All MFN blog Archives - Page 14 of 142

Surviving a Toxic Society: Nutrition 101

Nicholas Prukop/19 May 2023/ All MFN blog/

Understanding how to read a food label, determining appropriate portion sizes, making healthy food choices, calorie consumption vs. burning, fats, carbohydrates, protein, micro and macro nutrients, calorie dense vs. nutritionally dense foods, water and staying hydrated, hidden calories and so much more. These are just SOME of the challenges being faced by people of all ages today – and it’s getting WORSE with each passing day! With these topics I have just scratched the surface of what it means to survive in our toxic world – and ultimately thrive. These and many other issues have contributed to our society’s obesity crisis and as a result, the onset of multiple chronic diseases as a consequence of our inattention to the basic nutritional requirements for healthy living.

It is appalling to me that in only the span of half of my life, we are seeing the manifestation of this inattention to healthy eating taking many forms such as the onset of type II diabetes in children starting at under the age of 13! This trend – if not corrected or addressed NOW – WILL destroy scores of families if we don’t find solutions for these BASIC pressing issues now. This article is designed for all of us – me as a review – and for those of you who don’t know – an opportunity to “catch up” and maybe make different choices in not only your own lives – but those you love as well!

We associate healthy eating with weight loss and diet programs – everything else is eating for fun. We take care of our emotional and spiritual wounds through food. Families gather to eat at Thanksgiving but in the interim we “eat out”, rarely seeing that special time with family again as our days spiral on one to another. Our lifestyle has become toxic through overeating, unhealthy choices, and massive quantities – all in the desire to “forget” or calm ourselves from the stresses of the day. We are immersed in technology and tied to an unforgiving master who demands more from us than many of us can afford to give. The idea of reading a label, or noticing calorie counts before we eat something seems impossible – so we go for the easy “fix” and just say “I’ll get back to making an effort tomorrow”. It is always going to be tomorrow until tomorrow finally doesn’t come.

I see this problem as a “three pronged” issue or challenge:

1. People are woefully unprepared to deal with the enormous impact of marketing and media and the power they hold over our lives

2. The complexity of foods and their confusing claims about their value is taking our ability to choose rationally away from us

3. The food industry has basically “kidnapped” healthy eating by making it easy to select every possible harmful form of nutrition (packaged, processed foods, fast food, massive portions and so much more).

The basics of healthy eating have become such a “mystery” to most Americans so that every talk show imaginable schedules healthy eating segments and how to lose weight for good regularly! When I was a boy on Maui I ate peanut butter and jelly sandwiches and bananas and we NEVER went out to eat. All our meals were at home with the family sharing in the effort.

Calories count and there is no difference between them – they just “are”. Burning calories is what we do to stay alive so eating pretty much is a given. Learning about portion control and balanced intake of nutrient dense/calorie deficient foods is not rocket science. It requires a desire to improve your choices by providing our bodies with the fuel they need to survive and thrive – nothing more, nothing less. We need to get back to “eating to live, NOT living to eat”. The calories now proclaimed on menus throughout America should be a wakeup call to Americans of all ages. Should our food be fried or baked? Should it have sauce or no sauce? Should we eat everything we are served or save some for later? What is the source of the primary calories – saturated fat or carbohydrate? Are we getting enough protein in our diet and is it from healthy sources? These and other questions need to be addressed and I will do my part to help answer them. I am not allowed by my professional code of conduct to provide specific advice on what and how much someone should consume – that is for a licensed professional to determine, but I am allowed to talk about nutrition and the role it plays in leading a healthy and happy life. That is part of my job and I take it very seriously!

Today I saw a lady at McDonald’s who was eating their terrific side salad but had also ordered the large order of fries – a common staple at McDonalds (what was she thinking – that the one would “cancel” out the other? or was she NOT thinking but going for the joy the fries bought? I don’t know but it happens all the time!). People don’t go to this place for the salads – they go for the fries! McDonald’s is REALLY good at selling those fries and one cannot blame them for wanting to make a profit after all, can they? The idea that one could order a meal that includes the burger and fries and NOT notice it contains over 1200 calories is “mind blowing” to me. I would have to run 8 miles to burn those off at just under 55 minutes of hard running! We need to “connect the dots” as I do every day when I choose and IF I choose the pizza I am absolutely sure I can run that pizza off tomorrow. Every choice has consequences and every day we will live with those consequences until our bodies say “NO MORE”. That day of reckoning is not far off and if today’s children don’t get to live longer than their parents then we will all be to blame to some degree, won’t we?

When you look at food think of it as fuel to keep you alive and ask yourself: Does it have water as a primary part of its makeup? Is it fried, boiled or baked? Is it good for me? Will it promote my general health and preserve my immune system? Will I enjoy it and possibly eat it again? Can I find a way to eat more or less of this food? If it has lots of chemicals associated with its manufacture will that eventually harm me? Am I being proactive in my food choices and not reactive to the inevitable emotional swings in my mood that occur throughout my day? Do I eat for reasons other than because I am hungry? Am I compulsive when it comes to eating alone and do I overeat for reasons beyond my knowledge and control? These and other questions are a part of the dialogue on healthy eating and MUST be addressed if we are to slow the death spiral being brought on by the obesity crisis – and its cousin the “sitting of America”.

I see the massive need for ongoing education and communication at ALL levels of society and from all aspects of life that touch the American family. These include the schools, government, the weight loss community, the food manufacturer’s, the restaurant community (including McDonald’s of course who IS actually “trying” to make healthy choices available to its customers although not fully succeeding because of those “damn” fries), supermarkets, the community at large, non profits, spiritual centers and so many more. It will take “that village” referred to earlier to solve the problems we are facing but they MUST be addressed if we are to save lives in the future. I will discuss basic food issues in future articles and identify some of the ways in which we can all participate as part of the solution. If we each just help one person improve something in their nutritional lives TODAY we end up helping “the many” too – and I think that is well worth the effort! Don’t you?

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

The Stress Factor

Megan Johnson McCullough/17 May 2023/ All MFN blog/

What lights a fire under you?? What grinds your gears, makes you angry, sad, worried, or STRESSED?? We each deal with the components of life differently, and our reactions to circumstances dictate our emotional well-being. Time, relationships, work, school, kids, family…. all these responsibilities can require a balancing act that seems impossible. But that’s life. And unfortunately, stress can have adverse effects on our health… especially weight.

Your body and mind are one and the same. When put under pressure, your brain kicks into a flight or fight mode. And guess what? Your body wants to use calories in its defense. As such, “Most of us become overeaters when we’re feeling a lot of pressure. This happens thanks to your fight-or-flight response, a.k.a. survival mode — once your body reaches a certain stress level, it does what it feels it needs to. In most cases, that means overeat.” ⁽¹⁾

Initially, adrenaline spikes in the body, making one feel less hungry. However, soon after cortisol takes over. Cortisol is the stress hormone. When activated, inhibition can go out the window. Here’s run down: “Because increased levels of the hormone also help cause higher insulin levels, your blood sugar drops and you crave sugary, fatty foods.”⁽¹⁾ Cheap, convenient, processed foods, are right there to answer the calling.

Here’s the catch: “Today’s human, who sits on the couch worrying about how to pay the bill or works long hours at the computer to make the deadline, does not work off much energy at all dealing with the stressor! Unfortunately, we are stuck with a neuroendocrine system that didn’t get the update, so your brain is still going to tell you to reach for that plate of cookies anyway.” ⁽²⁾

We have to learn to relax, sleep, and breathe. Many clients ask me what foods to turn to. Here’s what I found:·

Dark chocolate: Two studies of 95 adults showed that consuming dark chocolate reduced their cortisol response to a stress challenge.

Many fruits: A study of 20 cycling athletes showed eating bananas or pears during a 75-km ride reduced levels compared to drinking water only.

Black and green tea: A study of 75 men found 6 weeks of drinking black tea decreased cortisol in response to a stressful task, compared to a different caffeinated drink.

Probiotics and prebiotics: Probiotics are friendly, symbiotic bacteria in foods such as yogurt, sauerkraut and kimchi. Prebiotics, such as soluble fiber, provide food for these bacteria. Both probiotics and prebiotics help reduce cortisol.·

Water: Dehydration increases cortisol. Water is great for hydrating while avoiding empty calories. A study in nine male runners showed that maintaining hydration during athletic training reduced cortisol levels.⁽³⁾

Life’s demands throw us for a loop from time to time. Reassure yourself that patience is the key and that this too shall pass. Don’t let your negative thoughts take the wheel. Healthy choices outlast split second mistakes. Be kind to your BODY, even in it’s weak moments.

Originally printed on Every BODY’s Fit blog. Reprinted with permission.

Dr. Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health and a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

healthy middle aged man workout at the beach

The Aging Athlete

Jeremy Kring/15 May 2023/ All MFN blog/

If you’re reading this you are likely interested in beginning or improving in a recreational activity or sport. You might want to train for stadium football, a rec team, fun runs, obstacle courses or something as major as a triathlon. While you may be anxious to jump right into a training program there are a few things you should consider such as your current activity level, current physical condition (i.e. chronic conditions, aches, past surgeries, injuries), and knowledge of physical fitness programming.

Who is the Aging Athlete?

The aging athlete can be anyone who needs to rethink their recovery strategy as it relates to the rigors of the desired/continued activity due to the aging process. Likely this is any athlete or recreational athlete in their 30’s, 40’s and beyond. The National Strength and Conditioning Association (NSCA) states, that while the cardiovascular endurance and muscular strength of older competitors or athletes are truly exceptional, even the most highly trained athletes experience some decline in performance after the age 30. As such participating in recreational sports or activities fully depends on your health and preparation and the sport or activity you are pursuing.

Before you begin you should consult with your primary health care provider (PHCP). If you’ve been cleared but inactive for any period of time complete a physical activity readiness questionnaire (PAR-Q) to ensure nothing has changed. Additionally, if you have a chronic condition, chances are your PHCP has already discussed exercise with you, and most likely gave you some general guidelines. A chronic condition defined by the Center for Disease Control and Prevention (CDC) is a condition that lasts one year or more and requires ongoing medical attention or limits activities of daily living or both. This does not preclude you from participating in recreational sport or activity necessarily, but it is a factor to be taken into consideration. You may be asking yourself, is this something I can do? Is this something I can do on my own? Do I need a trainer? How do I know what trainer I should go to?

Is this something you can do on your own?

The answer is yes, with this caveat. Unless you have a background in exercise, likely there will come a point when you will need someone to reach out to for advice. If that happens reach out to a professional with the appropriate qualifications. Frequently, I have heard gym members echo comments questioning the validity or worth of paying someone to do something they can do on their own. They often do not realize or recognize that hiring a professional who is educated and experienced in strength and conditioning is more than just programming exercise, it’s also injury prevention. Activities, movements, or lack of recovery may not have caused injury in the past, but as we age the dynamic changes, and to remain healthy and injury free, we must change. Commonly people just work around injuries, avoid certain exercises, or reduce intensity and accept that’s just part of aging, so they press forward. However, if they would have consulted with a fitness professional they may have found a better more comprehensive solution.

Working around past injuries is a useful and worthy approach, if done correctly. However, the truth is that most of those injuries are a result of their habits. Perhaps they have been predominantly inactive, spending much of the day sitting. Perhaps they were training hard without any or little variation in intensity, without any or little variation of joint movement, and without any or little variation in program design. These all add up to repetitive stress injuries. Common repetitive stress injuries often appear as bursitis, arthritis, tendonitis, and lower back pain/injuries.

That is not to say you cannot do this on your own nor that you need a trainer or will always need a trainer. It is to communicate the point that we do not inherently know how to exercise properly. Many in their youth have participated in sports, and the programs they were taught may be missing some crucial elements to keep them healthy and pain free. These elements are missing sometimes because years ago we did not have the information we have today. Sometimes it’s because we only remember some of what we were taught, and other times it’s because we have aged, or our physical needs have changed and require a change in programming.

If you’ve never exercised before, it’s recommended you either take a few classes (not a fitness class such as spin, but an instructional class offered at a gym, YMCA, or college) or hire a trainer for a short period of time. Perhaps you are on the fence on taking a class or seeing a trainer. If that is the case, ask yourself these questions:

Are you developing aches and pains that are lasting for longer periods of time?
Do you know what a plane of motion is, and how to exercise your joints in each plane of motion?
How often do you change your program? Do you have a chronic condition?
Are you developing lower back, knee, or hip pain?

The answers to these questions can give you a good sense of whether you may benefit from seeking professional assistance or instruction.

The Key is Individualized Programming

Assuming your destination is recreational sports and activities or even occupational activities the program should be appropriately progressed in intensity, duration, and specificity to get you to your desired destination. Repetitive stress injuries occur because one set of tissues in the body/muscle/joint continue to be challenged in the same way at the same spot over, and over again. By taking your occupation, past activities or recreational sports into account your program can be structured to bring the proper balance of strength, and flexibility to the areas that may be neglected or strained. Below is a list of general guidelines if you’re choosing to do this on your own:

General

It is recommended you undergo a health screening by your PHCP prior to beginning
Cardiovascular and resistance training are both recommended, intensity in both depend on your medical clearance, training status, and sport of choice
Perform exercise through a full pain free range of motion, and do not exercise if the joint is in pain or inflamed³
Listen to your body, and when in doubt seek guidance from a qualified fitness professional

Resistance, Cardio and Sport Specific Exercise

Warm-up for 5-10 minutes with low-moderate aerobic activity and calisthenics, and perform static stretching after the warm-up and at the end of the workout²
For cardiovascular/endurance perform 20-60 minutes of large-muscle aerobic activity most days at an intensity of 60%-90% of age-predicted heart rate¹
If you have been sedentary or are just beginning, resistance train no more than twice a week, allowing 48-72 hours to recover, as you progress you can workout daily with different muscles groups at different intensities each day²
Focus on mastering basic resistance exercises then implement exercises that are more sport specific, as well as balance, free weights, multi-directional, multi-joint, and power/agility exercises²
Begin doing 8-12 repetitions of a weight that is equal to 50% of your maximum weight and gradually increase to up to 80% of your maximum weight, weight should be lifted and lowered in a controlled manner, and at a slower speed in the beginning (2 seconds for the lifting phase, and 2 seconds for the lowering phase), for 1-3 sets²
Take 1-3 minutes of rest between sets³
Avoid holding your breath during exercise²
Once you’ve advanced to power/speed training, perform 1-3 sets per exercise at 40-60% of your maximum weight and 6-10 repetitions at a high (but controlled) speed²
Train each joint in multiple directions (ie. planes of motion). For example, the hip can perform flexion, abduction, adduction, or circumduction.

What Should I look for in a Trainer?

If you elect to see a trainer there’s a few things you want to look for. You want a trainer with verifiable experience, an accredited certification/college degree, and liability insurance. The fitness industry is largely unregulated and there is some debate among which certifications are the best. A good place to start is the MedFit Network as trainers have to meet professional criteria in order to be listed. Additionally, it is important that their experience and background suits them to your specific needs. If you have a chronic condition, dealing with pain or have past injuries these are areas you want to be confident they can serve. As you are either engaged in athletic activity or want to engage in athletic activity it is important that the trainer have a solid foundation of periodization, and athletic performance. Quack science and self-professed gurus have no place here. The trainer’s practices should be founded in the principles set forth by the American College of Sports Medicine (ACSM), and the National Strength and Conditioning Association (NSCA). Most trainers offer a free assessment, which gives them an opportunity to learn about you, and you to learn about them. Be sure to meet with several trainers and ask for client references. This is a reasonable request and a quality trainer will not take offense. Lastly, if something feels off, seek a second opinion.

When undertaking rigorous activity and sport, there are other services you may want to consider, or discuss with your PHCP such as massage therapy, nutritional counseling, or chiropractic care depending on your needs. Remember one size does not fit all and by keeping your health in balance now you will be able to continue to enjoy the activities and sports you love for years to come.

Jeremy Kring, holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com

References

Jacobs, P. L. (2018). NSCAs essentials of training special populations. Champaign, IL: Human Kinetics.
Haff, G., & Triplett, N. T. (2016). NSCAs essentials of strength training and conditioning. Champaign, IL: Human Kinetics.
Brown, L. E. (2017). Strength training se/National Strength and Conditioning Association. Champaign, IL: Human Kinetics.

The Hijacking of Exercise

Greg Mack/12 May 2023/ All MFN blog/

I have been involved in exercise personally and professionally since I was in grade school.

My introduction to exercise was initially through sports.

I remember doing the President’s Council on Physical Fitness assessments while in grade school in the late 1960’s. (I know, I know – I’m getting old). For those readers as ancient as I, can you remember those tests?

Max pull-ups
V-sit-and-reach
Sit-ups (one minute)
30-foot shuttle run
One-mile run

There were comparisons for each test that placed the individual in some percentile of a normative value system. This set of supposed tests of fitness were the standard in schools for decades. They underwent some changes in the 80’s and I think are now known as “Let’s Move”.

The idea that fitness is attached to some performance standard is alive and well. In the modern philosophy of exercise process, known as “Functionalism”, the exercise and fitness enthusiast are all considered “athletes”. This notion of exercise being an athletic endeavor, and that all exercisers are treated like (and should consider themselves) as athletes, dominates the fitness and – even physical therapy – landscape.

I think sports has hijacked exercise.

I think this is a mistake.

Now, don’t get me wrong. I understand and support that athletic individuals participating in sports need to exercise. I understand that athletes working to achieve high levels of physical capabilities use the exercise process in ways that a non-athlete might never even consider, let alone need, to achieve a modicum of fitness. But, athletes seem to accumulate physical injury. When the exercise process expects the exerciser to push their limits in order to squeeze out ever-increasing physical performance feats, an injury is not far behind. Getting injured using exercise for general fitness is not fitness. Why would a non-athlete want to pursue exercise under these conditions?

It sometimes seems as if the modern message of “everyone is an athlete” coming from the exercise and fitness community to the general population, most of which are not athletes and have no interest in sports, dissuades the non-athlete from pursuing exercise. The images used to promote exercise are composed of athletes pushing their physical limits and expressing the pain and discomfort that comes with that pursuit. This can be intimidating to the non-athlete. The exercise processes used to exercise individuals under the “everyone is an athlete” paradigm are high risk and unnecessary for general fitness and wellness.

My thesis is this: The message and delivery of exercise and fitness as an athletic endeavor truncates the already difficult process of getting more individuals to start and maintain an appropriate lifelong exercise process that achieves the powerful benefits regular exercise can bestow.

My answer is this: The modern message needs to be more balanced in order to avoid stereotyping exercise as only for those that are athletically inclined. One that presents images of average everyday folks exercising and enjoying non-athletic physical pursuits. It is our responsibility as exercise and healthcare providers to stimulate and inspire more of the general population to engage in a regular and reasonable process of exercise. One that does not tell them that they have to be an athlete, nor will be treated like one during exercise whether they like it not. Let’s create messaging that encourages and exhorts participation at all levels for all classes. Let’s move away from just offering a protocol based athletic exercise process. Let’s customize the process to not just the client’s physical needs but their mental perspective of self and how they want to experience exercise.

Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease.

Simple Tips to Stave of Arthritis Symptoms

Christine Conti/8 May 2023/ All MFN blog/

Offer up these simple tips to aid arthritic clients reduce flare-ups, decrease symptoms, and experience more pain-free days!

There are many simple practices that may greatly decrease the risk and severity of flare-ups. To help reduce painful and swollen joints, improve mood, and increase quality of life, implementing a few of these simple techniques may make a world of difference.

1. Drink Water! The body is comprised of about 60% water. Dehydration causes a decrease in function of all major organs, muscles, and even bones.

2. Get to Sleep! Adults of all ages need 7-9 hours of sleep each night. Sleep is when your body repairs muscles, organs, and cells. In this resting state, chemicals will circulate in the blood that help to strengthen the immune system.

3. Set a Schedule! Plan your days! Get into a routine of good habits. Setting alarms to get up, make phone calls, exercise, cleaning, and meals will provide a daily purpose. Writing “to-do” lists on a paper calendar and crossing off items as they are accomplished provides a heightened sense of satisfaction and self-worth.

4. Eat Real Food! The fewer ingredients, the better. Read labels to avoid too much sugar, salt, and oil. I call these the “S.O.S.” These are foods that are known to cause inflammation and increase the risk for flare-ups. For example, if you have the choice between an apple or apple pie, choose the apple with less ingredients. It also most likely contains less sugar or processed ingredients.

5. Exercise Daily! Think of exercise as something you “work in” each day and not as a “work out.” Improving muscle strength, mobility, flexibility, and cardiovascular health reduces symptoms of autoimmune disease.

6. Hiring a Arthritis Fitness Specialist once or twice a week to provide accountability and write safe and effective exercise programs is a great start!

7. Practice Mindfulness! The simple act of taking a few deep and meaningful breaths throughout the day is a great way to reduce stress and decrease negative physiological responses. Incorporating some gentle stretches in the morning, after periods of inactivity, and before bed is also a great way to bring awareness to the body, ease tension, reduce anxiety, and lessen the symptoms associated with arthritis.

Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is the author of the MedFit Classroom Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.

Protecting the Spine from Kyphosis

Susan Randall/5 May 2023/ All MFN blog/

People with bone loss in the spine are often concerned about changes in the spine or the backbone that cause it to curve forward. This curve is called kyphosis. It can happen when a person with osteoporosis breaks several of the bones that form the spine. These bones are the vertebrae. When they break, they are called vertebral or compression fractures. There are also other conditions that cause kyphosis. Kyphosis causes a person’s posture to look stooped or hunched and the person loses height. As more bones break in the spine, the spine becomes more curved. When it is severe, some people call kyphosis a dowager’s hump. Fortunately, people can take steps to protect the spine, maintain height and posture and prevent kyphosis.

Broken Bones in the Spine

Breaking one or more bones in the spine can cause sharp back pain that does not go away, or sometimes, there can be no pain at all. After having several of these breaks, people may start to have a curved spine and lose height. When there is no pain, many people do not know they have broken a bone in the spine. After becoming shorter by an inch or more in one year’s time, some people realize there is a problem with the spine. Because of height loss and changes in the spine, clothes may start to fit poorly.

For some people, kyphosis causes constant pain. This pain happens when the spine becomes more curved and the muscles, tendons and ligaments of the back are strained and stretched. Sometimes nerves are also pinched. Severe kyphosis can reduce the space for internal organs. It may also cause the stomach or abdomen to push forward and appear to stick out. As a result, it is harder for some people to breathe or eat, and they may not get enough food and nutrition for their health. Severe kyphosis may also affect balance and cause falls.

Tests to Look for Spine Fractures

People with osteoporosis who have back pain should see a doctor or other healthcare provider trained to treat osteoporosis. Most healthcare providers will want to check for a broken bone. The dual energy x-ray absorptiometry machine (also called a DXA machine) that tests people for osteoporosis can be used to look at the spine to find broken bones. This test is called a lateral vertebral assessment. A lateral x-ray of the spine is another way to find a broken bone in the spine. These two tests used to look for spine fractures are also called vertebral imaging tests.

People with osteoporosis should have their height measured once a year preferably at the same healthcare provider’s office each time. NOF recommends that healthcare providers consider performing a vertebral imaging test to look for spine fractures in the following individuals:

All women age 70 and older and all men age 80 and older if the T-score is -1.0 or below.
Women age 65 to 69 and men age 70 to 79 with a bone density T-score of -1.5 or below.
Postmenopausal women age 50 to 64 and men age 50 to 69 with specific risk factors, including:
- Height loss (e.g. 1.5 inches or more from young adult height or rapid height loss in a short period of time)
- Recent or ongoing use of steroid medicines (such as prednisone or cortisone)

Moving Safely

It is important to protect the spine by moving properly during exercise and daily activities. Activities that place stress on the spine can increase the likelihood of breaking a bone. For example, people with bone loss in the spine should not:

bend over from the waist with straight legs
do toe-touches, sit-ups or abdominal crunches
twist and bend at the torso (trunk) to an extreme
carry packages that are too heavy
bend forward when coughing and sneezing
reach for objects on a high shelf

For some people with a lot of bone loss, simply hugging a friend or picking up a grandchild can cause a broken bone in the spine.

Seeing a Physical Therapist

People with osteoporosis may want to speak with their healthcare provider about a referral to a physical therapist (PT) who understands osteoporosis. PTs can help people protect their spines. For example, PTs can help people limit the amount of kyphosis by teaching proper posture and exercises that make the back muscles stronger. They can also show people how to safely sit, stand and move.

Taking an Osteoporosis Medication

A person who has broken one or more bones in the spine is at very high risk for breaking more bones in the spine. All people with these fractures should speak with their healthcare provider about taking a medication to treat osteoporosis. NOF encourages people to look at both the risks and benefits of taking or not taking a medication. Other healthy lifestyle behaviors, including getting enough calcium and vitamin D, not smoking or drinking too much alcohol and maintaining a safe exercise program can also help individuals reduce the chance of breaking bones in the spine.

Susan Randall RN, MSN, FNP-BC is Senior Clinical Advisor for the National Osteoporosis Foundation (NOF) in Washington, DC,

Healthy Aging: How Beginner’s Yoga Can Help You Live an All Around Healthier Life

Kaitlin Krull/3 May 2023/ All MFN blog, Conditions/

While most of us know that regular exercise is an important part of overall health, it can be difficult to make our bodies perform in the ways we think are necessary in order to feel the physical benefits. This is especially true as we age, when muscles and organs begin to work differently and we lose flexibility and mobility. Beginner’s yoga is the perfect remedy for addressing these limitations as we age. With both physical and mental benefits, the regular practice of yoga, at any level, can help you to live an all around healthier life. Here are just a few of the best reasons to take up yoga now, regardless of the number on your birthday card.

Physical Benefits

Many people begin practicing yoga in order to reap the physical benefits of the exercise. These are some of the ways yoga improves your physical health:

Increases stamina, flexibility, and mobility
The regular practice of yoga strengthens muscles and joints, allowing you to achieve more with your body, which is especially important as you age. It increases stamina, flexibility, and mobility, together with balance and coordination, which provides an effective yet gentle total body workout.

Helps encourage weight loss
We all know that increased physical exercise, when coupled with a healthy diet, can help you to achieve weight loss success when repeated regularly. This is also true for yoga. Once you begin to strengthen some of those forgotten muscles and joints, you will be able to practice yoga at a higher calorie burning level.

Alleviates physical ailments
Yoga practitioners around the world sing the praises of the exercise’s ability to remedy a number of physical ailments, some of which are particularly prevalent as you age. Regular yoga, even at the beginner’s level, can help to alleviate symptoms of heart conditions, blood flow and circulation issues, and muscle, bone, and joint problems. This kind of physical exercise also lowers cholesterol and blood sugar, thereby lowering your risk for other related health issues like diabetes and stroke.

Mental Benefits

If you weren’t convinced to begin practicing yoga by the physical benefits alone, check out the ways in which yoga can increase mental health as well.

Relaxes mind as well as body
The repetitive and meditative style of yoga is called upon time and again to help relax both the body and the mind. Poses performed at the beginning and end of yoga routines in particular are focused at calming the mind and relaxing the muscles in your body. This relaxation cannot be underestimated when it comes to the state of your mental health and well being.

Gives focus and awareness
Repeated exercises like those found in beginner’s yoga classes are designed to focus and sharpen your mind, increasing both your awareness of the world around you as well as your concentration levels. This can be especially beneficial for very busy people, older adults, and even energetic children, who find that yoga helps them to focus their train of thought and remain calm even in the most stressful of situations.

Relieves stress
Calming thoughts and repeated poses that are common to yoga have the ability to release tension in the body, giving focus to the practitioner. This focus allows positive thought, which logically relieves stress. Lowered stress levels are good for everyone, but best of all they have positive knock-on effects with regards to your physical health too, making yoga an all around positive practice for a healthier life

Kaitlin Krull is a writer and mom of two girls living the expat life in the UK. Her writing is featured on Modernize.com and a number of fitness, health, and home decor sites around the web. She’s a yoga enthusiast of 5 years and loves anything that promotes a healthy mental state and positive lifestyle.

Using the SOAP Note Format for Medical Fitness Clients

Joshua Slone/1 May 2023/ All MFN blog/

The SOAP note format, the acronym of which stands for Subjective, Objective, Assessment, and Plan, is one of the standard document formats that healthcare providers use to document patient information and treatment progress. This article will take you through the format and teach you how to use it with your medical fitness clients.

The Subjective section will include the Chief Complaint of the client/patient, which is the reason they are working with you. This can be an official diagnosis from a licensed healthcare provider, such as Type 2 Diabetes Mellitus, or a symptom of a condition that is causing quality-of-life reduction, disability, or pain. You are not diagnosing any disease, injury, or health condition. You are merely stating the reason for the visit. You can include a brief patient medical history in this section, though you should strive to be succinct in your summary. The healthcare provider for your patient already knows their conditions and struggles and does not need a full page on the topic.

The Objective section is for vitals, how the client/patient presents at the visit physically and psychologically (attitude) and any recent lab or imagery results that are pertinent to your scope of practice and the patient’s Chief Complaints. When documenting the results of lab tests, only record what was tested and whether the result (such as fasting blood glucose levels) falls within normative values for the client/patient population. When documenting imagery results, record the type of imagery and the reviewing technician’s assessment (such as an MRI that shows posterior rotator cuff tears). The vitals you can and should take are heart rate, blood pressure, weight, and today’s pain rating on a 1-10 scale if applicable.

The Assessment section is typically used by healthcare providers for differential diagnosis, which is outside your scope of practice. The Assessment section will consist of your statement on the client/patient’s conditions and how they currently influence their fitness and general health. This can include notes on nutrition and physical activity levels. If the client/patient is presenting with an issue that session, such as restriction in shoulder flexion past 80 degrees, you will document that as well. If joint ROM is a focus of the client/patient’s training plan you should assess this at the beginning of the session and document the current ROM state relative to the previous session or baseline evaluation.

The Plan section is where you record the client/patient training for the day. This is also where you will annotate future training/care plans, such as periodization and progression. This section tells the healthcare provider exactly what you are doing with their patient and enables them to provide you with objective feedback on your training plan if necessary. Your training plan should reflect all guidelines and restrictions the patient’s healthcare provider has given you.

The following is an example of a completed SOAP note:

Date: 5/1/2023
Patient Name: John Q. Public
Provider/Trainer Name: Slone, J.

Subjective:
Chief Complaint: pain secondary to posterior rotator cuff partial thickness tear, restriction in ROM due to said injury, weakness of posterior RC due to injury. Pt is alert, attentive, and appears in good spirits and motivated.

Objective:
HR: 85
BP: 120/90
WT: 241lbs
PAIN: 2/10 at rest

Assessment:
Horiz. Shldr abd. restricted to 70/90 degrees, dull, achy pain during concentric posterior RC movement that improves during warmup. No active shldr flex today. Shldr ext does not provoke pain. Ext. rot. does not provoke pain.

Plan:
Today’s Care:
Warmup: arm bike 5min @ RPE 3-4
2×12-15 low face pull w/medium-light band within pain-free ROM
2×12-15 horiz. Abd. w/light band within pain-free ROM
2×8-10 ext. rot. w/light band within PF-ROM
2×8-10 scap retrac. w/medium band
2×3-5 overhead eccentric weight bearing, 3lbs, no pain

2x30s cross-body posterior RC stretch
2×10/12 finger ladder steps within PF-ROM

Future Care:
Continue with periodized RT to build function and strength within PF-ROM. Improve joint restriction through flexibility plan. Adhere to PCP guidelines.

This not unlike what a completed SOAP note in a physical therapy clinic would look like. Objective measures that a PT would use are measured joint ROMs with a goniometer (visual estimation is nearly as accurate in most cases and is acceptable for you to use). In a PT clinic, the Plan would also include treatment modalities, which are outside the trainer’s scope of practice (massage, manual therapy, e-stim, heat, cold, etc).

While you are not required to use this format with your clients/patients, it is of great benefit to use a standardized format that ensures you capture all pertinent information and are able to relay that to allied healthcare providers.

Here is a Word document template for the SOAP note format that you may download and use with your patients: SOAP Note Template.

Reprinted with permission from the Move Well, Live Well blog.

Joshua Slone is an Exercise Physiologist and Pain Therapist. He serves as Rehab Team Lead/Physiologist at the Center for Health in Yucca Valley, CA. His clinical expertise includes chronic pain management, joint replacements, sport and orthopedic injuries, complex medical condition management, geriatrics, degenerative neurological conditions, and psychiatric disorders. Visit his website, movewelllivewell.org

References

Instructor Showing Health Results On Clipboard To Senior Couple

Respiratory Disease and Exercise

CarolAnn, M.S., CPT, CN/28 April 2023/ All MFN blog/

According to the World Health Organization (WHO), hundreds of millions of people suffer every day from chronic respiratory diseases (CRD). Currently in the United States, 24.6 million people have asthma¹, 15.7 million people have chronic obstructive pulmonary disease (COPD)² while greater than 50 million people have allergic rhinitis³ and other often-underdiagnosed chronic respiratory diseases. Respiratory diseases do not discriminate and affect people of every race, sex, and age. While most chronic respiratory diseases are manageable and some even preventable, this is what is known about the nature of chronic respiratory diseases⁴:

Chronic disease epidemics take decades to become fully established.
Chronic diseases often begin in childhood.
Because of their slow evolution and chronic nature, chronic diseases present opportunities for prevention.
Many different chronic diseases may occur in the same patient (e.g. chronic respiratory diseases, cardiovascular disease and cancer).
The treatment of chronic diseases demands a long-term and systematic approach.
Care for patients with chronic diseases should be an integral part of the activities of health services, alongside care for patients with acute and infectious diseases.

Exercise and CRD

If you are a health and fitness professional, some of your clients may be suffering from a chronic respiratory disease and you may be an important source for relief. Moderate exercise is known to improve use of oxygen, energy levels, anxiety, stress and depression, sleep, self-esteem, cardiovascular fitness, muscle strength, and shortness of breath. While it might seem odd that exercise improves breathing when one is short of breath, exercising really does help one with respiratory disease. Exercise helps the blood circulate and helps the heart send oxygen to the rest of the body. Exercise also strengthens the respiratory muscles which can make it easier to breathe.

Beneficial Types of Exercise

There are several challenges to exercise prescription and physical activity participation in this population, but a large body of evidence demonstrates important health benefits from aerobic exercise. Resistance training has also been shown to increase muscle mass and strength, enhancing individuals’ ability to perform tasks of daily living and improving health-related quality of life.⁵

Aerobic exercise is good for the heart and lungs and allows one to use oxygen more efficiently. Walking, biking, and swimming are great examples of aerobic exercise. The guidelines are approximately the same as generally healthy individuals. One should attempt to train the cardiorespiratory system 3-5 days a week for 30 minutes per session. One should exercise at an intensity level of 3-4 on the Rating of Perceived Exertion Scale (Scale Rating from 0 Nothing at All-10 Very, Very, Heavy).

Resistance exercise increases muscular strength including the respiratory muscles that assist in breathing. Resistance training usually involves weights or resistance bands but using one’s own body weight works just as well depending on the severity of the symptoms. It is recommended that one should perform high repetitions with low weight to fatigue the muscles. This type of resistance training also improves muscular endurance important for those with CRD. Resistance training should be performed 2-3 days a week working all major muscle groups.

Stretching exercises relax and improve one’s flexibility. When stretching, one should practice slow and controlled breathing. Not only does proper breathing help to deepen the stretch, but it also helps one to increase lung capacity. One should gently stretch all major muscles to the point of mild discomfort while holding the stretch for 15 to 30 seconds, slowly breathing in and out. Repeat each stretch 2-3 times. Stretching is an effective method to warming up and cooling down before and after workout sessions.

When exercising, it is important to remember to inhale in preparation of the movement and exhale on the exertion phase of the movement. An individual should take slow deep breaths and pace him/herself. It is recommended to purse the lips while exhaling.

Use of Medication

If an individual uses medication for the treatment of respiratory disease, he/she should continue to take the medication based on his/her doctor’s advice. His/her doctor may adjust the dosage according to the physical activity demands. For example, the doctor may adjust the flow rate of oxygen during exercise if one is using an oxygen tank. In addition, one should have his/her inhaler on hand in case of a need due to the increase of oxygen demand during exercise.

Fitness professionals can effectively work with those who have a chronic respiratory disease providing them with a better quality of life through movement. You as their health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness.

Continued Education for Fit Pros

Fitness Professionals & Personal Trainers: Become a Respiratory Disease Fitness Specialist!

Some of your clients may suffer from a respiratory disease and you may be an important source of relief. The Respiratory Disease Fitness Specialist online course will equip you with the knowledge to safely and effectively work with these clients to help improve their quality of life.

Known as the trainers’ trainer, CarolAnn has become one of the country’s leading fitness educators, authors, and national presenters. Combining a Master’s degree in Exercise Science/Health Promotion with several fitness certifications/memberships such as FiTOUR, ACSM, ACE, AFAA, and LMI, she has been actively involved in the fitness industry for over 25 years. She is currently the Founder and Director of Education for Chiseled Faith, a Faith Based Health and Fitness Program for churches. Visit her website, www.CarolAnn.Fitness

References

2015. NHIS Data; Table 3-1. www.cdc.gov/asthma/nhis/2015/table3-1.htm
Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
CDC, Gateway to Health Communication and Social Marketing Practice. Allergies. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Allergies.html
World Health Organization http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf
Eves ND, Davidson WJ. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Applied Physiology Nutrition and Metabolism. 2011;36(Suppl 1):S80–100. [PubMed]