Many women post-pregnancy are very eager to rejoin the exercise world and at least resume the physical activities they once enjoyed prior to pregnancy. More and more women are seeking out fitness professionals or exercise programs to help them lose the baby weight and engage in safe and effective exercises.
According to the Advanced English Dictionary, © HarperCollins Publishers, “if you refer to a time or event as the moment of truth, you mean that it is an important time when you must make a decision quickly, and whatever you decide will have important consequences in the future. Both men knew the moment of truth had arrived. (As a sentence example)”
We all come to crossroads in life when we are faced with a decision that will change our life’s direction one way or the other. You have to make that decision quickly, without procrastination, and decide where you are headed. Sometimes, if you get old enough like me, these times come more than once. They are said to be our “moment of truth”.
In September of 2017, I started a closed Facebook Group called MS Fitness Challenge GYM for those of us with MS who are doing their best to beat MS through fitness. It is a platform for MSers to be educated on exercise, nutrition and mindset in the battle against this disease. It’s also a place where we can interact, share our goals, talk about our trials and victories and be able to connect with like-minded MSers who want to encourage and uplift each other in a positive atmosphere of health. We currently have, at the time of this writing, over 7,000 members.
Every day, I read a post about how hard it is to exercise and follow a strict nutrition plan from the members enrolled. The member’s post about the limitations, pain and issues of their symptoms that make it difficult to follow through with exercise. And, they talk about the mental blocks to sticking with an exercise or diet program.
I know. It’s not easy having MS or any challenge in life and dealing with our ups and downs let alone trying to push ourselves to get to a gym or work-out at home and follow a diet that is ONLY full of great foods and supplements for MS. I get it!
But what I’d like you to look at is the consequence of NOT getting into a regular fitness routine, NOT watching what you put into your body, and NOT setting your mindset to the positive dial. MS will not go away; it’s incurable (right now). And the disease symptoms will not improve unless you take a proactive stance against it. Exercise, nutrition and the thoughts in your mind has been proven, through programs such as my MS Fitness Challenge and many others, to help MSers in one way or another in this battle. You can read over and over again, in a multitude of platforms, the testimonials from MSers who have switched to an MS-based diet and implemented an exercise routine seeing great improvement in their quality of life. We are not talking cure here. We are talking a better day-to-day existence despite MS. And, really, this translates to any obstacle you have in your mental or physical health. The choice is yours. Do you want to choose the road that takes the work necessary to a more fulfilled lifetime, or let whatever your challenge is tell you how to live? This is the moment of truth.
The first step is getting your thoughts, motivation and determination in order. Your body will not go where your mind doesn’t take it. So fitness starts in the most influential muscle in your body… your brain. Getting revved up and ready to take on your barrier through fitness is a choice that has to be made. It is not something that most have waiting to come out. It is a desire found deep in your thoughts and feelings. You have to dig down and pull it out because there is a serious amount of action that needs to be put into play with the reaction of… “I want to beat MS” or “I’m tired of being obese” or whatever your challenge is. And once you make this choice in your moment of truth, you do not want to look back.
When your choice to overcome your challenge is made, now it’s time to settle in on the exercise and nutrition programs that will kick start this new truth in your life. I understand the confusion of where to begin; what are the best programs for you; who helps you? This is where research and support comes in and why I founded my MS Fitness Challenge charity. We are the MS cause dedicated to educating, training and inspiring people with MS to live a lifestyle of fitness through knowledge.
So, who’s ready to stand at that fork in your road, look at it hard and tell it you are going down the road to fitness? I’ve been traveling that road my whole life, without MS and with MS and there is no better path to follow. Your moment of truth has arrived…
Become a Multiple Sclerosis Fitness Specialist! This MedFit Classroom online course, co-authored by David Lyons and CarolAnn, will prepare you to work with clients with MS to help develop strength, flexibility, balance, breathing, and improve their quality of life.
David Lyons, BS, CPT, is the founder of the MS Bodybuilding Challenge and co-founder of the MS Fitness Challenge with wife Kendra. He has dedicated his life to helping people with MS understand and be educated on the importance of fitness in their lives. He is an author and sought after motivational speaker, dedicated to helping others by sharing the lessons gained from his life experience. His most recent book, Everyday Health & Fitness with Multiple Sclerosis was a #1 New Release on Amazon at its release. He is the 2013 recipient of the Health Advocate of the Year Award; in 2015, he received the first ever Health Advocate Lifetime Achievement Award, and the Lifetime Fitness Inspiration Award in Feb 2016. In 2017, David received the Special Recognition Award from the National Fitness Hall of Fame.
One of my highest honors as a Personal Trainer has been to work alongside my clients in preparation for knee surgery and post-surgery rehabilitation. Working alongside a Physical Therapist (with the client’s permission to share information) to bring the client to a complete recovery has been a privilege and an excellent learning opportunity.
Pre and post-surgery are two very different stages, but both require the client and trainer’s knowledge, trust, and commitment. Today I will focus on the preparation for knee surgery from the perspective of a Personal Trainer.
First and foremost, the Personal Trainer must act within their scope of practice. Most nationally accredited Personal Trainer certifying agencies have clearly outlined the scope of practice that a trainer must work within.
Here are a few DO’s and DON’Ts from The American Council on Exercise (ACE) that apply to the subject of pre-knee surgery clientele.
Personal Trainers DO receive guidelines from Physicians or Physical Therapists. They DO design exercise programs, refer clients to appropriate allied health professionals or medical practitioners if needed. Trainers DO design exercise programs after a client has been released from rehab, and as trainers, we work with clients, not patients.
Personal Trainers DON’T diagnose, prescribe, treat injuries or disease, rehabilitate or work with patients.
There was a time when I would stop working with a client as they were awaiting knee surgery for fear of causing more damage. Still, after going through my own knee surgery, I realized there is much I could have done to prepare appropriately and that trainers can do for clients as they prepare for surgery to help put them in the best possible position for a full recovery.
One significant preparation step for any knee surgery, often overlooked, is upper body strength. The client will likely be on crutches or possibly a wheelchair post-surgery. When your legs are not fully functioning, you rely heavily on your upper body to move from place to place, from sitting to standing and getting to your Physical Therapy sessions. I found success doing body weight work for the upper body in preparation is very helpful and can prevent shoulder injury as the client needs to move their body from bed to crutches or crutches to toilet and the like. Lifting out of a chair and putting a large amount of body weight on the arms is exhausting and, again, can strain or injure those joints and muscles, which can put the healing process from the surgery leg on a slower rehab pace.
Body weight exercises for the client pre-surgery can be as simple as lifting and scooting themselves laterally across a bench, or maybe learning to use rail support to lift themselves out of a seated position, sitting with legs extended on a mat on the floor, lifting their hips to clear the ground to shift around. Engaging and strengthening the shoulders, biceps, triceps, and even strengthening the wrists and handgrip has excellent benefits. Encouraging core work from all six sides (Rectus abdominus – front, erector spinae – back, Obliques internal and external – right and left, diaphragm – top, and pelvic floor – bottom) to support the upper body moving the body weight is very beneficial. We also shouldn’t forget mobility and stability in the upper body to assist in recovery.
The second important step to surgery preparation is strengthening the muscles that support the knee in all directions. This will allow the client to be in the best possible condition to rehabilitate well. It may be necessary to be creative in finding ways to do this without putting weight on the knee joint. Place a high priority on mobility and strengthening in the upper leg; quadriceps, hamstrings, hips, glutes: the lower leg; gastrocnemius, soleus, tibialis, and lower leg extensor muscles.
Personal Trainers can make a difference. Stay within your scope of practice, educate yourself on knee health, and take advantage of every opportunity to collaborate with a physical therapist or medical practitioner to learn, grow, and serve your clients with the highest quality.
With knowledge, trust, and commitment, trainers can make a marked difference in the clients’ recovery.
Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30 plus years of experience to a long, fulfilling career in the fitness industry. In the past 13 years at the University of Texas at Austin, Shannon has led continuing education workshops in multiple group fitness formats and topics specific to personal training; she also has written the curriculum and manuals for numerous workshops accredited by the American Council on Exercise (ACE). Shannon is currently a monthly contributor to Campus Rec Magazine for Fitness and Wellness.
When it comes to managing chronic pain due to past injuries, most of us are familiar with common modalities like oral medication, topical analgesic gels, acupuncture, massage, pain therapy machines, meditation/mindfulness, or even surgery. However, did you know that exercising regularly is also an effective tool to manage chronic pain?
Treating pain mainly falls into 2 categories:
Passive treatment includes treatments that are performed on you such as ultrasound, infrared rays, needling, and manual therapy such as massage or chiropractic manipulation. The therapist is in control during this type of treatment and it mainly focuses on acute pain relief. It does not address or correct the cause of the pain. Brief pain-free periods may ensue, but passive treatment rarely increases the likelihood of complete recovery. For most, one of the main reasons is because people rely too much on passive treatment alone. Passive treatment is usually recommended during the early stage of rehab or for acute pain to help regain minimal functionality, to promote early stages of healing, and to break the vicious pain-cycle.
Active treatment requires you to be physically involved in the process while working towards a cure to pain. Some active treatments include stretching, a corrective exercise program, and resistance training. However, it is extremely important that you are given the correct active treatment program that is relevant to your injury or condition as well as your goals. Correct exercises are able to address the root of the problem and may even prevent injuries. Active treatment is salient in the mid to late stages of rehab when one is nearly back to full functional capacity. The key is to strike a balance between passive and active therapies to best suit the type of chronic pain.
In order to treat chronic pain, it is important to understand that pain is a complex and individualized experience. Moreover, physical exercise may seem counterintuitive when you’re already suffering from pain, but whether your pain is intermittent or constant, adopting exercise as part of your active treatment can play an important role in managing pain for the long run.
Here are the 7 reasons why exercise is essential to manage chronic pain:
Athletes tend to report higher resilience towards pain compared to people who are sedentary. Studies have shown that active individuals are also likely to perceive pain differently. People who perform aerobic exercise or resistance training regularly, may develop the ability to adapt and desensitize the sensation of pain, thereby altering their pain tolerance in the process.
Recurring injuries can happen when an excessive load surpasses the tissue tolerance level. Excessive load can come in many forms such as lifting up a pail of water, gardening, or from over-training. Gradually performing optimal exercises coupled with rest can stimulate and improve tissue tolerance margin. An increased threshold can help prevent an injury from reoccurring.
Source: McGill, Stuart; (2017). Ultimate Back Fitness and Performance. Backfit Pro Inc.
Frequent exercise is associated with enhancement of the cardiovascular system. Aside from reducing risk of heart disease, increased blood flow raises the oxygen levels and helps deliver key nutrients within the body that are essential for cellular healing and reparation of injured tissues.
People living with chronic pain may experience severe disturbances in their psychological state. One can become anxious, depressed or stressed due to physical limitations. Therapeutic exercise can help elevate mood by releasing feel-good hormones such as endorphins and dopamine while at the same time reducing stress due to the release of hormones such as cortisol.
Common injuries such as chronic lower back pain can be caused by many factors like continuous poor movement, muscle imbalances or past traumatic injuries. Exercise can help tackle the root of the problem by identifying compensating movements or muscle weakness through a series of assessments and resolve them with an exercise program.
“Use it or lose it” is a popular phrase used by physical therapists and exercise professionals when it comes to exercise. The connective tissues that move our body and support the joints are muscles. When the muscle stop being challenged, they lose function and strength. Over time, this weakens muscles and exposes the musculoskeletal structure to potential harm.
In addition to strengthening muscles and improving overall health, exercise can also enhance motor skills by stimulating the connection between the central nervous system and the muscles. Neuromuscular training helps improve balance, stability, proprioception and joint control. This can translate to pain-free movement and a decreased risk for falls. Practicing quality movements via routined exercise can boost functional capacity to perform various activities of daily living without fear of injuries.
Regular exercise that encompasses both aerobics and strength training is strongly recommended because it is both healthy and effective to decrease chronic pain. However, be sure to seek the advice of a certified medical fitness professional to help you design an appropriate pain management strategy that is appropriate for your condition.
Ke Wynn Lee is an author and an international award-winning corrective exercise specialist who currently owns and operates a private Medical Fitness Center in Penang. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.
References
Falling is an issue for almost every chronic condition discussed in this text, from peripheral neuropathy to CVA’s, as well as sarcopenia that leads to fragility. Things like poor hearing, dizziness, joint stiffness or even wearing glasses can also disrupt a person’s balance. Some medications such as blood pressure, sleep medications and antidepressants may influence balance. A bad fall can make a chronic condition even more disabling. The consequences of a fall include serious injury, limited activity and significant medical costs. Many older people never fully recover from a fall.
If they are going to fall, most people (particularly stroke victims) will fall toward their weak side. They can also fall forward or backward. They fall primarily because their muscles are weak and their legs crumple under them or because their balance is poor. The American Geriatrics Society suggests fall screening be done at each annual doctor’s visit. Tell your client to mention to the doctor if they are having a balance problem or have fallen within past 12 months.
Safety Tip
If the person’s left side is weaker, stand at the person’s left side and just a little behind. Put your right hand on their belt or transfer / gait training belt and your left hand on the front of their shoulder. In this position you can push back on their shoulder and push forward on their hips to straighten them up, or you can pull them against yourself. In case you cannot hold the person up, you are in a good position to ease them gently to the floor if they should start to fall. Remember to use good body mechanics. If a person is falling, you can do more harm to your back and to them by straining to hold them up than if you ease them to the floor. You should never hold a person only by the arm or let them hold onto you, because if they suddenly start to fall, you will both fall over.
Tip: Transfer belts are available at most drug stores.
Keeping the walkways well lite is a good precaution. Nightlights on. To make house safer consider the following top 10 safety checklist items:
Reprinted with permission from Karl Knopf
Karl Knopf, Ed.D, served as the Director of The Fitness Therapy Program at Foothill College for almost 40 years. He has worked in almost every aspect of the industry from personal trainer and therapist to consultant to major Universities such as Stanford, Univ. of North Carolina, and the Univ. of California well as the State of California and numerous professional organizations. Dr. Knopf was the President and Founder of Fitness Educators Of Older Adults for 15 years. Currently, he is the director of ISSA’s Fitness Therapy and Senior Fitness Programs and writer. Dr. Knopf has authored numerous articles, and written more than 17 books including topics on Water Exercise, Weights for 50 Plus to Fitness Therapy.
References
The combination of physical intensity with cognitive complexity is where the magic happens when it comes to fitness for brain health. Here’s one way to do it.
The coronavirus pandemic has had a major effect on all areas of people’s lives, and physical activity levels are no exception. Recent studies show that the pandemic and associated lockdowns prompted many people to go one of two ways with regard to their exercise program. They either decided to work out more in an attempt to get in the best shape of their lives, or chose to spend lockdowns sitting at the computer, watching TV and/or enjoying long phases of inactivity. Both of these choices, while seemingly unrelated, have led to an increased number of people experiencing musculoskeletal injuries.1,2,3
The COVID-19 situation prevented most people from utilizing in-person fitness and exercise services. Consequently, those individuals who decided to increase their physical activity levels often did so without the supervision of a qualified fitness or exercise professional. In addition to engaging in exercise endeavors unsupervised, research found that they tended to work out longer and harder than would have been appropriate, and tried more extreme forms of exercise. This has resulted in many of these people experiencing musculoskeletal overuse injuries.1
Alternatively, individuals who stopped exercising during the pandemic and instead spent more time watching TV, playing computer games, and generally sitting for longer periods of time became deconditioned. Once lockdowns and COVID-19 restrictions began to ease up, these people experienced musculoskeletal injuries as they tried to return to their pre-pandemic exercise levels in a deconditioned state. 1,2
Corrective exercise specialists and fitness professionals well-versed in corrective exercise methodologies are uniquely positioned to help people overcome pain, injuries and musculoskeletal issues that have arisen as a result of over- or under-exercising during the pandemic.
Helping Over-Exercisers
Clients who sustained overuse injuries in their pandemic pursuit of ultimate fitness will benefit most from incorporating activities into their exercise regime that actively promote rest, recovery and rejuvenation. Coach these people to take days off from strenuous activity to instead perform self-myofascial release and gentle stretching exercises appropriate for their musculoskeletal issue or condition. Areas of the body that were overly-strained, stressed and/or injured during high levels and intensities of exercise should now be prioritized with these corrective exercise techniques.4
Helping Under-Exercisers
A deconditioned client trying to resume their pre-pandemic physical activity levels without adequate reintroduction will benefit from the application of gradual progression. Coach them about the need to address musculoskeletal changes that have occurred as a result of prolonged static postures like sitting, and the importance of slowly reintroducing exercise stress to help safeguard their body from the pain and injury that can result if they overdo it upon returning to the gym.4
As the availability of in-person exercise and fitness services begins to resume, corrective exercise specialists are in a unique position to assist people that have sustained musculoskeletal injuries as a result of too much or too little exercise. Whether helping clients get over pain and injuries incurred during the pandemic, or reintroducing exercise safely to those who are unfit and out of shape as a result of long periods of inactivity, expertise in the area of corrective exercise is now more important than ever.
Justin Price is one of the world’s foremost experts in musculoskeletal assessment and corrective exercise and creator of The BioMechanics Method Corrective Exercise Specialist certification (TBMM-CES). The BioMechanics Method is the fitness industry’s highest-rated CES credential with trained professionals in over 70 countries. Justin is also the author of several books including The BioMechanics Method for Corrective Exercise academic textbook, a former IDEA Personal Trainer of the Year, and a subject matter expert for The American Council on Exercise, Human Kinetics, TRX, BOSU, MFN, Arthritis Today, BBC, Discovery Health, Los Angeles Times, Men’s Health, MSNBC, New York Times, Newsweek, Time, Wall Street Journal, WebMD and Tennis Magazine.
References
There are a number of factors that influence obesity. These include behavioral choices, environmental circumstances, and genetics. Genes don’t always predict someone’s weight future, but science has shown that genetics play a role in obesity. Genes increase a person’s susceptibility to become overweight, but this is not an isolated causality due to behavior and environment.
Take for instance the number of people living in a certain environment with all the same living conditions. How is it so that in an environment that promotes inactivity and high calorie foods that not all of these people become obese? Not all these people will have the same resulting health problems or body fat distribution. Even people in the same family, of the same race, and of the same ethnicity, will not all become obese given this environment. The diversity in body types leads one to believe that genetics do play a role in weight.
Genes are what instruct the body. They map out how the body will respond to a given environment. Genes dictate behaviors including a person’s choice to be sedentary, to overeat, and their metabolic functions. Genes tell the body how to store fat and how to use food for fuel as energy. Both hunger and food intake are associated with genes. For example, take two siblings or twins raised in very similar environments — they still may not have the same body weight distribution.
For now, science does not have genetic testing which would determine one’s weight future. There is no science that shows a personal diet plan or exercise regimen will result in exact body types. Bardet-Biedl syndrome (BBS) and Prader-Willi syndrome are the only two directly related obesity causing genetic factors. BBS is associated with increased body fat in the abdominal area, poor functioning kidneys, eyes, and genitalia, as well as intellectual impairment. Prader-Willi syndrome is associated with a constant desire to eat. This causes dangerous weight gain, stunted growth, and poor health. Research is still being performed on genetic response to weight gain. Knowing one’s family history won’t change the path to obesity, but lifestyle behavior and environment can be adjusted as a proactive and preventable method. For example, children of obese parents are more likely to become obese themselves due to their lifestyle and environment. Marketing has also become a strong influence for eating patterns.
The finger can’t be pointed at genetics alone for weight problems. However, we do know that even under exact circumstances, two bodies can react entirely different. The research is not entirely there YET, but hopefully in the near future we can have helpful answers to help fight the obesity epidemic.
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 is a current doctoral candidate in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.
References
You may ask yourself, what is trauma informed care? Is this about having trauma ourselves so we can relate? Is this about understanding what trauma is? In actuality, trauma informed care is the idea of being mindful that others have past trauma that can influence how they feel, see, and interact with the world around us, and us as providers being mindful of that within our actions. To further explain, it goes back to being mindful of how the things we say and our own actions can inadvertently impact others, and how we can become self aware of that to help our clients feel safe and at ease to the best of our abilities.
We entered into a helping professional field to help individuals become stronger, better, happier and healthier, and yet sometimes, our clients & patients still struggle even with our best efforts. There might be times where we feel like we’re banging our head against the wall, even though we are doing everything we can to help! In my upcoming webinar, we will be looking at what some of those barriers are. We’ll discuss how something as simple and direct as changing how we say things, and having a sense of mindfulness to an individuals background and history, can not only change the dynamic of the relationship, but improve growth in treatment.
One important thing to remember is the intention of this is not to focus on what we might be doing wrong, but rather to expand in areas that we can grow in. We all are helpers because we want to see individuals grow and heal, and when we become trauma-informed, it can allow us to be aware of potential barriers, while at the same time, understanding how to overcome those barriers.
Join me for for my upcoming webinar on this topic of trauma informed care for personal trainers and medical personnel. I’ll discuss what trauma informed care means, how it can impact clients, and how the lack of trauma informed care can impact client care.
Bradley Lawrence Mallett, MA, is a Licensed Professional Counselor, EMDRIA Approved Consultant and Certified EMDRIA Therapist. After completing his Master’s in Counseling, he became a counselor and pursued work within mindfulness, DBT, and trauma-focused care as a way to deal with anxiety management and trauma processing. Bradley strives to help individuals and communities learn about themselves, what their own barriers are, and their strengths as a way to help bring about the change that is needed and desired.