All MFN blog Archives - Page 18 of 142

group of happy pregnant women talking in gym

Pelvic Floor Dysfunction in Pregnant Women and New Mothers, Preventable & Treatable

Danielle Spangler/10 February 2023/ All MFN blog/

Pelvic floor dysfunction, or PFD, is a broad term used to describe several physical conditions that occur mainly as a result from pregnancy and childbirth. As a pre and postnatal fitness specialist for over 20 years, almost every one of my clients has had some form of PFD. What does this mean and why is it relevant to women’s fitness? I will further define PFD in detail and explain how it changes the way we as exercise professionals program design for this clientele.

First, let’s look at the pelvic floor muscles. The pelvic floor looks like a sling or hammock that forms the floor of the bony pelvis and it serves several important functions in our bodies. The internal layer or “pelvic diaphragm” work with the external muscles of the pelvic floor to support our internal organs, stabilize our bodies, allow for sexual function, urinary and bowel movements and assist in contracting and pushing in the birthing process. These muscles are prone to trauma from the various functions they perform. The stress of the growing uterus in the body during pregnancy coupled with the changing gravity, posture and production of the hormone Relaxin all contribute to weakening the pelvic floor muscles.

Second, consider the whole Neuromuscular Core system. Pelvic floor muscles connect to the Transverse Abdominus (TVA) and they work together in harmony essentially hold the body upright. It is almost impossible to engage one without the other. Tightness in the hips combined with weak pelvic floor muscles creates PFD.

Diastasis Recti, Symphosis Pubis Dysfunction (SPD), Urinary and or fecal incontinence, pelvic pain, chronic lower back pain, Piraformis syndrome, sciatic pain, pelvic organ prolapse are all conditions under the pelvic floor dysfunction umbrella. Below these conditions are listed and defined in more detail.

Diastasis Recti: This is a separation of the right and left side of the Rectus Adbdominus in the Linea Alba connective tissue more than 2 cm in width

Pubic Symposis Disorder: A separation of the pubic bones, which often occurs during birth but sometimes during the third trimester.

Urinary incontinence: Uncontrollable leakage from bladder.

Fecal incontinence: Uncontrollable leakage of fecal matter from colon. Usually as a result from severe tearing during birth.

Pelvic pain: This type of pain can be during sex or when performing a movement that is irritating or uncomfortable, many possible underlying issues.

Chronic lower back pain: Unexplainable chronic lower back pain

Sciatica: Pain that radiates from lower back down one leg along the sciatic nerve as a result of compression of the sciatic nerve

Piraformis syndrome: Also a result of an inflamed sciatic nerve but more localized

Pelvic organ prolaps: When organs of the pelvis fall as a result of weak pelvic floor muscles.

These conditions can be limiting for many women and go untreated because they are embarrassed or told that they are normal “experiences” after giving birth. Until recently, very few fitness programs existed to help women strengthen pelvic floor muscles. It is my opinion that every pregnant woman and new mother should be automatically screened for PFD and treated right away. If women do not learn proper strengthening exercises of pelvic floor muscles they can potentially live in discomfort for years. The sooner preventative care is offered the better the quality of life for these women.

As mentioned earlier, many of these conditions are preventable and remedied through a combination of functional strength with corrective, posture-based range of motion exercises. When a woman becomes pregnant there is an immediate increase in pressure to the pelvic floor muscles. The body begins to produce relaxin which affects the joints throughout the body, especially the pelvis as it prepares to accommodate the growing uterus and eventually for birth. If treatment begins to help women continue strengthening the muscles surrounding the hips immediately, the pressure on the pelvic floor muscles will be reduced.

It was common practice until recently that women were advised to learn and perform Kegel Contractions. We understand more now as movement therapists that Kegel contractions are very hard to teach, very isolated, and in most cases, when examined internally by a women’s healthcare PT, women are not performing them correctly. A more effective approach to strengthening the pelvic floor muscles is to treat the entire hip complex as “one”– or a “global approach” — as described in applied functional science.

So, how do fitness professionals help create beneficial, safe and effective exercise programming for pregnant clients and new mothers that hone in on the core and pelvic floor? We must start by helping our clients improve their posture first and foremost, then work on proper breathing techniques and lastly incorporate larger exercises that do not isolate, but recruit many muscles from the hip complex and surrounding muscles groups. By incorporating all three planes of motion instead of working primarily in the sagittal plane (forward and backward) when performing even the most basic of exercises (i.e., the squat), you must change the movement by foot placement, arm placement, direction, tempo, range of motion etc. The variety in actions creates good stress to the pelvic floor and core muscles. Additionally, increasing the adduction and abduction action simultaneously while performing various exercises will help activate and recruit pelvic floor muscles subconsciously. Anatomically speaking, everything is connected in the body. Understanding that big global movements of the upper body and lower body together affect the position and strengthen of pelvic floor and core muscles is essential. The body is most efficient at strengthening the small muscles when big muscle groups are stimulated in combination. Throughout my years, I have seen much success with clients that incorporated these types of movements into their workout regimen and were safe and conscientious not to perform exercises that added bad stress to the external abdominal muscle group or impact exercises.

Each woman is different on how quickly it takes her to recover from PFD. The most important rule of thumb is to be reassuring and provide support and remember the time line is different for everyone depending on severity of PFD, the fitness level of the client, if the client is breast feeding and prior injuries that could prolong healing time.

Online Course for Fit Pros: Prenatal and Postpartum Exercise

Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com

Your Journey to Pain Free Movement

Jacqueline Gikow/8 February 2023/ All MFN blog/

I want you to think differently about exercise. We have to understand that exercise is not only about body builders and gyms. Being strong leads to a better quality of life. Training for fitness gives us the ability to manage

Harness the Limitless Potential of Your Mind with Meditation

Briana Bragg/6 February 2023/ All MFN blog/

The mind is a powerful tool or weapon that can be used to work for us or against us. Everything begins with a thought. From the moment we wake up until laying our head on the pillow each night, our mind is consumed with thoughts; more than 60,000 a day by the time we reach age 40.

95% of those thoughts occur in the subconscious mind, making us unaware we have them or even what they are most of the time. Thoughts run on autopilot throughout the day unless we do the internal work to become aware of them and shift our thinking.

Awareness is the first step to reprogramming the mind with different thought patterns. Once we begin practicing a mindful lifestyle and becoming aware of the thought patterns that are regularly showing up in our lives, we can then learn and use tools to reprogram the mind to think differently. Think of it like this: the brain is the hardware, and our mind is the software, the software we use daily determines how we think, feel and react or respond to various situations.

The good news is, it is possible to “rewire the brain” a term referred to as neuroplasticity. The latest technology in science reveals that by creating new neural pathways in the brain, we are capable of rewiring neural pathways, creating new neurons that fire together which allows us to think and process differently, thus leading to less reactionary responses and more responding to our external environment.

The question is how do we do this if our mind is on autopilot and we are mostly unaware of our thoughts?

One answer is through the long-practiced method of meditation, a process of refocusing the mind. Meditation is a mental exercise that with practice trains the brain to think and process differently. It is through refocusing the mind to think about one thing and ultimately “no thing” that allows for us to tap into our subconscious mind and create new programming.

Often people say they cannot meditate or can’t calm their monkey mind. That is true for those who do not practice training it to be different. Being mentally fit is a practice that requires exercise, just as muscles do when training in the gym or recovering from a physical ailment. The mind must also be exercised and taught to think and react differently.

There are many different modalities to the practice of meditation, just as there are many workouts in the gym to become physically fit. It’s about exploring the types of modalities and finding one that works for you or your client. Mental resilience is built each time new neural connections are made, each time we go through a challenging time and overcome it, we become more mentally fit thus giving us resilience for the next time we face something hard.

Understanding how the brain works and how it pre-dispositioned to think negatively over positively, allows us to have compassion and patience with ourselves while learning to create a consistent routine of practicing meditation. Discovering the mind/body connection and how they work together also empowers us to be able to choose differently in situations where we become aware we are reacting from autopilot rather than choosing to respond.

Meditation is currently a $1 billion industry and is rapidly growing. Learning how to use meditation in your own life, while also learning how to instruct others through science-based, proven modalities expands your revenue offerings as well as helps clients heal faster and live happier lives.

Learn More: Online Education from Briana Bragg

Check out Briana’s short courses with MedFit Classroom for more. Click course for details:

Briana Bragg is the founder of Vacation of the Mind®, a mental wellness company dedicated to helping one million people or more reduce stress, refocus the mind, and lead healthier and happier lifestyles through practical techniques of nature-centered mindfulness and meditation. Briana is the author of “Journey into Tranquility®”, a meditation teacher training course that utilizes science-based methodologies of nature, meditation, and creative visualization in a three-step process Breathe, Refocus, Journey, curating guided journeys that connect people to nature and stillness. Briana’s dynamic energy and passion are fueled by her devotion to the well-being of others.

Blues-Busting Foods: Rx For Emotional Eating

Deborah Kesten, MPH/3 February 2023/ All MFN blog/

For many, negative feelings, such as anxiety and depression, lead to out-of-control eating…and ensuing weight gain. Knowing which foods can bust the blues, without weight gain, could reduce the odds of emotional eating episodes. Meet the foods that may help.

Mac and cheese. Chocolate chip cookies. A pint of Ben and Jerry’s. Some call it “comfort food”; others say it’s “food as friend.” However you phrase it, turning to food to soothe unpleasant feelings—from depression and anxiety to anger, loneliness, even fatigue—is the key cause of Emotional Eating. As a matter of fact, our research revealed that eating to cope with negative feelings is the #1 reason we overeat; and the key cause of weight gain.

Theories abound about the causes of out-of-control eating. Is it linked to brain chemistry? Or is it a behavioral addiction? Or both? What is clear is that when some people experience unwelcomed feelings such as fear, anger, anxiety, or depression— because of physical (such as back pain), emotional (negative feelings), mental (stress-filled thoughts), or spiritual (emptiness) distress, they may turn to food to feel better. Why? Because food does, indeed, have the power to bust the blues! Here’s why.

Anatomy of Emotional Eating

Have you ever felt frustrated, and turned to carbohydrate-dense fries, cake, cookies, or potato chips—seemingly unable to stop until the whole bag (or bags) is gone? If so, it’s possible you’re self-medicating unpleasant feelings with food. How so? Certain hormones—naturally occurring “chemical messengers” released when you consume certain nutrients (such as carbohydrates, protein, fat, and so on) in food—have the power to “replace” negative emotions with feel-good feelings. This is because high-carb foods, such as chips, stimulate the production of serotonin, an emotion-friendly hormone that calms and soothes the psyche.

It seems so easy: load up on carbs, feel better. But you pay a price for this feel-good fix. This is because processed, sugar- and fat-laden junk food—from donuts, cookies, and cake, to chips, fries, candy bars, and soda—ultimately, are “downer” foods. This means these often tasty, high-carb foods may provide some short-term comfort by releasing soothing serotonin, but you won’t get long-term relief. Rather, sugar-laden comfort foods could worsen negative feelings, because after they drive up insulin (a hormone that controls blood sugar and energy absorption), your blood-sugar levels inevitably plummet, leaving you even more depressed and fatigued then prior to eating them.

Damage Control: Calming Carbs Without the Crash

If you’re an emotional eater—if you cope with unpleasant emotions by overeating and bingeing on high-carb, super-sweet foods—there are many proactive steps you can take to turn the tide. For starters, consider consuming some blues-busting foods that bring the benefits of serotonin—without the downside of the emotional “crash” and the weight gain that bingeing on processed, high-calorie, “downer” food (products) can cause.

Here are some quick-fix, mood-friendly foods and snacks that not only may bust the blues, they may crush cravings and curb your urge to splurge.

FLASH TIP: BE SURE TO WAIT AT LEAST 20 MINUTES AFTER YOU EAT TO GET THE CALMING AFFECTS OF SEROTONIN. THIS IS HOW LONG IT TAKES FOR YOUR BRAIN TO REGISTER THAT SEROTONIN IS WORKING ITS WONDERS.

Smoothie. Combine 2 cups chopped dark leafy greens, 1 cup blueberries, 3 walnut halves, 1 cup milk of choice (cow, soy, almond, rice), ½ cup juice of choice, 3 walnut halves, 1 teaspoon flax oil. Blend.

Avocado spread. Toast a piece of multi-grain bread or choose whole-grain rice crackers. Mash ½ avocado, add salt and pepper to taste. Spread the avocado on the bread. Or a tablespoon of nut butter (peanut, tahini, etc.) on it.

Popcorn. Pop some air-popped popcorn. Spritz lightly with olive oil. Sprinkle with a dash of salt and pepper. Toss.

Cereal. Enjoy a bowl of cracked oatmeal with a handful of blueberries and milk of choice.

Nuts/Seeds. Try a ¼ cup of raw, unroasted nuts or seeds of choice. A sampling: walnuts, cashews, almonds, pumpkin or sunflower seeds.

Veggies. Munch some carrots, celery, cherry tomatoes; crunch kale or Romaine lettuce leaves. Optional: Use the nut butter blend, above, as a dip or spread for your veggies.

Fish. Enjoy a tuna or salmon salad. Mix together water-packed tuna fish, 2 tablespoons mayonnaise, diced celery and red onion, juice from ½ lemon, salt and pepper.

Fruit. Have an apple, papaya, orange, frozen grapes, banana, kiwi, cherries, pineapple pieces, tangerine, or any other fruit you like.

Chocolate. Savor a piece or two of dark chocolate with 70% or higher cocoa content. Or make hot chocolate with 100% cocoa powder and milk of choice.

The take-away: Enhancing emotions by consuming fresh, whole, blues-busting foods—instead of processed foods that are high in sugar, fat, and calories—is a sound step toward overcoming Emotional Eating, the #1 overeating style our research on Whole Person Integrative Eating has revealed.

In other words, if you turn to food that enhances feel-good feelings, but that also nourishes your mind and body—without the “downer” crash—you’re more likely to lower your odds of Emotional Eating episodes. How so? You’ll keep your mind-body in balance.

Visit Deborah’s website, makeweightlosslast.com, for free evidence-based, credible information and education about optimal eating for weight loss and well-being. You can also visit her blog, integrativeeating.com.

Originally printed on integrativeeating.com. Reprinted with permission from Deborah Kesten.

Deborah Kesten, M.P.H., is an award-winning author, specializing in preventing and reversing obesity and heart disease. Her expertise includes the influence of epigenetics and diet on health, Lifestyle Medicine, and research on the Whole Person Integrative Eating dietary lifestyle to treat overeating, overweight, and obesity. She and her husband, behavioral scientist Larry Scherwitz, Ph.D., collaborate on research and writing projects.

Fit PACE: Substance Abuse & Exercise

Megan Johnson McCullough/1 February 2023/ All MFN blog/

Research has shown the positive influence of exercise on alcohol use disorder (AUD) recovery as well as other drug-related substances. However, qualitative research has been missing regarding the influence of exercise on substance abuse disorders. In 2021, I performed a qualitative study involving interview and exercise journal data, which further validated the benefits of exercise during addiction recovery (specifically AUD). Most importantly, the results of the study showed how exercise can persuade the decisional balance a person has when working through the process of recovery. The benefits of exercise (pros) are better than the benefits of drinking (which are now cons). Another important theme participants expressed was that exercise does help recovery, but it should be a tool, not a replacement to other forms of treatment. Therefore, exercise shouldn’t replace strategies such as group meetings (e.g., AA or NA), cognitive behavioral therapy, or medications. Rather, exercise can compliment a comprehensive treatment program as a tool to maintain abstinence from alcohol and other substances, with the ultimate goal of avoiding relapse and reaching termination of the addiction. The intention of my study was to help medical and fitness professions better understand how persons connect exercise performance to their recovery process. This information also leads to better strategic planning programs for recovery, including exercise.

As a result of my research, I have developed the PACE Method to assist persons in recovery who are using exercise as a tool in order to combat not only relapse but also the threat of replacing one addictive behavior with another. One might replace exercise with the aforementioned forms of treatment, and in doing so, replace the psychology/physiology of their addictive habits with exercise performance. Even if exercise is considered “healthy”, in excess, there are consequences to the body. Currently the DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders from the American Psychological Association) does not have diagnosis for exercise addiction. What is considered the appropriate/recommended, “normal” amount of exercise? Leaving that up to be self-determined, particularly to persons in recovery who are at risk for addictive forming thoughts and behaviors, can be problematic. Just like any program planning, a medical and/or fitness professional may refer/recommend, there needs to be an appropriate guide to properly integrating exercise into recovery without reaching excess.

PACE stands for Proactive Awareness Controlling Excess. Fit PACE is a guideline/tool to incorporate exercise into recovery safely by being proactive and ahead of excessiveness, being aware of your own addictive behaviors, controlling thoughts/actions, and deterring/avoiding reaching exercise in excess. I have just released the Fit PACE mobile app which details a program for persons in substance abuse recovery to follow for exercise performance. Users not only log days performing exercise for accountability (and to avoid excess), but they also log number of days sober. Graphical images display progress and track this information. Users can connect to other persons on the app, which emulates the group meeting, community support aspect recovery. Users can select their exercise goal and tailor workouts to their level of fitness. It is my hope that both fitness and medical professionals can refer/recommend the Fit PACE app to download and use as a tool during substance abuse recovery. This is in alignment ACSM’s Exercise is Medicine philosophies.

To download the Fit PACE app, look in the applicable store for your cellular device:

Online Course: Fit PACE – Alcohol, Addiction and Exercise

Want to learn more? Sign up for Dr. McCullough’s short online from MedFit Classroom, Fit PACE – Alcohol, Addiction and Exercise

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.

Redefining Healthcare: A Battle Cry for Medical Fitness Professionals

JR Burgess/25 January 2023/ All MFN blog/

For years, fitness and medical professionals have advocated the need for bridging the gap that exists between preventative care and chronic pain and disease. Medicine today does the heavy lifting of disease management, acute trauma, and injury. We are an advanced nation in regard to communicable disease, traumatic and emergency medicine. However, the system is imploding with high costs of care coupled with an epidemic of unresolved chronic disease and pain within traditional insurance-covered care. Inside the healthcare system, the financial and political power lands at the top of the chain – pharmaceutical producers, government, insurance companies, the food industry, hospitals, and surgeons – yet we are failing at producing successful and sustainable care.

A new measure for quality of care

At a recent nationally recognized orthopedic conference I was part of a roundtable of practice executives reviewing key elements on running a profitable practice. Each group was discussing how many patients their top producing physicians were able to see per day. One group was cheering that their top physician is able to see 80 patients a day. Another said 70, and another 60 as if that was a badge of honor. I spoke up and said, “Let’s assume that doctor only uses the bathroom once, walks to the next room between each patient, washes their hands after each patient, and somehow spends no time in his medical charts. At best he or she has three to four minutes to spend with each patient. I would not want that care for you, a family member, or anyone I would refer. We should be ashamed of seeing this as quality care.”

As a result, over the last decade, we have seen a rising trend of medical providers experiencing burnout, dissatisfaction, and moral conflict. Many have decided to go against the grain of the standard care in medicine and open functional, lifestyle, regenerative, and direct primary care clinical models that have been formed in an effort to provide restorative, root cause, and preventative medicine that can reverse the rise of chronic disease. It’s a model where medical providers have the proper time to listen, evaluate, diagnose, empathize, connect, provide options, coach, and empower patients towards optimal health.

The third leading cause of death right now in the United States is medical negligence, according to the Journal of the American Medical Association. This is an alarming fact because many medical errors are entirely preventable. Functional medicine physician and pioneer, Joseph Mercola recently stated at the healthcare event, Mindshare, “Those in control are building the largest tribe and protecting advertisers. It’s a threat, PR firms are doing all they can to discredit those that want to heal the world.” We have the science and evidence to not let a diagnosis be the reason for a life of decline. However, we are all fighting Goliath on steroids. Those in the position of profits-over-people are doing their best to keep education, research, innovation, and successful outcomes from progressing to be an option for all. Alternative healthcare providers attempting to educate the public are seeing censorship through Google and social media on topics such as vaccinations, lifestyle medicine, plant medicine, and functional medicine. In response, many health leaders are looking to create an alternative search engine specifically designed for uncensored health-related information.

Think differently and independently

To begin to redefine healthcare, it requires us to think differently and independently about how to slow the rise of chronic disease. Here are four frameworks from which to begin to explore new solutions in healthcare:

See to believe
Keep an open mind and realize that most exercise and nutrition plans have their place for the right person. Visit alternative offices and practitioners to see the outcomes they are having with patients. See if the service or treatment has a history of successful outcomes that can be consistently repeated.
Look at evidence
Practitioners often state that the research shows there is no evidence. Ask them about the last paper or research article they have read on the subject matter. For instance, there are several new research studies showing the effectiveness of regenerative treatments such as platelet-rich plasma (PRP) and stem cells that have new data to support effectiveness compared to other standard of care treatments.
Experience it
The only thing better than seeing it, is having had it work for you. If it worked for others, it may work for (you) others.
Know the research and the outcomes
Just because the FDA approves a drug, or that surgery is your only option, you have no guarantee it’s going to heal you or help you without affecting another part of your system or worse.

Requirements for redefining healthcare

If the entire medical system turned around today and added preventative and less invasive options like nutrition, fitness, health coaching and energy medicine, we would not be prepared to fill the immediate demand. Consumers seeking optimal health are now aware and seeking expert health professionals who can listen, empower, hold them accountable, and help deliver successful outcomes.

Private clinics offering cash procedures and preventative care need to charge more to be able to spend more time with patients. This would allow providers to dig deeper with root cause lab analysis and would offer a greater probability to help lead patients toward successful outcomes. Healthcare in general will perform significantly better when providers are paid based on successful outcomes as opposed to time and service fulfillment. True healthcare is in demand for personal trainers, health coaches, and those with exercise physiology and kinesiology backgrounds to help deliver provider-recommended, outcome-based treatment programs. Most medical providers do not have the training, education or time to provide the nutrition, exercise or individualized care for patients that health and fitness professionals are trained to provide. Therefore, this article is a battle cry to the next-level fitness professional.

Not one doctor, trainer, diet or even single field of study has the answer to deliver the best health to the world. This all-encompassing effort can include surgeons, researchers, regenerative medicine specialists, functional medicine providers, behavioral therapists, chiropractors, acupuncturists, nutritionists, personal trainers, massage therapists, physical therapists, energy healers, naturopaths and coaches; not one alone has had all the answers. It will take a combination of the right internal, physical, emotional, nutritional and spiritual support to take a person on the journey towards optimal health.

The only way for primary care and transformative clinical models to succeed are with patient behavior change. Clinics need certified personal trainers and health coaches who have expertise in the more specific needs to help patients follow through on the recommended treatment plans. The medical fitness professionals of the future can fill the gap by becoming fluent in any of the following niches:

General biometric lab analysis (serum, gut, nutrient, saliva, heavy metals, etc.)
Genetics and epigenetics
Bio-hacking technology and equipment such as near and far inferred light, PEMF, vibration therapy, cryotherapy, hyperbaric chambers, and many more
Energy work
Functional movement evaluation and corrective exercising programming
Artificial Intelligence
Bracing, foam rolling, taping
Safe and progressive exercise for all conditions
Health coaching centered around: purpose, hydration, nreathing, oxygen, nature, mindfulness, stress management, communication, preparation, sleep, nutrition, and movement.
Food sensitivities
Mental health
Disease management
Hormones
Detoxification
Group health education
In-home fitness products
Tele-health
Medical compliance
Corporate wellness

The demand is rising and will explode in the coming decade. Private practices are on the rise. Self-insured companies are seeking savings from healthcare costs. The equipped health and fitness professional will have no shortage of opportunity. If you have a solid knowledge base in any of these areas, there is significant opportunity to work for, partner, refer to, or carve out your own fitness and health business of the future.

To change the entire healthcare system over the next few years, we need everyone to collaborate to create universal consensus where all these areas are necessary to comprehensively treat patients. This will require leading experts in all areas of health to come together. Groups such as the MedFit Network are collaborating with medical leaders and are dedicated to raising the bar for personal trainers by defining how the medical fitness professional of the future can support the necessary shift. Those who are filled with passion and purpose for the medical fitness model of the future will see the monetary rewards of their exceptional work as the demand will outnumber the caregivers.

Webinar with JR Burgess

Join JR for the webinar presentation, Impact, Results and Income Opportunities to Enhance Your Coaching or Medical Fitness Center.

This article was featured in MedFit Professional Magazine.

JR Burgess found his purpose for helping people be free from pain at a young age. JR has played an integral role in replicating a proven integrated model of care in more than 80 clinics worldwide. He is driven to make the greatest contribution by changing the way healthcare can be delivered by integrating profitable, regenerative, functional and lifestyle medicine into clinics world-wide. He is a husband, father, two-time #1 bestselling author, and international speaker.

Don’t Let Arthritis Stop You: Move On

Dr. Irv Rubenstein/23 January 2023/ All MFN blog/

Arthritis comes in many forms and has many manifestations, affecting almost every joint in the body. We generally speak in terms of the two most-known if not popular forms of arthritis: rheumatoid (RA) and osteo-arthritis (OA.) The essential difference is in the root cause. RA is an auto-immune disease whereby the body, for unknown reasons, attacks itself, particularly in the joints. OA, on the other hand, is often considered the downstream effect of wear and tear, over-use, prior injury, or, as we’re seeing more of as society gets more sedentary, from lack of use. In OA, typically, some insult to the joint disrupts the natural repair processes and further deterioration occurs subsequently.

Due to their differing causes, there are obviously differing treatments; but the basics of medical management are essentially the same. I am not qualified to address the specifics of the treatments available but, in lay terms, treatment usually entails some version of anti-inflammation and pain-reduction drugs, precautionary movement or positional guidance (don’t do’s, for example), physical therapy to manage pain and inflammation, and therapeutic exercises to support the structures affected as the disease itself causes not just inflammation and pain but damage to the structures that support the joints. Typically we identify arthritis as something that damages cartilage and, in truth, that is often what the standard ‘films’ – X-ray, possibly MRI (magnetic resonance imaging) – show. We now know that the synovial sacs around the joint are also affected and that these and other chemical disturbances affect the muscles and tendons that move and support the joint. In almost all cases of arthritis, pain, inflammation, reduced strength and range of motion (ROM) ensue, diminishing quality of life in many ways and, because some of the drugs used to treat it, potentially reducing quantity of life. (Gastrointestinal bleeding from non-steroidal anti-inflammatories (NSAIDs) or bone loss (osteoporosis) from corticosteroids can lead to fatal outcomes (such as spontaneous fractures leading to falls from osteoporosis) if not treated with other medications.)

When someone is potentially afflicted or actually diagnosed with a form of arthritis, the medical community goes into hyper-drive, encouraging changing one’s habits, be they the types of activities one engages in recreational, competitively, or professionally; or the types of non-activities one currently does, in particular, being inactive.

In some cases, dietary advice is offered as we are learning more about foods that are pro-inflammatory and others that have anti-inflammatory benefits. In the former category, we are learning that excessive sugar or simple carbohydrates, including processed wheat products, may exacerbate inflammation while others, such as salmon, dark, green veggies, and certain oils (e.g., olive oil) are capable of reducing the inflammatory elements circulating throughout our bodies and our joints. Furthermore, in more extreme cases, when arthritis becomes very painful and debilitating, over-the-counter and/or prescription-fitted braces may be offered to defer some of the more end-line procedures such as surgery to fuse the joint or replace it with a prosthetic device.

The most common non-pharmaceutical and non-surgical treatment for arthritis of any sort: exercise.

Note that there are several legitimate ways to integrate exercise through resistance training programs that have proven quite effective in arthritis management. Yoga, Pilates (floor or machine based), Tai Chi, Qigong and water-based, or aqua, exercise are all beneficial to many aspects of the overall arthritis program of strength, ROM, proprioception and ultimately function. Since many of these are quite technical and are often done in class formats, one should ask the instructor(s) as to their experience working with arthritis clients.

As with any form of exercise, by whatever professional instruction, you should be totally aware of your pain levels as going “through” the pain is not recommended; thus, you must assert control over the exercise sessions. There will be some exercises, however, that are not destructive and may be somewhat painful but must be done in order to maintain reasonable levels of function and independence. So long as the pain subsides within a couple of hours – preferably as soon as you stop – and there is no exacerbation of inflammation the next day, you can assume that the exercise was just enough. If symptoms flare up over the next 24 hours, however, assume you did more than you should have and alert your trainer or instructor so that he/she can avoid doing the aggravating exercise(s) as much or as hard next time. For these reasons, along with all the other recommendations so far as exercise interventions are concerned, it is best to seek the counsel and assistance of a fitness professional with a background in medical fitness. This could be someone with a more advanced academic degree, someone with a license to practice rehabilitation exercise (physical therapist, athletic trainer, etc.), or someone who’s taken several educational programs to have a greater understanding of the variety of disorders and diseases that may benefit from exercise interventions.

Dr. Irv Rubenstein graduated Vanderbilt-Peabody in 1988 with a PhD in exercise science, having already co-founded STEPS Fitness, Inc. two years earlier — Tennessee’s first personal fitness training center. One of his goals was to foster the evolution of the then-fledgling field of personal training into a viable and mature profession, and has done so over the past 3 decades, teaching trainers across through country. As a writer and speaker, Dr. Irv has earned a national reputation as one who can answer the hard questions about exercise and fitness – not just the “how” but the “why”.

Hashimoto’s Disease: When the immune system turns against you

Megan Johnson McCullough/21 January 2023/ All MFN blog/

Hashimoto’s Disease, also called Hashimoto’s Thyroiditis, occurs when the immune system turns against the body’s own tissues. The immune system directly attacks the thyroid. This then leads to hypothyroidism, which is when the thyroid isn’t making the necessary hormones for proper body functioning. The thyroid plays a leading role in our body, as it is the controller of our metabolism. Without the right hormones, how quickly our body uses calories from what we eat, can be greatly impacted. It is the most common thyroid disorder, affecting 14 million people in the United States.

Symptoms of Hashimoto’s include having an enlarged thyroid. The front of the neck (where the thyroid is located) looks swollen. Symptoms associated with an underactive thyroid, due to the lack of hormone production, include fatigue, weight gain, cold body temperature, hair thinning and loss, depression, irregular menstrual cycles for women, and joint and muscle pain.

The exact cause is not known. There is a strong genetic component. Hormones play a major role, especially since Hashimoto’s is seven times more common in woman than men. Its primary target is middle-aged women. Many women experience thyroid problems after childbirth and about 20% of these women develop Hashimoto’s later on. Certain medications with high levels of iodine can cause this problem. Radiation exposure also can lead to thyroid troubles. In fact, the atomic bombs of Japan lead to this disease in many people. Then, this can be passed on genetically.

Unfortunately, there is no cure for Hashimoto’s. The medical community is not sure what causes autoimmune disorders. Getting medical help is important in order to prevent the progression of the disease. If left untreated women can experience problems with fertility and the risk of high cholesterol increases.

There are some self-care, natural approaches to try to improve or prevent this condition, including your diet. Making sure your diet consists of enough selenium, zinc, vitamin D and iron. Foods to include would be red meat, poultry, beans and dark vegetables. If you do not eat meat, do understand that plant sources are not as absorbable, but taking vitamin C can help with this. Foods you should minimize and eliminate include those that cause inflammation. These include gluten, sugar, artificial sweeteners, soy and dairy. Gut health is critical so making digestion as clean and easy as possible is important. Avoiding toxins can help too, such as plastics, beauty products, air fresheners or candles. Keep your air clean.

Exercise can also be beneficial for Hashimoto’s because it helps lower inflammation and stabilizes the functioning of the immune system. This is because exercise stimulates regulatory T cells which are big inflammation fighters. Also in the process, exercise can balance the pro-inflammatory Th1 system and the anti-inflammatory Th2 system to be less inflammatory. Exercise also helps to release immune cells called IL-6, which lessen inflammation. Just going for walks is a great start but depending on how the person feels, even high-intensity-interval-training (HIIT) can boost workouts and help manage Hashimoto’s. Exercise tolerance is a case-by-case situation and overdoing exercise will only worsen inflammation.

For those I have trained with this condition, we sometimes have to do a trial-and-error approach to ensure the person is doing what their body permits without causing a flare up. It has been my job to scale back intense workouts but still give the client the encouragement and motivation that inspires them to keep exercise as a lifestyle change to support living with Hashimoto’s as best as possible. Many times clients avoid movement thinking their condition prevents them for doing certain types of exercise so why try at all. Movement is medicine so if it’s just walking, it is doing the body good versus being sedentary and lethargic.

Thyroid disease is becoming a major problem. Nearly 20 million Americans have some form of the disease. Diagnosis isn’t always clear at first, but we know when we don’t feel right. Don’t give the thyroid any more power than it already has. Hormones might be tyrant rulers, but we can control our actions and attitude towards feeling our best. Autoimmune diseases are unpredictable. The thyroid greatly influences our metabolism, so our weight is readily affected by its functioning. Although our genetic makeup can leave us powerless, we do have the ability to control our response, adherence to medical help and ability to keep a positive outlook despite medical situations.

References

trainer-outdoor-workout-all-ages-kettlebell

Industry Trends 2023 Report

Debbie Bellenger/16 January 2023/ All MFN blog/

There has never been a better time for our Industry to position ourselves to be the Health, Fitness and Wellness Experts to fill the gaps that are looming in front of us. Gaps such as serving the 80 % of our population whose health journey may not begin with exercise but with Stress Management, or Nutrition or Sleep Hygiene. Gaps such as Burnout now reported as 1 in 2 Americans suffering and becoming more and more comprised in their productivity at work, with their health and suicide on the rise. Gaps such as the healthcare systems struggling post pandemic with staffing shortages, quality of care issues, burnout, and closures – it all begs the question, “Where does the average consumer start their health and wellness journey?”

It starts with our Industry!

We are the experts, innovators, creators, coaches, trainers, and business sector to reach out and lead the charge of delivering health, fitness and wellness to the people; no matter where they are located – Employers, Churches, Apartment Complexes, Schools, Resorts/Spas, Golf and Country Clubs, Assisted Living and Older Adult Communities, to name a few.

From my lens of corporate wellness, medical wellness, healthcare and fitness industry challenges; I forecast the following trends for 2023:

Increased interest in activities that promote recovery and the feeling of well-being such as massage, cryotherapy, IV therapy, restorative yoga, breathing and meditation classes, smaller byte size classes for new consumers to try activities at their starting level on their path to health and wellness.
Increased interest in outdoor activities for fitness embracing the great outdoors for fitness experience, this will continue to foster the growth of running, hiking, walking and cycling communities.
Increased interest in fitness activities that bring people together in search of socialization, community and camaraderie. This will foster the growth of leagues, tournaments, health and wellness programs and in person activities.
Increased interest in the fitness industry from other potential business partners due to the increased interest in Health overall in America. Example, in Corporate America employee voice = employee choice. With employees valuing health more than their pay check, employers will need to align benefit plans and offerings with fitness, health and wellness experts to provide what it is that their employees need. Employers need our expertise.
Increased need for niche services to include programming for chronic conditions which are out of control (diabetes, obesity, hypertension), stress management and anxiety, specialty populations who are currently underserved such as Parkinson’s Disease, Alzheimers Disease and so many more. What about Niche Clubs for different sectors of the population ie Over 50 years of age who have not returned to the Fitness Clubs at levels pre-Pandemic? With a growing % of the population forecasted to be over 50, why not?
Increasing Hollywoodization of our Industry with Fitness Influencers leading the way in content on social media platforms. This can be perceived as a threat to our industry as so much of this content is free, so it is undermining our value.
Consumption of health and fitness will remain multi-faceted with at home, on demand, in person as long -term choices.
Increasing need for fitness to align with healthcare systems and allied health professionals to establish referral systems, credibility in the local community and to support healthcare systems in their need for step down programming and experts. Physicians do not refer to gyms, they refer to programs and a trusted partner. We need to work together to create a continuum of care model with all of the key stakeholders investing in improving health outcomes. Our motivations to engage may be different at the outset but the anticipated outcomes can be the only answer to bend the cost curve of sickness in America.

WHY will these trends occur?

The Pandemic has had a devastating impact on the health of the workforce and its employees which is where we find the vast majority of adults.

Employers are experiencing:

a) More than one in four Americans delayed routine health care appointments.
b) Fear and fatigue have had cumulative effects on chronic health conditions.
c) High blood pressure and diabetes can develop undetected and so for employees who have missed annual well visits, the future impact on their health can be devastating.
d) Benefits Pro reported the cost of care of per employee for health care coverage is projected to be about $13,800 for 2023 with a projected 6.5% increase year over year.

Employees are experiencing:

a) Decrease in mental health (42%)
b) Decrease in social well-being (41%)
c) Decrease in financial security (32%) and
d) Decrease in physical health (29%)

So, why will these trends occur?

One in five Americans is suffering burnout, as reported by APA and we now have an ICD-10 code for medical billing of this condition. It is difficult to find the energy to exercise, take the step to join a gym when exhausted day over day.
Outdoor exercise has proven for many to be a lower barrier choice and lower cost choice to getting activity with some vitamin D. It can also be more time efficient when lacing up sneakers to go out the door for a walk or run, and it can encompass family time which no childcare costs needed.
With 1 in 6 now working from home (prior to the Pandemic it was 1 in 67), feelings of isolation, depression, loneliness and despair on the rise. There is a direct correlation between having quality relationships in one’s life and health outcomes. We are human beings not human doings are we are meant to be with others.
We are now only really starting to feel the impact of the Pandemic fall out. The financial impact of the pandemic payouts to individuals and businesses have created a fall out of our economy with many not wishing to work again and loan re-payments that are arduous. The health impact of the Pandemic has stimulated rising costs of healthcare due to increased sickness/chronic conditions and shortages in healthcare providers. Current burnout stats demonstrate the lack of health in Corporate America which is reducing productivity which may be directly related to fiscal performance of a company.
With the rising sickness in America, the demand for specialized services will only increase. CDC forecasts that by 2030, over 50% of Americans will have a BMI of over 30. With increasing BMI’s comes increasing chronic diseases and co-morbidities, increased cost of care both in medical and pharmacy and increasingly complex programming needs for obese individuals. We must learn as an industry to meet this population where they are and provide specialized programs and services, and talent educated in these disease states.
Social media influencers will fill the gap in education in health, fitness and wellness knowledge until we do. We must position ourselves in our communities to be the credible health and wellness experts.
Consumer choice = consumer voice, so with so many Americans working from home, having choice each day on how/where to their workout in and/or health knowledge is not going away. We must embrace options and hear ongoing consumer needs as they change.
Physicians and allied health professionals need partners to refer their patients to. It only makes sense that we build bridges with the healthcare system for a long term model of shared successes since we all need numbers to perform year over year.

How the Industry Should Respond?

Change the lens and language from Fitness to Wellness so that it advocates for more than exercise in our competencies and expertise. It allows us to explore how we position ourselves to be a holistic provider in our communities and to be more inclusive.
Hold ourselves to a higher standard of wanting more for the industry in advocacy, credentialling and certification standards and producing quality data outcomes that may be published and shared interdisciplinarily. Data is king to bridge gaps.
Bring healthcare providers and allied health professionals into our centers to leverage partnerships and services for a win-win long term. Host MD’s as guests for a Speakers Bureau, a health fair with flu shots and wellness programs – it is a win win strategy. They know you are in the community and they get to share their expert knowledge and capture potential new market share.
Focus on the outreach in the community to create opportunities for additional partnerships and referrals to your centers ie, join Rotaries, Chambers, Society of Human Resource Managers etc…
Create an Employer Wellness Advisory Committee in your Center to invite and host employers in your center once a month to simply provide solutions to their pain points which are rising healthcare spend, low productivity, low morale and increasing turnover. Health, wellness, fitness and onsite activities in your center that promote fun, engagement, team dynamics all wrapped in health; can be a great start to increased revenues in corporate wellness activities.
Partner with Brokers who need points of differentiation to sell their product and who have the pre-established relationships with employers.
Embrace partnerships with individuals and organizations to offer a comprehensive menu of services so you that you do not have to carry all the fiscal burden. (i.e., partner with local dietitians, social workers, behavioral therapists, etc.)

Originally printed in Club Industry 2023 Trends Report. Reprinted with permission from Debbie Bellenger.

Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer. Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies. Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.