PNES

Program Chatter 3: Where we can't work an athlete into the dirt

Welcome to the third installment of program chatter. This is going to be a long post as I’ve had about 7 months to work with an athlete with a unique condition that prevents the athlete from taking on too much generalized stress. As a coach, part of our jobs is to strategically apply mechanical stress to the athlete to create positive adaptations in muscular strength and coordination, so her condition means that we have had to be very judicious with adding in sets, reps, or exercises.

Athlete Info:

19 year old female whose weight would fluctuate between 46-50 kg with diagnosed PNES (Psychogenic Nonepileptic Seizures). She had an athletic history of winning a district 200m dash as a sophomore in high school, early childhood participation in gymnastics, and dance through all of middle, and high school, and had qualified for USAW Nationals previously as a youth athlete. During her prep for youth nationals, she had taken a jerk from the blocks at above the American Record for her age/weight class at the time. She had taken 2 years off of organized sports as she learned how to manage her PNES, which she noticed she would have more convulsions and seizures during stressful times in her life: Finals, job hunts, break ups, etc. She has since been pursuing weightlifting as a sport for about 8 months and in that time has managed to qualify for USA Weightlifting Junior National Championships.

Program 1:

To begin, we started practicing the sport of weightlifting 1 day a week, doing as little as was necessary to create improvement as measured by her Snatch and Clean and Jerk from week to week. A typical training session for this time would look like:

  • Tempo Snatch x2 + 1 Overhead Squat - build to heavy complex for day

  • Snatch - 4 attempts to heavy single

  • Tempo clean x2 + 1 Jerk - Build to heavy complex for day

  • Clean + Jerk - 4 attempts to heavy single

  • Back or Front Squat: We would work up to a rep max. Typically 8/6/ or 4 depending on week.

  • Core Accessory.

She was able to consistently add kilos to her lifts using this schedule from week to week and over the course of 7 weeks went from 38 snatch/50 clean and jerk to a 48/63. The following three weeks her numbers were stagnant or lower so we then added in a second day per week.

Program 2:

During this phase of training we wanted to not push her into the dirt, so we would have a heavy and a moderate day. Her biggest technique issues were getting early to the toes in her pull, and an inconsistent receiving position on snatch, so lots of halting and tempo lifts were used and extra overhead squats. A typical week would look like:

Day 1:

  • Snatch + overhead squat: Build to Heavy Complex

  • Clean + Jerk: Build to heavy complex

  • Front Squat - Build to a Rep Max (5 or 3 depending on how far out

  • Push and Core Accessory

Day 2:

  • Halting Snatch x2 + Overhead Squat x1, or Halt Snatch + Snatch + Overhead squat depending on proximity to competition. Load would be 80-90% of Best Recent Heavy Single (BRHS).

  • Halting clean x2 + Jerk x1, or Halting Clean + Clean + Jerk depending on proximity to meet. Load was 80-90% BRHS.

  • Back Squat Build to a Rep Max (6 or 4 depending on how far out)

  • Pull and Core Accessory.

After 10 weeks of this she won her weight class, and the best Junior Lifter Award at a local meet and in the process managed to qualify for USA Weightlifting Junior Nationals. Following that meet, she had a job change and some personal life stress, and had a few more frequent PNES episodes, so we took about 4 weeks off of training. Coming back she knew she wanted to push for a big total at Junior Nationals, and compete in her state championship meet to enjoy time with weightlifting friends. So far in her prep we have been running 3 days per week most weeks, with the exception of some 2 day week deloads when she felt that she needed it.

Program 3:

Day 1:

  • Tempo Snatch + Overhead squat. Reps have varied based on phase, but in general we’ve based the load for this off of 85-90% of a control exercise from the previous week. Typically Snatch x 2 or Snatch.

  • Tempo Clean + Jerk. Same concept as snatch. Getting in practice reps at sub maximal weights to develop timing, positional strength, and balance.

  • Front Squat. Work up to a Rep Max Based on phase.

  • Upper body and core accessory

Day 2:

  • 3 Position Snatch (top down) - 75-80% of control exercise. Enough sets to feel balance and rhythm.

  • 3 Position Clean (top down) - 75-80% of control exercise.

  • Snatch Pull - 3x3 @ 95-105% BRHS

  • Clean Pull - 2x3 @ 95-105% BRHS

  • Core accessory

Day 3:

  • Snatch - Control exercise for snatch movements. Either a double or single depending on phase.

  • Clean + Jerk or Clean + Front Squat + jerk - Control exercise for week. Either doubles, 2+1+1, or 1+1 depending on phase.

  • Back Squat. Work up to heavy rep max depending on phase.

  • Lower body and core accessory.

Don’t want to give away too much of how her states/nationals prep is going but we feel pretty good about her chances to really improve on her numbers and push for some state records in snatch/clean and jerk for the 49 kg class, and possibly get her senior national qualifying total out of the way this year before she ages up. It is important to note she has still had PNES episodes while doing this, but their frequency has not increased relative to before she returned to weightlifting. I am not a medical professional and I’m not going to comment on why that is, but as her coach I’m just super proud that she gets up and keeps fighting to the best of her ability every day.

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