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What Will You Leave Behind?

I can’t quite remember where I heard it, but somewhere I once heard someone say that their deepest desire in life is to not leave an ounce of potential behind when they’re gone.

It made me re-evaluate how I live in each major area of my life – health/fitness, relationships, business, finance, and much more. It still helps me focus on constant improvement in each area.

Also, it’s important to consider the legacy you will leave behind. Likewise, how do you want to be remembered?

If you get one body in this lifetime, do you want to give it the best care and the attention that it deserves? Or do you want to neglect it, to take it for granted?

I want you not only to leave an incredible legacy behind in every area of your life, but I also want you to feel the magic of tremendous self-care, much of which happens through fitness and the choices we make regarding our health every single day.

So, tell me, what do you want to be your full legacy? And how, specifically, do you want to care for this amazing human body you have?

In conclusion, are you giving your body the chance to live up to its full potential?

Originally printed on Move Well Fitness blog. Reprinted with permission.

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD. With almost two decades in the industry, he’s worked with a wide range of clients, including those with health challenges like diabetes, osteoporosis, multiple sclerosis, hypertension, coronary artery disease, lower back pain, pulmonary issues, and pregnancy. Maurice is also a fitness educator with Move Well Fit Academy and NASM.  

Surgery word cloud

Can I Avoid Surgery?

Did the title of this article capture your attention?  It should because surgery, no matter how big or small, is serious business. The type of surgery this article is speaking to is orthopedic surgery. This means surgery due to pain, disease, and dysfunction in your muscles, tendons, ligaments, bones, and joints.

Maybe you, or someone you care about, have been told that surgery is necessary.  You have done what the doctor suggested.  You tried Physical Therapy.  You went beyond that, and tried massage, acupuncture, chiropractic, drugs, and other alternative interventions. Why would avoiding a surgery even come into your mind? You are in pain, the doctor said you need it and that should be the end of the discussion right?

It’s a tough decision with uncertain consequences. Second and third opinions are recommended.

There might be several reasons why you want to avoid it; the thought of someone going in and “cutting you” (surgery is really a controlled injury), the risks associated with being put under anesthesia, the long recovery time and disruption to your life routine post surgery, you know someone that had surgery and months later are still not feeling much better, or they may be suffering complications from the surgery itself.

You have doubts.

Maybe you have read the recent research that concluded that a very common surgical procedure on knees actually showed more long term harm than good. (1)

Have you read the research that shows that there are many individuals with a diagnosable orthopedic disease that don’t report pain?  And there is research that shows that some report pain and nothing can be found wrong that directly explains the pain. (2) (3)

Maybe you will need the surgery. But is there one more conservative non-surgical alternative that you haven’t tried yet?

There is… Exercise.

But wait, you already did exercises at the physical therapy clinic. Even the chiropractor gave you some stretches and rubber bands to tug on and that didn’t work.

Here is the problem. All exercise is not created equal. What may work for one person doesn’t work for another.  Why is that?

Because every pain situation, just like people, is unique.

Pain is a word. When you choose to use the word pain to describe a sensation in your body you are clearly elevating the level of concern you have for the sensation.

Pain is not a thing like a brick, cat, glove, or car. Pain is the brain’s conclusion about all of the information it is receiving and processing from within the body moment-to-moment.

If you are considering surgery because you are experiencing a sensation that you choose to use the word pain to describe, then in a sense you are having surgery to remove the pain right? Which is weird because pain isn’t a thing to be removed, as it is simply a word chosen to describe a subjective conclusion based on bodily information. So a surgeon doesn’t remove pain with a scalpel, they remove the body part that they think is causing the pain. Sometimes this works great. Sometimes it doesn’t. See previous references.

What the surgeon is doing, what the drugs are doing, what the spinal manipulations are doing, are changing, or at least trying to change, the information that the body is producing to see if changing the information that way will lead to a new conclusion of the brain.

Change the information and possibly change the conclusion.

Back to the exercise thing.

What is exercise? It is stimulation to, and of, the body that changes the information within it. Sometimes those changes are short term and sometimes they can be of a longer term.

But you tried exercise in physical therapy and with the chiropractor and it didn’t help.

As stated earlier not all exercise is equal. Often exercises are just given to work on the area of the body that hurts. This might not be the best way to change the information. Exercise has very specific influences on the body depending on HOW you do it. The old adage “Just Do It” is painfully inaccurate advice. We need to know the quantity but also need to know the quality of your experience with different exercises.

Pain is a subjective experience that, at least right now, does not have an objective measurement like temperature, pressure, and distance. Your pain is totally unique to you and cannot be experienced by anyone else. Pain has a component of quality associated with it. It certainly can have a cause like when you break a bone, cut of your skin, tear a muscle, or sprain a ligament. But sometimes the cause is not so clear-cut.

So what am I proposing? What could be the thing that you haven’t tried yet?

A different approach. A totally different strategy. A more precise HOW.

I am talking about exercise that is highly catered and highly specific to your unique body.

Your body has its own unique history, a unique genetic profile, a unique combination of diseases and dysfunction, all of which confluence towards a unique problem. This requires a completely unique solution. A completely unique HOW.

This unique strategy and HOW is based on some simple concepts.

  1. All physical exercise uses the Muscular System in some form or another.
  2. The Muscular System receives and produces information form the nervous system.
  3. Muscles control you in three primary ways:
    • By contracting to maintain your joint positions,
    • By contracting to change your joint positions by lengthening,
    • By contracting to change your joint positions by shortening.
  4. Your body is a system that by definition means that all of the body parts are interconnected, interacting, and interdependent.
  5. A system’s control over information, and the stability of that information, can be assessed by perturbing it – by knocking it off course a bit – to see if it can make the necessary course corrections in order to stay in control.
  6. You should be the center of attention – not the exercise. You should not be made to conform to the exercise – the exercise should be made to conform to you.

If number 4 is true then it stands to reason that any part of your body’s information generation and processing can affect any other part’s information.  You may good at contraction shortening but are not so good at contraction lengthening.

If number 5 is true then a good way to see if you actually have control and assess the information control is my assessing your ability to do number 3.

Given the fact that your body is completely unique from any other body, this means that any strategy and HOW must be created to explore your unique information control system and any influences between parts. See number 6.

This is what Muscle System Specialists are trained to do. To systematically explore your information control by assessing your muscles’ ability to hold joint positions and change joint positions via lengthening or shortening contractions. This tells us about the quality of you information generation and processing.

The challenge is to find those places and conditions. You have roughly 600+ muscles and are capable of being in a dizzying array of positions and motions.

It’s okay – we have a process to explore your unique body’s abilities and start discovering the solutions it needs in order to change its control, to change the quality of information within it that just might lead to a change a reduction in pain.

Can you avoid surgery? Maybe. You have to decide if it’s worth some time and effort to exhaust conservative non-surgical options. Always speak with your doctors regarding this important decision.

Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms, and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

Charlie Rowe, CMSS joined Physicians Fitness in the fall of 2007 after spending 9 years as the Senior Personal Trainer at Oak Hill Country Club in Rochester, New York. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist since joining Physicians Fitness. Charlie has earned the Cooper Clinic’s Certified Personal Trainer, the NSCA’s Certified Strength and Conditioning Specialist, the American College of Sports Medicine Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and American Council on Exercise Certified Orthopedic Exercise Specialist Certifications. 


  • Thorlund, J., et al, Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms, BMJ 2015;350:h2747 doi: 10.1136/bmj.h2747
  • Ave Marie, L., Why Most People Are Wrong About Injuries and Pain – SimpliFaster Blog, 12/24/2018
  • Brinjikji, W., et al, Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations, Apr 2015 www.ajnr.org

Gait and Alignment

Many times when I run in Central Park, I see some elite runners. They look like gazelles. However, sometimes, I will see runners who have knees turned in, toes turned the opposite way, or simply just POUNDING on their feet.

When I teach Yoga, or even strength training, I advocate aligning the hip bone (asis joint) with the knee, and the 2nd toe.

i.e., Squats.

Often trainers will tell students to “bring their feet hip width apart” and perhaps, having read too many magazines with models who are super thin, they bring their feet so wide that they are BEYOND the alignment they could possible sit in or walk in. Imagine the MANSPREAD on the subway. Over time, if clients keep doing “squats” with their feet so beyond the width of their hips, it puts undo strain on the ACL, ankles, and causes many muscle imbalances.

In a squat, the goal is NOT to “go lower”.

A member once wrote a nasty comment via the gym website that “I didn’t go low enough” in my squat. What is “low enough”? If you are compromising form, or bending your back over more to make up for the fact that knees can only bend so much, then this is counterproductive.

When squatting, you should “crease” the hip joint (hip flexors) and imagine a chair being pulled out for you. Reach for the chair with your butt while bending your knees. The chest may tilt slightly forward, but the movement is NOT initiated by bending the upper body into forward flexion. Imagine if you were wearing all white, dry clean only clothing, and were carrying a tray of martinis (or red sauce). You would have a mess if you bent forward with your upper body. Therefore, keep your chest high, hold the platter high, and only angle forward as needed. This way all the work goes into the quads and glutes, and not into the back.

Exercise Samples (L to R): One leg step up; one leg dead lift; squat to one leg

Another drill I like to teach is a step-to 1 leg squat. Take a step to your right, balance on the right leg, and perform 1-3 squats. Then repeat by stepping left. To advance this, take a little hop, and then do 1-3 1 legged squats.

1 leg step ups (pictured above): place 1 foot on a bench laterally. The step should have 2 risers on each side if you are between 5’ and 5’4, and maybe 3 risers if you are above 5’6, and 4 risers if above 6’ tall. Press the weight into the foot that is on the bench and full stand up on this 1 leg. Then sit back down into the squat stance with both knees bent (one will be on the floor).

1 leg dead lifts  (pictured above): based on warrior 3: 1 leg is very straight without locking. Like a seesaw, pitch forward by lifting the free leg as high as it can go, but do not round the back, or drop the chest. I also look forward and keep my chest slightly lifted. Recover to upright by raising the gaze. Repeat 4-8 reps per leg.

Sit, stand, raise lower…this is a combination 1 leg squat into 1 leg deadlift (warrior 3). Repeat 4-8 reps.

Practicing 1 legged drills will make it so that when you perform drills such as squats on 2 legs, you will remember that if you were to take 1 leg off the ground, your stance/width should be based on this idea.

This will give you better form for running, and even walking.

The hip, knee, and 2nd toe should always REMAIN FRIENDS in every exercise for better alignment, and pain-free workouts.

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 new book, “Healthy Things You Can Do In Front of the TV” is now on sale on amazon.com, BN.com, and Kindle. Visit Kama’s website, bodyfriendlyoga.com, and kamalinden.com.


Step up to Better Balance

When we are young we take our balance and coordination for granted. Yet as we progress through the years sometimes our muscles get weaker and joints get tighter and our posture changes all contributing to decreases in balance skills.

Everybody knows to stay fit a person needs to engage in cardiovascular exercise, stretch what is tight and strengthening what is lax. But too often people miss an important aspect that is critical for functional fitness, which functional balance. The ability to maintain balance is a very complex skill that requires a vast array of systems to interact simultaneously.  Even the basic activity of walking involves a complex sequence of neurological and muscular interactions.

Functional Balance is critical for everyone from the world-class skier to the wounded warrior trying to regain his or her ability to walk again.  Functional balance is a combination of both static and dynamic balance.  These two parts of balance are critical for maintaining an independent and fully functional life!  It is easy to see how the loss of functional balance can inhibit even the simplest activities of daily living, to a person’s involvement in recreational sports.

Many common chronic conditions from arthritis to neurological issues can influence a person’s ability to maintain proper balance.  Some research published in the Archives of Physical Medicine and Rehabilitation 2015 discussed that person’s with Osteoarthritis and Rheumatoid had better mobility, and more stability after participation in a balance training program. Person’s with Ankylosing Spondylitis had improved quality of life after a seven months of balance training. Another study found that individuals with Fibromyalgia had less falls after 6 weeks of balance training.

What is balance? 

Balance is defined as “the ability to maintain the center of a mass over the base of support”.  This is evident even when you see rocks strategically placed on top of each other to produce sculptures.

Types of Balance

Static balance means remaining stationary in one place for a period of time. A common balance assessment to measure static balance is to stand on one foot for a period of time. A functional example of static balance is standing on your tiptoes while reaching for something without losing one’s balance

Dynamic balance is when the body is able to maintain in a state of balance while in motion or transition. Functional examples are being able to move effortlessly and gracefully from one place to the next at any given speed, or to be able to change direction quickly while still maintaining balance. Dynamic balance is critical for performance in most sports but is underappreciated until deficits set in sometimes seen in aging or in chronic health condition.

Extrinsic & Intrinsic Factors that Influence Balance

The occurrences of Chronic Conditions are often classified as “intrinsic” factors influencing the likely hood of diminished balance.  Many common chronic conditions from arthritis to neurological issues to sensory losses can impair balance.

Extrinsic Factors come in all shapes and sizes. Many extrinsic factors that contribute to falls are preventable. The following is a list of things that are commonly listed reasons people fall and visit the ER.  These can occur no matter what your age or fitness level.

Home Hazards

Loose carpets, slippery rugs, ill-fitted slippers, things left on the floor, clutter, reaching for objects, poor lighting, bathroom showers and tubs.

Outdoor Hazards

Wet/icy surfaces, uneven surfaces, hurrying, climbing ladders and wearing inappropriate shoes.

Effects of Medication

Many medications/drugs interfere with balance. Whether the medication is prescribed or is an over-the-counter medication it can still have a deleterious effect upon a person’s balance and coordination. Taking more than four medications increases a person’s risk of falling.  Also, it has been found that older clients (65yrs and over) cannot tolerate medications the same way a younger person can. It also goes without saying that alcohol; marijuana and other recreational drugs can impair balance and coordination.

Other Factors that Influence Stability

COG = center of gravity

Base of Support = the wider the base of support the better the stability of the person.

Friction = often called the glue/traction between the surface and the supporting platform.

Supporting systems = having enough strength to support the person. Thus the use of a cane, crutches and walkers are examples of aides to improve the supporting system.

More and more research supports the incorporation of balance training in a comprehensive fitness program.

Six Steps to Better Balance

  1. Avoid Disuse, which will cause atrophy. Use it or lose it! If flexibility and muscle development are not done on an on-going basis, the strength and flexibility will be lost! Maintain adequate strength and flexibility in joints and muscles.
  2. Keep core muscles firm.
  3. Maintain good lower leg and ankle strength and flexibility.
  4. Practice proper posture and head placement.
  5. If you suspect a deficient in the sensory, visual or neurological systems seek medical attention. No amount of balance training will help if a dysfunction exists.
  6. What you do today determines your tomorrows. Practice balance work daily. Some people practice while brushing their teeth or walking to work.

Balance Assessment

  • Stork Stand. Can the client stand on 1 leg for 30-60 seconds without wobbling all around?
  • Can the client get up and down from a chair in 30 seconds?
    • If under 40 years of age, over 15-20 times = good
    • If over 60 years of age, over 10-12 times = good
  • Sit to stand and walk 10 feet and turn around and return to your seat.


One thing is for sure when it comes to balance, change will occur! Diminishes in balance range from a simple embarrassing slip to a major fall leading hospitalization. It is up to the person whether the change is positive or negative.  The good news is balance can be maintained and often improved at any age or condition.  It is never too late to make positive contributions to better balance.

For more specific information and exercise protocols from Dr. Knopf, check out his book, Stability Workouts on the Balance Board

You can also read some of our other articles on the topic,  4 Exercises to Increase Balance for Seniors and Strategies to Improve Your Balance and Stability

Karl Knopf, Ed.D, was the Director of The Fitness Therapy Program at Foothill College for almost 40 years. He has worked in almost every aspect of the industry from personal trainer and therapist to consultant to major Universities such as Stanford, Univ. of North Carolina, and the Univ. of California well as the State of California and numerous professional organizations. Dr. Knopf was the President and Founder of Fitness Educators Of Older Adults for 15 years. Currently, he is the director of ISSA’s Fitness Therapy and Senior Fitness Programs and writer. Dr. Knopf has authored numerous articles, and written more than 17 books including topics on Water Exercise, Weights for 50 Plus to Fitness Therapy.

running legs

Advanced Running: Establishing the Mindset for Success

I took my first yoga class in more than a decade today and it wasn’t pretty. I was stiff, ungainly and awkward and had to literally fight the desire to stop! I found out my instincts were right about my body – it IS strong and fast but when it comes to balance and flexibility – and mind-body awareness – I am way behind the “8 ball”.

What I also learned today is that to continue to follow my program of the past 10 years as it is currently constructed would NOT benefit me in the long run. Injury and other issues WILL surface if I don’t respond to what I have discovered today so I will share some ideas and thoughts with you in this article that may help prevent you from making similar mistakes that I have made in my own running life.

Lessons from my first yoga class

I realized that being 66 the way I am today is truly a blessing – and a curse as well. My thoughts are forming about this new process I am entering and the impact it will have on me in the years ahead if I respond appropriately – and remain flexible and unafraid of the unknown. I can honestly say I felt WAY of out of my comfort zone today and that IS a good thing. I needed a “wake up call” and I got one loud and clear today. Whatever you do with this information on running and establishing the mindset of success and achievement, it will finally be defined and determined by how much – and how often – you step outside your comfort zones.

We ALL do what we love and avoid those things that make us uncomfortable in the end. Will I go back once a week – this next time with my daughter Lisa and share my discomfort with her support? YOU BET I will!. Remember I said earlier that I am a solitary soul and have run almost my entire life alone? Well, now I need to share this part of my journey with others who know more about this subject called balance and flexibility than I do. After all these years I have another long process to start and the challenge of discovering new things about myself that I knew would NOT be easy or comfortable to learn AT ALL!

The reality is my hamstrings and my lower back are REALLY tight and it will take me time to “undo” what I have done to them after all these years of hard training. I will need to remain committed to developing – and maintaining – my flexibility and balance in the years ahead for sure. What is in this for you? The knowledge that you MUST engage in balance and flexibility activities – either in a group or on your own if you are willing to do the work yourself. This will ensure injury is minimized as you engage your body in high intensity (sometimes of course) and challenging training to improve your fitness levels and enhance your quality of life.

What do I do about this now that I know more about my limitations?

The answer – or answers – to this important question will be given to me over time I am sure. What I am not sure of at this point is how I much work I must do on my own between classes to ensure my own development as a runner –and athlete. To be honest with you, I am a bit in shock about how poorly I performed in class today. The women kicked my butt for sure – but I am going to absorb this information and work on a plan of changing my approach to the training I will do this year. I set aside January of 2013 as a “month of recovery” because of the intense 2 year period I am just emerging from after setting records for mileage and speed. I also found out today how exhausted I am mentally and physically so these are the “red flags” I am now aware of at this particular time in my life.

What “red flags” are waving in your life and are you aware of their presence at all? I walked a mile on the treadmill at 3.5 after class today because that is all I could do. I was dismayed (to say the least) at how the yoga class had affected my legs! I will have NOW decided to “follow through” on my pledge to make January a TRUE recovery month – or I will PAY dearly in the months ahead for sure. This information I am sharing with you now is brand new to me. I am not 35 or 45 or 55 or even 65 now. I am 66 and finally am recognizing what limitations “feel like”. Your limitations will become apparent to you as you begin to train with more intensity and increased volume – just as they have for me. We cannot avoid paying a price for whatever we do – or don’t do – in our running and training lives.

I will continue running and lifting weights but now I will add additional stretching, flexibility and balance work at the end of each workout. I will attend one yoga class per week and run different programs at slower speeds to enhance my recovery period. Since I did not take recovery time during the last two years of my running life I will evaluate recovery periods more clearly when they are apparent to me and learn to add them when I need them. This is the “mindset of success” I am referring to in the title of this article. The REAL surprise to me is that after all these years of working out and running – and training clients on these principles as well – it is that I am still struggling to follow what I know NEEDS to be done – and WORKS ON MYSELF!


Take what I am sharing in this article and APPLY it to your own training. I am secure in the knowledge that as I continue to learn – and in some cases like today “re-learn” what I already know to be true – that we NEVER truly “KNOW IT”. We are continuously exploring territory in our lives – whether it be running or the yoga discipline – that we have never seen before. We know what we need to do if we accidentally “bump into new knowledge” but the unknown remains ever-present.

Today I merely learned what I suspected for a long time – that to run really fast and train with success – I (we) must never forget the basic principles of training: Remain open-minded, dedicated and committed to our purpose, passionate about what we do – and love, and finally BE WILLING TO CHANGE what needs to be changed in order to continue to be successful!

Tomorrow I will run slowly (force myself actually “for now”) and work on incline (hill stride) training in order to start working my legs differently than all the hundreds of runs I have done over the past 10 years! I will be patient and open to this next phase of my running life because now I KNOW I have to do this if I intend to NOT breakdown somewhere in the future! A little discomfort today will be well worth feeling in order to be GREAT tomorrow – and all the tomorrows that will hopefully still be coming my – and your — way as well!

Article reprinted with permission from Nicholas Prukop. 

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach and fitness professional with over 25 years of experience. His passion for health and fitness comes from his boyhood in Hawaii, where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.


Have a Fit Vacation with Fido

While most people picture their ideal vacation as lazing about on the beach getting roasted by the sun and sipping Mai Tais, you are not like most people. If you’re going to take time off and travel, you want to make the most of it and be active during your travels. A great way to stay motivated is to bring your dog along. When you travel with your pooch, the two of you can spend your time exploring cities on walks, traversing hike and bike trails, and generally being more active than your usual lazy vacationer.

Safety First

Whenever you travel with your dog, you want to remain safe at all times. While many dogs love trying new things, they can also be overwhelmed in unfamiliar situations. Always keep your dog on a leash unless you are in a designated off-leash park. To stay safe even when off-leash, be sure your pup has updated ID tags1 and that their microchip has your current contact information. Dogs shouldn’t go to public places without vaccinations and parasite prevention products, including heartworm medicine and flea/tick/mosquito repellant. If your dog gets in a scuffle with another pooch at the park, be careful not to get in between them; instead, work at distracting your dog to get out of the fray as soon as possible.

Enjoy the Open Road

If you’re going to bring your dog on vacation, keep the locale within driving distance. Airlines may technically be able to “ship” your dog to your destination, but the process of crating, drugging, and shipping your dog in an airplane’s cargo hold is traumatic2 for the little guy. In fact, the Humane Society strongly advises against animals traveling in cargo. Beyond the stress that it causes dogs, airlines also have a habit of losing — and sometimes killing — dogs. Instead of risking it, plan a trip within driving distance so you know your dog is in good hands.

A Lot of Personality

Dogs differ in personalities3 just like people do. While some dog owners know their pup would love a day touring microbreweries in the city by foot, others would feel anxious surrounded by all those strangers’ feet and the smell of alcohol. Keep your dog’s personality and how they respond to situations in mind when planning activities. For instance, don’t take a little dog with short legs on a 10-mile hike up a mountain. Or, if your dog isn’t big on water, don’t book an afternoon kayaking in hopes that this time he will get used to it. Remember: this is your dog’s vacation too — he wants to enjoy it just as much as you do.

Take a Breather

While a fun and active vacation is great, don’t over-exert your pup. Even the most high-energy breeds need to rest. Be sure wherever you’re staying is shaded and cool if outdoors or climate controlled if indoors. Always bring a supply4 of freshwater and a travel bowl that your dog is comfortable using. Whether hiking, biking, kayaking, or simply walking around the city, your dog needs frequent water breaks to stay hydrated and healthy. Finally, it’s okay to spend a little time apart — your dog doesn’t have to be the center of the social spotlight 100 percent of the time. If you are staying in a dog-friendly room and only plan to be gone for a couple hours, he should be fine hanging out there for the time being. If you want to take a little longer than a couple hours, look into a local doggie daycare5 or pet sitter that will watch your pup while you shop, go to a museum, or do whatever not-so-dog-friendly activity you want to do.

When you bring your dog on vacation, you can’t sit around and be lazy. Beyond the daily activity a dog needs, you have to be mentally alert and stay on top of their safety. Dogs generally shouldn’t fly — you’re going to want to plan a road trip for this excursion.  Keep your pup’s personality in mind, and don’t put him in a situation that will cause anxiety. Finally, find ways to take breaks so your dog doesn’t get too worn out by this vacation.

Henry Moore is the co-creator of FitWellTraveler. The site blends two of his favorite subjects (travel and health) to provide readers with information about how to get the most out of both.


1 Dog Park Safety Tips – Angie’s List
2 United Airlines had most animal deaths in 2017… – Market Watch
3 Dogs Have These 5 Major Personality Types – I Heart Dogs
4 Planning on Taking Your Dog on Your Next Vacation? – Whole Dog Journal
5 What’s the benefit of doggy daycare… – Mother Nature Network

Instructor Showing Health Results On Clipboard To Senior Couple

Respiratory Disease and Exercise: How to help your clients not suck at exercise!

According to the World Health Organization (WHO), hundreds of millions of people suffer every day from chronic respiratory diseases (CRD).  Currently in the United States, 24.6 million people have asthma1, 15.7 million people have chronic obstructive pulmonary disease (COPD)2 while greater than 50 million people have allergic rhinitis3 and other often-underdiagnosed chronic respiratory diseases.  Respiratory diseases do not discriminate and affect people of every race, sex, and age.  While most chronic respiratory diseases are manageable and some even preventable, this is what is known about the nature of chronic respiratory diseases4:

  • Chronic disease epidemics take decades to become fully established.
  • Chronic diseases often begin in childhood.
  • Because of their slow evolution and chronic nature, chronic diseases present opportunities for prevention.
  • Many different chronic diseases may occur in the same patient (e.g. chronic respiratory diseases, cardiovascular disease and cancer).
  • The treatment of chronic diseases demands a long-term and systematic approach.
  • Care for patients with chronic diseases should be an integral part of the activities of health services, alongside care for patients with acute and infectious diseases.

Exercise and CRD

If you are a health and fitness professional, some of your clients may be suffering from a chronic respiratory disease and you may be an important source for relief.  Moderate exercise is known to improve use of oxygen, energy levels, anxiety, stress and depression, sleep, self-esteem, cardiovascular fitness, muscle strength, and shortness of breath. While it might seem odd that exercise improves breathing when one is short of breath, exercising really does help one with respiratory disease.  Exercise helps the blood circulate and helps the heart send oxygen to the rest of the body.  Exercise also strengthens the respiratory muscles which can make it easier to breathe.

Beneficial Types of Exercise

There are several challenges to exercise prescription and physical activity participation in this population, but a large body of evidence demonstrates important health benefits from aerobic exercise.  Resistance training has also been shown to increase muscle mass and strength, enhancing individuals’ ability to perform tasks of daily living and improving health-related quality of life.5

Aerobic exercise is good for the heart and lungs and allows one to use oxygen more efficiently. Walking, biking, and swimming are great examples of aerobic exercise. The guidelines are approximately the same as generally healthy individuals.  One should attempt to train the cardiorespiratory system 3-5 days a week for 30 minutes per session.  One should exercise at an intensity level of 3-4 on the Rating of Perceived Exertion Scale (Scale Rating from 0 Nothing at All-10 Very, Very, Heavy).

Resistance exercise increases muscular strength including the respiratory muscles that assist in breathing.  Resistance training usually involves weights or resistance bands but using one’s own body weight works just as well depending on the severity of the symptoms.  It is recommended that one should perform high repetitions with low weight to fatigue the muscles.  This type of resistance training also improves muscular endurance important for those with CRD.  Resistance training should be performed 2-3 days a week working all major muscle groups.

Stretching exercises relax and improve one’s flexibility.  When stretching, one should practice slow and controlled breathing.  Not only does proper breathing help to deepen the stretch, but it also helps one to increase lung capacity.  One should gently stretch all major muscles to the point of mild discomfort while holding the stretch for 15 to 30 seconds, slowly breathing in and out. Repeat each stretch 2-3 times.  Stretching is an effective method to warming up and cooling down before and after workout sessions.

When exercising, it is important to remember to inhale in preparation of the movement and exhale on the exertion phase of the movement.  An individual should take slow deep breaths and pace him/herself.  It is recommended to purse the lips while exhaling.

Use of Medication

If an individual uses medication for the treatment of respiratory disease, he/she should continue to take the medication based on his/her doctor’s advice.  His/her doctor may adjust the dosage according to the physical activity demands.  For example, the doctor may adjust the flow rate of oxygen during exercise if one is using an oxygen tank.  In addition, one should have his/her inhaler on hand in case of a need due to the increase of oxygen demand during exercise.

Fitness professionals can effectively work with those who have a chronic respiratory disease providing them with a better quality of life through movement.  You as their health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness.

Expand your Education to Work More Effectively with these Clients!

Check out CarolAnn’s 4 hour course with PTontheNet, Respiratory Disease and ExerciseThe goal of this course is to educate health and fitness professionals on how to effectively implement exercise training techniques and work with clients that suffer from various respiratory diseases to help develop strength, flexibility, balance, breathing, and improve their quality of life.  Click here to learn more about the course.

Known as the trainers’ trainer, CarolAnn has become one of the country’s leading fitness educators, authors, and national presenters. Combining a Master’s degree in Exercise Science/Health Promotion with several fitness certifications/memberships such as FiTOUR, ACSM, ACE, AFAA, and LMI, she has been actively involved in the fitness industry for over 25 years. She is currently the Founder and Director of Education for Chiseled Faith, a Faith Based Health and Fitness Program for churches. Visit her website, www.CarolAnn.Fitness


  1. 2015. NHIS Data; Table 3-1. www.cdc.gov/asthma/nhis/2015/table3-1.htm
  2. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
  3. CDC, Gateway to Health Communication and Social Marketing Practice. Allergies. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Allergies.html
  4. World Health Organization http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf
  5. Eves ND, Davidson WJ. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Applied Physiology Nutrition and Metabolism. 2011;36(Suppl 1):S80–100. [PubMed]

Which exercise is most important for older adults?

As a kinesiologist who specializes in exercise programming for older adults, I am often asked which exercise is the most important to do regularly.

Well, you might not like my answer!  An older adult who wants to live an active and exciting life needs to be a “Jack Of All Trades” when it comes to exercise, making time for many different training techniques.  Here’s why:

As we get older, the aging process takes a toll on most physical functions, such as muscle strength and cardiovascular endurance.

A way to illustrate this is through “Aging Curves”. Look at this illustration (below) and see how function improves early in life as we grow and mature, then begins to decline during adulthood.  The amount of decline is not set in stone and is modified by our lifestyle choices.  Research has demonstrated that function declines more slowly in those who are physically active (red curve) and declines more rapidly in those who are sedentary (blue curve).  Without a doubt, staying active is the key to an active and exciting older adulthood!

However, there is no single exercise that benefits all parts of the body.  So, in order to keep any of our aging curves from plummeting to the disability threshold, we need to include exercises for cardiovascular fitness, muscular strength/power, flexibility, balance, and agility in our training programs. Or, put it in another way, we need to become a “Jack of All Trades”!

Are you a fitness professional interested in learning more on this topic? Check out Dr. Thompson’s 4 hour course with PTontheNet, Exercise Programming for Active Older Adults.

Christian Thompson, PhD is an Associate Professor in the Department of Kinesiology at the University of San Francisco and founder of Mobility Matters, an exercise assessment and program design platform designed to help fitness professionals and clinicians work with older adults. Christian has published scientific articles on exercise programming for older adults in peer-reviewed journals such as Medicine and Science in Sports and Exercise, Journal of Aging and Physical Activity, and Journal of Applied Research.


Stress Management in the Modern World

It’s exhausting being a human today – there are over one million Google hits per day for the word “stress”. Good and bad stress is a part of the human condition and it can be real or imagined and it is certainly a broad societal issue. By making a positive “next step” in managing your stress you can avoid becoming worn out by the journey of life.

Stress was first described in 1915 and the theory states that we react to threats with a general discharge of the sympathetic nervous system, priming the person for fighting or fleeing. Biologically, physical activity gives the body a chance to practice dealing with stress. Physical Activity releases mood-elevating endorphins, self-confidence and improves your sleep. Studies show that one can access the REM state (the most restorative phase of sleep) quicker on days you include physical activity. Under stress, our raised heart rate and blood pressure but tensions in our arteries and cause damage. Chronic stress which goes on longer than 20 minutes contributes to heart attacks just as acute stress does. It also causes constriction of the blood vessels, dilation of pupils, auditory exclusion and decline of peripheral vision. As the body heals this damage, artery walls scar and thicken which can reduce the supply of blood and oxygen to the heart (occluded arteries). Since the brain uses 20% of the oxygen delivered by the heart foggy-thinking may result. Stress can also cause the telomeres to shorten and erode. The telomeres protect the end of the chromosomes and if they shorten too much, they cannot multiply and die off resulting in quicker aging.

The President of the Salk Institute, Elizabeth Blackburn, and the recipient of the Nobel Prize states, “We’ve found that the better your telomeres are protected, the less chance you’ll have of getting any of the big diseases.” She suggests to stop the erosion, do physical activity of various types and don’t have long-term stress.

Begin to take charge of your thoughts, your emotions, your schedule, your spending, your environment and the way you deal with problems – especially family system challenges. Ask yourself, is it worth my health? Is this situation/person worth negatively impacting my health? Choose to be happy – it can boost your emotional well-being as stated in studies published in the Journal of Positive Psychology. Be mindful of good and hard-earned accomplishments and enjoy your small victories. Appreciate the simple pleasures, devote time to giving, make a point to listen to the other person’s ideas and UNPLUG! Ferris Bueller said – “Life moves pretty fast. If you don’t stop and look around once in awhile, you could miss it”.

Hamlet said, “There is nothing good or bad…but thinking makes it so.” Positive thinking is medicine and every thought can enhance or diminish our health, happiness and stress level. Dr. Robert Sapolsky of Stanford proposes in his book Why Zebras Don’t Get Ulcers, “If you are a normal mammal, stress is the three minutes of screaming terror in the jungle which either it is over with OR you’re over with. Perceived threats spark the same physiological survival responses (fight or flight) that crocodile attacks do.” Our modern-day stressors have changed. Fighting off prehistoric predators and trying to find food are replaced by juggling deadlines, multitasking and always being “connected” and available. Modern day saber tooth tigers are bills, traffic, family pressures but our bodies react the same way without the natural release that we would get from fighting or fleeing. Try not to turn to sugar and caffeine which can result in swings in blood sugar levels, limit alcohol to one drink per day and try to achieve a balanced, clean diet on most days of the week to even out your beautiful life.

The United States Government has suggested 150 minutes per week of physical activity in addition to two days per week of strength training for 20 minutes and stretching every day. There are many meditation, relaxation response and calming apps which you can download to have with you and use when you are having a challenge with managing stress. Sit and stand tall and do not “slump” as this can cause shallow chest breathing which can trigger the fight or flight response. Try not to make important decisions while under undue stress as this may result in poor or faulty decisions.

A 2016 study by the American College of Sports Medicine stated if workers do not have emotional resilience skills and habits to help support them during stressful times, their productivity declines. Work-related requirements such as precision and accuracy, problem solving, interpersonal communications as well as speed and quality of work output will suffer. We  need to adjust to change without disruption or difficulty while maintaining good functional capacities. We need to bounce back without breaking and without giving in, giving up or breaking down. Stress Management is an integral component of Global Employee Health and Fitness Month (every May) healthandfitnessmonth.org and as the Architect of this initiative I felt passionately about including this component along with nutrition and physical activity, to give each and every worker the opportunity to go home “whole.”

Each and every day when confronted with stress, think about what advice you would give to a friend and then take this advice yourself!

Diane Hart, Owner of Hart to Heart Fitness, (www.harttoheartfitness.org) is a Nationally Certified Fitness Professional, Personal Trainer, Health Educator and is current President of the National Association for Health and Fitness (www.physicalfitness.org) founded in 1979 by the U.S. President’s Council on Sports and Fitness.