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A Doctor, a Lawyer, and a Quitter Walk into a Bar…

No, it’s not the beginning of a joke. It’s just what happens every time I go into a bar. I have a medical degree and a law degree…and if there were a professional certification for quitting, I’d not only have it, but I’d display it in my office as proudly as I do the other two.

I consider myself an expert-level quitter, and it’s a distinction to which I firmly believe more people should aspire.

Why? Because quitting is the most underrated tool for achieving success not only in business, but in relationships, personal happiness and well-being. In fact, it’s one of the most underrated self-care tools out there.

The walls of Amazon’s virtual bookstore are overflowing with self-help books telling us to live our best lives. But rarely do they address one of the main reasons that people get stuck in something less than their best life: no one tells them how to get through the necessary quits to leave whatever isn’t working. They just tell you to transform your life and strive to make progress…until one day you’ve suddenly arrived at said ideal life.

And quitting ain’t easy.

It’s a process fraught with unwarranted stigma -partially thanks to unhelpful sayings like “quitters never win and winners never quit.” And if you can get past the stigma, you’re then smacked in the face with many of the fears associated with quitting, like wondering if another opportunity will arise to replace whatever you’re leaving, or wondering what people will think about your quitting, or fear that the new scenario you find post-quit won’t truly be more fulfilling than the original one.

It’s enough to make someone just stay put. Stuck in the less-than-ideal.

But it doesn’t have to be. Quitting can be your best friend. But not just regular old quitting. Strategic quitting.

Now I could tell you theoretically about why strategic quitting is the greatest thing since avocado toast, but I think it will be slightly more effective if I show you what it looks like in the real world. Because at this point you may be (understandably) wondering how someone with both medical and law degrees has ever quit anything.

I quit all the time.

Because what does it take to get through that much school and training? Time, money, and energy. How was I able to make sure I had enough of all three to get through? By quitting things that were draining my time/money/energy and focusing only on the things that served me.

So what does it look like in action? Before medical school, I was a multimedia designer, but the sinking feeling I got while sitting in coding classes learning new programming languages told me this was not the field for me — so I quit. I started completely fresh and decided to try to get into medical school.

And after I finished medical school and residency in family medicine, I finally got to my sports medicine fellowship, as I had decided I wanted to be a sports doc. However, I got that same feeling when I was doing sports medicine — like something just wasn’t right. Mostly I didn’t like that the hours were somehow both 9 to 5 and nights and weekends, leaving little time for myself.

So I quit. Again.

At this point you may be thinking, “whoa…but what about all of that time and money you wasted on medical school?” Well that’s where strategic quitting comes in. With regular quitting, I would have walked away from medicine altogether and tried some other career that may have had all the same attributes I disliked about medicine.

But with strategic quitting, you take stock of exactly what parts of a job or relationship, etc. aren’t working for you, and quit only those…and you stay vigilant not to get in new situations that have features that didn’t work for you previously. And as long as you learned something from a past situation, it wasn’t a waste.

So I quit the long hours of sports medicine, and took a job where I make my own schedule. And in the future, you can bet that I won’t be taking any new jobs that have night or weekend hours, because I learned from my previous experience. And as for the money and time I spent? Well having spent a lot of time or money on something that isn’t working for you is a terrible reason to spend more time or money on it. Sticking it out doesn’t get you back your investment, it just gets you further from where you want to be.

Now you may be plenty happy in your job or relationship, but what about some smaller things that may be stressing you out?

Here’s another real-life example. I finished yoga teacher training last year, and during my training I had an unlimited membership to the yoga studio. However, shortly after receiving my instructor certification, I started volunteering with a political campaign and didn’t have time to go often enough to make the membership worth the money, which started to stress me out. Yes, you heard that right, yoga was stressing me out.

So what did I do? Did I quit yoga? Obviously not! I just quit the unlimited membership and switched to a class card, thereby taking away all the guilt and stress I felt over not being able to make it to class as much as I needed to.

Now look at your own life…is there something that brings you stress or causes a sinking feeling in your stomach? Is your body subtly trying to tell you to make a change by giving you heartburn or keeping you awake at night? As a doctor, I can tell you the effects of staying in something that is wrong for you are not minimal. Stress is a leading health risk these days, and a major cause of stress is doing something that’s not in line with your own personal good.

So if your job doesn’t light you up, or your relationship brings you anxiety, or your city just isn’t working for you anymore, I urge you to make close friends with strategic quitting before your body stops whispering to you and starts yelling in the form of chronic pain, depression, anxiety, insomnia, and more.

Strategic quitting is the self-care tool you never knew you needed, but that you’ll never give up once you’ve got it down.

Dr. Lynn Marie Morski is a Quitting Evangelist. She helps people to and through their quits through her book “Quitting by Design” and her podcast Quit Happens, along with speaking and coaching. She is also a board-certified physician in family medicine and sports medicine, currently working at the Veterans Administration. In addition, she is an attorney and former adjunct law professor at Thomas Jefferson School of Law. Visit her website, lynnmariemorski.com

Instructor Showing Health Results On Clipboard To Senior Couple

Respiratory Disease and Exercise: How to help your clients not suck at exercise!

According to the World Health Organization (WHO), hundreds of millions of people suffer every day from chronic respiratory diseases (CRD).  Currently in the United States, 24.6 million people have asthma1, 15.7 million people have chronic obstructive pulmonary disease (COPD)2 while greater than 50 million people have allergic rhinitis3 and other often-underdiagnosed chronic respiratory diseases.  Respiratory diseases do not discriminate and affect people of every race, sex, and age.  While most chronic respiratory diseases are manageable and some even preventable, this is what is known about the nature of chronic respiratory diseases4:

  • Chronic disease epidemics take decades to become fully established.
  • Chronic diseases often begin in childhood.
  • Because of their slow evolution and chronic nature, chronic diseases present opportunities for prevention.
  • Many different chronic diseases may occur in the same patient (e.g. chronic respiratory diseases, cardiovascular disease and cancer).
  • The treatment of chronic diseases demands a long-term and systematic approach.
  • Care for patients with chronic diseases should be an integral part of the activities of health services, alongside care for patients with acute and infectious diseases.

Exercise and CRD

If you are a health and fitness professional, some of your clients may be suffering from a chronic respiratory disease and you may be an important source for relief.  Moderate exercise is known to improve use of oxygen, energy levels, anxiety, stress and depression, sleep, self-esteem, cardiovascular fitness, muscle strength, and shortness of breath. While it might seem odd that exercise improves breathing when one is short of breath, exercising really does help one with respiratory disease.  Exercise helps the blood circulate and helps the heart send oxygen to the rest of the body.  Exercise also strengthens the respiratory muscles which can make it easier to breathe.

Beneficial Types of Exercise

There are several challenges to exercise prescription and physical activity participation in this population, but a large body of evidence demonstrates important health benefits from aerobic exercise.  Resistance training has also been shown to increase muscle mass and strength, enhancing individuals’ ability to perform tasks of daily living and improving health-related quality of life.5

Aerobic exercise is good for the heart and lungs and allows one to use oxygen more efficiently. Walking, biking, and swimming are great examples of aerobic exercise. The guidelines are approximately the same as generally healthy individuals.  One should attempt to train the cardiorespiratory system 3-5 days a week for 30 minutes per session.  One should exercise at an intensity level of 3-4 on the Rating of Perceived Exertion Scale (Scale Rating from 0 Nothing at All-10 Very, Very, Heavy).

Resistance exercise increases muscular strength including the respiratory muscles that assist in breathing.  Resistance training usually involves weights or resistance bands but using one’s own body weight works just as well depending on the severity of the symptoms.  It is recommended that one should perform high repetitions with low weight to fatigue the muscles.  This type of resistance training also improves muscular endurance important for those with CRD.  Resistance training should be performed 2-3 days a week working all major muscle groups.

Stretching exercises relax and improve one’s flexibility.  When stretching, one should practice slow and controlled breathing.  Not only does proper breathing help to deepen the stretch, but it also helps one to increase lung capacity.  One should gently stretch all major muscles to the point of mild discomfort while holding the stretch for 15 to 30 seconds, slowly breathing in and out. Repeat each stretch 2-3 times.  Stretching is an effective method to warming up and cooling down before and after workout sessions.

When exercising, it is important to remember to inhale in preparation of the movement and exhale on the exertion phase of the movement.  An individual should take slow deep breaths and pace him/herself.  It is recommended to purse the lips while exhaling.

Use of Medication

If an individual uses medication for the treatment of respiratory disease, he/she should continue to take the medication based on his/her doctor’s advice.  His/her doctor may adjust the dosage according to the physical activity demands.  For example, the doctor may adjust the flow rate of oxygen during exercise if one is using an oxygen tank.  In addition, one should have his/her inhaler on hand in case of a need due to the increase of oxygen demand during exercise.

Fitness professionals can effectively work with those who have a chronic respiratory disease providing them with a better quality of life through movement.  You as their health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness.

You can join CarolAnn at the Medical Fitness Tour Chicago, October 25-26; she’ll present a session on Respiratory Disease and Exercise at the conference.

CarolAnn is also the author of a course with PTA Global on Respiratory Disease and Exercise. More info at ptonthenet.com/mfef

Known as the trainers’ trainer, CarolAnn has become one of the country’s leading fitness educators, authors, and national presenters. Combining a Master’s degree in Exercise Science/Health Promotion with several fitness certifications/memberships such as FiTOUR, ACSM, ACE, AFAA, and LMI, she has been actively involved in the fitness industry for over 25 years. She is currently the Founder and Director of Education for Chiseled Faith, a Faith Based Health and Fitness Program for churches. Visit her website, www.CarolAnn.Fitness


  1. 2015. NHIS Data; Table 3-1. www.cdc.gov/asthma/nhis/2015/table3-1.htm
  2. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
  3. CDC, Gateway to Health Communication and Social Marketing Practice. Allergies. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Allergies.html
  4. World Health Organization http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf
  5. Eves ND, Davidson WJ. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Applied Physiology Nutrition and Metabolism. 2011;36(Suppl 1):S80–100. [PubMed]
Walk Park

The Hijacking of Exercise

I have been involved in exercise personally and professionally since I was in grade school.

My introduction to exercise was initially through sports.

I remember doing the President’s Council on Physical Fitness assessments while in grade school in the late 1960’s. (I know, I know – I’m getting old). For those readers as ancient as I, can you remember those tests?

Max pull-ups
Sit-ups (one minute)
30-foot shuttle run
One-mile run

There were comparisons for each test that placed the individual in some percentile of a normative value system. This set of supposed tests of fitness were the standard in schools for decades. They underwent some changes in the 80’s and I think are now known as “Let’s Move”.

The idea that fitness is attached to some performance standard is alive and well. In the modern philosophy of exercise process, known as “Functionalism”, the exercise and fitness enthusiast are all considered “athletes”. This notion of exercise being an athletic endeavor, and that all exercisers are treated like (and should consider themselves) as athletes, dominates the fitness and – even physical therapy – landscape.

I think sports has hijacked exercise.

I think this is a mistake.

Now, don’t get me wrong. I understand and support that athletic individuals participating in sports need to exercise. I understand that athletes working to achieve high levels of physical capabilities use the exercise process in ways that a non-athlete might never even consider, let alone need, to achieve a modicum of fitness. But, athletes seem to accumulate physical injury. When the exercise process expects the exerciser to push their limits in order to squeeze out ever-increasing physical performance feats, an injury is not far behind. Getting injured using exercise for general fitness is not fitness. Why would a non-athlete want to pursue exercise under these conditions?

It sometimes seems as if the modern message of “everyone is an athlete” coming from the exercise and fitness community to the general population, most of which are not athletes and have no interest in sports, dissuades the non-athlete from pursuing exercise. The images used to promote exercise are composed of athletes pushing their physical limits and expressing the pain and discomfort that comes with that pursuit. This can be intimidating to the non-athlete. The exercise processes used to exercise individuals under the “everyone is an athlete” paradigm are high risk and unnecessary for general fitness and wellness.

My thesis is this: The message and delivery of exercise and fitness as an athletic endeavor truncates the already difficult process of getting more individuals to start and maintain an appropriate lifelong exercise process that achieves the powerful benefits regular exercise can bestow.

My answer is this: The modern message needs to be more balanced in order to avoid stereotyping exercise as only for those that are athletically inclined. One that presents images of average everyday folks exercising and enjoying non-athletic physical pursuits. It is our responsibility as exercise and healthcare providers to stimulate and inspire more of the general population to engage in a regular and reasonable process of exercise. One that does not tell them that they have to be an athlete, nor will be treated like one during exercise whether they like it not. Let’s create messaging that encourages and exhorts participation at all levels for all classes. Let’s move away from just offering a protocol based athletic exercise process. Let’s customize the process to not just the client’s physical needs but their mental perspective of self and how they want to experience exercise.

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. 

almonds bowl

Testing Your Almond Knowledge: Can you pass this quiz?

Almonds are a popular snack not just because they are nutrient-rich, but primarily because they are crunchy and taste yummy. In this day and age when snacks are replacing meals, you want to reach for good tasting, health-promoting snacks. Almonds can fit that bill!

I learned a lot of almond information while on a tour sponsored by the California Almond Board. Here’s a quiz to share what I learned—and for you to see how much you know about this popular sports snack.

True or False: Eighty-percent of worldwide almonds are grown in California?

True. The Mediterranean climate and rich soil in California’s Central Valley is one of only 5 places in the world that is ideal for growing almonds. The majority of these almonds stay in the US, with exports going primarily to Spain, India, China/Hong Kong, and Germany.

True or False: Growing almonds requires a lot of water?

True. Almonds, like all nuts, need more water per serving than fruits and vegetables do. That’s because making the protein and fat in nuts requires more energy and water than does making the carbohydrate in fruits and veggies. The amount of water required by almonds is similar to other nut trees. Because water is limited and expensive, the almond industry has created innovative ways to improve water usage. For example, the vast majority of almond growers have installed new drip irrigation systems that water the roots of the tree instead of the whole grove. By using automated moisture sensors, the trees do not get over-watered. These better irrigation practices have led to almond growers being 33% more efficient with water usage than 20 years ago. Plus, the water actually grows four products: the edible almond, shells for livestock bedding, hulls for cattle feed, and skins for beer. Nothing gets wasted!

True or False: The average American eats about a quarter of their calories from snacks?

True. People are eating more snacks and fewer sit-down meals. The typical American consumes about 24% of daily calories from snacks. Most snacks eaten before lunch tend to be selected mindfully, with an eye to nutritional value. Evening snacks, however, tend to be more about reward and comfort (think fewer fruits and vegetables; more sweets, salty snacks, and baked goods). Obviously, making smart snack choices are key to having a good sports diet.

True or false: An ounce of roasted almonds (23 almonds) contains 160 calories, but the body can use only 130 of those calories?

True. The official portion size for almonds is 1 ounce (28 grams). That equates to about 23 almonds, one large handful. Count them out to learn how many fit into your palm! A one-ounce portion offers 160 calories, but due to digestibility, one-ounce of roasted almonds actually contributes only 130 calories of good nutrition to your daily intake. Almond butter, however, is more digestible and contributes the full 160 calories.

True or False: Almonds are fattening

False. Almonds are not inherently fattening. That is, almond eaters are not fatter than almond abstainers. A study with overweight and obese adults who ate about 1 to 1.5 servings of almonds daily for 12 weeks reports they lost more body fat (and more belly fat) than those who did not eat almonds as a part of the reducing diet. (1) Because almonds are satisfying, they can actually help you save calories. That is, a handful of almonds will curb hunger for a lot longer than a handful of Skittles.

True or False: Almonds are an excellent source of protein.

False. While a one-ounce handful of almonds offers 6 grams of protein, I rate that a good source of protein­—but not an excellent source. You could get three times that protein from 160 calories of chicken.

If you are a vegetarian, the protein in an ounce of almonds is the same amount you’d get in a half-cup of pinto beans. Along with the protein in the almonds comes other important nutrients: fiber, health-protective monounsaturated fats, vitamin E, potassium, and yes, even a little calcium (25-percent of what you’d get in a glass of dairy-milk).

True or False: For vegetarians or people who are lactose intolerant, almond milk is an equal swap for dairy milk.

False. While almond milk is a vegan alternative to dairy milk, it is nowhere near as nutritious as dairy milk, or for that matter, soymilk. I consider almond milk as really being “almond juice” with minimal nutritional value (other than the calcium the producer adds to the product). An 8-ounce glass of almond milk offers only 1 gram of protein, as compared to 8 grams in the same amount of dairy milk. (Read labels to compare brands of almond milk; some might have added pea protein or other nutrients.) Young children, in particular, do not get the protein they need from almond milk. If you choose to avoid dairy, the smarter choice, nutritionally speaking, is soymilk.

True or False: Almonds contain monounsaturated fats that reduce your risk of heart disease.

True. Almonds are a heart-healthy snack. By trading traditional snacks (chips, cookies, candy) for almonds, you can not only reduce your intake of salt, sugar, and saturated fats, and also boost your intake of healthy fats, fiber, protein, magnesium, vitamin E and many other vitamins and minerals. Research suggests almonds help people lower their bad LDL cholesterol when they swap their “junk snacks” for almonds.

True or False: Almonds appeal to today’s health-seeking consumers.

True. If you are looking for a satisfying snack that is vegan, gluten-free, preservative-free, GMO-free, lactose-free, and health promoting, look no further than a packet of almonds. Crunch away!

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

Disclaimer: While the California Almond Board sponsored the trip to observe the almond harvest and processing of the almonds, the opinions are my own.


1. Dhillon J, Tan SY, Mattes RD. 2016 Almond consumption during energy restriction lowers truncal fat and blood pressure in compliant overweight and obese adults. Journal of Nutrition 146(12):2513-2519.


Member Spotlight: Health and Wellness Coach and WRAP Facilitator in Homestead, FL

Name: Linda Fredrick
Location: Homestead, Florida
Website: auspiciousfish.com
Occupation: Health and Wellness Coach/WRAP (Wellness & Recovery Planning) Facilitator

How do you or your business help those with chronic disease/medical conditions or who need pre & postnatal care?

I started my company, Auspicious Fish®, specifically to help folks navigate life shifting changes — whether they sought those changes, or had them thrust upon them with changes in their health. My coaching services help clients understand themselves, what engages them, what motivates them and how to overcome the inevitable stumbling blocks they will encounter as they work toward achieving their vision of wellness. My WRAP (Wellness & Recovery Planning) services do that as well as provide a detailed framework for clients to build a highly individualized Wellness and Recovery Plan. This is particularly helpful for anyone learning to live well with a chronic condition.

What makes you different from all the other fitness professionals out there?

I am committed to using only client centered, evidence-based programs which meet gold standard criteria. I am proud to be among the first in the US to receive certification from the National Board of Health and Wellness
Coaching and I am currently the southernmost WRAP Facilitator in the US. I have a unique skill set with a diverse background and I’ve worked with diverse populations, at the end of the day, all folks have one thing in common, they want to be listened to. They want the information and power of being a partner in their care. Auspicious Fish gives clients that rather than squeezing them into a one size fits all program.

What is your favorite activity or class to participate in?

I love being outside, but it’s pretty obvious the beach is my go-to for self restoration. As for classes, ZUMBA! I love the energy of it. I find myself smiling when we all get into the zone and the moves are in sync, and then we all laugh as the timing goes awry and that’s okay!

What is one piece of advice that you would give other fitness professionals about working with special populations or those who need pre-& postnatal care?

There is always HOPE. Everyday we see the amazing ability of the body to heal and the mind to find a way. If approached with an experimental mindset, we can encourage clients to try on new ideas and tools and discard those that don’t work — not as failures, but as a part of a natural exploration process. This can keep the ‘deflated
motivation disorder’ at bay. What type of community activities are you involved in? I am a strong believer in volunteering so both as an individual and professional. As an individual, I am committed to supporting youth develop in my community through Scouting and I serve in several capacities. As a professional, I do the usual
health fairs and community wellness seminars but I also look for unique opportunities to promote the idea that wellness is fun not just work. This past year, I volunteered at a roller derby exhibition and sponsored a Tea Duel. (yes, psychological warfare with tea cups and biscuits — it’s hilarious!)

What is one of your favorite memories involving working with someone who has a health challenge or disability?

Hmm, hard choice! All of my favorites come down to those moments when the client has achieved their goal, when they didn’t know if they could, and often no one else believed they would. One of my favorite memories involves a client recovering from a back injury, who had the added challenge of being diagnosed with Bipolar Disorder as a young adult. Despite the fact that she was now a mother of grown children, for most of her life she was relegated to a back seat position in her healthcare and indeed much of her life. After a few months, the lightbulb turned on for her, and she said, “I never knew I could have a choice. I feel like I can take control and say what I need to say.” She decided to go on to explore a job training program that would allow her to work with her limited mobility.

What would you like to see change, develop, or emerge in the future of healthcare and the fitness industry?

While I greatly value our medical community, more of them need to embrace the benefit of becoming full partners with the fitness industry and client centered, self directed care practices into the mix. It’s a hard shift to attain for medical personnel who, historically, had to have all the answers. Now we know wellness lifestyles are the best form of preventative care, and our fitness professionals deserve parity in the new partnership paradigms. But we mustn’t leave out the client as the driving force of these partnerships or we eventually alienate the client.

And what are you doing to make this happen? 

I intentionally search for like minded professionals in the health and wellness field who share the belief and create partnerships with them, both in my physical and virtual communities. Also, while It’s a challenge to stay on top of technology I make an effort to do so. of course the tool is only useful when it’s used. Many clients have a love/hate  relationship with their fitness wearable and maybe their home systems but I see great strides in the future for applications that will merge the tech of these devices and give individuals and their providers more meaningful information.

What is your favorite fitness/inspirational/motivational quote?

Einstein said, “Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” I think that sums it up nicely.

Anything else we should know about you?

I was born with a pretty severe clubbed foot. Luckily my father was military and I was ‘re-engineered’. I would never have won any awards for sports as a kid because I had to struggle so HARD to overcome the limitations! In fact, I was often shut out in phys ed classes and recess because of it. Even yoga is still challenges me though I began practicing as a teen and have continued throughout my life. The fact remains my tendon and bone structure is different on that foot. It wasn’t until my mid 40s really that I began to challenge the idea that progress wasn’t possible and began to move away from my work in traditional casework in mental health and search for better ways to wellness. I won’t win medals but now in my mid 50’s I’m more fit than ever. I do fun runs (such as the bubble run picture at right), and do what excites me, like training to hike a portion of the Appalachian Trail in late October.

View Linda’s MFN profile >


Keep the Goal

I think you’d agree that we are in an age of information overload. Between internet search engines and social media, ALL the advice and opinions are available to you. It is really easy to get caught up in the shiny object syndrome. It is hard to Keep the Goal.

The noise of everything can become too loud! And it’s hard to tune out that noise.

But I’m here to remind you today to stay focused on your goal(s). If you’re doing something that’s working, don’t change it up because of a shared article you read on Facebook about a new wonder food or supplement! Yep, don’t go down that rabbit hole…

Is your goal weight loss? Then, take daily actions that are focused toward that – clean whole foods, weight and cardio training, hydration, stress management and good sleep. If the goal is performance for an endurance race, follow your training plan. If the goal is pain management, do the required exercises. Even your goal is just basic movement and get in the gym 3x/week, stick to that, ok?

It’s a simple concept, but it’s not easy to execute when everything is so loud and in your face. Quiet the noise and keep things out of your face by staying laser focused on you.

So, stay focused on the goal and take the daily necessary steps to get there. If you aren’t sure what those are, hire a coach (like me) who can help you get there.

In conclusion, Keep the Goal!

Originally printed on Move Well Fitness blog. Reprinted with permission.

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD. With almost two decades in the industry, he’s worked with a wide range of clients, including those with health challenges like diabetes, osteoporosis, multiple sclerosis, hypertension, coronary artery disease, lower back pain, pulmonary issues, and pregnancy. Maurice is also a fitness educator with Move Well Fit Academy and NASM.  


Heart Disease and the Framingham Study

Heart disease that can consist of coronary heart disease, heart attack, congestive heart failure, and congenital heart disease is reported to be the leading cause death for men and women in the United States which is one of the reasons it is becoming recognized as a national problem. With the inclusion of high blood pressure and elevated cholesterol it is estimated that about 60 million Americans have a cardiovascular disease (CVD).


In 1948, scientists and participants set out on an ambitious project to identify the risk factors for heart disease. During this time very little was known about the general causes of heart disease and stroke but it was becoming immediately recognized that the death rates from CVD was steadily increasing and becoming an American epidemic.1

The goal of the Framingham Heart Study was to help identify the factors and contributors to CVD by following participants (5,209 men and women between the ages of 30 and 62) from the town of Framingham, Massachusetts over an extended period of time who had not developed CVD or experienced a heart attack or stroke.2

Additional efforts were made to the study in 1971, 1994, and 2002 with new generations of participants. Throughout the years, the Framingham Study has identified the major CVD risk factors that can include:

These risk factors can be modified by those who wish to minimize or reduce their risk. The identification of this major CVD risks has been recognized as the cornerstone of CVD and the strategies that are employed for prevention and treatment in clinical practice settings.2

To date, the Framingham Heart Study continues to serve as a critical element towards achieving a better understanding of CVD and assisting with the development of diagnostic tools for the condition.

While cardiovascular disease is still recognized as a national problem that is the leading cause of illness and death in the United States, the performance of the Framingham Heart Study serves as the foundation for addressing this issue.

Abimbola Farinde, PhD is a healthcare professional and professor who has gained experience in the field and practice of mental health, geriatrics, and pharmacy. She has worked with active duty soldiers with dual diagnoses of a traumatic brain injury and a psychiatric disorder providing medication therapy management and disease state management. Dr. Farinde has also worked with mentally impaired and developmentally disabled individuals at a state supported living center. Her different practice experiences have allowed her to develop and enhance her clinical and medical writing skills over the years. Dr. Farinde always strives to maintain a commitment towards achieving professional growth as she transitions from one phase of her career to the next.


  1. Scutchfield & Keck, 2003
  2. Framingham Heart Study, 2016
healthy middle aged man workout at the beach

The Aging Athlete

If you’re reading this you are likely interested in beginning or improving in a recreational activity or sport. You might want to train for stadium football, a rec team, fun runs, obstacle courses or something as major as a triathlon. While you may be anxious to jump right into a training program there are a few things you should consider such as your current activity level, current physical condition (i.e. chronic conditions, aches, past surgeries, injuries), and knowledge of physical fitness programming.

Who is the Aging Athlete?

The aging athlete can be anyone who needs to rethink their recovery strategy as it relates to the rigors of the desired/continued activity due to the aging process. Likely this is any athlete or recreational athlete in their 30’s, 40’s and beyond. The National Strength and Conditioning Association (NSCA) states, that while the cardiovascular endurance and muscular strength of older competitors or athletes are truly exceptional, even the most highly trained athletes experience some decline in performance after the age 30. As such participating in recreational sports or activities fully depends on your health and preparation and the sport or activity you are pursuing.

Before you begin you should consult with your primary health care provider (PHCP). If you’ve been cleared but inactive for any period of time complete a physical activity readiness questionnaire (PAR-Q) to ensure nothing has changed. Additionally, if you have a chronic condition, chances are your PHCP has already discussed exercise with you, and most likely gave you some general guidelines. A chronic condition defined by the Center for Disease Control and Prevention (CDC) is a condition that lasts one year or more and requires ongoing medical attention or limits activities of daily living or both. This does not preclude you from participating in recreational sport or activity necessarily, but it is a factor to be taken into consideration. You may be asking yourself, is this something I can do? Is this something I can do on my own? Do I need a trainer? How do I know what trainer I should go to?

Is this something you can do on your own?

The answer is yes, with this caveat. Unless you have a background in exercise, likely there will come a point when you will need someone to reach out to for advice. If that happens reach out to a professional with the appropriate qualifications. Frequently, I have heard gym members echo comments questioning the validity or worth of paying someone to do something they can do on their own. They often do not realize or recognize that hiring a professional who is educated and experienced in strength and conditioning is more than just programming exercise, it’s also injury prevention. Activities, movements, or lack of recovery may not have caused injury in the past, but as we age the dynamic changes, and to remain healthy and injury free, we must change. Commonly people just work around injuries, avoid certain exercises, or reduce intensity and accept that’s just part of aging, so they press forward. However, if they would have consulted with a fitness professional they may have found a better more comprehensive solution.

Working around past injuries is a useful and worthy approach, if done correctly. However, the truth is that most of those injuries are a result of their habits. Perhaps they have been predominantly inactive, spending much of the day sitting. Perhaps they were training hard without any or little variation in intensity, without any or little variation of joint movement, and without any or little variation in program design. These all add up to repetitive stress injuries. Common repetitive stress injuries often appear as bursitis, arthritis, tendonitis, and lower back pain/injuries.

That is not to say you cannot do this on your own nor that you need a trainer or will always need a trainer. It is to communicate the point that we do not inherently know how to exercise properly. Many in their youth have participated in sports, and the programs they were taught may be missing some crucial elements to keep them healthy and pain free. These elements are missing sometimes because years ago we did not have the information we have today. Sometimes it’s because we only remember some of what we were taught, and other times it’s because we have aged, or our physical needs have changed and require a change in programming.

If you’ve never exercised before, it’s recommended you either take a few classes (not a fitness class such as spin, but an instructional class offered at a gym, YMCA, or college) or hire a trainer for a short period of time. Perhaps you are on the fence on taking a class or seeing a trainer. If that is the case, ask yourself these questions:

Are you developing aches and pains that are lasting for longer periods of time?
Do you know what a plane of motion is, and how to exercise your joints in each plane of motion?
How often do you change your program? Do you have a chronic condition?
Are you developing lower back, knee, or hip pain?

The answers to these questions can give you a good sense of whether you may benefit from seeking professional assistance or instruction.

The Key is Individualized Programming

Assuming your destination is recreational sports and activities or even occupational activities the program should be appropriately progressed in intensity, duration, and specificity to get you to your desired destination.  Repetitive stress injuries occur because one set of tissues in the body/muscle/joint continue to be challenged in the same way at the same spot over, and over again. By taking your occupation, past activities or recreational sports into account your program can be structured to bring the proper balance of strength, and flexibility to the areas that may be neglected or strained. Below is a list of general guidelines if you’re choosing to do this on your own:


  • It is recommended you undergo a health screening by your PHCP prior to beginning
  • Cardiovascular and resistance training are both recommended, intensity in both depend on your medical clearance, training status, and sport of choice
  • Perform exercise through a full pain free range of motion, and do not exercise if the joint is in pain or inflamed3
  • Listen to your body, and when in doubt seek guidance from a qualified fitness professional

Resistance, Cardio and Sport Specific Exercise

  • Warm-up for 5-10 minutes with low-moderate aerobic activity and calisthenics, and perform static stretching after the warm-up and at the end of the workout2
  • For cardiovascular/endurance perform 20-60 minutes of large-muscle aerobic activity most days at an intensity of 60%-90% of age-predicted heart rate1
  • If you have been sedentary or are just beginning, resistance train no more than twice a week, allowing 48-72 hours to recover, as you progress you can workout daily with different muscles groups at different intensities each day2
  • Focus on mastering basic resistance exercises then implement exercises that are more sport specific, as well as balance, free weights, multi-directional, multi-joint, and power/agility exercises2
  • Begin doing 8-12 repetitions of a weight that is equal to 50% of your maximum weight and gradually increase to up to 80% of your maximum weight, weight should be lifted and lowered in a controlled manner, and at a slower speed in the beginning (2 seconds for the lifting phase, and 2 seconds for the lowering phase), for 1-3 sets2
  • Take 1-3 minutes of rest between sets3
  • Avoid holding your breath during exercise2
  • Once you’ve advanced to power/speed training, perform 1-3 sets per exercise at 40-60% of your maximum weight and 6-10 repetitions at a high (but controlled) speed2
  • Train each joint in multiple directions (ie. planes of motion). For example, the hip can perform flexion, abduction, adduction, or circumduction.

What Should I look for in a Trainer?

If you elect to see a trainer there’s a few things you want to look for. You want a trainer with verifiable experience, an accredited certification/college degree, and liability insurance. The fitness industry is largely unregulated and there is some debate among which certifications are the best. A good place to start is the MedFit Network as trainers have to meet professional criteria in order to be listed. Additionally, it is important that their experience and background suits them to your specific needs. If you have a chronic condition, dealing with pain or have past injuries these are areas you want to be confident they can serve. As you are either engaged in athletic activity or want to engage in athletic activity it is important that the trainer have a solid foundation of periodization, and athletic performance. Quack science and self-professed gurus have no place here. The trainer’s practices should be founded in the principles set forth by the American College of Sports Medicine (ACSM), and the National Strength and Conditioning Association (NSCA). Most trainers offer a free assessment, which gives them an opportunity to learn about you, and you to learn about them. Be sure to meet with several trainers and ask for client references. This is a reasonable request and a quality trainer will not take offense. Lastly, if something feels off, seek a second opinion.

When undertaking rigorous activity and sport, there are other services you may want to consider, or discuss with your PHCP such as massage therapy, nutritional counseling, or chiropractic care depending on your needs. Remember one size does not fit all and by keeping your health in balance now you will be able to continue to enjoy the activities and sports you love for years to come.

Jeremy Kring, holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com


  1. Jacobs, P. L. (2018). NSCAs essentials of training special populations. Champaign, IL: Human Kinetics.
  2. Haff, G., & Triplett, N. T. (2016). NSCAs essentials of strength training and conditioning. Champaign, IL: Human Kinetics.
  3. Brown, L. E. (2017). Strength training se/National Strength and Conditioning Association. Champaign, IL: Human Kinetics.