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Pregnant-woman-at-gym

Building Strength is an Important Component in a Prenatal Fitness Routine

You may have heard people warn that pregnant women shouldn’t raise anything over their heads or lift objects that are heavier than ten pounds when pregnant. These are warnings that still make the fitness trainer rounds when working with pregnant clients, yet these warnings aren’t based on science.  In fact, there’s no evidence for warning pregnant women to avoid lifting over their head unless it causes discomfort or balance issues, and the ten-pound limit is even more questionable, as ten pounds would be too heavy for some women and as easy as a feather for others.

It’s important to always remember that each pregnant woman has a specific fitness level and ability, so setting arbitrary limits is an ineffective way to provide guidelines for this population. In addition, when confronted with statements such as these, always review the research that supports the claim before implementing the information into your training guidelines.

Many women choose to continue their pre-pregnancy strength training program while they are pregnant, and most women may safely start strength training during their pregnancy as long as they are cleared for exercise by their healthcare provider. When developing a pregnant woman’s fitness program, you should take into account her current level of fitness and strength and pay close attention to how she feels during and after exercise. The key to maintaining a safe and effective routine is through consistent modification of the exercises for comfort as pregnancy progresses.

Strength training is an essential prenatal fitness component, providing the muscle power needed to compensate for posture adjustments and weight gain that occurs with pregnancy. Women who continue or even start a strength training routine during pregnancy can help prepare her body for all the lifting done with a new baby and reduce the risk of low back pain. Strength training has not been shown to pose any harm to either the fetus or the mother as long as these general guidelines are followed:

  • A gradual reduction in weight loads from pre-pregnancy will likely occur as the pregnancy progresses.
  • Women may continue their pre-pregnancy strength training routine (wt/reps/set) as long as they modify the exercises for comfort as pregnancy progresses.
  • If training causes muscle soreness during the pregnancy, it is recommended that overload be progressed by increasing the number of repetitions versus the resistance/wt.
  • Monitor exercise techniques carefully by mirror observation or supervision in order to correct for progressive postural changes that occur with advancing pregnancy. Improper lifting techniques may aggravate back problems and increase soft tissue injuries.
  • Avoid maximal static lifts. They may cause a sudden increase in cardiac output and blood pressure and employ the Valsalva maneuver. During the Valsalva maneuver, there is a significant diversion of blood from the internal organs (such as the uterus) to the working muscles.
  • Maximal lifts may also place extreme stress on the lumbar spine and other joint areas. Never overload an unstable or weakened joint.
  • Modify supine positions after the first trimester of pregnancy by using an incline board or wedge.
  • A strength-training workout involving all the major muscle groups should be performed three times per week, with a rest day between each muscle group training bout.
  • Machines, free weights, resistance bands, and body weight
  • are all options for building a strength training routine.
  • Remind client that she should exhale with the lift and avoid holding her breath or bearing down and straining as she lifts.
  • If a particular exercise continues to produces pain or discomfort are modification, it should be discontinued. If pain persists, the client should consult with her healthcare provider.

As always, all pregnant women should check with her healthcare provider before starting or continuing an exercise program during pregnancy.


Catherine Cram, MS started her company, Prenatal and Postpartum Fitness Consulting, in order to provide current, evidence- based guidelines maternal fitness guidelines to health and fitness professionals. She was a contributing author for the textbook, “Women’s Health in Physical Therapy” and co-authored the revision of “Exercising Through Your Pregnancy” with Dr. James Clapp.  Her company offers the certification course, “Prenatal and Postpartum Exercise Design” which provides continuing education credits for over 30 health and fitness organization, including ACSM, ACE, ICEA, and Lamaze.

sun-behind-the-storm

Interesting Times for Interested People

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas New Wellness Areas
S-ocial Social – all interactions with people outside of ourselves
P-hysical Physical – our physiological status
I-ntellectual Intellectual – includes cognitive and emotional health
C-ognitive Career – includes educational and skill acquisition and financial health
E-motional Environmental (could include emotional) – clean, organized?
S-piritual Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

deep-breathing

How to Stay on Top of the Game and Not be Vulnerable in Hectic Times

There are a lot of uncertainties currently.  We may feel confused, anxious and fearful — which may lower the frequency of our EMF (1) and our defenses. A depressed immune system is more likely to get sick with anything, not just the Coronavirus. Take this time positively, as a way to be introspective and find new things to do for yourself, your career and relationships. Obstacles are like gifts because without them, life would stagnate. Obstacles create evolution in our lives, taking us to the next level.

Protect yourself physically and mentally

Keep up good hygiene by washing hands when you touch surfaces that could have been touched by others — door handles, street light buttons, credit cards, gas nozzles. Use common sense. You can carry an alcohol spray bottle to spray surfaces and your car floor. Antibacterial can be used also but it is loaded with chemicals. If you go to public bathrooms and have to touch handles, use a paper towel to open doors and then trash it. Try to use your elbows instead of your hands when you can.

Maintain regular positive conversations and support with your friends and family, even if it’s on the phone. It’s not good to be isolated when you have to stay home. Communicate with positive people and not those who only speak negatively or with fear, especially if you are empathetic. This will keep your vibrations high.

There are 2 main things with scientific evidence that you can do to maintain your high vibes and feel calm – which will help your immune system.

1. Meditation & Deep breathing:                        

When challenges are high, our emotions are also high and the situation becomes chaotic.

Our the body doesn’t know the difference between real danger ( i.e., being in war or being chased by a jaguar) and an imaginary one (i.e., not meeting a deadline, final exams, arriving late to a class). So, we can control these emotions as to not create more chaotic ones. Acute stress from these situations raises our cortisol levels, affects our cells and overall health. The mind gets blurry with a lot of thoughts and you cannot see the solution.

We don’t have to repress the situation but be aware and start controlling our breath. CONTROLLING OUR BREATH, concentrating in equal inhales and equal exhales, the body and the cells will understand they are safe and there is time to heal. The body will know that there is no way we are in a dangerous situation,  that it is time to relax, that we are safe, we are healing and we open our energies to receive better answers for our life choices.

Exercise:

Sit in a quiet area and concentrate on your breath. Start with 2 inhales and 2 exhales for one minute, then pass to 3 inhales and 3 exhales for 2 minutes,  then 4 inhales and 4 exhales for 2 minutes, until at least 6 minutes — or the most you can do. Observe how the more you concentrate on your breath, the less thoughts come to your brain.

Difference between deep breathing and shallow breathing

SHALLOW BREATHING is superficial breathing using only the lungs. The lungs have a limited air capacity contrary to what we think. This is the everyday breathing pattern we use in this fast paced society. It is the cause of stress, ailments, panic attacks, asthma, pneumonias, hyperventilation and many more problems. It makes stress a habit. It reduces the production of white blood cells that defend our bodies from external organisms that weaken the immune system. It also tightens the back, neck and shoulder muscles causing back pain and headaches.

DEEP BREATHING (2) is done using the diaphragm and the abdomen, which have more capacity for storing oxygen than the lungs. It is the breathing of babies. You inhale with a controlled rhythmic pattern (Pranayama). Retention of the air, exhalation and deep breathing every time, as practiced by the Yogis, can reverse health conditions, strengthen the immune system, lower high blood pressure,  alleviate heart conditions, muscle pain and respiratory conditions, like asthma and bronchitis.

Exercise:

Sit or lay down in a quiet area and put your hands on top of your diaphragm. Feel the diaphragm expanding as the air is filling your abdominal cavity like a balloon and then exhale feeling the air leaving the cavity. This will utilize the best amount of oxygen, keep thoughts away and relax the whole body. Do it for at least 5 minutes or the most you can do. Increase time progressively.

Maintaining the same breathing pattern concentrate on each part of your body especially where you feel pain or tension. Imagine a white light while you inhale and release. Visualize the tension leaving your body and evaporating.

2. Physical exercise and your immune system                                                                      

Gyms closed? No excuse to not keep or bodies moving. Exercise has something no other medicine can provide. When you move you are telling the cells, “I am alive, I am strong”. Even if we are not doing it consciously, our subconscious mind picks up the exercise habit and incorporates it as a pattern. This can change our subconscious from “I am weak” to “I am strong”. Thoughts can shape our whole body and our cells will benefit tremendously.

If you have to stay indoors, you can use any equipment you have to do at least 20-30 minutes of cardio to work on your strength and abs. You can see some ideas on my YouTube channel.

If you can go outdoors bike, hike, walk and run at beaches and parks.  The open environment is safer than indoors, especially because you can maintain the distance from others easily. You can do any routine or use my Beachblast video that can be done anywhere – in a park, at the beach or in a pool.  It combines cardio drills, core strength, pilates for abs and legs followed by relaxing Yoga posses.


Graciela Perez is a National Academy of Sports Medicine (NASM) Personal Trainer, Aerobics and Fitness Association of America (AFAA) Aquatic Specialist, CETI Cancer Exercise Specialist, Health & Wellness Coach and Energy Healer. She’s been helping people reaching their health and fitness goals since 2003. Visit her website, hollywoodfitness.org

Resources

(1) EMF: Electro Magnetic Field is the energy that surrounds our bodies and it is influenced by our thoughts and emotions. Our thoughts and emotions can pass to our EMF and can shape matter (the body, cells and how healthy we are). If we are in fear, this negative emotion will affect EMF (our energy) and affect our body’s immune system. For more info on Energy Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952118/

(2) For deep breathing:

std-gehm

Save the Date: Global Employee Health and Fitness Month is May 1-31

Employers and Employees everywhere can show their support for healthy living and well-being by participating in Global Employee Health and Fitness Month (GEHFM) sponsored by the National Association for Health and Fitness (NAHF).

“This amazing, new and improved GEHFM is truly historic in the arena of workplace wellness. Business and industry can encourage positive behavior change in the supportive context of workplace policies and culture and provide support that assists today’s workforce with their daily struggles.  Through GEHFM we will achieve the optimum result of a more physically active and healthier population…one healthy moment and one healthy group at a time,” said Diane H. Hart, President and Executive Director of the National Association for Health and Fitness.

All you have to do is create and share “Moments, Groups and Projects for Health” – such as preparing a healthy meal, organizing a recurring walk or bike ride with colleagues or participating in a clean-up day in your community.  Employers will challenge their employees to continue to do so throughout the month, concluding the month with a culminating project.  It is time to make healthy the norm in America and we believe GEHFM is a powerful effort toward the realization of this goal.

Since the founding of Employee Health and Fitness celebration in May of l989, there have been significant strides in documenting the evidence of the value of investing in employee health.  Employee health is a powerful, strategic component of an organization’s human capital management.  Progressive employers understand that their greatest asset is their employees, and an investment in their employees’ health is essential to managing health care costs, improving organizational productivity and employee morale.  We hope this event plants a seed that the small choices you make each day can have a big impact on long term health.

It’s simple to show your support for a healthy, active workplace.  Sign up at healthandfitnessmonth.org

Join Diane Hart for her free webinar, “Your Voice, Capitol Hill and America’s Health”.
Click here to sign up.

arms-up-celebrating

Be the Five

The current prevailing thought construction about COVID-19 is informed by a medical model of disease: respiratory illness. What we need is a paradigm shift. A model that promotes and encourages respiratory health and optimum wellbeing across the lifespan.

Google and WHO teamed to offer a PSA “Do the Five.” I invite you to consider an alternative. In addition to doing the five important tasks outlined in the “Do the Five” infographic, “Be the Five.” Yes. This is a different way of thinking – of being – one that runs counter to a culture of doing. Is it possible that one form of healthy aging is to simply be?

Let’s consider 5 ways to be:

Be ACTIVE by engaging in physical activity ranging from diaphragmatic breath practices, cardiorespiratory activities, strength, balance, flexibility, meditation or even hand mudras such as Prana Mudra for increasing immune health. Try actively saying a word(s) when you breathe in, such as “I am breathing in.” When you breathe out say something else, “I am breathing out.” Or try: Calm in. Peace out.  Or something else. Study findings suggest physical activity, such as cycling (on a bike or using solely your body mimicking cycling form), negates immunosenescence in subjects ages 55-79.

Be PRESENT by being aware of our body, our mind, thoughts, emotions, and others’ state of being. We are more likely to respond rather than react when we practice present moment awareness. By being present we are tuned into the finiteness of our bodily needs: hydration, nutrition, sleep, comfort. Try a self-hug. Physiologically, when we hug ourselves, our blood pressure lowers, immune system boosts, heart rate decreases, cortisol decreases, decrease inflammation, stimulation of brain memory centers, and release of oxytocin.

Be CURIOUS about the possibilities of what is going on. Adopting a mind that frames the world in a sense of “don’t know” can be powerfully emancipating. We don’t expect infants to know how to balance a checkbook – they are just beginning in the world. We too are just beginning. We have never lived this very moment before now. No one person needs to know everything. We are in this together. Try framing activities as play or exploration.

Be POSITIVE amongst all the uncertainty and unknowns, it is possible to alleviate some pressures by naming at least one positive thing that happens each day and/or smile. Stress creates inflammation and thinking positively reduces the negative effects of stress on the immune system. A study out of the University of Kansas suggests smiling reduces heart rate and blood pressure. Try smiling. Even if it’s a fake smile, physiologically, same effects.

Be KIND to yourself and to others. Many people are afraid, distracted and worried. By being gentle and kind we can create a parachute of peace that can aide us in a soft landing, as we all have been shoved out the aft end of an airplane at 14,000 feet above earth. Dacher Keltner, psychology professor at UC Berkeley, reminds us of the importance of the “survival of the kindest.” Try saying: May you be healthy. May you be comforted. May you feel safe. The you in these statements can be directed toward yourself as well as others.

When we “Be the Five”, we may move toward creating mind-body homeostasis, and this might allow us to age for perhaps one more moment. Even if the effects last for a millimoment, maybe there is liberating power in being.


Adrienne Ione is a cognitive behavioral therapist and personal trainer who integrates these fields in support of people thriving across the lifespan. As a pro-aging advocate, she specializes in the self-compassion of dementia.

Website: yes2aging.com
Guided Meditations: insighttimer.com/adrienneIone
Facebook: silverliningsintegrativehealth

Originally printed on Thrive Global. Reprinted with permission.

Food-question

Sports Nutrition: Fads, Facts and Fallacies

The average American, spends 24 hours a week online. That includes many athletes who spend a lot of time surfing the Web, looking for answers to their nutrition questions. They generally find way too much conflicting information and end up more confused than ever. Hence, the goal of this article is to offer science-based answers to a few popular sports nutrition questions and share some food for thought.

Carbohydrates

We have all heard trendy comments about carbs: They’re a waste of calories, sugar is evil. Fact? No…

Are carbs a waste of calories, with little nutritional value?

The answer depends on your definition of “carbs.” Many athletes define carbs as sugar-filled baked goods and foods made with refined white flour, such as pasta, bagels, bread. In reality, carbohydrates include all types of sugars and starches. Carbs are in fruit, vegetables, beans (pinto, lima, garbanzo, etc.), grains (wheat, rice, barley, corn), and milk. These “quality carbs” add important nutrients to a sports diet.

Should athletes cut out sugar?

Sure, if that means cutting out EXCESS sugar. But if you plan is to cut out all sugar, technically speaking, you would need to stop eating any form of carbohydrate (fruit, veggies, grains), given those foods end up as sugar (glucose) in your body. That sugar fuels your muscles and brain. You’ll also need to cut out performance-enhancing sport drinks and gels.

Please judge a food based on all the nutrients that accompany the sugar, more so than just the sugar content. Some sugary foods are nutrient-rich. The natural and added sugar in chocolate milk, in combination with the milk’s protein, make chocolate milk an excellent recovery food. (The sugar refuels the muscles; the protein builds and repairs the muscles.)

If your goal is to cut out added sugar, you might want to think moderation, rather than all or nothing. US Dietary Guidelines say 10% of calories can come from added sugar. Eating a small sweet a day will not ruin your health forever.

Athletes who report a desire to cut out sugar commonly have a love-hate relationship with (too much) sugar. While they may believe sugar is addictive, a standard reason for overdosing on sugar relates to hunger. The body of a hungry athlete screams for quick energy: sugar. One way to curb sugar-cravings is to eat a satisfying protein-rich breakfast and lunch. By curbing hunger, you’ll enhance your chances of being able to choose quality carbs later in the day. Yes, eating enough breakfast can (and does) impact and improve your evening food choices. Give it a try?

Protein

Many of today’s athletes believe protein should dominate a sports diet. True? Not quite.

What percent of my calories should come from protein?

Dietary guidelines recommend 10% to 15% of daily calories should come from protein. In truth, athletes should base their protein needs on body weight, not percent of calories. The target for most athletes is about 0.5 to 0.75 grams of protein per pound of body weight (1.0-1.5 g pro/kg) per day. Athletes who restrict calories or are new to lifting weights might need a bit more protein—but most hungry athletes consume that much—plus more—within the context of daily food choices.

Can I get enough protein without protein shakes, bars and powders? Yes!

I rarely meet athletes who consume too little protein. Those who might benefit from a supplement include athletes with anorexia (who consume too little of most nutrients), dieting vegetarian athletes who fail to consume adequate plant protein within their restricted calorie budget. That is, for 125 calories, you can consume 25 grams of protein from a can of tuna but less than 4 g protein from the dollop (0.25 cup) of hummus on a salad.

Can vegan athletes perform as well as meat-eaters?

For certain, as long as they consume adequate protein, iron, calcium and B-12, among other nutrients. Not hard to do if the vegan is eating responsibly (i.e., not living on “vegan” Coke & potato chips). They might even perform better when they shift from a meat-based to plant-based diet. Plant proteins (such as beans, lentils, and hummus) offer both protein (to build and repair muscles) and carbohydrate (to fuel muscles).

To optimally fuel muscles, athletes who train about an hour a day need about 2.25 to 3.5 g carb/pound of body weight, depending on the intensity of the workout. For a 150-pound athlete, this comes to about 340 to 525 grams of carb a day (1,360 to 2,100 calories from carb). To hit that goal, starchy beans and grains should be the foundation of each meal and snack. Vegan athletes can easily hit that target, while many meat-focused or carb-avoidant athletes end up needlessly fatigued when meat/fish/chicken and salads displace starches and grains. No wonder many athletes report performing better when they switch to a vegan diet!

Fat

While fat has been shunned for years, it is now popular. Here’s what athletes want to know about dietary fat…

To lose undesired body fat, should I train my body to burn more fat?

Don’t bother! Burning fat differs from losing body fat. You might burn 800 calories doing two hours of fat-burning exercise, and then can easily replace it all by devouring a big meal. No fat loss there!

A wiser plan is to lose fat when you are sleeping (not when exercising), by eating less at dinner to create a calorie deficit for the day. That way, you can surround your workouts with fuel, and optimize your ability to train well. Weight is more of a calorie-game than a fat-burning game.

What about the high-fat keto diet for losing weight?

Keto advocates often rave they can lose weight without feeling hunger. True, a high fat diet is very satiating. But what happens after the diet? I’ve heard stories of keto dieters succumbing to carb-binges and rapid weight regain. My recommendation: Embark only on a food plan you want to maintain for the rest of your life. Meeting with a sports registered dietitian can help you learn effective weight management skills.

What about a keto diet for endurance athletes?

Some ultra-runners and ultra-athletes embrace a keto diet. By burning fat for fuel, they can eat less during long events and experience less intestinal distress. More research is needed on keto-athletes who have fat-adapted for several months (many studies are for less than one month): Can they perform better than carb-eaters? Current research suggests keto athletes might perform as well as carb eaters—but not better than. That’s a lot of dietary restriction for questionable performance benefits. That said, each athlete is an experiment of one and no one diet suits everyone.


Sports Nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes at her private practice in the Boston-area. Her best-selling Sports Nutrition Guidebook answers most nutrition questions and can help you eat to win. Visit NancyClarkRD.com for more information.

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

Bridging Rehab with Fitness: Become the Trusted Referral for Rehabilitation Therapists

There are special and unique bonds that are made between clinician and patient in a rehabilitation setting. Many times, rehab patients are at a very difficult time in their lives and through months of daily expert guidance, hard work, education, and often even fun, alongside their rehab team, they make considerable gains back towards independence.

Because of this daily interaction, the rehab team develops a vested interest in the continued progress of their patient. Over the course of many months of the blood, sweat and tears of intensive therapy sessions, a friendship has been formed and considerable progress made together. It’s no wonder that rehab professionals are very selective with the fitness referrals they make once their patients are ready for the post-rehab world.

They are selective because they want the absolute best for their patient; they want someone with an understanding of their patient’s diagnosis; someone who understands medical precautions and contraindications; and someone who can safely continue to progress their patient without putting them at risk for a secondary issue. Though they may be selective with referrals, a trusted source for continuing their patients’ goals is needed.

Here are some ways to bridge the gap and gain the trust of your local rehabilitation professionals:

Require a medical or physical therapy release

Having medical releases before beginning ongoing sessions is an excellent way to open dialog with your client’s doctor or physical therapist and further, ensures that you are programming their fitness plan accordingly. Send your assessment with your client to share in their next appointment along with a simple inquiry form about restrictions or suggestions to use in your program design. This will go a long way in establishing a great level of trust and building a rapport with the clinic.

Volunteer at a rehab clinic

One of the best ways to build a rapport with local rehab professionals and patients is to spend time shadowing/observing or volunteering in a rehab inpatient and/or outpatient clinic. This can be a time-consuming start-up as many rehab clinics will have an orientation process and procedures to allow you to be present in a clinic, but it is definitely worth the time investment. Just being in this environment you can learn a lot about how therapists progress their rehab patients, guard their rehab patients during activity, interact with and educate their patients as they progress them to discharge (the point where you would continue their work). You may also get some valuable opportunities to learn from and build relationships with many therapists in one setting.

Lead warm-ups for local 5K races

There are 3.2-mile run-walk-and-wheels events that take place all over the country. Donating your time to your community Spina Bifida Walk ‘n Roll or Parkinson’s walk is a great way to become visible in your community and demonstrate what you have to offer for all abilities.

Speak at local support groups

Same as with the 5Ks, there are support groups that take place monthly or quarterly for stroke survivors, caregivers, individuals living with Multiple Sclerosis and more. Contacting the organizer of these groups and offering to donate time to speak about the benefits of continued exercise or even providing a no-cost group class during the scheduled talk time is a really good way to connect with both the organizers and their peers and those in attendance who would benefit from a continued exercise program.

Educate yourself on adaptive/medical exercise equipment

Understanding the different options there are for accessories and actual exercise equipment for stroke survivors or those living with spinal cord injury is another great way to demonstrate an understanding of working with a rehab population and continuing to bridge the gap between rehab and fitness. Not all equipment is accessible nor safe, so while thinking outside the box is great, ensuring safety is optimal. Take the time to learn about all the great adaptive equipment that can benefit the population you work with.

Host an open house at your gym

Host regular open house events at your facility and invite any and all rehab professionals, patients, and people from your community. Offer instructional sessions during the open house to demonstrate your adaptive programming/equipment. This is a great way give a sneak peek into what you’re doing to provide a safe environment for patients to continue their progress.

Offer to provide a lunch in-service to rehab staff

Meeting with a clinic full of therapists is an excellent way to educate those therapists that you have done your research, understand your population, and really want to bridge the gap between rehab and fitness. A presentation focused on the population you’re most comfortable working with (Parkinson’s, stroke survivors, etc.), the programs you offer, and pictures or videos of some of the work done in your gym. Bringing food is always a great incentive!

Bridging the gap between rehab and fitness is a process that is long overdue and much needed. By focusing on the points above you will be working towards and moving one step closer to improving the therapist-trainer model, adding a valuable resource to your community and providing a safe environment and safe programming to continue progressing your post-rehab clients.

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


Devon Palermo is a leading authority on Adaptive Fitness for those living with or recovering from a disability. He is the Founder and Principal director of DPI Adaptive Fitness, A company focused on safe and effective adaptive fitness for individuals living with disabilities. With over 15 years of experience in both fitness and rehab, He is the go-to resource for clients, therapists, and doctors in the DC, Maryland and Virginia area looking to maximize the benefits of adaptive exercise to improve strength, balance, function and abilities. dpiadaptivefitness.co

exercise-fitness-at-home

Managing Your Exercise In a Pandemic: 10 Easy Exercises to Build a Strong Core Without Leaving the House

Just in time for the novel coronavirus (COVID-19) social distancing and closures of gyms and fitness centers in many areas, here’s a revisit of many important core exercises you can do at home to keep yourself strong and healthy. Download the free illustrated PDF (Chapter 21 of Diabetes & Keeping Fit For Dummies) for illustrations of the exercise listed below. (You can also find a variety of other at-home exercises on Diabetes Motion Academy Resources for free download.)

Many people are stuck at home for one reason or another think they can’t work on staying fit, but the truth is that you can get a stronger core and stay fitter without leaving home. You’d be amazed at how easy it is to get your fit on.

Remember: Your body core — the muscles around your trunk and pelvis — is particularly important to keep strong so that you can go about your normal daily activities and prevent falls and injuries, particularly as you age. Having a strong body core makes you better able to handle your daily life, even if that’s just doing grocery shopping or playing a round of golf.

Core exercises are an important part of a well-rounded fitness program, and they’re easy to do at home on your own. To get started on your body core workout, you don’t need to purchase anything. (Some of the advanced variations do call for equipment like a gym ball or dumbbells.)

Tip: Include all 10 of these easy core exercises in your workouts, doing at least one set of 15 repetitions of each one to start (where appropriate). Work up to doing two to three sets of each per workout, or even more repetitions if you can. For best results, do these exercises at least two or three nonconsecutive days per week; muscles need a day or two off to fully recover and get stronger. Just don’t do them right before you do another physical activity (because a fatigued core increases your risk of injury).

#1: Abdominal Squeezes

This exercise (Figure 21-1) is great for working your abdominals and getting your body core as strong as possible. If you’re female and have had gone through a pregnancy at some point, getting these muscles in shape doing these squeezes is a must.

  1. Put one of your hands against your upper stomach and the other facing the other direction below your belly button.
  2. Inhale to expand your stomach.
  3. Exhale and try to pull your abdominal muscles halfway toward your spine.

This is your starting position.

  1. Contract your abdominal muscles more deeply in toward your spine while counting to two.
  2. Return to the starting position from Step 3 for another count of two.

Work up to doing 100 repetitions per workout session.

#2: Planks or Modified Planks

Nobody likes doing planks, but they get the job done when it comes to boosting the strength of your core. Both planks and modified planks (Figure 21-2) work multiple areas, including your abdominals, lower back, and shoulders.

  1. Start on the floor on your stomach and bend your elbows 90 degrees, resting your weight on your forearms.
  2. Place your elbows directly beneath your shoulders and form a straight line from your head to your feet.
  3. Hold this position as long as you can.

Repeat this exercise as many times as possible during each workout.

#3: Side Planks

A modification of regular planks, this side plank exercise (Figure 21-3) works some of the same and some slightly different muscles that include your abdominals, oblique abdominal muscles, sides of hips, gluteals, and shoulders. Try doing some of both types for the best results.

  1. Start out on the floor on your side with your feet together and one forearm directly below your shoulder.
  2. Contract your core muscles and raise your hips until your body is in a straight line from head to feet.
  3. Hold this position without letting your hips drop for as long as you can.
  4. Repeat Steps 1 through 3 on the other side.

Switch back and forth between sides as many times as you can.

Tip: Try these plank variations to mix things up a bit:

* Raised side plank: Lifting both your top arm and your leg upward brings other muscles into play and makes your core work harder to maintain balance, but don’t let your hips sag.

* Gym ball side plank: Resting your supporting arm on a gym ball, use your core muscles to control the wobble to further strengthen your side muscles.

* Side plank with lateral raise: While holding the side plank position, slowly raise and lower a light dumbbell or other weight with your top arm to improve your coordination and strength.

* Side plank pulse: From the side plank position, add a vertical hip drive by lowering your hips until they’re just off the floor and then driving them up as far as you can with each repetition of this move.

#4: Bridging

If you work on your abdominal strength, you also need to build the strength in your lower back to keep things balanced. Bridging (Figure 21-4) is a good exercise to do that as it works your buttocks (including gluteals), low back, and hip extensors. Remember to breathe in and out throughout this exercise.

  1. Slowly raise your buttocks from the floor, keeping your stomach tight.
  2. Gently lower your back to the ground.
  3. Repeat Steps 1 and 2.

Tip: Try the bridging with straight leg raise variation: With your legs bent, lift your buttocks up off the floor. Slowly extend your left knee, keeping your stomach tight. Repeat with the other leg. Do as many repetitions as possible.

#5: Pelvic Tilt

An easy exercise to do, the pelvic tilt (Figure 21-5) works your lower back and
lower part of your abdominals.

  1. Lie on your back on the floor with your knees bent and feet flat on the floor.
  2. Place your hands either by your sides or supporting your head.
  3. Tighten your bottom, forcing your lower back flat against the floor, and then relax.
  4. Repeat Steps 2 and 3 as many times as you can.

#6: Superhero Pose

Whether you want to leap a tall building with a single bound or not, try doing this superhero pose exercise (Figure 21-6) to get a stronger core. It works many areas, including your  lower back, upper back, back of shoulders, and gluteals.

  1. Lie on your stomach with your arms straight over your head.
  2. Rest your chin on the floor between your arms.
  3. Keeping your arms and legs straight, simultaneously lift your feet and your hands as high off the floor as you can.

Aim for at least three inches.

  1. Hold that position (sort of a superhero flying position) for 10 seconds if possible, and then relax your arms and legs back onto the floor.

Tip: If this exercise is too difficult, try lifting just your legs or arms off the floor separately — or even just one limb at a time.

#7: Knee Push-Ups

Push-ups are hard to do if you haven’t built up the strength in your shoulders yet, so this knee version (Figure (21-7) is an easier way to start for most people. This exercise works your chest, front of shoulders, and back of upper arms.

  1. Get on your hands and knees on the floor or a mat.
  2. Place your hands shoulder-width apart on the floor.
  3. Tighten your abdominal muscles to straighten your lower back and lower yourself down toward the floor as far as you can without touching.
  4. Push yourself back up until your arms are extended, but don’t lock your elbows.

Tip: If knee push-ups are too hard for you, try doing wall push-ups to start instead. Stand facing a wall at an arm’s length and place your palms against it at shoulder height and with your feet about a foot apart. Do your push-ups off the wall.

#8: Suitcase Lift

This exercise (Figure 21-8) is the proper way to lift items from the floor. Before you begin, place dumbbells or household items slightly forward and between your feet on the floor. You work the same muscles used in doing squats (lower back and lower body) with this activity.

  1. Stand in an upright position with your back and arms straight, with your hands in front of your abdomen.
  2. Bending only your knees, reach down to pick up the dumbbells.
  3. Grab the dumbbells or items in both hands and then push up with your legs and stand upright, keeping your back straight.

#9: Squats with Knee Squeezes

These squats (Figure 21-9) are not your normal squats. They’re more like a combination of squatting and wall sitting with a twist. You work the front and back of thighs, inner thighs (adductors), hip flexors and extensors all with this one exercise.

  1. Stand with your back against the wall, with your feet aligned with your knees and straight out in front of you.
  2. Place a ball or pillow between your knees and hold it there with your legs.
  3. Inhale to expand your stomach and then exhale and contract your abdominal muscles.
  4. Bend your knees and lower yourself into a squat.

Warning: To avoid injuring your knees, don’t bend them more than 90 degrees.

  1. Squeeze the ball with your thighs, drawing your stomach muscles more deeply toward your spine.
  2. Do as many squeezes as you can up to 20 and then return to the starting position.

#10: Lunges

Lunges (Figure 21-10) are a common activity to work on the front and back of thighs, hip flexors and extensors, abdominals, and lower back all with one exercise. Do them with proper form to avoid aggravating your knees, though.

  1. Keep your upper body straight, with your shoulders back and relaxed and chin up.
  2. Pick a point to stare at in front of you so you don’t keep looking down, and engage your core.
  3. Step forward with one leg, lowering your hips until both knees are bent at about a 90-degree angle.

Make sure your front knee is directly above your ankle, not pushed out too far, and don’t let your back knee touch the floor.

  1. Focus on keeping your weight on your heels as you push back up to the starting position.

Tip: To prevent injuries, if you feel any pain in your knees or hips when you do a lunge, do the following instead:

* Take smaller steps out with your front leg.

* Slowly increase your lunge distance as your pain gets better.

* Try doing a reverse lunge (stepping backward rather than forward) to help reduce knee strain.


Reprinted from Colberg, Sheri R., Chapter 21, “Ten Easy Exercises to Build a Strong Core Without Leaving the House” in Diabetes & Keeping Fit for Dummies. Wiley, 2018.

Sheri R. Colberg, PhD, FACSM, is the author of The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities (the newest edition of Diabetic Athlete’s Handbook). She is also the author of Diabetes & Keeping Fit for Dummies, co-published by Wiley and the ADA. A professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert, she is the author of 12 books, 30 book chapters, and over 420 articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites (SheriColberg.com, DiabetesMotion.com, or DMAcademy.com).