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TRAINING PLANS Athlete QuestionnaireContact InformationNameJane RobertsAddress26 High Valley View Circle, Houston, -5555FaxContact Preference1. Email, 2. Phone 3. Skpe (jrobertstriathlete)(email, phone, text)Emergency Contact(email, phone)Medical 125 lbsIs this your normal weight?YesResting Heart Rate54Resting Blood Pressure120/80Conditions/Chronic diseasesHave you ever had any of the following:DiabetesHepatitisPneumoniaHigh Blood PressureBack/jointpainHeart MurmurV.2 - 9/2015Kidney InfectionInfectious Mono

TRAINING PLANS Athlete QuestionnaireMedical HistoryCardiovascularAre you suffering from a heart Condition (heart attack, angina, irregular beat,hole in heart etc.)?YesX NoDo you feel pain in the chest when performing physical activity?YesX NoDo you suffer from high or low Blood Pressure?YesX NoAre you taking medication to control your blood pressure or a heartcondition?YesX NoDo you have a back or joint problem that could be made worsethrough physical activity?YesX NoDo you knowingly suffer from Diabetes?YesX NoDo you suffer from respiratory Illness (asthma, bronchitis,emphysema) or have shortness of breath with mild exertion?YesX NoAre you under medical treatment for any illness?YesX NoFor Ladies Only: Are you pregnant (or have you had a child in the last 3months)?YesX No

TRAINING PLANS Athlete QuestionnaireMedical History (cont.)SurgeriesAppendix removal / c-sectionMedicationsBirth controlAllergiesDon’t handle dairy / lactose wellInjuries (bones, joints, muscle)and/or surgeriesStress fracture of the tibiaTreatment for injuriesRest, non impact activitiesWhat aggravates injuriesHigh running mileageAny (safety) issue that wouldaffect training program?NoneHistory of medical issues duringexerciseTend to get dehydrated and have white residue on clothing after longtraining sessionsLifestyleWorkType; Schedule; Amount of sitting / StandingAdministrative Asst. / 30hr work week / shorter work day 9-3,Mon - Fri / 90% seated desk workFamilyWho; AgesHusband - 37 years oldSon - 5-years-oldSon - 7-years-oldHobbiesCookingTravelAmount; Trips during this yearSeldom / one family summer vacation per year - 10-days (Julytime-frame)Amount of vacation/Time offNumber of hours/week exercising5-6 hoursPreferred Time of Day exercisingMorning’sAccess to pools/waterLocal YMCA poolAccess to biking (outdoor/indoor)Mostly indoor - home trainer or spin class at YMCA, outdoor onweekendsAccess to running (outdoor/indoor)Mostly outdoor - quiet neighborhoods roads

TRAINING PLANS Athlete QuestionnaireExercise ilable2 hours1 hour3 hours1 hour2 hours3-6 hoursOffSwim30 min MBikeRun30 min E1 hour H1 hour E45 min E1 hour H1 hour MWeightsDietaryNumber meals/day1 meal (dinner), breakfast & lunch on-go. Snack levelCalorie intake (if known)Approx. 1400 per dayModified diet/restrictionsLower dairy intake, causes some GI issueFood preferencesGeneral - fit with family style balanced eatingDietary supplements (vitamins, herbs,minerals, protein, replacements)Multi-vitamin, Omega 2 supplement, protein shake couple timesa week

TRAINING PLANS Athlete QuestionnairePsychological [ 1 Poor 2 Fair 3 Good 4 Very Good 5 Excellent ]12345CommentXSelf-awarenessLevel of confidence to complete the A raceXAbility to set goals and targetXAbility to follow through with goalsXUse of visualization/imagery to prepare fora raceXUse of self-talk/thought controlXAbility to pay attention/focus under stressAbility to endure peak sensationXXAbility to excel under pressureXAbility to make decisions under stressXConsistencyXAbility to take recovery days without guiltXTriathlon HistoryDate 1st triathlon completedSeptember, 2010Number of triathlons completed11Longest distance completed- what- total time- splitsIRONMAN 70.3IRONMAN70.3 Texas, 3 years2014 - 5.23S - 35 / B - 2.54 / R - 1.48Other endurance eventsHouston Marathon, 2012 - 3.37 / 1/2 Marathon 2014 -1.39Qualifications/HonorsGoalsCompete training and racing for IRONMAN injury free and to feelgood on the run. To Finish IRONMAN70.3 hilly bike course feelinggood for the run.

TRAINING PLANS Athlete QuestionnaireAthletic History (other than triathlons)Other endurance eventsWhat: MarathonWhen: 2012Time/Ranking:3:37Other types of exercise/physical activitiesNoneType of organized sportsNone(current)Types of organized sportsNone(past)Triathlon and Other events for seasonPriorityRaceRace Name: IRONMAN Texas - A RaceRace Date: May (3rd weekend)Race Distance: IRONMANRace Name: Iron-Girl Sprint Tri - B RaceRace Date: Late FebruaryRace Distance: 1K/15K/5KRace Name: IRONMAN 70.3 Oceanside- B RaceRace Date: March (last weekend)Race Distance: IRONMAN 70.3Race Name:Race Date:Race Distance:Race Name:Race Date:Race Distance:Race Name:Race Date:Race Distance:

TRAINING PLANS Athlete QuestionnaireSwimmingYears swimming?4 years - some youth swimming during junior school yearsTotal weekly distance(Low;high) 3000 yds low - 6000 yds highWeekly frequency2-3 X per weekLongest swim (to date)3000 ydsOrganized program?NoPlanned workouts?Self plannedSwim capabilityTimes for 100 yd: come in at 1.40-1.45500 yd/-8.301,000; 1650 yd)- 18min/ 25minWhat do you think are your limiters?Time and solo trainingWhat do you think are your strengths?Getting it done on my own, ability to stick to plan w/oWhat equipment do you own?Paddles and pull buoyAccess to pool/waterLocal YMCA, 2 miles down road with 25 yard poolBikingYears biking?4 yearsTotal weekly distance(Low 50 miles; high 120 milesWeekly frequency2-3x’sLongest bike (to date)65 milesOrganized program? Racing club?NoPlanned workouts?NoBike capability (time/distances)Only tested during racesWhat do you think are your limiters?Time, weakness on hills - live in flat area, no access to hills. Brace IRONMAN70.3 has hills on bikeWhat do you think are your strengths?Motivation to get betterWhat equipment do you own?Indoor wind trainer, triathlon bikeAccess to riding (indoor, outdoor)Outdoors on weekends with husband, easy home training onwind trainer, spin bikes YMCADo you ride in a group?No

TRAINING PLANS Athlete QuestionnaireRunningYears running?12 yearsTotal weekly distanceLow - 15 miles ; high - 40 milesWeekly frequency3x per weekLongest run (to date)Marathon in 2012Organized program? Racing club?NoPlanned workouts?Hills? Intervals? Track? Off-Road?Self planned intervals on road 1x weekRun capability (time/distances)1 mile time;5k time; 22 min10k time; 43 min1/2 marathon; 1.39Marathon; 3.37What do you think are your limiters?Fear of higher mileage due to fear of stress injuryWhat do you think are your strengths?Consistency over many years, except for injury, favoriteactivityWhat equipment do you own?Garmin WatchAccess to running (outside, inside)Easy running in neighborhood and local park - flatStrength and ConditioningDescribe your current strength andconditioning program (include organizedNoneclasses, frequency and duration).Which of the following types ofequipment do you have access to?X Weight machinesX Free weights (dumbbells and barbells)X Cable machinesX Elastic resistance (rubber tubing and bands)X Medicine ballsX Kettle bellsSuspension trainersX Stability balls (including half-dome)

TRAINING PLANS Athlete QuestionnaireStrength and Conditioning (cont.)Does your occupation require extendedperiods of sitting?I sit most of the time at my desk, including lunch breaks.Does your occupation require extendedperiods of repetitive movements? (If yes,please explain)Yes. Typing on a keyboardDoes your occupation require you to wearshoes with a heel (dress shoes)?Occasionally

SWIM Swimming Assessment FormAthlete NameJane RobertsEquipmentEquipmentDescriptionSuitSpeedo training suit / ROKA Swim skinWetsuitRoka - MaverickGogglesSpeedoPaddlesYesPull buoyYesFinsNoAnkle bandNoResistant bands(dry-land) NoWatch / clockYes GarminHeart Rate MonitorNoLap counterNoMetronomeNOType of pool (and length)25yd - Local YMCAInterested?Yes

SWIM Swimming Assessment FormLevel of Skill (Self-Assessment)[ 1 Novice / Uncomfortable 5 Experienced / Comfortable N/A Not applicable D/K Don’t know ]12Open water swimming34XSwimming in wetsuitXSwimming in poolXCold waterXChoppy / wavy waterXSalt waterXFresh waterPacing (long distance)5XXInterpret swim workoutXEffort outputs RPE (zones 1 - 5)XD/KN/AComments

SWIM Swimming Assessment FormTraining HistoryLongest swim (to date)3000yds - once when training for 70.3Complexion of training sessions -pool (frequency, duration, type)Past 2x per week / 30-60 minutesCurrent - SameDesired - Need to build endurance and distance for IMComplexion of training sessions -open water (frequency, duration, type)Past – none, only open water has been at racesCurrent - sameDesired - would like more but opportunity is limitedGroup / organization (history, current,available)Coach / instruction(history, current, available)Swim capability (predicted)None – swim aloneMaster group at YMCA – have not joinedSome at junior schoolNone presently. Is a coach as swim program at YMCATimes for 100 yd/meter: 1.40Time for 500 yd/meter: 8.30Time for 1,000 yd/meter:18minTime for 1650 yd/1500 meter 25minTriathlon TimesSwim split: sprint – 15minSwim split: Olympic – 25minSwim split: IRONMAN70.3 – 35minSwim split: IRONMAN – predicted 1.15 – 1.20

SWIM Swimming Assessment FormStroke AnalysisBody PartEyesMovementEyes looking downSideDescriptionXHead is a bit droppedXhead not neutral - head positiondropped a littleXBreathes left - struggle with bilateralEyes looking upwardHead - water levelMid-line headForehead / hairlineHead neutralBreathingHead to side; low goggle underwaterHead high; forehead exposedHead out of waterUnilateralBilateralBreathing pattern (number of strokes) XEvery twoHead and trunk in alignment duringbreathingHead too lowX

SWIM Swimming Assessment FormStroke AnalysisEntry4 fingers and thumb together (flathand)Thumb firstLittle finger firstXSplashXNot full extensionXDistance from entry to headXEntry a little too close too the headXBreathes to left so tends to crossmidline with right handX and wrist at fullPosition of elbowextensionBefore catch(R) Hand catches across midline(L) Hand catches across midlineCatchLeft is good(R) Hand catches across midlineXSlight elbow drop - bothXS-pull crossing over midlineX

SWIM Swimming Assessment FormStroke AnalysisBody PartPull patternMovementSideArms pass under bodyDescriptionXArms pass next to bodyFingers togetherS-pull (crossing over midline)XHip rotation (0-30)Hip rotation (30-60)XHip rotation (60-90)RecoveryElbow leads - bentXArms away from bodyStraight armHipsNear surfaceXBelow surfaceKickFoot plantarflexed (pointed)Foot dorsiflexedKick amplitudeFoot slightly breaks surfaceRight legRatingLeft legXNumber of beatsXWidth between legs (tight) duringentry / rotationX1 fair2 okay3 good2-34 good5 very good6 excellentWith right arm

SWIM Swimming Assessment FormStroke Analysis TechniquePriorityRaceSolutionHeadRaise head to more neutral positionlook down to muchDrills – especially open water sighting type drill,raising headBreathingBreathes only to left causingcrossover with right armDrills, especially cath-up and more pull buoysets to allow focus on head position balanceLegsModerate scissoring when breathingDrills and pull buoy to balance rotation to bothsidesFitnessMethod of measurementX 100 yd / meter repeats500 yds / meters1000 yds / metersMeasurementsSet 1Set 2Set 3Set 4Set 5Speed (min:sec / dist)1.351.361.361.381.39Strokes (per length)191919202033444Stroke (rate)Heart rateRPE