Friday, October 29, 2010

Swiss Ball : a story

Hello  Everyone,
I am a versatile device,  I was born in 1960's not from the human womb but from a human mind of a Italian Plastic Company.

I have different names, but I am famous only after a name coined by a Physiotherapist from United States in 1980's.

Some says I am being used extensively in Switzerland, So they call me in that name.

"I am"  being widely used around the world now a days, from light aerobic classes to professional athletic training institutions, as more and more people learn the benefits of using "ME".

Many movement scientists (Physiotherapists) says various benefits can be expected from using "ME" like

  •   Enhanced Balance
  •   Improved Posture & support around joints
  •   Greater Muscle strength, power & endurance
  •   Greater Flexibility and Range of Movement in Joints
  •   Improved metabolism, Body weight control
  •   Prevention of muscle and Joint Atrophy (Loss of Muscle Mass)                                      caused by ageing
  •   Reduced Risk of Injury 

How one can Choose "MY" Correct Size

    Height                  Ball size required
                 
    Up to 5'6"            55 cm (22 inches) 
    5'7"- 6'."               65 cm (26 inches) 
    6'1"- 6'9"              75 cm (30 inches)  

Found any Clue ??

Yes,


"I am"

"The Swiss Ball"

Sunday, October 24, 2010

The Physical Therapist Relationship with the Family of CP child

The role of the primary treating physical therapist, especially for the young child between the ages of 1 and 5 years, will incorporate the typical role that the grandmother and the general pediatrician play for normal children. In addition, the therapist fulfilling this role must have knowledge and experience in dealing with children with CP. This role model involves time spent teaching the parents how to handle and do exercises with their child. This role also involves helping the parents sort out different physician recommendations, encouraging the parents, and showing and reminding parents of the positive signs of progress in the child’s development. When this role works well, it is the best therapeutic relationship a family has. The positive aspects of this role are providing the parents with insight and expectations of their child, reassuring the family that they are providing excellent care, and being readily available to answer the family’s questions.
The “grand mothering” role of the therapist has associated risks. One of the greatest risks in our current, very unstable medical environment is that a change in funding or insurance coverage may abruptly end the relationship. An abrupt  change can be very traumatic to a family. The therapist must be careful not to be overly demanding of the family, but to help the family find what works for them. Occasionally, a therapist may be fixated on a specific treatment program and  believe that it is best for the child; however, the parents may not be in a situation to follow through with all this treatment.
The parents feel guilty, and the therapist may try to use this guilt to get them
to do more. The physical therapist in this role as a therapeutic “grandmother” can help parents sort out what medical care and choices are available. The therapist can help parents by attending physician appointments and making the parent ask the right questions, which is often not possible because of funding restrictions. The physical therapist must not give specific medical advice beyond helping parents get the correct information. Therapists with extensive experience  should recognize that they have great, detailed, and deep experience with a few children and that generalizing from the experience of one child is dangerous. We have heard therapists tell parents on many occasions that their child should never have a certain operation because the therapist once saw a child who did poorly with that surgery. This type of advice is inappropriate because one child’s experience may have been a rare complication of the operation. Also, there are many different ways of doing surgery. This would be like telling someone to never get in a car again after seeing a car accident. A more appropriate response to the family would be giving them questions to ask the doctor specifically about the circumstance with which the therapist is concerned and has experience.
Another physical therapist therapeutic relationship pattern is the purely clinical relationship in which the therapist thinks the family is incompetent, unreliable, or irresponsible and only wants to deal with the child. Almost invariably, this same therapist next will complain that the family and child never do the home exercise program or that the child is not brought to therapy regularly. This relationship may work for a school-based therapist or a therapist doing inpatient therapy, but it leads to great frustration for both the therapist and family when it is applied to an outpatient-based, ongoing developmental therapy. In this environment, the therapist must try to understand and work within the family’s available resources.

Water for Fat Loss

If you don’t drink enough water you can actually get fatter. I have put this sentence right upfront because I know what works on you. So now that I have your attention, I will take it from the beginning.  Water makes up 55 to 75% of your total bodyweight. Your blood is made up of ninety percent water. Reduction in 10 % of water can make you sick and 20% can cause a death.

If you do not provide enough water to your Kidney’s, your liver becomes forced to detoxify toxins. When your liver takes on this role, then your liver becomes less effective in completing it’s other jobs including metabolizing the food that you eat.
It is important that you drink enough water so that your liver can do it’s job to metabolize body fat as efficiently as possible.

If you don’t drink enough water then extra glucose remains in the blood until it reaches the liver at which point this glucose becomes stored as fat instead of glycogen. All of this nastiness can be avoided by drinking a healthy amount of water.
It is recommended that you drink plenty of water on a daily basis  – make sure to drink water 20 minutes before exercising to ensure that your body is properly hydrated. It is also recommended to drink water after high carbohydrate  meals. You don’t have to wait until your body signals you that you are thirsty. By the time you realize you are thirsty you are already dehydrated.
One of the best ways to check if you are dehydrated is to check your urine. Relax – just a quick glance below can tell you what you need to know. If your urine is dark with a strong smell then chances are you are dehydrated. The lighter and clearer it appears the better. If you really feel like you have to go to the toilet, but only pass a small amount of urine, this could also signal that your body needs water.
Our muscles are made up of up 70 to 80% water. You can very quickly see why drinking enough water is vital for performance.

Sunday, October 17, 2010

Pehr Henrik Ling

Per Henrik Ling (15 November 1776–3 May 1839) was a developer and teacher of Swedish medical-gymnastics.

Contents

[hide]

[edit] Early life

Ling was born at Ljunga in the south of Sweden in 1776, the son of a minister, Lars Peter Ling, and the former Hedvig Maria (Hedda) Molin. Through his mother, he was a great-great grandson of the famous Swedish scientist Olof Rudbeck (1630–1702), discoverer of the human lymphatic system. After graduating from Växjö gymnasium in 1792, he studied theology at Lund University from 1793, but went to Uppsala University and completed his degree there in 1797.

[edit] Travels and Mr. Ming

Ling then went abroad during seven years: on his first voyage he befriended a certain "Ming", a Chinese fellow who was both a martial artist and tui na practitioner.[citation needed] They soon became fencing and exercise partners in Copenhagen, where Ling studied at the University of Copenhagen and taught modern languages. During the first four years of his voyage Ling had received much guidance by his Chinese friend, specifically on fighting, exercise and health philosophies that fascinated him for their amazing integration and efficiency.
His journey then took him to Germany, France and England during which he continued to acquire more knowledge on his friend's special "gymnastics" or exercises designed to improve the strength, flexibility and overall stamina necessary to his fencing passion. Financial difficulties, joint (overuse) injuries and rheumatism caused him to return to Sweden where he took the time to heal himself by applying these pressing-pulling and squeezing exercises and maneuvers he had learned.

[edit] Teaching

Having established himself as a teacher in these arts at Lund, Ling was appointed fencing-master to the Uppsala University (1805). He found that his daily exercises had completely restored his bodily health, and his thoughts now turned towards applying this experience for the benefit of others. He saw the potential for adapting these techniques to promote better health in many situations and thus attended classes on anatomy and physiology, and went through the entire curriculum for the training of a doctor. He then elaborated a system of gymnastics, exercises and maneuvers, divided into four branches, (1) pedagogical, (2) medical, (3) military, (4) aesthetic, which carried out his theories and would demonstrate the required occidental scientific rigor to be integrated or approved by established medical practitioners.
After several attempts to interest the Swedish government, Ling at last obtained government co-operation in 1813, when the Royal Gymnastic Central Institute for the training of gymnastic instructors was opened in Stockholm, with Ling appointed as principal. The orthodox medical practitioners were naturally opposed to the larger claims made by Ling and his disciples concerning cures of diseases, so far at least as anything more than the occasional benefit of some form of skillfully applied massage and maneuvers was concerned; But the fact that in 1831 Ling was elected a member of the Swedish General Medical Association (Svenska läkaresällskapet) shows that in his own country at all events his methods were regarded as consistent with professional recognition. He was elected a member of the Swedish Academy in 1835 and became a titular professor the same year.

[edit] Legacy

Ling died in 1839, having previously named as the repositories of his teaching his pupils Lars Gabriel Branting (1799–1881), who succeeded him as principal of the Institute, and August Georgii, who became sub-director; his son, Hjalmar Ling (1820–1886), being for many years associated with them. All these, together with Major Thure Brandt, who from about 1861 specialized in the treatment of women (gynecological gymnastics), are regarded as the pioneers of Swedish medical gymnastics.
Ling and his earlier assistants left no proper written account of their treatment, and most of the literature on the subject is repudiated by one set or other of the gymnastics practitioners. The origins and greatest influences of Dr Ling's work was certainly those of his Chinese friend "Ming" who had introduced him to Tuina and martial arts. The loss of filiation with these oriental influences were uncovered inadvertently by Johan Georg Mezger (1838–1909) who coined a reduced set of maneuvers and techniques of Dr. Ling's system as the "Swedish massage" system. These techniques were effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements), and vibration (rapidly shaking or vibrating specific muscles). These are also basic techniques of tui na and Chinese massage.
Ling's system of medical gymnastics also influenced later institutions and systems. The Gymnastic Orthopedic Institute was founded in Stockholm in 1822 by Nils Åkerman, which after 1827 received a government grant. Around 1857, Gustaf Zander elaborated a medico-mechanical system of gymnastics, known by his name, and started his Zander Institute at Stockholm in 1865. At the Stockholm Gymnastic Central Institute, qualified medical men have supervised the medical department since 1864. The course is three years; one year for qualified doctors.
Broadly speaking, there have been two streams of development in the Swedish gymnastics founded on Ling's beginnings, either in a conservative direction, making certain forms of gymnastic exercises subsidiary to the prescriptions of orthodox medical science, or else in an extremely progressive direction, making these exercises a substitute for any other treatment, and claiming them as a cure for disease by themselves. A representative of the latter, more extreme, section was Henrik Kellgren (1837–1916), who had a special school and following.
Other variants and accounts of Dr Ling's practice and philosophies were published: a Handbook of Medical Gymnastics (English edition, 1899) by Anders Wide of Stockholm represents the more conservative practice. Henrik Kellgren's system, which, though based on Ling's, admittedly goes beyond it, is described in The Elements of Kellgren's Manual Treatment (1903) by Edgar F. Cyriax, who, before taking the MD degree at Edinburgh, had passed out of the Stockholm Institute as a gymnastic director. See also the encyclopedic work Sweden: its people and its industry: historical and statistical handbook (1904), p. 348, edited by Gustav Sundbärg for the Swedish government.

Friday, October 15, 2010

Classification of Impingement Syndrome According to Neer

Stage 1: Edema and Hemorrhage

Typical age               <25
Differential diagnosis Subluxation
                                    A/C arthritis
Clinical course            Reversible
Treatment                   Conservative

Stage 2: Fibrosis and Tendinitis

Typical age                  25–40
Differential diagnosis  Frozen shoulder
                                     Calcium deposits
Clinical course             Recurrent pain with activity
Treatment                    Consider bursectomy
                                     C/A ligament division

Stage 3: Bone Spurs and Tendon Rupture

Typical age                   <40
Differential diagnosis   Cervical radiculitis
                                      neoplasm
Clinical course              Progressive disability
Treatment                     Anterior acromioplasty
                                      Rotator cuff repair

Sunday, October 10, 2010

Spot Reduction

You cannot spot-reduce fat from your body. I cringe when I see an informercial for one of the many ab busters claiming that you can lose five inches off your waist and drop three dress sizes in a month simply by using their product for five minutes a day. These claims are flagrant misrepresentations that border on consumer fraud. Weight training helps develop shape and hardness in your physique. It cannot make an area of your body smaller, no matter how often or intensely you exercise a given muscle. In the case of the abdominals, training your stomach with crunches, sit-ups, leg raises, or any other abdominal exercise will serve only to increase muscle tone in that area. These exercise will do nothing to flatten your stomach, no matter how hard you try.    

       
    Initially, the thought of training your entire body every workout is intimidating. This workout is not a cakewalk, but its difficulty is somewhat mitigated by a reduction in the total volume and intensity of the routine. As you will see, the system is configured in a way that optimizes your body's recuperative abilities and builds a foundation of muscle without completely draining your resources. The following is the protocol for the weight-training component of the body-conditioning routine:    
       
    Exercises: For each muscle group, you will use only one exercise per training session. Each week you will work your entire body three times. Although training your muscles this frequently can sometimes be overwhelming, the sparseness of the workload will alleviate the risk of overtraining. By performing only one exercise per muscle group, you limit the amount of stress applied to each muscle. This allows you to recuperate quickly from a workout and enables you to train each muscle on a regular basis.    
       
    Sets: You should perform three sets of each exercise. This provides ample muscular stimulation without overtaxing the muscles. Do not move from one exercise to the next, as in a circuit routine. Rather, perform one set of an exercise, rest, perform your second set, rest, and then do your third set. This will keep the blood circulating through a muscle group, which increases your muscular pump and thereby augments definition. After finishing three sets of an exercise, move on to the next muscle group and perform your subsequent sets in a similar fashion.    
       
    Rest: You should rest no more than 30 seconds between sets. This will heighten exercise intensity and increase the aerobic benefit of the workout. In most cases, your routine will take slightly longer in the initial stages of training. As a novice, you will be unfamiliar with the intricacies of training and excessively concerned with matters such as your form, breathing patterns, and so forth. These factors will tend to slow the pace of your training. Still, it is best to keep your rest intervals close to the suggested limits. Rest longer only if you are feeling dizzy or overworked. Your body will quickly adjust to a fast-paced tempo, and you will soon be able to move from one set to the next without incident.    
       
    Repetitions: The repetition target will be 15 per set. It is essential to train with good form and to apply continuous tension to your muscles during each repetition. Make an effort to develop your mind-to-muscle link early, making each rep count. From the outset, do not fall into the habit of trying to determine where you are feeling muscular stress. This passive attitude indicates that you are not properly visualizing the target muscle. Rather, think about where you are supposed to feel an exercise. Your task is to isolate a muscle or group of muscles, purging all other thoughts. Do not be concerned with your surroundingswhatever might be going on around you is irrelevant. Forget your troubles, your business dealings, your family obligations. Concentrate only on performing each repetition with total focus on your target muscle.    
       
    Intensity: You should perform all sets with a weight that is approximately 75 percent of your maximum poundage. Your maximum poundage is defined as a weight that causes you to reach muscular failure on the 15th repetition. A weight of 75 percent of maximum poundage would normally induce momentary muscular failure at 20 repetitions. For example, let's assume that performing leg extensions with 40 pounds causes you to reach failure on the 15th repetition. In this scenario, your working weight for this exercise would be 30 pounds (40 ´ .75). By your 15th repetition, this weight should begin to feel heavy without causing you to struggle or compromise form to complete the set. As you gain strength, increase the amount of weight to maintain your target of 75 percent of maximum. Moreover, as you gain experience, you can gradually increase the percentage of maximum weight to a point where you begin to approach failure (going as high      as 90 percent of maximum poundage). This can help prepare your body for the intensity required in the next level of training. It is not advisable, though, to attempt to train to absolute failure. Your body is not yet geared for such intense exercise, and you will invariably become overtrained.    
Conditioning Protocols

Number of exercises:1 per muscle group
Number of sets:  3 per exercise
Rest between sets: No more than 30 seconds    
Repetitions per set: 15
 % of maximum weight: 75%
       
    The element in the left margin summarizes the specific protocols of the body-conditioning phase of this system. Follow these protocols rigidly, with little modification. As you become familiar with the training process and progress to the more advanced phases of this system, you will have flexibility to alter the structure of the routine. At this level, however, it is best to keep things simple.    
       
    Using a training diary can help you move smoothly through your routine. A good strategy is to write down in advance the exercises that you will perform. You can then do your workout routine knowing exactly what you are supposed to accomplish in the session. In this way, you won't aimlessly wander around thinking about which exercises to perform. The diary should include the exercises you used in each session, the amount of weight that you used in each set, and any notes that might help you in the future.    
       
    If you have never trained before, or have not trained for some time, consider your first few workouts an acclimation period. The goal should be to adapt your body to the routine and allow it to adjust to the stresses of weight training. Although you are probably already eager to see results, you should approach this phase as if you were about to swim in a cold pool. Obviously, it would be ill advised to dive headfirst into the pool without first testing the water! Your body could go into shock from the extreme difference between body temperature and the temperature of the water. Similarly, your muscles, connective tissue, and nervous system will experience shock from the demands of training, making it easy to overtax your body during this fragile period. If you are not careful, you can experience severe soreness, headaches, or injuries from overzealous efforts. These ailments can set back or stop your ability to work outand limit your potential to achieve results. Nothing can derail your workout regimen more than an injury, so use discretion.    
       
    Moreover, conditions related to age can further inhibit initial training efforts. After the age of 35, a woman loses roughly 1 percent of her muscle mass and bone density each year. By age 45, a woman will have lost about 10 percent of her fundamental body mass, by 55, 20 percent, and so on. Because this progression compromises strength and endurance, your capacity to train at an intense level will, at first, be hampered. Consequently, the older you are, the more careful you should be to acclimate your body during the initial stages of training. Although you can reverse the effects of aging, it will take time and a dose of patience.    
       
    To acclimate your body, you should use only 50 percent of your maximum weight during your first training session. In each successive workout, you can gradually increase the poundage until you reach your target weight. Determining your starting weight requires you to estimate your initial strength level, but without physically training to failure, you can only make an educated guess of your lifting abilities. To prevent injury, err on the side of caution and choose a      weight that is too light rather than too heavy. Remember, this is only an acclimation period, and you need not push hard. You will soon be able to gauge your strength and know beforehand the weight required for a particular exercise.    
       
    Even with proper acclimation, you should expect to feel a degree of muscular soreness. This is especially prevalent in the first few weeks of training, but you will experience this malady even after becoming an accomplished trainee. Although the pain should not be severe, you should feel tenderness and sensitivity in the muscles that you trained. Unfortunately, soreness is a necessary by-product of the training process. It arises from microscopic tears that occur from the stress of weight training, which subsequently cause internal swelling in your muscles and connective tissue. Usually, the soreness will last several days and slowly subside as your body initiates the healing process. This is an indication that your body is adapting to the demands of exercise and preparing itself for the next training session.    
       
    It is important that you not let muscular soreness inhibit or deter your training efforts. Working out during periods of mild soreness can help assuage the associated pain and discomfort. Training aids the circulation of blood flow through your muscles and connective tissue, which can accelerate recuperation. If you are extremely uncomfortable and simply cannot train, take a few days off and use soothing remedies such as whirlpool baths to alleviate the soreness. Try not to stay completely sedentary, though; even mild activity can increase circulation to body tissue and accelerate the healing process. Of course, if you experience any sharp pain, stop training immediately and seek the advice of a physician.    
       
    During the initial four- to six-week training period, you should employ compound movements whenever possible. As previously discussed, compound movements will stimulate the greatest amount of muscle fibers, as well as strengthen your connective tissue and orient your nervous system to the demands of weight training. This will help you achieve balanced development from the outset and negate the possibility of developing muscular deficiencies as you progress in your endeavors. The many variations of compound exercises permit you to add variety to your training and still meet this directive.    
       
    Table 3.1 details a three-day sample routine that you might use in the first four to six weeks of your routine. These routines, like all the sample routines in this book, are only a guide to the possibilities of creating a diversified workout. A multitude of combinations is available for you to explore. Varying your routine will optimize results and help prevent boredom.    

Table 3.1 Conditioning Program Three-Day Sample Routine
Muscle group   
      Day 1             Day 2        Day 3       

Chest     Incline dumbbell    presses    Machine chest presses    Push-ups
Back    Front lat pulldowns    Seated rows    One-arm dumbbell rows
Shoulders    Military presses    Arnold presses    Upright rows
Biceps    Seated dumbbell cruls    Cable curls    EZ curls
Triceps    Nosebreakers    Pushdowns    Close-grip bench presses
Quadriceps    Leg presses    Squats    Lunges
Hamstrings and glutes    Good mornings    Stiff-legged deadlifs    Hyperextensions
Calves    Seated calf raises    Donkey calf raises    Standing calf raises
Abdominals    Crunches    Bench leg raises    Knee-ins

       
       
    It is important to note the order of the exercises and how they relate to each muscle group. In the beginning stages of training, it is best to train large muscle groups first in your routine. Although it does not really matter whether you train your upper or lower body first, you should train the muscles of the torso (chest, back, and shoulders) before the arms (biceps and triceps) and the muscles of the quadriceps before the hamstrings. If you train smaller muscles first, they will be less able to serve as secondary muscle movers in exercises for the larger muscle groups. Ultimately, your secondary muscles will fatigue before your primary muscles, and you will not achieve maximal stimulation of the target muscle. For instance, performing a barbell curl will exhaust your biceps. If you then perform a seated row, your biceps will tend to give out before you fully stimulate the muscles of your back, thereby decreasing the effectiveness of the exercise.    
       
    Moreover, when training the upper body, it is best to alternate between pushing and pulling movements. The chest, shoulders, and triceps are used to push a weight, while the back and biceps are pulling mechanisms. Alternating these movements allows several minutes for the antagonist muscle to rest, thereby improving energy resources for exercise performance. Notice in the sample routine that you train first the chest (which uses the shoulders and triceps as secondary muscle movers), next the back (which uses the biceps), then the shoulders (which use the triceps), and finally the biceps and triceps. In this way, you maximize muscular recovery between each exercise.    
       
    After the initial four- to six-week acclimation phase, you should begin to incorporate isolation movements into your routine. Experiment with different exercises, paying close attention to the unique qualities of each movement. Make sure, though, that you do not neglect to include compound movements in your workout. These staple exercises, because of their all-encompassing effect, have great utility for beginners. Mixing a variety of compound and isolation movements into your workout will serve as a precursor to the next level of training, in which you will use a split routine.    
       
    Table 3.2 shows a three-day sample routine that expands on the initial routine by combining a variety of compound and isolation movements. You should now be comfortable with the structure of this routine and should work on perfecting what you have learned. Again, be creative and do not be afraid to try new exercises. This will not only provide stress to a maximum number of muscle fibers but also hone your performance skills for future gain.    


Table 3.2 Three-Day Routine With Compound and Isolation
Movements
Muscle group           Day 1          Day 2                  Day 3
Chest                    Pec decks    Flat dummbell      Flat bench flys
                                                   presses   
Back         Reverse lat pulldowns    One-arm seated rows Straight-arm pulldowns
Shoulders         Shoulder presses    Lateral raises    Bent lateral raises
Biceps              Preacher curls    Incline curls    Concentration curls
Triceps            Triceps kickbacks    Triceps dips    Overhead extensions
Quardriceps      Leg extensions    Hack squats    Front squats
Hamstrings and glutes    Lying leg curls    Abductor pulls    Seated leg curls
Calves                 Seated calf raises    Toe presses    Donkey calf raises
Abdominals         Rope crunches    Hanging leg raises    Twisting crunches



     When executing unilateral movements (in which you train one arm or leg at a time), it is best to avoid resting between sets. In the one-arm dumbbell row, for      instance, you should start with one arm, perform 15 repetitions, go to the other arm, perform 15 repetitions, and repeat this process without rest. Thus, one side will be able to recuperate while you use the other for performance of the movement. By the time that you have completed 15 repetitions on one side, your alternate side should be fully recovered and ready to continue with the set. Because your body is never totally at rest, you will be able to maintain an accelerated heart rate, increasing your body's ability to burn fat.    
       
    As you try different exercises, you will probably find some movements uncomfortable or awkward to perform. There may be several causes for this. Sometimes, even after repeated attempts, an exercise will just not feel right to you. If this is the case, simply drop it from your routine and move on to a complementary movement. There is no reason to keep the exercise in your training arsenal. You may decide, however, to try the exercise again after you have further developed your strength and motor skills. Often, you ultimately will find the movement to be natural and realize additional benefits from added variety.    
       
    You might wonder what to do if you are not able to perform a complete set of 15 repetitions of a particular exercise. In most cases, you should be able to decrease the weight enough so that you can achieve your target rep number. But you will probably come upon an exercise that, no matter how hard you try, will defeat your effort to finish an entire set. This may especially be true in abdominal exercises and other body-weight-influenced movements, in which your own weight will affect your strength capabilities. If you just cannot attain 15 reps for a given set, perform as many repetitions as you can until your body gives out. Fortunately, strength and endurance tend to build up quickly, and you will see rapid improvement in these areas. With continued effort, you should be able to achieve your target repetition number on virtually any exercise.

Once you have used the body-conditioning routine for a while, you will probably reach a point where you feel that you are ready to advance to a higher level. Understand, though, that taking the next step involves a significant increase in discipline and intensity. Each subsequent level of training requires a greater amount of effort. You therefore must use discretion in going forward. You may then wonder How do I know when I am ready to take the next step? In truth, there is no certain answer. Before you continue, however, you should consider these points:    
       
    Make sure that you are knowledgeable about the basic principles of exercise. The mental aspects of training become increasingly important as you climb the ladder in your fitness endeavors. Understanding these principles will be crucial in maximizing results at the next level of training. Make sure that you are clear on each principle and understand how they apply to the training process.    
       
    Make sure that you are comfortable with a variety of compound and isolation exercises. You should be able to perform dozens of exercises and be able to move easily from one to the next. Moreover, you should have a good grasp of exercise form and function and know the muscles that each exercise will target. In the next level of training, this knowledge will allow you to combine these movements to mesh synergistically with one another.    
       
    Make sure that you are willing and able to increase your exercise intensity. It is one thing to want to train on a more advanced basis; it is another to endure the intensity required for this progression. Many women do not realize the increased effort required to train at the next level. The body-conditioning routine is preparation for developing overall intensity. You should gauge your ability to progress based on the difficulty you have with this routine.    
       
    If you are still not proficient or capable in any of these areas, take more time to develop your skills and mental acuity. Work on the basics, preparing your mind and body for more intense training. Do not pressure yourself to advance to the next phase. In fact, if you are happy with the way that you look at this point, you can continue with the body-conditioning phase indefinitely. Many women do not aspire, or are not willing, to train at a higher pace and are content with maintaining the status quo. This routine, however, will not advance you to your genetic potential. Therefore, if you want to take the next step and begin the process of bodysculpting, advance to chapter 4 and read on.