Fitness Professionals Archives - Page 44 of 63

senior man having a massage in a spa center

What is an Allied Healthcare Professional?

Jaclyn Chadbourne/20 March 2018/ All MFN blog/

Whether it’s exercise, nutrition, or massage therapy you are seeking, finding the right person to do the job can be incredibly challenging. The area known as allied healthcare professionals can be a challenging one to navigate.

The professions that require a state or national licensures, such as physicians, nurses, or physical therapists, help to provide checks and balances on who should and should not be providing a service to any individual. However, there are many professions within our healthcare community that are poorly understood and many times misrepresented by individuals with minimal certifications or credentials.

Allied healthcare professionals are thought to make up roughly 60% of the healthcare workforce by providing a range of diagnstic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve. All categories of allied healthcare require either registration by law to practice or post secondary degree or higher education. Click here for more information about allied healthcare professions.

Is it time to re-assess who you trust with your healthcare needs?

It is essential to know the credentials and education of anyone you are trusting for information or advice whether it be an accountant, lawyer, dentist or teacher. Healthcare is no different, but there are many misunderstood healthcare professions.

Distinct from nursing, dentistry or medicine, allied healthcare professionals make up approximately 60% of the health workforce. Examples include athletic trainer, exercise physiologist, paramedic, and massage therapist. Many times, these professionals are those you are referred to by your physicians to help manage your healthcare needs daily, weekly, and monthly. National and state licensures ensure that certain healthcare professionals uphold the standards and scope of pratice that is pertinent to their level of education.

Multiple allied professions remain to establish this key aspect of standardized care which simply means that certain professions are more susceptible to individuals claiming a level of expertise or knowledge that can be misleading or confusing to the general population. For example, as a Clinical Exercise Physiologist, I clearly understand the difference between my skillset and that of a personal trainer; however, to the general public, both professions provide guidance with exercise. Due to lack of established licensure exams, it is unclear to many people that some Exercise Physiologists (like myself) have a Master’s Degree, while others may have earned a weekend certification. It is incredibly important for you to understand the roll of any healthcare professional from which you seek treatment and advice as well as their experience and background in relation to your particular healthcare needs. Accessing information about these resources from a knowledgeable professional can help to ensure proper connection to an individual that is appropriately educated to effectively meet your needs.

Jaclyn Chadbourne, MA, CES has worked within the allied health profession as a Clinical Exercise Physiologist for 15 years. She is currently the Director of Research and Development at Universal Medical Technology, and serves as Adjunct Faculty at University of New England DPT Program

Tips for Exercising With Multiple Sclerosis

Robyn Kade/12 March 2018/ All MFN blog/

Exercise and stretching are very important for someone who has Multiple Sclerosis. Each individual, however, is different and exercises need to be tailored specifically to that person. The exercises that are chosen depend on the progression of the disease, what the individual is capable of doing, and even the day. Exercises may have to be changed if the client is too tired or is feeling stronger and has more energy.

What exactly causes Multiple Sclerosis is not known but there are symptoms to look out for. The symptoms are fatigue, walking difficulties, vision problems, spasticity or stiffness, weakness, bladder problems, depression, dizziness or vertigo, emotional changes, cognitive changes, pain, headaches, tremors and breathing problems. Exercise prescriptions need to be planned according to the symptoms that are being presented. Each time you work with your trainer talk to them about how you feel that day. This will help to ensure that you don’t overdo a workout.

Many times, we hear the saying no pain, no gain. Please keep in mind that this is not true for individuals with Multiple Sclerosis. You want the workout to feel challenging but it is important not to overheat. If you feel warm, simply take a break and continue when you feel that you have cooled down. Individuals in wheelchairs benefit from exercise as well. I would like to share an example of a client of mine.

My client, Sally, (the name has been changed) was a client of mine for 4 years. She is in a wheelchair and had no leg movement and minimal arm movement. Through exercise she is almost able to feed herself and I have her doing simple leg movements. I cannot see any leg movement but she can feel it. She reports that her muscles are sore when we are finished. The important thing is to just move.

It is important to start an exercise program slowly and to set goals. If you would like to get to 20 minutes of activity maybe start with 10. Do not assess how well you are doing by comparing yourself to others. Look for progress in yourself through reaching personal goals as in the example of my client.

As an individual with Multiple Sclerosis starts exercising they may have less depression, improved strength, better bladder and bowel function, a positive attitude and be better able to participate in social activities. Please remember that it is important to share any symptom changes with your trainer. The exercises may have to be adjusted frequently for a safe and effective workout.

Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

Sources
http://www.nationalmssociety.org/Living-Well-With-MS/Health-Wellness/Exercise
http://www.webmd.com/multiple-sclerosis/guide/multiple-sclerosis-symptoms-types

Exercise & Pregnancy

Maurice D. Williams, MS/7 March 2018/ All MFN blog/

Beautiful pregnant woman gym fitness exercise The understandable fear (due to things like decreased oxygen supply to the baby) that existed with pregnancy & exercise years ago is no longer warranted. Because of substantial research, it is now safe for women to continue or start exercising while pregnant. As long as she gets approval from her doctor & seeks out a qualified and certified fitness professional, she should be confident in knowing that the recommendations below will help her.

Considerations & Exercise Suggestions

1. Posture Change from the Growth of the Baby: As a result of the baby growing in the wound, the mother to be’s posture will change. This causes certain muscles to become weak, particularly her core. In the 1st and 2nd trimester, a mother to be should focus on strengthening her core through exercises such as planks, bridges, and birddogs. Once the 3rd trimester hits, it would be wise for the mother to be to avoid supine or prone core exercises. She can still work her core by doing standing exercises such as medicine ball chops, reverse chops & rotations. All of these exercises can be performed 2-3 days/week, 1-2 sets of 12-15 reps with appropriate rest time (45-90 seconds) between sets.

2. Cardiovascular Exercise: With the growth of the fetus, also comes more stress to the mother to be’s heart and lungs. As a result, her ability to work harder and longer is decreased. However, a mother to be can still perform low impact or step aerobics that do not involve jarring motions. Walking on the treadmill, stationary cycling and water aerobics done 3-5 days/week for 15-30 minutes is suggested.

3. Flexibility Exercise: Because the mother to be’s body posture has changed, this may cause certain muscles to overwork or become tight. As a result, she may feel the need to stretch certain muscles. This is ok to do so. Static and active stretches are advised along with foam rolling that can be tolerated. However, foam rolling on varicose veins or swollen muscles should not be done. I would advise stretching muscles that appear to be overworking such as her calves and lower back. This can be done everyday for 1-2 sets, holding each stretch for 30-60 seconds.

Pregnant woman holding dumbbells 4. Weight Training Exercise: Circuiting training has shown to be very effective for mother’s to be throughout their entire pregnancy. These include exercises that work the entire body and can be performed back to back with little rest in between. I recommend exercises that work the following muscles: legs, chest, back, shoulders and arms. They can be done 2-3 days/week, 1-2 sets of 12-15 reps. The rest period can be in between 45-75 seconds.

5. Cautions: Mothers to be should stop or avoid exercises that cause nausea, dizziness, stomach pain, prolonged shortness of breath, bleeding and fainting.

Conclusion

By taking the appropriate precautions, mothers to be can safely exercise during pregnancy. As a result, the pregnancy can be smoother and the recovery can be quicker.

Helpful links for exercises

http://blog.nasm.org/fitness/exercise-pregnancy-physiological-changes-exercise-programming/
http://www.fitpregnancy.com/exercise/prenatal-workouts/weight-training-pregnancy

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

Source
Clark, Sutton, Lucett. NASM Essentials of Personal Fitness Training, 4th Ed. Revised. 2014

personal trainer showing stopwatch time to senior client

The Space Between Fitness and Medicine: Where “the Good You Do For Others” Brings the Reward you Deserve | Part 1

Phil Kaplan/26 February 2018/ All MFN blog/

This is part one in a three-part series.

In every field you find the big earners and those who are “paying the bills.” In every field you find excellence and mediocrity. In every field you find those who fully engage and those who invest just enough to play in the arena.

Here’s one of the many challenges that keeps the personal training field in its own aura of uniqueness. The delivery of extreme value isn’t always met with what we might consider just reward. In other words, an investment of attention, energy, discipline, and devout practice ensures nothing more than a fair attempt at turning human interaction into revenue.

I think its time to change that.

VALUE SHOULD BEGET REWARD

Great surgeons command great remuneration, as do great quarterbacks, great attorneys, and great architects. We can judge them by the effectiveness of their work, by their “wins,” or by their track records.

Do great work. Make great money.

A peripheral glimpse of our field might lead to the perception that the big earners rely more on personality, social skill, and media exposure than expertise, but that’s only a glimpse. Whether it’s an accurate or flawed conclusion, I promise you this. It can be changed.

In this 3-part series, I want to change the way you think. I want to give you control over your future, your position, and… your income, not by sharing marketing tricks bur rather by giving you a willingness to accept an important truth.

You are an entrepreneur.

I know. Some of you gagged, some fought back the vomit reflex, and others considered it might best to stop reading. Entrepreneurs have to have some business expertise, they have to deal with finance, and they have to… ready for this… sell!!!

EEEAAAAUGH!!!!!

I’m not finished turning the screw. I’ll make it, for the moment, even harder to swallow. As an entrepreneur you are FULLY IN CONTROL of the value you deliver, the number of lives you touch, the number of lives you change for the better, and the number of dollars that make up the balance in your bank account. Nobody will do it for you. It’s all on you.

Here’s another truth. Most personal trainers pursue their professional commitments out of two complementary driving forces. They love helping people and they have a passion for fitness. That’s good. It’s both, their greatest strength and their source of vulnerability . . . because “making money” falls somewhere lower on the list than “finding reward in gratitude.”

IF THANK YOU’S WERE DOLLARS, YOU’D BE A MILLIONAIRE

As a trainer you LOVE when a client says thank you. You melt when a client says, “you changed my life,” and you puff up like a blowfish when you read the text that says, “OMG, lost 20, feel great! Thank you.”

This innate deep-rooted altruism allows you to work for less money than you deserve and to justify the financial deficiency with “I’m helping people.”

Let me share another insight. You are wired more like a doctor than you are like the proud and hungry entrepreneur. Doctors are driven by the same altruistic inner calling, at least when they decide to sit for the MCAT’s and pursue intensive study, knowing it’ll be followed by an internship and residency before they even earn their first dollar.

So why do doctors earn what you perceive to be “the big money” while trainers settle for per-session fees? One reason. They’re given permission.

The medical paradigm is polarizingly different than the one you operate under. The medical student doesn’t “set” his future pricing, the paradigm does.

The fees for an MRI, a bypass procedure, lab tests, and cosmetic enhancements are established. The medical student simply steps into the universe where value already exists.

You, whether you emerged your educational prep with a degree or a certification, stepped into a universe where the paradigm is based upon “training sessions,” not upon true delivery of value.

I might not share these perspectives with an audience of trainers at a general fitness conference. I’m sharing them with you because you’ve demonstrated interest in or become connected with the Medical Fitness Network. This demonstrates that you have an interest beyond “training sessions.” At some level, you have interest in helping people rediscover health. There’s value in that. Extreme value.

Let’s do a quick comparison.

Where is there more perceived value? In a training session promising to make someone sweat, contract, stretch, and increase respiration, or in the undoing of a chronic condition?

WHAT IS THE VALUE OF RESTORATION?

We dare not suggest we can cure any disease, but there’s a massive and-ever growing body of evidence demonstrating that shifts in eating and movement can create shifts in biochemistry and physiology moving people away from physical compromise and back toward health.

I’m suggesting that if you become a practitioner delivering human betterment to those who live in compromise, you’re standing on the cusp of establishing a new paradigm. You’re potentially moving into a position where you can claimpower over the impact you have upon your clients and concurrently upon the fees you command and the reward you deserve.

I want you to see yourself as somehow different than “the rest of the field.” Without ego playing a role, consider that you have the ability to elevate, to accept a position of greater responsibility, and with it, greater reward.

In the next two parts of this three-part article, I’ll share what I call “The Three Levels of Profitability” and show you how you immediately leave the income ceiling behind when you stop up to Level 2, but for now I simply want you consider movement. I want you to realize, if you opt to pursue a “specialty,” to offer a solution to a market that is bound by pain, discontent, or limitation, you have a far greater value than a practicing workout expert.

No longer will you be “in the fitness field.” You won’t leave it entirely, and you’ll still carry your fitness passion and wield it as a weapon, but you’ll move into a space that’s the open sea, a space where earnings will escalate for those who master the skill set allowing them to find a new level of comfort in entrepreneurship. We’ll consider it the space between Fitness and Medicine. It’s the space where a massive segment of our population will rediscover their own power to live in health, regardless of their past or present level of compromise. It’s the space where guidance is lacking, the space where ancient wisdom will marry scientific discoveries, the space where you can prosper and thrive.

If you hunger to be in this space, stay connected. This is simply the eye opener. I’m about to share insights that will completely shift your recognition of your own potential. Stay tuned.

This is 3 part series. Read part 2 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. Visit Phil’s website, philkaplan.com; you can email him at phil@philkaplan.com

How To Overcome Stress When Diagnosed With Cancer

Nick Jack/13 February 2018/ All MFN blog/

“CANCER”. For those who are not diagnosed with this condition, just saying the word out loud to yourself highlights many negative connotations associated with it.

Depression. Anxiety. Loneliness. Weakness.

jack-article1 We all consider the undesirable aspects associated with cancer and think to ourselves how lucky we are not to have that added stress in our life. But what about those who are diagnosed with cancer?

Life can already be quite overwhelming when considering the financial strains, family events and various appointments scheduled into each day. But then add cancer into the mix and what do you get? You get a situation that can be very debilitating both physically, socially and emotionally, and can cause an array of adverse behaviours such as excessive alcohol consumption, sedentary behaviour and smoking. There is some evidence to suggest that elevated stress levels heighten the inflammatory response associated with stress hormones which may be directly related to cancer development and growth, however, there is an abundance of research showing an in-direct link between stress and cancer growth due to the adverse behaviours mentioned above. Thus, having the ability to conquer stress, identify the best way for you to deal with stress, and to become resilient to it will positively impact the management of your cancer and the fighting process.

So we know that stress and anxiety are typically elevated in people with cancer, and we know through available research that we need to lower or eliminate these stress levels to stop risky adverse behaviours associated with stress, but how do we go about doing that?

Recently at our training studio we began an exercise program for clients diagnosed with cancer called Lift For Life. Our trainers discussed the idea of stress and anxiety with our cancer clients and what that means to them. During our discussion we identified many situations which cause stress in their lives, both related and not related to cancer. Some of these situations were:

Family
Work
Negative thoughts
Feeling lonely
Feeling as though they have no one to talk to
Cancer Doctor appointments and the negative connotations associated with them
Waiting for results
Feeling as though people are sick of them talking about their cancer
Finances

After identifying what causes heightened stress levels, we brainstormed ideas we could implement to help overcome such stresses:

Joining cancer education groups and classes
Counselling
Communication with family and friends
Joining stress management, meditation or relaxation classes
Download stress relief applications

We recognize that stress factors in to a large degree. In the treatment of this deadly disease, and while we see the need for exercise and nutrition, there must also be a focus on improving the lifestyle habits and the personal ability of the person to be mentally healthy as well. Far too many programs focus on just the physical component or treat the physical symptoms, neglecting the importance of addressing the psychological and emotional needs to assist the body in healing itself. This is why our program is designed around exercise and education. There is an abundance of research illustrating the physical, health and emotional benefits of exercise for those suffering and over-coming cancer. Cancer brings with it atrophy, osteopenia, increased risk of cardiovascular disease and falling. The benefits of exercise and stress reduction can help alleviate many of these ancillary negative conditions associated with cancer. Some of these benefits include:

Regulation of blood flow (reducing your risk of blood clots)
Improved muscular and bone strength/health
Reduced risk of falling
Improvement and maintaining of functional capacity and independence
Reduced risk of secondary cardiovascular diseases and co-morbidities associated with cancer
Improved mental status
Improved quality of life.

After the Lift For Life brainstorming session I had with my cancer clients I was surprised to find that no one had identified what I perceived as being the most important elements in overcoming stress and anxiety. Exercise and rhythmic breathing. Of course once I mentioned this, all clients agreed that these were both extremely important.

It is at this point you may be thinking “yes I know about the importance of exercise and the benefits associated both physically and mentally, but what has breathing got to do with it?”

Why is breathing so important?

When I think of someone being stressed or anxious, I picture someone hyperventilating into a brown paper back and trying to slow down their breathing. Most people who are stressed are stuck in a constant state of over breathing and hyperventilation. Often when people are stressed they are told to “take a deep breath and relax”. This is, however, quite problematic as this action reinforces anxiety and stress symptoms by overstimulating the sympathetic nervous system, and eventually causes habitual over breathing actions. Even when the stress is no longer present, a person will continue to breathe this way as this is how they have taught themselves to breath. Dr James Mercola (of the Game Changer) emphasizes this further when he stated “When you feel tense and anxious, the sympathetic fight-or-flight aspect of your nervous system turns on, quickening your breathing and increasing your heart rate, blood pressure and stress hormone production. Uncontrolled, rapid, chest-oriented respiration can actually initiate your sympathetic nervous system — even if no other stress factors are present — locking you into a state of breathing-induced stress”. Hence, learning how to breathe slowly and softly through the nose is critical.

What can I do to start breathing better and help reduce my stress and anxiety?

There are many breathing exercises which can help to reduce stress levels, improve your health and calm your body. A simple breathing exercise which can be done anywhere and has been reported to help reduce stress and anxiety symptoms is as follows:

Inhale through your nose for 5 seconds
Hold for 5 seconds
Exhale through your nose for 5 seconds
Repeat 5 times.
Once completed make sure you continue to breath normally through your nose and not your mouth otherwise you won’t be able to crack this over breathing habit you have taught yourself.

The 4-7-8 breathing technique taught by Dr Andrew Weil is also quite effective in reducing stress levels and regulating your breathing.

Conclusion

We must acknowledge the damage that stress can cause on our health and when we are already in a state of poor health, a little bit more than normal is enough to create more problems. Stress cannot be avoided for it is something we will all encounter at many times in our lives. However, being stuck in an extended state of stress will do serious damage to your body. Learning different strategies and having tools and resources to combat the symptoms associated with stress and anxiety are essential in the prevention and treatment of cancer as well as all kinds of other health problems and diseases.

References:
http://www.mercola.com/
http://www.cdc.gov/
Cancer Council Australia

Nick Jack is owner of No Regrets Personal Training a Rehabilitation & Sports Training Studio located in Melbourne Australia. Having worked as a Trainer for over 10 years and has qualifications as a CHEK Exercise Coach, CHEK Golf Performance Specialist & Master Rehab Trainer and Twist Conditioning Sports Conditioning coach he specializes in working with rehabilitation and injury prevention programs. You can check out his website at www.noregretspt.com.au

How Many Studies Does It Take? How Many Lives Must Be Lost?

Shira Litwack/25 January 2018/ All MFN blog/

I pride myself on being a science geek through and through. I understanding the scientific method, I understanding retesting getting consistent results. But I think accepting results of scientific testing comes down more to the mighty dollar and marketing than to the betterment of human lives.

5 Elements to Boost the Retention in Your Fitness Studio

Josh Leve/11 January 2018/ All MFN blog/

Retention – the infamous “back door” that has plagued the fitness industry for decades – demands the attention of any studio that intends to stand the test of time.

Here are five of the rules to live by in order to keep your studio’s members coming back – with smiles on their faces.

1. Understand the Cost of Retention vs. Acquisition

Consider these three axioms of customer acquisition as opposed to retention:

It costs five times as much to acquire a new customer than it does to retain a current customer;
The probability of selling to an existing client is 60-70%, while the probability of selling to a new prospect is 5-20%;
The fitness studio industry average retention rate is roughly 70%, meaning you can expect to lose 30% of your customers every year.

Furthermore, retained clients are, generally, happy clients. They tend to become “Word of Mouth” advocates of your business, leading to cost efficient acquisition. Just like “the best offense is a good defense,” so is “closing the back door opens the front door.”

Clearly, Retention – keeping the members you have – is the name of the game.

2. It Starts from Day One

The old expression “You never get a second chance to make a first impression” definitely holds true in the fitness studio business. Studios need to know who the newbies are and from the get-go do everything possible to make the very first experience in your studio top-notch.

This means friendly greetings, knowing client’s names, and introducing the new member to staff and fellow clients. The first day of membership or the first class taken is the first step (and lasting impression) toward retention.

Whatever your onboarding strategy – and you must have one – it starts now. Not tomorrow.

3. Deliver on Your Brand Promise

A key component of retention is in understanding what attracted your clients in the first place. Whatever your brand promise was that got them there – it’s incumbent on you to deliver on that promise.

If you’re touting your studio as the best this or the best that – then you need to be exactly that! If you’re marketing the largest this, or greatest that, – deliver.

This generally means a friendly, helpful, non-judgmental workout environment along with working machines, no canceled classes, and trainers/instructors as advertised.

Most importantly, deliver programmatically. If you’ve established a 60-day weight loss program, do whatever it takes for your clients to be successful – within the parameters of the positive client experience.

4. Personalization

One of the most compelling differentiating factors of the studio business is the personalization factor. Most happy members and clients are pleased because they feel their studio experience is unique to them – that what they are doing is not cookie cutter, but that they matter.

Personalization cannot be overstated. If the experience is fun, effective, and unforgettable for each client every time – that client will continue to frequent your studio. In some ways it’s akin to a doctor. The good ones treat your disease; the great ones treat the disease AND the person.

afpa1 In the case of a studio, the “disease” might be to “lose 20 pounds in two months.” Don’t allow this client to feel like he/she was thrown into “another class” to achieve the goal. “We have classes for that,” won’t do. Rather say, “Let me put together a custom program just for you based on what you like to do.”

5. Listen to Your Clients and Your Staff

Everybody makes mistakes. Nobody nor anything is perfect. Problems do arise. It’s the nature of life and can’t be avoided. The key is how you respond when things go wrong.

Most members and especially most staff are eager to point out when something in your studio could have been done better. Listen to them, consider their point of view, and take remedial action as soon as possible.

Responsiveness leads to improvement. If you don’t know a problem exists, it will continue. Encourage members and staff to let you know when a problem exists and how they believe it should be remedied.

When people believe their input has value, they will continue to provide it – and your business will continue to improve.

Retention can be a tricky element in the overall context of your fitness business. The most important strategy is to always, always keep your eye on retention – it’s the key to your bottom line.

Josh Leve is responsible for the strategic development and growth of the Association of Fitness Studios. Josh brings more than 10 years of sales, consulting, advertising, marketing, operations, and retail experience to AFS and has spent more than a decade in the fitness industry.

a trainer helping a senior woman doing fitness

Exercise and Multiple Sclerosis

Lisa Dougherty/29 December 2017/ All MFN blog/

A study published by researchers at the University of Utah in 1996 was the first to demonstrate clearly the benefits of exercise for people with MS. Those patients who participated in an aerobic exercise program had better cardiovascular fitness, improved strength, better bladder and bowel function, less fatigue and depression, a more positive attitude, and increased participation in social activities.

MS is the most common neuromuscular disease affecting young adults. The onset of symptoms usually occurs between the ages of 20 and 40. The disease is twice as prevalent in woman as in men.

The National MS society provides the following parameterof different functional levels of people with MS:

Level 1 – Mild: People with this level of MS may be walking independently but may also walk with a cane. They may have some visual and coordination issues.

Level 2– Moderate: People with this level of MS may be dependent on a walker or a wheelchair. They may be able to transfer themselves or they may require assistance.

Level 3 – Progressive: People with this level of MS may be paralyzed primarily in the lower extremities. They will spend most of their time in a wheel chair.

Associated Impairments

Fatigue: Usually mid-afternoon after waking up feeling reasonably rested
Spasticity: Most common areas of the body to be affected are the legs and postural muscles.
Weakness: May be present all the time or only during times of acute flare-up. Pain leads to disuse and disuse leads to even greater weakness and los of functional fitness.
Tremors: These are not predictable as exhibited with Parkinson’s disease. They tend to vary widely in intensity and oscillation.
Balance, Coordination, and Gait: Often the first symptom of MS is the great mental effort it takes to perform movements that previously were automatic. They may observe foot dragging and shuffling or a foot that turns in while walking. They may exhibit shaking and jerky movements know as ataxia.
Muscle Cramps and Spasms: Flexor spasms in muscles that increase flexion of a muscle may occur.
Numbness and Tingling: Most often sensed toward the periphery of the extremities such as fingers and toes.
Heat Sensitivity: High ambient temperature and humidity can exacerbate the symptoms and lead to fatigue, loss of balance, visual changes and general worsening of symptoms.
Vision: people may experience optic neuritis in one eye where vision may be blurred for minutes. Response of the pupils to light is slowed.
Hearing: Changes in hearing are rare.
Cognition: 50% of people experience some degree of mild cognitive disfunction.
Cardiovascular Dysautonomia: Irregular function of the autonomic nervous system leads to blunted heart rate and decreased blood pressure in response to exercise.

Benefits of Physical Activity for People with MS

Research shows that the proper dose of exercise can provide people with MS with beneficial results.Loss of muscle strength resulting from the onset of neurological damage cannot be improved through exercise. However, muscle atrophy as a result of disuse can be.

Regular exercise can counteract muscle weakness, lower the risk of bone fracture, improve the efficiency of the respiratory system, increase bone density, lower stress, and contribute to a general feeling of well-being.

The benefits of regular exercise and therapeutic fitness training include:

Maintained optimal health and decreased incidence of secondary health problems related to disuse syndrome
Increased energy
Decreased muscle atrophy
Managed spasticity
Improved cardiovascular function and blood lipid management
Reduced risk factors for cardiovascular disease
Reduced obesity and glucose intolerance
Depression lessened or eliminated
Improved sleep
Enhanced self-esteem
Improved balance and basic motor skills
Activities of daily living become easier to perform

Exercise Guidelines:

Incorporating mild interval training is an effective method to prolong stamina, as it enables people to perform more exercises without fatiguing or overheating.
Activities that necessitate pointing the toes should be avoided as that position might increase spasticity in the legs.
When strength training, focus on areas of muscle imbalance. Coordinate the flexibility portion with strength training static flexibility movements after that focuses on increasing mobility and lengthening of tight areas (chest, calf, and hip flexors).
It’s important to develop strength before endurance and participating in balance activities.
Use eyes to follow movement of a limb. This will increase periphery input and influence adjustments in stability.
Emphasize proper body alignment during all activities. Poor posture hinders controlled and safe movement
Incorporate warm-ups before exercise
Exercise progressions should be gradual and based on response and tolerance
Minimize stress to joints. Be prepared for low impact or non-weight bearing activities if person experiences compromised balance or numbness in their lower extremities, or orthopedic problems
Weight bearing helps to reduce spasticity, therefore, standing exercise are recommended if possible
Incorporate rotational exercise patterns to break up abnormal motor patterns caused by spasticity or rigidity
Do not bend neck forward (cervical flexion) as this type of movement can cause Lhermitte’s sign – a brief stabbing, electric-shock-like sensation that runs from the back of the head down the spine.
Avoid overheating
Simple movements before complex movements
Static moves before dynamic moves
Slow movements before fast movements
Low weigh loads before high weight loads
Two-arm movements (or two-leg) before single-arm(or single-leg) movements
Stable surfaces before unstable
Quality movements before quantity of movements
Focus on core of trunk as well as stabilizers of each joint
Employ proper use of open kinetic chain moves versus closed kinetic chain exercises.
Focus on proper use of concentric, eccentric, isometric, isokinetic and plyometric moves
Maintain functional range of motion – know the anatomical motions that occur at each joint
A comprehensive fitness program should incorporate perceptual-motor skills – visual, auditory, tactile, and proprioceptive senses.
Balance training is important as it underlies nearly every static and dynamic posture that requires the body to be stabilized against the pull of gravity
The goal of cardiovascular exercise is to between 50%-80% of max heart rate

There are medical fitness trainers that are certified to work with individuals with multiple sclerosis. They have acquired the tools and strategies to improve physical fitness and functional ability for clients with MS who have varying symptoms of the disease and levels of ability. They have learned exercise precautions, program design, perceptual motor and balance skill development, and much more.

Lisa Dougherty founded Whole Body Fitness in 1999. She graduated from the University of CA, Irvine, Fitness Instructor Program, and is a Certified Personal Trainer and Health Coach through the American Council on Exercise. She has specialty certifications to work with those with medical conditions, post surgical/rehab as well as pre & postnatal fitness. Course work includes: Heart Disease, Breast Cancer Recovery, MS, Parkinson’s, Diabetes, Alzheimer’s/Dementia, Arthritis, Respiratory Disease, Fibromyalgia, Knee and hip replacement, and Pre and Postpartum fitness. Lisa founded the Medical Fitness Network in 2013.

Exercise and Fibromyalgia

Eric Lemkin/22 December 2017/ Conditions/

Fibromyalgia is a debilitating condition that affects roughly 1 to 3% of the general population. The syndrome is characterized by widespread muscle aches and pains, stiffness, fatigue and muscle spasms. Most people with fibromyalgia report difficulty doing everyday activities such as carrying objects, walking and competing ADLs (activities of daily living). Pain, fatigue, helplessness, psychological distress and

difficulty coping with stresses plague many people with the condition. The exact causes of fibromyalgia are not well understood, but it is thought to be a combination of increased sensitivity to pain and environmental and psychological factors. Criteria for diagnosis of Fibromyalgia from the American College of Rheumatology include:

Chronic widespread pain in all four body quadrants
Pain in 11 of 18 tender points
Other symptoms: fatigue, weakness, attention and memory disturbances, heat and cold intolerance, and weight fluctuations.

For unknown reasons, a much larger percentage of women suffer from fibromyalgia than men.

Treatment of Fibromyalgia

Long-term effective treatment includes education, pharmacotherapy, behavioral therapy, and exercise. It is important to educate individuals that fibromyalgia is chronic, but it is not progressive and does not cause permanent damage or inflammation. Active participation is the key to improving their condition.

Can Exercise Help?

One would think that individuals with fibromyalgia shouldn’t exercise. And many people limit physical activity out of fear that it will make their symptoms worse. But in reality, if you have fibromyalgia, you can’t afford to not exercise.

If done correctly, exercise interrupts the downhill spiral of muscular and cardiovascular deconditioning and the resulting loss of function. Deconditioning leads to increased muscle soreness after even minimal amounts of physical activity. Additionally, many individuals have postural imbalances, tight muscles and poor range of motion, all of which place more strain on the body and movement.

A program including consistent aerobic exercise improves function, symptoms and well-being. And strength training improves muscle strength and reduces exercise-related pain and exercise-induced muscle fatigue. Overall, an exercise program can help to alleviate many of the physically and emotionally painful symptoms of fibromyalgia.

Exercising Safely With Fibromyalgia

Prior to increasing physical activity, discuss your plans with your physician. Because postural imbalances and tight, inflexible muscles are common in individuals with fibromyalgia, every activity session should begin and end with mobility (flexibility and range-of-motion) activities. You should also include self-myofascial release or foam rolling to help loosen tight muscles and prepare the body for movement. These exercises should be done slowly, emphasizing quality of movement, and never be painful.

Once you are able to perform these basic exercises comfortably, add strength training two to three times a week using light weights. The emphasis is not on quantity, but rather on the ‘quality’ of muscle movement. If you use too much weight, try too many sets or repetitions, you can cause muscular microtrauma, which leads to muscle soreness and can potentially worsen your symptoms.

Aerobic exercise should also be on your exercise plan. Warm water provides an optimal medium for beginning your exercise program. Many communities have facilities that offer warm-water exercise sessions for people with arthritis and these classes are ideal starting points for those with fibromyalgia as well. Walking is also an excellent activity. Other types of exercises, such as cycling, stairstepping and using other popular machines found in fitness facilities, may increase symptoms if you don’t maintain correct posture. Aerobic activities should be undertaken at a moderate intensity a minimum of three times per week. Start with just a few minutes and gradually increase duration to build up to 20 to 40 minutes of activity each day.

The key to exercise success for individuals with fibromyalgia is consistency. When you experience flare-ups, back off or take a day off. Resume your physical-activity program as soon as you feel better.

With appropriate mobility exercises, strength training and aerobic conditioning, you can expect to see improvement in your functional status overall.

How can an exercise professional help someone with Fibromyalgia?

If you have fibromyalgia and are considering starting an exercise program, you may have questions such as:

What type of exercise should I be doing? Aerobics? Weight training? Both?
How intensely should I be working?
What if I feel pain or discomfort during exercise?
Where should my heart rate be?
What time of day should I exercise?
Should I change my nutritional habits at all?

A certified personal trainer or other exercise professional can help to answer all these questions and develop an exercise program that is tailored towards your needs and abilities. Your trainer will do an initial evaluation on you to find out your baseline measures in terms of aerobic capacity, strength, flexibility, bodyfat, and circumference measurements. An evaluation may also look at your posture and how you perform basic movement patterns. Based upon this information, your trainer can determine what muscles may be tight and need to be stretched or foam rolled. The evaluation process will also indicate what muscles are weak and need to be strengthened through resistance training to help improve mobility and improve quality of life. An exercise professional can also formulate a target heart rate zone for you to train in while you perform aerobic exercise.

If you develop any symptoms during exercise, your trainer should recognize the situation and alter the activity accordingly. Individuals with fibromyalgia often have flare-ups of intense pain. Communication between you and your trainer can help to pin point certain exercises or movements that may cause these flare-ups and be avoided or decrease the intensity. Sometimes rest is the best remedy for pain flare-ups. Your trainer will develop a strength training routine customized towards your needs and abilities and shows you ways to modify exercises or movements that may be too intense or demanding, especially at first. The goal of the client-trainer relationship is to create an exercise program that is effective, challenging, yet comfortable and ultimately leads to a better quality of life.

Eric Lemkin is a certified personal trainer, strength & conditioning specialist, corrective exercise specialist and founder of Functionally Active Fitness. Lemkin has been a certified personal trainer for 17 years and has helped people ages 8-80 reach their fitness goals through customized personal training – specializing in exercise for the elderly or handicapped.

References

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4. Tuck, I., and D. Wallace. Chronic fatigue syndrome: A woman’s dilemma. Health Care of Women International 21:457–466, 2000.

5. Clauw, D.J., and L.J. Crofford. Chronic widespread pain and fibromyalgia: What we know, and what we need to know. Best Practices in Research and Clinical Rheumatology 17:685–701, 2003.

6. Norregaard J., P.M. Bulow, J.J. Lykkegaard, et al. Muscle strength, working capacity and effort in patients with fibromyalgia. Scandinavian Journal of Rehabilitation Medicine 29:97–102, 1997.

7. Simms R.W., S.H. Roy, M. Hrovat, et al. Lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism. Arthritis and Rheumatism 37:794–800, 1994.