Fitness Professionals Archives - Page 4 of 64

Coaching Hardiness of Heart: Buffers vs. Band-Aids

Pat VanGalen/26 January 2024/ All MFN blog/

Like a leaky roof, do we just patch the hole, and hope for the best? Or do we replace and restore it, and do the maintenance to optimize it, despite extreme weather conditions? In ski-speak, we joke about variable conditions, never predictable. In life, it’s the same thing. Are we prepped and ready for the curveballs and Murphy-strikes that WILL come our way? Do we have an ample buffer, a reserve capacity to pull from? Can we bounce back, repeatedly, take hits and remain solid? Hardy folks can and do! Think of a hardy person you know. What keeps them surviving, and thriving?

Today, it is well-accepted that cardiovascular disease (CVD), the leading cause of death in the U.S., is rooted in inflammation, insulin-resistance, oxidative stress (rusting), hormonal imbalances and exposure to toxins. We also know that a lousy diet, long-term micro-nutrient deficiencies, physical INactivity, chronic DIStress, and various toxins, raise cholesterol and blood pressure exacerbating an inflammatory response in our arterial endothelium. Remember that half of the people who experience heart attacks do NOT suffer from hypercholesterolemia. To quote Mark Hyman, M.D., Founder, Cleveland Clinic Center for Functional Medicine, “CVD is not about cholesterol; it is about inflammation in a cholesterol environment.”

So, when 45 year old 2-stent Charlie, husband, father of three, small business owner, with a passion for hunting and fishing comes to me, I need Whole-Charlie coaching. A Hardiness model fills the bill.

Hardiness Coaching is designed to fortify FIVE structural pillars: 1) Movement, 2) Diet, 3) Rest-Recovery-Regeneration, 4) Stress Resistance and, 5) Purpose-Relevance-Meaning. The Pillars are grounded in a foundation of DAILY habits, patterns and practices, not programs with a start and end date. They are interconnected, and the robustness of one supports the others; if one crumbles, the others bear the brunt. By repairing cracks and leaks within a given pillar, we boost overall resilience, durability, and robustness, not just the CV issue at heart (no pun intended). Hey, what’s good for the heart, is good for the brain is good for the gut is good for the immune system is…

Our clients come to us with the desire to move better, feel better and get back to living life, even surpassing it, despite their issues. Their current health does NOT define them, nor does their age. It’s our responsibility to meet them where they’re at, know where they have been [for decades], and get them where they want to go. Keeping their hopes and dreams alive is paramount.

As Hippocrates so eloquently stated, “Know the person who has the disease, not just the disease that has the person.”

So, when we hear ‘cardiac or cardiovascular’, think beyond the heart and vasculature for transport and waste removal. Think integration with the lymph and respiratory systems, and their role in running a well-oiled machine, one where the other six systems [gut microbiome, immune/inflammatory, energy production (mitochondria), waste disposal – detoxification, communication (neurotransmitters, hormones), structural (cells, tissues, organs) synergistically thrive. This is a Functional Medicine model. Check it out.

Clinical psychologists, physical therapists or medical doctors, we are not. But, we impact lives in a multitude of ways, some measured by hard data, and others, by those intangibles like confidence and joy. Yes, we work within the physical realm, but when we take the integrated pillar approach to coaching Hardiness, we sync and link the pillars, buttressing them to exponentially resist and adapt better to the stresses and strains of life. Buttresses, NOT band-aids!

Coaching MUST transfer to performing and feeling better, at home, in labor, care-giving, recreation and even competition. For example, with regards to the movement pillar, there are three realms: 1) physical activity, as in walking, stairs, labor and chores, 2) recreation, as in sport, dance, all-seasons GO on snow, ice, sand or water, and 3) TRAINING, exercising with purpose. ALL contribute to the robustness of our movement pillar. Training is only one piece of the movement pie, so yes to targeted training, AND to more movement in labor, hobbies and play.

When training any adult, there are 7S Buckets that may need to be restored and refilled. The 7th Bucket is Specificity and Specifics. Specificity refers to “we get what we train for; we keep what we do!” Specifics are those things unique to our client; in this case, those CV conditions that propelled the client in our direction in the first place. It may have been a primary care Doc, a referral from cardiac rehab or simply the client’s grit to BE better. Whatever, we are here to fortify all their pillars of hardiness.

Don’t get me wrong. We must know CVD pathologies, physiology, metrics and measurement, and network with relevant healthcare professionals. But more importantly, we must customize and personalize coaching to provide the springboard for Charlie to thrive, as a husband, father, business owner and outdoorsman, to optimize his health-span, and his zest for living life to his fullest.

So, from pacemakers, stents, meds and more, to risk factors, co-morbidities, MSK challenges and all else in store, we practitioners are here to reboot, rebuild, coach, train and restore.

Specialization for Fit Pros

Join Pat VanGalen in the online course, Cardiac REHAB Fitness Specialist. Learn the nuts and bolts of coaching hardiness within the cardiovascular system. Evidence-based facts, figures, updates AND case studies will tweak your coaching. Integrate, don’t isolate!

Patricia ‘Pat’ VanGalen, M.S. brings a unique blend of education, practical experience, common sense application, science and research to her lecturing, teaching, training and coaching. She launched her professional career 40+ years ago in physical education and coaching, then spent the next 10 years in corporate-industrial fitness, health promotion, cardiac rehab and injury risk reduction programming design, implementation and management. Visit her website, activeandagile.com

Healthy-Lifestyle-Nutrition-Exercise-Medicine

The Power of Why: Motivation for Better Health

Trevor Wicken/15 January 2024/ All MFN blog, Conditions/

As a movement practitioner, I love it when my clients become my teachers. One conversation with someone going through the process of changing their life and fighting challenges may prompt, lead, or sometimes shove me into examining my practice, my approach, and my connection with the people I serve. Just recently Mary, one of my clients, wanted to meet with me to discuss her progress and our conversation inspired this article.

Understanding and Conquering the Relative Insulin Resistance of Midlife – Beyond the Blood Tests

Carla DiGirolamo, MD, CF-L1, PN-1/3 January 2024/ All MFN blog/

One of the most common things my midlife clients struggle with is weight gain. “The things that worked before just don’t work anymore” is the mantra of so many during this phase of life. They visit their healthcare provider with concerns about “waking up in someone else’s body”. The doc runs some tests – thyroid levels, blood sugar studies, and insulin – and all the results come back in the normal range. “Great news!” says their doc. “There’s no problem. You’re just getting older”. End of story.

Many of you who have heard me on various podcasts know that I’m not a fan of the notion that hormone testing reflects the entirety of the Human experience as many “practitioners” would have you believe. The relative insulin resistance of midlife is a perfect example. One does not have to meet the criteria for “pre-diabetes” or metabolic syndrome for there to be real changes for which there are interventions. Isn’t the goal of medical care to prevent these things in the first place rather than just send you away until you actually become diabetic?

One does not need to meet the criteria for “pre-diabetes” or “metabolic syndrome” for there to be changes for which there are interventions. Isn’t the goal of medical care to prevent these things in the first place rather than just send you away until you actually become diabetic?

This is where understanding what’s happening inside your body during the various phases of hormonal life keeps you one step ahead of mainstream medicine. Today we will discuss the phenomenon of relative insulin resistance – the physiologic changes to energy utilization occurring in your body as a result of the normal hormonal changes of midlife – and how to mitigate the effects of these changes so that you can be your healthiest self.

Your Body on Carbs

In a nutshell, carbohydrate is consumed in the diet, digested and absorbed as glucose (among other simple carbohydrates), and utilized as fuel by the tissues in the body. Excess glucose that is not used is stored as glycogen in the liver and muscles, but also as fat. The hormone, “insulin”, is secreted by the pancreas in response to glucose entry into the bloodstream. Insulin drives glucose into the cells so that the cells can use the glucose as fuel to carry out their functions. The “efficiency” of insulin function is impacted by cycling estrogen and estrogen receptors on the surface of cells.

The two bodily systems that use the greatest amount of blood glucose are the brain and skeletal muscle – the voluntary muscles that move our bodies. During midlife, there is a decrease in cycling estrogen and estrogen receptor presence on the surface of skeletal muscle cells. As the ovarian hormonal cycles change and become irregular, there is less circulating estrogen. As a result, muscle mass, strength, and power decline along with the efficiency of the muscle’s ability to utilize blood glucose through insulin-mediated pathways.

A prominent player in cellular and insulin efficiency is an intracellular organelle called the mitochondria: the “batteries” that supply energy to cells. Below is an excerpt from my course Menopause Health and Fitness Specialist Course through MedFit Classroom that explains the science behind how skeletal muscle function is impacted by changes in estrogen and its receptors.

As we just mentioned, when blood glucose is not used as fuel, the excess is stored as fat. When the hormonal changes of midlife reduce the efficiency of glucose utilization by skeletal muscle, the result is a greater excess of unused glucose and increased storage of fat which results in changes in body composition.

Your End-Run Around Relative Insulin Resistance

There are three basic approaches to mitigating the impact of the hormonally-driven changes in how our bodies manage glucose. Resistance training (particularly weight training), nutrition, and neuroendocrine activation.

Resistance Training

If you want your muscles to use more glucose, then you need to increase the activity of those muscles. This looks different for different individuals. If you are sedentary, then starting with walking for 30 minutes 4-5 times per week is a great start! From there, add a weighted backpack, then maybe add some hills or even hiking trails. Simultaneously, engage a personal trainer for 6 weeks and become familiar with weight training. If you are an endurance athlete, make friends with the barbell. If you are a powerlifter, explore different ways to stimulate the muscles that add cardiovascular stimulation like combining running segments with heavy deadlifts. The point is, no matter what your fitness level or expertise, there are new and exciting ways to increase the functional capacity of your skeletal muscle.

Why does this work? The Human body is an amazing machine designed for survival. Mother Nature has programmed redundancies within our physiologic systems to promote longevity. We discussed the impact of our cycling reproductive hormones on how our muscles utilize blood glucose. Fortunately, other physiologic pathways facilitate glucose entry into the muscle cells that depend less on cycling hormones, most notably, the GLUT4 pathway. GLUT4 is a glucose transporter protein that works with muscle contraction to transport glucose into the cells. So when we stimulate muscle contraction through resistance training, this activates the GLUT4 pathway to facilitate the entry of glucose into the cells to be used as fuel, leaving less excess to be stored as fat.

GLUT4 is a glucose transporter protein that works with muscle contraction to transport glucose into the cells. So when we stimulate muscle contraction through resistance training, this activates the GLUT4 pathway to facilitate the entry of glucose into the cells to be used as fuel, leaving less excess to be stored as fat.

Nutrition

We have discussed how glucose enters the cells of our tissues through pathways involving insulin and GLUT4 and how unused, excess glucose is stored as fat. In this section, we will discuss the other important part of this equation, which is the load of glucose that enters the bloodstream by way of the foods we eat.

Glycemic Index – The glycemic index is a measure of how much a carbohydrate source will increase blood sugar over 2 hours from the time of consumption. There are low, medium, and high glycemic index foods with a great description in this resource from Healthline. A lower glycemic index reflects lower blood sugar following consumption and a higher index reflects greater increases in blood sugar. This is important because the glycemic index reflects the glucose “load” on the systems (such as insulin and GLUT4) that need to shuttle the glucose into the cells. When the glucose load is greater, the systems can become overloaded, leaving more excess to be stored as fat. When the load is less, insulin and GLUT4 can better “keep up” with transporting glucose into the cells for use as fuel leaving LESS excess to be stored as fat.

By focusing on carbohydrate sources with a lower glycemic index and minimizing those with a higher glycemic index, you can effectively decrease the glucose load that insulin and other glucose transport pathways see and thus more efficiently use carbohydrates as fuel and minimize the excess that is stored as fat.

Neuroendocrine Adaptation

Adaptation is the ability of the body to adjust or “make familiar” movements or tasks that we undertake. This is a coordinated effort by the muscles, joints, metabolic, and endocrine processes all driven by the master puppeteer we know as the Nervous System!

Because Mother Nature designed Humans for survival, our ability to adapt to physical stimuli and physical tasks is powerful! When we stimulate the muscles repetitively in the same way for an extended period of time, the body doesn’t need to work as hard to manage the load or task and effectively switches into “Auto-pilot”. This is great for elite athletes where the tasks that their sports require become second nature through adaptation.

However, from the standpoint of muscle physiology, they crave something more! This is why we train differently in the off-season: to keep the muscles guessing and thus contantly adapting to become fitter, faster and stronger so that we can crush it on game day! To learn more about this incredible phenomenon, check out Neuroendocrine Adaptation: Your End-Run Around the Menopause Transition.

Key Points for Combatting Midlife Relative Insulin Resistance

Get moving! The first step to using more glucose as fuel and storing less as fat is to move those muscles. For the sedentary, walking, backpacking, and hiking are great ways to start.
If you have never trained with weights, another great place to start is a group “boot camp” style fitness class. Find one at your local gym and sign up with a friend! My favorite group class for getting started with weights is Les Mills BodyPump.
Any level of athlete can benefit from a 4-6 week training program with a trainer or strength coach to gain some basic skills and techniques from basic to more advanced movements depending on your fitness level/familiarity.
Incorporate resistance/weight training at least 2-3x per week.
No equipment, no problem! Push-ups and their many variations are fantastic for anyone of any fitness level to add mass, strength, and power to the muscles of the upper body.
Take an inventory of your carbohydrate intake and using the resources in this LINK, identify carbohydrate sources and potential substitutions that can move the needle toward lower glycemic index choices.
Nutrient timing is a strategy where carbohydrate intake is timed within an hour before training and within an hour after when the muscles are “looking” to fuel movement during the workout and then looking to replenish glycogen stores in the liver following a training session.
Most importantly, be consistent, but be patient! It’s about progress, not perfection. Every little bit you can do has benefits.

Fit Pros: Offer menopausal and perimenopausal women an individualized approach to training, nutrition and wellness as a Menopause Health and Fitness Specialist.

Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School.

Exercise and Prostate Cancer

Carol Michaels/22 December 2023/ All MFN blog/

The rising rate of prostate cancer necessitates developing better methods to prevent and treat prostate cancer. Prostate cancer is the third leading cause of cancer death among U.S. men, according to the American Cancer Society. The country’s 3.3 million prostate cancer survivors account for 21 percent of all cancer survivors.

There are many reasons why a cancer patient should stay as active as possible through cancer treatment and recovery. I will begin by pointing out a few studies that show how exercise can benefit cancer patients. These studies demonstrate how exercise can reduce certain side effects from treatment, increase energy, decrease stress, and improve quality of life.

There is evidence to support the use of exercise in prostate treatment. Exercise plays a role in the all-around improved physical and mental health and therefore should be considered in the treatment plan. We know that exercise can decrease recurrence for some cancers and the role it plays in weight control, which is correlated with some cancers. For prostate cancer specifically, data indicates that obesity increases the aggressiveness of prostate cancer, and thus mortality. Men receiving androgen deprivation therapy are at higher risk for depression. Exercise reduces depression.

Studies do have their limitations. Some use self-reported data about lifestyle and exercise. Moreover, there may be a low number of minority participants who may often have higher cancer rates. The following are a few of the published studies, which confirm that exercise should be included in the treatment plan for prostate cancer patients.

Studies have suggested that patients with high levels of physical activity had a lower rate of disease progression and also reduced mortality from prostate cancer. Ying Wang, PhD, a senior epidemiologist in the Epidemiology Research Program at the American Cancer Society in Atlanta, and colleagues analyzed data on 10,067 men diagnosed with non-metastatic prostate cancer between 1992 and 2011. Men with prostate cancer, which hasn’t spread may have longer survival the more they exercise. A study demonstrated that men who were the most physically active had a 34% lower risk of dying from prostate cancer when compared with men who were the least physically active. Men who either maintained or increased their exercise level also benefited. Prostate cancer patients who kept up a moderate to high level of physical activity also had better survival prognoses compared with their more sedentary counterparts. Those men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Wang concludes, “Our results support evidence that prostate cancer survivors should adhere to physical activity guidelines, and suggest that physicians should consider promoting a physically active lifestyle to their prostate cancer patients.”

Androgen Deprivation Therapy leads to numerous side effects, which can be decreased through exercise. Side effects of ADT include loss of muscle, increase in fat mass and osteoporosis. Risk for diabetes and heart disease also increases. Brian Focht, reported at the November AICR convention, that functional ability increased dramatically as did quality of life for those that exercise, and side effects of ADT were reversed.

Exercise can decrease blood sugar levels, which lower insulin levels and also helps to lower inflammation. There does appear to be a positive association between insulin levels, inflammation and prostate cancer risk.

The evidence for physical activity in reducing anxiety and depression, while increasing general-well being is fairly substantial. Improving well-being can have a dramatic beneficial effect on sexual function. Consistent exercise will also help to lower insulin, blood sugar, and improve overall cardiovascular health, all of which have positive impact on erectile dysfunction and libido ().

In 2016, Rider and Wilson studied the connection between ejaculation and prostate cancer, which was published in European Urology. Men that reported higher ejaculatory frequency were less likely to be diagnosed with prostate cancer . This study showed a beneficial role of frequent ejaculation particularly for low-risk disease.

Some doctors have traditionally told patients to rest during this time but Favil Singh’s research confirms the importance of getting fit prior to surgery. Singh’s research published in the journal Integrative Cancer Therapies has shown that a regular dose of physical activity prior to surgery helps the recovery process. This reduces time in the hospital.

Singh stated “This is the first time we’ve been able to demonstrate the benefits of ‘pre-habilitation’ for prostate cancer patients. It is safe, side effect-free and can be done while undergoing chemo or radiotherapy. Just two sessions a week of resistance and exercise training for six weeks can make a difference to recovery.”

Often, there is a waiting period in between diagnosis and surgery. If fitness level can be improved before surgery the patient, then the patient goes into the surgery stronger and may have a better recovery.

The American Cancer Society and American College of Sports Medicine recommends at least 150 minutes of moderate physical activity or 75 minutes of vigorous exercise each week. This advice is a good goal for those who have been inactive. Unfortunately, in my view this is insufficient for a significant number of cancer patients. Having worked with cancer patients for over 20 years, I believe that this recommendation needs to be changed. It is impossible to include aerobic exercise, strength training, and other exercise methods in the current recommended time frame.

Carol J. Michaels is the founder and creator of Recovery Fitness® LLC, located in Short Hills, New Jersey. Her programs are designed to help cancer survivors in recovery through exercise programs. Carol, an award winning fitness and exercise specialist, has over 17 years of experience as a fitness professional and as a cancer exercise specialist. Visit her website, carolmichaelsfitness.com

References

Steven C. Moore PhD, et al, Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016; 176(6): 816-825.

Lynch B.M., Dunstan D.W., Vallance J.K., Owen N. Don’t take cancer sitting down: A new survivorship research agenda. Cancer. 2013, Jun 1; 119(11): 1928-35 Medicine

Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner, Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study, Cancer Epidemiology and Biomarkers Prevention May 2007, 10.1158/1055-9965

Gopalakrishna et al, Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review. Journal of Cancer Survivorship, 2016 (5): 874-82

Vallance, J., Spark, L., & Eakin, E.. Exercise behavior, motivation, and maintenance among cancer survivors. In Exercise, Energy Balance, and Cancer (2013) (pp. 215-231). Springer

Cannioto et al., The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis, Cancer Epidemiology, Volume 49 August 2017

Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012; 14(11): CD006145.

Booth FW, et al., Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012 Apr; 2(2): 1143-211.

Stephanie Cash et al, Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiology, Feb 2013,37(1): 46-53

Hwang, Yunji MS; Lee, Kyu Eun MD, PhD; Park, Young Joo MD, PhD; et al, Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study, Medicine, March 2016, Mar; 95(9): e2893

Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011; 4: 486-501.

Galvao, et al. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010 Jan 10; 28(2): 340-7.

Galvao, et al. Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis. 2007; 10(4):340-6.

Winters-Stone KM, et al. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jan; 96(1): 7-14.

Giovannucci EL, Liu Y, Leitzmann MF, Stampfer MJ, Willett WC. A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med. 2005; 165: 1005-1010.

Storer TW, Miciek R, Travison TG. Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy. Asian J Androl. 2012, Mar; 14(2): 204-21.

Focht, Brian C.; Lucas, Alexander R.; Grainger, Elizabeth; Simpson, Christina; Fairman, Ciaran M.; Thomas-Ahner, Jennifer; Clinton, Steven K., Effects of a Combined Exercise and Dietary Intervention on Mobility Performance in Prostate Cancer, Medicine & Science in Sports & Exercise. May 2016:48(5S): 515.

Rider J, Wilson K.et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow up, European Urology. December 2016, volume 70, issue 6

Singh F. et al. Feasibility of Presurgical Exercise in Men With Prostate Cancer Undergoing Prostatectomy, Integrative Cancer Therapies (2016). DOI: 10.1177/1534735416666373

Wang et al, Recreational Physical Activity in Relation to Prostate Cancer–specific Mortality Among Men with Nonmetastatic Prostate Cancer. European Urology July 2017 online bit.ly/2tXMK6Y

The Walking Games

Jonathan Ross/13 December 2023/ All MFN blog/

Walking is the most readily available form of physical activity that most people can do regularly. As the days turn darker and the temperatures drop, the innate enjoyment of walking outdoors can make regular walking harder as we spend more time indoors.

The solution? Walking Games.

These are strategies to bring enjoyment and engagement to indoor physical activity. Further, these strategies also sneak in some added of brain health benefit with added cognitive challenge and an emotionally enhanced experience beyond what people expect from “walking.”

Brain games alone are not enough. They can provide some cognitive benefit, but for most of human history, we solved intensely meaningful problems directly related to survival while moving, not sitting on a couch playing a low-stakes brain game or working on a crossword puzzle.

Likewise, any exercise is good for brain health. But when you add cognitive challenge to exercise, the benefits multiply. Conceptually, it’s as simple as considering the difference between the treadmill and a trail for walking. The latter requires using sensory information to consciously choose where and how to take each step.

The strategies below are designed to create a “think and move” experience, all while enhancing the emotional response to movement.

Walking Game 1: Alphabet Walk

Mark off a rectangular or oval space with cones, water bottles, shoes, pillows, or anything else readily available.
Within the space, walk to trace letters on the floor with your feet. Use names of favorite movies, books, musical artists or names of friends, family, or pets or perhaps names of travel destinations.

The highly variable direction of movement makes the walking more beneficial and the use of letters of cherished names adds cognitive benefit and enhances the emotional state while walking by keeping favorite pop culture offerings or loved ones front-of-mind while moving.

Walking Game 2: Balloon Tap Walk

Blow up a balloon and gently tap it as you walk to keep it up by “air dribbling.”

The need to track the unpredictable action of the balloon will result in variable walking speeds and co-coordination of eye-hand movements.

Walking Game 3: Balloon Wall Dribble

Blow up a balloon and face a wall.
Tap the balloon into the wall and keep tapping it into the wall, adjusting body position slightly side-to-side to move with the balloon.

Optional add-on for balloon exercises: Use a light-colored balloon and a dark-colored marker. Write letters or numbers on the balloon. Use it to perform any of the following (in increasing order of difficulty):

Call out the letter or number most visible when tapping the balloon.
Call out words in the same categories introduced above in “Alphabet Walk”
Using the numbers, designate a left and right hand for even and odd numbers, then tap the balloon with the corresponding hand. Or, perform simple math like addition or subtraction.
Combine use of letters and numbers. For example, call out favorite musical artists for letters and use the left-right/even-odd hand tap for numbers.

Walking Game 4: Bounce, Catch…or Fetch

This can be done strolling slowly through any indoor space or standing still. Use a ball, a pet’s toy, a pillow, or any object which you can bounce and/or toss and catch. Bonus brain points for using something without an “easy” shape as it requires more manual dexterity to catch. And if you drop the object, you get some extra essential life skill movement by fetching it from the floor.

Wrap Up

The reason people become less active when spending more time indoors is that the usual ways of moving more indoors are boring – no one is realistically going to take a walk around their house. However, moving consistently is important to our physiology and our brain health regardless of the weather or season.

Using these and other similar strategies that you think of can make staying active when spending more time inside more appealing, and that is the key to making it happen more regularly. You can be an inspired leader to the people you serve when you make things enjoyable, more engaging, and as a result easier to do (so they no longer have to force themselves to do them.)

Brain Health Education for Fit Pros

All physical activity is good for the brain, but the inclusion of specific elements such as coordination, reactivity, partner interaction, attention and memory challenges integrated with physical activity make it even more beneficial. MedFit Classroom’s Alzheimer’s Disease Fitness Specialist course blends current science with common sense to present cutting-edge ideas to optimize the impact that fitness can have in the lives of those you serve who are concerned about or diagnosed with Alzheimer’s.

Article originally printed in canfitpro magazine.

His “800 Pounds of Parents” directly inspired Jonathan’s prolific fitness career. He is a multiple Personal Trainer of the Year Award-Winner (ACE, IDEA, and PFP Magazine), master trainer for the American Council on Exercise (ACE), creator of Funtensity, brain fitness visionary, blogger, international speaker and author. He is the author of MedFit’s Alzheimer’s Disease Fitness Specialist online course.

Proprioception Training: An integral aspect of joint replacement fitness

Pat Marques/6 December 2023/ All MFN blog/

Proprioception refers to the conscious and unconscious perception of postural balance, muscles sense, and joint position and stability. Basically, it is your sense of where you are in time and space for movement. We have found over the years that the best way to explain proprioception to clients comes from Dr. Eric Cobb at Z-Health Performance Solutions:

“Proprioception is the body’s 3D map of itself in time and space. AKA our movement and awareness map”.

The detail and definition of this “proprioceptive map” comes from several specialized mechanoreceptors (i.e. nerve endings) in the muscles, tendons, joint capsules, fascia, and skin. As fitness trainers as we are usually taught about muscle spindles and Golgi tendon organs when we learn about flexibility training, but there is a lot more to proprioceptive input. You are affecting the proprioceptive input to the brain when you use a neoprene knee sleeve (pressure), kinesiology tape (skin stretch), heat or ice packs (temperature), TENS units (electric), etc.

Why understanding and training proprioception is important for joint replacement clients

Several conditions can alter proprioception, thus “clouding” the map and degrading movement sense and capability, including pain, trauma, effusion, and fatigue. A joint replacement client also likely had poor motor control of the joint in the first place that resulted in compensatory movement patterns and overuse injury over time. Complicating the matter further, although it may have been necessary, the surgery itself is an “insult” to the musculoskeletal and nervous systems.

To move a joint well, you must be able to feel the joint and surrounding tissue well. An extreme example of what can happen without the sense of touch or joint position is the story of Ian Waterman. A rare neurological illness resulted in his losing all touch and joint position sensation, effectively paralyzing him from the neck down even though the motor control area of his brain and the descending pathways to send movement information to his musculature were fine!

Varied stimulus drives improved mapping

We can improve proprioception in several ways:

Reduce causes of proprioceptive “inhibition” (i.e., pain, fatigue, and effusion) – Therefore we need to only move in pain-free ranges of motion, and build muscular endurance.
Augment sensory information – We can do this by providing novel sensory stimulus to the affected area such as vibration, kinesiology taping, skin stimulation, pressure, or temperature.
Weight Bearing Exercise Therapy – Loading, appropriately and progressively, compound movements.
Motor Skills Training – Exercises to target accurate movement such as multi-directional movements based on visual stimulus.

The important take away is that building a “library” of prior movement patterns is especially important for the post-medical joint replacement client. We want to get their new joint moving in multiple directions, at multiple speeds, under multiple loads.

The concept of proprioception and how to harness it is not only for joint replacement, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with joint replacement clients with our Joint Replacement Fitness Specialist online course, available through the MedFit Classroom!

Pat Marques is a Z-Health Master Trainer and NSCA-CPT specializing in training the nervous system to improve performance and get out of pain. After retiring from the Active Duty Army, Pat pursued his education and certifications in exercise science, initially working with wounded, ill, and injured soldiers. During this time that Pat discovered the power of using a neurological approach to training to get out of pain and improve fitness and performance. 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 and professional athletes.

References:

Lephart, SM and Fu, FH. (2000). Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics.
Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).
Cole, J. and Waterman, I. (1995). Pride and the Daily Marathon. MIT Press.
Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).

Healthy Aging: Train for becoming older — not old!

Nicholas Prukop/20 November 2023/ All MFN blog/

How do you want to be old? This question was on my mind as I entered my 70’s in August 2016. We never think it will happen to us, but inevitably we all age. Prevention in all its aspects is part of the answer and the remainder is in the choices we make and the habits we develop over a lifetime.

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Become a Movement Detective!

Holly Benson, BS/17 November 2023/ All MFN blog/

Often clients have nagging pains and aches that do not seem to go away. Pain inhibits seniors from doing more. And they WANT to do more. You need to find out what is causing pain. You might need a team of referral partners. You might figure it out yourself. You start by becoming a Movement Detective !

Analyzing your clients’ daily patterns and repetitive activities as well as how they spend their “down” time will give you many CLUES into what might be causing the aches and pains of daily living. A careful detective asks the best probing questions in a conversational manner. There once was a 70’s TV detective named Columbo. He was always asking questions to get to the bottom of the crime. You need to get to the bottom of the crimes of poor movement and poor sedentary postures.

Once you discover a few clues, then you can incorporate alternative patterns and postures that may be less irritating to the joints and safer for the client. Just because they are still climbing stairs and ladders does not mean they are doing it well. Sewing all day in a hunched over position is doing nothing to improve that chronic neck and shoulder pain. Plopping into car seat and grabbing the seat belt with too much force and rotation is not helping with their back pain. See where this is going?

A. WHAT to look for

Ask your client to answer these questions. Give them a day or two to think about it. Write them down on an index card for them to carry around and be prompted to pay attention to their personal patterns.

Things you do the most often…

Where do you sit?
Where do you stand and what do you do there?
Where do you move around? What areas of the home?
What tools do you use? Home. Garden. Hobbies.
What do you pick up and put down? Pets. People. Stuff.
What shoes do you wear? Home. Outdoors. Exercise.
What kind of car do you drive? SUV. Sedan. Low/High.
In what position do you like to sleep? Side. Back. Tummy.

B. HOW to set up the crime scene for examination. Clues are in the moves.

Have your client demonstrate how they maneuver through their day inside and outside the house.
Have them demonstrate a few ADLS like picking up and putting things down.
How they work at a counter and desk.
How do they talk on the phone and work on their devices.
How and what do the like to keep clean?
Have them sit in their favorite chair and get cozy.

C. WHO to refer to if you spot a problem that you are not qualified to address.

Having a strong network of allied health professionals for your client to consider is a level of service most trainers are unable to provide.

Sometimes we notice things that are troublesome like seeing the client wince in pain when doing daily movement. This is when you ask about it and see if they would consider going to the doctor or physical therapist to determine if there is pathology to the pain or other discomforts such GI issues, headaches, etc. (Take detailed notes here. This will help the allied health professional if your client goes to them for diagnosis and treatment).

Important things to remember:

Refer not Defer!
When in doubt… Refer Out!
Stay in Your Scope of Practice!

D. WHEN and WHERE to begin teaching the client new ways to do these everyday things.
BETTER and PAIN FREE.

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

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

Holly H. Benson, BS, is a veteran in the Recreation and Fitness industries with over 35 years of administrative and technical experience. She holds two bachelor’s degrees, Corporate & Community Fitness and Recreation Administration, and numerous fitness certifications. She has developed thriving fitness programs for special populations and has passionately focused her career on the much older adult. She currently owns and operates Moving Strong Medical Exercise, LLC in Lakewood, Colorado and provides in-home and virtual fitness training to older adults and persons with chronic medical and orthopedic conditions.

Caregivers: The Often Overlooked Gold Mine in the Senior Market

Sharon Bourke/6 November 2023/ All MFN blog/

Caregivers… what does that mean? Obviously, it means someone who takes care of others. In this case, seniors 65 and older. Now you might say that 65 is a very young age to need caregiving, but not if you have a chronic condition like Parkinson’s, COPD, Multiple Sclerosis, even Type II Diabetes. What happens when these seniors suddenly can’t navigate through their life like they used to and even simple things like getting to the doctor and grocery shopping become extremely difficult to manage? They find they need a break after doing these simple tasks. At this point, they either have their adult children take on these tasks or hire someone to do them. These people — the Caregivers — are a huge untapped market for medical fitness professionals to provide our valuable services.

Do you have connections to this market? They tend to be overlooked as they are not the end-user of our services. Yet, they hold the key to introducing us to pre-qualified clients. There is a huge trust already established between these caregivers and their relatives or employers. The client values and relies on their recommendations, therefore, it is very advantageous to cultivate a presence in their world.

As with all targeted marketing, where do they hang out and what are their needs? Did you know there are entire associations geared specifically toward caregivers with a subcategory of the adult children, or “parents taking care of parents”? If you didn’t, you need to. It is where the goldmine begins, and the subcategory of caregivers we are going to focus on. I have been a caregiver with both of my parents and with numerous clients I’ve worked with. When you tap into this market, you find yourself becoming a caregiver as well. If you are great at establishing trust, you too become a trusted resource for referrals. This is a compelling reason to develop a network of preferred medical practitioners that hold similar values and approach towards care.

From the biopsychosocial aspect of where these caregivers are, they are stressed out from providing care for both their parents and their own children as well. Their parents will fall under the category of Condition Impacted Dependent© to Extensively Dependent and Frail©, meaning they need assistance or improvement with their IADLs (Instrumental Activities of Daily Living). The caregiver demographic will be working a full-time job and juggling their own children, they have very full plates. They literally will not have the energy or time to research and find a qualified professional who can provide in-home medical exercise services designed to make their lives easier. They will welcome any respite in managing their parents’ condition; improving function is added frosting on the cake.

When it comes to getting noticed, start with your message.

Preventing further decline – how valuable do you think that is to stressed-out caregivers?
Increasing their parents’ ability to function more independently can prevent further decline, allowing them to take on more of their own IADLs and in the process keep their cognition.
The capacity to bounce back after setbacks is instrumental to all the people involved.
The biggest take-home is that it will reduce the caregiver’s anxiety of having to care for their parent.
Have your materials ready to educate people on what medical exercise is and specifically what the benefits are to the caregiver and the client’s lives.

Marketing Plan

Research groups that support caregivers, specifically adult children of seniors (see resources)
Offer presentations on how-to’s. Build fall resilience, improve strength for grocery shopping, resources on balance training, presentation on 10 best exercises seniors can do for function. Make sure you have these ready to go, it will save a lot of stress later.
Have a PDF ready of your services and costs. The caregiver might be tech-savvy, but they will need to have something easily accessible to show to their parents
Hone your empathic listening. When a potential caregiver calls you up, listen. A lot of times this technique will put you above the competition. Seniors love to chat, it is how they make connections and establish trust. I know that if a trainer is constantly interrupting me or seems to have divided attention when talking to me, they are certainly not going to be listening to my rambling parent/client.
Network within your community. Join a local chamber of commerce, look up villages and volunteer your time.

This is just the tip of the iceberg, we haven’t even covered other categories of caregivers, CNAs, housekeepers, assisting hands companies, etc. That and more is covered in-depth in the Geriatric Fitness and Lifestyle Specialist online course, available through MedFit Classroom.

Sharon Bourke has been involved in the health and fitness industry for more than 28+ years presenting, teaching and coaching in fitness clubs and private studios throughout the Washington metropolitan area. She holds certifications in Medical Exercise Specialist, Personal Training Pre-Postnatal fitness, Fitness for Arthritis, and Multiple Sclerosis. Sharon founded the Life Energy Foundation,to utilize her extensive experience and network to create exercise and behavior modification programs and resources to help people avoid becoming immobilized from their chronic conditions.