What if you can’t do the “perfect” exercise to get fit?

He was frustrated and confused. Jason (I’m using a fictional name for this individual) came in with low back pain after exercising.

Jason was in his 50’s and decided he finally wanted to get fit. He excitedly hired a trainer and began a weight training program. But then he started having low back pain. It seemed to always come after doing bent over barbell rows. The trainer insisted that bent over barbell rows were an important exercise, so Jason kept at it. The pain continued session after session. And it got worse. Finally, Jason decided to see a doctor. The doctor gave him pain-relieving medications, recommended physical therapy, and told him that weight training is dangerous.

So, Jason comes to the PT clinic with conflicting advice. The trainer insists that the exercise (the bent over barbell row) is fantastic and crucial to getting fit. The doctor says that weight training is dangerous.

Sound familiar?

Unfortunately, this happens all too often. Trainers fetishize certain exercises. They insist on the superiority of a particular exercise to get fit. Then on the other hand, some doctors and physical therapists say that certain exercises are inherently dangerous.

So what does someone new to exercise do?

In the example with Jason, we first ruled out a more insidious, “red flag” cause of the low back pain. Note that in the vast majority of people with low back pain, there is not an insidious, “red flag” cause of pain (such as tumor or fracture) (Hartvigsen 2018), (Seizer 2007).

Next we zoomed out to ask, “Why do bent over barbell rows?”

We do them to strengthen the upper body pulling muscles like the biceps, latissimus dorsi, rear deltoids, and trapezii.

The next question, “How else can we strengthen those upper body pulling muscles?”

There are many options; seated cable rows, arm supported dumbbell rows, and more.

We found exercises to work those upper body pulling muscles, while not aggravating his low back. This might seem like an obvious solution. But many coaches fixate on certain exercises as being of vital importance. They fit the person to the exercise, rather than fit the exercise to the person.

Why do coaches prize certain exercises?

Well-intentioned coaches may focus on certain exercises because of their training. Some training organizations and influential fitness gurus prefer certain exercises. Aspiring coaches learn from them and then carry on the tradition.

For example, some coaches dogmatically state that low bar back squats are superior. However, research suggests that many squat styles, both back and front squats, produce similar muscle activation (Yavuz, 2015). Anecdotally, you observe people building plenty of muscle and strength using different squat styles.

Further, the squat is not even necessary for everyone. Research shows that for those new to lifting, the leg press exercise can build just as much strength and muscle as a squat (Rossi, 2018).

A caveat. If you want to compete in a sport like powerlifting or must perform a specific exercise for athletic testing, that is a different story. In that case, you have to specifically train that exercise at some point.

Are bent over barbell rows “bad”? Is weight training dangerous?

There is nothing inherently dangerous or “bad” about the bent over barbell row. I use them for myself and clients. They can be a fantastic exercise. But certain people, at certain phases in their life, may not tolerate them well.

For Jason at that point in his life, the bent over barbell row was not a good exercise. But later, when his back was feeling less aggravated, we could reintroduce it. Just because an exercise is not well tolerated now, does not mean we cannot return to it later.

Broadly speaking, there is nothing inherently dangerous about weight training. Research suggests that the injury rate of weight training is low (similar to that of walking for exercise – quite low) (Powell, 1998). This is not to say that walking is dangerous. Rather, that weight training is a safe, healthy activity just like walking. Further, the Center for Disease Control (CDC) actually recommends “muscle-strengthening activities” at least 2 days per week for adults.

So, to wrap up, there are no “perfect” exercises that you need to get fit. And most exercises aren’t inherently dangerous or “bad”. In weight training, we have a menu of options for different people in different phases of life. 

*Medical Disclaimer: Please be advised, the information provided in this article is educational in nature and not meant to diagnose or treat any disease, illness, or condition. For individualized recommendations it is best to follow up with a licensed provider, like myself or another physical therapist.

The Real “Secret” to Getting and Staying Fit

Getting and staying fit can be tough. And we have limited time and energy. So how should we allocate our precious resources of energy and time?

We can use the analogy of big rocks. Focusing on big rocks helps us get results, rather than get distracted and confused by minor or irrelevant things. It is a mantra I repeat to myself and clients to stay focused on what matters.

The Big Rocks Analogy

Imagine you have some small stones, big rocks, and a jar. If you first put the small stones in the jar, you’ll fill up the jar but not have room for the big rocks. However, if you start with the big rocks, you’ll fit all the big rocks in the jar AND have room for the small stones.

Similarly, in fitness there are big rocks and small stones. And there are some things that shouldn’t even go in the jar.

Example: Big Rocks for Weight Loss

Let’s take weight loss as an example.

One of the big rocks for weight loss is eating whole, minimally processed foods that keep you full. Another big rock is eating fewer processed foods and liquid calories (like soda, juice, and alcohol). Both of these big rocks reduce overall caloric intake which contributes to weight loss.*

On the other hand, a small stone for weight loss is eating an exact ratio of carbs, protein, and fat. This might be relevant once someone has lost a lot of weight and wants to get a 6-pack. However, for the majority of weight loss, focus on the big rocks first.

Lastly, there are things that don’t even belong in the jar. For weight loss this would be gimmicks like apple cider vinegar shots and green tea extracts. At best, they are a waste of time and money. At worst, they are a distraction from the big rocks that truly matter for weight loss.

Most Fitness Goals Have Big Rocks

The big rocks analogy holds for goals other than weight loss. For example, a big rock to get stronger is to lift increasingly heavier weights consistently over time. Choosing the best brand of lifting belt is a small stone.

Usually big rocks are not cool or sexy. The results take longer, but are real and sustainable.

Whatever your fitness goal, first ask what are the big rocks?

*There are other big rocks for weight loss, but for brevity, I’ve just listed two big rocks in this article.

Does Stretching Pre-Workout Decrease Strength?

We hear lots of narratives about stretching before lifting. Some lifters insist on stretching before training. Others claim that it hurts performance.

But what does the research say?

Behm et all did a systematic review of research on the effects stretching.1 They looked at the effect of stretching pre-exercise on strength. They examined other variables too, but we’ll focus on strength today.

What studies were included?

The review included 125 studies looking at:

  1. Static stretching – holding a muscle at its lengthened position.
  2. Dynamic stretching – moving joints through their full range of motion.
  3. Proprioceptive Neuromuscular Facilitation (PNF) stretching – a technique of contracting and relaxing muscles to increase flexibility.

How did stretching pre-exercise affect strength?

Generally, static stretching and PNF stretching caused a decrease in strength afterwards. Dynamic stretching did not affect strength much afterwards.

Static Stretching

Static stretching was associated with a 4.8% decrease in strength.

But the story doesn’t end there. The researchers found a “dose-response relationship”. Meaning that as stretch duration increased, strength was further decreased. For stretches performed for < 60 seconds, strength decreased by 2.8%. However, when stretches were held for > 60 seconds, strength decreased by 5.1%.

Dynamic Stretching

Dynamic stretching had trivial effects on strength. Strength decreased by only 0.23%.

PNF Stretching

PNF stretching was similar to static stretching – it was associated with a 5.5% decrease in strength.

It makes sense that PNF stretching would follow the same trend as static stretching. Both involve relaxing and holding muscles at their end range.

What does this mean for lifting?

-If you want to maximize strength, do static stretching after training.
-If you really want to do static stretching before training, keep it brief (30 seconds per stretch). Research suggests that a 30 second stretch increases flexibility as much as a 60 second stretch.2
-Dynamic stretching before training has trivial effects on strength.

I personally do not have clients stretch before lifting. In addition to this research, I’ve observed that static stretching is relaxing and calming. Before training, we want to get amped up and excited – the opposite of lying on the ground relaxing into stretches.

Static stretching can feel great. But to maximize lifting performance, save it for after training.


  1. Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2016). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme41(1), 1–11. https://doi.org/10.1139/apnm-2015-0235
  2. Bandy, W. D., Irion, J. M., & Briggler, M. (1997). The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Physical therapy77(10), 1090–1096. https://doi.org/10.1093/ptj/77.10.1090

5 Steps to Pass the CSCS

Annoyed. Caught off guard. Surprised.

These are common reactions of candidates who take the Certified Strength and Conditioning Specialist (CSCS) exam. I’ve known candidates with exercise science degrees and even physical therapists who have not passed the exam.

According to the National Strength and Conditioning Association (NSCA), only 58% of candidates pass both sections of the CSCS exam (the exam has 2 sections-“Scientific Foundations” and “Practical/Applied”). At the time of this writing, retaking a single section costs as much as $385. Besides the money spent on a retake, consider the time wasted studying again and retaking the exam. It’s fair to say that you probably want to pass the whole exam on the first attempt-saving money and time.

You can pass the exam with the right strategy. I’ll show you the exact steps I took to pass the CSCS exam on the first attempt.

1. Read AND Understand the Textbook

The “Essentials of Strength Training and Conditioning” textbook houses the foundational content for the CSCS exam. However, the textbook includes a lot of research and information that may not be directly applicable to the exam.

While reading, focus on deeply understanding these areas:

  • Charts, graphs, and diagrams/images. These graphics synthesize much of the relevant content from each chapter.
  • Bolded vocabulary terms. You should understand these terms with respect to human physiology and real world coaching. Simply memorizing definitions is of little use for the exam.
  • Understand the cues and technique corrections for each exercise. Many candidates are gym goers and have a false sense of confidence with respect to exercise technique. Unfortunately, the NSCA has specific, detailed cues for each exercise that you may have never given much thought. Also, the corrections for technique errors might vary from your personal experience as an athlete or coach, so you’ll need to understand the NSCA’s corrections.

2. Apply the Information Practically

Too often, candidates only understand the CSCS information intellectually, without knowing how it relates to the real world. Applying the information to real athletes makes the information stick better and improves you as a coach.

Start by applying the information to your own training. For example, I experimented with some of the plyometric progressions; squat jump > tuck jump > single-leg tuck jump. This gave me a kinesthetic understanding of the increasing intensity of each exercise.

Besides your own training, apply techniques to your clients. For example, I learned of the 2-for-2 “rule” (if the athlete performs 2 more reps than planned for a given weight, for 2 workouts, then it’s time to increase the load). I started applying this to training clients as a conservative way to increase load.

3. Test Yourself with Practice Questions

Test taking is a skill and practice questions are the most specific way to improve that skill.

Practice questions help you:

  • Simulate exam conditions. Studying with calming music, snacks, and coffee breaks is significantly different than sitting in a quiet exam room for 4 hours straight. Practicing questions in exam conditions builds the mental endurance needed to pass.
  • Experience the format of exam questions. Having experience with exam question format means you’ll spend less time reading and analyzing questions and more time answering questions.
  • Practice rusty math skills. Many candidates forget that calculators aren’t allowed on the CSCS exam. There will be basic math on the exam like calculating percentages, multiplying, and long division. You want to do be able to do these calculations effortlessly-save the mental exertion for the tough questions.

4. Understand the Content Outline

A major mistake candidates make is only reading the textbook and ignoring the content outline. The content outline lists topics that are not heavily covered in the textbook (such as deceleration drill technique). These topics are still relevant and can appear on the exam, even if they are not emphasized in the textbook.

5. Use Flashcards

While, you should prioritize understanding the content and its application, certain pieces of information simply have to be memorized.

For example, it’s great to understand that pre-exercise carbohydrates help athletes. But you need to know the specific recommendations in terms of timing, quantity, best sources of carbohydrates, etc.

Studying with these steps will help you pass the CSCS exam on the first attempt. Passing the CSCS exam depends on studying hard AND studying smart.

CSCS Practice Question Preview

A critical part of studying for the Certified Strength and Conditioning Specialist (CSCS) exam is practicing test questions. However, just practicing questions is not enough. Every question should be “milked” out for all its worth. Each question is an opportunity to hone in on topics you don’t yet have a good grasp on.

To aid you with that, here is a sample of practice questions. Also, I’ve included explanations and heuristics to help you understand the content, rather than just use rote memorization.

You can grab a free downloadable version below:

1. The lowest myoglobin content is found in which of the following muscle fiber types?

A. I

B. IIa

C. Ix


2. Activation of which of the following structures causes relaxation of a muscle:

A. Muscle spindles

B. Golgi tendon organs

C. Intrafusal fibers

D. Extrafusal fibers

3. Force output of a muscle can be increased by:

I. Increasing the number of motor units activated

II. Increasing the frequency of firing of individual motor units

III. Increasing the strength of the action potential

IV. Increasing the amount of acetylcholine released, well beyond the minimum





4. Caffeine supplementation would primarily provide which of the following benefits to a powerlifting athlete?

A. Increased mental alertness

B. Increased maximal strength output

C. Increased hypertrophy

D. A synergistic effect with creatine to increase maximal strength output

5. While a basketball athlete practices free throws, a coach should use which of the following reinforcement strategies:

A. Say “Great job” after each successful free throw

B. Bench the athlete for the first 10 minutes of the next game if they make less than 50% of free throws

C. Assign 10 pushups after every missed free throw

D. Stay silent to let the athlete improve their self-efficacy


1. B

Myoglobin is found in muscle and transports oxygen into/throughout the muscle cell. Hemoglobin is found in red blood cells and transports oxygen throughout the circulatory system to be distributed to various tissues.

Myoglobin will be found in higher content in muscles that rely more on aerobic energy systems (and vice versa, less myoglobin is found in muscles that rely more on anaerobic energy systems). Type I fibers, or slow twitch fibers, are fatigue resistant, have a high capacity for aerobic energy production, and have a low capacity for rapid force production. On the other hand type IIa and IIx fibers, or fast twitch fibers, fatigue quickly, have a poor capacity for aerobic energy production, and high a capacity for rapid force production. Type I and type IIx fibers are the extreme ends of the spectrum-type I are the most aerobic and weakest and type IIx are the most anaerobic and strongest. Type IIa fibers are a hybrid with qualities of both.

Type I fibers produce high amounts of aerobic energy so they have much more myoglobin. On the other hand, type II fibers do not rely heavily on aerobic energy systems, so they have much less myoglobin.

To remember the difference between type IIa and type IIx fibers, think of “A”=awesome. Type IIa fibers are “awesome” because they have qualities of type I and type IIx fibers and can be thought of as a hybrid of each.

2. B

Proprioceptors are the sensory receptors in joints, muscle, and tendons that respond to pressure and tension. The 2 main types are muscle spindles and Golgi tendon organs (GTO’s).

Muscle spindles are a specialized fiber found within muscles. Muscle spindles are considered intrafusal fibers because they are within the muscle. Muscle spindles run parallel to the “normal” (extrafusal) muscle fibers.

Muscle spindles sense lengthening of a muscle, so when lengthened (stretched), they cause a reflexive contraction of that same muscle. An example, is the patellar reflex. By tapping the tendon of the quadriceps, the muscle is shortened which activates this reflex, causing a quadriceps contraction.

On the other hand GTO’s are found at the musculotendinous junction. They sense lengthening of the tendon of the active muscle. When a heavy load is placed on a muscle, the GTO actually inhibits muscular contraction, causing it to relax. Researchers believe that one of the neuromuscular adaptations of resistance training is the ability to override this relaxation response caused by GTO’s.

3. C

The force output of a muscle is determined by: the number of units activated (recruitment) and the frequency of activation of those units (rate coding).  A muscle produces more force when more motor units are activated and/or those motor units are activated at a higher frequency. Besides, the neurological factors ofrecruitment and rate coding, the morphological factor of muscle cross sectional area determines force output. Increased muscle cross sectional area (hypertrophy) means a larger output of force.

The action potential to create a muscular contraction is caused by sufficient acetylcholine release. However, beyond the minimum level required, more acetylcholine release does not create higher force output.

Also, the strength of the action potential does not determine the force output, rather the frequency of the action potentials (rate coding) determines the force output.

To remember the three main ways of increasing muscular force output, we’ll use a car analogy.

You can go faster in car by upgrading the engine of the car. Getting a more powerful engine allows you to go faster-let’s say upgrading from a V6 Toyota Camry to a V8 Corvette. This is the effect of adding muscle cross-sectional area (hypertrophy).

-You can go faster by making the engine more efficient. Maybe you already have a Corvette, but only half the cylinders in the engine are firing. You tighten a few screws and now all cylinders fire. Through training, we can increase the recruitment of MORE motor units, thus increasing the force output (recruitment).

-You can go faster by learning to shift into higher gears. You might be pushing the gas pedal, but if you’re stuck in 1st gear, you won’t be going very fast. Being able to shift up to your top gear lets you access those higher speeds. Through training, we can increase the frequency of activating motor units (rate coding).

4. A

Caffeine appears to benefit both anaerobic and aerobic athletes. The main benefits are increased mental alertness, improved work capacity, and decreased feelings of exertion.

In aerobic events, caffeine increases time to exhaustion. In anaerobic events, caffeine may increase power performance in trained athletes.

In any case, the recommended dosage is 3-9 mg/kg bodyweight taken 60 minutes before exercise or during prolonged exercise. A lethal dose is 5 g. As a reference point, a typical cup of coffee has 120 mg of caffeine.

5. A

In coaching, behavior change strategies can help modify athlete behaviors. These strategies can be positive or negative and are focused on reinforcement or punishment.

In “Positive” behavior change strategies the coach ADDS something. However, this doesn’t mean that it is always something good. On the other hand, in “negative” behavior change strategies, the coach SUBTRACTS something.

Now for the terms reinforcement and punishment. Reinforcement strategies focus on promoting the desired behavior (successful performance of the task). Punishment strategies focus on eliminating undesired behavior (errors in performance of the task).

So when we put these together, positive reinforcement is ADDING something as a reward for the desired/correct behavior. In this question, we are ADDING the “Great job” to promote the desired behavior of making the free throw.

On the other hand, negative reinforcement is SUBTRACTING something seen as bad to promote the desired/correct behavior. An example would be SUBTRACTING wind sprints at the end of practice to promote the desired behavior of making the free throw.

Positive punishment is ADDING something bad to eliminate undesired/incorrect behavior. In this question, assigning 10 pushups is ADDING something bad to eliminate the undesired behavior of missing the free throw.

Negative punishment is SUBTRACTING something good to eliminate undesired/incorrect behavior. In this question, benching the athlete for the first 10 minutes of the next game is SUBTRACTING something good to eliminate the undesired behavior of missing the free throw.

Here is a summary in table format:

Generally, coaches should use reinforcement strategies to help athletes focus on what they do correctly. Positive reinforcement strategies tends to promote the athletes focus on task relevant cues such as the ball, hoop, and the motions of the free throw. On the other hand punishment promotes a focus on irrelevant cues which can decrease performance.

To get more practice questions, in-depth explanations, and tips for CSCS preparation, enter your email below to get the full study blueprints e-book when released!