Active IQ Level 3 Diploma in Instructing Pilates Matwork (sample manual)

Manual 

Level 3 Diploma in 

Instructing Pilates 

Matwork 

Version AIQ004724

Section 1: The heart and circulatory system and its relation to exercise and health 

The valves of the heart 

In order to function effectively as a pump, the heart needs 

to direct blood through the atria, ventricles and then the 

arteries of the body. The heart prevents unwanted backflow 

of blood into the chambers using a number of valves. 

These valves open and close in response to changes in 

pressure as the heart contracts and relaxes. The structure 

of the valves means that they only allow blood to flow 

in one direction by shutting once blood has been pushed 

through them. This is fundamental to effective circulation; 

any back-flow through the heart will compromise the 

efficiency of each heartbeat, which is likely to affect 

exercise performance and health. 

The main valves of the heart are the atrioventricular (AV) 

valves and the semilunar (SL) valves. The AV valves are 

located between the atria and the ventricles and prevent 

the back-flow of blood from the ventricles into the atria. 

As the ventricles contract, pressure rises and forces the AV 

valves to snap shut, allowing blood to be directed through 

the arteries leaving the heart (pulmonary artery and aorta). 

SOMETHING EXTRA 

As the AV valves snap 

shut, they are anchored 

in place by tendonlike 

chords (chordae 

tendineae) which prevent 

the valve flaps from being 

pushed too far into the 

atria. 

The SL valves are located at 

the base of the arteries leaving 

the heart (aorta and pulmonary 

artery). After each contraction, 

there is a relative drop in 

pressure within the ventricles 

as they relax. At this point, the 

blood within the pulmonary 

artery and aorta could potentially 

flow back into the ventricles. To 

prevent this, both sets of arteries 

have SL valves positioned at the 

point where they emerge from the ventricles. As the blood 

moves back towards the ventricles, the SL valves snap 

shut so blood cannot re-enter. 

It is the sequential shutting of the valves during the cardiac 

cycle that causes the distinct ‘lub-dub’ noises associated 

with the heartbeat. 

Superior 

vena 

cava 

Right 

pulmonary 

veins 

Right 

atrium 

Right 

ventricle 

Inferior 

vena cava 

Atrioventricular (AV) 

valves 

Aorta 

Pulmonary 

artery 

Figure 1.2 The heart 

Figure 1.3 The valves of 

the heart 

Left 

pulmonary 

veins 

Left 

atrium 

Left 

ventricle 

Semilunar 

(SL) valves 

MEMORY JOGGER – HEART CIRCULATION 

The heart is stimulated to contract by a complex series of integrated systems. The heart’s pacemaker – 

the sinoatrial (SA) node – initiates the cardiac muscle contraction. The SA node is located in the wall of 

the right atrium. The myocardium (heart muscle) is stimulated to contract about 72 times per minute 

by the SA node as part of the autonomic nervous system. 

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Section 1: The heart and circulatory system and its relation to exercise and health 

Short-term effects of exercise on blood pressure 

A short-term effect of exercise is a linear increase in systolic blood pressure (SBP) 

with increasing levels of exertion. In contrast, diastolic blood pressure (DBP) may 

decrease slightly during exertion due to vasodilation, or it will remain unchanged. 

Individuals with hypertension may experience a rise in DBP as a result of an 

impaired vasodilatory response. 

Heavy weight training and isometric exercise will significantly increase both 

systolic and diastolic blood pressure. It is important for an individual not to hold 

their breath when performing these exercises to avoid the Valsalva effect. This 

effect is created by the Valsalva manoeuvre, which involves holding the breath 

while straining or a forced exhalation against a closed airway (glottis). This action 

increases pressure within the thoracic cavity and thereby impedes venous return 

of blood to the heart. During the manoeuvre, the mouth and nose are closed while 

the air is ‘pushed’ against the closed airway without breathing out. It’s similar to 

the pressure created when passing a bowel movement. The Valsalva effect can 

drastically increase blood pressure and heighten the risk of a cardiovascular event 

such as a heart attack or stroke. 

Long-term effects of exercise on blood pressure 

Aerobic exercise using large muscle groups in rhythmical activity is very useful for reducing blood pressure 

over time. Durstine and Moore (2003) state that endurance training can elicit an average decrease of 10 

mmHg in both systolic and diastolic blood pressure in mild and moderate hypertensives. 

Anatomy and physiology for exercise and health 

With the exception of circuit weight training, chronic strength or resistive training has not consistently been 

shown to lower resting blood pressure. Resistance training can have many benefits for hypertensives, but it 

is not recommended as a means of decreasing blood pressure on its own. 

Exercise and blood pressure considerations 

Short-term increases in blood pressure result naturally from physical activity. These increases can be 

exaggerated by the Valsalva effect, which causes rapid short-term rises in blood pressure. Consequently, blood 

pressure can be elevated to dangerously high levels during exercise in people with pre-existing hypertension. 

Increased risk of stroke 

during and immediately 

after exercise. 

Exercise is therefore 

associated with 

a number of 

cardiovascular risks 

including: 

Increased risk of heart 

attack (myocardial 

infarction) during and 

immediately after 

exercise. 

TRAINER TIP 

To avoid excessive 

increases in blood 

pressure while 

resistance training (as 

a consequence of the 

Valsalva effect), inhale 

as you’re bringing the 

resistance back to its 

resting position and 

exhale as you’re working 

hardest against the 

resistance. 

For certain clients, the risks associated with exercise need to be weighed up against the benefits before they 

engage in any physical activity – especially if it’s high-intensity. Physical activity can carry risks for people 

with high blood pressure, but for most people, the benefits far outweigh the dangers. 


Section 2: The musculoskeletal system and exercise 

The shoulder girdle 

The shoulder girdles are comprised of the scapulae and clavicles. They need to move in concert with the 

shoulder joints in order to enable the complex movements of the upper limbs. 

Posterior muscle of the shoulder girdle 

The upper back of the shoulder girdle is occupied by the trapezius, rhomboids 

and levator scapulae muscles. These allow for various combinations of elevation 

(shrugging the shoulders), retraction (military posture – shoulders back, chest out) 

and depression (shoulders dropped) movements to occur. 

KEY POINT 

The shoulder girdle is 

comprised of the scapula 

and clavicle. 

Rhomboid major Rhomboid minor Levator scapulae 

Trapezius 

Figure 2.7 Muscles of the shoulder girdle 


Anterior musculature of the shoulder girdle 

The pectoralis minor and serratus anterior muscles originate from the costal bones 

and run to the anterior surfaces of the scapulae area. The anterior–inferior alignment 

of these muscles enables them both to protract and depress the shoulder girdle. 

When combined with the appropriate shoulder joint action, these muscles assist 

the types of pushing movements associated with performing a press-up or throwing 

a punch. 


Serratus comes from 

the Latin ‘serrare’ which 

means ‘to saw’. This 

refers to the serrated 

origin of the serratus 

anterior muscle as 

it comes off the first 

to eighth ribs. This is 

clearly visible in leaner 

individuals. 

Serratus anterior 

Pectoralis minor 

Figure 2.8 Anterior musculature of the shoulder girdle 


Section 6: Energy systems and their relation to exercise 


Research by Robergs et al. (2004) casts severe doubt on the fatiguing effects of lactate. Traditional theories describe lactate as the 

cause of the burning sensations and fatigue during high-intensity activities. The cause is in fact a concurrent build-up of hydrogen ions 

which makes pH levels drop – a state known as acidosis. Acidosis inactivates various enzymes involved in energy production and can 

interfere with muscles’ contractile ability (McArdle et al., 2001). 

This question arises: does lactate production cause an increase in hydrogen ions or does this just occur at the same time? Hydrogen 

ions are released when ATP is broken down to ADP. These ions are normally absorbed in the aerobic energy system, but during highintensity 

activities, the breakdown of ATP is occurring at a massive rate and thus the build-up of hydrogen is unavoidable. Pyruvate can 

be used to maintain the pH and buffer these hydrogen ions by binding with them – the result is the formation of lactate. The study by 

Robergs et al. (2004) proposes that the production of lactate is, therefore, a result of the body’s attempt to prevent acidosis and is not 

actually the cause of it. 

Aerobic (oxygen) system 

Aerobic simply means ‘with oxygen’ and refers to the energy system that produces ATP from the complete 

breakdown of carbohydrate and fat in the presence of oxygen. The aerobic energy system is dominant during 

low- to moderate-intensity activities (up to 75% HRmax), when ATP demands are low and so oxygen is 

relatively plentiful, e.g. sleeping, sitting, walking and light aerobic activity (such as jogging, recreational 

cycling and swimming). 

The aerobic system produces carbon 

dioxide, water and heat as by-products 

of the breakdown of CHO and fat. 

Carbon dioxide is breathed out during 

respiration and the water is available 

to the cells or is lost through sweat 

or expiration. Lactic acid does not 

accumulate during aerobic metabolism 

because oxygen is present. 

With the abundance of CHO and fat in 

the body, there is almost no limit on the 

amount of ATP that can be produced, 

and therefore the low- to moderateintensity 

activity supported by the 

aerobic energy system can be sustained 

indefinitely. There are, however, limits 

on the rate of aerobic ATP production. 

oxygen 

CO 2 

H 2 

0 

fatty acids 

cellular respiration in 

mitochondria 

glucose 

ATP 

Figure 6.4 Aerobic system 


As discussed earlier, when exercise intensity reaches a certain point, 

the lactate system will start to provide more and more energy during 

the buffering process. The point at which this occurs will vary according 

to individual aerobic fitness (the ability to take in, transport and utilise 

oxygen). The higher the aerobic fitness, the higher the exercise intensity 

that can be maintained without the accumulation of fatiguing waste 

products (i.e. one can run faster for longer). This point will be explored 

further when we address training adaptations. 

Assuming the absence of any overuse injury, the recovery time from this 

type of exercise will be the time taken to eat, drink and replenish fuel 

stores. 

KEY POINTS 

The aerobic system sustains low- to 

moderate-intensity activity (up to 

75% HRmax). 

This system supplies energy 

aerobically from the complete 

breakdown of carbohydrate and fat. 

The by-products of the system, 

carbon dioxide and water, are easily 

removed. 


Section 4: Providing ongoing customer service to clients 

Section 4: Providing ongoing customer 

service to clients 

Any person you attend to while working in a professional role can be considered a customer. 

KEY POINT 

Client care is the ability 

to consistently meet 

(and, ideally, exceed) 

customers’ needs, wants 

and expectations. 

EXTERNAL 

CUSTOMERS 

• Are the people who pay to 

use services and facilities, 

e.g. health club members, 

visitors and guests of 

members. 

INTERNAL 

CUSTOMERS 

• Are people who work for or 

with an organisation; they 

include people who rely on 

the instructor and people on 

whom the instructor relies 

for support, information and 

products. Internal customers 

include managers, cleaners, 

receptionists, maintenance 

staff and healthcare 

providers. 

The terms ‘client care’ and ‘customer service’ describe the ability to consistently meet (and, ideally, exceed) 

customers’ needs, wants and expectations. 

The importance of good client care 

Customers are vital for every organisation or service in the health and fitness industry. The industry would 

not survive without customers. 

Supporting clients who take part in exercise and physical activity 

Upholding standards of customer care is essential. It is important for the client, as it allows for an enjoyable 

experience in the health and fitness environment and encourages long-term involvement in physical activity. 

It also benefits the organisation by helping to secure repeat business and recommendations. 

ADVANTAGES FOR THE CLIENT 

Provides a positive customer experience. 

Increases their enjoyment and satisfaction. 

Ensures that their needs, wants and expectations are 

met. 

Increases the likelihood of them adhering to their 

programme. 

Makes them likely to share their experience with friends. 

Makes them likely to continue using the services. 

Provides a positive, upbeat environment for external 

customers. 

ADVANTAGES FOR THE ORGANISATION 

Builds a positive reputation. 

Shows high standards of professional practice. 

Increases the chance of repeat business and returning 

customers. 

Helps to acquire new customers through recommendation. 

Helps the business to flourish and grow. 

Promotes industry sector growth. 

Provides a positive working environment for internal 

customers. 

Table 4.1 The advantages of good client care 


Section 1: The components of fitness 

The strength and endurance continuum 

Some exercises can be classified as strength-biased or endurance-biased, but it is often individual factors that 

determine whether a specific activity involves more strength or endurance. 

A person who is only able to perform one press-up, for example, would be developing strength whereas a 

person who is able to perform lots of press-ups would be developing endurance. So strength or endurance 

bias will be determined by the individual and how hard the exercise is for them, which will influence the 

resistance they can lift and the number of repetitions they can perform (see figure 1.4). 

STRENGTH 

LOW REPETITIONS 

HIGH RESISTANCE 

1-10 repetition maximum 

ENDURANCE 

HIGHER REPETITIONS 

LOWER RESISTANCE 

40-70% of repetition maximum (RM) 

Figure 1.4 Muscular strength and endurance continuum 

Principles Of exercise, fitness and health 


Neutral spine 

A neutral spine is when the spine has retained its natural ‘S-shaped’ curves. It is one of the safest positions 

and minimises stress on the spine. Generally it is the mid-point, or halfway between a flat back and hollow 

back position (Norris, 2001). The spine is neither flexed (when the posterior muscles are lengthened and the 

discs compressed), nor extended (when the anterior muscles are lengthened and the facet joints compressed). 

7 Cervical 

(secondary 

curve) 

Intervertebral 

foramen 

12 Thoracic 

(primary 

curve) 

Intervertebral 

disc 

Vertebral 

body 

Facet joints 

5 Lumbar 

(secondary 

curve) 

Structure of a vertebral disc 

5 Sacral 

(fused) 

4 Coccygeal 

(fused) 

One way of teaching the neutral spine position is to bring the client’s attention to the natural curve in the 

cervical spine from a semi-supine (crook lying) position. The thoracic spine should be supported on the mat, 

the pelvis in a neutral alignment and the lumbar curve should be present. The size and shape of the lumbar 

curve is individual, but most people should just be able to slip the back of their hand under the curve. 

NB: Other start positions can be used to find neutral, semi supine. Crook lying is one of the easiest to use 

because the floor offers a surface to ‘feel’ the movement.

Active IQ Level 3 Diploma in Instructing Pilates Matwork (sample manual)

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