Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
Male doctor explaining the spine to a senior patient in medical office

3 Curves = Straight: The Importance of Neutral Spine in Exercise

I have been teaching strength training, as well as Pilates based mat and Vinyasa Yoga for over 2 decades. As a former dancer, I know that I was always struggling with having a “flat stomach” or having a “flat back”. Dancers, in trying to achieve that “perfect turnout” and “flatness”, were often taught to “elongate the spine” by “tucking the pelvis” under, which basically leads to a posterior tilt. Unfortunately, this idea is often taught in fitness to the general population. Trainers and teachers alike, some coming from the dance world, will tell students to “protect their back” by tucking the pelvis such as during standing exercises, even bicep curls, or worse, curl their knees into their chest while lying on the ground or bench, and attempting to do a chest press. Students will be so conditioned to this ROUND SPINE and TUCKED PELVIS, that eventually when they stand, this is their posture. Over time, the discs can bulge, and the forward pelvis will eventually lead to lower back pain they were trying to avoid, as well as knee pain and other issues.

I am a reformed pelvic tucker. I advocate neutral spine when teaching, whether it be standing work such as bicep curls, pronated work such as plank and push-ups, or supine work such as leg lowers and overhead triceps.

The spine has 3 curves: the cervical spine (at the neck) has a concave curve, the thoracic spine (back of the rib cage) has a convex curve, and the lumbar spine (lower back) has a concave curve. And if you want to add a 4th, the pelvis/sacrum has a convex curve as well.

Together, this “S” shape is what keeps a body “straight”. Constantly flattening one’s back or pushing one’s vertebra into this position will eventually damage them. Plus you have to learn to CONTAIN YOUR MUSCLES, not force your vertebrae. There is a moment when the base of your ribs and your pelvic bone will feel like they are aligned in the front, like suspenders. Whatever curves are left over should remain.

Sometimes I do my supine abdominal work as well as strength training on a foam roller (pictured at right). This way there is no avoiding working in neutral spine. Plus, the foam roller will target the transverse abdominus as you are struggling to keep the foam roller still while performing exercises such as chest press, chest flies, overhead triceps, single and double leg lowers, etc.

Another bad habit that trainers and teachers tell their clients and students is to “sit on their hands” while performing exercises such as leg lowers. This is BAD for every reason. Your hands have small bones and veins which are easily damaged by sitting on them. Say you are 200+lbs, and you are putting all of your body weight on your hands! This is not good! I often joke and tell my students “I am a guitar player! I am not going to sit on my money makers!” Also, sitting on your hands again causes the pelvis to tuck, and the shoulders to protrude forward. By teaching this, you are telling your clients and students to “slouch”. You have not taught them how to gain strength by maintaining neutral spine. Third, more often than not, the reason the clients are feeling “pain” in their lower back is they are attempting to lower their legs beyond the range where the abdominals are effective. For me, about a 45 degree angle from the top is plenty of work. Attempting to lower one’s legs all the way to the floor and back will usually be out of the range of someone’s abdominal strength. Find a range of motion where the abdominal muscles fell the work, and the lower back is not effected. You can also put your client on the foam roller, or if you do not have a foam roller, place a thin towel under the sacrum to alleviate any pain the floor may be causing, as well as teach neutral spine.

For “plank”, I often joke (as I am a realtor as well) that “if the plank is not straight, I am returning it to aisle 4 in Home Depot”. People tend to hang their heads when something is difficult. I advocate looking a few floor boards ahead while performing plank, as well as push-ups, and to use a side mirror to check that the line of the head, shoulders, ribs and hips are aligned, while keeping the natural lumbar curve. Again, the ribs and hips should feel like suspenders. Push-ups are basically a “plank with an arm bend and straighten”. So it is important not to hang one’s head, especially when the floor is getting close :). (Planks pictured at right)

In closing, remember that you want to teach your students functional exercises that will help them out in the real world. Teaching neutral spine alignment is one of the most important ideas. You would never want to lift a box with a rounded, tucked spine, so why teach clients to “tuck their knees into their chest” while performing chest press? Sometimes it will take some time for a client to undo these bad habits, but in the end, clients will be stronger, and use the transverse abdomens vs poor alignment to perform daily tasks.

Photos courtesy of ANDREW MARK PHOTO.


Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, Pilates, Vinyasa Yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS.   You can order her new book, “Healthy Things You Can Do In Front of the TV” on Amazon and Kindle. 

deep-breathing

The Secret To Improving Mental Health With Physical Activity 

When I first entered the field of performance coaching, terms like building resilience, develop focused attention, manage sustainable energy levels and strengthen our emotional intelligence were sought after areas of development not only in elite athletic training; but also, executive development. 

As the demands of life rise for our clients, the best way we can support them is by designing health and fitness routines that combine all the elements of health and performance.  Our clients are seeking our expertise on how to “feel” better physically, mentally and emotionally. And the one tool that links the mind, body and brain is BREATH.

Prescription for good health diet and exercise flat lay overhead with copyspace.

Bridging the Gap Between Fitness and Healthcare: Why the Future Needs Medical Fitness Professionals

With over half of U.S. adults living with at least one chronic disease or medical condition, there’s a growing demand for professionals who can bridge the gap between healthcare and fitness. The solution? A new wave of educated, specialized fitness professionals trained to work with clinical populations.

A Broken System, By the Numbers

Despite massive healthcare spending, the U.S. continues to struggle with preventable health outcomes:

  • The U.S. spends more on healthcare than any other country, yet ranks 49th in life expectancy.¹
  • Among peer nations, the U.S. has the lowest life expectancy for both men and women.²
  • The U.S. leads in obesity rates, nearly twice the average, and the highest rate of people with multiple chronic conditions.³
  • We also see the highest rates of hospitalizations and deaths from treatable or avoidable conditions.³
  • Overall, the U.S. ranks just 35th out of 169 countries in global citizen health.⁴

These sobering statistics paint a clear picture: Our system focuses heavily on treatment, not prevention.

Exercise is Medicine!

Physical activity is one of the most powerful tools we have to prevent and manage chronic disease. The evidence is overwhelming. An increase in physical activity directly correlates with improved health outcomes, across nearly every domain of health.

A Study by the American Journal of Lifestyle Medicine reveals physical activity-related health benefits for adults, both healthy and with medical conditions/chronic diseases.

ADULTS 
All-cause mortality          Lower risk  
Cardiometabolic conditionsLower cardiovascular incidence and mortality (including heart disease and stroke) Lower incidence of hypertension Lower incidence of type 2 diabetes
CancerLower incidence of bladder, breast, color, endometrium, esophagus, kidney, stomach, and lung cancers
Brain HealthReduced risk of dementia                             Improved cognitive function Improved cognitive function following bouts of aerobic activity Improved quality of life Improved sleep Reduced feelings of anxiety and depression in healthy people and in people with existing clinical syndromes Reduced incidence of depression
Weight StatusReduced risk of excessive weight gain Weight loss and the prevention of weight regain following initial weight loss when a sufficient dose of moderate-to- vigorous physical activity is attained An additive effect on weight loss when combined with moderate dietary restriction
OLDER ADULTS
FallsReduced incidence of falls incidence of fall-related injuries
Physical FunctionImproved physical function in older adults with or without frailty
INDIVIDUALS WITH PREEXISTING MEDICAL CONDITIONS  
Breast CancerReduced risk of all-cause and breast cancer mortality
Colorectal cancer             Reduced risk of all-cause and colorectal cancer mortality
Prostate CancerReduced risk of prostate cancer mortality
OsteoarthritisDecreased pain Improved function and quality of life
HypertensionReduced risk of progression of cardiovascular disease risk of increased blood pressure over time
Type 2 DiabetesReduced risk of cardiovascular mortality Reduced progression of disease indicators: hemoglobin A1c, blood pressure, blood lipids, and body mass index
Multiple SclerosisImproved walking Improved physical fitness
DementiaImproved cognition

Why Education Matters: The Role of Medical Fitness Professionals

To work effectively with clients dealing with chronic diseases, aging-related conditions, or post-rehab needs, you must go beyond a general personal training certification.

Specialized education is critical. You need:

  • A deep understanding of medical conditions you are working with.
  • The ability to design safe, customized programs that account for limitations, medications, and symptoms.
  • Communication skills to collaborate with healthcare professionals.
  • A passion for service, empathy, and whole-person wellness.

Medical fitness professionals are a vital extension of the healthcare team, and their impact can be life-changing.

Take the Next Steps

Whether you’re just starting or already working in the space, the MedFit Global Virtual Conference is the ultimate opportunity to expand your expertise in medical fitness.

📅 October 22–26, 2025, 100% virtual event
✔ Attend from anywhere — 100% virtual event! If you can’t watch live, your registration includes 6 month access to recordings after the live event.
✔ Gain evidence-based strategies from 85+ expert-led sessions across diverse health topics.
✔ Learn how to build a thriving practice in the medical fitness space.
✔ Earn CEUs while expanding your ability to serve clients with chronic conditions.

Use coupon MEDFIT to save 25% off registration for this event!

Register at https://www.fbasucceed.com/medfit


References

1. US News and World Report, World Bank Data, 2022

2. Peterson KFF, Health Systems Tracker

3. U.S. Health Care from a Global Perspective, Commonwealth Fund

4. 2019 Bloomberg Healthiest Country Index

trainer-with-2-clients

You Are Not Meant to Do This Alone: Why Coaches Must Advocate With (Not Just For) Their Clients

Let’s get one thing straight: you’re not supposed to know everything.

If you’re a wellness professional, a coach, or a trainer who’s ever felt the pressure to have all the answers—pause right there. The most powerful thing you can do for your clients living with chronic conditions, complex needs, or layered life stress isn’t giving them the perfect workout plan. It’s giving them a team.

  • A tribe.
  • A wellness village.
  • A network of practitioners who care as much as you do.

That’s where advocacy meets real results.

Because the more we partner with physicians, physiotherapists, mental health providers, dietitians, chiropractors, pelvic floor specialists—and yes, even energy workers or doulas—the more we can truly offer whole-person care. This is not just good ethics. This is smart, scalable, and sustainable business.

Five Reasons This Approach Works Brilliantly for Clients

Layered Support = Deeper Healing

One coach can’t address every facet of a chronic condition—but a collaborative circle can. From movement to medication, it’s all covered.

Increased Safety and Confidence

Clients feel safer and more motivated when they know their care providers are communicating and aligned—not contradicting each other.

Reduces “Health Overwhelm”

Navigating appointments, jargon, and options alone is exhausting. A coach-led village offers clarity and calm in the chaos.

Personalization Without Pressure

Referring out doesn’t mean you’re stepping back—it means you’re curating a smarter, more personalized, and more powerful plan of action.

Empowerment Instead of Dependency

The goal isn’t to keep clients needing us—it’s to help them thrive. A team model teaches self-advocacy, not dependency.

Top 10 Reasons Referral Networks Build Profit (Yes, Profit!)

  • Increased Referrals Back: Practitioners who trust you, refer to you. Period.
  • Higher Retention Rates: Clients stay longer when they feel supported beyond the gym.
  • Program Expansion: Collaborate on workshops, health talks, or shared services.
  • Reputation Boost: You become known as the connector—a go-to expert with integrity.
  • Cross-Promotion: Shared newsletters, blogs, podcasts, and campaigns reach more eyes.
  • Client Outcomes Improve: Better results = more testimonials, more word-of-mouth.
  • You Can Charge More: You’re offering comprehensive care, not just training.
  • Reduces Burnout: You’re not carrying it all alone. You share the load.
  • Loyalty from Clients and Partners: They remember who helped build their wellness web.
  • Opens Doors: Speaking gigs, funding opportunities, strategic collaborations—they all begin with being trusted and known.

Fyonna Vanderwerf is an award-winning educator, Ironman finisher, and inclusive fitness coach with over 25 years of experience transforming how wellness is delivered. At Bees Knees Wellness Muskoka, she leads a client-centric, compassion-first approach where collaboration is non-negotiable and community is everything. Whether in-person, virtually, or on retreat, Fyonna helps clients and fellow coaches build strength, energy, and self-trust—one empowered step at a time.

health-investment

How Do You Know Which Exercise Is Best For You?

ANY exercise is better than no exercise, but there’s no such thing as one workout for everyone and everything. There’s carryover between different kinds of exercise, but there’s a lot that doesn’t. Runners don’t automatically become skilled martial artists. Specificity is a thing.

We also have a limited amount of time to work with. Two, maybe 3 disciplines can be added before the logistics get prohibitive. There are no world-class ultramarathon powerlifting circus performers.

Is yoga enough? A favorite sport? Lifting weights and running, followed by a little stretching?

What’s your yardstick?

It depends on what’s important to you

Ask a doctor, and speaking as a doctor, the doctor will want you to optimize the following:

  • Muscle mass: for blood sugar, brain function, and mortality reduction
  • Mobility: for fall reduction and general injury prevention
  • Cardio: for blood pressure and cardiovascular risk reduction plus longevity

​Ask a martial artist and the qualities to develop will look different, possibly emphasizing endurance, quickness, and explosiveness. It will be different for a firefighter, a caregiver for the elderly, an elderly caregiver, and a traveling lecturer.

The argument has been made, very diligently by folks like Dr. Peter Attia, that there’s a minimum core set of activities that all humans, regardless of professional or recreational needs, should maintain during their lifetimes.

It’s only a problem if there’s a gap

Is where you are where you want to be?

In your heart of hearts, are you satisfied with your health, by whatever metric—weight, blood pressure, energy level, calmness, feeling warmly pleased?

If yes, then you’re golden.

If no, then one of two things logically follows:

  • You’re working on closing the gap
  • Something is stopping you from closing the gap

​If you’re closing the gap, again, you’re golden. Keep closing.

​If something is stopping you, then by definition, it’s bigger than your health goal.

Just had a heart attack? No one expects you to run marathons right away; the myocardial damage is bigger than your running goal, at least for now.

Family or work objections halting your efforts? Very understandable—but this means their peace of mind is bigger/more important than your health. Is it?

Too busy to put your health first… means pretty much what it says. You consider your health to be secondary to all the things you’re juggling. Is it?

And if you have all the knowledge, support, and bandwidth to improve, and you still don’t, then I suspect you’re getting lost in all the pretty shapes and colors of the Internet—doomscrolling about money, climate change, politics.

Because the alternative—that you didn’t really want to improve your health and well-being—is the biggest nope nope nope of all.

​Which is more likely in today’s modern world? That you don’t want what you want? Or that there are corporate, media, and tech level entities with vested interests in keeping you a distracted, docile, dependent consumer?

Action Item

This is about exercise, but it applies to any action you take to improve your health. Ask yourself if you’re as active as you want or need to be. If you are, make sure you have a maintenance program to keep it up.

If not, examine what is in your way, and whether it’s truly more important than staying as mobile and active as YOU choose to be.


Peter Beck Kim, MD, is passionate about helping others stay healthy and active as they age—whether that means getting back on the mat after 50 or pulling a 100 lb. warbow. As both a physician and an active practitioner of jiu-jitsu and archery, he understands firsthand that maintaining performance requires more than just strength and skill—it demands resilience, strategy, and thoughtful planning.

Dr. Kim shares a free, in-depth guide to avoiding illness and injury while optimizing health and fitness for an active lifestyle: https://drpbkim.com/

heart-stethoscope

Body Fat Promotes Heart Disease

Risk factors for heart disease – elevated LDL cholesterol, hypertension, elevated triglycerides, inflammation, and blood glucose – are all exacerbated by excess body fat, and overweight/obesity itself is considered a risk factor.1-3

Is it beneficial to be a little overweight?

However, there has been controversy about a potential “obesity paradox” in heart disease: the idea that some amount of excess weight either does not pose any risk or is even protective. Unfortunately, the studies that suggest there may be a protective effect of body fat are often the ones that get more news coverage; but this does a disservice to an already overweight and nutritionally misguided public, allowing them to believe that excess body fat won’t harm their health.

Is there really an obesity paradox? Or is it just that BMI is not a good measure of body fat?

Many of these studies have used body mass index (BMI), however BMI, which only takes into account height and weight, is not an accurate indicator of body fatness. BMI does not distinguish between fat mass and lean mass, nor does it take into account fat distribution (visceral fat vs. subcutaneous fat). Many people whose weights are within the “normal” BMI range are still carrying excess fat.

There has been no evidence providing a convincing explanation of how excess fat could possibly provide a cardiovascular advantage.  Plus, there are numerous medical conditions may cause unintentional weight loss, including depression, anxiety, autoimmune diseases, cancers, and digestive disorders. In the elderly especially, a low BMI may be an indicator of muscle loss and frailty rather than an indicator of a healthy low level of body fat. In short, people who are thinner are not necessarily healthier.

Relationship between body fat and heart disease: using better measures than BMI

A new study  is helping to clear this issue up,4 in a cohort of almost 300,000 people in the UK (age 40-69) who were followed for an average of 5 years. Their first analysis puts the optimal range of BMI for heart disease prevention at 22-23 kg/m2. It was a “J-shaped” association, meaning risk rose both above and below the 22-23 range. But the researchers went further. They used multiple measures of body fatness to get a more accurate picture: waist circumference, waist-to-hip ratio, waist-to-height ratio, and percent body fat.

Ultimately, what the researchers found was that using BMI produces different results than the other indicators. BMI was the only one that showed an increase in risk at the low end (<18.5 kg/m2). When they excluded smokers and participants with pre-existing diseases, the increase in risk associated with low BMI almost disappeared.  The more accurate measures of body fatness – body fat percentage, waist circumference, waist-to-hip-ratio, and waist-to-height ratio – showed a clear trend: more body fat, greater risk.4


More body fat, greater cardiovascular risk

The researchers concluded that the obesity paradox observation mainly occurs due to confounding effects of disease and other factors on BMI, and that the “public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged.”4

As discussed above, a low BMI is often an indicator of disease, rather than an indicator of a healthy weight resulting from healthful eating. The standard American diet (SAD) is fattening. If someone is eating the SAD and is not overweight, there is likely something wrong.

Lose weight permanently on a Nutritarian diet

The dramatic weight loss-promoting effect of the Nutritarian diet contributes to cardiovascular protection. A 2015 study published in the American Journal of Lifestyle Medicine analyzed and reported weight loss results provided by 75 obese patients who had switched to a Nutritiarian diet. The average weight loss was 55 pounds, and very importantly, they kept the weight off. None of these respondents had gained back the lost weight after three years.5

Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease.  Visit him at DrFuhrman.com

 

References

  1. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
  2. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013, 93:359-404.
  3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017, 135:e146-e603.
  4. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J 2018:ehy057-ehy057.
  5. Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
Eric Chessen 1

Can’t Vs. Doesn’t Understand; Coaching Towards Learning Style

“Okay, now let’s see a squat, I’m gonna go first and then you try.”

The above is a standard sentence during my PAC Profile assessments and it carries with it powerful proactivity. I just also serendipitously learned that “proactivity” is a real, bona-fide word. When we teach movement, it makes sense to demonstrate first. Explaining to anybody a physical activity they’ve never performed, or performed with questionable technique, will skew towards wheels-fall-off territory early. Proactive practices give us and our athletes more opportunity sooner, and reduce the need to backtrack.

The most efficient use of initial instruction time (the first time we are teaching an exercise) looks like this:

  1. Label
  2. Demonstrate
  3. Provide supported performance

For the ASD (Autism Spectrum Disorder) population, labeling in particular can have interim or long-term benefit for language (productive and receptive), memory, and independence. If the athlete is familiar with the word “squat” and can equate it to the movement pattern that constitutes a squat (whatever their current ability level), the coach does not have to repeat and demonstrate and repeat and repeat and repeat. Because the athlete already knows. The word squat and the movement squat have been paired in a way that makes sense, and is memorable, for the athlete.

Labeling adds to the lexicon. It’s remarkable just how much functional language we can build through fitness programs. Not only exercise names “squat, press, pull-down, push throw, rope swings…” but objects “Sandbell, rope, cones, Dynamax ball, sandbag…” and abstract concepts including prepositions “in, on, under, right, left, up, down…” When our athletes are actively engaged in fitness activities teaching these terms/concepts is easily presented in a natural manner.

Demonstrating is crucial because it circumvents us and our athlete standing there and staring at one another (or off into the distance for those of our less-eye-contact-inclined friends). We always demonstrate a new exercise; this provides context and a framework for both the learning style and that athlete’s interpretation of what we just did. We’ll learn how they follow visual modeling and, often, how motivated they are to perform the thing they just saw.

Do they get right down to squatting? Are they hesitating? Overwhelmed? We will be given really good clues here.

Providing supported performance means that we are starting the athlete at a level of performance that they are sure to master quickly (if we have to progress the exercise immediately this is a good sign). If we wind up progressing an exercise five times during the first session then good. Good! This translates to the athlete having early successes that can be reinforced. We usually prefer to do the exercises that we’re good at, and our athletes with autism are not much of an exception.

We may provide a physical or guided prompt early on with an exercise to ensure safe and effective technical performance. With the squat this may mean having the athlete hold on to a resistance band attached to a secure, stable area and squatting to an elevated surface (we always use Dynamax balls propped up on cardio step risers).

Depending on physical, adaptive, and/or cognitive ability, we may be able to fade this support in the first session or it could take months.  I have some highly motivated athletes who, because of their physical needs, require longer practice with a given level of an exercise before they’ve reached mastery and can progress. The athlete should be held to the expectation of his/her best current level of performance (unless we’re talking about exceptional amounts of strength or power, because then programming changes a bit).

Efficient and effective coaching enables us to determine how best the athlete will learn a particular exercise. While it’s tempting to classify our athletes as “more visual” or “more kinesthetic” learners I’ve found that it is far better to approach this from an exercise-by-exercise basis. Some of my athletes need physical prompting through the end range of an overhead press but can “get” a band row when I demonstrate pulling my arms back while standing parallel to them.

“Don’t know how” is a misinterpretation of breakdown in effective coaching communication. We need to be instructing with less words, more action. More show than tell.

When our athletes, or any of us, don’t understand the direction, the contingency, or the expectation we freeze, get off-task, get frustrated, or a Lucky Charms marshmallow cornucopia concoction of all three.  Being proactive in coaching means giving our athletes the information they require delivered in a way that is useful.

It is easy to take for granted the neurotypical ability to interpret nuance, abstraction, and implied information; the untold stuff between the clearly marked things. Giving our athletes the context and environment to succeed, especially in the first few sessions or when teaching a new exercises becomes our bridge to success in coaching and performance.

Photos provided by Eric Chessen.


Eric Chessen, M.S., is an Exercise Physiologist with an extensive background in Applied Behavior Analysis. Eric provides on-site and distance consulting worldwide. He is the founder of Autism Fitness®, offering courses, tools, resources and a community network to empower support professionals to deliver adaptive fitness programming to anyone with developmental deficits to create powerful daily living outcomes that last a lifetime.

running-bleachers

Kick up the Cardio

Currently, health clubs offer a variety of cardio and strength options. They offer a plethora of equipment and classes yet attrition remains high. By combining the science of cardio and strength training with a motivated and energetic instructor new programming combining….