Fitness Professionals Archives - Page 24 of 63

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You Are The Solution

Dr. Evan Osar/19 May 2021/ All MFN blog/

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.

This article was featured in MedFit Professional Magazine.

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

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal, 22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey

U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.

What Happened During the Pandemic

Debra Atkinson/17 May 2021/ All MFN blog/

The Perfect Pandemic Storm?

The average weight gain during the pandemic was 1.5 pounds per month, according to a recent study in the Journal of the American Medical Association. As of May 2021, that’s 20 lbs. The results were gathered by monitoring smart scale users with Bluetooth technology. Subjects were male and female smart scale owners with a mean age of 51.

What Happened?

Shelter in place (SIP) orders combined with stockpiles of pantry items, ample take-out and door-to-door delivery. Additionally, many found themselves with either a household of varied food wants and needs, serving up a daily meal dilemma, or in isolation lending to depression and anxiety. Neither scenario made it easy to adopt or stick to routine healthy dietary habits.

Researcher Suggestions

From the results, researchers suggest a need to mitigate our present post-pandemic conditions with dietary interventions and physical activity.

As aforementioned, the study included both men and women. Women at age 51, however, have another challenge. Women reach menopause at the average age of 51.3. During the latter stages of perimenopause and early postmenopause, there is an accelerated rate of loss of both muscle and bone. The loss is experienced when there is a sharp decline of estrogen and a corresponding increase of cortisol.

Show Me the Muscle

While average weight gain was the reported data in this study, changes in body composition weren’t included. This author suggests we may safely assume this was fat weight and not muscle. There is a need for both exercise and nutrition interventions.

There is also a potential need to identify solutions to sleep disruption and stress (as cortisol can have a negative impact on fat storage and muscle breakdown). Sleep disruption is common for women in menopause and often accompanies stress or anxiety, of which the pandemic provided an abundance.

Hormonal Contributing Factors

Testosterone and growth hormone also decline with age and levels will suffer more in women who experience unresolved insomnia during menopause. These two hormones are produced in the greatest amounts during deep sleep cycles, which menopausal women may reach with less frequency or for shorter durations.

Women who were in late-stage perimenopause, early-stage post menopause window during the pandemic have the greatest potential for devastating disability. This is especially true if they weren’t strength training with adequate intensity. We may see these effects in a decade if losses of muscle and bone are not mitigated.

Sarcopenia, a significant loss of muscle and strength, is experienced by 42% of women by the time they reach 65. This is true in normal times, without a 14+ month decrease in adequate exercise stimulus. Sarcopenia results in frailty, greater risk of falls, and with bone loss also occurring at accelerated rates during menopause, fracture risk is higher.

Compounding Problems

Pre-existing obesity or that stemming from weight gain during the pandemic coupled with sarcopenia provides an even more severe condition known as sarcopenic obesity. Both obesity and sarcopenia are independent risks for disability. In adults diagnosed with both, there is a 2.5-fold increased risk of disability.

Inadequate Stimulus

When hormone levels offered a stimulus for muscle decline, there must be some other stimulus to replace it.

Remember the shortage of dumbbells early in the pandemic? While Peleton sales skyrocketed and walking increased for many, access to the type of anaerobic strength training that has the biggest pro-aging benefits for women in midlife required creativity. For those not familiar with strength training, or not online due to connectivity or comfort, muscle and bone loss awareness and solutions are warranted.

The Perfect Storm for Fitness Professionals

For personal trainers and fitness pros, this truly is a perfect storm. It’s an opportunity for a legacy of impact on a female demographic that touches three generations. Her young adult children, friends and life partners, and parents & in-laws. Household decisions and health habits are influenced most by her. No one else has as much influence on health as she does.

The unnecessary devastating disability that could result for those who’ve gained and sustained significant weight during the pandemic can be avoided. Fitness pros who take proactive measures to educate, publicize, and offer positive solutions for behavior change can be a part of reversing this significant health risk.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She serves on the MedFit Education Foundation Advisory Board, is an international fitness presenter, and author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

References

Lin AL, Vittinghoff E, Olgin JE, Pletcher MJ, Marcus GM. Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study. JAMA Netw Open. 2021;4(3):e212536. doi:10.1001/jamanetworkopen.2021.2536
Front. Endocrinol., 21 May 2020 | https://doi.org/10.3389/fendo.2020.00332

Is Your Brain Really “Plastic”? – The Key to Stroke Recovery

Dr. Grove Higgins/14 May 2021/ All MFN blog/

Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections. This occurs through the changing of neurons, the organization of their networks, and their function via new experiences. Neuroplasticity is also called neural plasticity, brain plasticity, cortical plasticity, or cortical re-mapping.

You are experiencing neuroplasticity every time you learn something new, such as how to use a new computer program, a new line of music, a new app on your phone, or a new exercise in your workouts. Learning is neuroplasticity.

For brain injuries such as stroke, neuroplasticity takes on an even greater importance. Because the injury literally damaged or even destroyed neurons, we must harness neuroplasticity to build new neural connections to do regain or improve upon the resulting dysfunction. The cool thing is that other areas of the brain, those not normally associated with a given action, can assist if the stimulus is strong enough.

Why neuroplasticity matters for all brain injury survivors

The concept of neuroplasticity is very important and if you work with stroke survivors it is a concept you will want to explain at some level. Here are some points of why neuroplasticity is so important:

Neuroplasticity provides hope – Despite the fact that the concept of neuroplasticity has been around for several decades, it is still not widely understood in the public arena. When we explain neuroplasticity to our pain and brain injury clients, they often reply that knowing this gives them hope. Hope is especially important for a stroke survivor, in which the loss of a major motor function occurs so swiftly that it can seem to be a very daunting process to recover from.
We can target neuroplastic change – The great thing about learning a neuro-centric approach to training and exercise therapy is that the nervous system is very orderly and so we can be very targeted in our training to regain or improve dysfunctions.
Neurons that wire together, fire together – Understanding some basic neuroanatomy can go a long way. The bottom line is that areas of the brain that live close to one another can affect one another. Here is an easy example:

- In the picture above, we see the sensory (purple) and motor (blue) cortices of the brain; if we had an issue with knee articulation, we could stimulate that area by moving the hip and/or ankle, which would “fire” into the knee area just by their proximity.
- Here is a less obvious example: Also, notice how close the eyes and the hands are in the sensory and motor maps; you can help motor control of the hands by doing eye exercises.
You have lots of “backup disks” in the brain – A stroke can damage whole neuronal areas beyond repair. While this sounds daunting, it is still possible to regain function. One aspect of neuroplasticity is that other areas of the brain can actually take over to learn and perform tasks they are not normally associated with, given the right kind and amount of stimulus.

The concept of neuroplasticity and how to harness it is not only for stroke recovery, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with stroke survivors with our Stroke Recovery Fitness Specialist online course, available through the MedFit Classroom!

Dr. Grove Higgins is a chiropractor, rehabilitationist, soft tissue injury expert, researcher, anatomy instructor, biomechanist, human performance expert, speaker, and corporate health consultant. In 2015, Dr. Higgins cofounded Neuroathlete with Coach Patrick Marques (LTC, US Army Ret.) and Peter Hoversten. Neuroathlete’s goal is to more broadly deliver neurological training to a global audience.

Master Trainer Pat Marques served in the Active Duty Army for 20 years in the Infantry and Special Forces, including combat tours in Iraq. Upon retiring Pat decided to try and combine his two passions – soldiers and fitness. He was able to work with soldiers through adaptive physical training, helping them deal with amputations, chronic pain, PTS, and traumatic brain injury. Pat has completed over 600 hours of neurological training, becoming a Z-Health Master Trainer. He currently provides exercise therapy, movement reeducation, and strength and conditioning for all levels of clients at NeuroAthlete, from chronic pain sufferers to Olympic-level athletes.

What Is an Anabolic Window?

David Lyons/13 May 2021/ All MFN blog/

If you’re trying to build muscle, strength training is the best way to do it. Strength training damages the muscles, which causes them to repair and grow. The result is bigger, stronger muscles. Bigger, stronger muscles to someone like us with MS means the strength to move those muscles once we create the brain to muscle reconnection. However, optimal muscle growth goes beyond your actual workout. It also relies on post-workout nutrition. Your muscles need enough protein and carbohydrates to effectively recover.

Seniors with trainer in gym at sport lifting barbell

Set Yourself Apart: Facing the increasing challenge of competing with underqualified trainers

Andrea Leonard/12 May 2021/ All MFN blog/

As a personal trainer, you may find it increasingly difficult to compete in an industry that has no licensure and very little in the way of requirements. As an industry, we let anyone willing to take a two-, four-, six- or eight-hour online course become a personal trainer. This may explain the lack of expertise that is witnessed in so many trainers at gyms across the country. You may find yourself watching them from the sidelines, cringing as you notice the client performing deadlifts with an arched-back; squats with their knees caving in; or any other combination or poor supervision, direction and form.

It’s unfortunate, but the average person has no idea what to look for in a trainer. They don’t know the questions to ask, the accredited certifications and whether or not that trainer is able to work with any pre-existing conditions that they may have. As gyms hire underqualified trainers, underselling those of you who are worth your fee, clients continue to get injured. The client goes to a physical or occupational therapist and tells them they’ve been working with a trainer at X gym. The therapist rolls their eyes, having heard the story time and time again, discrediting personal trainers and the fitness industry as a whole.

If you have put your time in — getting your degree, obtaining every accredited certification you could get your hands on and starting at the bottom of the food chain, scraping your way to the top, you may be feeling frustrated and perhaps a little defeated.

Data from the U.S. Census Bureau shows that there are 76.4 million baby boomers. There were actually a total of 76 million births in the United States from 1946 to 1964, the 19 years usually called the “baby boom.” Based on these staggering numbers, many nationally certifying bodies are realizing the need for medical fitness professionals. They are looking to change the industry, set standards for our fitness professionals, and require advanced education in order to work with any special population. In the next few years, we are going to see the pendulum swing in the fitness industry. There is a movement towards medical fitness and you can get in at the ground level, setting yourself apart from the low-level trainers. You will be able to create a niche market that will open doors in the medical community, increase referrals and increase revenue.

Perhaps you or someone you love has been touched by cancer; there were an estimated 18 million cancer cases around the world in 2018!

One-quarter of new cancer cases are diagnosed in people aged 65 to 74
Median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer and 66 years for prostate cancer

In 2018, there were approximately 43.8 million cancer survivors diagnosed within the previous five years. By 2040, the global burden is expected to grow to 27.5 million new cancer cases. During the COVID-19 pandemic we are seeing that cancer patients, as well as others with compromised immune systems, are more alone and isolated than ever. This provides an unprecedented opportunity for you to provide a necessary and life-changing service to those in treatment or recovering from cancer. The Cancer Exercise Training Institute offers an online university fast-track program that also includes business coaching and training to take your business online. In five weeks, you can sit for the exam and, with at least an 80% passing grade, become a Cancer Exercise Specialist.

To some of you, working with what would appear to be an aging or sick population may not be of interest. You need to decide if you want to be like every other trainer, creating beach bodies and six-packs, or if you want to really make a difference in someone’s quality of life, and your success as a trainer. Think outside the box. Beyond the baby boomers, we have athletes and adolescents who have diabetes, who suffer with obesity, have asthma, cancer and so much more. This is a relatively untapped market.

For those of you who are up for a challenge, willing to step outside of your comfort zone and explore a new and exciting avenue in fitness, this offers a tremendous opportunity. There will always be those who want to lose weight, get toned, get ripped and improve sports performance, but after a while you can do that in your sleep. When you have clients that can’t get out of bed, can’t get up and down from a chair or can’t even perform self-care, and you are able to help them to take control of their life and their body in a way they never imagined was possible, it is truly the most meaningful and rewarding part of your career.

As we change the standards in the fitness industry, specialized training will be a requirement and you will be one step ahead of the game. By setting up meetings with nurses, doctors, patient navigators and support groups, you exponentially increase your potential client base. The unqualified trainer will not even be able to get in the door. The medical community will not accept a trainer without appropriate credentials.

As a highly credentialed trainer, you can establish yourself as a blog writer, magazine contributor and speaker. Opportunities may range from speaking to a support group at a local hospital to becoming a keynote speaker at a huge event. You can even conduct local or destination retreats for specific groups (i.e.; breast cancer, diabetes, juvenile diabetes, active aging etc.). The doors will also open up to you at medical fitness facilities and possibly hospitals that are looking for highly credentialed medical fitness professionals.

There are certainly other ways that you can make your mark and create unique marketing opportunities, but many of those will come and go with various trends and fads in fitness. Sadly, we live in a country that believes that “bigger is better” and wants “more for their money.” This has led to an epidemic of cancer, heart disease and diabetes, among other things. People will continue to age and whether it’s through the natural aging process or poor self-care, this is a market that is here to stay.

This article was featured in MedFit Professional Magazine.

Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.

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

Christine Conti/11 May 2021/ All MFN blog/

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

Healthcare Through Fitness

Dr. David Kruse/10 May 2021/ All MFN blog/

A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.

Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.

If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?

The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.

What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:

Regular medical oversight by a medical director
Practitioners with nationally-recognized certifications and training in the care of chronic disease
Comprehensive health assessments and exercise prescription
Exercise classes geared toward specific medical conditions

These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.

The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.

Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.

This article was featured in MedFit Professional Magazine.

Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com

How to Turn Your Fitness Facility into a Health and Wellness Facility and WHY!

Debbie Bellenger/7 May 2021/ All MFN blog/

2020 came and went with a pandemic and the resulting crash of our fitness industry as we knew. It seemed like time stopped. Fitness facility doors closed. Staff were furloughed and separated. Fitness delivery models changed overnight – hybrid models of live streaming and on-demand services. Business plans were re-done for a budget year that evaporated.

The OPPORTUNITY… there has been an increased awareness of the value of good health and the importance of exercise. Much of the research shared post-COVID clearly demonstrated that the sickest were at the highest risk with COVID and that those who were mostly healthy fared much better when diagnosed with COVID.

CDC reported that obesity worsens outcomes from COVID-19. Obesity increases the risk of severe illness, tripled the likelihood of being hospitalized, and is linked to impaired immune function, decreased lung capacity and many other risks. Obesity is forecasted to exceed 50% in Americans by 2030.

How do we go forward as business owners to capitalize on a perfect storm of individuals now realizing and valuing their health as an asset? How do we go forward to create environments in which our facilities feel like a home away from home for new exercisers, de-conditioned, COVID recoveries, overweight, out of shape and scared individuals who now wish to exercise?

American Psychological Association reported recently that Americans’ Physical Health has taken a back seat since the start of the pandemic. It was reported that 47% delayed or canceled healthcare services and that 53% have been less active than they wanted.

How do we fill the gap to provide services and welcome all ages, stages, shapes, sizes into our facilities to capitalize the business opportunity and to support those who need us most to get healthier?

Bring communities together by offering health and wellness programs to non-members that teach good health and prevention. Some examples:
- Post-hab COVID health program: 30 days to reset your health
- 8-week weight loss programs/challenges, 8-week pre-diabetes classes, 8-week cardiovascular health and wellness programs.
- Any program that can target a COVID risk factor that targets a certain element of health: cardiovascular, flexibility, strength, stress management, sleep, etc… or certain disease states such as asthma, obesity, diabetes, hypertension etc. all can be made into health and wellness programs for potential new members.
Consider offering these health and wellness programs (with a nominal registration fee) without requiring a membership to your facility. So, include a membership to your facility for the duration of the program, offer a discounted sign-up fee to convert them to members at the completion of the program, and perhaps a friends and family rate to enroll. Leave a trail of financial incentive crumbs with some skin in the game to get them to value your facility and programs to stay long-term. Show them the value-added they experience by having you at your facility. Let them “try before they buy” — but in the wellness space first. Not “gym and swim” first…that is too much for some.
Offer intro level and disease-specific type group classes that may group like-minded individuals with common goals. Example: Beginner cardio class, where you clearly accommodate beginners, new exercisers, those who are low-level fitness and who need a shorter duration of work.
Offer personal training programs that clearly measure pre and post-health metrics to show improvement to give individuals confidence in their improving health and an appreciation of the value of the services they pay for. This also allows for your trainers and your facility to connect their improved health outcomes to their primary care providers so you can get future referrals as a credible source for a patient who needs exercise.
Offer healthier food choices and nutrition education as part of your centers’ offerings. Consider adding a Dietitian to your team.
Partner with local health departments, health care systems to host health checks to promote good health awareness and to get more foot traffic into your center.

THINK “A GYM without WALLS” and offer wellness to all – become the health hub of your community!! It makes good business sense for all!

Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer. Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies.

Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.

Doctor Examining Male Patient With Knee Pain

Restoring Movement and Mobility: The fitness professional’s role in total joint replacement care

Dr. Stephen A. Black/6 May 2021/ All MFN blog/

According to the American Joint Replacement Registry, there are 860,000 total knee and hip replacements done in the United States per year. This number is projected to double in the next ten years. There are more knees than hips done per year and more females have these joint replacements than males.

According to Mike Carberry of Advanced Medical Integration, “Regenerative medicine is one of the most talked about subject healthcare has ever known; and for good reason. It could hold the solution to the puzzle of America’s failed healthcare system.”

This is wonderful news for the personal training industry. Insurance is paying for less and less, costing more while the number of consumers seeking optimal health is increasing. A perfect storm in the making!

A personal training certificate, however, is not enough to appropriately deal with the typical client with total joint needs. Specialization in anatomy, joint physiology, biomechanics and therapeutic exercise are necessary in order to adequately and appropriately manage total joint conditions. These skills and techniques in conjunction with medical communication skills will give physicians confidence to send these patients to the appropriately skilled personal trainer. Spending time with a physical therapist and surgeon specializing in these areas will go a long way in establishing confidence, trust and credibility in handling the client with total joint conditions.

Most individuals with true joint pain have some level of osteoarthritis. Approximately 27 million Americans suffer from degenerative joint disease (also known as degenerative arthritis or osteoarthritis). Degenerative joint disease is the most common chronic condition of the joints and occurs most often in knees, hips, lower back and neck, small joints of the fingers, and the bases of the thumb and big toe.

Osteoarthritis is the most common form of arthritis that causes a breakdown of joint cartilage, and it affects mostly middle-aged and older adults.

Although there is no cure for osteoarthritis, the good news is that it can be helped, and quality of life maintained by implementing and maintaining some simple changes in daily life. Regardless of the intervention, from routine steroid injections to platelet rich plasma/stem cell treatments to total joint replacement, here are a few areas where the personal trainer can intervene with great success.

Exercise

Exercise is key component of arthritis care, exercise strengthens the muscles, lessens joint pain and stiffness and improves overall health. Types of recommended exercises may include strengthening, aerobic activity (aquatic activity is wonderful), range of motion or stretching activities and balance exercises.

Joint protection

Protect the joints to ease pain and avoid further damage. Make sure to balance rest with activity as well as know when to stop. A good rule of thumb is to adjust down the frequency, intensity and duration by 50% of what a “normal” client can do or what the client thinks they can do. Remember these clients are typically deconditioned relative to strength and cardiovascular fitness. They will not handle the all-too-popular high-intensity interval training (HIIT). This population will succumb to overload and may be injured.

Pain control

Pain control routinely treated with prescription or over-the-counter medications can be replaced or augmented by relaxation techniques (yoga, Tai Chi, meditation and massage) along with application of heat, cold and/or vibration.

Post-procedure care

If the client has had regenerative therapy or a total joint replacement, they will need a specific post-procedure plan to allow for healing/protection, early intervention and return to activity function. Hopefully, they had pre-intervention care inclusive of appropriate exercise, nutritional counseling and insight on what to expect with the procedure and post-procedure care. Appropriate nutrition for optimal health and healing along with hydration techniques and insights are a must during these sessions.

Phase 1: Post-procedure care

Typical post-procedure care is in three to four phases. Phase one is protect/rest, restore and control pain. During this phase the focus is on mediating pain, restoring range of motion, controlling swelling and protecting the joint. This is typically fourteen to twenty-one days in duration. Stitches or staples are usually removed at this time and scar management can commence around the twenty-first day.

Phase 2: Post-procedure care

Phase two is the restore and regenerate phase. The

wound is healing (healed), the joint and soft tissue healing continues, and remodeling of tissue has begun. This phase is typically three to six weeks in duration. Techniques to restore range of motion and other soft tissue techniques to facilitate healing according to tissue physiology and the client’s general health are initiated (conditions such as diabetes, obesity, cardiovascular disease and others will alter the healing and remediation phases). Techniques for ambulation, gait and balance are initiated along with appropriate cardiovascular conditioning.

Phase 3: Post-procedure care

Phase three typically commences when the client has gained full range of motion, has good balance and gait mechanics and is able to tolerate closed-chain activities for both upper and lower extremity movement patterns. This phase is the final phase and progresses to full functional activity and return to sport or recreational activities of choice (these activities may be placed into a fourth phase). During this phase it is incumbent upon the personal trainer to load appropriately and have working knowledge of the mechanics of the sport or recreational activity. There are some tremendous resources available for this purpose.

Complications

Complications to be aware of when working with these patients include but are not limited to infection, blood loss, dislocation, blood clots and fatigue. The personal trainer should also be in contact with the client’s physician and physical therapist if one has been engaged. These are medical conditions requiring communication and conservative care.

Most physicians like to know who is working with their patients and appreciate the communication for optimal outcomes. The insightful and knowledgeable personal trainer with the right training can be an invaluable member of the total joint care team. The future is bright!

This information is provided as an overview and in no way should be interpreted as a protocol for treatment or otherwise. Our goal is to inform the reader on opportunities in the profession and stimulate further investigation.

This article was featured in MedFit Professional Magazine.

Dr. Stephen A. Black is a sports medicine specialist, author and clinician. His doctoral degree is in sports medicine and he holds degrees in physical therapy, athletic training and certification through the National Strength and Conditioning Association. Dr. Black has over forty years’ experience in patient care and practice management. He lectures frequently on topics in sports medicine, works with professional, Olympic and youth athletes and holds several academic appointments. Visit his website, rockymountainhpc.com