 138 9

150 W 156 13

200 W 172 16

250 W 178 18

YMCA Heart Rate

1st Stage - 25 W 89 bpm

2nd Stage - 100 W 145 bpm

3rd Stage - 125 W 146 bpm

4th Stage - 150 W ~180 bpm (HR monitor failed)

Interpretation:
For Cortney’s VO2 max test, we used the bike and metabolic cart to perform it. I set the
metronome to 60 bpm and increase the watts by 50 each time to hope she would hit her max
sooner than later. If I didn’t increase by enough, she would have stopped from muscle fatigue
and not hitting VO2 max. Looking at Cortney’s VO2 max results, her heart rate wasn’t within 10
bpm of her estimated max, but her RPE hit above the level it should be at when reaching
maximal VO2. I continued to look at her report from the test to see what that would show. Her
max VO2 according to the metabolic cart is 43.9 ml/kg/min. Comparing that to normative data,
she has a good VO2 max or within the 75th percentile.
When I went back to graph the results of the YMCA test, I noticed the results did not
seem right. Her heart rate did not increase enough from the 2nd stage to the 3rd stage. The 4th
stage was too high as well. When graphing the two submaximal heart rate points, you graph
anything above 110 bpms and below 85% of their heart rate max. Cortney’s 85% of heart rate
max would be 169 bpm. Therefore, I would not be able to graph 180 bpm. I would be left with
graphing 145 bpm and 146 bpm, but these values would not give me a true estimate of her max
VO2. In this case, we noticed our data is not correct and the test would have had to be redone.
With not enough time, Cortney and I were not able to retest her. I graphed the two points
anyways showing what the graph would look like with her two points if they had been correct.

Muscular Strength:
 Upper Body Push - Bench Press 1RM 110 lbs

Upper Body Pull - Seated Row 3RM Between 100-120 lbs

Leg Press 3RM 320 lbs

Interpretation:
After converting Cortney’s leg press 3RM to a 1RM, I looked at the normative data for
the leg press. Looking at the normative data, Cortney was well above average. Her relative value
was 2.39. I am not concerned with Cortney’s leg press.
Cortney’s bench press relative value was 0.77. Looking at the table, it is well above
average as well. I am not concerned with her bench press value.
For Seated Row, we used a cable machine to perform the task. We did a 3RM with the
machine. The machine skipped from 100 lbs to 120 lbs though, and Cortney could not perform
all 3 reps with the 120 lbs, but she was able to with the 100 lbs. Therefore, her 3 RM is between
100 and 120 lbs. Since there is no normal data to compare Cortney’s score to, I would just save
this information and use it to compare to her new score once we tested again at the end.

Muscular Endurance:
Push Up 18

Plank 1 minute 39 seconds

Right Side Plank 1 minute 4 seconds

Left Side Plank 56 seconds

Wall Sit 1 minute 27 seconds

Interpretation:
Cortney’s push up score was just good on the normative values table. Since it was scored
as good I am not concerned, but I am sure she can do more and improve.
For the plank, Cortney held a plank position for as long as she could. The time was
recorded. I found some data on planks using Topendsports.com. Her plank time was average
according to Topendsports.
For the side plank, we tested how long she could hold the plank position on each side of
the body. She held her right side plank 8 seconds longer than her left side plank. This is
something to note, because this could lead to injury with having the two sides not symmetrical.
Since there is no normative datas, I would keep this information and use it to compare to her new
data at the end of the 12 weeks.
For the wall sit muscular endurance test, Cortney held a wall sit for as long as she could.
She did it against a wall with her knees at a 90 degree angle. I don’t have normative data for a
wall sit, so we would just use this information for when we retested at the end of her program.
Postural Stability:
BESS On Ground On Pad

Normal Stance 0 0

Single Leg Stance 2 5

Tandem Stance 0 7

Y-Balance (in cm) Trial 1 Trail 2 Trial 3 Average

Right Anterior 59 57 61 59

Right Posteromedial 93 96 93 94

Right Posterolateral 86 93 99 93

Left Anterior 53 55 67 58

Left Posteromedial 92 88 95 92

Left Posterolateral 87 94 95 92

Right Left Difference

Anterior 59 58 1

Posteromedial 94 92 2

Posterolateral 93 92 1

Right Composite Score 86.3 %

Left Composite Score 90.2 %

Interpretation:
For the BESS test, Cortney was in the 90th percentile except for 2 of the tests. She landed
in the 76-90th percentile for single leg stance and tandem stance on the pad. Meaning she could
work on having more balance on the pad in other stances.
 Looking at the Y-balance test, between the right and left for each test the differences
were not significant. It would have stuck out if the numbers were greater than 4 cm. For the
composite scores, the right side is concerning. According to Plisky et al, there is a lower
extremity injury risk with composite scores below 94%. Both of Cortney’s composite scores are
below 94%. So, she is concerned at risk to Plisky et al. But looking at the differences between
the two numbers, she isn’t at risk. I would have to continue and just know she could be at risk.

Part 3:
BIG PICTURE:
Cortney’s goal is become symmetrical between both sides of the body & improve splits on each
side by 5% each week.

CRF plan: 2 days per week

Cardiovascular is not apart of Cortney’s goals, but it is good to keep Cortney doing this
to ensure cardiovascular health. The plan will include 30 minutes of 60% HRR (run or bike) on
days she is not doing strength training.

Strength and mobility plan: 4 days per week with mobility snacks
The first goal is becoming symmetrical between both sides. For this goal, we would have
to decide what is not symmetrical after completing the tests. Looking at all of the ROM tests,
Ely’s test and shoulder internal rotation were the only two that the left and right sides were off by
more than 2 degrees. For Ely’s test, the left side is close to the value it should be. So, the right
side would need more attention. I mentioned earlier I could have her roll out the rectus femoris
muscle and it would help. For the shoulder internal rotation, I could have her practice internal
rotation with a cable. She could do this as a mobility snack, because you wouldn’t need to add
weight. Looking at the FMS scores, only shoulder mobility was different between right and left.
Adding in shoulder mobility snacks would help fix internal rotation ROM and shoulder mobility
for FMS. I would suggest Cortney to do T-spine rotation movements for help fix both problems.
The second goal is improving splits on each side. The legs seemed to be symmetrical
when it came to ROM and strength tests. I am concerned with Cortney’s internal hip rotation
though, and that should be fixed before attempting to improve her splits. She could add butterfly
stretches, piriformis stretches, and lying hip rotations into her stretches to help out the internal
hip rotation problem. After 1 week, we will test and see the results of the internal hip rotation
test. Once this is fixed, her splits can be improved. Splits aren’t about strength exercises;
therefore, she would be adding more mobility snacks to improve her splits by 5%.