Walking is our freedom to GO anywhere, anytime, automatically, to get somewhere ‘on our own’ without fear or assistance.
It is the antithesis to the slipper shuffle and a key player in fall resistance, that is, staying UP. A shorter, wider stride, stiffer ankles and feet, and a hunched posture are not a function of aging per se. We CAN be spry, walk tall, with spring in our step, well into our 80’s and 90’s.
Pelvic floor dysfunction, or PFD, is a broad term used to describe several physical conditions that occur mainly as a result from pregnancy and childbirth. As a pre and postnatal fitness specialist for over 20 years, almost every one of my clients has had some form of PFD. What does this mean and why is it relevant to women’s fitness? I will further define PFD in detail and explain how it changes the way we as exercise professionals program design for this clientele.
First, let’s look at the pelvic floor muscles. The pelvic floor looks like a sling or hammock that forms the floor of the bony pelvis and it serves several important functions in our bodies. The internal layer or “pelvic diaphragm” work with the external muscles of the pelvic floor to support our internal organs, stabilize our bodies, allow for sexual function, urinary and bowel movements and assist in contracting and pushing in the birthing process. These muscles are prone to trauma from the various functions they perform. The stress of the growing uterus in the body during pregnancy coupled with the changing gravity, posture and production of the hormone Relaxin all contribute to weakening the pelvic floor muscles.
Second, consider the whole Neuromuscular Core system. Pelvic floor muscles connect to the Transverse Abdominus (TVA) and they work together in harmony essentially hold the body upright. It is almost impossible to engage one without the other. Tightness in the hips combined with weak pelvic floor muscles creates PFD.
Diastasis Recti, Symphosis Pubis Dysfunction (SPD), Urinary and or fecal incontinence, pelvic pain, chronic lower back pain, Piraformis syndrome, sciatic pain, pelvic organ prolapse are all conditions under the pelvic floor dysfunction umbrella. Below these conditions are listed and defined in more detail.
Diastasis Recti: This is a separation of the right and left side of the Rectus Adbdominus in the Linea Alba connective tissue more than 2 cm in width
Pubic Symposis Disorder: A separation of the pubic bones, which often occurs during birth but sometimes during the third trimester.
Urinary incontinence: Uncontrollable leakage from bladder.
Fecal incontinence: Uncontrollable leakage of fecal matter from colon. Usually as a result from severe tearing during birth.
Pelvic pain: This type of pain can be during sex or when performing a movement that is irritating or uncomfortable, many possible underlying issues.
Chronic lower back pain: Unexplainable chronic lower back pain
Sciatica: Pain that radiates from lower back down one leg along the sciatic nerve as a result of compression of the sciatic nerve
Piraformis syndrome: Also a result of an inflamed sciatic nerve but more localized
Pelvic organ prolaps: When organs of the pelvis fall as a result of weak pelvic floor muscles.
These conditions can be limiting for many women and go untreated because they are embarrassed or told that they are normal “experiences” after giving birth. Until recently, very few fitness programs existed to help women strengthen pelvic floor muscles. It is my opinion that every pregnant woman and new mother should be automatically screened for PFD and treated right away. If women do not learn proper strengthening exercises of pelvic floor muscles they can potentially live in discomfort for years. The sooner preventative care is offered the better the quality of life for these women.
As mentioned earlier, many of these conditions are preventable and remedied through a combination of functional strength with corrective, posture-based range of motion exercises. When a woman becomes pregnant there is an immediate increase in pressure to the pelvic floor muscles. The body begins to produce relaxin which affects the joints throughout the body, especially the pelvis as it prepares to accommodate the growing uterus and eventually for birth. If treatment begins to help women continue strengthening the muscles surrounding the hips immediately, the pressure on the pelvic floor muscles will be reduced.
It was common practice until recently that women were advised to learn and perform Kegel Contractions. We understand more now as movement therapists that Kegel contractions are very hard to teach, very isolated, and in most cases, when examined internally by a women’s healthcare PT, women are not performing them correctly. A more effective approach to strengthening the pelvic floor muscles is to treat the entire hip complex as “one”– or a “global approach” — as described in applied functional science.
So, how do fitness professionals help create beneficial, safe and effective exercise programming for pregnant clients and new mothers that hone in on the core and pelvic floor? We must start by helping our clients improve their posture first and foremost, then work on proper breathing techniques and lastly incorporate larger exercises that do not isolate, but recruit many muscles from the hip complex and surrounding muscles groups. By incorporating all three planes of motion instead of working primarily in the sagittal plane (forward and backward) when performing even the most basic of exercises (i.e., the squat), you must change the movement by foot placement, arm placement, direction, tempo, range of motion etc. The variety in actions creates good stress to the pelvic floor and core muscles. Additionally, increasing the adduction and abduction action simultaneously while performing various exercises will help activate and recruit pelvic floor muscles subconsciously. Anatomically speaking, everything is connected in the body. Understanding that big global movements of the upper body and lower body together affect the position and strengthen of pelvic floor and core muscles is essential. The body is most efficient at strengthening the small muscles when big muscle groups are stimulated in combination. Throughout my years, I have seen much success with clients that incorporated these types of movements into their workout regimen and were safe and conscientious not to perform exercises that added bad stress to the external abdominal muscle group or impact exercises.
Each woman is different on how quickly it takes her to recover from PFD. The most important rule of thumb is to be reassuring and provide support and remember the time line is different for everyone depending on severity of PFD, the fitness level of the client, if the client is breast feeding and prior injuries that could prolong healing time.
Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com
I want you to think differently about exercise. We have to understand that exercise is not only about body builders and gyms. Being strong leads to a better quality of life. Training for fitness gives us the ability to manage
The mind is a powerful tool or weapon that can be used to work for us or against us. Everything begins with a thought. From the moment we wake up until laying our head on the pillow each night, our mind is consumed with thoughts; more than 60,000 a day by the time we reach age 40.
95% of those thoughts occur in the subconscious mind, making us unaware we have them or even what they are most of the time. Thoughts run on autopilot throughout the day unless we do the internal work to become aware of them and shift our thinking.
Awareness is the first step to reprogramming the mind with different thought patterns. Once we begin practicing a mindful lifestyle and becoming aware of the thought patterns that are regularly showing up in our lives, we can then learn and use tools to reprogram the mind to think differently. Think of it like this: the brain is the hardware, and our mind is the software, the software we use daily determines how we think, feel and react or respond to various situations.
The good news is, it is possible to “rewire the brain” a term referred to as neuroplasticity. The latest technology in science reveals that by creating new neural pathways in the brain, we are capable of rewiring neural pathways, creating new neurons that fire together which allows us to think and process differently, thus leading to less reactionary responses and more responding to our external environment.
The question is how do we do this if our mind is on autopilot and we are mostly unaware of our thoughts?
One answer is through the long-practiced method of meditation, a process of refocusing the mind. Meditation is a mental exercise that with practice trains the brain to think and process differently. It is through refocusing the mind to think about one thing and ultimately “no thing” that allows for us to tap into our subconscious mind and create new programming.
Often people say they cannot meditate or can’t calm their monkey mind. That is true for those who do not practice training it to be different. Being mentally fit is a practice that requires exercise, just as muscles do when training in the gym or recovering from a physical ailment. The mind must also be exercised and taught to think and react differently.
There are many different modalities to the practice of meditation, just as there are many workouts in the gym to become physically fit. It’s about exploring the types of modalities and finding one that works for you or your client. Mental resilience is built each time new neural connections are made, each time we go through a challenging time and overcome it, we become more mentally fit thus giving us resilience for the next time we face something hard.
Understanding how the brain works and how it pre-dispositioned to think negatively over positively, allows us to have compassion and patience with ourselves while learning to create a consistent routine of practicing meditation. Discovering the mind/body connection and how they work together also empowers us to be able to choose differently in situations where we become aware we are reacting from autopilot rather than choosing to respond.
Meditation is currently a $1 billion industry and is rapidly growing. Learning how to use meditation in your own life, while also learning how to instruct others through science-based, proven modalities expands your revenue offerings as well as helps clients heal faster and live happier lives.
Check out Briana’s short courses with MedFit Classroom for more. Click course for details:
Briana Bragg is the founder of Vacation of the Mind®, a mental wellness company dedicated to helping one million people or more reduce stress, refocus the mind, and lead healthier and happier lifestyles through practical techniques of nature-centered mindfulness and meditation. Briana is the author of “Journey into Tranquility®”, a meditation teacher training course that utilizes science-based methodologies of nature, meditation, and creative visualization in a three-step process Breathe, Refocus, Journey, curating guided journeys that connect people to nature and stillness. Briana’s dynamic energy and passion are fueled by her devotion to the well-being of others.
Research has shown the positive influence of exercise on alcohol use disorder (AUD) recovery as well as other drug-related substances. However, qualitative research has been missing regarding the influence of exercise on substance abuse disorders. In 2021, I performed a qualitative study involving interview and exercise journal data, which further validated the benefits of exercise during addiction recovery (specifically AUD). Most importantly, the results of the study showed how exercise can persuade the decisional balance a person has when working through the process of recovery. The benefits of exercise (pros) are better than the benefits of drinking (which are now cons). Another important theme participants expressed was that exercise does help recovery, but it should be a tool, not a replacement to other forms of treatment. Therefore, exercise shouldn’t replace strategies such as group meetings (e.g., AA or NA), cognitive behavioral therapy, or medications. Rather, exercise can compliment a comprehensive treatment program as a tool to maintain abstinence from alcohol and other substances, with the ultimate goal of avoiding relapse and reaching termination of the addiction. The intention of my study was to help medical and fitness professions better understand how persons connect exercise performance to their recovery process. This information also leads to better strategic planning programs for recovery, including exercise.
As a result of my research, I have developed the PACE Method to assist persons in recovery who are using exercise as a tool in order to combat not only relapse but also the threat of replacing one addictive behavior with another. One might replace exercise with the aforementioned forms of treatment, and in doing so, replace the psychology/physiology of their addictive habits with exercise performance. Even if exercise is considered “healthy”, in excess, there are consequences to the body. Currently the DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders from the American Psychological Association) does not have diagnosis for exercise addiction. What is considered the appropriate/recommended, “normal” amount of exercise? Leaving that up to be self-determined, particularly to persons in recovery who are at risk for addictive forming thoughts and behaviors, can be problematic. Just like any program planning, a medical and/or fitness professional may refer/recommend, there needs to be an appropriate guide to properly integrating exercise into recovery without reaching excess.
PACE stands for Proactive Awareness Controlling Excess. Fit PACE is a guideline/tool to incorporate exercise into recovery safely by being proactive and ahead of excessiveness, being aware of your own addictive behaviors, controlling thoughts/actions, and deterring/avoiding reaching exercise in excess. I have just released the Fit PACE mobile app which details a program for persons in substance abuse recovery to follow for exercise performance. Users not only log days performing exercise for accountability (and to avoid excess), but they also log number of days sober. Graphical images display progress and track this information. Users can connect to other persons on the app, which emulates the group meeting, community support aspect recovery. Users can select their exercise goal and tailor workouts to their level of fitness. It is my hope that both fitness and medical professionals can refer/recommend the Fit PACE app to download and use as a tool during substance abuse recovery. This is in alignment ACSM’s Exercise is Medicine philosophies.
To download the Fit PACE app, look in the applicable store for your cellular device:
Want to learn more? Sign up for Dr. McCullough’s short online from MedFit Classroom, Fit PACE – Alcohol, Addiction and Exercise
Dr. Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health and a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.
*Before we begin, it is essential to look at your accrediting agency’s ‘Scope of Practice.’ Remember, as a Certified Personal Trainers, we DON’T diagnose, prescribe, treat injury or disease, rehabilitate, counsel, or work with patients. We DO perform fitness screenings, design exercise programs, coach, give general health information, refer clients to medical health professionals when needed, and work with clients.
I have been a personal trainer for over 30 years and have had clients with me for decades. You cannot work that closely for that long with human beings and NOT come across a crisis.
How do we define “Crisis”? The dictionary defines crisis as a time of intense difficulty, trouble, or danger. It includes but is not limited to death, divorce, health scares and medical diagnoses, job loss, financial struggles, family struggles, mental health journeys, injuries and illness, surgeries, car accidents, and so on.
The research is solid.
Exercise is proven to release positive endorphins and happy hormones. Exercise can be a tremendous stress and anxiety release. Exercise will not FIX the crisis but is an excellent way to cope with the problem, clear the mind, and settle the body to be in a better place to navigate the situation.
The good news is as personal trainers, we have a unique opportunity to be in the room where it happens. Physical exercise can be very cathartic for clients going through difficult situations. I cannot count the times I have had a client break down and cry in our sessions. In my own experience, numerous doctors and friends recommended I start yoga classes when dealing with high anxiety. I walked into a class taught by one of my dearest friends and almost had to leave because I was sobbing so audibly I was afraid to disrupt others’ experience. Something unlocked in me during that class. Yoga did not fix my situation or my anxiety, but it did help me navigate my situation better and soothe it for the time being.
I count it a privilege to walk alongside my clients when they are going through a crisis. But it is essential to do so professionally and avoid getting tangled in their situation yourself.
There is a visual picture that many supporting agencies or groups use when training to work with people in crisis that can also be helpful to personal trainers. The image is a large pit or hole in the ground, and the person in crisis is at the bottom of the pit and cannot get out on their own.
The dilemma is how to help that person without getting pulled down in the hole with them, but instead giving them the assistance and support to get themselves out of the hole.
Initially, we should provide a safe place for our clients to share what life is offering them at that time. It is crucial to their physical health and can affect their performance during the training sessions.
Avoid judging the story and offering advice, but rather asking questions. “What do you think is the next step to solve this issue?” Often our clients want to be heard and seen. Giving them the space to share can often lead them to the solution or the next step or provide them with the freedom to move through the grieving process, whatever the situation may be. Of course, direct your client to professional help if you feel they are in danger or experiencing extreme levels of depression, anxiety, or hopelessness. You should have referrals on hand for anything a client needs outside of your Scope of Practice! It takes a village to keep our health in check.
How do we do this and still train our clients? I certainly do not intend for you to have an hour-long listening session instead of training them. Quite the contrary; the training will help them through the crisis.
Here are some of my tricks:
You can be the missing puzzle piece that helps get them through.
It is a fine line between ushering your client through crisis and getting involved in their situation, but it can be done, and one size doesn’t fit all. Find the things that work for you and your client. But see them, hear them, and continue to point them to the positive benefits of working out during a difficult season of life. Their physical and mental health will benefit dramatically. It may not be the time to set huge fitness goals, but maintaining their fitness, assisting their immune system under intense stress, and helping with sleep during these times are critical to success.
In closing, I said earlier that I am privileged to walk with my clients through a crisis. And my favorite part of my job is seeing the light at the end of the tunnel. Then celebrate with them when the situation is over, or the grieving is complete. Don’t forget to point out how strong they are, how resilient they are, and not only where they were but how far they have come!
Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30-plus years of experience in the dance and fitness industry. Shannon is the Personal Trainer to the Kilgore Rangerettes and helps Collegiate Fitness and Wellness Directors fill in the gaps. She leads continuing education workshops in multiple group fitness formats and topics specific to personal training.
For years, fitness and medical professionals have advocated the need for bridging the gap that exists between preventative care and chronic pain and disease. Medicine today does the heavy lifting of disease management, acute trauma, and injury. We are an advanced nation in regard to communicable disease, traumatic and emergency medicine. However, the system is imploding with high costs of care coupled with an epidemic of unresolved chronic disease and pain within traditional insurance-covered care. Inside the healthcare system, the financial and political power lands at the top of the chain – pharmaceutical producers, government, insurance companies, the food industry, hospitals, and surgeons – yet we are failing at producing successful and sustainable care.
At a recent nationally recognized orthopedic conference I was part of a roundtable of practice executives reviewing key elements on running a profitable practice. Each group was discussing how many patients their top producing physicians were able to see per day. One group was cheering that their top physician is able to see 80 patients a day. Another said 70, and another 60 as if that was a badge of honor. I spoke up and said, “Let’s assume that doctor only uses the bathroom once, walks to the next room between each patient, washes their hands after each patient, and somehow spends no time in his medical charts. At best he or she has three to four minutes to spend with each patient. I would not want that care for you, a family member, or anyone I would refer. We should be ashamed of seeing this as quality care.”
As a result, over the last decade, we have seen a rising trend of medical providers experiencing burnout, dissatisfaction, and moral conflict. Many have decided to go against the grain of the standard care in medicine and open functional, lifestyle, regenerative, and direct primary care clinical models that have been formed in an effort to provide restorative, root cause, and preventative medicine that can reverse the rise of chronic disease. It’s a model where medical providers have the proper time to listen, evaluate, diagnose, empathize, connect, provide options, coach, and empower patients towards optimal health.
The third leading cause of death right now in the United States is medical negligence, according to the Journal of the American Medical Association. This is an alarming fact because many medical errors are entirely preventable. Functional medicine physician and pioneer, Joseph Mercola recently stated at the healthcare event, Mindshare, “Those in control are building the largest tribe and protecting advertisers. It’s a threat, PR firms are doing all they can to discredit those that want to heal the world.” We have the science and evidence to not let a diagnosis be the reason for a life of decline. However, we are all fighting Goliath on steroids. Those in the position of profits-over-people are doing their best to keep education, research, innovation, and successful outcomes from progressing to be an option for all. Alternative healthcare providers attempting to educate the public are seeing censorship through Google and social media on topics such as vaccinations, lifestyle medicine, plant medicine, and functional medicine. In response, many health leaders are looking to create an alternative search engine specifically designed for uncensored health-related information.
To begin to redefine healthcare, it requires us to think differently and independently about how to slow the rise of chronic disease. Here are four frameworks from which to begin to explore new solutions in healthcare:
If the entire medical system turned around today and added preventative and less invasive options like nutrition, fitness, health coaching and energy medicine, we would not be prepared to fill the immediate demand. Consumers seeking optimal health are now aware and seeking expert health professionals who can listen, empower, hold them accountable, and help deliver successful outcomes.
Private clinics offering cash procedures and preventative care need to charge more to be able to spend more time with patients. This would allow providers to dig deeper with root cause lab analysis and would offer a greater probability to help lead patients toward successful outcomes. Healthcare in general will perform significantly better when providers are paid based on successful outcomes as opposed to time and service fulfillment. True healthcare is in demand for personal trainers, health coaches, and those with exercise physiology and kinesiology backgrounds to help deliver provider-recommended, outcome-based treatment programs. Most medical providers do not have the training, education or time to provide the nutrition, exercise or individualized care for patients that health and fitness professionals are trained to provide. Therefore, this article is a battle cry to the next-level fitness professional.
Not one doctor, trainer, diet or even single field of study has the answer to deliver the best health to the world. This all-encompassing effort can include surgeons, researchers, regenerative medicine specialists, functional medicine providers, behavioral therapists, chiropractors, acupuncturists, nutritionists, personal trainers, massage therapists, physical therapists, energy healers, naturopaths and coaches; not one alone has had all the answers. It will take a combination of the right internal, physical, emotional, nutritional and spiritual support to take a person on the journey towards optimal health.
The only way for primary care and transformative clinical models to succeed are with patient behavior change. Clinics need certified personal trainers and health coaches who have expertise in the more specific needs to help patients follow through on the recommended treatment plans. The medical fitness professionals of the future can fill the gap by becoming fluent in any of the following niches:
The demand is rising and will explode in the coming decade. Private practices are on the rise. Self-insured companies are seeking savings from healthcare costs. The equipped health and fitness professional will have no shortage of opportunity. If you have a solid knowledge base in any of these areas, there is significant opportunity to work for, partner, refer to, or carve out your own fitness and health business of the future.
To change the entire healthcare system over the next few years, we need everyone to collaborate to create universal consensus where all these areas are necessary to comprehensively treat patients. This will require leading experts in all areas of health to come together. Groups such as the MedFit Network are collaborating with medical leaders and are dedicated to raising the bar for personal trainers by defining how the medical fitness professional of the future can support the necessary shift. Those who are filled with passion and purpose for the medical fitness model of the future will see the monetary rewards of their exceptional work as the demand will outnumber the caregivers.
Join JR for the webinar presentation, Impact, Results and Income Opportunities to Enhance Your Coaching or Medical Fitness Center.
This article was featured in MedFit Professional Magazine.
JR Burgess found his purpose for helping people be free from pain at a young age. JR has played an integral role in replicating a proven integrated model of care in more than 80 clinics worldwide. He is driven to make the greatest contribution by changing the way healthcare can be delivered by integrating profitable, regenerative, functional and lifestyle medicine into clinics world-wide. He is a husband, father, two-time #1 bestselling author, and international speaker.
Arthritis comes in many forms and has many manifestations, affecting almost every joint in the body. We generally speak in terms of the two most-known if not popular forms of arthritis: rheumatoid (RA) and osteo-arthritis (OA.) The essential difference is in the root cause. RA is an auto-immune disease whereby the body, for unknown reasons, attacks itself, particularly in the joints. OA, on the other hand, is often considered the downstream effect of wear and tear, over-use, prior injury, or, as we’re seeing more of as society gets more sedentary, from lack of use. In OA, typically, some insult to the joint disrupts the natural repair processes and further deterioration occurs subsequently.
Due to their differing causes, there are obviously differing treatments; but the basics of medical management are essentially the same. I am not qualified to address the specifics of the treatments available but, in lay terms, treatment usually entails some version of anti-inflammation and pain-reduction drugs, precautionary movement or positional guidance (don’t do’s, for example), physical therapy to manage pain and inflammation, and therapeutic exercises to support the structures affected as the disease itself causes not just inflammation and pain but damage to the structures that support the joints. Typically we identify arthritis as something that damages cartilage and, in truth, that is often what the standard ‘films’ – X-ray, possibly MRI (magnetic resonance imaging) – show. We now know that the synovial sacs around the joint are also affected and that these and other chemical disturbances affect the muscles and tendons that move and support the joint. In almost all cases of arthritis, pain, inflammation, reduced strength and range of motion (ROM) ensue, diminishing quality of life in many ways and, because some of the drugs used to treat it, potentially reducing quantity of life. (Gastrointestinal bleeding from non-steroidal anti-inflammatories (NSAIDs) or bone loss (osteoporosis) from corticosteroids can lead to fatal outcomes (such as spontaneous fractures leading to falls from osteoporosis) if not treated with other medications.)
When someone is potentially afflicted or actually diagnosed with a form of arthritis, the medical community goes into hyper-drive, encouraging changing one’s habits, be they the types of activities one engages in recreational, competitively, or professionally; or the types of non-activities one currently does, in particular, being inactive.
In some cases, dietary advice is offered as we are learning more about foods that are pro-inflammatory and others that have anti-inflammatory benefits. In the former category, we are learning that excessive sugar or simple carbohydrates, including processed wheat products, may exacerbate inflammation while others, such as salmon, dark, green veggies, and certain oils (e.g., olive oil) are capable of reducing the inflammatory elements circulating throughout our bodies and our joints. Furthermore, in more extreme cases, when arthritis becomes very painful and debilitating, over-the-counter and/or prescription-fitted braces may be offered to defer some of the more end-line procedures such as surgery to fuse the joint or replace it with a prosthetic device.
Note that there are several legitimate ways to integrate exercise through resistance training programs that have proven quite effective in arthritis management. Yoga, Pilates (floor or machine based), Tai Chi, Qigong and water-based, or aqua, exercise are all beneficial to many aspects of the overall arthritis program of strength, ROM, proprioception and ultimately function. Since many of these are quite technical and are often done in class formats, one should ask the instructor(s) as to their experience working with arthritis clients.
As with any form of exercise, by whatever professional instruction, you should be totally aware of your pain levels as going “through” the pain is not recommended; thus, you must assert control over the exercise sessions. There will be some exercises, however, that are not destructive and may be somewhat painful but must be done in order to maintain reasonable levels of function and independence. So long as the pain subsides within a couple of hours – preferably as soon as you stop – and there is no exacerbation of inflammation the next day, you can assume that the exercise was just enough. If symptoms flare up over the next 24 hours, however, assume you did more than you should have and alert your trainer or instructor so that he/she can avoid doing the aggravating exercise(s) as much or as hard next time. For these reasons, along with all the other recommendations so far as exercise interventions are concerned, it is best to seek the counsel and assistance of a fitness professional with a background in medical fitness. This could be someone with a more advanced academic degree, someone with a license to practice rehabilitation exercise (physical therapist, athletic trainer, etc.), or someone who’s taken several educational programs to have a greater understanding of the variety of disorders and diseases that may benefit from exercise interventions.
Dr. Irv Rubenstein graduated Vanderbilt-Peabody in 1988 with a PhD in exercise science, having already co-founded STEPS Fitness, Inc. two years earlier — Tennessee’s first personal fitness training center. One of his goals was to foster the evolution of the then-fledgling field of personal training into a viable and mature profession, and has done so over the past 3 decades, teaching trainers across through country. As a writer and speaker, Dr. Irv has earned a national reputation as one who can answer the hard questions about exercise and fitness – not just the “how” but the “why”.
Hashimoto’s Disease, also called Hashimoto’s Thyroiditis, occurs when the immune system turns against the body’s own tissues. The immune system directly attacks the thyroid. This then leads to hypothyroidism, which is when the thyroid isn’t making the necessary hormones for proper body functioning. The thyroid plays a leading role in our body, as it is the controller of our metabolism. Without the right hormones, how quickly our body uses calories from what we eat, can be greatly impacted. It is the most common thyroid disorder, affecting 14 million people in the United States.
Symptoms of Hashimoto’s include having an enlarged thyroid. The front of the neck (where the thyroid is located) looks swollen. Symptoms associated with an underactive thyroid, due to the lack of hormone production, include fatigue, weight gain, cold body temperature, hair thinning and loss, depression, irregular menstrual cycles for women, and joint and muscle pain.
The exact cause is not known. There is a strong genetic component. Hormones play a major role, especially since Hashimoto’s is seven times more common in woman than men. Its primary target is middle-aged women. Many women experience thyroid problems after childbirth and about 20% of these women develop Hashimoto’s later on. Certain medications with high levels of iodine can cause this problem. Radiation exposure also can lead to thyroid troubles. In fact, the atomic bombs of Japan lead to this disease in many people. Then, this can be passed on genetically.
Unfortunately, there is no cure for Hashimoto’s. The medical community is not sure what causes autoimmune disorders. Getting medical help is important in order to prevent the progression of the disease. If left untreated women can experience problems with fertility and the risk of high cholesterol increases.
There are some self-care, natural approaches to try to improve or prevent this condition, including your diet. Making sure your diet consists of enough selenium, zinc, vitamin D and iron. Foods to include would be red meat, poultry, beans and dark vegetables. If you do not eat meat, do understand that plant sources are not as absorbable, but taking vitamin C can help with this. Foods you should minimize and eliminate include those that cause inflammation. These include gluten, sugar, artificial sweeteners, soy and dairy. Gut health is critical so making digestion as clean and easy as possible is important. Avoiding toxins can help too, such as plastics, beauty products, air fresheners or candles. Keep your air clean.
Exercise can also be beneficial for Hashimoto’s because it helps lower inflammation and stabilizes the functioning of the immune system. This is because exercise stimulates regulatory T cells which are big inflammation fighters. Also in the process, exercise can balance the pro-inflammatory Th1 system and the anti-inflammatory Th2 system to be less inflammatory. Exercise also helps to release immune cells called IL-6, which lessen inflammation. Just going for walks is a great start but depending on how the person feels, even high-intensity-interval-training (HIIT) can boost workouts and help manage Hashimoto’s. Exercise tolerance is a case-by-case situation and overdoing exercise will only worsen inflammation.
For those I have trained with this condition, we sometimes have to do a trial-and-error approach to ensure the person is doing what their body permits without causing a flare up. It has been my job to scale back intense workouts but still give the client the encouragement and motivation that inspires them to keep exercise as a lifestyle change to support living with Hashimoto’s as best as possible. Many times clients avoid movement thinking their condition prevents them for doing certain types of exercise so why try at all. Movement is medicine so if it’s just walking, it is doing the body good versus being sedentary and lethargic.
Thyroid disease is becoming a major problem. Nearly 20 million Americans have some form of the disease. Diagnosis isn’t always clear at first, but we know when we don’t feel right. Don’t give the thyroid any more power than it already has. Hormones might be tyrant rulers, but we can control our actions and attitude towards feeling our best. Autoimmune diseases are unpredictable. The thyroid greatly influences our metabolism, so our weight is readily affected by its functioning. Although our genetic makeup can leave us powerless, we do have the ability to control our response, adherence to medical help and ability to keep a positive outlook despite medical situations.
Dr. Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health and a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.
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