The human body undergoes a lot of changes during its lifetime. From infancy to old age, there are biochemical processes in the body that define these changes.
Some of them are visible externally, such as the greying of hair, skin becoming less supple, etc.
But beneath all of this, some processes happen to make all of this possible.
Just a generation ago, women’s weight-lifting was largely isolated to professional athletes and competitive body-builders. Men have been lifting weights for years, but it has not come into the mainstream for women until the past 10-15 years.
Some of the barriers to the barbell for women may include fear of injury, lack of accessibility to an environment where they can learn and lift weights safely, and even more compelling are concerns about body image: “I don’t want to get too bulky”. Today, we know so much more about the overall health and athletic performance benefits of weight training. As more women have flooded competitive and professional sports and with the emergence of CrossFit and other resistance based group fitness classes, weight training has become commonplace in women’s organized sports and recreational fitness programs. But still today, the barriers to the barbell still exist with many misconceptions about risk of injury and body image concerns.
Being a well-rounded athlete includes not only endurance, flexibility and agility, but also muscular strength. Our muscles move our skeleton, protect our joints, are a major source of energy expenditure and play an important role in blood sugar management. Like our heart and lungs, our skeletal muscles need exercise to stay healthy so they can continue to carry out these functions for our entire lives. Over time, especially into the menopausal years, women begin to lose muscle mass and bone density. Decline in estrogen levels increases the rate of bone loss and joint laxity leaving us more vulnerable to injury and fractures. With the loss of muscle mass, our metabolism slows and activities may become limited. But it doesn’t have to be this way. One important weapon to combat these natural changes is the all-mighty barbell!
As young women, weight training helps performance across a spectrum of recreational and professional sports and builds a solid foundation of lean body mass, strength and functionality for the future. Starting from puberty, bone density increases until it peaks in our early 30’s. Weight-bearing exercise, along with sound nutrition, optimizes bone density development to prevent osteoporosis and fractures later in life. Into our 40’s, 50’s and beyond, weight training and attention to nutrition and recovery can not only slow the loss of bone density and muscle mass that comes with menopause, but may even result in continued improvement– especially if weight training was not started until later in life. Increasing and maintaining muscle mass in this age group also affords stability to joints such as shoulders, knees and hips thus preventing injury. But what if I’m already in my 60’s and beyond and I have never lifted weights before? Is it too late to start? Absolutely not! At age 89, my mother started doing deadlifts and chair squats with gallon milk jugs. Weight training for beginners can start with weighted household items, progress to dumbbells and to group classes such as Boot Camps, Crossfit and other similar type classes. In all age groups, like with any new sport or activity, beginners should focus on strict technique and mechanics with an experienced coach or instructor before increasing load and intensity.
When I started weight training in the mid-1980’s, skinny was in. I was always self-conscious about doing too much leg work because my legs became very muscular. So I stopped training my legs – for literally decades. And now I am paying the price. But through Crossfit I have regained a lot of what I could have developed in my younger years. Today, I very much regret surrendering to the societal ideal at the time. Because “society” doesn’t have to contend with my personal struggle to start rebuilding leg strength after age 45. Fortunately, today is different, “Strong is the new sexy”. But the body-shamers and the haters still exist and feel compelled to impose their beliefs and ideals on others. But the truth is that your strongest, healthiest, most confident self is your most beautiful self – not some societal ideal. So whether you are 18 or 80, grab those weights and give your body the gift of strength that will keep you healthy, active and living life to the fullest for years to come.
Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School. She is a North American Menopause Society (NAMS) Certified Menopause Practitioner and has been featured in multiple podcasts and speakerships at various events discussing the physiology of the hormonal changes of menopause, hormone therapy and functional fitness training.
In America today, 40% of females, including women, children and teens, suffer in silence with either primary or secondary dysmenorrhea every month. Primary dysmenorrhea accompanies the monthly menstrual cycle without any underlying medical conditions. Secondary dysmenorrhea means that there is another medical issue present, such as endometriosis. This condition makes it hard to function, with most women being bedridden for three to five days or longer. Dysmenorrhea is not a weakness, but a real medical issue.
Generally, the female client will have severe throbbing pain from the waist down. They can feel it in their stomach, low back, legs and feet, making it hard to move. Other symptoms include nausea, vomiting, diarrhea, anxiety, stress, depression, lightheadedness, fatigue, headache, fever, and depression, weakness and fainting. Risk factors are smoking, obesity, being underweight, strong family history, high levels of stress, anxiety and/or depression. Women can still have painful stomach cramping well after menopause if they have Endometriosis.
This is a silent stressor for many women because they rarely choose to speak about it. Some have been living with the pain for twenty years or more and think there is nothing they can do. If a client comes to you and mentions that they have a lot of pain, urge them to see their doctor. This conversation is more likely to happen with a female personal trainer. The good news is that fitness professionals can help their clients to feel better during this painful time of the month.
It is important to acknowledge this painful condition because of the physical and mental implications that come along with it. As the trainer you, may be working with a therapist as well as an OB/GYN. You are trying to help your client feel better overall. We recommend scheduling an assessment first to understand the client’s medical history. As a fitness professional, you may want to refer your clients to other professionals as well. Acupuncture, for example, is well known for helping women to ease and reduce anxiety. When you network with other professionals, you form a referral system to obtain more clients for yourself, too.
After completing your assessment, you will develop a wellness program for your client. The program will include: exercise, meditation (specific to this condition), and aromatherapy, as well as other components. Try to have your client establish a regular daily wellness routine. Journaling is also important as it helps to connect your thoughts, feelings and behaviors. Support groups can also help as women share their experiences with others.
Robyn Kade is the President/CEO of The Stress Management Institute for Health and Fitness Professionals™ and the SMI Business Institute™. Robyn received her Bachelor’s Degree from Rowan University in Health Promotion and Fitness Management. She is an American Council on Exercise (ACE) personal trainer and group fitness instructor, received a certificate in PTSD through the Kew Training Academy, and is a Compassion Fatigue Resiliency and Recovery – Educator. Robyn is also certified through the American College of Sports Medicine for Exercise Is Medicine (EIM) Level 1. Robyn is currently pursuing her Master’s Degree in Wellness and Lifestyle Management with a concentration on Wellness Coaching at Rowan University.
References
Research indicates that walking can help seniors live longer, healthier lives. Regardless of your current fitness level, walking has multiple health benefits that are backed by peer-reviewed research.
Let’s jump in!
To minimize injuries and subsequent negligence claims/lawsuits, exercise professionals need to be aware of their many legal duties and risk management responsibilities. When faced with a negligence lawsuit, courts will determine the standard of care (or duty) of an exercise professional. If the court finds that the exercise professional breached a duty and the breach of duty caused harm to the plaintiff (injured party), the exercise professional (and the professional’s employer) may be found negligent and, thus, liable for the plaintiff’s harm and will need to pay monetary damages. The damages can be in the millions of dollars. For example, the jury awarded the plaintiff $14,500,000 in Vaid v. Equinox (1).
Legal scholar, the late Betty van der Smissen, stated: “if one accepts responsibility for giving leadership to an activity or providing a service, one’s performance is measured against the standard of care of a qualified professional for that situation” (2, p. 40).
A “qualified” professional possesses proper credentials and is competent. A competent exercise professional knows how (has the knowledge and practical skills) to design and deliver a “safe” and “effective” exercise program.
As described by van der Smissen,“for that situation” is determined by reference to the following three factors:
The professional must be aware of the skills and abilities the participant needs to participate “safely” in the activity, e.g., the exercise professional must possess adequate knowledge and skills to lead “reasonably safe” exercise programs.
Example: Exercise professionals that lead exercise programs that are considered “advanced” that can increase the risk of injury (e.g., Olympic lifting, high intensity programs) need to have advanced knowledge and skills necessary to safely lead these types of programs, i.e., they need to be fully informed of precautions that must be taken.
The professional must be aware of individual factors of the participant, e.g., medical conditions that impose increased risks and know how to minimize those risks.
Example: Exercise professionals that design/deliver exercise programs for individuals with medical conditions (e.g., pregnancy, diabetes, back problems) need to possess credentials and competence in clinical exercise by completing clinical academic coursework/education as well as obtaining clinical certifications and experience (3). From a legal liability perspective, it is essential that exercise professionals fully understand any additional or unique risks the medical conditions(s) might impose and how to minimize those risks. In Bartlett v. Push to Walk (4), the court stated:
Programs like Push to Walk “May impose particular duties that an ordinary health club would not have…What would constitute…negligence would differ between an ordinary health club and a facility like Push to Walk” (p. 7).
The professional must be aware of any conditions that may increase risks, e.g., weather conditions such as heat/humidity, floor surfaces, exercise equipment, and know how to minimize those risks.
Example: Exercise professionals need to have the necessary knowledge and skills to properly implement important safety precautions to help prevent heat injuries. Knowing and implementing precautions to minimize risks associated with slippery floor surfaces and improper maintenance of equipment is also important.
A personal trainer had a client, Levy with known osteoporosis, perform a series of jump repetitions on a BOSU ball. After a few reps, she lost her balance and fell fracturing her wrist that required surgery to have a plate and screws inserted into her wrist. She filed a negligence lawsuit against the defendant facility.* The facility filed a motion for summary judgment (request to dismiss the case). Trial court granted the defendant’s motion, and the plaintiff appealed. Upon the appeal, the appellate court reversed the trial court’s ruling. The court stated that the trainer, knowing Levy had osteoporosis, unreasonably increased the risk of harm to her by having her perform an advanced exercise. The appellate court considered the nature of the activity (jumping repetitions on a BOSU ball) and the type of participant (client with osteoporosis) and determined that the exercise professional did not meet the standard of care for that situation.
*In a negligence lawsuit, in addition to the exercise professional, the fitness facility is also named as a defendant through a legal principle called respondeat superior, in which the employer can be vicariously liable for the negligent acts of its employees.
Meeting the standard of care when prescribing exercise for individuals with medical conditions begins by exercise professionals obtaining the necessary credentials and competence. It was obvious that the trainer in the Levy case did not have the necessary knowledge and skills to prescribe a safe and effective program for a client with osteoporosis. The trainer failed to take important precautions to minimize the risk of a fall.
Information provided in this article comes from: Law For Fitness Managers and Exercise — the only comprehensive resource for fitness managers and exercise professional who want to: PROTECT THEMESELVES, THEIR BUSINESS, AND THEIR CLIENTS! For education programs that accompany the text, go to: Educational Courses (fitnesslawacademy.com)
JoAnn M. Eickhoff-Shemek, Ph.D., FACSM, FAWHP, professor emeritus, Exercise Science at the University of South Florida and president of the Fitness Law Academy, LLC, is an internationally known author and speaker. For more than 35 years, her teaching and research have focused on fitness safety, legal liability, and risk management issues. Dr. Eickhoff-Shemek is the lead author of a comprehensive legal/risk management text, Law for Fitness Managers and Exercise Professionals, and is the co-author of another textbook, Rule the Rule of Workplace Wellness Programs, published in 2020 and 2021, respectively.
References
Strength training boosts a key longevity hormone more than aerobic exercise does – so we love ‘em both. No need to have a favorite.
“I lost 10 pounds and vowed to keep them off, but no such luck. I’m so discouraged.”
“I reached my goal weight, then BOOM, I regained it once I stopped dieting.
“This is my 3rd time losing 40 pounds…”
If any of those stories sound familiar, you are not alone. Research suggests dieters tend to regain lost weight within five years, if not sooner. This includes many fitness exercisers and athletes who struggle to stay at a goal weight.
If you are fearful of regaining your hard-lost weight, this article will help you understand why maintaining lost weight takes effort. Paul MacLean, PhD, Professor of Medicine & Pathology at the University of Colorado School of Medicine, has carefully studied weight regain. He notes three reasons why dieters regain weight: biology, behavior, and environment.
Biology: The body has a strong biological drive to regain lost weight, as noted with increased appetite and a slowed metabolic rate. As backlash from dieting, the body learns to store fuel very efficiently as fat.
Behavior: After three to nine months, dieters tend to be less strict with their low-calorie diets; they often report they have hit a weight plateau. Despite self-reported claims they are diligently dieting (yet only maintaining weight), these dieters can become discouraged and less adherent. (Note: Diligently dieting anecdotes are hard to verify.)
Environment: We live in an obesogenic environment with easy access to ultra-processed foods, a sedentary lifestyle, and chemicals that contribute to weight gain including those found in upholstered furniture, pesticides, cosmetics, and who knows where else. Weight is far more complex than self-induced over-eating and under-exercising!
When adding on exercise, some people lose weight and some gain weight. Exercise alone does not guarantee fat loss. Exercisers who lose weight tend to keep the weight off if they stick with their exercise program. High levels of exercise are linked with greater success. That’s good news for athletes who train regularly! That said, a fine line exists between compulsive exercisers (who exercise to burn off calories) and athletes (who train to improve their performance). Fear of weight gain can impact both groups.
Questions arise:
Finding answers to these questions is hard to do in humans because of biology, behaviors, and environment. So MacLean turned to studying formerly obese rodents who had lost weight by being put “on a diet” and then were allowed to eat as desired for 8 weeks. Some weight-reduced rodents stayed sedentary while others got exercised.
When followed over time, the longer the rodents were weight-reduced, the stronger their appetites and drive to eat got. When allowed to eat as desired, they quickly regained the weight. “At least people, as compared to rodents, can be taught to change their eating behaviors to help counter those biological pressures,” noted MacLean. For example, people who have lost weight can stop buying fried foods, store snacks out of sight, limit restaurant eating, etc.
More depressing news. Most of MacLean’s data is from reduced-obese male rodents. Exercised males showed less weight regain than did exercised females. The female rodents seemed to know they needed extra energy to exercise, so they ate more and regained weight. MacLean states we need more research to understand the clear differences in the biological drive to regain weight.
The best way to maintain weight is to not gain it in the first place. Yes, easier said than done (as stated upfront), but at least athletic people who maintain a consistent exercise program can curb weight regain. We can also change our behaviors to minimize weight regain by prioritizing sleep, curbing mindless eating, and choosing minimally processed foods.
Ideally, the sports culture will change so that athletes can focus less on weight and more on performance. It’s time to acknowledge that athletes, like dogs, come in many sizes and shapes. Some athletes are like St. Bernards, others are like Greyhounds. A starved St. Bernard does not become a Greyhound, but rather a miserable St. Bernard.
By fueling your genetic body type and focusing on how well you can perform, you can enjoy being stronger, more powerful—and likely can still meet your sports goals. When being leaner comes with a life-long sentence to Food & Exercise Jail, you might want to think again?
Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.
As fitness professionals, what we can expect is the unexpected. Often the last person we think may send an inquiry, does. If you’re like me and the majority of your training is in-home, you often get the privilege to work with so many you may not otherwise in a traditional gym or studio setting.
While I was used to receiving various inquiries from those with different chronic conditions or disease, disabilities and other limiting factors, the one I didn’t anticipate was a blind client. The first thing I did before responding was see what trainers in my area may be willing to work with this individual, no response, no one was interested. My first thought was my “scope of practice”. Surely this wasn’t in that category for me. While I took time to reflect on how I could possibly help this person, I did some asking around to a well-respected fitness professional not in my area. I asked him, “How do you train a blind person?” He responded by saying, “I have never had the chance to do that but I would say you train him just like anyone else.” That made complete sense to me in that moment. What I didn’t know I would research. Next, I would fully disclose that I did not have prior experience with training a blind person, but I would be happy to take him on. So, I did.
In researching training the blind community and speaking with a few people in various agencies, I couldn’t get much beyond the science and statistics. No methods, no accommodations, no modifications, no advice, not much to guide me. I did learn about Orientation and Mobility Specialists and while that was needed in the beginning for my client, it was not needed for him to have at the time for the training to take place.
You adjust everything you know about training. A huge eye opener for me was learning that I had a vision dependency on cueing. My verbal cueing was subpar. Too often I was used to saying, “Watch me first, then you try,” then correcting form as needed. In programming for my client, I needed to better learn to be descriptive so that what he could not see, he could imagine in the mind. It had to make sense.
What helped me to make progress, not just with my blind client but in general, was to really read the descriptions of exercise, movement and anatomy. Even if I had to read it continuously to better explain, that is what I did. When something didn’t make sense, we just eliminated it and found a better option.
Learning to count steps was another big deal. It was critical to know how to express inches, feet, yards when walking or moving around. For example, we are 2 yards from your driveway, in 2 feet there is a table, it is 35 steps to your mailbox.
Blindfold yourself. Close your eyes when exercising. Have another trainer, family member or friend, tell you some of the exercises that you find hard to describe and learn from those examples. Get a real feel for what your client may experience. Learn how they use their cane and the types of canes (sticks). One wealth of information came to me from a blind athlete. He took time to talk to me and just reinforce how important it is for my client to be independent.
Announce what you’re doing before you do it. It’s the same with asking to touch a client, “Is it okay if I touch your elbow?” Or, “I am going to pick up these dumbbells.”
Learning to not be so protective, smothering and motherly, as was my nature as a mother of five. I was scared every moment, what if my client falls, trips, bumps into the wall, anything. I felt I had to always be on guard and with the slightest change in movement or awkward movement, I would have my arm ready to catch if I needed. Too much! It was very helpful that a few times I had another trainer in training (my husband) come along with me and he brought it to my attention. I told him, I know I can do it, but what if something happens? He said, it just will and I can’t spend every minute in protection mode. It’s not good for me or the independence of my client.
Programming always changed. There were days we just walked because that was as much as my client could handle. Cancellations due to various reasons required me to step up and not be taken advantage of as well. Adapting to all of that and being patient in what my client needed took time.
Addictions (substance abuse). While I won’t get into much depth on this topic, there were many other challenges within this area that I was exposed to and needed to refer out and gain help for. Again, it was the unexpected.
Nutrition problems. Making sure my client was eating, what and when. There were many discussions we had regarding proper nutrition. Much of it would lead back to other barriers, such a cigarettes or substance abuse. It required other professional intervention, as I am not a Registered Dietitian, but we did review general eating habits and good vs bad. Occasionally, we got it just right.
While the primary goal was weight loss and increased strength for my client, we tackled everything. We incorporated cardiovascular activities and ones we did often were running together with a rope (tether), jumping jacks, and walking. But every part of the programming goals were to incorporate functional exercises which all required flexibility, balance, core, resistance, strength training, and what my client could focus on doing alone. We used dumbbells, resistance bands, sandbells, medicine balls, jump ropes, tires, picnic table, stairs, Airex pad and simply bodyweight. The most important use of all the exercise was in how it would further benefit my client and the goals we set. Nothing should be useless training.
While there is so much more to be said on how I trained my blind client, the most important message to relay is to not be afraid of what you can’t do, but do what you can. We should always ask questions, always expand our knowledge and do what we as fitness professionals are here for — to assist in living a healthier, active lifestyle. We can’t promise the moon, but it is our responsibility to do the very best we can within our scope, and what we are hired for. If you’re doing that, than you are probably doing it well.
Dawn Baker is an Independent Contractor Personal Trainer, founder of One Accord Fitness LLC and has been changing lives in the fitness industry for 6 years.
According to the CDC (2022), about 1 in 44 children has been identified with autism spectrum disorder (ASD). Autism Spectrum Disorder (ASD) is a neurological disorder marked by deficits in social communication as well as repetitive behaviors and restricted interests (Hodges et al., 2020. This information tells us, that it is likely in the near future or even now as a fitness professional, we may experience having a client with ASD. Being a neurological disorder, there can be faulty lines between mind and body communication that influence body movements and mechanics. Therefore, as a fitness professional, working with an ASD client would require individualized programming tailored to specific needs, but there are common sensory and motor skill deficiencies we as fitness professionals can certainly assist with.
The Diagnostic and Statistical Manuel of Mental Health Disorders (DSM-5) has now coined the term “spectrum” to include both lower and higher functioning forms of autism.
The ”spectrum” consists of the following:
Furthermore, the DSM-5 requires the following for diagnosis:
Individuals must meet all the social communication/interaction criteria:
Must also meet 2 of the 4 restricted and repetitive behaviors criteria that do cause functional impairment:
There are a number of risk factors for ASD including sex because ASD is 4 times more common in boys than girls. Other risk factors include family history, age of parents when born, and being born early (CDC, 2022). The fitness professional will of course meet the ASD after diagnosis but being aware of certain behaviors and traits is an important component to help better understand and relate to the client’s needs and abilities. The fitness professional can become part of the ASD client’s comprehensive treatment program. There is a need for our help, especially since obesity rates are higher among persons with ASD. Although some of this can be related to diet, lack of physical activity is a key contributor to this phenomenon. We know that P.E. at school alone is not enough time spent moving, and because persons with ASD might need special sensory and motor accommodations, this can be a deterrent for participation. Without the advocacy of parents, activity may not be prioritized.
Common among persons with ASD, there exist vestibular, proprioception, interoception, low muscle tone, postural instability, and compromised endurance and balance deficiencies (Autism Speaks, 2022). Adding to these, persons with ASD have been found to have differences compared to those without ASD with gait (stride width, velocity, and stride length) (Autism Speaks, 2022). As fitness professionals, we have the knowledge and experience to program design for these fitness and skill related components, so having a specialization to reach this population makes us both more credible and more marketable. Special populations need special people like us to add exercise as medicine and improve quality of life, despite the challenges, stereotypes, and stigmatisms that exist when it comes to persons on the “spectrum”.
Join Megan for her webinar on this topic, Working With Special Populations: Autism Spectrum Disorder (ASD) Fitness Integration
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.
References
Autism Speaks (2022). Autism diagnosis criteria: DSM-5.
Autism Diagnosis Criteria: DSM-5 | Autism Speaks
Centers for Disease Control and Prevention (2022). Data and Statistics on Autism Spectrum Disorder. Data & Statistics on Autism Spectrum Disorder | CDC
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(Suppl 1), S55– S65. https://doi.org/10.21037/tp.2019.09.09