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Flip the Script: How Fitness Professionals Can Overcome Challenging Clients

If you are a fitness or medical fitness professional, there is a good chance you have heard one or more of the following statements at least once in your career. In fact, there is also a good chance you have heard these statements on a daily basis. 

1. I am a little tired and my muscles are a little sore from our last session, so I am going to cancel today and rest. 

2. I don’t want to do “that exercise” because I have never done it before.

3. My doctor told me that I should not be squatting, bending, reaching, twisting, etc… 

Many of you reading this article can relate to at least one of the above and may have even let out a slight sigh of frustration when it comes to overcoming challenging clients. Overwhelming amounts of research show that exercise can help to improve your health and fitness without hurting your joints.(1) With your current treatment program, exercise can: 

  • Strengthen the muscles around your joints 
  • Help you maintain bone strength 
  • Give you more energy to get through the day 
  • Make it easier to get a good night’s sleep 
  • Help you control your weight 
  • Enhance your quality of life 
  • Improve your balance 

However, many of our clients still believe that exercise will aggravate their joint pain and stiffness, but that is not the case. Lack of exercise actually can make your joints even more painful and stiff.(2) If the muscles and surrounding tissue are strong, it helps to maintain support for your bones. Choosing not to exercise weakens those supporting muscles, creating more stress on your joints. 

While fitness and medical fitness professionals understand the importance of exercise, the way we translate this to our clients is key. Oftentimes, clients receive misinformation along with mixed messages from doctors, family members, friends, and of course, social media. However, after decades of both academic and professional research working with special demographics, I have discovered a powerful technique to increase clients’ willingness to improve their health through exercise. The answer lies not only in showing the client how each exercise emulates real-life situations, but also how it affects their independence.

For example, telling a client, “Today we will be working on how to safely and effectively execute a squat,” is a lot different than saying, “Today we will be practicing our sit to stand movements so that you have the lower body strength and flexibility to rise from your favorite chair without assistance.” 

Most importantly, it is important to reiterate to your client that their lack of strength, mobility, and balance leads to a more sedentary lifestyle that will decrease their ability to function independently as time progresses. Additionally, muscle atrophy, joint immobility and poor flexibility are key indicators that functional movements, or movements that are required to perform everyday tasks, will soon be a thing of the past.

If a client is unwilling to perform various exercises, here are some conversation starters:

  1. Did you know that this is not just an exercise, but one of the foundational movements to support strength, balance and flexibility in your everyday life?
  2. Do you know the definition of functional fitness?
  3. Do you know that this isn’t just an exercise, but will help you walk up and down the stairs, get up from a seat, carry your groceries, and pick up a grandchild?
  4. Are you ready to give up your independence? 

Christine M. Conti, BA, M.Ed, is an international fitness educator and presenter. She currently serves as the Director of Membership for MedFit Network, sits on the MedFit Education Advisory Board and is a course author for MedFit Classroom. She is also CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation and co-host of Two Fit Crazies & A Microphone Podcast

Check out Christine’s online course with MedFit Classroom, Arthritis Fitness Specialist:

References

  1. CDC: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. (2021, April 5). Benefits of Physical Activity. Center for Disease Control and Prevention. Retrieved September 10, 2021, from https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
  2. Mayo Clinic. (2021). Exercising With Arthritis: Improve Your Joint Pain and Stiffness. Mayo Clinic. Retrieved September 9, 2021, from https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20047971
senior-couple-walking-exercise

The Pharmacologics of Exercise: Yes, Exercise Is Medicine!

It’s been said: “If all the benefits of exercise could be placed in a single pill, it would be the most widely prescribed medication in the world.” Scientific evidence continues to mount supporting the numerous medicinal benefits of exercise. In fact, there’s hardly a disease that I can think of that exercise won’t help in one way or another, be it prevention, treatment, or even cure in some instances.

eating-for-arthritis-SOS

Eating for Arthritis and S.O.S. — Sugar, Oil & Salt… Oh My! 

Is there such a thing as an anti-inflammatory diet? While there is no specific “diet” that people with arthritis or rheumatoid arthritis (RA) should follow, researchers have identified certain foods that can help control inflammation. Many of them are found in the so-called Mediterranean diet, which emphasizes fish, vegetables, olive oil, whole grains, nuts and seeds, among other staples.

trainer-and-senior-woman-gym

Specialize and Thrive: Working with Individuals with Osteoarthritis and Joint Replacements

Arthritis is the most common cause of disability in the world.3 Osteoarthritis, the most common form of arthritis, has led to a dramatic increase in the incidence of hip and knee replacements in recent years. The rate of total hip replacements has almost doubled between the years 2000-20101 and approximately 7.2 million Americans are now living with hip and/or knee replacements. 6 While these rates have nearly doubled in recent years, the number of younger individuals (ages 45-54) having these replacement surgeries is increasing.5

The rapid and dramatic increase in individuals living with osteoarthritis and/or joint replacements has created a massive void between the number of people living with these issues and the number of qualified individuals to help them safely and effectively accomplish their functional goals. This void, however, has created an incredible opportunity for fitness professionals to align themselves with allied health professionals to become part of the solution. This article will discuss some recent changes in the thought process about how osteoarthritis develops, how fitness professionals are an important part of the solution, and why this is the most opportune time for fitness professionals to specialize and align themselves with health professionals.

Why do so many individuals experience osteoarthritis and what can be done about it?

While injury, overuse, age, obesity, genetics, and race have been given as possible causes, there has been a lack of solid evidence to explain why the incidence rate of osteoarthritis continues to skyrocket. 2,3,5 However, recently there have been suggestions that osteoarthritis is not as previously suggested, due only to old age or genetics. Dr. Ian Wallace, a postdoctoral researcher who has studied more than 2,000 skeletons, believes the recent dramatic increase in osteoarthritis isn’t an inevitable consequence of living longer. He believes it is more attributable to the modern decline of physical activity and is quoted as follows: “Dr. Wallace thinks the most obvious candidate to explain the increase in knee osteoarthritis is the modern decline in physical activity.” 8

Nevertheless, it is not just about people needing more quantity of activity; it’s also about the quality of the exercise.10,11 If exercise is performed without optimal joint alignment and control, the individual is at risk for developing degenerative joint changes.10,11 Therefore, it’s imperative that fitness professionals specializing in working with individuals that have osteoarthritis or joint replacements are able to properly assess for non-optimal and inefficient posture and movement habits and from these results, develop an appropriate exercise program. Additionally, fitness professions specializing in this niche must also be able to instruct proper exercise form and understand what exercises or activities are contraindicated with these populations. 10,11

A well-designed exercise program that includes flexibility, strength, and cardiovascular exercise is required to appropriately address the postural and movement habits that contributed to the development of osteoarthritis. Likewise, many individuals will have developed compensatory patterns as a result of joint pain or loss of mobility and subsequently developed non-optimal posture and movement habits that need to be addressed.

Several organizations including the Arthritis Foundation, Center for Disease Control, and American College of Sports Medicine have created guidelines for working with individuals that present with arthritis. General recommendations include improving joint mobility/flexibility, aerobic conditioning, resistance training, maintaining a healthy weight, and consulting with a medical doctor.2,3,13

Helping individuals develop a more optimal and efficient posture and movement strategy is one of the most effective strategies for safely working with individuals with osteoarthritis and joint replacements.9,10,11 An approach that includes using the most appropriate soft tissue release, mobilization, stretching, neuromuscular activation strategies, and appropriately progressing the individual through the fundamental movement patterns has been shown to improve joint mobility and strength in individuals with osteoarthritis as well as joint replacements. 9,10,11 Additional strategies that have been shown to be helpful in improving strength and mobility and managing the symptoms of osteoarthritis include three-dimensional breathing7,9,10,11, proper nutrition featuring a whole-foods, plant-based diet4, and meditation.14

The future

The great news is that there is a growing need for qualified fitness professionals to work with the increasing numbers of individuals that have osteoarthritis and/or joint replacements. However, this requires that the fitness professional have both the right education and the appropriate skillset as many of these individuals will require a thorough approach to address their specific needs and to provide them with the best functional outcomes. Organizations such as the MedFit Network, The Institute for Integrative Health and Fitness Education, and the Functional Aging Institute are helping to create the education necessary for health and fitness professionals to develop specializations in working with special populations including the older adult populations experiencing osteoarthritis and joint replacements. Additionally, through their educational platforms and live course work, they provide fitness professionals with strategies for aligning and working with allied health professionals.

For many individuals experiencing pain or loss of function secondary to osteoarthritic changes, seamless integration between medical procedures, rehabilitation, and functional fitness is becoming a viable and necessary alternative to narcotics and surgery. Hence, the birth of the medical fitness space where fitness professionals work either in collaboration with or in the actual physical location of medical doctors, physical therapists, chiropractic physicians, and massage therapists. Clinics such as Rejuv Medical have provided a model for how to improve patient outcomes by combining the benefits of regenerative medicine procedures (Plasma Rich Protein and Stem Cell Therapy), physical therapy, and personal/group training.

Specialization in working with individuals that have osteoarthritis and/or joint replacements and working in the medical fitness space is the future. The fitness professional that acquires the appropriate education and develops a working relationship with allied health professionals will be able to attract more individuals that need, want, and will pay for their expertise. By providing a more integrated and effective approach to helping individuals accomplish their health and fitness goals, these fitness professionals will continue to thrive in the coming years.

This article was featured in MedFit Professional Magazine. Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Evan Osar is an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the on-line educational resource www.IIHFE.com

 

References:

  1. American Association of Hip and Knee Surgeons. NCHS Releases Hip Replacement Data. Retrieved from http://www.aahks.org/nchs-releases-hip-replacement-data/
  2. Arthritis Foundation. Osteoarthritis Treatment. Retrieved from http://www.arthritis.org/about-arthritis/types/osteoarthritis/
  3. Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
  4. Clinton, C., O’Brien, S., Law, J., Reiner, C., Wendt, M.R. (2015). Whole-Foods, Plant-Based Diet Alleviates the Symptoms of Osteoarthritis. Arthritis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359818/
  5. Dotinga, R. (2015). Number of Hip Replacements Has Skyrocketed, U.S. Report Shows. Retrieved from https://consumer.healthday.com/senior-citizen-information-31/demographic-arthritis-news-37/number-of-hip-replacements-has-skyrocketed-u-s-report-shows-696419.html
  6. Mayo Clinic. First nationwide prevalence study of hip and knee arthroplasty shows 7.2 million Americans living with implants. Retrieved from http://www.mayoclinic.org/medical-professionals/clinical-updates/orthopedic-surgery/study-hip-knee-arthroplasty-shows-7-2-million-americans-living-with-implants
  7. Mattek, J. and Fisher, S. (2017). What Lies Beneath: The under-realized effects of breast, abdominal, and pelvic surgeries. St. Bernardino, CA: Niche Pressworks.
  8. McDonald, B. (2017). Skeletons say arthritis isn’t about aging – it’s about activity. Retrieved from http://www.cbc.ca/radio/quirks/august-19-2017-1.4252722/skeletons-say-arthritis-isn-t-about-aging-it-s-about-activity-1.4252755
  9. Osar, E. (2012). Corrective Exercise Solutions for Common Hip and Shoulder Dysfunction. Chinchester, UK: Lotus Publishing.
  10. Osar, E. (2017). Integrative Corrective Exercise Instructor Certification Program: Training the Older Client. Chicago, IL: Institute for Integrative Health and Fitness Education course handouts.
  11. Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning
  12. Pagnano, M., Wolfort, M., Berovitz, A. 2015. U.S. National Center for Health Statistics. Data brief; National Center for Health Statistics.
  13. Riebe, D., Ehrman, J., Liguori, G., Magal, M. ACSM’s Guidelines for Exercise Testing and Prescription. 10th Philadelphia, PA: Wolters Kluwer.
  14. Selfe, TK., Innes, KE. 2013. Effects of Meditation on Symptoms of Knee Osteoarthritis. Alternative Complementary Therapies; 19(3): 139-146.

 

Young woman having knee pain

Rolling to Fight Arthritis!

By the year 2040, an estimated 78.4 million (25.9% of the projected total adult population) adults aged 18 years and older will have doctor-diagnosed arthritis” (Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA)

The time is now! Let’s talk about how to prevent the onset and symptoms of various forms of arthritis through myofascial release!

What is myofascial release?  

It is a type of physical therapy often used to treat myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder caused by sensitivity and tightness in your myofascial tissues. These tissues surround and support the muscles throughout your body that are affected by arthritis.

What is fascia tissue? 

This holds the muscle together and keeps them in the correct place. The fascia separates the muscles so they can work independently of each other. The fascia provides a lubricated surface so that the muscles can move smoothly against each other. When fascia is constricted, it prevents blood flow and decreases circulation.

What parts of the body can I roll?

  • Head, Face & Neck
  • Shoulders, Chest Arms, Wrists & Hands
  • Upper & Lower Back, Hips, Glutes, Thighs, Knees, Ankles, Feet

What is the Benefit of Rollga Rolling My Face & Neck? 

Rolling for Youth Preservation: First, let’s discuss regaining a rejuvenated look for our skin. When looking at what causes skin aging, it is a slowing down of circulation of blood. As noted by the NIH, this consists of a slowing in the circulation of nutrient-rich blood and detoxifying lymph and increasingly sluggish skin-cell turnover; the skin becomes more “stagnant.”

Rolling the Face. When “rolling” the face, be sure to apply gentle to medium pressure. The two main points of tension are in the superficial fascia and the other is lymph. Lymph is a highly underrated circulatory system within the body that is responsible for detoxifying waste from the skin on a cellular level, in addition to its many, many other functions. When holding tension in the muscles and fascia, lymph cannot move freely and do its job of clearing out waste from the tissue. The result of poor lymph flow can present as dull skin, an accumulation of blackheads and milia, and/or stubborn hyperpigmentation, and more. Superficial fascia is the layer of connective tissue right under the skin on the face. It acts as the support and infrastructure for your skin and is responsible for giving it “lift and tone.” It can also carry a lot of tension and adhesions that restrict circulation of blood and lymph. If you’ve ever used a foam roller on tight legs, think of how much softer one leg feels after rolling when compared to the unrolled leg. Foam rolling is a form of self-administered myofascial release, and that is EXACTLY what we want to do for the face.

Rolling for Neck Tension. The neck is the superhighway of ALL circulation to and from the face. A tight neck acts like a traffic jam between the body to face and back again. This prevents detoxifying lymph from draining as well as it should, and working the neck alone can be major in bringing flow and vitality back to the complexion as well as reducing puffiness in the face. Many people experience a very high level of neck and jaw tension due to everyday stress. Remember that working hard also means you must self-care harder!

Rolling to Fight Arthritis: To reduce the onset of symptoms from various diseases such as arthritis that affect facial and neck muscles, various myofascial release techniques such as Rollga rolling stimulates muscles, improves blood flow and enhances circulation. Because the jaw is a joint that is commonly affected by arthritis, myofascial release eases tension, improves joint mobility and decreases pain while speaking or chewing.

Learn more about Rollga rolling for the face and neck by contacting info@ContiFit.com

Request a manual, attend a workshop, or take an online course to learn about myofascial release with Let’s FACE it Together™ Facial Exercise & Rehabilitation!

Check out the Arthritis Fitness Specialist Online Course from MedFit Classroom.


Reprinted with permission from Christine Conti. Originally printed on rollga.com.

Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is currently writing the MedFit Network Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.

senior-man-and-trainer-treadmill

General Strength Training Advice for Those With Arthritis

If you have arthritis but want to improve your current strength levels, there are smart strategies to get you there. In this article, we’ll discuss them and provide some basic steps to follow. With a solid foundation in place, you’ll be feeling stronger in no time.

Seek out a certified & trained professional

The best bet is to start working with a personal trainer who’s trained clients with arthritis. That way you get to work with a professional who knows the appropriate training style and protocol to use.

Someone who knows to avoid exercises that put more stress on your joints. And instead provide exercises to improve your range of motion, flexibility, and of course, overall strength — all in a comfortable and safe way.

Then after several months of one-on-one training, you’ll have the knowledge and skills to confidently work out on your own, or continue training with the professional, if that’s what you prefer.

Choose an ideal workout time

Pick a time of the day where your pain level is at its lowest. Exercising while in pain, stiff, or feeling inflamed will make the exercise uncomfortable, and that’s exactly what we don’t want.

Warm-up before exercising

Always warm up your body before an exercise. With arthritis, it’s better to have a longer warm-up time, so plan on setting aside 10 minutes or so. After this, your joints will feel lubricated and will make the exercises more enjoyable.

Choose the right equipment and weights

If you decide to workout at home, rather than with a personal trainer or physical therapist, then you’ll need to purchase some dumbbells or resistance bands if you don’t already have them.

Dumbbells and bands are more ideal than a barbell because they’re easier and safer to use. Safer in the sense that you could have an imbalance in joint strength and that would make it more difficult to use a barbell. Whereas, with dumbbells or bands, you can work your left or right sides individually and gradually increase your strength over time.

Start out slow & use good form

If it’s been many months or years since you exercised, then ease back into it gently and slowly. Pushing yourself too hard too soon will only overload and burden your muscles, which can increase joint pain.

This means starting with low weights as we just mentioned. It’s better to do more repetitions than to start off using heavy weights and only doing a few reps. Also, try to do a little bit every day. Even if that means going for a walk, doing some light stretching, or a few bicep curls. Being active every day will help decrease arthritis-related pain.

Furthermore, when you do work with a professional trainer or physical therapist they’ll teach you good form. And this is not only fundamental to effective exercise, but also for injury prevention.

Stay hydrated

Hydration keeps your body healthy, and it helps to lubricate the joints. As you know, this is essential for minimizing pain from arthritis. Plus, the more you exercise and sweat, the bigger the need for hydration becomes.


As the owner of Results Performance Training in Williamsburg, Virginia, Detric Smith helps people achieve their fitness goals through customized training and action-based coaching. Over the last two decades, Detric’s made it his mission to study the habits, strategies, and techniques of personal trainers and coaches who are successful and, most importantly, happy. Also, during this time he’s authored a book, mentored trainers through multiple organizations, and his own business. Finally, Detric’s written for well-respected fitness websites, magazines, and journals. Find out more about Detric at: resultsperformancetraining.com and  www.detricsmith.com

 

References:

  1. 5 Weight Training Tips for People With Arthritis
  2. Hydrate For Better Performance and Less Joint Pain

 

Depositphotos_84018014_l-2015

SIMPLE TIPS TO STAVE OFF ARTHRITIS SYMPTOMS!

In 2020, COVID-19 changed the world. Businesses closed, social gatherings ceased, isolation grew, and the fear of catching the Corona Virus was on the rise. In fact, for those with compromised immune systems due to chronic autoimmune diseases, the increased stresses of navigating a world full of dangerous contagions has led to an increase in the consumption of medications to battle painful symptoms and lingering flare-ups. Isolation and loneliness have led to an increase in feelings of depression, anxiety, and overall mood, which directly impacts the ability to deal with painful symptoms.

ORTHOPEDICS CONSULTATION WOMAN

If You Can’t Beat It, Use It: An Exercise Guide to Post-Joint Replacement Wellness

It all started over 40 years ago, when I chose as my sport – some would say, my life – the Korean martial art of Tae Kwon Do. I was young, fit, pretty strong and, unbeknownst to me, very flexible – perfect for the art of kicking high and hard. Once I got hooked on it, I was in the gym a few hours a day, 6-7 days a week…for the next almost 20 years. That did not include the running I did to get my cardiovascular conditioning primed for the art and sport I was practicing at high levels of both skill and competition. I knew then, at age 19, that I was going to pay for the training and abuse I was putting my body through, but not until I was older, say, 40 or so.