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diabetesmanagement

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!

Expand your Education to Work More Effectively with Diabetic or Pre-Diabetic Clients

Check out Dr. Colberg’s 4 hour course with PTontheNet, Working with Clients with Diabetes or Prediabetes. With more knowledge about how to be active safely and effectively, you as their personal trainer can be a strong positive influence in getting diabetic or prediabetic individuals on the path to better health. Click here to learn more about the course!


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.

stress-woman

Stress Management in the Modern World

It’s exhausting being a human today – there are over one million Google hits per day for the word “stress”. Good and bad stress is a part of the human condition and it can be real or imagined and it is certainly a broad societal issue. By making a positive “next step” in managing your stress you can avoid becoming worn out by the journey of life.

Stress was first described in 1915 and the theory states that we react to threats with a general discharge of the sympathetic nervous system, priming the person for fighting or fleeing. Biologically, physical activity gives the body a chance to practice dealing with stress. Physical Activity releases mood-elevating endorphins, self-confidence and improves your sleep. Studies show that one can access the REM state (the most restorative phase of sleep) quicker on days you include physical activity. Under stress, our raised heart rate and blood pressure but tensions in our arteries and cause damage. Chronic stress which goes on longer than 20 minutes contributes to heart attacks just as acute stress does. It also causes constriction of the blood vessels, dilation of pupils, auditory exclusion and decline of peripheral vision. As the body heals this damage, artery walls scar and thicken which can reduce the supply of blood and oxygen to the heart (occluded arteries). Since the brain uses 20% of the oxygen delivered by the heart foggy-thinking may result. Stress can also cause the telomeres to shorten and erode. The telomeres protect the end of the chromosomes and if they shorten too much, they cannot multiply and die off resulting in quicker aging.

The President of the Salk Institute, Elizabeth Blackburn, and the recipient of the Nobel Prize states, “We’ve found that the better your telomeres are protected, the less chance you’ll have of getting any of the big diseases.” She suggests to stop the erosion, do physical activity of various types and don’t have long-term stress.

Begin to take charge of your thoughts, your emotions, your schedule, your spending, your environment and the way you deal with problems – especially family system challenges. Ask yourself, is it worth my health? Is this situation/person worth negatively impacting my health? Choose to be happy – it can boost your emotional well-being as stated in studies published in the Journal of Positive Psychology. Be mindful of good and hard-earned accomplishments and enjoy your small victories. Appreciate the simple pleasures, devote time to giving, make a point to listen to the other person’s ideas and UNPLUG! Ferris Bueller said – “Life moves pretty fast. If you don’t stop and look around once in awhile, you could miss it”.

Hamlet said, “There is nothing good or bad…but thinking makes it so.” Positive thinking is medicine and every thought can enhance or diminish our health, happiness and stress level. Dr. Robert Sapolsky of Stanford proposes in his book Why Zebras Don’t Get Ulcers, “If you are a normal mammal, stress is the three minutes of screaming terror in the jungle which either it is over with OR you’re over with. Perceived threats spark the same physiological survival responses (fight or flight) that crocodile attacks do.” Our modern-day stressors have changed. Fighting off prehistoric predators and trying to find food are replaced by juggling deadlines, multitasking and always being “connected” and available. Modern day saber tooth tigers are bills, traffic, family pressures but our bodies react the same way without the natural release that we would get from fighting or fleeing. Try not to turn to sugar and caffeine which can result in swings in blood sugar levels, limit alcohol to one drink per day and try to achieve a balanced, clean diet on most days of the week to even out your beautiful life.

The United States Government has suggested 150 minutes per week of physical activity in addition to two days per week of strength training for 20 minutes and stretching every day. There are many meditation, relaxation response and calming apps which you can download to have with you and use when you are having a challenge with managing stress. Sit and stand tall and do not “slump” as this can cause shallow chest breathing which can trigger the fight or flight response. Try not to make important decisions while under undue stress as this may result in poor or faulty decisions.

A 2016 study by the American College of Sports Medicine stated if workers do not have emotional resilience skills and habits to help support them during stressful times, their productivity declines. Work-related requirements such as precision and accuracy, problem solving, interpersonal communications as well as speed and quality of work output will suffer. We  need to adjust to change without disruption or difficulty while maintaining good functional capacities. We need to bounce back without breaking and without giving in, giving up or breaking down. Stress Management is an integral component of Global Employee Health and Fitness Month (every May) healthandfitnessmonth.org and as the Architect of this initiative I felt passionately about including this component along with nutrition and physical activity, to give each and every worker the opportunity to go home “whole.”

Each and every day when confronted with stress, think about what advice you would give to a friend and then take this advice yourself!


Diane Hart, Owner of Hart to Heart Fitness, (www.harttoheartfitness.org) is a Nationally Certified Fitness Professional, Personal Trainer, Health Educator and is current President of the National Association for Health and Fitness (www.physicalfitness.org) founded in 1979 by the U.S. President’s Council on Sports and Fitness. 

Physio assisting elderly woman during exercise with power band a

Treating Chronic Health Conditions: A Guide for the Fitness Trainer

The biggest question fitness trainers need to ask themselves is “Why do you want to work with the chronic populations?” Is it because:

a) The stats (IDEA, IRHSA) out there say it is the fastest growing population/market?

b) You really want to help people that tend to have multiple issues because it is rewarding?

c) You feel drawn to it because one of your clients now has a condition?

d) You like figuring out puzzles?

e) All of the above.

All of the above factors play a role in working with chronic conditions. It takes a much different approach than working with the general population. For starters, what defines a chronic condition, besides something that is ongoing?

The Center for Managing Chronic Disease defines it as such:

“A disease that persists for a long time. A chronic disease is one lasting three months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. Eighty-eight percent of Americans over 65 years of age have at least one chronic health condition (as of 1998). Health damaging behaviors – particularly tobacco use, lack of physical activity, and poor eating habits – are major contributors to the leading chronic diseases.”

What I find so fascinating is in the last sentence: “health damaging behaviors”. That is the core of working with chronic conditions; you want to impact a person’s or client’s health damaging behavior. If they are coming to you with a condition, we already know they have one, if not more, behaviors that need to be addressed and changed. This means you not only have to work with the biomechanical/physical implications of their condition, but the emotional/psychological aspects of it as well. Welcome to the world of medical exercise, a very rewarding and extremely challenging area of the fitness industry–a part where you will need to wear several different hats: health coach, sleuth, guide, emotional supporter, cheerleader, and fitness professional. Therefore, you need to be prepared.

Be Prepared

Start by deciding which medical conditions you are interested in; a great list can be found at Chronic (Medicine) on Wikipedia. Next, find out if any of these support organizations offer a certification–National MS Society, Arthritis Foundation, and Cancer Training Institute are some out there. Visit websites and request information. Most support organizations have a lot to offer on their websites, or try googling the condition itself. It may take some time, since with search engines today advertisements tend to come up first. Research support groups in your area, and ask to attend a meeting. This will expose you to the emotional side as well as the physical limitations of their condition, and what difficulties they face on a day to day basis. This will aid you in designing an appropriate exercise program for their specific needs. Read, read, and read some more, and then be critical. A lot of information is very general; dig deep, and if an article or website does not have the information you need, ask a professional.

Create a Board of Advisors

As a certified fitness professional, I did not go to medical school or physical therapy school, nor do I have a degree in nutrition. But I have learned a lot over my 20+ years working with special populations–and as a person who has fibromyalgia–but I don’t come close to knowing enough. As clients with conditions come through my door, many on numerous medications with eating habits that would make most trainers cry, medical questions come up. For example, “Can I eat dairy products if my medication says not to take calcium supplements with it?” Or “I find every time I walk upstairs I get out of breath–does that mean it is my condition or am I just out of shape?” And “Have you heard that Maltitol is bad for you, and what is Maltitol?” At this point, unless I feel there is a huge medical issue that needs addressing (then they get sent to their doctor immediately), I contact the appropriate person on my board and ask them the question. The board also helps with disseminating and understanding clinical test results that clients give me, or any other physiological question that is beyond my knowledge. It also builds your credentials as a professional when dealing with the medical community.

Scope of Practice

Most fields in the medical community are clearly defined by a scope of practice. From having spoken with more than a few doctors, they are very hesitant to refer to personal trainers, mostly because of injuries as a result of improper exercise programming or what they have observed in the gym. In the medical fitness industry, it is even more imperative to be precise and transparent with what you are doing. When a new client comes to me, I contact their doctor or physical therapist–usually via e-mail or letter–detailing what I have found from my assessment, the condition, and what kind of program I am designing. This gives them the opportunity to comment or change it accordingly. It also opens up lines of communication. The professional knows I am not going to have a spinal fusion client performing kettle bell swings right out of the gate; they will see my progressions and know that if something is off, I will refer back to them.

One of the hottest issues in the fitness industry is licensing; for it, against it, I am not going to argue it here, but as a fitness professional, I need to make sure I do not prescribe or diagnose. Even if I am 99.9% sure a person has impingement syndrome because of all the presenting symptoms, I am not going to say it. I am going to refer them to a medical professional. Especially with this population, there are a lot of cross over issues, and it is not our responsibility to diagnose but to help manage and improve their condition.

Empathy and Trust

Working with chronic conditions requires a lot of empathy and the ability to set boundaries. You need empathy more than sympathy; if you cannot get inside what they are going through pain- and limitation-wise, it will be hard to establish trust. Establishing trust is the biggest tool you can develop–my clients trust I will not hurt them, make them worse, or ask them to do anything they cannot accomplish. If you get the opportunity to attend a support group or speak with people who have chronic conditions, most want to get better, but don’t know how. They are afraid of making things worse; even the avid exercisers who have tried to “fight through the pain” find it doesn’t work, and are at a loss as to how to proceed. You have to understand how life changing their condition is, where they started, and where they are right now. It can help to take courses in health coaching or read up on behavior modification– even better if you can find something geared toward the specific condition you are dealing with.

Avoid the “over-empathy” trap, because people with chronic conditions can use it as a crutch, too. Balance in sessions is important; include activities they really like to do in with the exercises they hate.

I guarantee the exercises they hate are the exact ones they need to do the most! Offer rewards, if they do their homework exercises, or it could be just to get through a session. It can be difficult to manage both their emotions and their physical selves; if you don’t feel prepared, refer to an outside professional. Yes, you may lose your client, but in the long run, it gains you credibility and more trust.

Recharge Yourself

Recharging and recovering are the new buzz words in the health and fitness industry. It is even more important in the chronic condition realm, for both clients and professionals. More than in any other population, chronic conditions will sap your energy, your strength and sometimes your emotions. Most of this community will not see huge improvements like general exercisers; in some instances you will observe regression. They will have good days and bad days; they have challenges every day of their lives–just getting out of bed and getting ready for the day can seem like climbing a mountain. Then we come through the door and want them to do exactly the last thing on earth they want, which is to move more. They may be cranky, and in the case of depression or mental illness, downright nasty, leaving you to pull all your happy tools out just to make it through the session. In this case, what do you do to recharge your batteries? Funny as it seems, pay attention to the advice you are giving your clients–often times it can go both ways. I tell my clients to meditate, get a massage, plan a fun outing, or simply review their happy journal. These are the exact activities that recharge me!

It is easy to work, work, work, and this clientele is more demanding of our time and attention. Don’t ignore yourself; make sure you work in time to rebalance. Put it on your calendar as faithfully as you do your workouts or doctor’s appointments. All work and no play will bring on the exact condition in yourself that you are working hard to alleviate. If you really want to serve the chronic condition population, lead by example, and make time to recharge.


Sharon Bourke is an MFN member and the owner of Life Energy Fitness. At Life Energy Fitness, her goal is to identify where the compensations are and to help your body relearn proper movement patterns. The results are more energy, less chronic pain, an ability to participate in activities you love, and to prevent other problems from forming.

postnatal exercise

Tips on Postpartum Exercise Programming for the Fitness Professional

Many women post-pregnancy are very eager to rejoin the exercise world and at least resume the physical activities they once enjoyed prior to pregnancy. More and more women are seeking out fitness professionals or exercise programs to help them lose the baby weight and engage in safe and effective exercises. Many women understand the toll pregnancy and childbirth took on their bodies and they are ready and willing to seek out professional advice. Working with the postpartum client has benefits for both the trainer and the client. I encourage those who treat this population to get as much education in this area so you can better serve their needs.

Once you begin your journey caring for the postpartum client, there are several important factors to consider when beginning exercise program design.

First, remember she gave birth. Look at birth like any client who is rehabilitating from any type of injury or surgery. The postpartum phase is typically the first 12 months after having a baby but can be longer if a woman is nursing.

Second, consider how long it has been since exercise has been part of her regular routine. Even if she exercised regularly during pregnancy, she probably was limiting the intensity compared to her pre-pregnant self. Keeping that in mind, it may feel like for you (and her) that you are working on a beginner level as you begin.

Third, it’s really important to know the type of birth the woman had and how it affected her pelvic floor muscles. Obviously for vaginal birth pelvic floor prolapse, vaginal tearing or possible Pubic Symphosis diastasis could have occurred. For women who have gone through a cesarean (C-section), the abdominal muscles have been affected through the incision made into the abdominal wall and uterus.

Fourth, it is vital to understand the fitness level of the woman prior to pregnancy and the activities in which she participated. The fitness level or prior activities or sports in which she participated could shape the type of recommended exercises in her program.

Finally, consider any injuries or medical history that may affect her current fitness especially if she has been inactive or just returning back into exercise. Many of this information may be obtained in your initial meeting or phone consultation. You can use a PAR-Q (Physical Activity Readiness Questionnaire) to access this information. I suggest customizing the Par-Q to be very postpartum specific and asking detailed questions about pregnancy and delivery before you begin treatment.

Considering all of these factors, lets now look at how to exercise safely and effectively following delivery.

Procede Gently

Start with basic range of motion exercises and corrective, posture-based movements that will help her body begin to feel restored. A little movement goes a long way.

Get to Know Her Limitations

As with other injuries, or surgeries, childbirth is comparable for your client as her body is still healing, hormones are still adjusting that affect range of motion, core is weak and most women are sleep deprived for months after giving birth. With this in mind, her balance and equilibrium are affected. Careful of movements that change position briskly or go from standing to lying.

Establish Realistic Expectations

Develop reasonable exercise goals for your client. Along with her physical health, mental health is also affected.
Exercise is directly linked in helping to prevent postpartum depression, however, setting fitness goals may create anxiety or worsen her mental state, so be sensitive to this. Start with manageable times to exercise during the week. As the client become stronger you can increase the number of days you exercise per week in addition to the exercise intensity.

Create a Supportive Network

Connecting clients who are going through similar life experiences may help motivate them to exercise more regularly and in a small group setting the cost is usually less per person and more efficient for the trainer for the hour. This may also help give the client additional accountability.

Teach Sustainable Lifestyle Habits

Help your client embrace this journey as a marathon rather than a sprint. Explain that the baby weight will come off but the end goal is to do this safely and cautiously. You must be ready to advise on sustainable, healthy eating habits and adapt if the woman is nursing.


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

7 Tips for Membership Sales Success

The Active Wellness Membership Teams compiled our top sales best practices to ensure a successful sales year ahead.

1. Create a Monthly Action Plan

A monthly action plan should include who, what, when, where, why and how for each action item ensuring your plan is set and ready for execution. Every plan should answer how you will obtain tangible leads to turn into sales.

2. Set Daily & Weekly Numbers

Understanding your daily and weekly numbers will help you strategize and plan for a successful month ahead. These goals will help you determine how many appointments are required, calls needed, etc. Our rule of thumb is to have at least 2x as many appointments as your daily goal with the theory in mind that 50% of appointments will be closed.

3. Create a Fluid Pipeline

Sales representatives cannot only rely on marketing to deliver leads. Your membership team should always be looking for referrals. They can obtain referrals at point of sale from their new member, member retention calls, outreach opportunities such as health fairs and local events, and corporate leads.

4. Understand your Client/Prospect

It’s critical for your membership team to understand their client’s goals, interest, and needs. Learning these three things will allow you to learn more about your client, empathize with their best interests in mind and build trust to steer the conversation and tour.

5. Follow the 80/20 Rule

It is very important for your membership sales team to practice the 80/20 Rule which is 80% listening /20% speaking. Listening to your client is key to building trust and understanding their goals and interests.

6. Role Play, Role Play, Role Play

Your team should role play and practice various scenarios as much as possible to build confidence and help your team be prepared for any request or objection. Consistent role-playing will also help them be more prepared and focused on the end result  – the sale.

7. Ask for the Sale

The worst thing a Membership Representative can do is to not ask for the sale. There are two things that happen when you ask for the sale. The prospect either joins or has an objection which allows for another opportunity to walk through the objection with the prospect to ultimately signing. If you don’t ask, you lose on both these great opportunities.

Originally printed on the Active Wellness blog. Reprinted with permission. Written by Jerry Cardinali of Active Wellness.


Active Wellness is a specialty management company passionate about building active communities through fitness and wellness. Their mission is to BUILD AND INSPIRE HEALTHIER, ACTIVE LIVES through high touch interactions and technologies that support a better quality of life.

Senior woman with help of physiotherapist

Knowledge (Alone) is Not Power

A number of years ago, I applied for a job as a personal trainer in a gym. During my interview with the manager, he called me “book smart.” It wasn’t a compliment, since he was suggesting that I only knew the information in books, and that what really mattered was a person’s experience. “We really want someone who has been doing this for a while,” he said, before sending me on my way. Ouch. I left the interview frustrated, because it seemed as if my education precluded the gym manager from seeing what I could do. Or perhaps I hadn’t shown him. I had not yet proved to him that I was more than just book smart, that I could actually use my education to train someone to get fit and lose weight.

Knowledge alone is not power. One must be able to apply the knowledge one has. This is where a formal education fails us. I have met many brilliant scientists who have no idea how to train someone. (I once spoke to the scientist who studied cyclist Lance Armstrong for years in his laboratory at the University of Texas, and when I asked him about Lance’s training, he acted like a deer caught in headlights.) Universities do a great job of supplying us with knowledge, but a poor job of showing how to apply that knowledge. That part is up to us to learn on our own.

Too much of the knowledge gained from the great research done by my academic colleagues remains in academic circles, never reaching the fitness professional or the general public. Academic conferences are nothing more than scientists communicating their research to other scientists. Scientists need to do a better job at communicating the results of their research to the people who can benefit from it and showing them how to use it, and fitness professionals need to do a better job at acquiring and applying the education. It is not enough to know how muscles contract; we need to know how to design and administer resistance workouts to help our clients’ muscles get stronger and look better. It is not enough to know how the heart works; we need to know how to design and coach workouts to help our clients’ improve their cardiovascular systems.

Wouldn’t it be great if all fitness professionals were required to have an education that consists of book knowledge and practical knowledge? The latter can be obtained from “rotations” akin to those in medical school. We would all spend a couple of years taking the science courses and then do rotations in health clubs like medical students do in hospitals, to learn how to work with different populations and conditions. Upon graduation, we either become a fitness general practitioner or choose a specialty. I choose running. But you already knew that.

Reprinted with permission from Jason Karp.


Jason Karp is the creator of the REVO2LUTION RUNNING certification, 2011 IDEA Personal Trainer of the Year, and recipient of the 2014 President’s Council on Fitness, Sports & Nutrition Community Leadership Award. A PhD in exercise physiology, he has more than 200 publications, mentors fitness professionals, and speaks around the world. His sixth book, “The Inner Runner”, is available in bookstores and Amazon. Visit his website, Run-Fit.com

Back pain

Exercise Not Helping Your Back Pain? It’s Not you, It’s Your Strategy! | Part 2

This is part 2 in a series. Click here to read part 1.

In Part 1 of this series, we discussed the dilemma of back pain that persists despite your persistent efforts to solve the problem.  You’ve been prescribed medication, exercise, and a myriad of methods to “stretch” and “loosen” your muscles, but no avail. You must be a lost cause . . . right?

Maybe not.

It’s not your effort that’s lacking; perhaps it’s your strategy of solving the problem that’s in need of some tweaking.

In Part 1 we established that the body operates as a system:  an interconnected, interactinginterdependent set of parts designed to achieve a goal– and in the case of the human body, the goal is production of high-quality movement for the sake of survival.  Part of its genius, in my opinion, is in its sophisticated setup for communication within itself: the body is one continuous, cohesive system with a built-in mechanism that allows for every part to be aware of, and work with, the other parts to achieve the goal of operating efficiently.  The human body is a truly amazing system!

Every body movement is a whole-body task that requires an internal, whole-body solution.  Your muscles are an interconnected, interacting, interdependent system, constantly communicating back and forth, working together to create and control movement. All of your muscles are involved in one way or another in any bodily event.

Conversely, an issue with low-quality muscle function in any area of your system has the inherent potential to affect the performance quality—and your brain’s conclusion about how you feel–  in any other area of your system.

 Let’s apply this Systems Approach to form a new strategy to address your back pain.

Solving Your Body’s Problems Using the Systems Approach

The fact that your back is where you feel muscle pain and tightness doesn’t necessarily mean your back itself is the problem.  The standard Western medicine approach subscribes to the philosophy of “Local pain means a local problem, which requires a local solution”, but this isn’t always the case.

Imagine you start your car in the morning, and the “check engine” light pops up.  What’s wrong with your car?  Is the “check engine” light itself the problem?  No– the “check engine” light is an indicator, a safety mechanism built into your car’s system to alert you of a problem somewhere in the car’s system that needs to be addressed.

Likewise, pain you experience with movement is simply an indicator that there’s low-quality function somewhere in your muscle system . . . but not necessarily at the specific location you feel the pain.  The pain is just symptom, the downstream result of poor quality.  The pain itself is not the problem to be solved; the low-quality control is the problem!  Instead of focusing directly on the part where you feel pain, my work focus is on the quality of your position control.  Any area of the body with low-quality muscular control can contribute to a problem with movement, pain, tightness, or discomfort you are experiencing in any other area of their body.

While the work of a Certified Muscle System Specialist™ and the work of a physical therapist may look similar, the philosophy and thought process differ greatly.  Physical therapy generally focuses on a patient’s complaint of pain or tightness, and as a result the therapy is almost always performed on or around the area of the patient’s pain. The physical therapy approach often subscribes to the philosophy of “local problem, local solution” we discussed earlier.

The same goes for massage therapy, stretching, chiropractic, pain medication, and other traditional options for treatment of muscle pain and tightness.  The “local problem, local solution” approach focuses on the pain instead of on the quality of your muscle function as a cohesive, dynamic system.  Chasing “the pain” is rarely an effective problem-solving method. This is the reason why using generic protocols and pre-packaged plans to “treat back pain” are not effective.  This is also why “strengthen your core” isn’t always the panacea for back pain we’re led to believe.

So . . . you’ve completed physical therapy, diligently taken your medication, foam rolled the “tight” area every day . . . but your “check engine” light is still on.  So, how can you understand what your system needs to turn it off?

Find a “systems mechanic” for your muscle system.

Work with a practitioner who is able to look under the hood, run a battery of diagnostics, find areas of low-quality function throughout your muscle system, and prescribe a system-wide plan to remedy the problem and put into place an ongoing maintenance process (like getting regular oil changes and maintenance on your car) so you can keep your system running at its optimal operating potential.

This is the role of a Certified Muscle System Specialist™– we’re muscle system mechanics!  As we help you improve control throughout your system, we can elicit a significant, positive effect on how your entire body feels and moves. Our clients are often surprised that improving muscle control in an area can lessen pain they were experiencing at a different location of their body!

So the next time you’re feeling muscle pain and tightness—or any change in the quality of how your muscles move and feel– remember that the whole is greater than the sum of its parts.  The strategy you’re using to take care of your system matters!

About the Certified Muscle System Specialist™

If you’re interested in learning more about how a Certified Muscle System Specialist™ can help you move better, feel better, and live better, click here.

To find a Certified Muscle System Specialist™ near you, see our list of practitioners throughout the U.S. and Canada.

If you’re a fitness practitioner who is interested in learning more about how to become a Certified Muscle System Specialist™, visit us at www.exerciseproed.com.

Originally published on Physicians Fitness. Republished with permission.


Jessica Cahen, M.S., CMSS, ACE-CMES, RTS is a Course Facilitator for Exercise Professional Education, a rapidly-growing Continuing Education company for exercise professionals, offering the Certified Muscle System Specialist™ course as well as custom-tailored CEC courses for groups upon request.

Jessica holds a Masters Degree in Clinical Exercise Physiology and the Certified Muscle System Specialist™ designation.  She has also earned the distinction of being one of only a handful of ACE Certified Medical Exercise Specialists in the Midwest.  She practices as a Certified Muscle System Specialist™ at Physicians Fitness in Columbus, OH.