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The Pharmacologics of Exercise: Yes, Exercise Is Medicine!

It’s been said: “If all the benefits of exercise could be placed in a single pill, it would be the most widely prescribed medication in the world.” Scientific evidence continues to mount supporting the numerous medicinal benefits of exercise. In fact, there’s hardly a disease that I can think of that exercise won’t help in one way or another, be it prevention, treatment, or even cure in some instances.

lightbulb thought

Don’t Practice Positive Thinking… Practice POWER THINKING

In his book, Secrets of the Millionaire Mind, T. Harv Eker talks about positive thinking vs. power thinking.

Positive thinking is our default when we want to improve an area of our lives. We journal, recite affirmations, and work to build our positive thoughts. What Eker points out is that positive thinking implies that we accept our own thoughts as truth.

Instead, he suggests focusing on power thinking, which is an extension of positive thinking in that you are working to build your belief, but instead, you acknowledge that things only have meaning because we give them meaning.

You can attach a particular meaning to anything but that doesn’t mean it’s real.

For example, just because you’ve fallen off the wagon in your fitness and nutrition dozens of times doesn’t mean that you’re incapable of success.

Secondly, just because you’ve missed a few workouts last week doesn’t mean that your entire plan to lose weight has been destroyed.

But that’s the meaning most people give it right? In other words, we tend to be ultra hard on ourselves which ends up being sabotaging.

I bring this concept up in the hopes that the next time a situation arises where you feel “less than” or defeated that you stop and ask yourself “what meaning am I giving to this situation?”

By understanding this, you then have the power to change the meaning you assign for the better and propel yourself to new levels of commitment and success.

In conclusion, don’t practice positive thinking. Practice POWER THINKING!

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.  

Exercise: A Must for Both MS Patients to Partake In and Healthcare Providers to Promote

Exercise is an essential component of the Multiple Sclerosis patient’s treatment plan. Unfortunately, until the 1990s, exercise was highly regarded as contraindicated to MS patients. In 1993, the first medicine was approved by the FDA for MS and in 1996; the first research showing the benefits of exercise was published by the University of Utah. These were two major breakthroughs which have given hope to a population consisting of the most common disabling neurological disease of young adults (most common onset between ages 20 and 50).

Multiple Sclerosis is a neuroinflammatory autoimmune disease of the central nervous system (CNS), consisting of the brain, spinal cord and optic nerve.  The immune system attacks the myelin sheath of the nerves which insulates, protects as well as affects the signal speed from the CNS to the affected body part. Presentation of initial symptom of MS include optic nerve inflammation, poor balance (ataxia), dizziness (vertigo), weakness, double vision (diplopia), bladder/bowel dysfunction, pain, sensory loss, cognitive impairment, fatigue (most common) and a host of others including but not limited to gait impairment, depression,  tremors, thermoregulatory dysfunction (autonomic) and spasticity. Because many symptoms are invisible (not outwardly visible), most notably fatigue, pain and cognitive impairment, they can affect confidence, relationships, and discourage patients from seeking treatment or help.

Currently, with more than 16 FDA approved disease modifying treatments, as well as exercise being greatly encouraged by health care providers treating MS, the face of MS is changing for the better. While exercise will not change the course of the disease progression, both aerobic and anaerobic conditioning have greatly helped reduce secondary and tertiary symptoms such as falls, injuries, anxiety/depression, impaired activities of daily living (secondary) and increase self-esteem, and independence while reducing social isolation and family disruption (tertiary).

The benefits of a safe, progressive/adaptive exercise program are improved overall fitness, ability to perform activities of daily living, moods, sense of well-being, strength while decreasing spasticity, fatigue and may prevent a host of co-morbidities. Because MS patients may be less mobile and underweight/overweight, coupled with the possibility of side effects from the use of corticosteroids, it increases the likelihood of developing conditions such as osteoporosis and diabetes mellitus. This is an even a greater reason those affected with MS should work with professionals who understand the disease.

Although many patients are still hesitant to begin an exercise program because of fear of exacerbating their condition, lack of confidence or inability to find professionals skilled to work with them, now is the best time in the history of MS treatment for both patients and professionals to be on the same page. Exercise no longer has to be an activity of an MS patient’s past. It is simply a must of the present and future.

Jeffrey Segal, owner and chief operator of Balanced Personal Training, Inc., since 2004 is a personal trainer, motivational speaker and educator who has been working in the fitness industry for over 20 years. 

At the age of 25, Jeff was diagnosed with Multiple Sclerosis. He was told fitness was not going to be part of his future as an activity. Within a couple of years, Jeff was unable to walk, was visually impaired and barely able to speak.  Rather than succumb to his prognosis, he fought for the life he once knew while burying his head in research. Within a year, not only could he walk, see and speak but he used his knowledge, skills and abilities to physically train others in both sickness and in health with an emphasis on Multiple Sclerosis patients. 

Senior Man On Cross Trainer In Gym

Exercise and Wellness and Their Role in Injury Reduction and Prevention

For many exercise professionals, the goal of training and educating clients is to improve health, increase strength and performance, and improve fitness parameters. The concept of reducing injuries may not be high on their radar screens.

Active seniorsHowever, in American business, the aspect of doing anything that will reduce injuries (and health insurance costs) is of utmost importance. So much so that many businesses, universities, and manufacturing companies are hiring wellness professionals as part of their efforts to reduce heath care costs.

One aspect of providing a wellness program to companies is to define your services. Will you be performing ergonomic analysis?
Is a comprehensive stretching program part of your offerings?
Will employees be able to train in a health club environment?
Will there be any post-rehab therapy services available?

Many wellness programs segregate their services from ergonomics – which is a certified practitioner who may perform intrinsic (body mechanics), or extrinsic ergonomics (fitting proper equipment to the employee). Wellness programs are also not athletic training or rehabilitation, but may incorporate some of the elements of each of these disciplines.

Wellness services concentrate on sound basic exercise, stress management, aerobic conditioning (walking/machines), massage therapy, weight management, smoking cessation, and general health services (coaching, phone follow ups, etc.).

Perhaps the most important aspect of wellness programs (other than great instruction) is defining outcomes. HOW will employees lose weight? Will gaining core strength reduce total lost days? Can stretching and balancing programs reduce total medical payments for low back pain?

Outcomes will make a program successful. Results from university programs show that regular exercise programs may reduce back pain levels by up to 50%. Workers who have less pain won’t mind coming into the office more often. These same programs help reduce total low back injuries (many by over 75%).  Most importantly – these programs save money. From the Steelcase programs in the mid-1980s to programs today – people who are actively engaged in regular exercise, range of motion, massage therapy (chair massage), core training, balance training, nutritional intervention, relaxation training, smoking cessation, and regular health monitoring (body weight, body fat, blood pressure, specific blood lab values) improve health, reduce health risks, and save appreciable dollars over companies that do not provide these services. It is not uncommon for the return on investment to be higher than 4:1. This is remarkable considering most wellness programs have a modest budget.

Speaking of a modest budget – many wellness programs can be done well even if inexpensively. For a staff of 200 employees – approximately $2,500-3,000 can be spent on fitness balls, rubber tubing, dumb bells, stretch mats, and flyers can suffice to produce good results. Other equipment that may be used would include relaxation CDs, or a machine called Resp E Rate, which is a biofeedback unit that works to reduce heart rate through specific music programming. TENS units and chair massage may be used for pain management. Although these modalities are usually found in a PT office, they can be used anywhere where staff experience chronic pain levels that are not threatening.

Doctor showing a woman a part of a spineThe power of the wellness practitioner may also be the power to refer. When an employee experiences high levels of pain, depression or anxiety, or an injury or condition (blood pressure) that will not normalize – they need to be referred to medical personnel. It’s actually a great feeling to have a network of providers that can assist in bringing an employee to a more healthful and productive place in their work status.

In closing – the field of injury reduction and prevention is one of the fastest growing areas of health promotion – and should be investigated thoroughly. Some resources below may give wellness instructors some insight into the area of injuries, safety, and certifications. Remember, too that employers in private sectors companies may pay well for services that save them money. This is yet another reason to look into this interesting and challenging health promotion field of the future.

Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

Resources: www.resperate.com; www.stretchwell.com


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.