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Doctor and patient

Health Coaches Don’t “Diagnose or Treat Disease”: Those Words and Others Don’t Belong in Our Vocabulary

It is nothing new that there’s inevitable overlap between the practice of medicine and providing sound health coaching. Ideally, there should be a seamless continuum between the two endeavors, but that could only exist where there is a continuum of cooperation and respect. Health Coaches need to be careful with how we describe and present our work. While health coaching is a vibrant movement, it is still a junior partner to “traditional medicine” and for self-preservation; we should seek to avoid direct “turf wars” with Physicians.

The most balanced approach requires continuous consideration of the distinctions between these complementary fields. While there will always be principled differences, the practical applications change steadily along with knowledge and technology. The most prudent approach is for Health Coaches to simply concede medicine’s proprietary terms. We need to understand them, and can use them, but anytime we do we must draw distinctions that educate our clients about the difference in objectives and procedures of these complementary endeavors. In that sense, there are no “forbidden words”, but there are plenty of places where lack of clarity in purpose and practice can cause problems. Some of the major terms that should be conceded include:

Patient, practice, diagnosis, cause, disease/pathology, prescribing, medicine, treatment, management, effectiveness, intervention and cure.

Health Coaches should strive to embody in our mission what comes from consideration of those terms. We develop relationships with clients, we are not in the practice of seeking responsibility for treating patients. We are helpful guides in exploring the vast, common sense resources of the field of wellness, not prescribing proprietary agents or using medical modalities to treat disease. We act as individual guides on a quest that prioritizes personalized discovery and anecdotal utility, not practitioners who prescribe antidotes approved by impersonal population-based investigations.

Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization.

We look for associated (natural) influences that can combine to re-establish balance, not for a cause or diagnosis that be controlled by the use of a foreign/artificial agent. Health Coaches are about beings, synergy, elasticity, balance, flourishing and optimization. Medicine predominantly lays claim to systems that don’t display those features.

“The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.”

Each term, of course, could be expanded upon greatly as time permits. Back in 1903, Thomas Edison said that “The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” Edison was simply wrong. Health Coaches should focus on care of the human frame and diet which are the wellsprings of function and flourishing. That’s a big task that requires ever-increasing knowledge and wisdom.

Unfortunately, the human “machine” is inevitably subject to decay of various sorts and severities. Medicine will always have a very important place in providing resources for comfort where nature has been pushed to failure – which is not an uncommon occurrence. The line between those positions shifts over time, but until utopia breaks out, reality will maintain a vast market for both types of emphasis. For now, it is up to the junior partner to hold up their banner while keeping the peace.

Originally printed on the FDN blog. Reprinted with permission.


Reed Davis is a Nutritional Therapist and has been the Health Director and Case Manager at a wellness clinic San Diego for over 15 years. Reed is the Founder of the Functional Diagnostic Nutrition® Certification Course, offering functional lab training, data-driven protocols, tools and leadership you need so professionals confidently solve your client’s health issues and grow your career.

brain-digital-image

The Neuroscience of Mind-Body

In an era where neurological disorders and mental illness run rampant, effective and scalable non-pharmacological interventions are desperately needed. Luckily, science continues to demonstrate the efficacy of exercise-based interventions in improving cognitive, neurobiological, and mental health outcomes in a variety of populations. Multiple modalities of exercise, such as aerobic training and resistance training, continue to demonstrate improvements in several measures associated with brain health. While aerobic exercise has received a majority of the spotlight over the past couple of decades, other forms of exercise have also moved to the forefront of the exercise-neuroscience literature.

brain-neurons

Parkinson’s Disease and Exercise

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease.  Unfortunately, the incidence of Parkinson’s disease has not declined, and its impact is seen in all races.  This is due in part to the fact that the population of the world is greater than ever before and increasing. In addition, people are living longer than in previous generations, and the baby boomer generation, one of the largest generations in history, has reached old age.

Risk factors for Parkinson’s disease include:

Age: Risk of Parkinson’s disease increases with age.  The average age of onset for this disease is 55 years and the rate of incidence increases steadily until the age of 90.

Gender: Men have a higher risk for Parkinson’s disease than women.

Family history: Individuals with a family history of Parkinson’s disease are at a higher risk for Parkinson’s disease. Moreover, it is said that those with affected first-degree relatives double their risk of Parkinson’s disease.

Agricultural work: Individuals exposed to pesticides and herbicides have a greater risk of developing Parkinson’s disease symptoms. Drinking well-water and living in rural areas have also been associated with an increased incidence of Parkinson’s disease.

Head Trauma: Head trauma can be a risk factor for Parkinson’s disease as is seen in the case of boxers. One study showed that trauma to the upper cervical region, head, and neck was a risk factor for Parkinson’s disease. However, in some cases it took years for these symptoms to appear.

The exact cause of Parkinson’s disease is unknown.  Regarding the molecular events that lead to the development of this disease, there is still some uncertainty in terms of what causes the neurodegeneration seen in Parkinson’s disease. The current hypothesis is that Parkinson’s disease may result from the interaction between environmental factors and genetic susceptibility.

The primary symptoms for PD are deficiencies in motor performance due to the loss of the dopamine pathways in the brain. Decreased dopamine production in the substantia nigra in the brain causes the 4 primary motor symptoms:

  • Bradykinesia: described as slowness in the execution of movements while performing daily activities.
  • Rigidity or Stiffness: caused by an involuntary increase in tone of the limbs and axial musculature.
  • Resting Tremor: Found primarily in the arms and hands and can be socially bothersome. Resting tremors are less disabling since they often vanish with the initiation of activity (especially in the early stages of Parkinson’s disease).
  • Postural Instability: manifested in a slow speed of walking, shortened stride length, narrowing of base of support, and leaning towards one side.

Exercise should be targeted for the primary motor symptoms with exercise and occupational therapy to improve quality of life. Recommended program components include:

  • Posture, gait, mobility
  • Fall risk reduction
  • Cardiorespiratory health
  • Strength and function
  • Depression and Anxiety
  • Joint health

Exercise prescription for clients with PD includes: (ACSM)

  • An individualized program
  • Cardiorespiratory: use guidelines for healthy adults
  • Muscular Fitness: use guidelines for healthy adults
  • Flexibility: slow, static exercises for all major and minor joints in the body including the upper torso, spine, and neck.
  • Neuromotor Exercises: help with balance, gait, and postural instability. Clinicians use a gait belt or parallel bars to ensure safety depending on the severity of the symptoms.  Include functional exercises to improve ADLs and quality of life.

PD exercise therapy includes intervention with many kinds of exercise modes. Both personal training and group fitness have been successful in helping to manage the disease and reduce the symptoms. There is not strong evidence at this point to show that exercise prevents PD, but it is believed that exercise may play a role.  Exercise is however the mainstay for symptom management and slowing disease development.

 


June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.

References and Resources:

pregnancy-fitness

High Altitude Sports During Pregnancy: Are the Risks Worth the Thrill?

Research in the field of prenatal fitness has conclusively shown that exercise during pregnancy provides health benefits to mother and fetus, and the American College of Obstetricians and Gynecologists encourages pregnant women without complications to continue or start a fitness routine during pregnancy. Although prenatal exercise is considered safe for most pregnant women, some activities are more controversial because of potential injury risks or because of the environment where they take place.

Many women enjoy downhill skiing, cross country skiing, and snowboarding, and have questions about whether it’s safe for them to continue these sports during pregnancy. The safety of these sports, as well as the effect higher altitudes, may have on pregnant women and their fetuses, are important factors to consider before taking part in high altitude snow sport activities.

Several studies have examined pregnancy outcomes and complications comparisons between pregnant women who were exposed to high altitudes versus pregnant women who did not travel to high altitudes. One study (1) that examined the association between high altitude exposure and self-reported pregnancy complications found that there is a low rate of complications for pregnant women who participated in activities and travel in high altitude areas.

Another study (2) suggested that pregnant women who traveled to high altitudes (determined as above 2440 meters, or 8,000 feet) did not have a higher risk of pregnancy complications when compared to women who did not have high altitude exposure. These women were more likely to have preterm labor than those not exposed to high altitude, but the percentage of preterm labor in the study were below the US population rate of preterm births. There was a statistical increase in newborn oxygen need at birth, but no complicating issues were associated with this.

Although these study results are reassuring, more rigorous research is needed to provide further information regarding the safety of high-altitude exposure and exercise during pregnancy.

There are key factors that may influence the degree of hypoxia-related pregnancy complications for the fetus and mother.

  • Duration of exposure
  • Intensity of activity
  • Degree of altitude
  • Difference between altitude at home and sport

These factors should be taken into consideration by a pregnant woman who is planning to travel to (and exercise in) high altitude. If she lives in a low altitude area, it’s a good idea to build in several days of progressive altitude increase to allow time for her to adjust. If possible, she should vary the duration of her exposure by sleeping at lower elevations. She should be aware of signs of hypoxia (see list below) and move to a lower altitude if she experiences increased symptoms.

Complications from exercise at higher elevations may be compounded by increased dehydration as a result of dry and cold air. Maintaining adequate fluid intake and allowing for rest breaks to hydrate can avoid this issue.

The key to avoiding altitude-related issues is being aware of how altitude is affecting the body and pregnancy and knowing the signs and symptoms of hypoxia.  As long as a pregnant woman continues to feel well and isn’t experiencing any issues while exercising at higher altitudes, she can feel confident that her pregnancy won’t be negatively affected.

*Signs of Hypoxia

  • Feeling dizzy and lightheaded
  • Persistent cough
  • Headache
  • Vision changes
  • Extreme fatigue
  • Nausea
  • Confusion and mental status change

It’s important also to consider the risks of some types of snow sports. Downhill skiing and snowboarding require good balance, and as pregnancy progresses, the changes in a woman’s center of gravity can affect her balance and make her more prone to falls. Also, the risk of collisions with other skiers and snowboarders is a concern, especially when slopes are crowded. Careful consideration of a woman’s skill level and difficulty of the ski slope should be weighed, and modifications such as switching to easier slopes and terrain can reduce risk.


Catherine Cram started her company, Prenatal and Postpartum Fitness Consulting, in order to provide current, evidence- based guidelines maternal fitness guidelines to health and fitness professionals. She was a contributing author for the textbook, Women’s Health in Physical Therapy and co-authored the revision of Exercising Through Your Pregnancy with Dr. James Clapp.  Her company offers the certification course, “Prenatal and Postpartum Exercise Design” which provides continuing education credits for over 30 health and fitness organizations, including ACSM, ACE, ICEA, and Lamaze.

 

References

Wilderness Environ Med, 2016 Jun;27(2):227-35. doi: 10.1016/j.wem.2016.02.010. Outdoor Activity and High Altitude Exposure During Pregnancy: A Survey of 459 Pregnancies. Keyes LE1Hackett PH2Luks AM3.

Senior-and-Trainer

MS and Circuit Training

I was recently told that a very high percentage of people with Multiple Sclerosis (MS) DO NOT exercise. As a fitness professional with MS, that blew me away. I wish I could find the actual percentage but I don’t think that’s a statistic high on the priority list for any studies! But with all the time I spend in the MS community educating about fitness, I tend to believe that this is a fact, as I hear so many say they don’t exercise because they don’t know how. This is where I have found my niche to fill the gap.

According to Multiple Sclerosis News Today, The first study on the benefits that exercise can provide to people with MS was published by University of Utah researchers in 1996. The participants improved their cardiovascular, bladder and bowel function, increased their strength, experienced less fatigue, developed a more positive attitude, and suffered fewer bouts of depression”.

With information and proof like this, why don’t more people with MS get into the gym, exercise at home or do some form of fitness program? My answer is lack of knowledge and fear. When you don’t know where to start, don’t understand how to find an exercise program that fits you, or you are not educated on the benefits of exercise for MS, you become immobilized and therefore do nothing. I believe this is the main reason why the percentage of MSers who aren’t exercising is so high.

This is where becoming a MS Fitness Specialist makes a ton of sense. Providing a proper workout plan for those with MS is not just a great thing to do, but a much-needed service.

There is a very good selection of workouts that can benefit people with MS, and one of these programs is circuit training. This type of workout gets your heart rate up and strengthens your muscles at the same time. You will never get bored in a circuit training program.

With little rest between each exercise, you rapidly go from one exercise machine to another to work different muscle groups. Depending on the intensity of the workout, you may use 8 or 12 different machines performing a different exercise and muscle group each stop.

I have my clients do 10-12 reps at each machine, using a time under tension (TUT) pace, lasting between 120–144 seconds, before moving on to the next stop.

To keep things exciting and motivating, you can change it up a bit by switching the exercises you do for each body part. A circuit training workout can be done at the gym with equipment, at home with dumbbells and resistance bands, or on an outdoor fitness trail by alternating push-ups and squats with fast-paced walking, jogging or biking.

You will need 20-30 minutes to take a MS client through the workout. The great thing about circuit training is it is easy to adjust the level of intensity by the rest time spent, the pace you perform each movement (TUT), and the speed in which you go through the circuit. A program like this works all areas of your body so you get an effective full-body workout in a short amount of time, as long as you select an exercise for each muscle group: core, arms, chest, back, shoulders and legs. The cardiovascular aspect of the program is taken care of in the time spent at rest. The less rest between sets and exercises, the more your heart rate will be elevated and the more heart-healthy cardio benefits you will receive.

There are many benefits in a circuit training routine as it is aerobic, low-impact and strength training all wrapped up in one program. You get the benefits of muscle building and toning along with a cardio workout. So, if you’re looking for a full-body workout for a MS client that can be don in 30 minutes or less, circuit training checks off all the boxes. The exercise options are endless as well with the variety of machines, resistance bands, free weights and bodyweight movements that can be incorporated into this style of program. Circuit training is an excellent workout choice for MS once you completely understand how to do it at a level that is safe yet challenging for the client you put through this program.

I want to see the percentage of people exercising with MS to overshadow the percentage that do not. You have a tremendous opportunity to be a solution to avoid in the fitness industry by becoming a MS Fitness Specialist and working with a community that needs you.


David Lyons, BS, CPT, is the founder of the MS Bodybuilding Challenge and co-founder of the MS Fitness Challenge with wife Kendra. He has dedicated his life to helping people with MS understand and be educated on the importance of fitness in their lives. He is an author and sought after motivational speaker, dedicated to helping others by sharing the lessons gained from his life experience.  His most recent book, Everyday Health & Fitness with Multiple Sclerosis was a #1 New Release on Amazon at its release. He is the 2013 recipient of the Health Advocate of the Year Award; in 2015, he received the first ever Health Advocate Lifetime Achievement Award, and the Lifetime Fitness Inspiration Award in Feb 2016. In 2017, David received the Special Recognition Award from the National Fitness Hall of Fame.

Physical therapist gesturing thumbs up besides senior woman on yoga ball

Medical Fitness – A Win for Professional and Patient

Medical Fitness is a growing trend in health care. Medical Fitness helps extend basic healthcare from the classic and formal model of a person being a patient, receiving treatment and being discharged entirely, to after care professional services. Medical Fitness is the integration of ongoing fitness, wellness and preventive care under the supervision of health professionals such as, physical therapists, exercise physiologists, personal trainers, nutritionists, acupuncturists, chiropractors, massage therapists, mental health practitioners, health and wellness coaches, yoga professionals and more.

Physical therapist gesturing thumbs up besides senior woman on yoga ballMedical Fitness is appropriate for many types of conditions such as arthritis, diabetes, orthopedic conditions, pre and post natal, heart disease, fibromyalgia, stroke, cancer, mental disorders,  and others. When properly implemented, Medical Fitness is a win-win for both patient and health professional.

Medical Fitness Advantages for the Patient

First, after discharge from the formal healthcare world, the patient can be referred to a variety of health professionals educated in the patient’s condition, providing both a continuum of care and a multi-discipline approach. For example, a person discharged from physical therapy after a total knee replacement might be referred to a certified personal trainer facility educated in post-rehabilitation of a total knee to continue to make further functional gains and improvements. If that person needed help with weight loss, perhaps a referral to a nutritionist would be included. If they also had issues with coping with their diminished function, a consult with a specialist in mental health might be provided as well.

Second, many times the medical facility in which care was provided will have a Medical Fitness component associated with it. Direct referral to this type of facility can provide the patient with security and confidence, being familiar with the facility and with the knowledge that the new health professional is familiar with their condition and diagnosis.

Medical Fitness Advantages for the Health Professional

First, by being part of a Medical Fitness community the health professional can refer a discharged patient for follow up care, secure in the knowledge that their patient will be cared for by an ancillary care professional who is trained and certified to provide a proper continuity of care plan along with the appropriate goals and treatments.

senior man with trainerSecond, by referring to a Medical Fitness multi-discipline team, the health professional receives security that if their patient has any other issues, those concerns will be addressed. For instance with the example of the total knee replacement patient needing assistance with weight loss or nutrition consults, (treatments that don’t fall under the umbrella of physical therapy), the physical therapist is assured their patient will be helped to achieve a better transition back into their “non patient” status.

Third, when the health professional refers their patient into a Medical Fitness wellness and preventative care environment, the chance for overall improved outcomes is increased. Patients learn better self-confidence in caring for themselves, taking charge of their own health and lifestyle. If a patient’s condition begins to backslide, the wellness program professionals can help make sure the patient gets referred back to the health professional in a timely manner.

In conclusion, Medical Fitness benefits all involved. Quality of care is improved. Patients receive access to multi- discipline care and can learn to take charge of their life. Health professionals receive security of proper continuity of care and gain improved patient outcomes.


Douglas Feick, PT is a licensed physical therapist in Texas, with emphasis in orthopedics for over 15 years. He is President of BioEx Systems Inc, a software company providing software solutions for physical therapists, athletic trainers, chiropractors, dietitians and personal trainers. His hobbies include scuba diving, raising bees and he is an avid skydiver.

Jicama-Broccoli-Coleslaw

The Naturopathic Chef: Jicama Broccoli Coleslaw

This salad is perfect as the weather warms up. The taste and health benefits are amazing. Bone building, hormone balancing, and heart health are just a few of the wonderful “side effects” of one of my most requested recipes. It’s a fresh and vibrant side dish to liven up any BBQ, picnic, or potluck.

Ingredients

  • 1 cup jicama, julienne
  • 1 cup broccoli florets
  • ¼ cup flat leaf parsley, chopped
  • ¼ cup purple onion, minced
  • ¾ cup grapeseed oil mayonnaise (Follow Your Heart brand)
  • ¼ cup lemon juice
  • 2 tsp fresh horseradish, shredded
  • 1 Tbsp honey

Directions

Toss first four ingredients together in a bowl and set aside. Combine Grapeseed oil mayo, lemon juice, fresh horseradish and honey in a separate bowl.  Pour over vegetables and toss to coat.  Chill and serve.

Phyte Bites

Horseradish relieves pain, reduces inflammation, and stimulates the metabolism.

Broccoli is a powerful weapon against hormone-based cancers (prostate, cervical, breast, and lung.)

Parsley is high in Apigenin and is a great bone strengthener. Harvard School of Medicine thinks Apigenin may possibly lead to a cure for ovarian cancer.

All of the ingredients listed contribute to strong bones, ligaments, and tendons. Grapeseed oil is the only oil we know of that actually clears plaque from our arteries. This combination of ingredients is a powerhouse of antioxidant activity.


Get more great recipes from Tina Martini — her book, Delicious Medicine: The Healing Power of Food is available to purchase on Amazon. More than a cookbook, combining 20+ years of experience, along with her love of coaching, cooking and teaching, Tina offers unexpected insights into the history and healing power of clean eating, along with recipes to help reduce your risk of disease and improve overall wellness so you can enjoy life!

Affectionately referred to as The Walking Encyclopedia of Human Wellness, Fitness Coach, Strength Competitor and Powerlifting pioneer, Tina “The Medicine Chef” Martini is an internationally recognized Naturopathic Chef and star of the cooking show, Tina’s Ageless Kitchen. Tina’s cooking and lifestyle show has reached millions of food and fitness lovers all over the globe. Over the last 30 years, Tina has assisted celebrities, gold-medal athletes and over-scheduled executives naturally achieve radiant health using The Pyramid of Power: balancing Healthy Nutrition and the healing power of food, with Active Fitness and Body Alignment techniques. Working with those who have late-stage cancer, advanced diabetes, cardiovascular and other illnesses, Tina’s clients are astounded at the ease and speed with which they are able to restore their radiant health. Tina believes that maintaining balance in our diet, physical activity, and in our work and spiritual life is the key to our good health, happiness and overall well being. Visit her website, themedicinechef.com

fitness-exercise-at-home

Exercise is great, but it shouldn’t injure you!

“Many people trying online routines during the coronavirus pandemic are finding it’s not so easy to do them right.” A recent article in the Wall Street Journal, titled “New Home Workouts Come With New Aches and Pains”, has pointed out an unfortunate side effect of folks exercising at home during the pandemic shelter-in-place order.

They are getting injured.

Social media has been saturated with home-based exercise programs as the fitness industry works hard to get, and keep, individuals exercising during this intense, but temporary, period of partial social isolation and staying at home.

We wish we could tell you that under any and all conditions you should always be pursuing exercise because it is always good for you…

It’s not!

“This is chess, not checkers” —Alonzo Harris: Denzel Washington’s Character in the movie, Training Day

Of course, we commend everyone who has made the wise choice to begin and sustain a regular routine of physical exercise.

Exercise is simple, right?

It looks so easy when the trainer and therapists are doing it on the video.

There is a name for the exercise, there is a way it is supposed to be done, you do it, and it helps you!

Right?

Apparently not.

Physical exercise is certainly presented like checkers: a relatively simple and easy game that doesn’t require a lot of skill and deep thinking… some quick fun for the family.

But physical exercise is really more like chess. Chess is a complex game that requires deeper thinking, patience, and skill. So is physical exercise.

Why?

Because the human body is really complicated!

Because exercise places stress on your body.

There are hundreds of muscles, joints, tendons, ligaments, nerves, bones, and on and on.

These structures and tissues have varying properties and tolerances for handling stress.

Some are better at it than others. If you haven’t exposed some of them to the demands of the physical stress of exercise in awhile, or you have had surgeries, previous injuries, or diseases that negatively affect some of your body’s tissues then they just might not be ready.

Instead of being a great thing to do to promote health and wellness, physical exercise becomes a process that degrades it.

But there is a solution.

1 Take honest stock of your own body. Ask yourself some questions:

  • How long has it been since I really exercised and moved the way that an exercise is “supposed” to be done?
  • Have I had injuries or surgeries that could have compromised parts of my system

2. Put the ego aside. Expediency is the wrong mindset for exercise. Physical exercise is a long game.

3. Start slowly and do not assume that because an exercise looks easy it will be.

4. Pay attention to body signals. You’re the expert on your bodily experience. Trust that. If it doesn’t feel right to you stop or modify.

5. Take on the perspective of what is the least amount of exercise I need to do to reach my goal, not the most. Overdosing exercise is the problem.

6. Seek professional guidance and support from a qualified healthcare professional and trainer.

  • Get a thorough pre-exercise assessment to identify any areas of your body that need to be shored up prior to engaging in unrestricted physical exercise.

7. Take Dr. Nicholas DiNubile’s Advice: “The managed dose of exercise that will do the most for you – without harming you – needs to be measured out for you alone.” (1)

If you have been injured while exercising, see your physician to make sure nothing really serious has happened that will require medical attention. When the doctor gets done, and there is no serious problem, seek out an Exercise Professional from the MedFit Network to discuss how we can help measure out the right dose of exercise – just for you – so you can exercise safely and effectively for life.


Co-written by Charlie Rowe and Greg Mack.

Charlie Rowe, CMSS joined Physicians Fitness in the fall of 2007 after spending 9 years as the Senior Personal Trainer at Oak Hill Country Club in Rochester, New York. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist since joining Physicians Fitness. Charlie has earned the Cooper Clinic’s Certified Personal Trainer, the NSCA’s Certified Strength and Conditioning Specialist, the American College of Sports Medicine Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and American Council on Exercise Certified Orthopedic Exercise Specialist Certifications. 

Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms, and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

References

(1) DiNubile, MD, Nicholas A. Framework: Your 7-Step program for healthy muscles, bones, and joints, 2005, Page xix.