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4 Simple Ways Your Fitness Routine Can Benefit from Self-Care

/27 July 2022/ All MFN blog/

When you think of taking care of your health, exercise is one of the first things that comes to mind. You know you need to stay active and stay in shape to protect your body, but what you may not realize is that you also need self-care to protect your mind. Combining self-care and fitness is the best wellness move you can make. Here are some ways to do it.

Start Working Out More at Home

Sticking to your fitness goals is important. If getting to the gym causes you stress or interferes with your schedule, though, you may want to think about building a gym at home. It’s easier than you think, and can make getting those daily workouts in easier on your schedule. You can use any extra space you have, whether it’s your garage, a spare room or a basement, and quickly set up a workout space in your home. The equipment you fill it with will hinge on your needs and the amount of space available, but for most people, basic workout equipment, like a jump rope and dumbbells, is enough to get a good workout at home and stick to their budget.

Consider Holistic Wellness Practices

A regular fitness routine will help keep your body in shape. Working out can help enhance your mood as well, but it’s not really enough to manage your mental health. You also need to find ways to help your body recover after all that effort, which is where holistic self-care practices come in handy. Incorporating practices like acupuncture, Pilates, massage and chiropractic treatment can be beneficial for relieving stress and helping keep your emotions in balance. Yoga is another practice that complements most physical fitness routines, and it improves strength and flexibility in your body. Runners can use beginners poses such as downward facing dog and pigeon to help build more muscle and keep joints flexible, all while reducing stress.

Treat Pain Through Self-Care and Exercise

If you suffer from chronic pain, you can combine self-care and fitness to find relief. The trick is to find simple workouts that get your body moving while helping your mind feel calm.

Yoga is also a good choice here, but you can also try doing tai chi. This slow, intentional practice is especially effective for seniors looking to decrease pain symptoms and decrease their fall risk.

You can treat more than arthritis with exercise and self-care, though. Studies have also shown that regular physical activity can help Alzheimer’s patients, and exercise may even play a role in preventing this debilitating condition. Research around this is still limited, but one thing that’s for sure is that adults who exercise are less prone to other chronic health conditions. Heart disease, diabetes, and certain cancers can all be prevented with the right fitness routine.

Help Yourself Age Well with Fitness and Self-Care

Older adults who are looking to stay in their best shape also need to factor self-care into the equation. Without self-care, you are leaving your body and mind vulnerable to the effects of chronic stress. Consistent levels of high stress can leave older adults struggling with heart disease, anxiety and other health issues. Staying active is a great way to care for your well-being, but you also need to make sure you are taking time to really enjoy life. Practicing daily mindfulness can help all adults live more fulfilling lives. Being mindful means taking time to pause and reflect on your life, and to be thankful for the things that make you happy. In between workouts, take a 15-minute break to meditate or to write down what you’re grateful for.

Physical fitness can go a long way in preserving your overall health, but it’s not the only wellness habit you should commit to for a better life. Finding ways to work self-care into your fitness routine and your everyday life can change your body and mind in many positive ways, so make time for more self-care, and keep working toward those health and fitness goals.

Sheila Olson has been a personal trainer for five years. She created FitSheila.com to spread the word about her fitness philosophy and encourage her clients to stay positive. She incorporates mindfulness and practices for reducing negative talk into her sessions.

 

References

preworkout supplement

Commercial Sports Foods: A Matter of Preference

/25 July 2022/ All MFN blog/

“I thought I was supposed to use gels during long runs. Can candy work just as well..?”

 “Are electrolyte tablets the best way to replace sodium loses from sweaty workouts?”

 “I get diarrhea when I use some commercial sports foods…help!”

If you are among the many athletes who have no idea which commercial sports foods are best to support your workouts, welcome to the club! Advertisements have led many active people—from serious competitors to anyone who breaks a sweat—to believe that pre-workout drinks, energy gels, and electrolyte replacers (among the many other commercial sports foods) are a necessary part of a sports diet. Guess what? Real foods can often work just as well.

While there is a time and a place for commercial sports foods, many athletes needlessly spend lots of money on them. The purpose of this article is to help you become an informed consumer, so you know what these products are (convenient, expensive)—and what they are not (essential for all exercisers). Whatever you do, test them during training, so you can learn if they settle well in your gut. You don’t want surprises during competitions!

Pre-Workout Supplements

When you feel low on energy and are dreading your afternoon training session, pre-workout products that promise explosive energy, sharp focus, and incredible results can be very tempting to buy. While simply eating a heartier breakfast, lunch, and pre-exercise snack can help prevent an afternoon droop, many athletes fail to appreciate the power of food. Instead, they look for “magic.”

  • The “magic” ingredient in most pre-workout products is caffeine. You could just as easily get stimulated with coffee or NoDoz. True energy comes with eating a pre-exercise banana, granola bar, or carb-based snack.
  • The best pre-workout snacks digest easily and don’t talk back to you. Standard supermarket foods (e.g., toast, oatmeal, animal crackers, dried pineapple, dates, banana, even a swig of maple syrup) are likely more familiar to your gut (less likely to cause intestinal upset) than unfamiliar commercial sport fuels.
  • Some pre-workout products tout they are sugar free, as if sugar is evil for athletes. Sugar (carbohydrate) is a true energizer in comparison to caffeine, which is just a stimulant. Carbs + caffeine will offer a better workout (for those who tolerate caffeine, that is)!
  • Some pre-workout products contain creatine, vitamins, beta-alanine, and/or other stuff that looks good on the label. The dose may be inadequate to make a significant difference in your performance. Do your homework to learn what is an effective dose.
  • Buyer beware, pre-workout products are poorly regulated. Who knows what the products contain. Claims that sound too good to be true should raise an eyebrow. Be sure your choice says NSF Certified for Sport or Informed Sport on the label.

Gels

During hard exercise lasting 1 to 2.5 hours, you’ll perform better if you consume ~30 to 60 grams (120-240 calories) carbohydrate per hour. Take your choice of gel, sport drink, or gummi bears!

  • During extended exercise lasting more than 2.5 hours (ultra-marathon, long bike ride), you want to target 60 to 90 g carb/h (240-360 calories), depending on the intensity of your exercise, your body size, sport, and intestinal tolerance.
  • Most gels offer 100 calories (25 g carb) in the form of some type of sugar, such as maltodextrin, sucrose, fructose, or glucose. The Nutrition Facts on the gel’s label can you help determine the right amount to consume.
  • Many athletes love the convenience of gels because they come in a good portion-size and are easy to carry. Others dislike them due to their consistency. For some athletes, gels digest poorly because they contain a type of sugar that can trigger bloat, diarrhea, and undesired pit stops. Always experiment with new gels during training!!!
  • Some popular alternatives to the 100 calories of carb (sugar) in a gel include gummy bears, Twizzlers, Swedish fish, gum drops, peppermint patties, maple sugar candy, even chocolate (though it melts in hot weather). The trick with choosing “real food” is to figure out how to carry it. Pockets help.

Electrolyte tablets

Electrolytes (electrically charged particles, most often known as sodium, calcium, magnesium, and potassium), are minerals abundant in food.

  • For sweaty athletes, sodium (a part of salt) is the main electrolyte of concern. Salty foods enhance fluid retention and help keep you better hydrated than plain water, which goes in one end and out the other.
  • Many electrolyte replacers are lower in sodium than you may think. By reading food labels, you’ll discover a slice of bread can have more sodium than 8-ounces of Gatorade.
  • Athletes who sweat heavily might lose about 500 to 1,000 mg sodium in an hour of vigorous exercise. Some options for replacing these sodium losses include:
Commercial Sports Food Sodium (mg) Salty food Sodium (mg)
Propel Electrolyte water, 8 oz

 

 105 String cheese, 1 stick   220
Gatorade, 8 oz

 

 110 Beef Jerky, 1 oz   600
Gu Salted Caramel, 1 gel 125 Salt sprinkled on food, ¼ tsp   600
Nuun, 8 oz

 

 175 Broth, from 1 cube Herb-ox 1,100
  • Replacing sodium is most important for athletes who sweat heavily for extended periods in the heat. Yet, these athletes generally consume foods that contain sodium before, during and after exercise. For example, football players who refuel from morning practice with a high-sodium ham and cheese sandwich with mustard and dill pickles can bypass the Gatorade at lunch.
  • Consuming 500 mg. sodium before you exercise helps retain fluid, delay dehydration, and enhance endurance. Sprinkle salt on that pre-exercise omelet, pasta, or sweet potato before you exercise in the heat!

The Bottom Line

While commercial sports foods have their time and place for intense exercisers, not every athlete needs to pay the price for pre-wrapped convenience.

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.

veg in hand

Heart Disease is Preventable and Reversible through Nutritional Intervention

/22 July 2022/ All MFN blog/

Heart disease is devastating to both our health and our economy. It is the number one cause of death in the country. Cardiovascular disease (CVD) accounted for 32.1 percent of deaths in the United States in 2013 – one out of every three deaths is due to this preventable disease.1 A significant number of research studies have documented that heart disease is easily and almost completely preventable (and reversible) through a diet rich in plant produce and lower in processed foods and animal products.6-9

As the prevalence of CVD escalates, medical costs are rising rapidly. The American Heart Association has projected that by 2030, 40.5 percent of the US population will have some form of cardiovascular disease, and the direct medical costs attributed to cardiovascular diseases will triple compared to 2010 costs.2

Risk factors for heart disease are commonplace for U.S. adults:32.6 percent have hypertension, 13.1 percent have total cholesterol above 240 mg/dl,3 9.3 percent of U.S. adults have diabetes,4 and 68.5 percent of U.S. adults are overweight or obese.5 As a result, it has become considered normal in our society to have atherosclerosis, and to die from cardiovascular disease. If you eat the standard western diet that most people eat in the modern world, you will surely develop heart disease and may die from it.

Fighting heart disease: Superior nutrition versus drugs and surgery

In 2015, I published a scientific article in the American Journal of Lifestyle Medicine demonstrating, with survey data and case histories, the dramatic weight loss and cardiovascular benefits possible with a Nutritarian diet. Respondents who started out obese lost an average of over 50 pounds two years after the switch to a Nutritarian diet. After one year, in those who started out with hypertension, there was a 26 mm Hg average reduction in systolic blood pressure. In respondents who were not taking cholesterol-lowering medication, there was an average 42 mg/dl decrease in LDL cholesterol, and an average decrease in triglycerides of 79.5 mg/dl.10

The surgical interventions commonly used to treat heart disease, such as angioplasty and bypass surgery are futile. The COURAGE trial and additional studies conducted since have documented that patients undergoing those invasive procedures do not live longer or have fewer heart attacks compared to those receiving medical therapy  with modest lifestyle changes.11-12 Surgical interventions are not long-term solutions to heart disease; they merely treat a small portion of a blood vessel, while cardiovascular disease continues to progress throughout the vasculature.

Drugs that treat hypertension and elevated cholesterol carry serious risks and do not stop heart disease from progressing. Cholesterol-lowering statin drugs are known to increase the risk of diabetes, impaired muscle function, cataracts, liver dysfunction and kidney injury. 13 Each different class of blood pressure-lowering medications is associated with its own risks and side effects. ACE inhibitors commonly cause a persistent cough; diuretics are linked to increased risk of diabetes; beta blockers are associated with increased likelihood of stroke; calcium channel blockers may increase risk of heart attack and breast cancer; and ARBs are associated with increased risk of lung cancer.14-20

The risk associated with these treatments is unacceptable when there is a safe, effective alternative —smart nutrition and exercise – that can actually reverse heart disease and obliterate the need for risky and even futile medical care. Atherosclerotic plaque can be reversed, and cholesterol lowered without drugs or surgery.

Success stories (two of numerous)

Ronnie weighed over 300 pounds when he wound up needing emergency quadruple bypass surgery.  Three years later, he was back for an angioplasty and three stents, but his chest pain returned within one month of the surgery. Working with Dr. Fuhrman in the Ask the Doctor Community, Ronnie lost 140 pounds and went off all medications. He runs and plays sports and has served as an inspiration to family members who have also lost weight and begun to live healthier lives. Read his story.

Julia had three heart attacks within three months. After her fifth angioplasty, she still had constant chest pain. She was on 10 different daily medications, suffered migraines, and, at the age of 60, could not walk even one block. Today, Julia has lost 105 pounds, and now enjoys every day pleasures like exercise, gardening, and playing with her grandchildren. She went from a “cardiac cripple” to a healthy, happy woman. Read her story.

Like Ronnie and Julia, over the last 20 years hundreds of my other patients with advanced heart disease have demonstrated that dramatic reversal of advanced disease can even occur in a relatively short time.

Following the lenient recommendations of the American Heart Association and wearing a red dress pin do not form an effective strategy for protecting you or your loved ones against heart disease. Also, drugs and surgery do not cure heart disease. A health-promoting, nutrient-dense (Nutritarian) diet, that I have designed and advanced over the years (coupled with exercise) is dramatically effective and protective for preventing and reversing  high blood pressure, high cholesterol and diabetes — as well as heart disease — because it removes the primary dietary cause of heart disease, while providing the most protective and life-span promoting diet-style. For more information, check out my book, The End of Heart Disease.

Everyone needs to know that heart disease can be avoided; and those who already have heart disease deserve to know that they can reverse their disease. Conventional medical care does NOT protect against heart disease-related death. Only a Nutritarian diet can offer dramatic lifespan-enhancing benefits against both cardiovascular disease and cancer.

Originally printed on DrFuhrman.com. Reprinted with permission.

Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient-dense, plant-rich eating style.

References

  1.  Xu J, Murphy SL, Kochanek KD, et al: Deaths: Final Data for 2013. Natl Vital Stat Rep 2016;64:1-119.
  2. Heidenreich PA, Trogdon JG, Khavjou OA, et al: Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association. Circulation 2011.
  3. Mozaffarian D, Benjamin EJ, Go AS, et al: Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133:e38-e360.
  4. American Diabetes Association: Diabetes statistics [http://www.diabetes.org/diabetes-basics/statistics/]
  5. Ogden CL, Carroll MD, Kit BK, et al: Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-814.
  6. Ornish D, Brown SE, Scherwitz LW, et al: Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133.
  7. Ornish D, Scherwitz LW, Billings JH, et al: Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998;280:2001-2007.
  8. Esselstyn CB, Jr.: Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol 1999;84:339-341, A338.
  9. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al: A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract 1995;41:560-568.
  10. Fuhrman J, Singer M: Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
  11. Boden WE, O’Rourke RA, Teo KK, et al: Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503-1516.
  12. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, et al: Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373:911-918.
  13. Hippisley-Cox J, Coupland C: Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197.
  14. Simon SR, Black HR, Moser M, et al: Cough and ACE inhibitors. Arch Intern Med 1992;152:1698-1700.
  15. Bangalore S, Messerli FH, Kostis JB, et al: Cardiovascular protection using beta-blockers: a critical review of the evidence. J Am Coll Cardiol 2007;50:563-572.
  16. Gupta AK, Dahlof B, Dobson J, et al: Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31:982-988.
  17. Wassertheil-Smoller S, Psaty B, Greenland P, et al: Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA 2004;292:2849-2859.
  18. Group PS, Devereaux PJ, Yang H, et al: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008;371:1839-1847.
  19. Li CI, Daling JR, Tang MT, et al: Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years. JAMA Intern Med 2013.
  20. Sipahi I, Debanne SM, Rowland DY, et al: Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials. Lancet Oncol 2010;11:627-636.
trainer-with-senior-woman-at-treadmill

How the Human Body Changes As It Ages

/20 July 2022/ All MFN blog/

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.

woman lifting crossfit-534615_1280

Why Women Should Lift

/18 July 2022/ All MFN blog/

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. 

The Effect of Aging on our Muscles and Joints

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! 

Health Benefits of Weight Training

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.

A Word about Body Image

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.

Fit Pros: Offer menopausal and perimenopausal women an individualized approach to training, nutrition and wellness as a Menopause Health and Fitness Specialist.

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.

woman heating pad

Why Suffer in Silence?

/15 July 2022/ All MFN blog/

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

gavel

Exercise Prescription and the Standard of Care

/11 July 2022/ All MFN blog/

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).

Factors Courts Consider When Determining the Standard of Care

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 Nature of the Activity
  • The Type of Participants
  • The Environmental Conditions

Nature of the activity

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.

Type of participants

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).

Environmental conditions

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.

Case Example: Levy v. Town Sports International, Inc. (5)  

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.

Conclusion

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.

Join Joann for her webinar on this topic, Exercise Prescriptions: Linking Safety and Business Success

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

  1. Vaid v. Equinox, CV136019426, 2016 LEXIS 828 (Conn. Super. Ct., 2016).
  2. Van der Smissen van der Smissen B. Elements of Negligence. In: Cotten DJ, Wolohan JT, eds. Law for Recreation and Sport Managers, 4th Ed. Dubuque, IA: Kendall/Hunt Publishing Company,
  3. Warburton DER, Bredin SSD, Charlesworth SA, et al. Evidence-Based Risk Recommendations for Best Practices in the Training of Qualified Exercise Professionals Working with Clinical Populations. Applied Physiology Nutrition and Metabolism 36, S232-S265, 2011.
  4. Bartlett v. Push to Walk, 2018 WL 1726262 (2018 U.S. Dist. Ct., D. N.J.).
  5. Levy v. Town Sports International, Inc., 101 A.D.3d 519 (2012 N.Y. App. Div. LEXIS 8543).