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Active Living for Seniors and Nordic Walking

Healthcare professionals working with older adults are routinely prescribing walking, as part of rehabilitation and overall health and wellness programs. There are over 100 research studies identifying health benefits of adding specialized poles to any walking routine. Due to the improved balance, posture, reduce impact off painful joints and improved mood and confidence health, this accessible and affordable activity, urban poling, and especially the use of Urban Poling‘s unique ACTIVATOR™ poles, has become a popular choice for persons requiring help with stability and balance, as well as for older or perhaps less active adults. The ACTIVATOR™ poles are the only ones like it available on the market which have been co-designed by an occupational therapist for maximum safety, comfort and effectiveness, as well as reducing the factors related to falls.Dr. Agnes Coutinho

Research Benefits

Evidence based research relating to older adults clearly identify poling, with the proper training, as a healthy activity suited for improving quality of life. Proven benefits include:

  • Increase balance & stability
  • Increase in mobility
  • Improve posture
  • Reduce impact off lower extremity joints
  • Improve gait speed
  • Improve strength (poling can engage up to 90% of your muscles)
  • Increase confidence

Short-term and long-term effects of Nordic Walking training on balance, functional mobility, muscle strength and aerobic endurance among Hungarian community-living older people: a feasibility study. Balance, functional mobility and aerobic endurance significantly improved in the Nordic walking group.  This study showed that Nordic Walking is a simple, well–tolerated and effective physical activity for older people in Hungary.1

Effect Of Walking Poles On Dynamic Gait Stability on the Elderly. Texas Women’s University study, which concluded that walking poles provided increased gait stability at both preferred and fast speed.2

Effects of Nordic walking compared to conventional walking and band-based resistance exercise on fitness in older adults. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults.3

The effects of pole walking on health in adults: A systematic Review. The effects of pole walking (PW) on cardiorespiratory fitness were most extensively studied. The most frequently examined psychosocial measure was quality of life. All studies reported at least one beneficial effect of PW compared with the control group. The results of this systematic review indicate that PW  programs have some beneficial effects on both physical and psychosocial health in adults with and without clinical conditions.4


Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

References

(1) Viraq et al., 2014

(2) Kwon, Silver, Ryu, Yoon, Newton & Shim, 2006 (unpublished)

(3) Takeshima et al., 2013

(4) Fritschi et al., 2012.

The information in this article is not intended to replace existing rehabilitation programs. The testimonials are those of independent therapists and are not a guarantee of results. The consumer should not rely solely on this publication but should also consult their physician or therapist. Urban Poling Inc. and its employees and representatives do not accept any liability for the information contained in this publication or any damages.

urban poling image 2

Getting Active at Every Age and Stage: Benefits of Nordic Walking

With a shocking 70% of children leaving organized sports by the age of 13 and obesity rates on the rise, we know that we need to be introducing our children to activities that they can do across a lifespan, whether they are 5 or 95 years of age!

Join Urban Poling for a free webinar that will walk through some of the most important and challenging stages of life. Learn why Nordic Walking can be beneficial for each age group to ensure longevity and exercise adherence across a lifetime!

Webinar Overview:

  • Shocking Stats & a look into the Sport-Lifecycle Trends
  • What is Nordic Walking?
  • Research supporting Nordic Walking for All Ages and Stages
    • Childhood (3-11 Years)
    • Adolescence (12-18 Years)
    • Adulthood (Pre/Post Natal, Weight Management & Disease Prevention, Pre/Post Hip/Knee)
    • Seniors & Mitigating Falls

This webinar will be presented by Gabriella De Nino, Registered Kinesiologist, CSEP-CPT & NCCP Certified Soccer Coach.

June 26, 12:00-12:45 EST
Webinar Registration ►


Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

ed-concept-signs

Top Ten Things a Personal Trainer Should Know About Working with Eating Disorders

Having worked as a certified personal trainer and strength and conditioning specialist early in my career, and now as a certified specialist in sport dietetics who specializes in treating clients with eating disorders who are often over-exercising, I feel it is critical for trainers to have some training about how to deal with their clients with these issues because you will be seeing these clients.  Given eating disorders can present as over-exercise and under-fueling, a personal trainer is in a position to be the first identifier of these issues and can be a key player on an eating disorders treatment team.  I often utilize personal trainers to help these clients develop exercise limits, boundaries, or assist with reiterating the “fueling and hydrating” messages the dietitian may be providing the client.  I have helped in developing a new tool available to those who work in the fitness and coaching field called Running on Empty,an online eating disorders awareness and prevention program for coaches and exercise professionals, through a non-profit eating disorders outreach and prevention organization, Eating Disorders Information Network. I have also invited one of our recovery speakers to share her tips in this article. She is both an ACE certified personal trainer and a recovery speaker for EDIN. She, Kristy Wegert, shares her thoughts as a professional who currently treats clients who are on their recovery path.

A key reference on this topic is the new International Olympic Committee’s position statement on RED-S, Relative Energy Deficiency in Sport. Many of us will work with people with sub-diagnostic cases of eating disorders who may present with many of the negative energy balance physical issues discussed in this consensus statement. Working with an exercising population means helping this population stay in energy balance or eating appropriately to fuel for the level of activity in which they are engaging without harming the body because of lack of energy for basic body systems to function.  All body systems are affected when limiting the body to too little energy to function fully, including the systems visually represented below. It is the job of the eating disorders treatment team, including the exercise professionals, to be aware of this set of possible consequences and treat/refer to treatment accordingly.

A sport dietitian’s top 5 tips for working with the exercising client with an eating disorder:

1. Keep your client in energy balance by reminding them about appropriate fueling, recovery, and hydration. Complex carbs rule before exercise. Encourage your clients to fuel on these before they train vs. training on empty. Common “on the go” examples of this can be as simple as a slice of toast or a higher carbohydrate energy bar. Encourage your client to drink hydrating fluids and even an electrolyte beverage during their training session with you. Also, most active clients need to drink 4 oz. of fluids every 15 minutes. Encourage your client to take these breaks.  Encourage your clients to have a protein recovery choice within 15-45 minutes after they finish their workout.  This could be a glass of chocolate milk or a smoothie with protein.

2. Encourage and educate your clients with a non-diet mentality. This means “All Foods Fit” and that there are “No Bad Foods.” All foods have some energy value and can fit into our performance plan. In fact, when we exercise, we have need to eat more energy. If we adapt the mentality that all foods fit, then we will have less chance of sabotaging ourselves with exercise or restriction.  Check out the references Moving Away from Diets by King, Katrina, and Hayes and Intuitive Eating by Tribole and Resch for more on this way of working with clients.

3. Be aware of different types of eating disorders or disordered eating that may present to you. An individual with Binge Eating Disorder may be a common client seeking a trainer’s help for weight loss. Be sensitive to this type of client’s energy needs, orthopedic limitations, and potential resistance to traditional exercise and Health at Any Size®.

4. If you must take any anthropometrics, make sure you discuss amongst the team who is the best person to take those measurements.Often the dietitian is the best fit on the team to do this, to discuss these results, and to comment on realistic body weight ranges and appropriate food intake to fuel activity with a sport nutrition approach in a way that is focused away from calories.

5. Set reasonable boundaries on movement to include at least 2 rest days per week; sessions not exceeding 1 hour in duration; alternate cardio and strengthening to not over-exercise; consider cross training or varying types of activities to lower risk of over-training (such as outside, non-gym activities like road biking, climbing, kayaking, etc.); encourage gentle and restorative activities during the week as well, like yoga, barre, and Pilates; support varying types of classes (dance, kickboxing, karate, etc.) that have appropriate warm-ups and cool downs and are led by a certified instructor; and lastly, exercise with others who have reasonable exercise boundaries to give one appropriate containment and normal exercise boundaries.

A personal trainer’s top 5 tips in working with an exercising client with an eating disorder:

1. Exercise will bring up past trauma in the body. It can get emotional. Be prepared for some distress and perhaps, some crying. Hence, it is important to consult with the treatment team so you are prepared and can offer the appropriate type of support.

2. Don’t assume that a small person is weak; that a larger person cannot move or has never worked out; that someone in a larger or smaller body doesn’t purge. Bottom line…never assume. Check out the Health at Any Size® movement to learn more about this mindset.

3. Offer privacy when possible. Many people in early recovery feel awkward in their own bodies. Try to help them feel as comfortable as they can during a workout. This may mean taking them out of the traditional exercise environment and away from mirrors, or going outside.

4. Get written permission to speak with therapists, doctors, dietitians, sponsors, partners, and parents. People who are in recovery from anorexia, bulimia, binge eating disorder, and OSFED need well-defined, appropriate boundaries and you may need help from the treatment team in determining this. People who are in recovery need a team to help them.

5. Fitness is about function, healthy lifestyle, and feeling good. No matter what the client asks for, focus away from aesthetics. Have fun! Exercise should be a good time for your clients. Help them have a positive experience!


This article was co-written by Page Love, Vice President of the Board for Eating Disorders Information Network (EDIN) and Kristy Wegert, recovery speaker for EDIN. Originally printed on ED Resource Catalog. Reprinted with permission.

Page Love is a registered dietitian, certified specialist in sport dietetics and nutrition therapist, and runs a thriving private practice specializing in eating disorders nutrition therapy, sports nutrition, and weight management nutrition counseling in Atlanta, Ga.  She served as a clinical dietitian for Atlanta Center for Eating Disorders for 20 years and has run ANAD groups in Atlanta for 25 years, and has served as a consultant to The Renfrew Center and Veritas Collaborative.  She has developed materials for the NEDA, Renfrew Center, and EDIN and has been published in the Renfrew Perspectives, International Journal of Sport Nutrition, and International Journal of Sport Science for Tennis Medicine.  She currently serves as the Vice-President of the board for EDIN, Eating Disorders Information Network.  She also serves as a consultant for the International Women’s Professional Tennis Tour (WTA) and the Men’s Tour, Association for Tennis Professionals (ATP), the Atlanta Ballet, The Atlanta Falcons Cheerleaders, and formerly with the Atlanta Braves.  She has recently co-authored Running on Empty, an online education program for the exercise professional working with eating disorders through Eating Disorders Information Network, a non-profit for the prevention and outreach for eating disorders in Atlanta, Ga.

At 40 years old, Kristy Wegert made some decisions that caused a mid-life career change. She decided after some much needed deep thought, that she was meant for the fitness industry. She holds an ACE Personal Trainer Certification. While she was studying for the ACE exam, she decided to get herself into the industry. There was just no point in waiting (and  she was too excited!) so she became a certified Cycle Instructor. (A little back story: Kristy lost 100 pounds after being heavy most of her life and has kept off that weight since 2008). Kristy loves to exercise and loves being an inspiration to others. Her current passion is to help others in a safe, fun way and watch them transform. Her company, My Workout Buddy, embodies everything she feels is important in the fitness industry…rigorous yet fun physical activity, a well balanced lifestyle, and the safety of a properly educated personal trainer at your side.

References

The IOC consensus statement: beyond the Female Athlete Triad

bjsm.bmj.com › Archive › Volume 48, Issue 7

Running on Empty; A online eating disorders awareness and prevention program for coaches and exercise professionals, Love and Guntermyedin.org http://www.myedin.org/athletes.html

Moving Away from Diets Hayes, Katrina, and King

Health at Any Size Bacon

Intuitive Eating Tribole and Resch

Sports, Cardiovascular, and Wellness Nutrition dietetics practice group of the Academy of Nutrition and Dietetics Practice Manual:  https://www.scandpg.org/e-learning-and-events/a-practice-manual-for-professionals/

American Council on Exercise Podcast on Why We Eat: https://www.acefitness.org/health/resources.aspx

trainer client squat

Squats: Five Things to Consider

The fitness community has some how deemed the squat the king of all exercises. “They” say it’s great for your glutes (Butt), Quads, hamstrings, total body challenge, it’s “functional” weight loss, etc. The list goes on. I’m not saying there isn’t some truth to all those things in the right context. They just aren’t absolute truths like some magazines or trainers may claim. Here’s a list of 5 things to consider when squatting or even deciding if a squat is an appropriate exercise for you.

1. What’s Your Goal? 

What part of your body are you trying or wanting to work?  If you have a specific target area you would like to address, your squat should match that goal. Not every squat is the same or works the same things, especially with each person having different limb lengths (Tibia, femur, & trunk). Picture this, if you squat down and your line of force is further away from your knee joint (Big Moment Arm), you’re mostly working your anterior knee muscles. Conversely, if you squat down and your line of force is further away from your hip joint (Big Moment Arm), you’re mostly working posterior hip/low back muscles. Neither are good or bad, right or wrong. It just depends on your goal.

2. Lever Lengths (Limb Lengths)

Your proportions play a role in how you’re going to squat. If your tibia (shin bone) is a lot shorter than your femur (leg bone), and your trunk (torso) is very long, your squat will look vastly different from a person who has equal length from there tibia, to there femur, and trunk. The goal of the body when it’s standing is not to fall. It’s about keeping your center of mass over your base of support. In order for that to happen, you’re going to have to modify the way you fold up in a squat to not fall over. While you do that, the forces at other joints are going to change, for example hips, knee, spine, etc…  again, what’s your goal?

3. Resistance Profile/ Strength Profile

A squat has a very distinct profile. Relatively balanced at the top of the motion and very hard at the bottom. There are several ways to account for this. Many people think they have to do everything through a “full range of motion”, but you don’t. In a situation like this, you can simply use different loads (weights) at different points in the range of motion to match the profile. For example, at the top of the motion use a heavier weight where your strongest and go down a little bit. Then drop the weight and go down lower where you are weakest with the lighter load. This way you can challenge the full range of motion you have available without sacrificing the load. Your joints will thank you.

4. Holding Dumbbells/KettleBells vs. Bar on Back/Front 

This  is a topic that I don’t think is discussed a lot. If you’re holding a dumbbell/kettlebell while doing a squat, what do you think is going to give out first? Your ability to grip and hold the dumbbell/kettlebell or the tolerance of your whole lower body and spine? Again, it goes back to what’s your goal? If your goal is hypertrophy and/or strength in those muscles then using an appropriate load to challenge them is necessary. I’m not saying you can’t hold dumbbells or kettlenbells, I’m saying this is something to consider. If the bar is resting on your upper back or front, you don’t have to worry about holding it. You just have to balance it.

5. Available Active Range of Motion 

Before you decide to squat, I would suggest checking all the motions of the squat and making sure you have those ranges available to you (Dorsiflexion, Hip Flexion, Knee Flexion, Spinal Flexion, Spinal Extension, Hip Extension, Knee extension, PlantarFlexion). If you see a difference relative to the other side, assuming there is no structural abnormalities, you may want to consider doing an isometric. You can use that as a warm-up. For the isometric, contract into the position of limitation for about five seconds at approximately 50% of effort. Repeat 3-5 times.

I hope these tips will help you, or at least make you think about some things that otherwise you may not have considered.


Dominick Nusdeu has been certified as a Personal Trainer for over 20 years. He holds the distinction of Muscle System Specialist, Resistance Training Specialist, ACE Orthopedic Exercise Specialist, as well formally being one of only 14 Instructors of Muscle Activation Techniques worldwide and was one of only 85 Master Level Muscle Activation Techniques Specialists in The World. Dominick has completed well over a 2000 hours of advanced coursework in biomechanics, exercise mechanics, neuroscience, anatomy, physiology, and muscle function. Dominick is a trainer to the trainers, teaching his highly successful course, “Decision Making 101: From the Table to the Floor.” He currently owns and operates MotionMechanix (MMX), Muscular System Optimization LLC, and MotionMechanix Academy, which was formed out of a need to give fitness enthusiasts and current exercise professionals quality, high level education backed my science, not what’s currently trendy or “cool”.

Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

Personal trainers have the opportunity to do more than just help people they train become more active. We need to be prepared to also help our clients implement lifestyle behavior changes related to stress, family history of coronary heart disease, obesity, smoking, high blood pressure and high cholesterol.

A look at what is called metabolic syndrome will help you understand why, even though increasing physical activity levels is the overall best thing you can do for any client, there are additional ways to guide them to a healthier lifestyle. Sometimes you may be able to help them make the changes yourself; and, sometimes you will need to refer them to another health professional like a doctor or dietitian for guidance. Either way, knowing how to help them or when to direct them to someone who is more knowledgeable than you is important. So, first let’s become familiar with the syndrome and the clinical criteria that the doctor uses to diagnose it. Your goal is then to help your clients understand and make the necessary changes so that they don’t progress to cardiovascular disease and the almost certain heart attack heart that will be the end result.

Cardiovascular disease is still the number one cause of morbidity and mortality in the United States and much of this burden of disease can be linked to poor nutrition and a dramatic increase in sedentary lifestyles, leading to overweight and obesity. This increase in weight leads to an increase in the incidence of type 2 diabetes, and blood pressure and cholesterol problems, which are all well-established cardiovascular disease risk factors. The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III has updated the recommendations for the evaluation and management of adults dealing with high cholesterol, renewing its emphasis on the importance of lifestyle modifications for improving cardiovascular risk. The NCEP has coined the term “therapeutic lifestyle changes” (TLC) to reinforce both dietary intake and physical activity as crucial components of weight control and cardiovascular risk management.

As well as focusing attention on the LDL cholesterol (also called bad cholesterol) levels, the NCEP also identified metabolic syndrome as a secondary target of therapy. Metabolic syndrome (also called insulin resistance syndrome and syndrome X) is characterized by decreased tissue sensitivity to the action of insulin (pre-diabetes), resulting in a compensatory increase in insulin secretion. This metabolic disorder predisposes individuals to a cluster of abnormalities that can lead to such problems as type 2 diabetes, coronary heart disease and stroke. The prevalence of the syndrome has increased 61% in the last decade. It is crucial for medical professionals to identify patients at risk and follow these patients closely and counsel them about making lifestyle changes to lower the risk of type 2 diabetes and cardiovascular disease.

GUIDELINE: According to the NCEP, the criteria for metabolic syndrome includes at least 3 of the following 5 clinical factors

Risk factor Defining level
Abdominal obesity
Men
Women
Waist circumference
>40 in (>102 cm)
>35 in (>88 cm)
Fasting triglyceride level >150 mg/dL
HDL cholesterol level
Men
Women
 
<40 mg/dL
<50 mg/dL
BP >130/>85 mm Hg
or taking antihypertensive medication
Fasting glucose level >100 mg/dL or diabetes

Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health; 2001. NIH publication 01-3670.

Millions of Americans at risk for metabolic syndrome can sharply lower their chances of getting this disease by adopting a healthy lifestyle (stop smoking, low-fat diet, weight loss/maintenance and increased physical activity). Without diet and exercise modifications, most patients will eventually fail and progress to type 2 diabetes within a decade and experience a heart attack about 10 years later. Experts recommend a diet reduced in saturated fats (<7%), low in cholesterol (<200 mg/day), high in fiber (20-30gm/day) and reduced in simple sugars. Weight loss of only 5-7% (less than 15 pounds) can make a big difference in health markers like cholesterol and blood pressure. A program that includes daily exercise reaching 85% of heart rate for age is reported to be of benefit too. However, any exercise is better than none, and a target of 30 minutes every other day is a reasonable level for most people.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. The medical community is good at diagnosing this syndrome, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases, you have more knowledge in this area than the physician who has been trained in tertiary, not preventative, (i.e. most MD’s know very little about diet and exercise since this is not a focus in medical school) medicine.  Often times all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. A personal visit to your primary care doctor and others in your area is even better. But, be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.


Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

References

  1. Centers for Disease Control and Prevention. Early release of selected estimates based on data from the January-June 2003 National Health Interview Survey. URL: cdc.gov/nchs/about/major/nhis/released200312.htm.
  2. Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2016 https://www.cdc.gov/nchs/nhis/SHS/tables.htm 16 Apr. 2018.
  3. Centers for Disease Control and Prevention. Prevalence of health care providers asking older adults about their physical activity levels—United States, 1998. Morbidity and Mortality Weekly Report. 51(19):412-4, 2002.
  4. Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.
plank 2 elbows 2

The Power of Plank

Many people will go to the gym in hopes of “looking” better. Although we all want to be our best selves, working out for a “look” vs. overall strength and well-being can lead to imbalanced muscles, as well as other injuries. This can be especially true for those looking for a “flat stomach” or “washboard abs”. However, the true importance of abdominals is to strengthen and contain the organs in our central region, as well as support the spine, especially the lumbar region.

In Pilates, as well as in Yoga, our main focus is the Transverse Abdominus. A way to think of this: the saran wrap, or casing of a vegan sausage, that wraps all the way around, and holds everything together.

For this reason, many exercises are done in neutral spine, vs. merely moving one’s head up and down. In fact, many people injure their necks because they “pull on their heads”, and don’t even come up high enough to achieve enough forward flexion to have the desired result of abdominal contraction.

I have also encountered students who have had neck and spinal injuries that prevent them from curling up. Does that mean that abdominal strengthening is off the table? The answer is quite the opposite.

Plank is such a wonderful and functional exercise. Learning how to maintain one’s body in neutral spine plays into everything that a person does in daily life activities: from simple sitting and walking, to running and spinning. And you would NEVER want to lift a box in a rounded spine, so it is important to learn to TRAIN the body for real life.

When working with beginners, I will often use a raised box or platform to take the edge off, as having the chest inclined upward will help a new person ease into the idea of eventually having a horizontal line. However, remember that this is not a FLAT line by any means! 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”.

To get started: Find and all fours position where you can feel “the suspender” action: when the base of your ribs and your pelvic bone will feel like they are aligned in the front. All your curves in your spine will be present. Your arms will be directly under the line of your shoulders.

At this point I will cue, “Elbow, elbow, leg, leg”. Place one elbow on the mat or on the bench (if modifying), then the other, then walk one leg back straight, followed by the second. The elbows will still be right under the line of the shoulders. The Head will remain elongated (never hung, and DEFINITELY not hanging into one’s hands, hoping for it to be over). The chest is expanded, not rounded, as if you have a great necklace or t-shirt you want everyone to see. The feet are parallel, not spread apart. And although a strong plank will lead to a strong downdog, the BUTT is NOT above the chest. The opposite can be true, especially for a beginner on a box, or when doing the plank on straight arms, but sticking the butt up in the air takes away from the abdominals, and will eventually hurt one’s back and shoulders. Same is true for pelvic tucking/back rounding. The trick is to find and enjoy the neutral spine alignment.

As you progress, some fun variations on plank are:

  1. Gently lifting one foot off the floor a few inches, and placing back down. Doing 8-16 reps alternating legs.
  2. On straight arms (if on the mat), or on bent elbows (on a platform that is 2-4 risers high), gently bend one knee to 90 degrees, hold for a second, place back to parallel on the floor, and switch sides. Doing 8-16 reps alternating legs. This is NOT to be done as a run, as many people will lift their butt/hang their head/round their back. This is meant to be done in a slow and controlled manner for the most pain, I mean FUN!
  3. More advanced, you will see me do a plant on straight arms with my feet on a foam roller. Without changing out of neutral spine, I will gently roll the roller with my feet toward my midline, (about a 90 degree angle), and then extend back to the original plank, without letting my center sag. I do not do this on a ball as that would lift my butt. Again, it is better to have the chest higher than the hips, rather than the reverse.

Of course, plank does involve a bit of strength. Therefore, new students could simply go to an all fours and practice finding neutral spine. Or, to modify further, sit at the edge of a hard backed chair, and practice aligning one’s ribs and hips, and then containing the abdominals. Hold for a count of 5, and release.

In closing, abdominal strength is so much more than flat stomachs and washboard abs. Using the power of the plank, one can achieve true abdominal strength that will help with all sports and daily life activities.


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.  Her newest book is titled, “Healthy Things You Can Do In Front of the TV”.  Visit her website, bodyfriendlyoga.com

Active senior friends talking and working out in fitness club

Fitness After A Stroke

Strokes are devastating, not only physically, but mentally. They change lives, many of which are very young and active. When stroke patients are discharged from physical therapy, many are just beginning to recover physically, especially from a fitness and strength perspective. This is where the experienced Athletic Trainer, Strength Coach or Personal Trainer can make a huge difference in their quality of life.

Both physical and mental aspects must be addressed when entering a fitness program. From the physical perspective, balance, strength, flexibility, coordination and cardiovascular fitness are just some parts that may be incorporated into the fitness program. The mental aspect may be even tougher in addressing fear, complacency and motivation, to name a few.

The stroke patient can be addressed just like any other fitness client and should be. Ask them the same questions.

  • What are your goals?
  • What do you need to be able to do to obtain your goals?
  • What are your current limitations?

Active retired people, old man and woman talking and exercising in fitness gym

With these answers in mind, a professional now needs to assess where the client currently is physically by looking for strengths, weaknesses, asymmetries, flexibility issues, etc. At this point, a proper plan can be designed. Since strokes typically affect one side of the body, it is important to train each side independently. For example, step ups or isometric lunges for lower body and single arm presses or rows with a band can work each side of the upper body. The resistance or range of motion may need to be modified depending on how the client has been affected. Yes, resistance or strength training needs to be a part of the program. In an article in NeuroRehabilitation, investigators determined that targeted strength training in patients with muscle weakness due to strokes significantly increased muscle power without any negative effects on spasticity.

Considering many stroke clients are de-conditioned when they begin a fitness program, it is important to incorporate strength exercises into the sessions to improve active daily living activities such as walking through a crowd, wearing high heels or getting through a work day with less physical effort. Others may benefit by being able to start running again or getting involved with other types of sporting activities they have been missing.

Core stability and flexibility are two other aspects that need to be addressed in a program as well. The core muscles which can include the abdominal, low back and hip musculature provides a base of support for the arms and legs to work. There are a million core exercises that can utilized, but start with simple and progress to complex work. Isometric and anti-rotational core exercises like planks, planks with leg lifts or resistance band chopping exercises are a great place to start. Flexibility and mobility are also important aspects to consider and should be addressed one side at a time. Since contractions typically occur in strokes, they can limit movement and function. It is also important to send the client home with some stretching exercises to perform on their own.

The mental side of the program may be a little more trying than the physical side. Some clients may be fearful to perform certain exercises because they assume they just can’t do those things anymore, some frustrated that they can’t do what was once easy and some that have just lost motivation. It is the professional’s job to find ways to overcome these issues, whether modifying exercises or showing how they relate to their goals. Progress is the biggest component here. Showing improvement and where a client has come from and their accomplishments is the key to success. Simply reminding a client how hard an exercise used to be or what they do now without thinking that was difficult before goes a long way.

Clients recovering from a stroke are no different than any other client, they may just have different goals and different limitations that affect the way a program is put together. Developing a relationship with a client and devising programs that are specific to their needs is the key to helping former stroke patients obtain the goals they are looking for.


Chris Phillips is the owner of Compete Sports Performance and Rehab in Orange County, CA. Chris is a certified Athletic Trainer, Strength and Conditioning Specialist and Corrective Exercise Specialist.

Senior woman with help of physiotherapist

The Space Between Fitness and Medicine: Where “the Good You Do For Others” Brings the Reward you Deserve | Part 2

In our first part of this three-part discussion, in addressing the topic of financial reward, I asked you to ponder the value of restoration.  What, I prompted you to consider, is the value of helping someone who has moved along the dis-ease continuum, gradually leaving health in the proverbial rear-view-mirror back toward divine health?

It isn’t an easy question to answer.  We can tackle it by considering all of the dollars those who incur inflammatory issues, chronic challenges, and cellular degradation will have to invest in maintaining function and comfort.  We might also attempt to place a monetary value upon lost quality of life.  We might even consider the simple question, “what would someone pay to rediscover health” considering their fear and apprehension of the alternative, and from that extrapolate the value.

If you are willing to believe that personal trainers with advanced education and the development of a complementary skill set can have immeasurable impact upon “the unwell population,” one perspective becomes clear.

The trainer versed in restoring health commands a far greater value than the personal training mainstream.

That’s important.

STEPPING UP A LEVEL

As in any field, a specialist with enhanced value will serve his or her marketplace best by finding a direct line of contact with those in need of their specialty.

In the sentence above, “need” is the key word.

While it’s oft been said that personal trainers are a luxury or a privilege, with an appropriate adjustment in perspective, those who have slipped into the largest segment of our adult population, the unwell market, might consider any therapeutic resource, if wellness is a goal, a “need.”

Now that I’ve mentioned it a few times, I’ll provide a general description of the market I’m referring to as “unwell.” Then I’ll help you see the opportunity to step up, to meet this population in an arena where they “need” you.  I’, to command a value in line with a well-justified fee, and . . . here’s the biggie . . . to provide them the service they will truly benefit from.

WHO ARE THE UNWELL?

Let’s be really clear here.  I’m not suggesting the opportunity lies in training “sick people.”  I’m suggesting the largest, most opportune market share is made up of many American adults between the ages of 35 and 65.  They aren’t “sick” in a clinical sense.  They work.  They drive their kids to school.   They shop in the malls and grocery stores.  They eat in the neighborhood restaurants.  They pump gas in the same gas stations you do and they frequent Starbuck’s, Chipotle, and the local pizza place.

They don’t have need for hospitalization or chronic care . . . but they’ve slipped, moved along what I’m calling the dis-ease continuum.  They’ve begun a process of maladaptation, a movement away from healthful homeostasis, and while many haven’t yet been diagnosed (many have), their bodies have become imbalanced.  Whether it’s a hormonal imbalance, thyroid irregularity, blood sugar elevation, hypertensive condition, hypercholesterolemia, or chronic inflammation of one or several bodily systems, they have moved into a place where innate homeostasis is no longer their “norm.”

Not sick, at least not clinically, but not well.  What’s alarming is, I’m describing near 65% of the adult population over the age of 45.  Yes, the market is vast.

If the unwell were being cured of their ailments or remedied by the conventions of medicine, I wouldn’t see the “need” as being this opportune.  All I need to share is a single statement to help you see why there’s a desperate need for a new type of health practitioner, one who masters the exercise and eating intervention.  Here’s that statement.

In a society where chronic disease is most treated with pharmaceutical intervention, there isn’t a single medication that will cure any chronic disease.

Read that again.  While there exists a wild array of meds to manage conditions and change biomarkers, there isn’t one that will cure the plight of the unwell.

Conversely, there is an extensive body of evidence to demonstrate the power we have over shifts in blood sugar, blood pressure, and hormonal disruption when we strategically employ a variety of exercise modalities and guidance in the realm of supportive nutrition.

If the demand is great, the “need” remains unfulfilled, and the greatest potential lies in the skill set we, as fitness professionals, have access to . . . our value escalates above virtually any conventional yet impotent “cures.”

THE LEVEL 2 TRAINER AS A CORRECTIVE HEALTH SPECIALIST

If we consider a “Level 1” trainer someone who is qualified, credentialed, and able to provide safe and effective exercise prescription to a healthy population, let’s consider a “Level 2” someone who can effectively target this Unwell niche and deliver improvements in biomarkers, condition, and quality of life.

The Level 2 trainer can identify his or her “ideal client avatar.”  Moving forward I’ll refer to the Ideal Client Avatar as an “ICA.”

In establishing a presence and a track record with the Unwell, the enhanced personal trainer (enhanced with a higher level of education than the standard and an ability to implement positive change in the unwell) can justifiably command fees in line with other health practitioners, medical practitioners, and specialists.

In setting a fee structure, there should be a professional standard, a relationship-based fee that is consistent, one that exceeds “an industry standard.”  Remember, if you deliver above the standard, you deserve reward above the usual.

HOW DO YOU STEP UP AND CREATE AN AUDIENCE?

Marketing, for the Level 2 trainer targeting this niche is not as haphazard as “pass out cards, talk it up in the gym, and talk to everyone about what you do.”

In order to establish your position, you’ll want to have four.  Four strong successes.  Four living examples of the value you deliver, and finding those four requires a bit of front-end work.  Once you have your four you have a sound foundation upon which to build.  The question, therefore, that merits consideration is . . . how do you “break in.”  Where do your “four” come from.

I’ll make it step by step.

Note that everything that follows is based upon the assumption that you have received extraordinary training, that you’ve established a level of education complementary to your base credential, and that you’re positioned to initiate and maintain a practice with a revised focus on empowering clients to reverse the imbalances inherent in chronic disease.  This is a prerequisite of paramount importance and although I won’t invest any more time in addressing it here, don’t allow my failure to repeat and reiterate this point as an indication its any less than vital.

STEP ONE: Define your Ideal Client Avatar.  If you have a personal connection to a given condition or population (i.e. a relative with diabetes, a personal history with thyroid issues, etc.) and you have a passion for helping others who you feel are kindred spirits, that’s where you should best direct your marketing.  You can’t “market well” until you define your ICA.  This is a “must” in turning your ambition into financial security (and it’s the step most who seek to elevate their careers miss or ignore).  Your ICA may not be based on your personal experience, but rather on where you see the greatest opportunity or where you have the greatest inroads.  Devote time to getting clear on your ICA.  It’s the true key to successfully “Stepping up to Level 2.”

STEP TWO: Determine your fee structure, your promise, and your offer.  You don’t want to approach each prospective client with an open negotiation, nor do you want to exhibit uncertainty.  As any business owner, design your foundation.  What, precisely, are you promising each client?  How are you compensated for that?  What, precisely, is the person considering retaining you, supposed to do now, as a point of commitment.

STEP THREE: Choose a location, an affiliation, a network, and a social media platform where you can “meet” your ICA and spread the word.  This is far simpler than it sounds.  In outlining your ICA, simply as the question, “where do I find him (her)?”  This is marketing at its core.  Don’t think “medical.”  Think real life.  Where can you do a talk, a workshop, a presentation, knowing your ICA sits in the audience.  I realize this is the intimidating step . . . but it’s also the one that brings  you to human connection, and ultimately to commitment and money exchange.  Perhaps in the future I’ll share an entire article devoted to “finding your ICA in the real world.”   For now, accept that you have the answer to the question, you have the ability, and all it takes is a bit of courage and determination.

STEP FOUR: Create your Four.  Do your thing.  Work your magic.  Use your skill set.   Bring about change.  Documentable change.  Once you have your first four successes, you begin to build what I call an Arsenal of Evidence, and from that point on, the marketing challenge is replaced by magnetic appeal.

STEP FIVE: Build your business confidently, massively, professionally, and without limit.

This 3-part piece is intended, not to be a complete primer for business building, but to give you a sense of both the opportunity and your ability.

In creating a distinction between the progressive trainer willing to study, learn, and elevate, I’ve used the term “Level 2,” not to suggest any elite status, but to demonstrate a clear escalation in earning potential.  Before I conclude this second part of the piece, I’ll outline a few elements of what I’m calling The Level 2 Trainer.

FIVE DISTINCTIVE ELEMENTS OF THE LEVEL 2 TRAINER

  1. You are a specialist among a given population
  2. You command fees above the norm
  3. You have a consistent promise and offer
  4. You have a track record and consistently grow a marketing / referral base
  5. You understand and recognize the value in the potential you have as a guide to empower others to move away from chronic disease and back toward divine health

Is there a level above the Level 2 trainer?  Yes.  And the sky’s the limit.  Literally.  More to come in Part 3!

This is 3 part series. Read part 1 here, and part 3 here

 


Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment.  He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease.  His dual passion combines helping those who desire betterment and helping health professionals discover their potential.  Email him at phil@philkaplan.com

Are You BUILT TO LAST?

Lately I can’t go to the gym without someone coming up to me looking for advice because in their efforts to remain fit and active they have hit a roadblock. Something hurts- a sore knee, achy shoulder or bad back that goes out more than they do. Ditto for my practice where I have seen a significant increase in exercise related ailments. I should give out orthopedic frequent flyer miles.

I’m an orthopedic surgeon specializing in sports medicine who has also had a life long interest and commitment to exercise. What I have learned over the years is that the far majority of exercise related ailments are preventable with some simple measures. That is why I wrote FrameWork- Your 7 Step Program for Healthy Muscles, Bones and Joints, as well as the FrameWork “Active for Life” series (Rodale Press).

Exercise is essential for maintaining optimal health, and being sedentary is just not an option, yet many individuals run into difficulties in their quest to be fit. Just about anyone can get into trouble, from young, fit and seemingly indestructible, to older and somewhat “beat-up”. We all bring “weak links” to the gym or out on the field. I‘ve learned this from working not only with my sports medicine patients but also athletes at the highest levels, including professional and Olympic. I have also learned the harder way, personally. A high school football injury that came back to haunt me, and a more recent low back issue.

The key is to find those “weak links” before they find you!

The human body does, and will, breakdown, especially when often pushed to the break point. Some of us are more vulnerable than others. And many of our “weak links” are of our own making. Workouts, activities or sports that leave imbalances in your frame, overuse, inadequate recovery, and so much more, mostly preventable factors. Musculoskeletal ailments have surpassed the common cold as the #1 reason people seek medical care in this country. It is no wonder for many, that workouts can be a challenge. Also, as Arnold Schwarzenegger so wisely said in the FrameWork forward, “I have really come to appreciate how the body is a dynamic, ever-changing structure that is different at different times. At 30 you need a different approach to fitness than when you were a teenager”. His workouts have evolved with him and even the Terminator himself has had to visit the repair shop. So, how can you be more durable, with less risk of breakdown? FrameWork offers 7 easy steps that can benefit everyone, young and old.

In FrameWork, I outline a 7-Step comprehensive plan for optimal health and durability. In Step 1, a unique self- test (take the interactive on-line version of the self-test) asks the question “are you built to last?” and finds your individual “weak-links” (we all have them). These “weak-links” or points of vulnerability may be old injuries or ailments, suboptimal nutrition, genetics, lifestyle, workout design, mindset and more. They are like hidden land minds, just waiting to be found, waiting to rear their ugly heads and put you on the sidelines, rather than in the game.

Step 2 thru 7 allow you to customize a program for your unique frame (based on the self-test and your own history) focusing on balanced workouts, frame-friendly nutrition and the important role of recovery and mindset. The program combines healing and restorative methods from the worlds of rehabilitation, martial arts, and yoga in a way never presented before. A “troubleshooting” section teaches you how to prevent, treat and safely work (out) around the “Top 20” sports medicine ailments from tendinitis and knee problems to back pain and pinched nerves. I also offer an insiders view of safely navigating the healthcare system, including a look into the very promising future for those with stubborn musculoskeletal issues. Most importantly, I use stories, drawn from my experience treating many wonderful athletes, entertainers and my many patients to help you better understand, and listen to your body- so that you can extend the warranty on your frame and it will be there for you when you go the distance. Remember, longevity and durability, two sides of the same optimal health and aging coin, are very different. We are certainly living longer and better, but without durability, problems are certain as we age. Fortunately many are preventable!

Find your “weak-links” and get a body that’s “Built to Last”.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.


Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA