We recently completed our first full 3-day training certification of the Integrative Corrective Exercise Instructor™ certificate program. The weekend was especially rewarding because it is the first time we’ve offered this certificate course in this format.
Water can be used as a therapeutic and healing medium for rehabilitation, swim training as well as for fun and relaxation. Aquatics therapies have been used for physical and spiritual cleansing in religions around the world for centuries.
There has been extensive research to explore the various uses, aides, restrictions, and safety measures relating to the use of water and the individual who chooses aquatics as a form of therapy or training. Included in that work is a variety of patient diagnosis, current states of health and the necessary modifications for particular swim strokes, stability, and safety.
What has been discovered is the level in which the aquatic instruction and props (if needed) would vary from not just student to student, but level of injury or skill level of the participant. Though water is a natural place to engage in healing, exercise and rehabilitation, much care is needed for a safe and beneficial experience. Exercising in water is quite different than exercising on land.
There are different reasons for choosing aquatics as an exercise medium. Aside from buoyancy and the feeling of weightlessness that comes with it, the hydrostatic pressure and velocity of the water gives one a feeling of support while in the water.
The type of aquatics therapy that is recommended would depend on the individual and the particular circumstances specifically relating to them. There are five important factors that must be considered when working with aquatics: 1) Gender, 2) Height, 3) Fitness Level, 4) Whether or not the person smokes and 5) If there is any known disease present. Any of these factors will have an effect on the air volume capacity of a given person.
Ideally there will be a team of licensed professionals working with the patient or student on their road to fitness and wellness. This is known as the Lyton Model (pictured below). It is imperative that the aquatics instructor understand the physiological responses to the body when immersed during any type of aquatic exercise or training. The heart, kidneys and adrenal glands are immediately impacted with immersion due to the shifts in blood flow (stroke volume) caused by the hydrostatic pressure. This change will shift depending on the level of the submersion. Example; waist, chest or chin height, the effects on the body will differ.
Lyton Model
Because water is so versatile, it can be used to treat injuries involving the muscular skeletal and the neuromuscular systems as well. In addition to the above mentioned properties of water, the thermal influence, viscosity, drag and turbulence can all be used and adjusted to produce: relaxation, pain reduction, edema reduction, increase nutrients and increase inflammatory mediators. Muscle tone can be improved and spasms can be reduced. The bones of the body are also said to be strengthened when immersed in water.
As with any exercise, the way in which one breathes is extremely important and breath control should be mastered. The patient or client should not be afraid of the water or be afraid to submerge the face, ears or head under water. Though the reasons for attending aquatics therapy may be different from one person to another, certain skills are necessary as a safe practice measure.
Specific skill training; fall prevention, balance strategies, induced movement and core stabilization therapies are important activities that should be in practice when working in the water. There are different methods and props to aid in accomplishing these goals if someone is having difficulty. The treatment goal will ultimately depend on the individual in training or the prescribed rehabilitation.
The modifications that have to be made for an individual with an upper body amputation will differ from the modifications that need to be made for someone with a lower body amputation. The location of the amputation of the limb is also relevant to the necessary adjustments. The adjustments and aides for someone who has suffered from cerebrovascular hemiparesis will be different from someone who suffers from arthritis pain or who is a paraplegic.
The trained aquatics therapists will recognize whether or not a patient or client is in need of a supportive aide (and which one in particular), if the patient needs to work longer on a specific exercise or if they are ready to progress. It is important for the therapist to be “hands on” in the water not just as a means of safety and to assist in recovery strokes but also as needed, physically change the dynamics of the water that is in close proximity to the client and his/herself as a therapeutic aide.
Talk to your healthcare provider to see if aquatic therapy or aquatic rehabilitation is the right option for you.
Michelle D. Talbot-Bey, BCTMB specializies in Personalized and Functional Medicine which includes Prevention, Diagnosis, and Treatment. She owns Pleasures II Wellness Natural Health Center in Woodbridge, VA, based on the ancient teachings and practices of Ayurveda. She offers therapeutic massage, mind/bodywork therapies, in depth consultations and natural pharmaceutical approaches and recommendations for Holistic healthcare, prevention, maintenance, and relief from chronic diseases. She has also completed the AFPA Aquatics for Rehabilitation and Fitness course.
Do you have hip pain? Knee pain? Do you think it is simply because you’re getting older? Or are you recovering from hip or knee surgery, have finished PT and now you don’t know where to turn to learn how to benefit from proper strengthening exercises? Maybe you also need to get back into shape after some down time. Either way, you want your life back. This is where strength training specific to your needs comes in.
I had my first hip surgery, hip resurfacing, in 2006 when I was 49, and then in 2010, I had hip replacement surgery at age 53. My surgeon told me that life caused these problems plus a high tolerance for pain and hyper-mobility. You see, I was an athlete my whole life. I have also worked as a personal trainer my entire life and have had many clients with a variety of injuries. I know how it feels to be in pain and I got my life back.
Specializing in hip & knee strengthening for people in their 40’s, 50’s and older is what I am most passionate about. Often, these adults suffer from various chronic diseases like arthritis, diabetes, and other conditions and often all it takes for them to be pain-free is to strengthen joints by targeting specific muscles in the right way, and to lose weight so that joints can last. I know from personal experience and as a personal trainer what it takes to get back to normal again after you’ve had surgery and how important regular strengthening exercises are in addition to easing into overall body conditioning exercises for weight loss and general fitness.
All too often, as we age, training tapers off in frequency and intensity, or altogether, people eat and may drink a little bit more, and boom! There’s suddenly an extra 20+ pounds. Often, your friends have also done the same thing. So you think, ‘I’m not so bad.’ But the aches and pains set in quickly due to inactivity. Truly, so many aches and pains can be alleviated with getting back into or starting a smart, consistent strength training program targeting knees and hips in addition to a cardiovascular program. Sound daunting? It may but people simply need to start with shorter but consistent workouts when you have to in between the longer sessions. It is well worth the time investment to be able to get back to being able to walk briskly, jog, hike, ride a bike, ski, play tennis, etc., and do the things you’ve always loved to do.
Mary K. Ludlow has a BA in Athletic Training, is a Certified Strength & Conditioning Specialist, a Certified Nutrition Coach, and a Certified Golf Injury Prevention Specialist. She has spent her life loving the outdoors as well as various sports including swimming competitively, gymnastics, skiing, hiking, backpacking, and surfing. At age 31 she used her 2 years of eligibility to return to college to run track and cross country. She also volunteered as an Athletic Trainer for the 1984 Olympics.
Mary K. has worked as a personal trainer most all of her life and developed programs for Sony Pictures Entertainment and Amblin/DreamWorks. She is passionate about her clients and takes a personal interest in each and every one. She thrives on seeing them get fit, get their lives back on track, and feel young again.
Once a virtual death sentence, cancer today is a curable disease for many and a chronic illness for most. With continued advances in strategies to detect cancer early and treat it effectively along with the aging of the population, the number of individuals living years beyond a cancer diagnosis can be expected to continue to increase.
Approximately 15.5 million Americans in the United States are cancer survivors. By 2026 that number is expected to reach 20 million. Anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of his or her life is considered a cancer survivor. And while not all cancer survivors are older adults, many are simply because of the cumulative effect of years of lifestyle issues that are risk factors for their disease. Survivors less than or equal to 19 years old comprise 1% of the cancer survivor population, 6% of survivors are aged 20–39 years, 33% are aged 40–64 years and 60% (more than half) are aged greater than or equal to 65 years.
Breast cancer survivors are the largest constituent group within the overall population of cancer survivors (22%), followed by prostate cancer survivors (19%) and colorectal cancer survivors (11%) (3). Gynecological and other genitourinary cancers each account for 9% of cancer survivors, followed by hematological cancers and lymphoma (7%) and lung cancer (4%). Other cancer sites account for much smaller percentages and together are responsible for 19% of the total number of survivors. In terms of stratification by gender, more than two thirds (69%) of all female cancer survivors have a history of breast (41%), gynecological (17%) or colorectal (11%) cancer. For male survivors, two thirds (66%) have a history of prostate (39%), other genitourinary (such as testicular or renal) (14%) or colorectal (13%) cancer.
Not surprisingly, cancer survivors are often highly motivated to learn more about things like nutrition, supplements and herbal remedies, and exercise that might improve treatment outcomes and ultimately their survival and quality of life. For many of the most important nutrition and physical activity questions faced by cancer survivors, the scientific evidence comes only from observational and laboratory animal data, or unreliable reports from poorly designed clinical studies. Moreover, the findings from these studies are often contradictory. Very few controlled clinical trials have been done to test the impact of diet, nutritional supplements or nutritional complementary methods on cancer outcomes among cancer survivors.
In an effort to identify and evaluate the scientific evidence related to optimal nutrition and physical activity after the diagnosis of cancer, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity and cancer. The findings of this group guide healthcare providers, cancer survivors and their families through the mass of information and help them make informed choices related to diet and exercise. The Expert Committee reviewed all of the scientific evidence and best clinical practices for different types of cancer and “graded” both the quality and certainty of the scientific evidence for factors affecting the most common cancers. As was already mentioned, there are few clear answers to many questions, a wide range of sources and often conflicting information. But, these experts agree that even when the scientific evidence is incomplete, reasonable conclusions can be made that can help to guide choices in the areas of nutrition and physical activity.
Physical activity may help cancer patients build up their physical condition; decrease the number of comorbid conditions (like heart disease and diabetes); reduce drug interactions; help cancer patients cope with treatment; restore good health; improve quality of life during and after treatment; and help cancer patients and survivors maintain independence as long as possible
Physical rehabilitation programs similar to those for cardiac rehabilitation may be effective in managing, controlling or preventing adverse medical and psychosocial outcomes manifested during cancer survivorship. For example, exercise programs are being developed as interventions to improve the physical functioning of persons who have problems with mobility as a result of therapy and are also being shown to be efficacious for weight control after breast cancer treatment, lessen the effects of chronic fatigue, improve quality of life, prevent or control osteoporosis as a result of premature menopause and prevent or control future or concurrent comorbidities.
Diet, weight and physical activity interventions carry tremendous potential to affect length and quality of survival in a positive manner and prevent or control morbidity associated with cancer or its treatment.
In general, physical activity is likely to be beneficial for most cancer survivors. Recommendations on the type, frequency, duration and intensity of exercise should be individualized to the survivor’s age, previous fitness activities, type of cancer, stage of treatment, type of therapy, and comorbid conditions.
Particular issues for cancer survivors may affect or contraindicate their ability to exercise. Effects of their cancer treatment may also promote the risk for exercise-related injuries and other adverse effects.
The following specific precautions are from the American Cancer Society:
For the general population, the ACS and other health organizations recommend at least 30 minutes of moderate physical activity at least 5 days per week to reduce the risk for cancer, cardiovascular disease and diabetes. These levels of activity have not been studied or tested specifically in cancer survivors, however. For the general population and for cancer survivors, any movement is likely beneficial. Therefore, although daily and regular activity may be preferred and may be a goal, any steps that are taken to move from a sedentary to an active lifestyle should be encouraged. For survivors wanting maximum benefit, the message should be that the health benefits of exercise are generally linear, with benefit related to higher intensity and duration, although extremely high levels of exercise might increase the risk for infections.
Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.
Looking towards the future, I’d love to see better connections between the allied health care professions and fitness. Medical Fitness is certainly that bridge. The healthcare industry can use our expertise. They just need to be educated about the helpfulness of our work for their patients.
What is dairy? Butter, buttermilk, cheese(s), yogurt, milks, cream
Quality Goals: Grass-fed/finished, organic, whole/full-fat
Grass-fed Benefits….
If you’ve been following this article/series since Part 1, here’s what you now realize:
There is a massive market of adults in “need” of exercise and nutritional interventions to rediscover the health they’ve moved away from.
Although the conventions of the medical field are poorly equipped to reverse chronic disease, and the conventions of the fitness field primarily offer protocols for training healthy individuals (even the “special pop” certifications address safety more than an aggressive approach toward dis-ease reversal), there is MASSIVE OPPORTUNITY for you to prosper in working with this “unwell” market.
It’s well-known exercise plays a vital role in your physical health, and now studies propose staying fit in midlife may protect your brain as well, avoiding mental deterioration in later years.
A new study, published in Neurology, that followed Swedish women for more than 40 years, suggests one’s level of physical fitness predicts the amount of protection from dementia decades later.1
At the onset of the study in 1968, 191 Swedish women ranging in age from 38 to 60 took part in a vigorous stationary cycling test to measure their exercise work capacity. Based on work capacity, women were split into low, medium, and high fitness categories. The women were followed from 1968 to 2012, and dementia diagnoses were recorded.
The measurement of exercise capacity is an important aspect of the strength of this study – it was based on the participants’ actual performance rather than relying on participants’ subjective reports of how much, how vigorously, and how often they exercised.
Dementia incidence correlated with fitness level, the greater the fitness level, the less the dementia: 32 percent, 25 percent, and 5 percent of women developed dementia in the low, medium, and high fitness groups, respectively.1 This particular study is one of the longest, following participants for up to 44 years, but shorter studies have come to similar conclusions.2-4
Another very interesting finding: in the subset of women whose initial exercise tests had to be stopped because of issues such as excessively high blood pressure, chest pain, or an abnormal EKG change, almost half (nine out of twenty women) developed dementia. Fit women who did develop dementia did so much later in life. Among the five percent of fit women who eventually developed dementia, the average age of development of dementia was eleven years later compared to the medium fitness group – age 90 vs. 79 – an extra eleven years of dementia-free life.
In another study, the effects of midlife physical fitness on the brain were visualized with MRI. Participants at an average age of 40 performed a treadmill test to determine their exercise capacity. Lower exercise capacity at midlife was associated with smaller total cerebral brain volume 19 years later, suggesting having a higher fitness level helps prevent brain shrinkage with age.5
Important to note, one’s fitness level is strongly linked to what you eat. People who are overweight as well as those who don’t eat healthfully, do not have the will, energy or capacity for regular exercise. When you eat right, you’re more likely to get fit; when you don’t eat right it is very difficult to get fit.
A nutrient-dense, plant-rich diet (Nutritarian) is the most critical determinant influencing whether one gets dementia or not. When you eat right you automatically crave exercise and it becomes pleasurable to do so.
This study also demonstrates the wide variety of health benefits, including reduced risk of cardiovascular disease and several cancers when you get fit. Mixing together nutritional excellence and exercise is when the magic happens to protect yourself from the common diseases of aging. Exercise offers additional benefits to cardiovascular health and insulin sensitivity, as well as some direct effects in the brain, such as the release of protective compounds called neurotrophins.6,7
It is never too late to start exercising and you are never too old. Studies have documented cognitive benefits from exercise (strength training and aerobic training) in all age groups, from children to the elderly.6-9 Today is the day to make sure you do both; eat right and get fit.
Originally printed on DrFuhrman.com. Reprinted with permission.
Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
References
In examining this subject I have found myself wondering about the challenges that this complex issue of technology and its impact on our lives is having. The reality is that NO ONE really knows what the impact of technology and our way of life holds in store for any of us. We DO know there is going to be a “reckoning” and that if we remain seated and stressed then significantly negative consequences will surely emerge. These include ongoing chronic medical issues such as heart disease, diabetes, and mental disturbances of all kinds to name a few. Finally an unhealthy aging process where people of all ages will be treated for these and other conditions will become a daily part of life for families all over America.
President Clinton was quoted in the past as saying that “this may be the first generation of children to not outlive their parents”. Quite frankly that thought shocked me so I became even more convinced that there is much work to be done before that statement can be labeled as true. It is still a real possibility and it will take all of us to find he answers. My grandson of 12 has already been diagnosed with high cholesterol and high blood pressure and this is only the “tip of the iceberg”. What about all the other children? What will their futures be like? What can be done? That is the question I will be spending the rest of my time on earth attempting to define and understand.
In this Part III I will examine the sedentary society and its corresponding partner the obesity epidemic and suggest ways we can move forward without “sitting still” until a crisis emerges that forces us to make changes to address the issues that we may have prevented in the first place! I believe in the possible and although this challenge may seem impossible we have to keep trying and not just throw up our hands in despair and do nothing. Our younger generations are counting on us to find answers and also to encourage us to ASK the best questions in order to present solutions and not merely shallow “guesses” or suppositions. That would be totally wrong!
After my training sessions I go to a nearby McDonald’s to read the paper and ponder and think – without any technology! Two examples are present in my mind of what I observe almost daily. The first one is of an elderly man who sits for hours staring at his phone and never speaking to anyone. He is always alone and he is there when I arrive – and when I leave. He is in my opinion in the “sitting and waiting to die” mode. I don’t know his circumstances but he appears to be alone in life. He is physically weak, overweight, always cold (he wears layers of clothes) and probably younger than me. Why he lives this way is a mystery to me but I DO know he is completely unaware of how his behavior is creating a future I am sure he would rather avoid!
The second one is the young man who brings his computer and sits for hours working on “whatever” while never looking up and “checking in” with his surroundings. He spends time checking websites and apparently without much purpose to his searches. The reality is that his computer appears to be his source of stimulation and while it can be a source of inspiration, a computer is not a companion. No real interaction occurs while he sits and stares at his computer. By the way, he is just one of many who do the same thing – especially on weekends. On many days there will multiple seating areas taken up with this same activity by as many as ten people.
These people are ALL “sitting their way to an early grave” and the only person who seems to notice this phenomenon is ME. Everyone, including the families with children, appear to be addicted to this form of behavior. I rarely see any people engaged in conversation and virtually NOBODY ever once looks at someone and smiles. This environment is not the one of my childhood on Maui or the times of my adulthood but it is the reality I observe everyday. Consequently, I live in a world where people no longer really interact with one another and the “quiet is deafening? This is not a world I know or feel I belong in except to say that I feel it is my job to say “WAKE UP” and MOVE!
This challenge exists but no one really knows why. Every diet in the world has not saved the world from its own gluttony. We are fatter and heavier than ever. When I was in college in the mid – late 60’s I saw virtually NO overweight or obese person. I walked everywhere on campus and exercised at the gym. I saw activity everywhere. The years following college saw more of the same. No technology – no obesity. The change came in the early 90’s. My daughter graduated from the Journalism School at USC in 1993. Her class was the last to use typewriters to write their stories. The school transitioned to computers and Lisa’s class was the last one to study her career specialty “the old fashioned way” that stories were told. News was reported with people being at the center of her universe – no twitter, Instagram, social media and all that has come to dominate our world.
From that moment on the world changed and with Steven Job’s invention of the cell phone a decade later the change became REAL and LASTING. We now live in a “seated world” where the only movement people get is when they get out their cars to do something that they CAN’T do from their cars. We line up at the drive through for banking, food and other services that keep us from walking. People even order at the drive through and now employees “walk” their order out to their cars. People SIT in their cars with the engine running eating their fries and burgers. I see this everyday also and it makes me wonder how their lives will turn out. Will they live lives of fulfillment and excitement and health or be in hospitals for “procedures” to keep them alive?
We are seeing huge increases in joint replacement surgeries on younger and younger people and because we are so inactive and heavy the issues will NOT go away without intervention and programs that address the underlying issues at the core. My answer as to why diets still are the main form of weight loss in this country is because a diet doesn’t require anything other than eating different food than we are accustomed to eating. Less than 5 percent of the people who stop dieting retain the loss – the rest gain the weight back – AND MORE!
The experts cannot agree on the solution(s) because the CAUSES are so complex. They cover a wide spectrum of possibilities from emotional, self esteem, physical, hormonal and so much more. This is why I recommend a comprehensive approach that encompasses examining all these areas in concert to arrive at an individualized approach than CAN work for EACH person in the population. However. the cost for this process may be prohibitive. There is no way we can know until we try new protocols beyond surgery, diets and drugs. I CAN say that if we do not address this issue it will cost the healthcare system billions – and possibly trillions – of dollars in the future. We just DON’T know at this point and if anyone says they THE answer – run the other way. Drugs and diets alone DON’T WORK!
I believe in the three basic principles of healthy aging. They encompass the mental, physical, and spiritual aspects of life itself. These paths can combine to bring us relief and the answers we need in order to solve this crisis. I believe technology will keep us seated and not moving as long as we remain “unconscious” to our choices, activities and days. If we choose to keep our heads buried in our computers and continue to stare at our phones, then I don’t know what else to say except “good luck getting old”.
As my dear friend Edith Bird has said to me on numerous occasions: “Getting old is NOT for sissies”! Edith is 84 and works out four times a week doing cardio and weights and stretching. She has a wonderful soul and never makes excuses while being blessed with a wonderful heart and nature. I respect her and admire her. I tell her she is MY role model and we laugh and enjoy the time we spend together at the gym – and then we go our separate ways until the next time we see each other.
When she finally passes on (assuming I am still here), I will always hold her in my memory as someone who made a significant difference in my life. She will have left me the gift of hopefully inspiring someone else as I live out the remaining years of my journey through life. I want you to think about HOW you treat yourself and remember to think – and be – like Edith: Fearless, honest, and devoted to living each day to its fullest – with no regrets. This is the beginning to acquiring – and embodying wisdom – and that is finally after all the ONLY goal that really matters at the end of our lives!
Originally published on Healthy New Age. Reprinted with permission from Nicholas Prukop.
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.