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couple-balancing

Step up to Better Balance

When we are young we take our balance and coordination for granted. Yet as we progress through the years sometimes our muscles get weaker and joints get tighter and our posture changes all contributing to decreases in balance skills.

Everybody knows to stay fit a person needs to engage in cardiovascular exercise, stretch what is tight and strengthening what is lax. But too often people miss an important aspect that is critical for functional fitness, which functional balance. The ability to maintain balance is a very complex skill that requires a vast array of systems to interact simultaneously.  Even the basic activity of walking involves a complex sequence of neurological and muscular interactions.

Functional Balance is critical for everyone from the world-class skier to the wounded warrior trying to regain his or her ability to walk again.  Functional balance is a combination of both static and dynamic balance.  These two parts of balance are critical for maintaining an independent and fully functional life!  It is easy to see how the loss of functional balance can inhibit even the simplest activities of daily living, to a person’s involvement in recreational sports.

Many common chronic conditions from arthritis to neurological issues can influence a person’s ability to maintain proper balance.  Some research published in the Archives of Physical Medicine and Rehabilitation 2015 discussed that person’s with Osteoarthritis and Rheumatoid had better mobility, and more stability after participation in a balance training program. Person’s with Ankylosing Spondylitis had improved quality of life after a seven months of balance training. Another study found that individuals with Fibromyalgia had less falls after 6 weeks of balance training.

What is balance? 

Balance is defined as “the ability to maintain the center of a mass over the base of support”.  This is evident even when you see rocks strategically placed on top of each other to produce sculptures.

Types of Balance

Static balance means remaining stationary in one place for a period of time. A common balance assessment to measure static balance is to stand on one foot for a period of time. A functional example of static balance is standing on your tiptoes while reaching for something without losing one’s balance

Dynamic balance is when the body is able to maintain in a state of balance while in motion or transition. Functional examples are being able to move effortlessly and gracefully from one place to the next at any given speed, or to be able to change direction quickly while still maintaining balance. Dynamic balance is critical for performance in most sports but is underappreciated until deficits set in sometimes seen in aging or in chronic health condition.

Extrinsic & Intrinsic Factors that Influence Balance

The occurrences of Chronic Conditions are often classified as “intrinsic” factors influencing the likely hood of diminished balance.  Many common chronic conditions from arthritis to neurological issues to sensory losses can impair balance.

Extrinsic Factors come in all shapes and sizes. Many extrinsic factors that contribute to falls are preventable. The following is a list of things that are commonly listed reasons people fall and visit the ER.  These can occur no matter what your age or fitness level.

Home Hazards

Loose carpets, slippery rugs, ill-fitted slippers, things left on the floor, clutter, reaching for objects, poor lighting, bathroom showers and tubs.

Outdoor Hazards

Wet/icy surfaces, uneven surfaces, hurrying, climbing ladders and wearing inappropriate shoes.

Effects of Medication

Many medications/drugs interfere with balance. Whether the medication is prescribed or is an over-the-counter medication it can still have a deleterious effect upon a person’s balance and coordination. Taking more than four medications increases a person’s risk of falling.  Also, it has been found that older clients (65yrs and over) cannot tolerate medications the same way a younger person can. It also goes without saying that alcohol; marijuana and other recreational drugs can impair balance and coordination.

Other Factors that Influence Stability

COG = center of gravity

Base of Support = the wider the base of support the better the stability of the person.

Friction = often called the glue/traction between the surface and the supporting platform.

Supporting systems = having enough strength to support the person. Thus the use of a cane, crutches and walkers are examples of aides to improve the supporting system.

More and more research supports the incorporation of balance training in a comprehensive fitness program.

Six Steps to Better Balance

  1. Avoid Disuse, which will cause atrophy. Use it or lose it! If flexibility and muscle development are not done on an on-going basis, the strength and flexibility will be lost! Maintain adequate strength and flexibility in joints and muscles.
  2. Keep core muscles firm.
  3. Maintain good lower leg and ankle strength and flexibility.
  4. Practice proper posture and head placement.
  5. If you suspect a deficient in the sensory, visual or neurological systems seek medical attention. No amount of balance training will help if a dysfunction exists.
  6. What you do today determines your tomorrows. Practice balance work daily. Some people practice while brushing their teeth or walking to work.

Balance Assessment

  • Stork Stand. Can the client stand on 1 leg for 30-60 seconds without wobbling all around?
  • Can the client get up and down from a chair in 30 seconds?
    • If under 40 years of age, over 15-20 times = good
    • If over 60 years of age, over 10-12 times = good
  • Sit to stand and walk 10 feet and turn around and return to your seat.

Summary

One thing is for sure when it comes to balance, change will occur! Diminishes in balance range from a simple embarrassing slip to a major fall leading hospitalization. It is up to the person whether the change is positive or negative.  The good news is balance can be maintained and often improved at any age or condition.  It is never too late to make positive contributions to better balance.

For more specific information and exercise protocols from Dr. Knopf, check out his book, Stability Workouts on the Balance Board

You can also read some of our other articles on the topic,  4 Exercises to Increase Balance for Seniors and Strategies to Improve Your Balance and Stability


Karl Knopf, Ed.D, was the Director of The Fitness Therapy Program at Foothill College for almost 40 years. He has worked in almost every aspect of the industry from personal trainer and therapist to consultant to major Universities such as Stanford, Univ. of North Carolina, and the Univ. of California well as the State of California and numerous professional organizations. Dr. Knopf was the President and Founder of Fitness Educators Of Older Adults for 15 years. Currently, he is the director of ISSA’s Fitness Therapy and Senior Fitness Programs and writer. Dr. Knopf has authored numerous articles, and written more than 17 books including topics on Water Exercise, Weights for 50 Plus to Fitness Therapy.

running legs

Advanced Running: Establishing the Mindset for Success

I took my first yoga class in more than a decade today and it wasn’t pretty. I was stiff, ungainly and awkward and had to literally fight the desire to stop! I found out my instincts were right about my body – it IS strong and fast but when it comes to balance and flexibility – and mind-body awareness – I am way behind the “8 ball”.

What I also learned today is that to continue to follow my program of the past 10 years as it is currently constructed would NOT benefit me in the long run. Injury and other issues WILL surface if I don’t respond to what I have discovered today so I will share some ideas and thoughts with you in this article that may help prevent you from making similar mistakes that I have made in my own running life.

Lessons from my first yoga class

I realized that being 66 the way I am today is truly a blessing – and a curse as well. My thoughts are forming about this new process I am entering and the impact it will have on me in the years ahead if I respond appropriately – and remain flexible and unafraid of the unknown. I can honestly say I felt WAY of out of my comfort zone today and that IS a good thing. I needed a “wake up call” and I got one loud and clear today. Whatever you do with this information on running and establishing the mindset of success and achievement, it will finally be defined and determined by how much – and how often – you step outside your comfort zones.

We ALL do what we love and avoid those things that make us uncomfortable in the end. Will I go back once a week – this next time with my daughter Lisa and share my discomfort with her support? YOU BET I will!. Remember I said earlier that I am a solitary soul and have run almost my entire life alone? Well, now I need to share this part of my journey with others who know more about this subject called balance and flexibility than I do. After all these years I have another long process to start and the challenge of discovering new things about myself that I knew would NOT be easy or comfortable to learn AT ALL!

The reality is my hamstrings and my lower back are REALLY tight and it will take me time to “undo” what I have done to them after all these years of hard training. I will need to remain committed to developing – and maintaining – my flexibility and balance in the years ahead for sure. What is in this for you? The knowledge that you MUST engage in balance and flexibility activities – either in a group or on your own if you are willing to do the work yourself. This will ensure injury is minimized as you engage your body in high intensity (sometimes of course) and challenging training to improve your fitness levels and enhance your quality of life.

What do I do about this now that I know more about my limitations?

The answer – or answers – to this important question will be given to me over time I am sure. What I am not sure of at this point is how I much work I must do on my own between classes to ensure my own development as a runner –and athlete. To be honest with you, I am a bit in shock about how poorly I performed in class today. The women kicked my butt for sure – but I am going to absorb this information and work on a plan of changing my approach to the training I will do this year. I set aside January of 2013 as a “month of recovery” because of the intense 2 year period I am just emerging from after setting records for mileage and speed. I also found out today how exhausted I am mentally and physically so these are the “red flags” I am now aware of at this particular time in my life.

What “red flags” are waving in your life and are you aware of their presence at all? I walked a mile on the treadmill at 3.5 after class today because that is all I could do. I was dismayed (to say the least) at how the yoga class had affected my legs! I will have NOW decided to “follow through” on my pledge to make January a TRUE recovery month – or I will PAY dearly in the months ahead for sure. This information I am sharing with you now is brand new to me. I am not 35 or 45 or 55 or even 65 now. I am 66 and finally am recognizing what limitations “feel like”. Your limitations will become apparent to you as you begin to train with more intensity and increased volume – just as they have for me. We cannot avoid paying a price for whatever we do – or don’t do – in our running and training lives.

I will continue running and lifting weights but now I will add additional stretching, flexibility and balance work at the end of each workout. I will attend one yoga class per week and run different programs at slower speeds to enhance my recovery period. Since I did not take recovery time during the last two years of my running life I will evaluate recovery periods more clearly when they are apparent to me and learn to add them when I need them. This is the “mindset of success” I am referring to in the title of this article. The REAL surprise to me is that after all these years of working out and running – and training clients on these principles as well – it is that I am still struggling to follow what I know NEEDS to be done – and WORKS ON MYSELF!

Conclusion

Take what I am sharing in this article and APPLY it to your own training. I am secure in the knowledge that as I continue to learn – and in some cases like today “re-learn” what I already know to be true – that we NEVER truly “KNOW IT”. We are continuously exploring territory in our lives – whether it be running or the yoga discipline – that we have never seen before. We know what we need to do if we accidentally “bump into new knowledge” but the unknown remains ever-present.

Today I merely learned what I suspected for a long time – that to run really fast and train with success – I (we) must never forget the basic principles of training: Remain open-minded, dedicated and committed to our purpose, passionate about what we do – and love, and finally BE WILLING TO CHANGE what needs to be changed in order to continue to be successful!

Tomorrow I will run slowly (force myself actually “for now”) and work on incline (hill stride) training in order to start working my legs differently than all the hundreds of runs I have done over the past 10 years! I will be patient and open to this next phase of my running life because now I KNOW I have to do this if I intend to NOT breakdown somewhere in the future! A little discomfort today will be well worth feeling in order to be GREAT tomorrow – and all the tomorrows that will hopefully still be coming my – and your — way as well!

Article reprinted with permission from Nicholas Prukop. 


Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach and fitness professional with over 25 years of experience. His passion for health and fitness comes from his boyhood in Hawaii, where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

Concept healthy food and sports lifestyle. Vegetarian lunch.  He

Sports Nutrition: Elite vs. Recreational Athletes

Nancy, do you offer different nutrition recommendations for elite athletes as compared to recreational exercisers? I am highly competitive, work out intensely, and often wonder if I am eating to be the best athlete that I can be.

Answer: Sports nutrition recommendations are based on the assumption we all want to get the most benefits from our workouts so we can perform to the best of our abilities. Because each elite athlete and casual exerciser is unique, a one-diet-fits-all approach doesn’t work. Rather, all exercisers want to be curious and experiment with a variety of fueling practices to learn what works best for their bodies. The following compares recommendations I might make for competitive athletes vs. recreational exercisers.

Note: Sports nutrition is a new science. In the near future, with the refinement of personalized nutrition based on genetics, sport dietitians will be able to offer individualized advice. Some athletes might perform better with more fat than carbs, or more beef than beans. Until then, here are today’s science-based recommendations.

Carbohydrate requirements

In this era that pushes fat and protein, carbohydrate deficiency is common. All exercisers can improve their performance (and health) by consuming adequate “high quality” carbs (grains, fruits, veggies) to fuel muscles and prevent needless fatigue. While elite athletes might want to strategically withhold carbs before specific training sessions to trigger performance-enhancing cellular adaptations, recreational exercisers want to focus on fueling well each day in order to have enjoyable workouts. A sports dietitian can help both elite and recreational athletes reach these carbohydrate goals:

Amount of exercise/day gram carb/lb. body wt. gram carb/kg body wt.
1 hour moderate exercise 2.5 to 3 5-7
1-3 h endurance exercise 2.5 to 4.5 6-10
>4-5 h extreme exercise 3.5 to 5.5 8-12

Example: For a 140-lb fitness exerciser who trains moderately hard for an hour a day, carb goals are 350 g (1,400 calories) For the competitive athlete who trains harder and longer, a good goal is 630 g carb (2,500 calories) a day. Divide that into 3 meals (400 to 700 calories from carb per meal) and 2 snacks (100 to 300 calories from carbs per snack). Start reading food labels to see how well you do. You’ll discover a spinach-cheese omelet doesn’t hit the goal.

Protein requirements

A well-fueled competitive athlete with trained muscles requires a little less protein than a novice exerciser who is building new muscle. The range of protein needs (0.6 to 1.0 g protein per pound body weight; 1.2 to 2.0 g/kg) tends to be moot, given most hungry exercisers and athletes consume plenty of protein.

Most competitive athletes can easily meet their protein needs by targeting about 20 to 30 grams protein per meal (a can of tuna) and 10 to 20 g protein per snack (a Greek yogurt). The protein in natural foods is preferable to protein supplements. Natural foods offer a complex matrix of nutrients that interact with a synergistic effect. Plus, they are unlikely to be spiked with illegal drugs and compounds that can lead to a failed drug test.

Fluids

Competitive athletes lose lots of sweat when exercising for hours on end. But so can recreational exercisers who are out of shape and working hard. That’s why everyone who sweats heavily wants to learn his or her sweat rate. You can learn this by weighing yourself (without clothing) before and after an hour of exercise without drinking anything at X pace and in X degrees of heat or cold. For each pound lost, you are in deficit of 16-ounces of fluid. Drink enough during exercise to minimize this deficit. Throughout the day, drink enough to urinate every 2 to 4 hours. (Peeing every half-hour is excessive; no need to over-hydrate!)

Fueling during exercise

For competitive athletes, a sport drink or gel is a convenient and precise way to boost energy during extended exercise over 90 minutes. With a target intake of 60 to 90 g carb per hour of extended exercise, an elite athlete generally prefers drinking a beverage than eating solid food. A casual exerciser might want some tastier orange slices or a granola bar.

Electrolytes

Electrolytes (potassium, sodium, magnesium, and calcium) are readily available in standard pre- and post-exercise foods. Most recreational exercisers don’t sweat enough to lose a significant amount of electrolytesHighly competitive athletes, however, train and sweat for 2 to 3 or more hours in the heat. They should add extra salt to their pre-exercise food (helps retain water and delays dehydration) and consume sodium-containing foods and fluids during extended exercise (endurance sport drinks). Afterward, chocolate milk beats Gatorade for an electrolyte-filled recovery drink. Most sweaty athletes intuitively seek salty chips, soup, or salted foods in for their recovery meal. If you are craving salt, consume salt!

Recovery

Recreational exercisers who train 2 to 3 times a week can easily recover by backing their workout into a balanced meal that contains carbs (to refuel) and protein (to build and repair) muscles, such as oatmeal + eggs; yogurt + granola; sandwich + milk; chicken + rice. Competitive athletes who train twice a day should more rapidly refuel by eating soon after working out. The key is to plan ahead to have the right recovery foods and fluids ready and waiting. While a commercial recovery drink can be handy, a fruit smoothie (made with Greek yogurt) or some chocolate milk does an excellent job. Real foods work well for everyone.

After lifting weights, no need for anyone to immediately slam down a protein shake. Muscles stay in building mode for the next 24 to 48 hours. Regular meals, with protein evenly spaced throughout the day, do the job.

The bottom line

Every exerciser and athlete can win with good nutrition. The key is to be responsible, and plan ahead to have the best foods and fluids available at the right times. Here’s to satisfying results from your hard work!


Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and good guide for soccer, marathoners and cyclists offer additional information. Visit NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

dog

Have a Fit Vacation with Fido

While most people picture their ideal vacation as lazing about on the beach getting roasted by the sun and sipping Mai Tais, you are not like most people. If you’re going to take time off and travel, you want to make the most of it and be active during your travels. A great way to stay motivated is to bring your dog along. When you travel with your pooch, the two of you can spend your time exploring cities on walks, traversing hike and bike trails, and generally being more active than your usual lazy vacationer.

Safety First

Whenever you travel with your dog, you want to remain safe at all times. While many dogs love trying new things, they can also be overwhelmed in unfamiliar situations. Always keep your dog on a leash unless you are in a designated off-leash park. To stay safe even when off-leash, be sure your pup has updated ID tags1 and that their microchip has your current contact information. Dogs shouldn’t go to public places without vaccinations and parasite prevention products, including heartworm medicine and flea/tick/mosquito repellant. If your dog gets in a scuffle with another pooch at the park, be careful not to get in between them; instead, work at distracting your dog to get out of the fray as soon as possible.

Enjoy the Open Road

If you’re going to bring your dog on vacation, keep the locale within driving distance. Airlines may technically be able to “ship” your dog to your destination, but the process of crating, drugging, and shipping your dog in an airplane’s cargo hold is traumatic2 for the little guy. In fact, the Humane Society strongly advises against animals traveling in cargo. Beyond the stress that it causes dogs, airlines also have a habit of losing — and sometimes killing — dogs. Instead of risking it, plan a trip within driving distance so you know your dog is in good hands.

A Lot of Personality

Dogs differ in personalities3 just like people do. While some dog owners know their pup would love a day touring microbreweries in the city by foot, others would feel anxious surrounded by all those strangers’ feet and the smell of alcohol. Keep your dog’s personality and how they respond to situations in mind when planning activities. For instance, don’t take a little dog with short legs on a 10-mile hike up a mountain. Or, if your dog isn’t big on water, don’t book an afternoon kayaking in hopes that this time he will get used to it. Remember: this is your dog’s vacation too — he wants to enjoy it just as much as you do.

Take a Breather

While a fun and active vacation is great, don’t over-exert your pup. Even the most high-energy breeds need to rest. Be sure wherever you’re staying is shaded and cool if outdoors or climate controlled if indoors. Always bring a supply4 of freshwater and a travel bowl that your dog is comfortable using. Whether hiking, biking, kayaking, or simply walking around the city, your dog needs frequent water breaks to stay hydrated and healthy. Finally, it’s okay to spend a little time apart — your dog doesn’t have to be the center of the social spotlight 100 percent of the time. If you are staying in a dog-friendly room and only plan to be gone for a couple hours, he should be fine hanging out there for the time being. If you want to take a little longer than a couple hours, look into a local doggie daycare5 or pet sitter that will watch your pup while you shop, go to a museum, or do whatever not-so-dog-friendly activity you want to do.

When you bring your dog on vacation, you can’t sit around and be lazy. Beyond the daily activity a dog needs, you have to be mentally alert and stay on top of their safety. Dogs generally shouldn’t fly — you’re going to want to plan a road trip for this excursion.  Keep your pup’s personality in mind, and don’t put him in a situation that will cause anxiety. Finally, find ways to take breaks so your dog doesn’t get too worn out by this vacation.


Henry Moore is the co-creator of FitWellTraveler. The site blends two of his favorite subjects (travel and health) to provide readers with information about how to get the most out of both.

References:

1 Dog Park Safety Tips – Angie’s List
2 United Airlines had most animal deaths in 2017… – Market Watch
3 Dogs Have These 5 Major Personality Types – I Heart Dogs
4 Planning on Taking Your Dog on Your Next Vacation? – Whole Dog Journal
5 What’s the benefit of doggy daycare… – Mother Nature Network

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.

Expand your Education to Work More Effectively with these Clients!

Check out CarolAnn’s 4 hour course with PTontheNet, Respiratory Disease and ExerciseThe goal of this course is to educate health and fitness professionals on how to effectively implement exercise training techniques and work with clients that suffer from various respiratory diseases to help develop strength, flexibility, balance, breathing, and improve their quality of life.  Click here to learn more about the course.


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

References

  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]
baby-boomers2

Which exercise is most important for older adults?

As a kinesiologist who specializes in exercise programming for older adults, I am often asked which exercise is the most important to do regularly.

Well, you might not like my answer!  An older adult who wants to live an active and exciting life needs to be a “Jack Of All Trades” when it comes to exercise, making time for many different training techniques.  Here’s why:

As we get older, the aging process takes a toll on most physical functions, such as muscle strength and cardiovascular endurance.

A way to illustrate this is through “Aging Curves”. Look at this illustration (below) and see how function improves early in life as we grow and mature, then begins to decline during adulthood.  The amount of decline is not set in stone and is modified by our lifestyle choices.  Research has demonstrated that function declines more slowly in those who are physically active (red curve) and declines more rapidly in those who are sedentary (blue curve).  Without a doubt, staying active is the key to an active and exciting older adulthood!

However, there is no single exercise that benefits all parts of the body.  So, in order to keep any of our aging curves from plummeting to the disability threshold, we need to include exercises for cardiovascular fitness, muscular strength/power, flexibility, balance, and agility in our training programs. Or, put it in another way, we need to become a “Jack of All Trades”!

Are you a fitness professional interested in learning more on this topic? Check out Dr. Thompson’s 4 hour course with PTontheNet, Exercise Programming for Active Older Adults.


Christian Thompson, PhD is an Associate Professor in the Department of Kinesiology at the University of San Francisco and founder of Mobility Matters, an exercise assessment and program design platform designed to help fitness professionals and clinicians work with older adults. Christian has published scientific articles on exercise programming for older adults in peer-reviewed journals such as Medicine and Science in Sports and Exercise, Journal of Aging and Physical Activity, and Journal of Applied Research.

diabetesmanagement

What Fitness Professionals Need to Know About Exercise and Diabetes

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

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

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

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

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

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

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

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

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

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

#4: Exercise is the best medicine there is

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

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

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


Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise.

stress-woman

Stress Management in the Modern World

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

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

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

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

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

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

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

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


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

Physio assisting elderly woman during exercise with power band a

Treating Chronic Health Conditions: A Guide for the Fitness Trainer

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

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

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

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

d) You like figuring out puzzles?

e) All of the above.

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

The Center for Managing Chronic Disease defines it as such:

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

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

Be Prepared

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

Create a Board of Advisors

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

Scope of Practice

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

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

Empathy and Trust

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

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

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

Recharge Yourself

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

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


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