Although stay-at-home restrictions are loosening around the USA and summer is coming, you may still need to get some of your activities indoors at home for a variety of reasons. If you aren’t doing resistance workouts already, you should really consider adding some resistance exercises to your normal regimens. 

In fact, if you do nothing else, doing these 5 key exercises is critical for people with diabetes who may have weak core muscles, altered gait and balance, and central and peripheral nerve damage.  If you lose your core strength, it will affect your ability to do all activities of daily living, including walking and living independently.

Do at least one set of 8-15 reps of each one, but work up to doing 2-3 sets of each one per workout.  For best results, do these exercises at least 2 or 3 nonconsecutive days per week — muscles need a day or two off to fully recover and get stronger — but just don’t do them right before you go do another physical activity (as a fatigued core increases your risk of injury).  

These and many more exercises are available on Diabetes Motion Academy for free download.

• Exercise 1: Crunches with waist worker
• Exercise 2: Chair sit-ups OR Low back strengthener
• Exercise 3: Modified push-ups
• Exercise 4: Squats OR Suitcase lifts
• Exercise 5: Sit-to-Stand exercise

#1: Crunches with waist worker

Crunches:

Directions:

• Lie down on your back with your knees bent. 
• Place your hands on your head right behind your ears. 
• While breathing out, contract your abdominal muscles to lift your head, neck, and shoulders off the floor and curl forward no more than 45 degrees. 
• Hold for a moment before returning to the starting position, then repeat. 

Waist worker:

Directions:

• Lie on your back on the mat with your legs bent, your feet flat on the floor, and your left hand behind your head. 
• Stretch your right hand across your body toward your opposite (left) knee and circle your hand three times around your knee in a counterclockwise direction; your right shoulder blade will lift off the mat. 
• Repeat the circular movement around the right knee using your left arm, but in a clockwise motion. 
• Keep your head in a neutral position and relax your neck to ensure that the contraction is in your abdomen area only. 

#2: Chair sit-ups OR Low back strengthener

Chair sit-ups:

Directions:

• Sit up straight in a chair with your feet on the floor, hands to your sides for support.
• Bend forward, keeping your lower back as straight as possible, moving your chest down toward your thighs.
• Slowly straighten back up, using your lower back muscles to raise your torso.
• For added resistance, put a resistance band under both feet before you start and hold one end in each hand during the movement. 

OR

Low back strengthener (Superman exercise):

Directions:

• Lie on your stomach with your arms straight over your head, your chin resting on the floor between your arms. 
• Keeping your arms and legs straight, simultaneously lift your feet and your hands as high off the floor as you can (aim for at least three inches off the floor).
• Hold that position (sort of a Superman flying position) for 10 seconds if possible, and then relax your arms and legs back onto the floor.
• If this exercise is too difficult to start, try lifting just your legs or arms off the floor separately–or even just one limb at a time. 

#3: Modified push-ups

Directions:

• Get on your hands and knees on the floor or mat. 
• If using a band for extra resistance, position it across your back and hold one end of it in each hand so that it is somewhat tight when your elbows are straight. 
• Place your hands shoulder-width apart on the mat. 
• Tighten your abdominal muscles to straighten your lower back and lower yourself (from your knees, not your feet) down toward the mat as far as you can without touching it. 
• Push yourself back up until your arms are extended, but without locking your elbows. 
• If this exercise is too hard, stand facing a wall and place your arms on it at shoulder height and your feet about a foot away; then, do your push-ups off the wall (with or without a resistance band).

#4: Squats OR Suitcase Lifts

Squats: 

Directions:

• Stand with a dumbbell (or household item, like water bottles) in each hand and your feet shoulder-width apart, with your toes pointing slightly out to the side.
• If you’re using a resistance band, tie both ends of your band onto a straight bar or broom handle, which is placed squarely across your shoulders with the loop of the tied band placed under your feet. 
• Keep your body weight over the back portion of your foot rather than your toes; if needed, lift your arms out in front of you to shoulder height to balance yourself.
• Begin squatting down but stop before your thighs are parallel to the floor (at about a 70-degree bend), keeping your back flat and your abdominal muscles firm at all times. 
• Hold that position for a few seconds before pushing up from your legs until your body is upright in the starting position. 
• Do squats with your back against a smooth wall if needed to maintain your balance.

OR

Suitcase lift:

Directions:

• After placing dumbbells (or household items) slightly forward and between your feet on the floor, stand in an upright position with your back straight. 
• Keep your arms straight, with your hands in front of your abdomen.
• With your back straight, bend only your knees and reach down to pick up the dumbbells. 
• Pick up the dumbbells or items in both hands, then push up with your legs and stand upright, keeping your back straight.

#5: Sit-to-Stand exercise     

Directions:

• Sit toward the front of a sturdy chair and fold your arms across your chest.
• Keep your back and shoulders straight while you lean forward slightly and practice using only your legs to stand up slowly and to sit back down.
• To assist you initially, place pillows on the chair behind your low back.

From Diabetes Motion Academy Resources, “Basic Core Exercises,” Sheri R. Colberg © 2017.

Sheri R. Colberg, PhD, FACSM, is the author of The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities (the newest edition of Diabetic Athlete’s Handbook), available through Human Kinetics, Amazon, Barnes & Noble, and elsewhere. She is also the author of Diabetes & Keeping Fit for Dummies. A professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert, she is the author of 12 books, 30 book chapters, and over 420  articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites, SheriColberg.com and DiabetesMotion.com.

A potential client nervously sits down before a very handsome LA plastic surgeon at the beginning of each episode of this extremely popular television show in the early 2000s. The surgeon asks the same question to each patient he meets.,“Tell me what you don’t like about yourself?” The potential client, slightly taken back by the magnitude and depth of this question, details what it is he or she wishes the doctor to change about them.

As a MedFit fitness professional and educator, this particular scenario really resonated with me. In fact, I have spent multiple decades trying to figure out the “WHY” behind the behaviors and mindsets adopted by my clients. What external or internal factors are positively or negatively affecting their ability to make healthy decisions, their ability to feel confident, or their ability to love themselves or others. This is exactly why we all must keep asking, why?

While designing fitness programs to support physical well-being is extremely important, are we providing enough positive reinforcement to encourage clients that “they are enough”? Are we building their confidence and self-worth? Are we empowering their mind and believing in them so hard until they start believing in themselves?

These are the questions we should be asking ourselves when we design fitness programs for the “whole person.”

The Why

Why do people feel the need to drastically change their appearance?

Where do these ideas come from and how will it have a positive effect on their future?

Why is outer appearance still considered more important than overall health when considering recent research to support longevity?

These are just a few questions to consider as a fitness or medical fitness professional as you begin to assess clients and “peel back the onion” to fully understand how you can best support their goals.

The How

If your client suffers from what I refer to as “negative self-talk,” those incessant self-deprecating statements act as a personal bully and obstacle to achieve true happiness — ask them why they feel this way?

Then, continue those “Why” questions until you find out the answers. This may take one whole session, or it may take months of shorter conversations. However, a medical fitness professional has the power to change lives, not only through physical fitness, but mental fitness. Mindset matters!

Consider

1. Is this negative thinking a result of a negative experience or is it being projected on them by others?

2. Ask questions and listen. Only when the fitness professional has developed a trusting, supportive, comfortable, and communicative relationship with their client can the fitness professional begin to understand their “why.”

3. “The way you make your muscles grow is through resistance training, where you work them until your muscle fibers are fatigued and break apart. With proper rest, recovery, and nutrition, those same muscle fibers grow back stronger than they were before. And you grow. The mind and your mindset work the same way.” –Dr. Bryan Price

Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is currently writing the MedFit Network Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.

Four years ago, almost to the day, I made a keynote presentation at the California Clubs of Distinction annual meeting in Palm Springs. It was not long after the Affordable Care Act, also known as Obamacare, was approved and launched. I decided to make this presentation because the landscape for medical health was at an all-time high, and the certification organizations knew this as they were all scrambling for their market share of this emerging opportunity.

I was making presentations in healthy aging and how to train elderly people in 2014, joined with and became a master trainer for an emerging group at the time, and got certified in functional aging. I had met with this energetic woman in Orange County who was starting a network for medical fitness — any guesses? Yes, Lisa Dougherty was super passionate about it and was busy enlisting all kinds of groups to collaborate with her. After working for the American Council on Exercise and knowing their interest in this market sector, I too saw an interesting niche in the fitness and health market that was not getting filled. The gap between an allied health care professional’s treatment and true functional health for any individual, but especially an aging one. Phil Kaplan has written and spoken quite a bit on this and labeled it as the “new blue ocean.” As he mentions, it is not a small niche, but a huge market opportunity, and it is driven by people valuing their health and quality of life.

Market Changes: What does the future hold?

Fast forward four years in what will go down in history as the COVID-19 year for the U.S. “We are all in this together” but six feet apart and in our own homes! There is a lot talk out there about what the future holds. Our country has not seen this level of unemployment and losses of income since the Great Depression. Our government is bailing out people and companies to the tune of trillions of dollars. Large companies such as 24-Hour Fitness is considering bankruptcy and has closed all 448 of their gyms. The social isolation has changed the landscape toward medical fitness even further! The other trend it is causing is online services to be popular. The stay-at-home quarantines we all are supposed to obey has meant a huge upsurge for education and training done online or virtually, respectively.

In an interview with Chris Rondeau, the CEO for Planet Fitness, he was mentioning how their facilities were always practicing good cleaning practices but felt the “personal cleaning etiquette” will now likely change amongst members. Thank goodness! No one wants to be on a piece of equipment where another’s sweat was left. This factor and the personal space will likely be in the forefront as the fitness clubs are part of the Phase 1 of the U.S. government’s reintegration policy. He also mentioned how the public understands that fitness is good for the immune system, and the lower price point of the Planet Fitness facilities are something the public will need to consider with the losses of income. He also mentioned how the company’s app and virtually lead fitness is exploding. He called it the digital content consumption and said it is at an all-time high for the company.

So what factors were part of my “perfect storm” as I labeled it? The Affordable Care Act, the baby boomers becoming seniors, people living longer, medical costs going out of control, ROI on preventative services being realized and new opportunities for corporate wellness as well. Now we have a new perspective on staying healthy during pandemics, keeping ourselves and our families away from large crowds, and watching our budget. There has been a shift in society for quite some time now from a “volume incentive” or paying a fee for a service, to a “value incentive” or paying for outcomes.

So several questions the public is asking;

1. Are the big box gyms doomed? No but they may need to serve the two ends of the spectrum, with clubs like Equinox serving the high-end client and clubs like Planet Fitness serving low-end clients.
2. Are group classes going to go away? Not likely, but the need to have six feet of spacing and therefore smaller classes are likely to change the way group classes are run, and that is “when” they come back.
3. Will online or virtual training increase? No doubt they will. This trend was already going strong with Peleton (stationary bikes) and other fitness devices having the virtual coach.
4. Will wellness and health coaching services increase? Also, no doubt. People, like me, have been not been in a standard gym for almost two months and are realizing the importance of their mental and physical health over just looking fit and trim.

What is next?

It is believed that the fitness marketplace will change over the next decade, and that the pandemic has sped this change along. 24-Hour Fitness was going through financial problems prior to the COVID-19 shutdowns. The evolution of “gyms” becoming “health care” facilities is happening. You should position yourself to either deliver a variety of wellness services or have a network of people you work with who can deliver these services. I believe the future health center will be a place offering several services and most will be proactive in nature.

You will need to join organizations that expose you to people who desire these services, like the MedFit Network. Be sure to take advantage of this “downtime” to “gear up” with education and new business plans that include specialties in disease conditions like osteoporosis, Alzheimer’s disease and obesity. Others like women’s health or cancer or multiple sclerosis are available through MedFit Classroom as well.

This article was featured in MedFit Professional Magazine. 

Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.