Fitness Professionals – Page 12

Coach, Therapist… What do you need today?

John Schessler/28 December 2022/ All MFN blog/

As I’ve stated many times before, personal fitness trainers are multi-faceted in their jobs because let’s face it, we have to be. You can’t teach someone how to be a people person, either you have the gift of versatility when you speak to a client or you don’t. Sure, you can wiggle your way through it uncomfortably but some people are better than others when trying to carry on a conversation or to lend an opinion to a client’s problem they are having at the moment.

Personally, it’s always been relatively easy for me to be caring, compassionate and to respond appropriately to clients’ wishes, problems and questions but like anything else that a person excels at, it definitely takes practice and finesse. This raises a question, however, about figuring out your clients needs during every session. Do they want a trainer who’s going to kick their ass and make them sweat or do they need a caring person to lend an ear and give solid advice? Trainers wear many hats. Aside from our titled job, we also are bartenders, hairdressers, therapists and the caring friend that they may not have in their life to provide advice, comfort and direction.

During most sessions with clients, I let them take the wheel as to how the conversation and friendly banter goes. 85% of the time we end up talking shop about what happened that day, weekend plans or special occasions coming up for them or myself. The other 15% of the time is where I change roles, usually the alter-ego that I play mostly is therapist. Ask most other seasoned trainers and they’re likely to agree that we hear a lot of other people’s problems from day to day. Most of the time, the person isn’t looking for a fix to the issue or even advice but someone to listen and to validate that whatever it is that they’re experiencing is valid. That’s it.

In the broader scope within humanity, this is all everyone wants, from the very normal person to people with mental health concerns and beyond. If people would learn that talking about their problems creates connection, vents frustrations and sets anger free, we’d probably see less problems in the world than we have today. I like to term myself as the ‘feelings trainer’ because if something is bothering you, I’m pretty much going to talk you through an emotional cleanse if that’s what you want/need.

That’s the first part, like I said. Trying to establish boundaries and develop a client dialogue for the session if the client wishes it to be that way. So many trainers miss these subtle hints and clues that may be a huge part of why they’re not reaching their goals, why their training sessions have fallen into the negative, etc. This is why it’s so important to require trainers to participate in behavior modification workshops or training to help them to recognize when specific behaviors surface in their clients and how to help them overcome whatever it is they may be experiencing that is holding them back from reaching certain goals.

Being able to read people isn’t rocket science but there is an art to being able to practice empathy and awareness for your clients effectively. Numerous fitness organizations offer behavioral modification training for continuing education credits (CEUs) or even offer a specialization in becoming Behavior Modification Specialists (BMS) through your certifying organization. Regardless, being able to spot emotional breaks in your clients and helping them to rectify them will help to further achieve their fitness goals and gain clarity in their lives.

John J. Schessler is a Pittsburgh-based NASM certified Personal Fitness Trainer and ISSA certified Exercise Therapist with over 13 years’ experience in the health and fitness fields. He also holds certifications as a Sports Injury/Orthopedics Specialist working with individuals with physical and mental disabilities. He currently is employed by Planet Fitness LLC as a tenured Personal Trainer and works as a Men’s Life Coach, assisting men gain the skills necessary to help enhance their lives in all areas. John is constantly gratified by the endless pursuit people have to better themselves everyday in his profession.

Understanding Health Coaching – Letting the Client Lead

Brian Prendergast/14 December 2022/ All MFN blog/

Health Coaches are trained to take an interesting approach in implementing a plan to help their clients. Successful Health Coaching programs have designs within that let the client set their own path to better health. That’s right. The client is often the one to determine which actions to take in obtaining, or retaining, the next level of better health that they hope to achieve.

Does this sound crazy? Well, if you think about the way things work in the world of sports, it makes great sense. Coaches coach and players play. The “player” in this instance is the client and the client is playing the game of life. It is their life. It is the client’s game to play. A coach’s role is to prepare the player (or person with the desire to improve their health) for action. A coach is there to guide. A great coach is one that asks the right questions; questions that bring awareness to the client’s needs and ultimately provide answers which will empower the client to proclaim their own path forward.

This is not to say a coach does not have a philosophy to which they adhere, or a knowledge base used to guide their clients. Nor does it mean that a coach will not step in and offer a more sensical path if the client chooses a step that clearly is not beneficial, or worse, potentially harmful. It simply means that the client can take the lead in determining the direction of their greatest gift, their own health. Instead of leaning on the coach like a crutch for support, the “player” stands on their own two feet.

Being told what to do and how to act is not a very effective way for making wholesale lifestyle and/or behavioral changes. The growth must come from within. The client must see and feel the importance of each step for themselves. Empowering the client to be aware enough to see the next possible, available, or achievable step is rewarding and the key to long-term growth.

It is common for a Health Coach, especially at the very beginning of the coach’s and client’s time together, to ask the client to simply observe their own behavior. As the great Yogi Berra once said, “You can observe a lot by just watching.” Seems simple, right? It is simple. The path to better health does not need to be complicated.

Pay attention to your own behavior and make note of what you observe. Or better yet, write down what you observe.

What do you see in your own life?
How well do you eat?
When do you eat?
What do you eat?
Do you snack?
What do you snack on?
When do cravings occur?
Do you notice your food when you eat (pay attention to how you see, smell, and chew your food)?
How well do you sleep?
What is your energy level like throughout the day?
Do you notice any sort of “crash” during the day?
How often does your mind drift?
Are your thoughts generally positive or negative?
Do you reach for technology often?
What are your relationships like?
What is your level of physical activity?
How does this activity make you feel – before, during and after?

…And on and on. These are just a few observable daily occurrences that a coach may suggest keeping an eye on to prime the pump, so to speak.

Asking a client to be a witness to their own life, their actions and how it relates to their current state of health, to be a detective and gather evidence on their own behalf is a sure-fire way to have the client detect their own tendencies, positive and negative, invest in their own progress and unturn areas that can propel them towards improved health.

Brian Prendergast is the Founder and Head Coach of High Five Health and Fitness, and Co-Creator/Co-Host of The Two Fit Crazies and a Microphone Podcast. Brian is a Certified Integrative Nutrition Health Coach, Certified Personal Fitness Trainer and Group Fitness Instructor, and USA Track and Field (USATF) Level 1 Coach and Competitive Masters Runner.

Can Tapping Into Your Memory Help You Stay Aerobically Fit?

Lori Michiel/9 November 2022/ All MFN blog/

November is Alzheimer’s awareness month. There are fun ways to teach your loved ones effective exercise and lively movement to improve their cardio and strength endurance—two activities that assist in brain health…

Woman Sitting On Pilates Ball Using Computer

Do You Slouch? Improve Your Health with Better Posture

Jacqueline Gikow/7 November 2022/ All MFN blog/

When babies learn to sit, they elongate their spine, which is naturally efficient and comfortable. Moreover, it provides the most skeletal support without requiring a lot of muscle strength. Despite this, around 4-years old, most of us began to slump. Why? Well, significantly, it’s probably because we started school and began spending more time sitting.

Poor posture often results from weak core muscles, and weak core muscles contribute to slouching. Also, most neck pain not caused by trauma is usually the result of poor posture and weak muscles supporting our head. For example, sitting at our computers, or hunching over our phone for several hours can strain our neck, and shoulders.

More importantly, strong core muscles lessen wear and tear on the spine. And that prevents falls and injuries. Strengthening your abdominal muscles improves your posture and enhances balance and stability.

You might not notice these actions: putting on shoes, picking up a package, or turning to look behind you, until they become difficult or painful. Core-centric activities include acts that spring from, or pass through, the core: lifting, twisting, carrying, hammering, reaching overhead — even vacuuming, mopping, and dusting.

What is Good Posture?

Good posture doesn’t mean standing like a stiff piece of board. Many people overcompensate for bad posture by standing up too straight. When our posture is correct, our ears, shoulders, hips, knees, and ankles align naturally. Good posture looks natural and relaxed.

Don’t Slouch! There is Power in Good Posture

Maintaining good posture is not easy. And despite the importance of good posture, most of us don’t do anything to improve it. As a result, we go about our lives uncomfortably hunching our backs and slouching. Practicing good posture strengthens our abdominal muscles and builds low back stability. If these muscles are weak, we’re more apt to slouch. For example, we may start the day sitting upright, but soon we’re lost in our work and slouching once again.

Good posture has many benefits. It aligns your body, and makes you look taller (you can lose 2 inches by slouching). Good posture even speeds up your metabolism (burn up to 350 calories a day). At the same time, having good posture reduces pain by using your muscles to support your skeleton) and improves your mood. (Don’tSlouch)

How to Improve Your Posture

Proper posture includes alignment, balance, and alignment. You’ll see immediate improvements in your posture by practicing the following two exercises. All you need is a wall. These two, quick and easy exercises realign and strengthen your muscles and ease pain and achiness that results from poor posture.

Exercise 1: The Chin Tuck is an exercise to strengthen your neck muscles. Start standing with your back to a wall. Extend your neck, keeping your gaze forward, and lean back so the back of your head touches the wall. You can also place a pillow behind your head if you can’t move all the way back. Keep your gaze forward, so that your chin is parallel with the floor. Retract your chin towards the wall until you you’re your neck muscles contract, then release the contraction. Repeat this movement 10 times.

Exercise 2: Wall Angels stretch your chest muscles, improve shoulder range of motion, and strengthen your upper back. Start standing with your back and head against a wall and your feet about 6 inches from the wall. With your arms at your side, face your palms forward. Slide your arms out to the side along the wall, bending your elbows at a 90-degree angle. Continue sliding your arms up along the wall to about 45 degrees above your shoulder. Stop when you feel your shoulders elevate or if you feel pain. Return your arms back down to the starting position. Repeat 10 times.

Jacqueline Gikow, is the owner of Audacious Living NYC™. Her holistic, health and wellness practice centers on pain relief through better movement. She is certified through the National Association of Sports Medicine (NASM), the National Board of Medical Examiners (NBCHWC), the Functional Aging Institute (FAI), Medfit (MFN), and the Arthritis Foundation (AFAP/AFEP). Her fitness practice includes in-home and remote, one-on-one fitness training and coaching in New York City. Jacqueline Gikow can be reached at: https://audaciouslivingnyc.com, or on Facebook: https://www.facebook.com/groups/audaciouslivingnyc

References

https://www.madisondias.com/posture/dont-slouch-the-power-of-good-posture/

http://lifehacker.com/fix-your-posture-with-these-three-simple-exercises-1754621367

Body Language, Self-Awareness and The Client Experience

Robyn Kade/4 November 2022/ All MFN blog/

As a trainer, you wear many different hats during a typical work week. In turn, you are pulled in many different directions among family, friends and clients. If you are focusing on too many topics at once you cannot be in the moment, which can lead to a lack of client retention.

Being in the moment.

There is a lot of competition in the studio market and potential members/clients like to belong to a gym – and stay with a gym – where they feel comfortable. That puts the limelight on personal trainers to generate the positive client experience that is so important to retention.

This is why being in the moment is vital to gaining new clients and retaining current ones. If trainers are distracted this may be apparent through body language. Members may perceive being distracted as receiving bad customer service.

Members decipher up to 93% of what is said through body language.

When you think of excellent customer service, which companies come to mind? What makes them stand out from their competition? The employees that work for these companies are mindful and in the moment. They anticipate the needs of the client and help them accordingly. Being in the moment means that your body language and what you say conveys the same message. This is important to note for customer service and member retention.

The importance of not ‘zoning out.’

Members are constantly making decisions on how they want to spend their money. When trainers work with clients they should be mentally and physically present for each session. If a trainer zones out the trainer leaves their client wondering if the session is important to them. Trainers also miss out on potential new clients who may have wanted their services.

Clients will typically get your attention first by asking if there is “something else you need to do”. This should be a clue that they know you are not in the moment. You want to fix this quickly before the client stops training at your facility. Potential clients also watch to see how focused and attentive you are. I once had a member watch my training sessions for 5 months before deciding that he wanted to hire me. He said that he was looking at my training style, personality and attentiveness. He passed up two other trainers because they seemed uninterested.

When you and/or your staff have better self-awareness you are able to anticipate the needs of your members easier. You will also notice that more clients would like to train with you. By being in the moment every day your clients feel like they had an experience that they want to share with friends and family.

Do you know what message you’re conveying?

Nonverbal communication involves facial expressions, gestures, eye contact, posture, voice, and touch -and is actually more important then what is said verbally. Trainers are communicating non–verbally with clients and members all of the time and when mixed signals are sent, clients have to try to figure out how you actually feel. You may be speaking to your client and sound present and in the moment but is your body language communicating otherwise?

Robyn Kade is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 18 years of experience in medical based fitness.

References

http://www.helpguide.org/articles/relationships/nonverbal-communication.htm

http://www.statisticbrain.com/gym-membership-statistics/

Helping Older Adults Flex their Stress Resilience Muscles

Cate Reade, MS/26 October 2022/ All MFN blog/

We can all agree that stress levels have skyrocketed to an all-time high following the “year of fear.” Older adults with chronic conditions have been the hardest hit since they are most vulnerable to Sars-CoV-2 and severe outcomes. Millions have been struggling with the fear of infection and mortality; inactivity and muscle weakness as well as social distancing and isolation. Helping older adults build stress resilience strategies into daily life is critical to bolster and protect physical, mental and social wellbeing.

Living under chronic stress leads to bad decisions. That’s because the part of the brain called the amygdala is activated when under threat. It is our survival brain with the “fight or flight” response being its signature. This means that blood is flowing to the “reactive” brain and away from the “thinking and planning” part of our brain, the pre-frontal cortex.

This can contribute to poor eating, activity and lifestyle choices. Convenience and processed foods can easily take center stage along with sedentary behaviors and heavier use of drugs and alcohol. This can lead to malnutrition, decreased blood flow and the increased risk and severity of chronic conditions as well as impairing immune function. It is a recipe for dis-ease and higher health risks, particularly in pandemic times.

Chronic stress puts the body into a catabolic state of “breaking down” while also turning down the volume on the body’s anabolic pathways of “building up” (1). The body was designed to live in the parasympathetic state, also known as “rest, digest, heal and repair” mode. Constantly living in the stress response leads to high levels of cortisol, oxidative stress and pro-inflammatory cytokines (immune messengers). This chemical marinade literally shrinks muscle and brain cells (2).

Chronic Stress Stinks & Shrinks

What happens when muscle and brain cells atrophy? Sarcopenia and cognitive decline arrive on the scene. This in turn leads to the downward spiral of physical and mental pathology that can include disability, dependency, dementia, an increased risk of falls, fractures and hospitalizations.

Resilience is a Process

The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress,” or “bouncing back” from difficult experiences (3). It is an adaptive process that can be developed. Being “hardy” or resilient is linked with positive outcomes, including improved functional mobility, health and longevity.

Medical fitness specialists can help older adults build stress resilience by empowering them with education and encouragement. This can be a powerful intervention as it combines education with behavior modification. It includes asking questions while providing clear messaging that reduce fears and clarify health benefits followed by simple actionable steps. The pro-active older adult can choose to practice the strategies that resonate with them. Being accountable to and encouraged by a trainer knowledgeable about geriatrics can support the process of building resilience to weather “stress storms.”

Building Stress Resilience

Like health, resilience is multi-dimensional and includes physical, mental and social components. As fitness professionals, we understand that exercise activity is the most powerful intervention to relieve stress because movement positively impacts the health of every cell in the body and brain. After all, who doesn’t feel better after an appropriate workout or walk in the sunshine?!

5 Simple Strategies

Being mindful of breathing, eating and moving are great ways to build stress resilience. Living in the present moment helps develop awareness, connection and calm. Avoid overwhelm by choosing to practice one small step at a time.

1. Breathe Deeply. Breath connects body and mind. Stress breathing is shallow breathing. By focusing on the depth and pace of breath, the parasympathetic nervous system is engaged. Encourage older adults to become aware of tension and overwhelm; to take “Breathing Breaks” while focusing on breathing in and out through the nose. It can be as simple as starting with 3 deep breaths and working up to 30.

2. Eat Slowly. In order to digest food and absorb nutrients properly, eat seated in a relaxed, calm environment. Encourage older adults to slow down and focus on chewing food 20-30 times. This supports the mechanical breakdown of food for better digestion. While eating, focus on the food’s aroma, flavor, texture, mouth feel and swallowing.

3. Tea Time. Take a few minutes to savor a warm cup of herbal tea like lemon balm, lavender or chamomile. Enjoy the aroma and feeling of warmth in hand and the body. This practice is a wonderful way to wind down at the end of the day or as needed.

4. Gratitude Attitude. Before rising and/or going to bed, think about, say out loud or write down 3 things you are grateful for. Practicing gratitude is linked with boosting happiness, optimism and a sense of greater well-being (3).

5. Move more. Inactivity and sedentary time slows down blood flow, metabolism and immune function. Encourage older adults to break up sedentary time with 5 minutes of movement every hour. Light intensity activity like house cleaning has been shown to reduce the risk of mobility disability by 40%! Simply moving more throughout the day is powerful medicine, especially when paired with a tailored exercise program.

Today, building stress resilience is absolutely critical for older adult’s functional and cognitive health. They will be so grateful for your guidance!

Fit Pros: Guide Older Clients as a Geriatric Fitness and Lifestyle Specialist

Millions of people over age 65 looking for guidance from fitness professionals who are knowledgeable in exercise, nutrition and lifestyle principles that can help them improve functional mobility, while also preventing and managing chronic conditions to live their highest quality of life. The Geriatric Fitness and Lifestyle Specialist online certificate course will give you insights, strategies and tools to be a successful professional in this rapidly growing market. Learn how to be a valued part of clients’ continuum of care, working with the medical team to improve functional outcomes and positively impact people’s lives.

Cate Reade, MS, RD is a Registered Dietitian, Exercise Physiologist and Functional Medicine Practitioner candidate on a mission to improve functional mobility and health span utilizing the power of lifestyle medicine. She has been teaching, writing and prescribing healthy eating and exercise programs for over 25 years. Today, as CEO of Resistance Dynamics and inventor of the MoveMor™ Mobility Trainer, she develops exercise products and programs that target joint flexibility, strength and balance deficits to help older adults fall less and live more.

References

Kirwan R et al (2020). Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. Geroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528158/
Mohammed A & Kunugi H (2021). Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era. Int J Endocrinol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152925/
MacLeod, S et al (2016). The impact of resilience among older adults. https://www.sciencedirect.com/science/article/pii/S0197457216000689

Gym woman pilates stretching sport in reformer bed

The Role of the Pilates Professional in Cancer Treatment and Rehabilitation

Graciela Perez/10 October 2022/ All MFN blog/

I am a 15 year breast cancer survivor, and experienced what cancer patients go through, not just from theory, but from living it. I’m going to talk about the role that Pilates had in my rehab and why I consider essential for cancer patients and survivors.

After surgery and treatment, most cancer patients are left with lack of flexibility and range of motion, and poor posture because of the scar tissue. Most experience fatigue from chemo and radiation or just stress of the circumstances. Many go through hormonal treatment which reduces the muscle mass, increases the risk of osteoporosis and bone fracture, bone pain, fatigue, mood swings and lack of stamina and stress.

Breathing is an essential part of Pilates. It helps with stress and stamina, reduces fatigue, opens the lungs and helps with mood swings. When we are paying attention to our breathing, we clear thoughts and allow the oxygen and energy flow through our bodies.

Awareness is a principle that helps us increase the consciousness of our body and the parts that are in disharmony and need to be repaired, isolating them from other parts to progressively make them stronger and healthier. Mind –Body connection

Control is another principle helps coordinate the body parts and move them with the correct alignment, avoiding jerky movements used in general workouts (especially using the Core which we call the powerhouse) and increasing BALANCE that is so affected in cancer patients.

Flexibility and range of motion are key in the rehabilitation for mobility and functionality of the limbs or part of the body affected so we start testing the patient range of motion without any resistance at first.

Pilates machines have springs that allow switching among different resistance according to the patient’s condition avoiding injuries and pain,

Allowing the patient to get FLEXIBLE then STRONGER and then MANAGE THEIR OWN BODY improving posture, Functionality, mobility, self-image and self-confidence.

Exercise Samples

Graciela Perez is a National Academy of Sports Medicine (NASM) Personal Trainer, Aerobics and Fitness Association of America (AFAA) Aquatic Specialist, and a Cancer Exercise Training Institute Cancer Exercise Specialist. She’s been helping people reaching their health and fitness goals since 2003.

Step up to Better Balance

Karl Knopf/21 September 2022/ All MFN blog/

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

Understanding Osteoarthritis

Chris Gellert/7 September 2022/ All MFN blog/

Osteoarthritis (OA), the most common form of arthritis, affects some 27 million adults per year and is on the rise. The Centers for Disease Control and Prevention (CDC) estimates that in 2005, self-reported arthritis or other chronic joint symptoms affected approximately 21.4 million Americans aged 65 years and older. This estimate is expected to reach 41.1 million by 2030. Osteoarthritis makes simple movements and activities of daily life painful and difficult to perform.

Osteoarthritis typically occurs in the hands, knees, spine and hips affecting a multitude of joints. Those affected with OA will typically complain of symptoms of stiffness, low-grade inflammation and pain. This stiffness and pain are most prevalent in the morning which improves with activity and as the day progresses.

Pathology

The cause of OA involves a combination of mechanical, cellular and biochemical changes. The processes involves changes in the composition and mechanical properties of the articular cartilage. Cartilage is comprised of water, collagen and proteoglycans, In healthy cartilage, there is continual remodeling that occurs as chrondocytes (cartilaginous cells) replace macromolecules that are lost through degradation. In Osteoarthritis, this process is disrupted leading to degenerative changes and abnormal repair response. 2

Contributing Factors

Despite increasing awareness of the negative effects of obesity on health and OA in particular, the prevalence of individuals who are overweight or obese is increasing. Data from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2000 show that 64.5% of the US population is overweight, including 30.5% classified as obese. Carrying extra weight places biomechanically places increased stress and force on the weight bearing joints. Other common risk factors include joint injury, mechanical stress, history of immobilization and trauma.

Medical Management

Arthritis treatment first begins with education. Treatment for osteoarthritis can help relieve pain and stiffness, however the condition can progress. Physicians will tend to focus to help those afflicted with OA by helping patients manage their pain. There are several ways to do this. The first commonly used approach is pharmacologic intervention. Traditional non-steroidal anti-inflammatory drugs(NSAIDs) have been shown to be effective for OA pain, and are perceived as second-line drugs for the treatment of mild to moderate OA.

Physical therapy is very effective in helping those suffering with OA. Where the focus is on helping the patient by improving their muscle flexibility, joint mobility and strengthening the weaker hip musculature. Resulting in improved mobility, function, decrease pain and improved quality of life.

Training Recommendations

Because arthritis is a “process,” the most effective training is education and prevention. From a cardiovascular perspective, a cardiovascular program should be tailored to the client. A recumbent or stationary bike is a great starting point to reduce the load to the hips and knee which can be progressed to the elliptical machine. Stretch the tight (postural) hip flexors and quadriceps seen in figure one will reduce the load to the knee joint. Yoga can also be an effective intervention which will improve flexibility, balance, strength and body awareness. Strength training should focus on targeting the weaker phasic muscles; glute maximus, glute medius/minimus as seen in figure two. These muscles are necessary for everyday movements such as arising from a chair, climbing stairs, and negotiating uneven surfaces.

**Figure 1. (left) Anterior muscles of the hip complex**
**Figure 2. (right) Posterior muscles of the hip complex**

Strengthening the core begins with simple exercises such as bridging with the ball (figure three), targeting glute maximus, hamstrings, and the lower back musculature. This can be progressed to having the client hold longer or to perform a single leg bridge. Functional strengthening exercises such as reverse lunges holding a medicine ball that can be progress to either holding overhead or adding trunk rotation will do two things. four and figure five). The use of aqua therapy can also be effective which eliminates gravity resulting in a client’s ability to strengthen their lower body in a relaxed environment.

**Figure 4. (left) Reverse lunge with wood chop**
**Figure 5. (right) Diagonal lunge with trunk rotation with medicine ball**

Summary

Arthritis continues to affect many individuals for various reasons. One thing is certain, knowledge, prevention and early screening is fundamental. Understanding the pathological process and medical approach is the first step in helping your clients with OA. Refreshing yourself on anatomy, biomechanics and understanding proper exercise prescription is fundamental. Any exercise program should be individualized resulting in improved function.

Chris Gellert, PT, MMusc & Sportsphysio, MPT, CSCS, C-IASTM, NASM CPT. Chris is the President of Pinnacle Training & Consulting Systems, LLC. A consulting and education company that is committed to creating and providing evidenced based educational material in the form of home study courses, dynamic live seminars, mini-books, DVD’s on the areas of; human movement, fitness and rehabilitation with unique practical application. Chris has 20 years clinical experience having worked with primarily orthopedic patients, spinal injuries, post-surgical conditions, traumatic and sport specific injuries and 20 years as a personal trainer. For more information, please visit www.pinnacle-tcs.com.

REFERENCES

David M Lee et al. Rheumatoid Arthritis. The lancet. Vol. 358. September 2001. pp: 1240-1242.
Hinton et al. Osteoarthritis: Diagnosis and Therapeutic Considerations. Journal of American Family Physician. 65(5) Pgs: 841-849. 2002.
Weinblatt ME, Maier AL, Fraser PA, Coblyn JS. Long-term prospective study of methotrexate in rheumatoid arthritis: conclusion after 132 months of therapy. Journal of Rheumatology. 25: pp: 238–42. 1998.
Kremer JM. Safety, efficacy, and mortality in a long-term cohort of patients withs rheumatoid arthritis taking methotrexate: follow-up after a mean of 13·3 years. Arthritis Rheumatology. 40: pp: 984–85. 1997.
Tugwell P, Wells G, Strand V, et al. Clinical improvement as reflected in measures of function and health-related quality of life following treatment with leflunomide compared with methotrexate in patients with rheumatoid arthritis: sensitivity and relative efficiency to detect a treatment effect in a twelve-month, placebo-controlled trial. Arthritis Rheum. 43: pp: 506–14. 2000.
Schneider, Rayfel. Et al. Rheumatology Disorders Clinics of North America. 28. pp: 503–530. 2002.
Braun, Jurgen et al. Ankylosing Spondylitis. The Lancet. 369, 9570; Research Library. pp. 1379. 2007.
Ding, T., Deighton, C. Management of Rheumatoid Arthritis. Journal of Medicine. Volume 38. Issue 4. 2009. pp: 172-1769.
Calin, A. Ankylosing Spondylitis. Journal of Medicine. Volume 34. Number 10. pp: 396-399. 2006.
Litman, D. Maximizing Success in Osteoarthritic Care: Benefits of a comprehensive Management Approach. Internet Journal of Rheumatology. Volume 5. Issue 2. pp: 1-2. 2008.