Athletes get injured. It’s part of the deal. Be it a torn ACL, Achilles tendonitis, or a pulled muscle, the questions arise: What can I eat to recover faster? Would more vitamins be helpful? What about collagen supplements? At this year’s virtual Food and Nutrition Conference and Expo (FNCE) of the Academy of Nutrition and Dietetics (AND, the nation’s largest group of nutrition professionals), several presentations offered updates on nutrition for injuries.
Are you working with any clients who have type 1 diabetes, type 2 diabetes, or even prediabetes? Well, you have a lot to learn if you don’t know the first thing about those conditions! There are over 100 million Americans currently have diabetes or prediabetes—some of them are, or will be, your clients.
Diabetes is a metabolic disorder that results in elevated levels of blood glucose (“blood sugar”) that can cause many health complications if not managed effectively. Although exercise is one of the three cornerstones of diabetes management, sometimes it can complicate keeping blood glucose levels under control, especially in people who have to replace the insulin that their bodies no longer make (or make enough of). How they respond to being active really depends on the type of exercise and diabetes.
In any case, on a basic level, it’s good to know more about how exercise affects people with diabetes. I have lived well with type 1 diabetes for nearly half a century at this point, and I have always known at some level that exercise did good things for my blood glucose, even before I had my first blood glucose meter (after going 18 years without one). How could I tell without a meter to test my levels? Honestly, it was because being active always made me feel better, physically and emotionally.
I earned a PhD in Exercise Physiology to better understand how exercising helped me. You don’t have to go that far with your education, but if you have diabetes or are going to work with clients or patients who have it, here are some basic things that you really need to know.
Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise. As a leading expert on diabetes and exercise, Sheri has put her extensive knowledge to use in founding Diabetes Motion (diabetesmotion.com), a website providing practical guidance about being active with diabetes. She also founded Diabetes Motion Academy (dmacademy.com), offering training and continuing education to fitness professionals.
According to studies, low back pain affects nearly 80% of all adults. Most low back injuries come from the following: wearing high heels (women), performing manual labor and people who sit for long periods of time (greater than 3 hrs.). Although these statistics are alarming, there are some simple steps one can take to make sure that they avoid current and future back pain or injury. These steps all involve simple exercises that can be performed from anywhere, including one’s office.
In order to prevent further injury or a relapse, the first thing to do is stretch common muscles that are tight and may have caused the lower back pain in the first place. Tight muscles are known to overwork and when this occurs, they become overactive and let us know through pain. These muscles include erector spinae, hip flexors, calves and the lats (the big back muscles).
For each stretch, you want to hold the stretch for 30-120 seconds and perform the movement for 1-2 repetitions 3-5x/week. (Watch Five Back Pain Stretches from WebMD.)
After you have stretched the tight muscles, now it is time to focus on strengthening the muscles that are weak or underactive. Typically, muscles become weak or underactive from lack of use or overuse by the muscles that assist or oppose the weak muscles. For example, if your hip flexor is tight, it could cause your glutes (butt) muscles to become weak. The muscles that tend to weaken with a lower back injury include certain core muscles, the butt and hamstrings.
For each strengthening exercise, you want to perform 1-2 sets of 10-15 repetitions 3-5x/week. (Watch Core Strength for Back Pain View and Good and Bad Exercises for Low Back Pain from WebMD).
Now that you have isolated the lower back with stretching and strengthening exercises, it’s time to focus on integrating your entire body back into exercising. Integrated exercises involve using as many muscles as possible in one given exercise. By performing integrated exercises, you will ensure that the your hip joint (which can be misaligned with low back injuries) starts and remains in the right position and the proper muscles are working as they should be.
For each integrated exercise, you want to perform 1-2 sets of 10-15 repetitions 3x/week. (View integrated exercises: http://www.allthingshealing.com/Chiropractic/Corrective-Exercise-for-Back-Pain/8558#.VIoTN74zf8E)
If you follow these three simple steps, you can avoid low back pain setbacks and ensure that your back is strong enough to handle your daily activities of life.
Maurice D. Williams is a personal trainer and owner of Move Well Fitness, as well as a fitness educator for Move Well Fit Academy With almost two decades in the industry, he’s worked with a wide range of clients, including those with health challenges like diabetes, osteoporosis, multiple sclerosis, hypertension, coronary artery disease, lower back pain, pulmonary issues, and pregnancy. Maurice is also an Assistant Professor of Health & Human Performance at Freed-Hardeman University.
Musculoskeletal issues have become the number one reason for physician visits.(1) Doctors are starting to agree that many surgeries may have been unnecessary.(2) The opioid crisis is a symptom of a larger societal issue to be sure, but it appears that too many people are turning to pain medications to manage their various aches and pains. Certainly pain medication and surgery can help many diseases and symptoms. However, they can also have long-term detrimental effects on human health. Can supervised exercise contribute to helping the problems of too many surgeries and too many pain medications being prescribed?
The modern research on this subject continues to support the notion that properly dosed and executed exercise can have a long-term positive impact on pain and possibly reduce the need for surgery. Who in the health and wellness community conducts supervised exercise? The Personal Fitness Trainer and Exercise Professional.
Personal Trainers are sought out to create fun and challenging workouts, help people lose weight, or help athletes perform better for their sport. We feel that although important, this puts exercise professionals like personal trainers in too narrow of a box.
Can a Personal Trainer be more?
Can an Exercise Professional transcend these service niches and be considered part of one’s healthcare team?
We not only believe so, we think that we must.
Exercise has more power than we, and the exercise consumer, give it credit for. Exercise can stimulate powerful natural medicine to help individuals overcome chronic pain and possibly even avoid surgery.
Our goal is to trumpet this message to exercise professionals and consumers alike and work to support the development of the exercise professional to meet this demand. Our plan is to be one of the pioneers that move exercise to the forefront of healthcare as a powerful, and often overlooked, process to be integrated proactively within a healthcare team for supporting individual health where pain persists and surgery is being considered. Will you join us?
Article co-written by Greg Mack and Charlie Rowe of Physicians Fitness.
Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease.
Charlie Rowe has been in the fitness industry for almost 20 years, and currently a Muscle System Specialist at Physicians Fitness. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist. Charlie hold numerous certifications, including Cooper Clinic’s Certified Personal Trainer, NSCA Certified Strength and Conditioning Specialist, the ACSM Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and ACE Certified Orthopedic Exercise Specialist Certifications. Charlie’s experience and continued pursuit of education make him one of the best in his field.
References
(1) Musculoskeletal Injuries: A Call to Action and Opportunity for Fitness Professionals, ACE Prosource 2013 by Nicholas A. DiNubile, M.D.
(2) Doctors Perform Thousands of Unnecessary Surgeries. Peter Eisler and Barbara Hansen, USA Today. Published 3:25 p.m. ET June 19, 2013. Updated 1:34 a.m. ET June 20, 2013
Getting into the health & fitness industry is great. There aren’t many careers that you can set your own hours and make upwards of $50 an hour. The caveat is that it typically isn’t a 9am-5pm job and a consistent paycheck isn’t always guaranteed. So how can you make that jump and create more stable income?
I have been teaching strength training, as well as Pilates based mat and Vinyasa Yoga for over 2 decades. As a former dancer, I know that I was always struggling with having a “flat stomach” or having a “flat back”. Dancers, in trying to achieve that “perfect turnout” and “flatness”, were often taught to “elongate the spine” by “tucking the pelvis” under, which basically leads to a posterior tilt. Unfortunately, this idea is often taught in fitness to the general population. Trainers and teachers alike, some coming from the dance world, will tell students to “protect their back” by tucking the pelvis such as during standing exercises, even bicep curls, or worse, curl their knees into their chest while lying on the ground or bench, and attempting to do a chest press. Students will be so conditioned to this ROUND SPINE and TUCKED PELVIS, that eventually when they stand, this is their posture. Over time, the discs can bulge, and the forward pelvis will eventually lead to lower back pain they were trying to avoid, as well as knee pain and other issues.
I am a reformed pelvic tucker. I advocate neutral spine when teaching, whether it be standing work such as bicep curls, pronated work such as plank and push-ups, or supine work such as leg lowers and overhead triceps.
The spine has 3 curves: the cervical spine (at the neck) has a concave curve, the thoracic spine (back of the rib cage) has a convex curve, and the lumbar spine (lower back) has a concave curve. And if you want to add a 4th, the pelvis/sacrum has a convex curve as well.
Together, this “S” shape is what keeps a body “straight”. Constantly flattening one’s back or pushing one’s vertebra into this position will eventually damage them. Plus you have to learn to CONTAIN YOUR MUSCLES, not force your vertebrae. There is a moment when the base of your ribs and your pelvic bone will feel like they are aligned in the front, like suspenders. Whatever curves are left over should remain.
Sometimes I do my supine abdominal work as well as strength training on a foam roller (pictured at right). This way there is no avoiding working in neutral spine. Plus, the foam roller will target the transverse abdominus as you are struggling to keep the foam roller still while performing exercises such as chest press, chest flies, overhead triceps, single and double leg lowers, etc.
Another bad habit that trainers and teachers tell their clients and students is to “sit on their hands” while performing exercises such as leg lowers. This is BAD for every reason. Your hands have small bones and veins which are easily damaged by sitting on them. Say you are 200+lbs, and you are putting all of your body weight on your hands! This is not good! I often joke and tell my students “I am a guitar player! I am not going to sit on my money makers!” Also, sitting on your hands again causes the pelvis to tuck, and the shoulders to protrude forward. By teaching this, you are telling your clients and students to “slouch”. You have not taught them how to gain strength by maintaining neutral spine. Third, more often than not, the reason the clients are feeling “pain” in their lower back is they are attempting to lower their legs beyond the range where the abdominals are effective. For me, about a 45 degree angle from the top is plenty of work. Attempting to lower one’s legs all the way to the floor and back will usually be out of the range of someone’s abdominal strength. Find a range of motion where the abdominal muscles fell the work, and the lower back is not effected. You can also put your client on the foam roller, or if you do not have a foam roller, place a thin towel under the sacrum to alleviate any pain the floor may be causing, as well as teach neutral spine.
For “plank”, I often joke (as I am a realtor as well) that “if the plank is not straight, I am returning it to aisle 4 in Home Depot”. People tend to hang their heads when something is difficult. I advocate looking a few floor boards ahead while performing plank, as well as push-ups, and to use a side mirror to check that the line of the head, shoulders, ribs and hips are aligned, while keeping the natural lumbar curve. Again, the ribs and hips should feel like suspenders. Push-ups are basically a “plank with an arm bend and straighten”. So it is important not to hang one’s head, especially when the floor is getting close :). (Planks pictured at right)
In closing, remember that you want to teach your students functional exercises that will help them out in the real world. Teaching neutral spine alignment is one of the most important ideas. You would never want to lift a box with a rounded, tucked spine, so why teach clients to “tuck their knees into their chest” while performing chest press? Sometimes it will take some time for a client to undo these bad habits, but in the end, clients will be stronger, and use the transverse abdomens vs poor alignment to perform daily tasks.
Photos courtesy of ANDREW MARK PHOTO.
Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, Pilates, Vinyasa Yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS. You can order her new book, “Healthy Things You Can Do In Front of the TV” on pre-sale on amazon.com, and it will soon be available on BN.com, and Kindle. Visit her website at bodyfriendlyoga.com
The need for trained maternal fitness professionals has greatly increased as a result of the number of fit women who desire to continue with their exercise routine once they become pregnant. The past several decades has provided a large body of evidence that supports the benefit and safety of prenatal exercise in uncomplicated pregnancies, and ACOG and other fitness and medical health organizations recognize the importance of fitness in a healthy pregnancy. Studies have shown that women who continue or even start an exercise program during pregnancy gain less fat weight, have fewer complications during labor and delivery, and return to their pre-pregnancy weight faster than women who didn’t exercise while pregnant.
Knowing what the current evidence based guidelines are for pregnant and postpartum women and being able to work with this population will open up opportunities to create a specialized program that fits their unique needs. Fitness professionals who have training in this field offer skilled support and guidance to pregnant and postpartum women and help them confidently include exercise as part of their lifestyle. Pregnant women are unsure of what exercises and activities they can continue throughout pregnancy and need guidance on how to monitor their routine for safety. As pregnancy progresses, women need strategies for modifying their exercise program as their body changes to maintain a comfortable and safe routine.
For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com
Article reprinted from Catherine’s Maternal Fitness blog with permission.
Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.
The foot is where movement begins, from the initiating of simple functional movements such as sit to stand or walking, to climbing stairs, to more complex dynamic sport movements such as playing soccer, football, rugby, and tennis. The ankle and foot complex require proper mobility in order for the body to initiate movement or change direction. In this article, we will review the anatomy of the ankle, common injuries to the ankle, functional assessments and training strategies to work with clients with previous injuries.
Knowledge is Power. Now our job is to prove this to the world. We so often want a crystal ball to gaze into our future. We have a number of crystal balls. These are crystal balls based on science and research, customized to our own unique DNA. I am referring to genetic testing, specifically BRCA testing.