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wearable-tech

Health Trackers & Apps are Dangerous… Scientists Say What?

With over 165,000 health-related apps in the App Store and Millions of wearables in the hands of the general public, scientists are wondering if they are “doing more harm than good”? One expert commented that the field can be “likened to the snake oil salesmen of the 1860s.” Is this true?

Question: What is the danger of health-related technologies in the hands of the general public?

Answer: Because health-related technology is often “one size fits all” with the data it provides mistakenly seen as the “holy grail” that leads to improved health, it can lead individuals down a path that does not correlate with improved behaviors. This should not be a shock to health professionals as it is certainly unfair to expect the average technology user to be a “health expert” who is able to accurately analyze health data and implement the proper behavior change.

Therefore, the real question should be . . . How can the power of health-related technologies that is already in the hands of the pubic, be appropriately leveraged? Well my friends, that answer lies square in the hands of the Health Professional who fills the significant gap between the individual and technology they use. I call this the Technology-Behavior Change Triad© (Details in the next article in this series).

Where the Rubber Meets the Road: While working with clients and patients for over 5 years we have successfully integrated health-related technologies with our patients and clients. During this time we have found them to be the key tool for providing patient-matched, actionable feedback related to long-term behavior change. Think about it, how else can we get “real-time”, individualized information from clients or patients when they are not with us? What’s more, smartphones and wearables are already in the hands in just about ALL of our current and potential clients and patients so as professionals we are remiss if we disregarded the use of this technology.

The Take Home Message: Health-Related technology provides valuable information to the end user. Can this be harmful? Well, the question really should be . . . How can this technology be most impactful for improved health? Simply put, the Health Professional can harness the power of Health-Related technology when it is integrated within the client or patient relationship. In the end, not only do these tools allow the creation of the best individualized motivational environment for each person, but they also take your business to the next level as you optimize your service offering with more efficient and effective engagement!

Reprinted with permission from Dr. Steve Feyrer-Melk.


Steve Feyrer-Melk, MEd, PhD, is a powerful, passionate, and trusted authority in Lifestyle Medicine who is bringing an innovative, refreshing, and successful approach to proactive health care. Dr. Steve co-founded the Optimal Heart Attack & Stroke Prevention Center where he crafts and hones real-world programs for immediate impact. Dr. Steve also serves as the Chief Science Officer of Nudge, LLC, a lifestyle medical technology company.

senior woman doing exercises

If Exercise is Medicine for People with Parkinson’s, Why Isn’t Everyone Doing It?

The three national thought leaders presenting at the Annual Parkinson’s Symposium in 2015 were all in passionate agreement: exercise is imperative in treating the symptoms of Parkinson’s disease. We have cultivated and grown many Parkinson’s-specific exercise programs in Sarasota County, from spin classes to yoga, at levels appropriate for all stages of the disease. In addition, exercise is the only know treatment modality with 100% positive side effects!

So why isn’t everyone doing it?

As a Care Advisor and Health Coach, I am continually striving to understand what motivates or inhibits people from exercising. Why are some in our Parkinson’s community committed exercise enthusiasts, while others seem to come up with innumerable reasons why they can’t participate in physical activities?

I believe a core reason may be what the American Council of Exercise refers to as the concern for “psychological safety.” If someone has Parkinson’s, that person may believe that participating in exercise is dangerous. A fear of falling, freezing of gait, or muscle stiffness preventing completion of an exercise class may prevent a potential exerciser from starting a program that could help reduce all these symptoms.

People with Parkinson’s may also have heightened feelings of self-consciousness, and may fear embarrassment while participating in a class setting. Gyms can be intimidating, and often it is difficult to know where to start. Even the most structured and supervised exercise classes have some levels of unpredictability.

Another concern people with neuro-degenerative diseases face is coming to terms with diminished physical abilities. If a person with Parkinson’s has had an active and athletic past, it may be difficult to acknowledge what the body can no longer do. Seeing others at later stages of Parkinson’s may dissuade someone from attending an exercise group that could slow down the progression of the disease.

So how can we address these concerns? Those with Parkinson’s first need to know that they are not alone, that there are many people fighting this disease with exercise and are having fun doing it. Finding a safe and effective exercise class with qualified professionals in a supportive environment is the next step. Often times it is less intimidating to attend an exercise class with a spouse or friend, and always know that if you are new to exercise, you will always be encouraged to go at your own pace until you become more confident in your abilities. Finally, not only do regular exercisers have fun and empower themselves with the ability to help diminish their Parkinson’s symptoms – they become stronger in body, attitude and spirit. Be a Parkinson’s fighter.


Carisa Campanella, BA, AS, is an ACE Health Coach and ACSM Personal Trainer. She is the Program Manager at the Neuro Challenge Foundation for Parkinson’s. Neuro Challenge provides ongoing monthly support groups and educational programs, individualized care advising and community resource referrals to help empower people with Parkinson’s and their caregivers.

mother-with-stroller

Postnatal Exercises

Exercise is recommended to keep the body strong and in proper working order. Exercise also builds and maintains healthy joints, bones and muscles. Postnatal exercises help a woman get back into shape after giving birth, and they also help combat postpartum depression. There are several basic exercises you can do within a few weeks after giving birth. However, if you’ve had a Caesarean section, you may want to wait at least six weeks before doing any abdominal exercises. If you experience pain while exercising, stop immediately and call your doctor for advice.

Walking

Walking is the most basic of exercises, and it’s a good way to begin a new workout regime. Begin by walking at a leisurely pace, and increase your pace and distance over time. Once you’re comfortable in your movements, take advantage of all those great baby registry gifts you’ve received. Put the baby in the baby carrier and push the child in front of you as you walk.

Some women enjoy walking with a friend, as it gives them time to socialize, an activity you may be neglecting while caring for your new baby. If you are a runner, avoid an intense running workout until you have spoken with your physician. Some women are discouraged from exercising strenuously in the first few weeks after giving birth, especially if they are waiting for the wound from a C-section to heal. A doctor can answer questions about your limitations.

Pelvic Tilt Exercise

The tummy is a major problem area for many women after giving birth. Thus, pelvic exercises are often helpful. The pelvic tilt exercise is easy to do and can tighten up your stomach and strengthen your back. Begin on your back on the floor with your knees bent and your feet flat against the floor. Then, flatten your back against the floor as you tighten your abs and lift your pelvis slightly off the floor. Hold this position for 10 seconds. Repeat the exercise by doing three sets of ten seconds each. Pelvic tilt exercises can be done anywhere. After you’ve finished breastfeeding and put the baby down for a nap, take a few minutes to do your exercises.

Kegel Exercises

Some people worry about finding the time to exercise. However, both pelvic tilts and Kegels can be done in a short time frame. The purpose of Kegel exercises is to strengthen the muscles in your pelvic floor. During pregnancy, the muscles of a woman’s pelvis are often weakened. This is why some women experience incontinence after childbirth. If you notice that coughing, sneezing or laughing causes you to leak small amounts of urine, then you could probably benefit from Kegel exercises.

Kegels are simple. First you must identify your pelvic floor muscles. These muscles are the ones you use when you stop yourself from urinating mid-stream. Practice stopping and starting urination while in the bathroom, but only do this once or twice to identify the proper muscles. Do not make a regular habit of contracting your muscles during urination, as this can cause bladder problems.

Once you’ve identified your pelvic floor muscles, you are prepared to do Kegels. Lie on your back and contract your muscles for five seconds, and then relax for five seconds. Do this until you can contract for ten seconds at a time. Do three sets of ten seconds 2-3 times each day. You can even do Kegels while standing up and walking around. Kegels can help those who leak a small amount of urine but probably won’t be helpful to women with a serious incontinence problem.

Forearm Planks

Planks are good exercises that target and tone your abs, thighs and butt. Planks are also a great way to strengthen your abs without straining your back and neck. Begin by lying on your stomach on the floor. Put your forearms on the floor beneath your shoulders and keep your back straight with your legs extended so that your toes touch the floor.

Then, lift your tummy from the floor so that it is parallel to the floor. Using your forearms and toes to hold your body weight, tighten your tummy and hold your abs off the floor for 30-60 seconds. Rest for 30 seconds, and then repeat the exercise 4-5 times. You can also do planks with your palms flat against the floor and your arms straight rather than placing your weight on your forearms.

Finding time to exercise after giving birth can be a challenge. Try to schedule a brisk walk several times weekly at a local park, or simply walk around your neighborhood. Any exercise is better than none at all. Kegels, pelvic tilts and planks can be done inside your home. Take a few minutes several times a day while your baby sleeps to do your exercises. It’s also a good idea to have your doctor recommend stretches and workout routines. Remember to start light, then increase your exercise intensity over time.


I’m the woman next door, with all of the problems and joys of everyday life. I know that the more I give, the more I’ll receive–so my blog is intended to help people, and hopefully, it will do good things for me too. As a working mother, I’m often faced with many practical, everyday situations that make life harder, but that shouldn’t be the case. Visit my website at thebabbleout.com

Sources
http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283
http://www.webmd.com/parenting/baby/6-exercises-for-new-moms#2
http://kemh.health.wa.gov.au/brochures/consumers/postnatal_exercise.pdf

blood-samples

The Rise of Consumer-Based Blood Testing: A Huge Step Forward for the Medical Fitness Profession

A recent report in Forbes Magazine by writer Unity Stokes discusses the recent issues concerning the validity of blood tests results from a Silicon Valley lab company called Theranos. Theranos was founded by a 30-something Elizabeth Holmes, who garnered over $5 billion from investors to launch her company that promised blood from finger sticks vs. whole venous blood draws. This year her company was investigated by the Department of Justice for investor fraud. Today Theranos has little investor value, but Ms. Holmes helped launch the consumer based blood lab model – in which patients can order blood labs from online companies when they want – essentially taking away a physician-ordered medical procedure.

While it may not mean too much for medical fitness professionals today – it should. There are two reasons. Even though Theranos is not the top dog in the blood lab industry now – they have changed the way we think of blood labs in general.

The big picture here, as explained by Stokes in his article, is that whatever the endpoint is for Theranos, consumer based lab testing is here to stay and will be one of the fastest growing areas of healthcare.

Simply put – consumer based blood lab companies allow patients to log onto web sites and essentially become “members” of an online community. Their membership allows them to receive blood labs independent of their physician referral.

Why is this important? For the Medical Fitness Professional – it is the game changer that they have been waiting for. Over the past 25 years they have pushed the terms “post rehab exercise” and “clinical exercise” to allow trainers to move into the health care environment.

While performing duties that may in some cases seem similar to physical therapy (in the eyes of the uneducated observer) they are now able to have a piece of health care that they can use to further their development of the clinical exercise realm.

Blood labs will allow personal trainers, health coaches, health nurses, sports conditioning coaches, and exercise physiologists to refer their clients and athletes to blood lab companies online and directly test the effects of an exercise and sport program on their health.

According to StepOne Health CEO Craig Brandman, MD – over 90% of healthcare decisions are make by the results of blood labs, and in sports medicine – we can only imagine looking at blood labs on an on-going basis to see how our prescribed exercise (or sport) program is doing on blood lab parameters.

Take diabetes for instance – in athletics or health improvement, the basis for medical decision making is in two critical areas – fasting and post blood glucose testing with a home monitor and long term care regarding the glycosylated hemoglobin (A1c). These tests are crucial to seeing how improvements are doing in overall diabetes health. The first test – the home glucose monitor – can be used in any health club and by anyone. The A1c test is a lab test and is usually prescribed by a doctor – until now.

Dr. Brandman and myself have been in communication for some time to bring StepOne Health into the realm of the health and fitness profession. As a former medical researcher – I can’t agree more. With cancer patients, weight management, hormone management, cardiovascular risk patients, and most others, the ability to manage blood labs may be the most important element in showing others in health care the benefits of exercise and sports training at any level.

Sports training programs rely on physical performance markers, injury status, range of motion, and other elements to see the improvement in athletes. Blood testing allows them to not only measure acute markers (blood glucose, lactate, etc.), but to look at markers such as Creatine, Testosterone, and BUN levels and prescribe fitness accordingly.

How will this come to pass? In my conversations with Dr. Brandman – we are working on two fronts. First is to enhance the education of health and wellness professionals as a whole. The Blood Lab Wellness Specialist course was launched in February of 2016, and it allows heath and wellness professionals to have a baseline understanding of the blood lab process. Second – StepOne Health will be creating a referral-based system whereby Medical Fitness Professionals and coaches can directly refer clients to the StepOne Health portal and become part of the referral family. This will include discount rates on blood panels, referral fees for professionals, genomic testing profiles, and online coaching when needed. In my opinion, it is the single most important step in bringing wellness and fitness into today’s health care system as any single faction.

I recently had the opportunity to interview Dr. Brandman about the issues concerning healthcare. In his opinion, health and fitness professionals SHOULD be referring clients to blood work. The more clients know about how their fitness impacts their overall health status, the better. See the interviews with Dr. Brandman on my medhealthfit YouTube Channel here:

https://www.youtube.com/watch?v=NFco-TrQ_hw
https://www.youtube.com/watch?v=O7IFebUXpXU

Lastly – the profession of medically based exercise is steeped in our tradition of sports medicine. Allowing for blood lab data (under HIPPA guidelines of course) to steer the course of exercise programs makes for formidable outcomes measures and research. It will allow practitioners to absolutely have clear cut outcomes on the programs they are teaching and will only strengthen the association with medical practice groups, hospitals, and health plans, who are looking for the best opportunity to work with providers at the best possible pricing. It is a win for all parties – especially patients, who can see how exercise truly affects their health status.

For more information – log onto www.steponehealth.com and look over the web site.

For more information on the Blood Lab Wellness Specialist, visit medhealthfit.com/health-lab.


Eric Durak is a pioneer in the post rehab movement. He has worked in personal training, medical research, environmental health, and is the author of numerous industry certification courses, such as the Cancer Fit-CARE program / coaching program, Fitness Medicine, Wellness @ Home, The Insurance Reimbursement book for wellness professionals, and recently – the Blood Lab Wellness Specialist. See all of his programs at the medhealthfit.com web site.

References

http://www.forbes.com/sites/unitystoakes/2015/11/04/despite-clamor-surrounding-theranos-the-entrepreneurs-vision-of-transforming-diagnostics-is-near/

http://www.inc.com/magazine/201510/kimberly-weisul/the-longest-game.html

http://www.wsj.com/articles/theranos-is-subject-of-criminal-probe-by-u-s-1461019055

Electronic bathroom scale and glucometer with result of measurem

Going Beyond Diabetes Treatment: Exercise!

There are many treatments for Type II Diabetes (which will be referred to simply as diabetes in this article) but none come with the level of benefits seen by the implementation of a proper exercise program. This is a tall order but exercise is effective for the treatment of insulin resistance and diabetes in three areas. These areas are inflammation, the cell mitochondria (where the cell generates power), and hyperinsulinemia (high blood insulin).2 Treating these areas with exercise goes beyond the benefits of treating just diabetes. In turn, you will be helping prevent other health issues associated with diabetes such as heart disease, stroke, and circulation issues. The questions is how does exercise do this and what kind of exercise is necessary?1

To understand how exercise treats diabetes, it is important to understand that diabetes is the end result of insulin resistance. Insulin resistance can be illustrated in that: when we eat something with carbohydrates or sugar, our body breaks it down into blood sugar known as glucose. This glucose triggers a response from our pancreas to produce the hormone insulin. Insulin in turn shuttles the blood sugar into the cells to be used as energy. However, when someone becomes insulin resistant the cells do not respond to the insulin’s attempt to shuttle the blood sugar into the cell, so the pancreas produces more insulin to get the same job done. In essence, the cells are developing a tolerance to the insulin and in order to get the blood sugar absorbed the cells begin to require more and more insulin to do the same job. This leads to the blood retaining the blood sugar for prolonged periods of time as well as an elevated presence of insulin. When someone has prolonged high blood sugar, we call this hyperglycemia and the person is said to be diabetic. Having high blood sugar is dangerous due to the stress it places on cells. It can cause many problems up to and including death.

In the area of inflammation, it is known that not all inflammation is the same. Inflammation can be acute — meaning it is brought on for a short period of time — which happens with activities such as exercise or when tissue undergoes some sort of trauma. Inflammation can also be chronic, meaning it is persistent and recurrent.

Acute inflammation is necessary, and healthy, because it begins the healing and repair process by bringing in white blood cells, and ridding the tissue of damaged cells. Inflammation is required otherwise the body would be unable to heal.

Chronic inflammation can be found in many conditions, such as autoimmune diseases, prolonged injury/infection, obesity, diabetes and other chronic diseases. When inflammation remains present, even at a low level, it begins to damage the body’s cells. Science now knows that:2

  • Obesity creates a level of chronic inflammation.
  • Inflammation is the precursor to every chronic disease including heart disease, arthritis, and cancer.
  • Inflammation suppresses the insulin signaling pathway (how insulin and your cells communicate) which is believed to be related to a reduction of a heat shock protein, this protein however, can be increased through exercise.
    • Increases of the protein begin after the first session of exercise.3

You may remember from science class the power generator of the cell is the mitochondria. This is where the energy is created from fatty acids and glucose. It is now believed that when the mitochondria of the cell becomes dysfunctional, less fatty acids are taken in, elevating fat (lipids) in the blood, and increasing fat storage. It is also believed that the cell becomes dysfunctional as a result of insulin resistance. This relationship may then further feed into the increased body fat and increased inflammation. Further scientific studies in this area have determined that:

  • Proper exercise increases mitochondrial efficiency, proper exercise being summarized as:
    • No less than 150 minutes of moderate activity per week but ideally more than 250 (start light and increase intensity).
    • Incorporate a combination of resistance exercise (i.e. calisthenics and weights) and cardiovascular exercise.
    • Supervision by a registered clinical exercise physiologist if two or more chronic conditions are present is recommended.4
    • Exercising following an interval training protocol ranging from 70-90% of maximal heart rate may provide superior results if tolerable by participant.5
  • It is well known that aerobic training increases the number of mitochondria in muscle fibers in order to increase the delivery of oxygen to the muscle. More mitochondria means more energy that can be generated within the cell.

Hyperinsulinemia is best described as an elevated level of insulin relative to the amount of glucose (blood sugar) present in the blood. This may be the truest indicator of someone who is insulin resistant and about to become diabetic.6 In the beginning, it was illustrated how insulin resistance develops, and it being characterized as requiring more insulin to do the same job. This additional insulin is the definition of hyperinsulinemia. When someone has hyperinsulinemia it can be expected that in a matter of time, even higher levels of insulin will be required as the cell increases its tolerance to the insulin. Eventually the pancreas will not be able to produce the level of insulin required to lower blood sugar and the person will be said to have hyperglycemia, and will be classified as diabetic. When someone is experiencing hyperinsulinemia, they are already experiencing inflammation, and a weakening of the insulin signaling pathway (ways the cells communication for glucose uptake), and likely a dysfunction of the mitochondria, which in turn may magnify the issue further.

What is known is:

  • Exercise lowers glucose in the presence of insulin, and thus exercise will lower both glucose and insulin levels.
  • If you’re currently diabetic and taking insulin, the amount may likely need reduced prior to exercise.
  • Consistent proper exercise may lead to the need to have a physician re-evaluate dosage or usage of insulin and/or pills (i.e. metformin). Never discontinue use of a medicine without consulting with your physician.

Proper exercise not only goes beyond the treatment of diabetes to the treatment of the cause (insulin resistance), it helps prevent other health issues that stem from diabetes. Health issues such as cardiovascular disease, stroke, and issues with circulation dramatically decrease with exercise. Also, remember diabetes aside exercise reduces risk of nearly every chronic disease.1


Jeremy Kring holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com

References

  1. Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology, 2(2), 1143–1211. http://doi.org/10.1002/cphy.c110025
  2. Ye, J. (2013). Mechanisms of insulin resistance in obesity. Frontiers of Medicine, 7(1), 14–24. http://doi.org/10.1007/s11684-013-0262-6
  3. Matos, M. A. de, Ottone, V. de O., Duarte, T. C., Sampaio, P. F. da M., Costa, K. B., Fonseca, C. A., … Amorim, F. T. (2014). Exercise reduces cellular stress related to skeletal muscle insulin resistance. Cell Stress & Chaperones, 19(2), 263–270. http://doi.org/10.1007/s12192-013-0453-8
  4. Moore, G. E., Durstine, J.L., & Painter, P. (2016). ACSM’s exercise management for personals with chronic diseases and disabilities. Champaign, IL: Human Kinetics.
  5. Roberts, C. K., Hevener, A. L., & Barnard, R. J. (2013). Metabolic Syndrome and Insulin Resistance: Underlying Causes and Modification by Exercise Training. Comprehensive Physiology, 3(1), 1–58. http://doi.org/10.1002/cphy.c110062
  6. Paniagua, J. A. (2016). Nutrition, insulin resistance and dysfunctional adipose tissue determine the different components of metabolic syndrome. World Journal of Diabetes, 7(19), 483–514. http://doi.org/10.4239/wjd.v7.i19.483
Pregnant woman using exercise bike at the gym

Benefits of Low Impact Exercise During and After Pregnancy

Pregnancy can be a joyous time for women and it is also a period where the body experiences many significant changes. Since exercise can be beneficial to the mother in managing stress and staying healthy, it is important to for every pregnant woman to get clearance from their physician for both starting a new exercise program and/or maintaining her existing one.

Before becoming pregnant, I led a healthy and active lifestyle and continued to teach classes until I was ready to deliver. During the first trimester I had to change all strenuous workouts to low-impact workouts with lots of self-care such as taking frequent breaks to hydrate. This article can help women in all stages of pregnancy assess value of low-impact exercise during pregnancy and postpartum.

What is low impact exercise? Low impact (LI) basically means maintaining movement with one foot always on the floor. We do this when we are walking, doing yoga, dancing and strength training.1 Low impact exercises have several benefits such as maintaining healthier joints, weight and heart.

Benefits of Exercise During Pregnancy

A combination of low impact dance classes, strength training and stretching during pregnancy helped me maintain my sense of self and self-esteem as my body changed drastically both anatomically and physiologically. There are several documented benefits of exercise during pregnancy including: improved circulation, sleep, digestion, as well as muscle tone to support joints, increased energy and endurance; improved body image and self-esteem.2

ACOG recommends that pregnant women get at least 150 minutes of moderate-intensity aerobic activity weekly. Moderate intensity means that you are moving enough to raise your heart rate and sweat and you can talk normally, but you cannot sing.3 If you are new to exercise it might seem daunting to get a 20 minute work out every day, but you can start out slowly and gradually increase your activity. For example, you can start with 5 minutes a day and add 5 minutes each week until you can stay active for 20-30 minutes a day. If you were very active before pregnancy, you can continue doing the same workouts until the third trimester, when a logical reduction in activity is recommended.2

Regardless of fitness level, one commonality between pregnant women is the release of Relaxin, the hormone that is responsible for softening the ligaments and joints during pregnancy and childbirth. Having relaxin in the joints can lead to wobbly, unstable joints and a loose pelvis so women should take extra precaution while choosing or continuing a fitness regimen.4

­­­­­Examples of some exercises that you can do safely while you are pregnant are walking, water workouts, stationary bicycling, yoga and Pilates. Walking is a good option for many pregnant women because it is easy on the joints and muscles and it also gives a total body workout. If however you have low back pain you might consider wearing a pregnancy support belt and/or water workouts to reduce stress on the back. The water supports your weight so you avoid injury and muscle strain. For those who like bicycling and want to continue, stationary bicycling is a great alternative to avoid falls. Modified yoga and Pilates are great for reducing stress, improving flexibility, and focused breathing. Keep in mind that balance poses/exercises can be challenging due to a shift in the center of gravity caused by a growing belly, so it is okay to modify to accommodate this change. Pregnant women should also avoid poses that require them to be still or lie on their back for long periods.3

Benefits of Exercise After Pregnancy

The postpartum experience is different for every woman both emotionally and physically. My postpartum experience brought a mild-depression and weight-gain due to nursing (yes, many women gain weight during early nursing). Like many women, I waited 8 weeks before starting an exercise routine (most women are given a time period of 6-8 weeks for healing). Getting back to exercise helped me gain a sense of control over my body and helped cope with depressive episodes. According to ACOG, exercising after your baby is born may help improve mood and can help you lose the extra pounds that you may have gained during pregnancy.3 Additional benefits of exercise for postpartum women are that it helps strengthen abdominal muscles, can regulate energy level, can promote better sleep and relieve stress.3

Like the exercise guidelines during pregnancy, ACOG suggests that the duration of exercise for postpartum women, after physician approval, is at least 150 minutes of moderate-intensity. Working out after having a baby is different for every woman and it is a good idea to go at your own pace, listen to your body and gradually increase intensity. A key point to remember is that since relaxin can stay in the body for up to six months postpartum,4 it’s a good idea to choose a workout that is not too jerky in movement and stretching is controlled. Doing a good warm up prior to the workout and a good cool down after the workout are essential. ACOG suggests aiming to stay active for 20–30 minutes a day and trying simple postpartum exercises that help strengthen major muscle groups, including abdominal and back muscles. It is also a good idea to prepare for your workout by wearing clothing that will keep you cool and wear a high-support bra. Hydration is key, and it is okay to take water breaks as you need during your workout. For those mothers who are breastfeeding, it will be important for you to either nurse your baby or express your milk prior to working out to avoid the discomfort of engorged breasts.

Although the pregnancy and postpartum experience is different for every woman, and each stage of pregnancy brings unique challenges, maintaining a low-impact exercise program can be very helpful to the mother in managing stress and staying healthy.


Richa Jauhari is a fitness instructor, personal trainer and proud new mother based in Los Angeles. She has a passion for seeing individuals strive for their best and achieve their goals. Her personal weight loss experiences, pregnancy journey and working with senior populations have helped her understand the value of believing in oneself, balance, healthy eating and regular exercise. Visit her website at richajfit.wixsite.com/richaj

References

  1. Schwecherl, Laura. “21 Low-Impact Workouts That Are More Effective Than You Think.” Greatist. Greatist, 27 Mar. 2017. Web. 15 June 2017. <https://greatist.com/fitness/take-it-easy-21-unexpected-low-impact-workouts>.
  2. Yoke, Mary M., and Laura A. Gladwin. “Special Populations.” Personal Fitness Training: Theory & Practice. Sherman Oaks, CA: Aerobics and Fitness Association of America, 2010. 320. Print.
  3. “Women’s Health Care Physicians.” Exercise During Pregnancy – ACOG. The American College of Obstetricians & Gynecologists, May 2016. Web. 2 July 2017. <https://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy>.
  4. Flashenberg, Debra. “8 Steps to Easing Back into a Fitness Routine After Birth.” Fit Pregnancy and Baby. Fit Pregnancy and Baby, 03 Apr. 2017. Web. 10 May 2017. <https://www.fitpregnancy.com/exercise/postnatal-workouts/8-steps-easing-back-fitness-routine-after-birth>.
Personal Trainer, Gym, Pull Down Machine, Exercising, Assistance

Training the Older Adult Client – Part IV: Key Corrective Exercise Patterns for the Shoulders

Welcome to the 4th installment of this edition of Integrative Movement Insider™ (IMI) where we’ve been discussing a few of the key concepts and corrective exercise patterns we use when training our older clients.

In the previous video we discussed how to implement the foundational concepts of the Integrative Movement System Corrective Exercise Strategy™ – improve our clients’ awareness, pay attention to the small details, and help your clients earn-the-right – to help our older clients successfully work towards achieving their health and fitness goals.

In Video 1, we discussed one of our go-to corrective exercise patterns for improving glute function and hip mobility. In Video 2 of the series, I shared with you one of the key corrective exercise patterns we use to improve scapular stability and overall head and thorax alignment.

If you missed either video you can access those videos here: Video 1 and Video 2

In the third video of the series, I’ll share another one of our go-to corrective exercise patterns for improving overhead shoulder range of motion.

You can be the specialist your current – as well as potential – clients need, want, and will seek out to help them safely and effectively work towards accomplishing their health and fitness goals.

By helping our older clients become aware of the factors that are within their control and helping them become more aware of their posture and movement we empower them for success.

By paying attention to the simple things like alignment, breathing, and control we can help our older clients address many of the underlying issues that are leading to chronic tension, discomfort, and/or the loss of performance.

By helping our clients ‘earn-the-right’ by appropriately progressing their patterns we empower them to safely and effectively work towards achieving their health and fitness goals.

If you like this information and want to learn more about how to develop your confidence and expertise in working with older clients that have Chronic back tightness, Degenerative joint disease, or Spinal stenosis and other issues related to the trunk and spine, then consider joining us for our one-day events. We share these concepts in our one-day, intensive training – Corrective and Progressive Exercise for the Older Client: The Trunk and Spine-Level I.

You will leave this training with the tools and strategies you need to successfully work with and attract older clients. You won’t think the same about training this population after attending this workshop!


Dr. Evan Osar is the developer of the Integrative Movement Specialist™ certification designed specifically to aid the fitness professional establish themselves as an invaluable part of their client’s health care team. In addition to his chiropractic degree, Dr. Osar has earned national certifications through the American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), National Strength and Conditioning Association (NSCA), and The Soma Institute – National School for Clinical Massage Therapy. He is the founder of Fitness Education Seminars, an education company with the mission of helping trainers and therapist recognize their role as a part of the solution to the health care crisis.