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Trainer helping senior woman exercising with a bosu balance

Core Strength is NOT Washboard Six Pack Abs: 4 Steps to Building Your Powerful Core Strength

Most people associate the core with the look of your abdominals. They believe that having a strong core is associated with the look of a washboard stomach or Six Pack Abs. In reality, there are 27 muscles that make up the core of your body. From pelvis and hip muscles on up, the core is an entire system. Only a few of the muscles are visible to the naked eye.


Athletes, Injuries & Nutrition

Athletes get injured. It’s part of the deal. Be it a torn ACL, Achilles tendonitis, or a pulled muscle, the questions arise: What can I eat to recover faster? Would more vitamins be helpful? What about collagen supplements? At this year’s virtual Food and Nutrition Conference and Expo (FNCE) of the Academy of Nutrition and Dietetics (AND, the nation’s largest group of nutrition professionals), several presentations offered updates on nutrition for injuries.


13 Reasons the Right Exercise Matters More in Menopause

During menopause, you’re more susceptible to negative effects of stress. Avoid the wrong exercise (that will worsen stress) and do the right exercise and you can reduce or eliminate symptoms of menopause. There are at least 84 symptoms associated with menopause. This short list of 13 pesky symptoms can be supported by the right exercise.

Hot Flashes (and Night Sweats)

Hot Flashes are potentially the most well-known and most-associated signs of menopause, affecting approximately 50% of menopausal women. They are a sudden sensation of feverish heat that spreads through your body.

Why they occur for some women and not for others, or why they may happen occasionally or for a time and then be gone, is not clearly understood. Vasomotor control is the reason behind why you might experience them when a girlfriend doesn’t when both your hormones may fluctuate.

Night Sweats are excessive sweat that occur during the night. They can contribute to sleep disruption and daytime fatigue or anxiety. That of course, is not the jackpot you want. Both hot flashes and night sweats are believed in part due to fluctuating or low estrogen levels.

Exercise can help this menopause symptom if it’s the right exercise. 

Women who are more fit, with better body composition, and who exercise with adequate intensity experience up to 62% less frequent and or intense hot flashes. What you need to beware of is your tendency to jump to conclusions about how to reach higher fitness levels. Longer and “more” exercise is not the answer. Due to this fast-paced life and your midlife status, the rules have changed.

In midlife, in 2020 and beyond, if you’re still playing the exercise game according to 1980 rules, you will lose.

Will You?

The variability of progesterone related to amount of estradiol had the greatest correlation with hot flash occurrence in more than one study. Increased progesterone variability was associated with decreased hot flashes. Though there’s not much that can be done to influence the variability in your progesterone levels. However, you can exercise to optimize your natural progesterone. Namely, keep stress (cortisol) in check.

Simply start with a smart plan according to your status right now. (More tips below). Ultimately,  include high-intensity intervals at the duration, frequency, and time of day that supports you instead of throwing you under the bus.

Did you know that if the only time you can exercise is late day and you push through high intensity, instead of losing weight you could set off a cascade of events that cause you to gain? The right exercise at the right time of day is a must.


Fatigue is that sluggish, always-tired feeling doesn’t go away with a good night’s sleep. You feel unproductive, moody and this fatigue can cause what’s known as wired-and-tired feeling. You desperately want to get a good night’s sleep and shake it but can’t. For some women, this is like period week fatigue only it doesn’t go away.

Extended periods of fatigue can be signs you’ve just been pushing through, using caffeine or sugar or both to serve you short term. If you rely on external substances too long, that false energy you borrow is going to catch up to you in the end and you will pay back that debt.

If you rely on external substances too long, that false energy you borrow is going to catch up to you in the end and you will pay back that debt.

So, what do you do when menopause fatigue hits and your calendar says HIIT? Or Long run? You rest. You can’t build fitness on a false foundation. Fake it till you make it doesn’t work with your midlife fitness. Plan the work. Work the plan. Override the calendar and rest if your workouts or your sleep, appetite, mood, or digestion is suffering.

An entire chapter in You Still Got It, Girl! Is dedicated to Rest & Recovery. Oh, there are chapters on exercise and on sleep too but Rest & Recovery is something few of us learned to do well. Now? We have to pay attention.

The right exercise when you’re fatigued could be no exercise. We need to remember what it’s like to just move more and rest well.

Low Libido

Libido is your overall sexual drive or desire for sexual activity. It’s influenced by biological, psychological, and social factors. It’s not just that you may feel dry and a lack of interest thanks to hormone shifts. If you’re experiencing fatigue and other menopause symptoms like weight gain and belly fat, you don’t feel sexy or want to be seen or touched.

One of my first Flipping 50 TV episodes was dedicated to low libido and what you can do about it. It’s partially due to changing hormones. But a lot of midlife women don’t realize that the exercise they’re doing (or not doing) is also destroying libido.

The right exercise will boost your testosterone. The wrong exercise kills it and the mood, girlfriend. Simply said, from the boardroom to bedroom this hormone is important. Last, exercise that gets your hips moving increases blood flow there and so it’s not all intense. Whether it’s dancing for you or it’s Pilates or Yoga is up to you.

Make this flip: Stop the endurance exercise and get on the short, intense train. Plus? If your partner snores? You may need to just have play dates together and sleep separately or the libido will keep being a problem. Sleep deprived and sexy don’t belong in the same sentence.

Sleep Disorders & Insomnia

Sleep disorders & Insomnia are often brought on by night sweats. Anxiety & Depression (below) can also be to blame. If your mind just won’t shut down and quiet when your body is crying for relief from fatigue, there are things you can do. If you think of your symptoms as little messengers something isn’t quite right, it may not just be hormones. Or it may be that your hormones will be helped by some gentle shifts.

It may be a micronutrient deficiency showing up. After all, at midlife, several things may be catching up to you. Have you had a less-than-5-star diet? Are you pretty passionate about your coffee and your wine both? Have you neglected your exercise? Just review your last month and get honest. If “busy” got in the way of you exercising and your regular routine is now a random one, get back on it if only for sleep. Truth is just 10 minutes of exercise can boost sleep by 33% according to a poll by National Sleep Foundation.

It could also be exposure to EMFs (too many screens, electronics) in your lifetime or at least right now. Our bodies weren’t made to handle all of this.

There are about 20 different things you can do (and stop doing) to support sleep. Try them sequentially, not randomly and adjusting until you’ve eliminated each one or find it works is something most of us struggle to do on our own. “I’ve tried everything,” too often means I’ve randomly tried this and that for a while.

The right exercise to help with sleep depends on how you’re currently sleeping.

The Short List

Menopause Symptoms Lessened or Eliminated by (Proper) Exercise

  • Hot flashes
  • Fatigue
  • Night Sweats
  • Libido
  • Sleep Disorders
  • Weight Gain
  • Incontinence
  • Muscle Tension
  • Osteoporosis
  • Insomnia
  • Anxiety
  • Depression
  • Belly fat

Weight Gain

If you’ve experienced weight gain, I have good and bad news for you. First, you can do something about it. Second, menopause is not to blame. Hormone fluctuation may have caused sudden weight gain. But often at a deeper level there is some behavior change that either did or needs to happen.

You may, as I did, find yourself in a perfect storm. Everything that happened for me in 2019 put me in a place of toxin exposure (hormone disruption), physical and emotional stress (hormone imbalance x 2), and related time and financial stress (hormone disruption). By the end of the year I’d gained 10 lbs. Now, at first glance, it’s possibly reasonable. However, I was training for an Ironman (that’s 140.2 miles of swimming, biking, and running in a day).

Endurance activity has the potential to throw women in midlife (and others) under the bus with adrenal fatigue and it certainly did me. I’d successfully trained for 7 prior to it, with excellent health (albeit, I modified my protocol intentionally for optimum training as opposed to volume).

During menopause, what you’ve been able to get away with until then, you may not.

Depression & Anxiety

Depression & anxiety are mood disorders more common among women than men. Dropping estrogen can negatively influence production of neurotransmitters (brain hormones) like dopamine and serotonin that regulate mood. Combined declining levels of progesterone and estrogen make it hard to restore happiness after incidence of sadness or anxiety.

During the pandemic if you’ve had a little more struggle with this, though perfectly natural and normal with a decrease in our social connections, as a woman in midlife you may struggle a bit more than you would have going through this say 10 years ago.

What can you do? Mood boosting exercise is a big part. Get outdoors and move and lift weights. Both are associated with increase in serotonin, and reductions in anxiety & depression.

Belly Fat

Belly fat didn’t make many “common symptom lists.” For over 90% of the women I’ve worked with belly fat is a big complaint, whether or not they’ve gained weight. Fat deposits tend to favor the belly.

There are two types of belly fat, visceral fat and muffin top or the pinch-an-inch type.

Visceral belly fat is internal around your organs. Muffin top is that spare tire, often in front and back for women.

The two types of fat respond to exercise differently. The right exercise for targeting menopausal visceral belly fat is high intensity interval training. Altering exercise to include high intensity intervals a few times a week can be enough. However, the muffin top requires more. You’ve got to do intervals and cut out your extra-curricular carb intake.


Osteoporosis and osteopenia (less than optimal but not quite to the 2.5 Standard Deviations from optimal bone that is osteoporosis) are both growing concerns for midlife and older women.

For good reason. Bone loss on average can be between 1-3% of total bone density per year if you’re not doing something about it.[Resistance weight training has the greatest positive influence on bone density. High impact weight-bearing exercise is second. The emergence of vibration therapy also contributes to bone density. However, vibrational therapy has to be combined with function stability movement for optimal prevention of falls and fractures.]

During the 3-5 years around a woman’s menopause bone losses can accelerate to 3-5% loss annually.

What’s the answer, or rather, what’s the answer while you’re at home, opting not to go to the gym during the pandemic? At the gym using the leg press, chest press, and seated row for strength will help most to load your hips, wrists, and spine. At home focus on squats, lunges, bent over row and chest press.

You’ve been conditioned to believe any exercise is better than no exercise. During menopause the right exercise for each woman is unique.

For Fitness Professionals

Gain the information, tools, and resources needed to coach and train this steadily growing population with Debra’s 10-hour online course with MedFit Classroom, Stages of Menopause and Exercise Intervention.

Given the number of women who have not exercised previously, and the current void in proper hormone balancing exercise prescription, there exists numerous, lucrative opportunities for fitness professionals to positively impact the lives and health spans of a great many women still seeking answers.

Reprinted from flipping50.com with permission from Debra Atkinson.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com













What Fitness Professionals Need to Know About Exercise and Diabetes

Are you working with any clients who have type 1 diabetes, type 2 diabetes, or even prediabetes? Well, you have a lot to learn if you don’t know the first thing about those conditions! There are over 100 million Americans currently have diabetes or prediabetes—some of them are, or will be, your clients.

Diabetes is a metabolic disorder that results in elevated levels of blood glucose (“blood sugar”) that can cause many health complications if not managed effectively. Although exercise is one of the three cornerstones of diabetes management, sometimes it can complicate keeping blood glucose levels under control, especially in people who have to replace the insulin that their bodies no longer make (or make enough of). How they respond to being active really depends on the type of exercise and diabetes.

In any case, on a basic level, it’s good to know more about how exercise affects people with diabetes. I have lived well with type 1 diabetes for nearly half a century at this point, and I have always known at some level that exercise did good things for my blood glucose, even before I had my first blood glucose meter (after going 18 years without one).  How could I tell without a meter to test my levels?  Honestly, it was because being active always made me feel better, physically and emotionally.

I earned a PhD in Exercise Physiology to better understand how exercising helped me. You don’t have to go that far with your education, but if you have diabetes or are going to work with clients or patients who have it, here are some basic things that you really need to know.

#1: Exercise can help erase your blood glucose “mistakes”

  • Exercise acts kind of like an extra dose of insulin.
  • At rest, insulin is the main mechanism your body has to get glucose into muscle cells.
  • During exercise, glucose goes your muscles without needing any insulin (via muscle contractions).
  • Being regularly active makes your muscles more sensitive to insulin, so it takes less to have the same blood glucose lowering effect when you eat during or after exercise.
  • What better way to help erase a little overeating of carbs (or some insulin resistance) than a moderate dose of exercise to lower your blood glucose?

#2: Exercise doesn’t always make your blood glucose go down

  • It doesn’t always make your blood glucose come down, at least not right away.
  • During intense exercise, the excess glucose-raising hormones your body releases can raise your blood glucose.
  • Over a longer period of time (2-3 hours), it usually comes back down, but who wants to wait that long?
  • If you take insulin, you’ll need to take less than normal to correct a post-workout high or your blood glucose will likely be crashing low a few hours later.
  • A cool-down of less intense exercise (like walking) can help bring it back to normal, so do an easy, active cool-down after intense workouts or activities.

#3: Your muscles are critical to managing your blood glucose levels

  • Exercise also helps you build and retain your muscle mass.
  • Muscles are the main place you store carbs after you eat them—like a gas tank.
  • Exercising helps use up stored carbs, but can also increase the size of the tank.
  • When you eat carbs post-exercise, they can easily go into storage with a little insulin.
  • Being sedentary keeps the tank full and makes you resistant to insulin.
  • Aging alone can cause you to lose muscle mass over time, but you can combat it to a certain extent by recruiting all of your muscle fibers regularly.
  • Resistance training and/or high-intensity intervals build muscle more because they
    recruit the faster fibers that you don’t use when walking or doing easier activities.

#4: Exercise is the best medicine there is

  • Use exercise to control stress and to stave off depression—with no bad side-effects!
  • It’s a natural antioxidant—more effective and better than supplements!
  • Being regularly active prevents all sorts of cancers.
  • If you’re active, you’ll likely feel better and look younger than you are (as long as you don’t exercise too much).
  • You’ll be even less likely to catch a cold if you exercise moderately and regularly.
  • Standing more, taking extra steps, and fidgeting even help—be active all day long, and don’t forget your daily dose of the best medicine there is!

LEARN MORE: Join Dr. Colberg for her upcoming webinar, Challenges Related to Diet, Nutrition and Exercise in Diabetes

Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise. As a leading expert on diabetes and exercise, Sheri has put her extensive knowledge to use in founding Diabetes Motion (diabetesmotion.com), a website providing practical guidance about being active with diabetes. She also founded Diabetes Motion Academy (dmacademy.com), offering training and continuing education to fitness professionals.

Back pain

Three Steps to Ease Back into Exercise After a Back Injury

According to studies, Low back pain affects nearly 80% of all adults.  Most low back injuries come from the following: wearing high heels (women), performing manual labor and people who sit for long periods of time (greater than 3 hrs.). Although these statistics are alarming, there are some simple steps one can take to make sure that they avoid current and future back pain or injury. These steps all involve simple exercises that can be performed from anywhere, including one’s office.

Step #1: In order to prevent further injury or a relapse, the 1st thing one should do is stretch common muscles that are tight and may have caused the lower back pain in the first place. Tight muscles are known to overwork and when this occurs, they become overactive and let us know through pain. These muscles include: erector spinae, hip flexors, calves and the lats (the big back muscles). For each stretch, you want to hold the stretch for 30-120 seconds and perform the movement for 1-2 repetitions 3-5x/week. (View Stretches: http://www.webmd.com/back-pain/living-with-low-back-pain-11/five-back-pain-stretches)

Step #2: After you have stretched the tight muscles, now it is time to focus on strengthening the muscles that are weak or underactive. Muscles become weak or underactive typically from lack of use or overuse by the muscles that assist or oppose the weak muscles. For example, if your hip flexor is tight, it could cause your glutes (butt) muscles to become weak.  The muscles that tend to weak with a lower back injury include: certain core muscles, the butt and hamstrings. For each strengthening exercise, you want to perform 1-2 sets of 10-15 repetitions 3-5x/week. (View core exercise: http://www.webmd.com/back-pain/living-with-low-back-pain-11/core-strength-for-back-pain; http://www.webmd.com/back-pain/lower-back-pain-10/slideshow-exercises)

Step #3: Now that you have isolated the lower back with stretching and strengthening exercises, now it is time to focus on integrating your entire body back into exercising. Integrated exercises involve using as many muscles as possible in one given exercise. By performing integrated exercises, you will ensure that the your hip joint (which can be misaligned with low back injuries) starts and remains in the right position and the proper muscles are working as they should be. For each integrates exercise, you want to perform 1-2 sets of 10-15 repetitions 3x/week. (View integrated exercises: http://www.allthingshealing.com/Chiropractic/Corrective-Exercise-for-Back-Pain/8558#.VIoTN74zf8E)

If you follow these three simple steps, you can avoid low back pain setbacks and ensure that your back is strong enough to handle your daily activities of life.

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

man back pain

Understanding the Pain Experience to Better Assist Your Clients

Pain is a very personal and subjective experience. Modern pain science no longer views pain as a sensation; rather, pain is viewed as an experience that results from an amalgamation of inputs that are physical, psychological, emotional and social. These inputs must be viewed interdependently, because they all directly affect one another and the overall pain experience.

The Bio-psycho-social Model of Pain

Researchers and clinicians have structured the bio-psycho-social (BPS) model of modern pain to better understand and treat chronic pain.

“Bio” represents biology, biomedical and/or biomechanical. This is the historical way chronic pain was treated—seeking disease, dysfunction or damage and then designing interventions that would address it.

“Pyscho” represents the current psychological characteristics of the chronic pain sufferer. This could include the individual’s beliefs about his or her situation, historical references related to past pain experiences, anxiety, depression and expectations about the future. Many of the psychological elements are influenced by family members and/or perceived experts or authorities (e.g., doctors, nurses, physical therapists and personal trainers).

“Social” represents the social implications of the pain experience. Social stressors relate to doubts that those around us don’t believe our pain is real and whether there is a social support structure in place. Additional stressors may be related to missing important social events, traveling or the inability to maintain employment or familial responsibilities.

The International Association for the Study of Pain defines pain “as an unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” The word “potential” is significant in this definition because it describes pain even in the absence of tissue damage.

In a 2018 paper, the Centers for Disease Control and Prevention (CDC) noted that 50 million Americans suffer from chronic pain and 20 million suffer from high-impact chronic pain. High-impact chronic pain is chronic pain that “frequently limits life or work activities,” according to the report.

As a health and exercise professional, the likelihood of working with clients who have chronic and/or recurrent pain is high. These are clients who have been cleared for exercise by their physicians and who have either completed or are currently involved with treatment by a licensed medical provider such as a physical therapist or chiropractor. Understanding evidence-based strategies for exercise and maintaining professional scope of practice provide an important service to this population. Exercise programming to reduce mechanical stress and improve movement confidence and function are well within our professional role. But at no time should a health and exercise professional attempt to treat or diagnose any condition or provide medical advice.

The growing body of evidence around pain is reshaping treatment approaches by medical professionals. As a health and exercise professional who will very likely work with clients experiencing chronic pain, understanding the bio-psycho-social paradigm and what it means in reference to program design, communication and expectations are paramount.

The Importance of Rapport

One of the most effective strategies for introducing physical activity to clients with chronic pain is to establish rapport, which in turn, may help relieve anxiety and fear and set expectations. Here are three strategies to get you started:

  1. First impressions are unavoidable. If your potential clients’ first impressions are that you have no understanding or empathy for their struggles, you are at a disadvantage. Many of these impressions will be nonverbal and immediately communicated by observing your attire, the environment and any observable interactions with other clients, members or staff. Dress professionally for your role. Find a quiet, “safe” environment to sit and speak with your clients/prospective clients to enhance privacy.
  2. Listen. Give your clients the opportunity to express their concerns and fears. Remember that many people with chronic pain have been rushed in and out of appointments and often do not feel as if they are being heard. Giving them this opportunity is significant. For example, one of my favorite and most impactful questions to ask a client before we begin our first session together is, “Is there anything that I haven’t asked that I should have asked?” This gives the client permission to share anything else that might be important or gives me permission to move to the next phase of the appointment.
  3. Validate. When it comes to starting an exercise program, arguably the greatest fear an individual with chronic pain will have is that it is going to make his or her pain worse. To validate your clients is to communicate that you understand that their pain is very real and that their concerns are understood. That is, you have to enter the client’s world. You have to understand a client’s challenges, frustrations and setbacks to be able to truly serve him or her.

Pain is a complex issue and it is neither helpful nor accurate to approach client communication and programming from an outdated paradigm. The current bio-psycho-social model contains elements of biology, psychology and sociology, of which all must be taken into account for lasting, pain-free movement.

Join Anthony Carey for a webinar on this topic, Reduce the Threat: 5 Things We Do with All of Our Chronic Pain Clients.

Article reprinted with permission from Anthony Carey.

Anthony Carey holds a Master’s degree in biomechanics and athletic training and is the inventor of the Core-Tex™. Anthony is recognized internationally as a leading expert in biomechanics, corrective exercise, functional anatomy and motor control. He was named Personal Fitness Professional Magazine’s 2009 Personal Trainer of the Year and has received recognition for his work in the national media, including the New York Times, Time Magazine and Oprah’s “O” Magazine.

Anthony has authored two best-selling books: The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulders and Joint Pain and Relationship and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community, and consults for the San Diego Chargers as well as some of the largest equipment manufacturers and health clubs in the world.