“I’m so fed up with my weight!”
“I am so uncomfortable in my clothes.”
“My fat clothes are beginning to be too tight!”
If you can relate to any of these statements, are you among the millions of people who have tried counting macros to get yourself back “on track?”
How do you want to be old? This question was on my mind as I entered my 70’s in August 2016. We never think it will happen to us, but inevitably we all age. Prevention in all its aspects is part of the answer and the remainder is in the choices we make and the habits we develop over a lifetime.
Often clients have nagging pains and aches that do not seem to go away. Pain inhibits seniors from doing more. And they WANT to do more. You need to find out what is causing pain. You might need a team of referral partners. You might figure it out yourself. You start by becoming a Movement Detective !
Analyzing your clients’ daily patterns and repetitive activities as well as how they spend their “down” time will give you many CLUES into what might be causing the aches and pains of daily living. A careful detective asks the best probing questions in a conversational manner. There once was a 70’s TV detective named Columbo. He was always asking questions to get to the bottom of the crime. You need to get to the bottom of the crimes of poor movement and poor sedentary postures.
Once you discover a few clues, then you can incorporate alternative patterns and postures that may be less irritating to the joints and safer for the client. Just because they are still climbing stairs and ladders does not mean they are doing it well. Sewing all day in a hunched over position is doing nothing to improve that chronic neck and shoulder pain. Plopping into car seat and grabbing the seat belt with too much force and rotation is not helping with their back pain. See where this is going?
A. WHAT to look for
Ask your client to answer these questions. Give them a day or two to think about it. Write them down on an index card for them to carry around and be prompted to pay attention to their personal patterns.
Things you do the most often…
B. HOW to set up the crime scene for examination. Clues are in the moves.
C. WHO to refer to if you spot a problem that you are not qualified to address.
Having a strong network of allied health professionals for your client to consider is a level of service most trainers are unable to provide.
Sometimes we notice things that are troublesome like seeing the client wince in pain when doing daily movement. This is when you ask about it and see if they would consider going to the doctor or physical therapist to determine if there is pathology to the pain or other discomforts such GI issues, headaches, etc. (Take detailed notes here. This will help the allied health professional if your client goes to them for diagnosis and treatment).
Important things to remember:
D. WHEN and WHERE to begin teaching the client new ways to do these everyday things.
BETTER and PAIN FREE.
Millions of people over age 65 looking for guidance from fitness professionals who are knowledgeable in exercise, nutrition and lifestyle principles that can help them improve functional mobility, while also preventing and managing chronic conditions to live their highest quality of life. The Geriatric Fitness and Lifestyle Specialist online certificate course will give you insights, strategies and tools to be a successful professional in this rapidly growing market. Learn how to be a valued part of clients’ continuum of care, working with the medical team to improve functional outcomes and positively impact people’s lives.
Holly H. Benson, BS, is a veteran in the Recreation and Fitness industries with over 35 years of administrative and technical experience. She holds two bachelor’s degrees, Corporate & Community Fitness and Recreation Administration, and numerous fitness certifications. She has developed thriving fitness programs for special populations and has passionately focused her career on the much older adult. She currently owns and operates Moving Strong Medical Exercise, LLC in Lakewood, Colorado and provides in-home and virtual fitness training to older adults and persons with chronic medical and orthopedic conditions.
Time, time, time. There never seems to be enough. This is especially true for busy executives and business travelers, not to mention parents, coaches, teacher, doctors, nurses… well, just about everyone in this over-scheduled world. Unfortunately, when Mr. Timecrunch visits, it’s usually our health that picks up the tab.
Once upon a time, food used to be one of life’s pleasures and athletes would eat with gusto. Today, food has become a source of anxiety—Will it ruin my health? Make me fat? Hurt my performance? Food has also become a source of shame—I shouldn’t have eaten so much. I eat well during the day but I’m so bad at night. I’m afraid I’ll eat too much pie at Thanksgiving.
A survey of Gen Z-ers (ages 11-26; born between 1997 and 2012) indicates 60% feel pressure to eat in a way that shows others they eat “healthy.” These student athletes and recent grads —many of whom are fitness exercisers and athletes—feel pressure from social media, if not from their parents, peers, and teammates, to choose a perfect diet (i.e., no chips, cookies, burgers, etc.). And then the binge-eating and sneak-eating happens: shame, guilt, embarrassment.
At the 2023 Food & Nutrition Conference & Exposition (FNCE) of the Academy of Nutrition and Dietetics (the nation’s largest group of nutrition professionals), food shaming was a hot topic. (This topic that is near and dear to the hearts of most registered dietitians (RDs), given “everyone” seems to scrutinize what we eat. Ha!) Food shaming happens not just among athletes at team meals, but also at family dinners, school lunches, and office coffee breaks. Maybe you, too, have experienced shame-producing food situations where you felt like you did something wrong because you ate, let’s say, a sandwich (tsk, tsk) at a team meal, while your teammates ate lettuce leaves?
Athletes can easily end up feeling awkward, inadequate, and embarrassed about their food choices. As one runner shared, “After visiting xxx college for a weekend, I decided against going there because the women on the track team nibbled on only dry salads with grilled chicken for lunch and dinner. I felt very awkward as I refueled my tired muscles with a plateful of pasta with meat balls.”
Unfortunately, in today’s world, we live with a lot of morality around food. Morality can easily spoil one’s peaceful relationship with food. Athletes who have been food-shamed start to focus on eating only (society-defined) “good” foods and eliminate the “bad.” Consequences of being food shamed include feeling bad about themselves, a desire to eat alone, and increased self-criticism of perceived body flaws. (“No wonder I’m so fat. I should eat better…) The more shame athletes feel about their food choices, the more likely they are to restrict what they eat and cut out “white” foods, fast foods, and all fun foods. This can become a slippery slope into disordered eating, if not an outright eating disorder.
While many athletes might wish they could “just eat normally”, they often hold too much shame to seek guidance from the healthcare professional who could help them: a registered dietitian (RD) who is board-certified in sports dietetics (CSSD). If they feel guilty, anxious, and vulnerable regarding their food intake, they’ll fear being judged. “I would feel too embarrassed to honestly tell a dietitian about what I eat…” If that holds true for you, rest assured, a professional RD will not make hurtful or judge-y, guilt-inducing remarks. (Most RDs have been food shamed themselves for enjoying fun foods, tsk-tsk, like Thanksgiving pies and holiday cookies. They understand how uncomfortable it can feel.)
Food-shamed athletes prefer to eat alone, deprive themselves of their “unhealthy” foods—and end up shamefully over-eating them at a time of weakness. According to FNCE speaker Tammy Beasley RD, shame thrives in secret, lonely places of over-indulgence. The RD’s job is to transform that shame into self-compassion and self-kindness; to let athletes know they are not alone; they are not the only humans who have devoured a pint of ice cream in one sitting.
To derail the cycle of food shaming, we need to abandon food morality. Food is fuel; it is not good or bad and what you eat does not determine if you are good or bad. Your goal is enjoy a balanced intake of a variety of nutrient-dense foods with some fun foods included. Please stop scrutinizing and “perfecting” your food intake. Instead, focus on fueling for optimal performance. Trust that eating bread and pasta will not result in your body exploding into obesity, but rather will fuel your muscles and enhance your athletic ability. A cookie or two will not ruin your health forever.
Social media is the number one instigator of food shaming. Given almost all of us use social media, and 57% use it more than 5 hours a week, we can see how food shaming can spiral out of control. Instagram photos with “healthy foods” can easily make anyone feel bad about choosing “imperfect” foods with less nutrient density. Hence, a good place to stop food shaming is at the source: limit the time you spend scrolling through endless triggering posts—and stop following triggering influencers.
Three tips to help transform your “shameful” eating into pleasurable fueling include:
• Let go of being a perfectionist and enjoy being human, like the rest of us. Stop trying to eat a “perfect diet.” An excellent diet will do the job. The goal is 85-90% quality-calories and 10-15% “whatever”, such as an apple some days, and apple pie on other days.
• An excellent sports diet can include some “evil” sugar. No need to avoid all sweets and treats! The US Dietary Guidelines allow for 10% of total calories to come from added sugar. That’s 240 to 300 calories (60-75 grams) of added sugar per day for most athletes, if desired. That’s the amount of sugar in 3 gels, 36 ounces of sport drink, or 24 gummi bears. Sugar in any form helps (re)fuel muscles during and after a hard workout.
• Enjoy a satisfying breakfast and lunch. Stop eating when your body feels content, not just when the food is gone, you think you should, or you’re feeling ashamed because you are eating more than your peers. Adequate daytime meals can curb afternoon and evening (shame-inducing) binges.
• Finally, bring fun back into your food-style. Yes, please shamelessly enjoy fun foods like Thanksgiving pie and Grandma’s special holiday cookies, keeping balance and moderation in mind.
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 info.
Caregivers… what does that mean? Obviously, it means someone who takes care of others. In this case, seniors 65 and older. Now you might say that 65 is a very young age to need caregiving, but not if you have a chronic condition like Parkinson’s, COPD, Multiple Sclerosis, even Type II Diabetes. What happens when these seniors suddenly can’t navigate through their life like they used to and even simple things like getting to the doctor and grocery shopping become extremely difficult to manage? They find they need a break after doing these simple tasks. At this point, they either have their adult children take on these tasks or hire someone to do them. These people — the Caregivers — are a huge untapped market for medical fitness professionals to provide our valuable services.
Do you have connections to this market? They tend to be overlooked as they are not the end-user of our services. Yet, they hold the key to introducing us to pre-qualified clients. There is a huge trust already established between these caregivers and their relatives or employers. The client values and relies on their recommendations, therefore, it is very advantageous to cultivate a presence in their world.
As with all targeted marketing, where do they hang out and what are their needs? Did you know there are entire associations geared specifically toward caregivers with a subcategory of the adult children, or “parents taking care of parents”? If you didn’t, you need to. It is where the goldmine begins, and the subcategory of caregivers we are going to focus on. I have been a caregiver with both of my parents and with numerous clients I’ve worked with. When you tap into this market, you find yourself becoming a caregiver as well. If you are great at establishing trust, you too become a trusted resource for referrals. This is a compelling reason to develop a network of preferred medical practitioners that hold similar values and approach towards care.
From the biopsychosocial aspect of where these caregivers are, they are stressed out from providing care for both their parents and their own children as well. Their parents will fall under the category of Condition Impacted Dependent© to Extensively Dependent and Frail©, meaning they need assistance or improvement with their IADLs (Instrumental Activities of Daily Living). The caregiver demographic will be working a full-time job and juggling their own children, they have very full plates. They literally will not have the energy or time to research and find a qualified professional who can provide in-home medical exercise services designed to make their lives easier. They will welcome any respite in managing their parents’ condition; improving function is added frosting on the cake.
This is just the tip of the iceberg, we haven’t even covered other categories of caregivers, CNAs, housekeepers, assisting hands companies, etc. That and more is covered in-depth in the Geriatric Fitness and Lifestyle Specialist online course, available through MedFit Classroom.
Sharon Bourke has been involved in the health and fitness industry for more than 28+ years presenting, teaching and coaching in fitness clubs and private studios throughout the Washington metropolitan area. She holds certifications in Medical Exercise Specialist, Personal Training Pre-Postnatal fitness, Fitness for Arthritis, and Multiple Sclerosis. Sharon founded the Life Energy Foundation,to utilize her extensive experience and network to create exercise and behavior modification programs and resources to help people avoid becoming immobilized from their chronic conditions.
While wisdom certainly comes with age, so do a lot of other things – like decreased bone density, slowed metabolism, frailty/weakness, sleeplessness, and excess body fat – just to name a few.
The crucial element that I always recommend to people when they say they have been experiencing anxiety, depression, addiction/s of some sort, or even sleeplessness, is exercise. Almost every time, I get a response like, “Does that help you?” Then I get to explain to them why I am so incredibly passionate about fitness. I discuss the fact that I never used to enjoy working out, and, as a matter of fact, still don’t enjoy it, but rather enjoy the feeling it gives me afterwards. This then opens the gateway for me to plead my case as to my passion and explain the many benefits that fitness provides. Exercise has helped people in many ways, but especially in terms of boosting mood and keeping mental illnesses at bay, both of which have a direct impact on addiction.
The reason I live, eat, drink, and breathe all things fitness is because of how beneficial it has been on my own personal wellness journey. Rather than get into my whole life story, I will instead discuss how crucial fitness is to achieve sobriety. When people hear the term “sobriety” they tend to think of only substance abuse — mainly alcohol, opioids, or hard drugs. Not only can sobriety refer to the latter, it can also include medications that an individual was prescribed that their body happened to develop an addiction to, or could even refer to an undesirable behavior or reaction. For example, I had a client who would unconsciously binge eat after an unpleasant encounter with her then-husband, now ex-husband. Eventually, we realized that she was using food, and unhealthy foods at that, to make her feel better after arguments. In essence, she was supplementing her body with sugary foods that would help her body produce the dopamine her body was craving in order to produce the emotional high that would make her feel better. Here’s a different example: a different client would unconsciously lash out at her mother after having been insulted by her critical father. Once we realized why this was happening, I had her incorporate fitness into her daily schedule, right before she went home from school to her parents. Going to the gym every time she got angry with her father resulted in much less conflict between her and her mother, and, in conjunction with therapy, opened up a new line of communication between the two of them.
Another common comment I encounter is after discussing the fact that I generally hit the gym for an hour and a half each day. Almost every single time, I get the exact same response, “I wish I had your energy!” For me, it’s not energy, it’s anxiety. I have discovered that I cannot eliminate it any other way than, as I say, “working out until I pass out,” or at least, until I’m thoroughly exhausted. I have found many other individuals who share my same sentiment, most of whom have also endured several instances of trauma, with the later group showing the most benefit and overall improvement from fitness. There have been numerous studies about the positive impacts that physical activity has on an individual’s mood and overall state-of-being. Exercise has been proven to reduce anxiety by promoting positive adaptations of several physiological processes within the body, such as improving dysregulations of the HPA axis of the brain, restoring abnormalities in monoamine function, producing endogenous opioids in the brain, and increasing BDNF (brain-derived neurotropic factors). There have been studies that suggest that fitness may increase neurogenesis, as well. Exercise has also proven to reduce the psychological effects of anxiety as well, such as reducing anxiety sensitivity, improving one’s sense of self-efficacy, and providing “time out” from one’s daily activities and stressors.
In short, work out to “work it out.” All of the above are reasons why I always suggest to anyone struggling with their mental health that they start some sort of exercise regimen. Whether a person is addicted to a substance or even an undesirable or destructive behavior, fitness will improve the problem and provide results.
Tambryn Crimson-Dahn is a certified personal trainer, fitness coach, nutritionist, and addiction recovery specialist with 4 years of experience. After having worked in the gym industry, she founded and now operates her own company, Crimson Wholistic Fitness. She specializes in overall mental health and wellness, addiction, and relationships and how they can affect mental health.
References
Pilates is a total body exercise method that is highly effective for strengthening and lengthening the entire body. While Pilates is mostly known to improve core strength (the “Powerhouse”), posture, and range of motion, this exercise method can be used to improve respiratory function in those suffering from respiratory diseases. Respiratory diseases include asthma, COPD, chronic bronchitis, emphysema, lung cancer, cystic fibrosis, pneumonia, and now COVID-19. These diseases affect the way one breathes and lowers oxygen saturation that the body needs to function properly. One of the main principles in Pilates is breathing, thus the need to take a closer look at the effects of Pilates on respiratory function.
Joseph Pilates, the creator of Contrology, stated in his book Return to Life Through Contrology: “Lazy breathing converts the lungs, literally and figuratively speaking, into a cemetery for the deposition of diseased, dying and dead germs as well as supplying an ideal haven for the multiplication of other harmful germs.”1
The literature is scarce and sometimes conflicting about the benefits of Pilates breathing related to the respiratory system. However, there are some existing studies that look at the increase in lung volumes, respiratory motion, SpO2, and the reduction in respiratory rate using Pilates breathing exercises. More research needs to be conducted. Refer to suggested reading at bottom of article.
Fitness Professionals & Personal Trainers: Become a Respiratory Disease Fitness Specialist!
Some of your clients may suffer from a respiratory disease and you may be an important source of relief. The Respiratory Disease Fitness Specialist online course will equip you with the knowledge to safely and effectively work with these clients to help improve their quality of life.
CarolAnn, M.S. Exercise Science and Health Promotion, is a 30+ year veteran in the fitness industry educating other health/fitness professionals to increase their expertise and brand influence. She is on the MedFit Education Advisory Board and the head health/fitness educator for FiTOUR. She is currently the Head Instructor at Club Pilates in Athens, GA.
Suggested Reading
References