Week of __________________________
You might want to make copies of this form. Leave this one blank, so you can copy it as needed.
This form is for keeping track of the activities and exercises you do each day.
(Make sure to check with your Doctor before starting any exercise program)
| Sun | Mon | Tues | Wed | Thurs | Fri | Sat | |
| Endurance: List the activity you did and how long you did it: | |||||||
| Activity: | |||||||
| How Long? | |||||||
| Flexibility. Check the box of each stretching exercise you did: | |||||||
| Hamstrings | |||||||
| Alternate hamstring | |||||||
| Calves | |||||||
| Ankles | |||||||
| Triceps | |||||||
| Wrists | |||||||
| Quadriceps | |||||||
| Double Hip Rotation | |||||||
| Single Hip Rotation | |||||||
| Shoulder Rotation | |||||||
| Neck Rotation | |||||||
SOURCE: National Institutes of Health (www.nih.gov)