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Self-Care Is Good For Your Mental Health

Stress and addiction are closely linked together. In fact, stress is one of the key factors(1) of addiction initiation, maintenance, relapse and treatment failure, according to Psychology Today. It is important to differentiate between chronic stress and normal stress. Normal stress can be healthy and even seen as pleasant.  However, chronic stress can have harmful effects on your physical and mental health.(2) One of the biggest sources of chronic stress is in the workplace. As a result, chronic stress can cause employees to turn to unhealthy coping mechanisms such as drugs and alcohol.(3) Luckily, self-care can help you cope with this stress in a healthy way.

Mental Benefits of Self-Care

Self-care has a number of key health benefits. In its most basic form, self-care is simply taking care of yourself. Exercising, for example, can prevent several diseases and disorders including heart disease.(4) However, self-care also has a number of mental benefits as well.

Taking time away to take care of yourself provides you with a way to recharge your batteries. After a long, hard day at work, coming home and taking a relaxing bath can be akin to hitting the reset button. This makes you able to withstand everyday stressors better and enables you to stay focused and more productive when you are working.

But, now that you know the benefits of self-care, how can you actually implement it in your everyday life?


Sleep is important for our mental and physical health, but it is very often overlooked. According to ResMed, sleep helps you heal damaged cells, boost your immune system, and recharge your heart and cardiovascular system for the next day.(5) On top of these physical benefits though, getting the correct amount of sleep also has tons of mental health benefits. No one feels 100 percent when they haven’t had enough sleep.

Sleep deprivation can prevent you from focusing, make your irritable, and cause you to crave unhealthy foods. It is hard to deal with even basic, everyday stress when you haven’t had a good night’s sleep. To help you get the sleep you need, it is important to have a set sleep routine and schedule. While it might seem like you can get more work done if you stay up, it is generally a much better idea to get the sleep you need and come back to your work later.

Take a Break

Taking a break can be helpful when you’re feeling stressed or overwhelmed. No one can concentrate on one task for long, especially if it isn’t a task that is fun or exhilarating. So, instead of trying to focus on a task for longer than you could do accurately, take regular breaks. This can help you stay focused while you do work and decrease the amount of stress you’re under, especially at work. We recommend taking at least one break an hour and possibly even more if the task you’re doing is particularly difficult.

Eat Healthily

Eating healthy can improve your physical and mental health. Healthy food helps to boost your mood and can keep you from being stressed. Keeping healthy snacks close at hand and having regular meals can greatly enhance your overall mood and your mental stability.

Self-care can do wonders for your mental health and can prevent relapse. By preparing your body to handle stress well, you can keep your outlook positive and handle whatever the world throws at you.

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.


  1. https://www.psychologytoday.com/us/blog/science-choice/201705/stress-and-addiction
  2. https://www.verywellmind.com/chronic-stress-3145104
  3. https://rockrecoverycenter.com/blog/work-stress-and-substance-abuse/
  4. https://draxe.com/benefits-of-exercise/
  5. https://www.resmed.com/us/en/consumer/diagnosis-and-treatment/healthy-sleep/what-happens-during-sleep.html

What is INFObesity & Do You Have It?

We want better health, and so we seek better nutrition and health information, and we share that information. And then we seek and we share, some more. And we seek and we share, and we seek and we share and…  we become INFObese – the unhealthy condition of having too much nutrition and health information.

To be clear, information is not the problem and not all information is bad or wrong. Actually there is a lot of better quality nutrition information today.

But just like the fats we eat, while some information is needed, even essential, for our bodies to run better, too much overwhelms, weighs down, and interferes with our body (and mind) running better.

Too much nutrition information is a health risk. Do you have INFObesity?

Assess your current nutrition information load to find out if you suffer from this condition:

  1. Grab a piece of paper.
  2. Draw a bull’s eye with five circles (like a dart board).
  3. In the center circle, write “Me Today”. This circle represents who you really are right now. Write down your likes, dislikes, lifestyle, health status, choices, and resources.
  4. In the next circle, write “My Health – Top 5”.  This circle represents who you are based on the top 5 things that are most important to your current health status and health goals.
  5. In the next circle, write “Me, Myself, and I”. This area represents the roles you play in your life currently like friend, spouse, ballerina, and more.
  6. In the next circle, write “You Don’t Really Know Me”. This area is how a company would target you if they didn’t know you on a personal level (so by your age, gender, where you live, your household role, your work).
  7. In the final circle write “You Don’t Know Me at All”. The outer circle is not targeted to you at all.

Image courtesy of ashleykoffapproved.com

Now on a separate piece of paper, jot down all the sources of nutrition and health information that you encounter in a week. Your neighbor, your guardian, a tweet, a magazine article, a TV commercial, a package of food, a yoga instructor, a dietitian or doctor’s advice.

Now assign each of the sources to a place on your bull’s eye. What does your picture look like?

When most of your information comes from sources in the first two circles (the bull’s eye and the next circle), you are doing better. You can still have too much information, but at least you are getting information specific to who you really are right now and to your personal health goals.

Look at the rest of your bull’s eye. Are you taking in highly-targeted information more often? Or are there more sources in the outer circles than the inner ones? And are there too many sources overall? You likely suffer from INFObesity.

The good news is that now that you have assessed your current information status, we can address what needs attention. But first, keep what is already better. Make sure to note and keep the sources that fall closest or are in the bull’s eye. And to rely on their information more often. To reduce your INFOload and improve its quality, could you get rid of some of the sources on the outer circles, could you choose different sources, more targeted sources, more often?

Want better help? Stop guessing what your body needs to run better (based on non-targeted or less targeted information). The better nutrition membership tools will help you assess your current nutrition and health so that you can see what your body really needs to run better. Then additional tools, including the weekly #Do1ThingBetter challenges will help you make better, not perfect, choices more often. (You can join The Better Nutrition Membership to have unlimited access to these better tools and support from me and other members.)\

Originally printed on ashleykoffapproved.com. Reprinted with permission.

Ashley Koff RD is your better health enabler. For decades, Koff has helped thousands get and keep better health by learning to make their better not perfect nutrition choices more often. A go-to nutrition expert for the country’s leading doctors, media, companies and non-profit organizations, Koff regularly shares her Better Nutrition message with millions on national and local television, magazines and newspapers. Visit her website at ashleykoffapproved.com. Ashley is also available for nutritional consultations.

team hands

Collaborative Thinking in Health & Wellness

Over the past 18 months, I have seen my primary M.D. three times, enjoyed the services of my favorite massage therapist six times, visited my chiropractor nine times, chatted with a local R.D. twice and seen my personal trainer regularly. And not one of them even asked if I was seeing any of the others, much less inquiring what their treatments or approaches to treatments might be. To me, that is like trying to achieve success with a baseball team where the 1st base coach, 2nd base coach, 3rd base coach and pitching coach never communicate with each other.

Success cannot occur in a vacuum, neither can true individual health & wellness, yet for decades these medical, fitness & wellness providers have proffered their services in distinct and distinctly separate spaces.

Even as the internet has made access to information easier and facilitated the sharing of knowledge, including private, HIPAA compliant information, these providers continue to operate in “informational silos.”

It is true that in the past some of these providers may have held less than favorable opinions of some of the other providers, but that is, and certainly should be, a thing of the past. No longer will M.D.’s consider Chiropractors “quacks”, R.D.’s claim nutritionists “just don’t know enough”, and Physical Therapists think of Personal Trainers as ”wanna-be P.T.’s who couldn’t hack the education.” Science, knowledge and time have evolved all these disciplines into valuable, useful and incredibly beneficial specialties, each offering specific training and specific methods to apply to their patients/clients. And all those patients/clients typically can benefit from their combined expertise and knowledge.

No longer is it sufficient to simply treat the symptoms. Real wellness needs to encompass the patient/client holistically… address the symptoms, understand the cause, strengthen the mind, examine the diet, resolve the issue and prevent future occurrences. And isn’t that best accomplished by viewing patient/client wellness as a Team Sport?

Over the years I have had the pleasure of knowing and speaking at length with many of these medical, fitness & wellness providers, and not one of them indicated there is anything in their training that says “Thou Shalt Not Collaborate.”

We are not talking about “asking for help.” Rather we are simply saying to include those other practitioners in the conversation. Instead of the M.D. telling the patient to “walk more to improve cardio health”, why not conference call with the Personal Trainer and discuss the walking program that is most appropriate. Let the Physical Therapist inform the Personal Trainer of any specific issues to address or avoid. Allow the Massage Therapist to work with the Chiropractor to ensure optimum results from both. In other words, (and the simplicity of all this may surprise you), just TALK TO EACH OTHER.

So, let’s start to make that happen. For more than 20 years my company has helped health clubs and fitness centers create mutually beneficial relationships with Physical Therapy practices, Chiropractic offices, Registered Dietitians, Nutritionists and Massage Therapists. Now is the time to extend the conversation, and, to return to my baseball metaphor, get ALL the coaches working together to create truly Championship results.

Cosmo Wollan is the Senior Executive at Synergy Cubed, a premiere consulting firm providing customized solutions to the health & fitness, parks & recreation, medical fitness and corporate wellness industries since 1994. His Fitness Industry clients have engaged him as an expert problem-solver in profit center development, retention strategies, customer engagement, sales training, programming design, operational streamlining and health club management.

change clouds

6 Steps to Total Life Transformations

One of the things I am most passionate about is helping people achieve things they thought were previously impossible. Hence, the amazing thing about working with people in fitness is that once they start to achieve those “impossible” feats, it trickles over into other areas of life.

Someone who loses 50 pounds or conquers new feats of strength for the first time suddenly gets a promotion at work, gains the confidence to quit their job and start that business they’ve been dreaming about. Furthermore, they might even leave a relationship that made them unhappy and wasn’t serving them.

It’s truly incredible to witness these total life transformations over and over again. And I believe it comes down to following these 6 steps to total life transformations:

1. Identify your impossible goal. What’s that thing you’ve been dreaming about but haven’t committed to or verbalized?

2. Commit to a deadline. Write it down, yet, make it non-negotiable too.  Look at the goal and deadline every day so that it sinks in and become a part of you!

3. Reverse engineer the steps it’s going to take to achieve that goal. So, ask for support from a friend or coach if you’re not sure.

4. Ask yourself “what will it cost me to achieve this goal?” Will it cost money, time, or giving up things you enjoy like television? Also, make sure you’re willing to commit to the cost no matter what.

5. Ask yourself “who do I have to become to make this happen?” Do you need to become a morning person, more independent, or figure out a way to eliminate excuses from your vocabulary? You MUST check in on yourself every day to ensure you are becoming who you need to achieve the goal.

6. Find someone who believes in you and get them to hold you accountable. Very few people achieve goals entirely on their own. As a result, having a coach to support you is one of the BEST things you can do. They will give you honest feedback, help identify your blind spots, and help you strategize when you feel like your plan isn’t working.

So, now it’s your turn!

In conclusion, give it some thought (or maybe you know right away) then share with me your IMPOSSIBLE GOAL! It is only by setting, working toward, and achieving the “impossible” that we truly live an extraordinary life.

As a result, I’m anxiously awaiting!

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.  


3 Tips for Recruiting Your Fitness Center Team

If you’re going to have a successful fitness center, you need a knowledgeable and enthusiastic team of employees working in your center. Like any business, a fitness center relies on customer satisfaction to survive and thrive, and customer satisfaction ultimately comes down to good customer service. Your employees may be providing fitness instruction or scheduling clients for yoga classes….


Member Spotlight: Author and Fitness Specialist Working with Stroke Survivors, Medical Conditions and Fall Prevention

Name: Tracy L. Markley
Location: Florence, Oregon
Website: tracyspersonaltraining.com
Occupation: Studio Owner, Fitness Specialist, Pilates & Yoga Instructor

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

I work with clients of all ages, but especially seniors and clients who have, balance, neurological issues, heart issues, stroke survivors, MS, scoliosis, fibromyalgia, diabetics and more. I train one on one with clients.

I have written 2 books: “The Stroke of an Artist, The Journey of a Fitness Trainer and a Stroke Survivor” and “Tipping Toward Balance, A Fitness Trainer’s Guide to Stability and Walking”.

Both books have been recognized nationwide and helping those in recovery, their families and those with balance a walking issue. My business helps clients, the community I live in and others who hear my interviews and or read my books with fall prevention, stability and walking, walking gaits, recovering the mind and body from a stroke and other personal challenges each individual clients has come to me to help them with.

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

Since I began in the fitness industry I have always searched out the knowledge and certifications to help me work with clients with the many conditions clients come to us with in this industry.

Both of my books have been recognized nationwide and helping those in recovery, their families and those with balance a walking issue.

I was an examiner for AFAA Group Exercise Testing, and I am a Master Trainer with FiTOUR and hold/instruct live certification workshops.

Each book I wrote, (and my third one is on it’s way) has a special chapter in it with anatomy illustrations and shared knowledge to reach out to other fitness professionals as well as educating clients and others who have my books to help them personally in care.

What is your favorite activity or class to participate in?

I like to hike in the forest and beaches with my dog. I like teaching classes, lol, not taking them. I love core, balance and Pilates. I think Pilates, Joseph Pilates method on Mat or reformer is my most favorite and I love battle ropes.

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?

I would advise other professionals to learn muscles and the science of movement of the body. I also would advice to be a good communicator and that that also means listening to what the clients feels and says.  Especially with special populations because each case is different and each person is different. Special population workouts are definitely not “cookie cutter workouts for all”.

What type of community activities are you involved in?  

I do talks and demonstrations at stroke recovery support groups and speak and balance and fall prevention. Next month We have a large book/author festival here in town where authors come from all over. I have been asked to sit on a panel with 3 other authors who are New York best sellers. I am so honored. I was asked because I am a new author and self-published and the Author who puts together this festival said she likes how I marked my books and myself as an author. The panel is on marketing books.

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

My most favorite is working with a very special man who came to me 6 months post stroke in a walker. It was educational and such a special journey, that it was my first book. I was with him when he got the sensation back his hand, to feel cold and hot. I was with him when he felt his spatial awareness come back. It was such an amazing journey of gains and communication. Although he passed away form surgery complicates when he had just got to 3 years post stroke, his journey and inspiration has lived on to continue to help others worldwide. He wanted this and I promised him no matter what that I would finish the book. He passed away right when it was beginning editing. He was an excellent example of working out everyday will help bring back the brain pathways and movements. This book is on strokesmart.org, a part of the National Stroke Association.

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

Trainers and class instructors to become more educated in their work with clients, especially the special needs. It upsets me to see trainers do 1 day certifications then market themselves and trainer clients as if they studied and learned the depth that is needed to bring the quality care needed for these clients. I feel if a trainer limits their knowledge they limit the clients recovery and progress and the client may never understand that is was not their challenge that limited them, it was the limit of the trainer.

And what are you doing to make this happen?

I had goals to make some certification courses with hopes others would reach out and learn, and then I got introduced to Lisa Dougherty [MFN Founder], and I have the opportunity on this large platform to reach more people to help make this happen as a joined group with the others she has brought together. And once my course I am writing are ready to purchase I will market the heck out of them so other fitness professionals know they are available.

What is your favorite fitness/inspirational/motivational quote?

The body was made to move.

The more you sit, the stronger you get at sitting, the more you move the stronger you can become at moving.

Anything else we should know about you? 

I was Tracy’s Personal Training & Boot Camps in Huntington Beach Ca for 17 years, before closing and relocating my studio in Oregon in 2013, where my parents moved to in 1999.

My dog Wasabi has been a therapy dog and has worked with me for a few years in my studio when I was in Huntington Beach and now he does it here.

View Tracy’s MFN profile >


Exercise and Dementia: Thinking Differently about Thinking

Many people are aware of the devastating effects dementia and Alzheimer’s disease (AD) has on families. I know this devastation personally, as my mother suffers from advanced stages of AD. It is very sad to have only the body present of someone you have known and loved your whole life! This article will discuss some of the newer developments in understanding and possibly reducing the disease, as well as the positive role exercise may have in slowing the onset and development of symptoms, and disabilities for any form of dementia.

The impact on family units and caretakers is even greater and can’t be measured by financial impact. Dementia is a group of symptoms that affect mental tasks like memory and reasoning. Dementia can be caused by a variety of conditions, the most common of which is Alzheimer’s disease. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases (http://www.alz.org). Much of the recent attention to professional football players and the repeated brain trauma is due to the increased incidence of dementia, not Alzheimer’s. Dementia is characterized by loss of memory, intellectual capabilities and executive functions.

Alzheimer Concept.According to the Alzheimer’s Association, in 2015, 5.3 million Americans are believed to have this incurable disease. The cost of Alzheimer’s to the U.S. is $226 billion, and this figure is estimated to more than quadruple to $1.1 trillion by 2050 unless some major discoveries are made. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented. One in three seniors will die with some form of dementia. Alzheimer’s is far more prevalent in women, with about 3.2 of the 5.1 million people, or 2/3rds, being women. The Baby boomer generation should cause the number of those affected to swell to 7 million, which may double by 2050. (http://www.alz.org/facts/overview.asp).

Factors Associated with Alzheimer’s Disease

While no one really knows exactly what causes Alzheimer’s disease (AD), there are several factors that are highly associated with it, and even some treatments that seem to slow its progression and onset. The two most prominent factors associated with AD are age and family history.

After age 65, the risk of Alzheimer’s doubles every five years. After age 85, the risk reaches nearly 50 percent. A type of AD is known as early onset or younger onset. This term actually is used for two types, a risk and deterministic form. Both may start in someone’s 30s or 40s and if someone has the gene it is 100%. This “determined” form is rare, accounting for only 5% of the total cases. Research has shown that those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness.

Biomarkers of Alzheimer’s Disease

  1. APOE genes
  2. Neuro-tangles associated with the Tau protein
  3. Beta amyloid plaques- a protein clump found in the brain- disrupting communication
  4. Inflammation
  5. Decreased brain size


When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. There are two categories of genes influencing a person developing a disease: risk genes and deterministic genes, both of which are present in Alzheimer’s disease.

Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Researchers have found several genes that increase the risk of Alzheimer’s.  Apolipoprotein (APOE)-e4 is the first risk gene identified, and has the strongest impact on disease risk. APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3.

Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s and those with two copies have an even higher risk, but still not a certainty. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual (early onset). Scientists estimate that APOE-e4 is implicated in about 20 to 25% of Alzheimer’s cases.

Brain Size and Function

We often associate brain size with cognitive capacities and for the most part this relationship holds true. While it is very difficult to measure any increase in mass due to neuroplasticity, we can measure increase activity in the brain due to exercise, or decreased activity from AD and other dementias.

How can Exercise and Diet Help

senior-exercise-trainerIt is important to understand some of the limitations of exercise and diet in helping either dementia or AD. First of all, one must separate non-Alzheimer’s dementia from Alzheimer’s, and then must understand what stage of AD the individual is in. Finally, one must realize if the symptoms have already manifested (onset), and then monitoring the progression.

Exercise has a more pronounced effect on helping decrease progression and even reversing some symptoms with non-Alzheimer’s dementia.  In addition, the earlier someone is able to perform preventative actions, the greater the effect those therapeutic actions will have. Exercises that really activate the brain such as dance, yoga, and new sports or techniques are the best for prevention.

By exercising regularly throughout your life you will lower your incidence of getting Alzheimer’s by 50% and by doing mental exercises with the physical exercises may lower your chances by 70%! This reduction would not apply to those with deterministic genes but it would for others.  Some researchers believe exercise can both delay onset and reduce symptom severity no matter what the cause.

Aerobic exercise in particular causes a release of brain derived neurotropic factor, which has been labeled as “Miracle Gro for the Brain” by the author of SPARK, John Ratey, M.D. In addition, aerobic exercise causes some angiogenesis or the development of additional circulation to the brain. When the brain cells receive more blood, they get more oxygen, and thus function better.

Other side benefits of exercise are the muscle strengthening and enhanced balance and activation of postural muscles. Many Alzheimer’s patients will be at risk for falls and disturbed gait patterns. A consistent exercise program can delay and slow these issues even in somewhat advanced stages.

The dosage is the same as that for the general public or 150 minutes of moderate activity a week. It is important not to push an Alzheimer’s patient into exercise. Many AD victims can become agitated quite quickly and the stress is unwarranted. Simply walking is the best exercise. Make sure the walking path is smooth and not filled with obstructions or difficult terrain.

In an article from Science News, “Walking slows progression of Alzheimer’s”, Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania, mentions, “We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer’s and MCI, especially in areas of the brain’s key memory and learning centers. We also found that these people had a slower decline in memory loss over five years. 

The type and magnitude of exercise needs to be carefully monitored with advancing Alzheimer’s or dementia but in those with mild cognitive impairment, a “healthy dose” of both resistance and aerobic exercise is advocated.

Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.

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.


Performance Based Training: A Discussion

I have noticed over the years that people who train at a fitness facility with the best of intentions never seem to change either in appearance – or behavior. I believe that the approach many of us end up taking to achieving their fitness goals become entrenched in predictable patterns that prevent the changes they envision from occurring. I appreciate the commitment that it takes to work toward health and fitness goals because I know first hand the many challenges – and roadblocks – that can arise on this important journey.

With this thought in mind I would like to share some thoughts with you on how you might make your efforts at becoming fit more fruitful, enjoyable, engaging and successful. Take time to reflect on your current efforts in this vital area of life and think about what it is you would REALLY like to accomplish going forward in life from a new perspective on “getting in shape”.


Any discussion on performance based training has to begin and end with appropriate goal setting. This process does not involve “looking better”, losing weight or any other number of superficial aims. Training to look better is nonsense because we ARE who we are. Genetics determines our look – not “working out”. If we don’t value ourselves in the very beginning (as I discussed in an earlier article) as we are NOW then how will we ever value who we want to become?

I believe in the power of the mind to determine our outcomes in life and the first place to begin before embarking on such a significant journey is within our own minds. What do you want to ACHIEVE? What do your want to GAIN from this endeavor? How will the ensuing results help you going forward in your life? The answers that you consider to these and other questions  – and then finally adopt – will give you your goals.

I am a runner and a weightlifter. I am these things so that I may remain strong and fast as I age. That’s it. My performance as a speaker depends on the depth and breadth of my training so I schedule time for my mind, my heart, my muscles, and my flexibility. I want to cover all of these bases on a daily basis so that I can PERFORM at my best when I am called upon to share what I have learned on the principles of healthy aging. I want to be my own BEST example of what is possible so my program reflects this desire.

When you set your goals remember to include milestones and “review points” to insure you are on the right track. Getting a fitness professional to help you clarify your goals will be helpful but NOT totally necessary if your take the time to determine what you REALLY want to accomplish with your training.


  1. Determine how you want to train your heart in order to make it as strong as possible. My goal is to be able to sustain a 6 minute pace for a mile. My training covers 6 miles 5 days a week so I know day to day where I am on my “heart journey”.
  2. Determine how you want to train your neuro-muscular system. I do this through a rigorous weight training program. I do 17 individual exercises and record my results in  a written journal that I keep with me while implementing my program. I see no other person tracking their resistance training in this way – ever. “If you don’t know where you have been, how will know where you are going?”
  3. Determine how you will address flexibility and balance issues. I do this through a stretching program that includes a push up routine (except on weight training days) and focuses on my legs, low back and upper shoulder area. I also spend five minutes in a Jacuzzi stretching my hamstrings, calves and quads. Note: Yoga is a wonderful way to embrace BOTH strength and flexibility issues.
  4. Determine how you want to train your mind. Set aside time to reflect on your goals and your progress. Think about your desire to keep improving your results and what it would mean to your quality of life going forward.
  5. Finally, visualize yourself actually DOING all the things you wish to do and see yourself enjoying every moment. I visualize myself walking on the Great Wall of China, walking through the many temple complexes in Kyoto – one of my favorite places on earth, and enjoying water skiing again in the clear waters in my REAL home of Hawaii where I spent the first 18 years of my life. In my 70’s all these are possible – and more – because I cared about my body – and mind – as they have aged over the past 7 plus decades – and DID something about it along the way.


Take time to review your goals and make sure to adjust your program to your progress. Don’t “over commit” and reach “burn out”. The fatigue factor sets in if we get too aggressive and don’t allow for recovery and “down time”. I see lack of focus as a major block to getting the results many people desire. Know WHY you are doing something. Is it an activity that supports what it is you want to accomplish or is it just a “time waster”? I see time wasting behavior all the time in my setting in the gym when I am there. I see no point is wasting precious time that should be dedicated to getting a result that would really matter to you.

People don’t realize how much time they lose by sitting on machines staring at their phones or just doing a couple of sets of something that probably does nothing toward achieving their goals. Everything I do in my training sessions is designed to do SOMETHING to further my objectives of achieving balance, strength and speed for the future. I think of this effort as making a deposit to my health and fitness bank account for the future. It is also helping me accomplish something that I truly wish to achieve because of my commitment to purpose which is: “To serve as the best example of the change I wish to see in world”.

“Doing” is the backside of “being”. BE yourself FIRST as you ARE and then move forward one day at a time, one exercise at a time. If you can’t walk comfortably set your sights on training to become comfortable walking. If can’t walk upstairs without getting out of breath – or carry your groceries while you do – then add strength training to your programming.

After 40 balance becomes a huge issue and the older we get without addressing our strength issues, the more prone we are to getting seriously injured in a fall. Think about ALL your physical needs and then implement plans that will help you in the future. Do NOT be at risk of experiencing the serious consequences of suffering through a serious accident or injury. I never wanted to tear my ligaments or tendons – especially my Achilles tendon – so I minimized my risk by NOT doing activities that could result in such an injury.


I promise you this: All the thought and planning that you can do IN ADVANCE of beginning a fitness program WILL pay dividends. Setting up your program with performance based milestones and goals in mind will pay off in spades if you are thoughtful in your evaluation of your present circumstances. Be realistic. Be focused. Be clear. MOST importantly: Be committed to your purpose.

I see my own performance based training sessions as just that – training for my future so that I might fully enjoy it. What could be more valuable than that? Take your time. There is no rush and you will find yourself getting more and more excited each day. I know I do. It brings me hope and a grateful attitude everyday I accomplish my goals. I will write more on this subject because NONE of us is getting any younger and the challenges WILL only become greater if we do nothing. See? I am accomplishing my purpose right now and it feels great!

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose 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.

If you need help in designing a fitness plan, you can contact Nicholas Prukop via email at runningnick@sbcglobal.net or read his inspiring book Healthy Aging & YOU.