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You Are The Solution

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.


This article was featured in MedFit Professional Magazine Winter 2020 issue. Subscribe to MedFit Professional Magazine to read more great content like this!

Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com.

 

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey

U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.

trainer-and-senior-woman-gym

Specialize and Thrive: Working with Individuals with Osteoarthritis and Joint Replacements

Arthritis is the most common cause of disability in the world.3 Osteoarthritis, the most common form of arthritis, has led to a dramatic increase in the incidence of hip and knee replacements in recent years. The rate of total hip replacements has almost doubled between the years 2000-20101 and approximately 7.2 million Americans are now living with hip and/or knee replacements. 6 While these rates have nearly doubled in recent years, the number of younger individuals (ages 45-54) having these replacement surgeries is increasing.5

The rapid and dramatic increase in individuals living with osteoarthritis and/or joint replacements has created a massive void between the number of people living with these issues and the number of qualified individuals to help them safely and effectively accomplish their functional goals. This void, however, has created an incredible opportunity for fitness professionals to align themselves with allied health professionals to become part of the solution. This article will discuss some recent changes in the thought process about how osteoarthritis develops, how fitness professionals are an important part of the solution, and why this is the most opportune time for fitness professionals to specialize and align themselves with health professionals.

Why do so many individuals experience osteoarthritis and what can be done about it?

While injury, overuse, age, obesity, genetics, and race have been given as possible causes, there has been a lack of solid evidence to explain why the incidence rate of osteoarthritis continues to skyrocket. 2,3,5 However, recently there have been suggestions that osteoarthritis is not as previously suggested, due only to old age or genetics. Dr. Ian Wallace, a postdoctoral researcher who has studied more than 2,000 skeletons, believes the recent dramatic increase in osteoarthritis isn’t an inevitable consequence of living longer. He believes it is more attributable to the modern decline of physical activity and is quoted as follows: “Dr. Wallace thinks the most obvious candidate to explain the increase in knee osteoarthritis is the modern decline in physical activity.” 8

Nevertheless, it is not just about people needing more quantity of activity; it’s also about the quality of the exercise.10,11 If exercise is performed without optimal joint alignment and control, the individual is at risk for developing degenerative joint changes.10,11 Therefore, it’s imperative that fitness professionals specializing in working with individuals that have osteoarthritis or joint replacements are able to properly assess for non-optimal and inefficient posture and movement habits and from these results, develop an appropriate exercise program. Additionally, fitness professions specializing in this niche must also be able to instruct proper exercise form and understand what exercises or activities are contraindicated with these populations. 10,11

A well-designed exercise program that includes flexibility, strength, and cardiovascular exercise is required to appropriately address the postural and movement habits that contributed to the development of osteoarthritis. Likewise, many individuals will have developed compensatory patterns as a result of joint pain or loss of mobility and subsequently developed non-optimal posture and movement habits that need to be addressed.

Several organizations including the Arthritis Foundation, Center for Disease Control, and American College of Sports Medicine have created guidelines for working with individuals that present with arthritis. General recommendations include improving joint mobility/flexibility, aerobic conditioning, resistance training, maintaining a healthy weight, and consulting with a medical doctor.2,3,13

Helping individuals develop a more optimal and efficient posture and movement strategy is one of the most effective strategies for safely working with individuals with osteoarthritis and joint replacements.9,10,11 An approach that includes using the most appropriate soft tissue release, mobilization, stretching, neuromuscular activation strategies, and appropriately progressing the individual through the fundamental movement patterns has been shown to improve joint mobility and strength in individuals with osteoarthritis as well as joint replacements. 9,10,11 Additional strategies that have been shown to be helpful in improving strength and mobility and managing the symptoms of osteoarthritis include three-dimensional breathing7,9,10,11, proper nutrition featuring a whole-foods, plant-based diet4, and meditation.14

The future

The great news is that there is a growing need for qualified fitness professionals to work with the increasing numbers of individuals that have osteoarthritis and/or joint replacements. However, this requires that the fitness professional have both the right education and the appropriate skillset as many of these individuals will require a thorough approach to address their specific needs and to provide them with the best functional outcomes. Organizations such as the MedFit Network, The Institute for Integrative Health and Fitness Education, and the Functional Aging Institute are helping to create the education necessary for health and fitness professionals to develop specializations in working with special populations including the older adult populations experiencing osteoarthritis and joint replacements. Additionally, through their educational platforms and live course work, they provide fitness professionals with strategies for aligning and working with allied health professionals.

For many individuals experiencing pain or loss of function secondary to osteoarthritic changes, seamless integration between medical procedures, rehabilitation, and functional fitness is becoming a viable and necessary alternative to narcotics and surgery. Hence, the birth of the medical fitness space where fitness professionals work either in collaboration with or in the actual physical location of medical doctors, physical therapists, chiropractic physicians, and massage therapists. Clinics such as Rejuv Medical have provided a model for how to improve patient outcomes by combining the benefits of regenerative medicine procedures (Plasma Rich Protein and Stem Cell Therapy), physical therapy, and personal/group training.

Specialization in working with individuals that have osteoarthritis and/or joint replacements and working in the medical fitness space is the future. The fitness professional that acquires the appropriate education and develops a working relationship with allied health professionals will be able to attract more individuals that need, want, and will pay for their expertise. By providing a more integrated and effective approach to helping individuals accomplish their health and fitness goals, these fitness professionals will continue to thrive in the coming years.

This article was featured in MedFit Professional Magazine. Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Evan Osar is an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the on-line educational resource www.IIHFE.com

 

References:

  1. American Association of Hip and Knee Surgeons. NCHS Releases Hip Replacement Data. Retrieved from http://www.aahks.org/nchs-releases-hip-replacement-data/
  2. Arthritis Foundation. Osteoarthritis Treatment. Retrieved from http://www.arthritis.org/about-arthritis/types/osteoarthritis/
  3. Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
  4. Clinton, C., O’Brien, S., Law, J., Reiner, C., Wendt, M.R. (2015). Whole-Foods, Plant-Based Diet Alleviates the Symptoms of Osteoarthritis. Arthritis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359818/
  5. Dotinga, R. (2015). Number of Hip Replacements Has Skyrocketed, U.S. Report Shows. Retrieved from https://consumer.healthday.com/senior-citizen-information-31/demographic-arthritis-news-37/number-of-hip-replacements-has-skyrocketed-u-s-report-shows-696419.html
  6. Mayo Clinic. First nationwide prevalence study of hip and knee arthroplasty shows 7.2 million Americans living with implants. Retrieved from http://www.mayoclinic.org/medical-professionals/clinical-updates/orthopedic-surgery/study-hip-knee-arthroplasty-shows-7-2-million-americans-living-with-implants
  7. Mattek, J. and Fisher, S. (2017). What Lies Beneath: The under-realized effects of breast, abdominal, and pelvic surgeries. St. Bernardino, CA: Niche Pressworks.
  8. McDonald, B. (2017). Skeletons say arthritis isn’t about aging – it’s about activity. Retrieved from http://www.cbc.ca/radio/quirks/august-19-2017-1.4252722/skeletons-say-arthritis-isn-t-about-aging-it-s-about-activity-1.4252755
  9. Osar, E. (2012). Corrective Exercise Solutions for Common Hip and Shoulder Dysfunction. Chinchester, UK: Lotus Publishing.
  10. Osar, E. (2017). Integrative Corrective Exercise Instructor Certification Program: Training the Older Client. Chicago, IL: Institute for Integrative Health and Fitness Education course handouts.
  11. Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning
  12. Pagnano, M., Wolfort, M., Berovitz, A. 2015. U.S. National Center for Health Statistics. Data brief; National Center for Health Statistics.
  13. Riebe, D., Ehrman, J., Liguori, G., Magal, M. ACSM’s Guidelines for Exercise Testing and Prescription. 10th Philadelphia, PA: Wolters Kluwer.
  14. Selfe, TK., Innes, KE. 2013. Effects of Meditation on Symptoms of Knee Osteoarthritis. Alternative Complementary Therapies; 19(3): 139-146.

 

fitness-dumbells-exercise

How You Can Be the Solution to the Sarcopenia Dilemma and Help Your Older Client’s Thrive

Gene, a 77-year-old retiree, has been in quarantine for the previous 10 months. He was not comfortable leaving his house to go to the gym and has declined invitations to do virtual (online) training. Hence, Gene has lost significant muscle mass, has been prescribed increased quantities of medications for Type II diabetes and high blood pressure. Additionally, his wife reports she has seen his muscle mass, bone density and health rapidly decline. He has lost his appetite and his quality of sleep has also suffered. Gene was prescribed an anti-depressant by his primary care physician to address associated lethargy and depression.   

Joel, an 85-year-old male, has left his house a total of five times in the previous 10 months. Through his wife’s encouragement, he continued his at-home workouts and even increased the frequency of his sessions from two to three times per week once the quarantine moved beyond four weeks. During this time, Joel has increased his lean muscle mass, improved his balance and his wife reports his legs are ‘rock solid and his energy has never been better.’ 

While Joel exemplifies the benefits of maintaining an active lifestyle and improving his muscle mass while in quarantine, he is in the minority. Unfortunately, there are millions of older adults just like Gene who are experiencing the deleterious impacts of quarantine and the sedentary lifestyle on their physical as well as emotional health. This is such a vital and overlooked aspect of health because many older adults may never fully recover in the event they contract a life-threatening disease.

This sentiment is summed up succinctly by (English and Paddon-Jones 2021):

“Thus, with advancing age, it becomes increasingly likely that even a brief, clinically mandated period of bed rest could initiate a serious decline in muscle strength and functional capacity, i.e., a “tipping point” from which some may not fully recover.”

This article will discuss how the Medical Fitness Professional (MFP) who focuses on educating and empowering their older clients can positively impact those experiencing sarcopenia-related health issues. Also included will be a brief discussion about the barriers to exercise suggestions the MFP can implement to address these issues. Finally, MFP’s will be empowered to utilize an education-first strategy while positioning themselves to attract more individuals that will seek out their expertise. 

The Impact of Sarcopenia-Related Multisystem Deconditioning

Sarcopenia, or age-associated loss of muscle density and strength, is a major health problem even when not in a period of quarantine. The loss of muscle mass is associated with all-cause mortality including cardiovascular disease, diabetes, cognitive decline, depression and an increased risk of falls (Kirwan et. al. 2020). The average adult over 30 years of age experiences a 3-8% loss of muscle mass per decade (English and Paddon-Jones 2010). This means that a sedentary individual could literally experience between 9-24% loss of muscle strength and function by the time they reach 60 years of age. Furthermore, 71% of older American males and 42% of older American females present with moderate levels of sarcopenia.

Unfortunately, this problem is exacerbated by periods of forced inactivity, for example, while bedridden. Young adults can experience a 5-6% decrease in muscle strength per week when bedridden (English and Paddon-Jones 2010). Because older adults begin with less lean muscle tissue than their younger counterparts, they are extremely susceptible to multisystem deconditioning and the subsequent health issues associated with the loss of muscle, strength and endurance. 

Sarcopenia is extremely concerning in vulnerable populations (example: older adults) as well as those with comorbidities (example: those with cancer). Muscle atrophy, weakness and pain (myalgia) is even greater after a significant illness and corresponding bedrest. It’s been reported that .5-6% losses in muscle mass per day can occur increasing risk of deteriorating health (Casey et. al. 2021). A 1.7% loss of muscle mass occurs in as little as 2 days and 5.5% after only 7 days of bed rest (Kirwan et. al. 2021). Additionally, 50% of patients experience ongoing myalgia and associated weakness which can last months after recovering from COVID-19 (Casey et. al. 2021). Additionally, the loss of smell, taste and appetite after illness leads to further losses in muscle mass as well as nutritional deficiencies potentially leading to further deterioration of one’s health. 

The Sarcopenia Solution

While its etiology is multifactorial, decreased physical activity and poor nutrition are the two primary aspects contributing to the progressive loss of muscle mass in both the sedentary populations and those with chronic health issues (Kirwan et. al. 2020). Kirwan et. al. recommends that resistance exercise “…be considered of prime importance in attempting to halt and even reverse the progression sarcopenia.” Additionally, Web MD suggests that “The primary treatment for sarcopenia is exercise, specifically resistance training or strength training (downloaded from WebMD 2021). 

While the strength and conditioning industry has long recognized and advocated the benefits of resistance training, getting individuals to comply with the recommended daily activity levels has been a challenge. The challenges to older adults remaining physically active have only been complicated by quarantine. Several organizations including the World Health Organization (WHO) have provided suggestions for getting the recommended 150-300 minutes of vigorous-intensity physical activity per week. To achieve this number while in quarantine, WHO Europe suggests taking short, active breaks, indoor walking and following an online exercise program. 

Since quarantine has forced the closure of many commercial facilities and due to the fact that many older adults are reluctant to leave their house, online or virtual exercise programs have become increasingly popular. Online platforms including but not limited to Zoom, Google and Facebook make it easy to create small group meetings which provide a powerful tool for educating, providing guided exercise programming and increasing socialization, all of which are vital in combatting sarcopenia and isolation-related depression that occurs with prolonged quarantine.  

While historically it has been a barrier to exercising at home, novel equipment such as resistance bands make training at home both practical and functional. Resistance bands provide a low-cost option as compared to free weights (Kirwan et. al. 2021). While Sanchez-Sanchez et. al. (2019) found resistance bands did not provide as much benefit for older adults experiencing sarcopenia as compared to moderate to vigorous exercise, anecdotal finds report contrary findings. Progressive overload utilizing varying tensions of resistant bands and novel anchoring positions has been clinically shown to increase muscle mass, improve joint health and foster confidence in older adults when incorporated into an overall resistance training program (Osar and Linkul 2021). 

In addressing sarcopenia, the importance of nutrition cannot be overstated. High-quality protein (25-30 grams with each meal) to increase muscle mass is part of the lifestyle program recommended by English and Paddon-Jones (2010). Additionally, the consumption of nutrient-dense, calorie-sparse foods like roots, leaves, fruits and seeds can have a positive hormonal effect (Mattioli et. al. 2020) thereby improving mood and quality sleep, both of which are necessary to the overall health and vitality in older adults. 

Solutions to the 3 Greatest Barriers to Resistance Training

Finally, while the benefits of resistance training for addressing sarcopenia are obvious, it would be remiss to leave this article without including a brief discussion covering a few of the barriers to older adults participating in physical activity. One of the greatest barriers for many adults participating in a physical activity program is the reluctance to be proactive about their health care. In part, this is because older adults haven’t been properly educated about the vital importance and their responsibility in self-care. Additionally, even when properly educated, older individuals are rarely given specific instructions and/or directions to achieving success. 

Solution: In addition to the in-session education, the MFP looking to maintain their current clients and wanting to attract more individuals, should dedicate several hours per week to educating their community. Invite current and past clients to participate in a no-cost, regularly scheduled webinar, podcast or virtual training on a relevant health topic. Encourage them to invite their friends, family and colleagues. It is important that these events be education-based rather than focused on selling one’s services. Include at least one simple, actionable health nugget – a bodyweight exercise, mindset habit or healthy shake recipe, for example – that the participants can easily incorporate into their current lifestyle. 

Another important barrier for older adults is the reluctance to seek out a fitness professional because the fitness industry has largely catered their offerings to younger, healthier individuals. This has discouraged countless numbers of individuals from exercising and made it increasingly challenging for the MFP to differentiate their services from the general personal trainer that is often ill-equipped in training the older adult. 

Solution: The number one method for differentiating oneself and to enroll older adults is to highlight current client’s success. Highlighting a current client’s success eliminates the temptation to spend needless time discussing why one’s education is superior to someone else’s. For example, the MFP should highlight clients who can successfully garden or play with their grandchildren or hike because of the resistance training program they’ve been performing. Older individuals need to see, and will, in turn, be empowered by, seeing others just like them achieving success with physical activity programs. Seeing one their own age successfully accomplish things they would like to be participating in will help foster a natural curiosity. This curiosity can ultimately lead to a conversation where the MFP discusses how a tailored program can also help them accomplish their health and fitness goals. 

Additionally, Fitness Professionals like Jackie Bachmeier (Evolution Fitness and Wellness) and Robert Linkul (Training the Older Adult), both of whom cater to training the older adult population, deliver the specific equipment (including resistance bands, hooks and self-myofascial release tools) they want their clients to utilize during their programs. This removes an additional obstacle while adding huge value to the client. 

The third major barrier to online training are technology-associated challenges. While many have legitimate technology challenges, the resourceful and proactive MFP can help remove that obstacle and ease older adults’ in their online transition. 

Solution: Both Robert and Jackie have dedicated specific time to helping technology-challenged clients understand and develop the confidence in using social media and related platforms. While it may seem a hassle in the beginning, when they recognize the relative ease and benefits of online training, many older clients will enjoy the process and in turn encourage their family, friends and colleagues to join in. For example, Jackie’s 83-year-old client Lillian commented that had she realized how easy technology was, she would have done virtual training earlier. She’s since referred her husband and several of her friends to Jackie’s programs. 

Conclusion

Sarcopenia is a rampant problem in older adults, complicating existing health issues and leaving this population particularly vulnerable to prolonged periods of inactivity. Exercise, particularly resistance training, and nutrition are two components that show strong evidence in improving muscle mass, improving health and reducing the risks of all-cause morbidity. By focusing older adults upon the factors within one’s control – i.e., physical activity, nutrition and mindset – the Medical Fitness Professional are well positioned to be the solution for both their current as well potential clients. By addressing the three major barriers to being physically active, the MFP can help their current clients regain their health and, in the process, differentiate themselves and attract more individuals that need, want and will pay for their expertise. By adopting these best-practices, the MFP can successfully position themselves as a major player in the solution to the sarcopenia dilemma.  


Dr. Evan Osar is a Chiropractic Physician, an adjunct faculty member with Rocky Mountain University of Health Sciences (Motor Control) and educator with the Integrative Movement Institute. He has authored “Corrective Exercise Solutions to Common Hip and Shoulder Dysfunctionand Amazon #1 Best Seller, “The Psoas Solution“. He developed the Integrative Movement System™, an evidence-based approach to improving clinical outcomes and helping patients perform at their highest level. Dr. Osar is currently in private practice in Chicago, IL and educates health and fitness professionals that specialize in posture, corrective exercise and medical fitness for the older adult population. 

 

References

Casey P, Ang Y, Sultan J. COVID-19-induced sarcopenia and physical deconditioning may require reassessment of surgical risk for patients with cancer. World J Surg Oncol. 2021 Jan 11;19(1):8. doi: 10.1186/s12957-020-02117-x. PMID: 33430881; PMCID: PMC7798369.

English, K. L., & Paddon-Jones, D. (2010). Protecting muscle mass and function in older adults during bed rest. Current opinion in clinical nutrition and metabolic care13(1), 34–39. https://doi.org/10.1097/MCO.0b013e328333aa66

Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. Geroscience. 2020 Dec;42(6):1547-1578. doi: 10.1007/s11357-020-00272-3. Epub 2020 Oct 1. PMID: 33001410; PMCID: PMC7528158.

Mattioli, A. V., Sciomer, S., Cocchi, C., Maffei, S., & Gallina, S. (2020). Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease. Nutrition, metabolism, and cardiovascular diseases : NMCD30(9), 1409–1417. https://doi.org/10.1016/j.numecd.2020.05.020

Osar, E. and Linkul, R. (2021). The Arthritis Training Solution 2.0. Training the Older Adult Live (Virtual). 

Sánchez-Sánchez, J. L., Mañas, A., García-García, F. J., Ara, I., Carnicero, J. A., Walter, S., & Rodríguez-Mañas, L. (2019). Sedentary behaviour, physical activity, and sarcopenia among older adults in the TSHA: isotemporal substitution model. Journal of cachexia, sarcopenia and muscle10(1), 188–198. https://doi.org/10.1002/jcsm.12369

Web MD. Sarcopenia with Aging. Downloaded 2/15/21 from https://www.webmd.com/healthy-aging/guide/sarcopenia-with-aging

World Health Organization. #healthy at home. Downloaded 2/15/21 from  https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome?gclid=EAIaIQobChMItpfrsInt7gIV7vLjBx1pAwf0EAAYAyAAEgKgTfD_BwE

World Health Organization (Europe). Stay Physically Active During Self Quarantine. Downloaded 2/15/21 from https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine

orthopedic-fitness-rehab-trainer-and-female-client

Fitness Pros: You Are The Solution

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.

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MedFit Network professional membership includes a listing on the public directory, and education opportunities & discounts. Our goal is to help members gain skills within their profession to help improve the quality of life for the aging population and those with medical conditions or chronic disease.

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Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

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Personal Trainer, Gym, Pull Down Machine, Exercising, Assistance

Training the Older Adult Client – Part IV: Key Corrective Exercise Patterns for the Shoulders

Welcome to the 4th installment of this edition of Integrative Movement Insider™ (IMI) where we’ve been discussing a few of the key concepts and corrective exercise patterns we use when training our older clients.

In the previous video we discussed how to implement the foundational concepts of the Integrative Movement System Corrective Exercise Strategy™ – improve our clients’ awareness, pay attention to the small details, and help your clients earn-the-right – to help our older clients successfully work towards achieving their health and fitness goals.

In Video 1, we discussed one of our go-to corrective exercise patterns for improving glute function and hip mobility. In Video 2 of the series, I shared with you one of the key corrective exercise patterns we use to improve scapular stability and overall head and thorax alignment.

If you missed either video you can access those videos here: Video 1 and Video 2

In the third video of the series, I’ll share another one of our go-to corrective exercise patterns for improving overhead shoulder range of motion.

You can be the specialist your current – as well as potential – clients need, want, and will seek out to help them safely and effectively work towards accomplishing their health and fitness goals.

By helping our older clients become aware of the factors that are within their control and helping them become more aware of their posture and movement we empower them for success.

By paying attention to the simple things like alignment, breathing, and control we can help our older clients address many of the underlying issues that are leading to chronic tension, discomfort, and/or the loss of performance.

By helping our clients ‘earn-the-right’ by appropriately progressing their patterns we empower them to safely and effectively work towards achieving their health and fitness goals.

If you like this information and want to learn more about how to develop your confidence and expertise in working with older clients that have Chronic back tightness, Degenerative joint disease, or Spinal stenosis and other issues related to the trunk and spine, then consider joining us for our one-day events. We share these concepts in our one-day, intensive training – Corrective and Progressive Exercise for the Older Client: The Trunk and Spine-Level I.

You will leave this training with the tools and strategies you need to successfully work with and attract older clients. You won’t think the same about training this population after attending this workshop!


Dr. Evan Osar is the developer of the Integrative Movement Specialist™ certification designed specifically to aid the fitness professional establish themselves as an invaluable part of their client’s health care team. In addition to his chiropractic degree, Dr. Osar has earned national certifications through the American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), National Strength and Conditioning Association (NSCA), and The Soma Institute – National School for Clinical Massage Therapy. He is the founder of Fitness Education Seminars, an education company with the mission of helping trainers and therapist recognize their role as a part of the solution to the health care crisis.