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midlife-woman-lifting

Keys to Empowering Women in the Weight Room, Part 2

In Part 1, I reviewed the ACSM study goals, statistics and barriers to weightlifting unique to women

In this article, I’ll cover the three E’s for empowering women in the weight room, and translate these recommendations into strategies that non-professionals can implement for themselves.

1. ENVIRONMENT

Understanding how physical attributes of gyms perpetuate negative messaging regarding women’s bodies and harmful myths about women’s fitness.

  • Body image as the sole motivator for exercise with full-length mirrors and posters presenting unrealistic expectations for women’s bodies.
  • Insufficient equipment and scaling options.
  • An overwhelming male presence and masculine perceptions that can complicate women’s relationship with the gym environment and diminish their confidence to participate.

Overcoming these barriers:

  • When considering an environment that is the best fit for you, avoid those spaces with attributes that make you feel uncomfortable. You may prefer a gym with more limited mirror space, and that has a more balanced male/female demographic and female trainers. An example of a more supportive environment is a typical CrossFit “box” where the male-to-female demographic is often split and you will rarely find a mirror.
  • Consider a female-only gym space.
  • Consider group weightlifting classes. As a former BodyPump instructor, I can vouch for this program as a fantastic way for any beginner to gain confidence with weights and develop a base of sound movement patterns.
  • One-on-one training is an excellent way to get personalized instruction on safe weightlifting technique and individualized goal-setting to gain confidence in the basics of weightlifting.

2. EXPERIENCE

People will often gravitate toward their comfort zones and do exercise routines that are more familiar and that are easy to execute.

  • Unrealistic expectations for results and timelines to achieve them.
  • “Weightlifting is hard.
  • Fear of injury or “being sore”.
  • “I don’t want to exercise by myself.”
  • “I don’t have time to lift weights.”

Overcoming these barriers:

  • Focusing on realistic goals of improvements in strength, movement quality, well-being, and specifically for mid-life women, maintenance of bone density and muscle mass to prevent fractures and maintain a healthy metabolism and glucose control.
  • Working with a Coach or Trainer to create a personalized program design and dispelling the misconceptions that one needs to spend many hours per week and be sore after every workout to achieve benefits.
  • Effective workouts can be achieved in as little as 10-20 minutes provided that the sets, repetitions, and rest periods are programmed accordingly.
  • Seek out gym environments that promote small-group weightlifting classes and allow members to bring a guest.

3. EDUCATION

Knowledge is power. Promoting an understanding of the principles of weightlifting and its benefits is key to debunking myths and misconceptions and building a healthy relationship with the barbell.

Common myths and misconceptions about weightlifting:

  • Resistance training is less beneficial than cardiovascular exercise.
  • Weight training is “dangerous” for women.
  • I need to spend hours in the gym to see any benefits.
  • Resistance training is not optimal for fat burning.

Overcoming these barriers:

  • Seek out opportunities to work one-on-one with experienced trainers who have experience with resistance training in female clients of all ages.
  • Take a personal “inventory” of what is most important for you to feel comfortable incorporating weight training into your fitness program and your specific goals. Do you prefer one-on-one instruction? Do you prefer a women-only environment? Is a group setting important to you? Do you have injuries or physical limitations that need to be considered?
  • Advocate for yourself. Once you have an idea of what is important for you to succeed, don’t be afraid to ask questions when visiting a facility.
  • Do your homework. Read reviews of a facility before you join. Talk to other members. Review the credentials and experiences of the Coaches who work at the facility.
  • Seek out reliable sources of information about the benefits of weight training for women as well as safe and effective approaches to the barbell for any level of experience. Here are some of my go-to’s for reliable information:

This is the time of our lives when we need to kick the societal status quo to the curb and take our health and wellness into our own hands and away from destructive narratives. The world is our oyster. We have established our careers, raised our children, and had our share of triumphs and failures. With that comes the wisdom to pave our own way into this new prime of our lives.

So, whether it’s your first back squat with a PVC pipe or a deadlift PR (personal record), congratulations on forging a new frontier to being your fittest, strongest, most vital self!


Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School. She is a North American Meno

Fit Pros: Offer menopausal and perimenopausal women an individualized approach to training, nutrition and wellness as a Menopause Health and Fitness Specialist.

References

  • Ford, C, Kercher VM, Kercher KA; The 3 E’s – Keys to Empowering Women in the Weight Room. ACSM’s Health & Fitness Journal 27(3):p 14-19, 5/6 2023.
  • Harne AJ and Bixby WR. The benefits of and barriers to resistance training among college-age women. Journal of Sport Behavior 19(2):151-66, 2005
woman lifting crossfit-534615_1280

Keys to Empowering Women in the Weight Room, Part 1

The hormonal changes of mid-life bring our muscle and bone mass under assault. As circulating estrogen declines and estrogen receptors in skeletal muscle become scarcer, changes in bone density, muscle mass, and metabolism become apparent.

Shoulder to shoulder with the importance of cardiovascular health, optimizing our muscle and bone health helps stave off decline in bone density which can lead to fracture, and can help mitigate the increasing insulin resistance that wreaks havoc on our changing metabolism.

To coin a phrase from Dr. Stacy Sims, there is a great benefit to women in this stage of life (and all stages of life) who “Lift heavy sh*t”. Now, if you have never lifted weights, this can sound intimidating. But don’t worry. You are not alone.

Historically, there have been many barriers to women in the weight room. Training environments where achieving a certain body image is the focus rather than building strength, healthy movement patterns, and improving body composition can be unmotivating and intimidating. The stigma of weightlifting as “masculine” or that it “makes you bulky” and the misconceptions that weightlifting is not beneficial for women are also among the many obstacles that women of all ages face.

In the May/June issue of ACSM Health and Fitness Journal, Claire Ford et al. do an excellent job of defining the obstacles that women face in the weight room and have created a framework called “The 3 E’s” that outlines strategies to overcome these barriers. I’ll take the summary points from this article and translate them into practical solutions for women and fitness professionals to empower themselves in the world of weightlifting.

The 3 E’s – Keys to Empowering Women in the Weight Room

Ford, C, Kercher VM, Kercher KA; ACSM’s Health & Fitness Journal 27(3):p 14-19, 5/6 2023.

Goal of the study

Use a socioecological model to provide insight into the nature of women’s unique experiences with weightlifting and describe a practical approach for empowering women in this environment.

Some statistics

Just 2 days per week of resistance training can reap physical, mental, and emotional health benefits.

Only 25% of the US population meets these recommendations.

17.5% of women engage in weightlifting on a regular basis

Benefits of Weightlifting

  • Improves body composition.
  • Helps prevent bone loss.
  • Maintenance of healthy metabolism.
  • Maintenance of quality movements over the lifespan.
  • Promotes emotional well-being and self-concept.

Barriers to weightlifting unique to women

The notion that women face unique barriers to weightlifting has been a subject of investigation. Harne and Bixby organized these barriers into the following 3 categories:

Time / effort

  • “I don’t want to get bulky”.
  • ”I’m afraid I’ll hurt myself”.
  • “I don’t want to be sore”.
  • “I’m in terrible shape”.

Physical Effect

  • “I don’t have time to lift weights”
  • “It’s too hard”
  • “It’s easier to hop on the treadmill”
  • “I’m overwhelmed at the gym

Social

  • “I don’t have anyone to go to the gym with”
  • “Isn’t weightlifting better for men?”
  • “I like the group classes because my friends can come with me”
  • “There are too many men. I feel like I don’t belong”

The 3 E’s: A framework through which we can understand and address women’s barriers to weightlifting

After identifying and categorizing these unique barriers to weightlifting that women face, the authors created a framework upon which to overcome these barriers. This framework is called “The 3 E’s”.

This ACSM article speaks to an audience of fitness professionals and how the fitness industry can work to overcome these barriers.

In Part 2 of this article, I take this a step further and translate these recommendations for fitness professionals into strategies that non-professionals can implement for themselves.


Fit Pros: Offer menopausal and perimenopausal women an individualized approach to training, nutrition and wellness as a Menopause Health and Fitness Specialist.

Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School. She is a North American Menopause Society (NAMS) Certified Menopause Practitioner and has been featured in multiple podcasts and speakerships at various events discussing the physiology of the hormonal changes of menopause, hormone therapy and functional fitness training.

References

  • Ford, C, Kercher VM, Kercher KA; The 3 E’s – Keys to Empowering Women in the Weight Room. ACSM’s Health & Fitness Journal 27(3):p 14-19, 5/6 2023.
  • Harne AJ and Bixby WR. The benefits of and barriers to resistance training among college-age women. Journal of Sport Behavior 19(2):151-66, 2005
weight lifting barbel

Lift Ugly!

The title of this article is a quote from UK physiotherapist Adam Meakins. The context is that one does not need to exhibit or use “proper exercise technique” constantly throughout daily life or even during physical rehabilitation for pain or injury.

Now, this at first sounds counterintuitive to what the majority of fitness professionals and even physical therapists are taught and believe. The mantra of “poor exercise technique leads to injury” has been spouted for decades… but there is absolutely no proof of this in medical and fitness-related academic research.

Yep, your absolute most favorite go-to coaching point as a FitPro is pretty much bunk. So, do we throw the baby out with the bathwater and let our clients lift just however they please? No, not exactly, context is king.

If you are working with an athlete, which includes body builders, stricter exercise technique is beneficial to a high degree (esp. with physique athletes who require symmetry and maximal muscle development) but real-life sport doesn’t look anything like the gym when it comes to movements. Some variation in technique is beneficial as it will expose the athlete to forces in various, and more realistic fashions that provide greater benefits on the sport field or ring.

If you are working with general population, mostly healthy clients, “proper” exercise technique should honestly not be force fed initially, as this can be both physically uncomfortable for the client as well as demotivating if they’re “still not able to keep the back flat on a deadlift.” Find whatever movement pattern is natural for them and coach from there.

I used to be a hardcore stickler for technique, now, not so much. Instead, I coach my patients to lift in a manner that “feels stable, safe, and powerful” for THEM. The result? Better client engagement, better client results, and far less stress on them and yourself during the coaching session.

Now what about medical fitness and physical therapy? While strict joint actions may be required during some phases of physical rehabilitation or other therapy, we must consider how a client naturally and instinctively moves and wants to move. We need to understand any fear-avoidance behaviors they might have developed previously, and we certainly want to know their beliefs about physical activity.

So, if “improper” exercise technique isn’t to blame for gym and sport injuries, then what is?

We don’t have a firm answer, but we can say with a high degree of certainty that it’s a combination of physical and mental stress, distractions, nutritional state, hydration, focus in the moment, and how well prepared the individual is for that movement they are about to engage in. Simply not getting a good night’s sleep before deadlifting the next day can potentiate an injury, but that’s not a guarantee either. Load management and recovery are far more important when it comes to injury prevention than anything else, and this is why you should be writing and logging client training plans and sessions and not winging it. Otherwise, you have no historical record with which to troubleshoot things with which will only frustrate you and your client.

I sincerely hope that I have ruffled some feathers and also have given you some food for thought. There’s a time and place for everything, including strict exercise technique, it just takes some insight and thought to determine if “this” is the appropriate context.


Reprinted with permission from the Move Well, Live Well blog.

Joshua Slone is an Exercise Physiologist and Pain Therapist. He serves as Rehab Team Lead/Physiologist at the Center for Health in Yucca Valley, CA. His clinical expertise includes chronic pain management, joint replacements, sport and orthopedic injuries, complex medical condition management, geriatrics, degenerative neurological conditions, and psychiatric disorders. Visit his website, movewelllivewell.org

emily-s-article

Biohacking Your Body with Barefoot Science

We are all on the eternal hunt to looking good, moving well and feeling young – however as responsibilities (job, school, family, friends) increase the time allocated to health and fitness often decreases. Surprisingly we expect the same results with less time in the gym but is this really even possible?

Perhaps it is.

Enter…..biohacking!

What is biohacking?

Biohacking, as the name suggests, is “hacking” or finding a way to more efficiently manipulate human biology. This can include areas of sleep, nutrition, mental health, strength, recovery.

If you are new the concept of biohacking – please think of this as a positive thing! Don’t get wrapped up thinking it is a mad scientist in his garage implanting computer chips into his own body.

Think of biohacking as a empowering concept which allows one to enhance or improve the efficiency of different aspect of health. It means taking ownership of your body and the aging system.

Can biohacking apply to fitness?

Absolutely!

In the case of fitness some examples of biohacking include drinking caffeine to give you energy during a workout. Or taking branch chain amino acids after a workout to enhance muscle repair and hypertrophy. Or using kinesiology tape to enhance proprioceptive stimulation and muscle activation.

Seems less mad scientist-y doesn’t it?

One area of biohacking that I am particularly a fan of is the application of barefoot science to improve your workout. As I mentioned at the start of this blog the one thing we never have enough of is TIME.

By integrating barefoot training into your workout you will hack your way into a more efficient workout allowing you to achieve faster fitness goals. Below are my top 4 biohacks integrating barefoot science.

Biohack #1 – Barefoot release to improve your balance

Next time you hit the gym start your workout start with just 5 minutes of trigger point footrelease the bottom of the foot. A 2015 study showed that 5 minutes of manual trigger point release was associated with an immediate improvement in single leg stability and postural control.

Since having someone do the trigger point release isn’t efficient we’ll instead use RAD Rounds by RAD Roller. These small rounds of different sizes can be used to apply pressure to different intrinsic muscles of the foot. I recommend 5 minutes in the morning, evening and before exercise.

View video below

Biohack #2 – Barefoot whole body vibration to enhance micro-circulation and tendon strength

In the world of proprioception whole body vibration is one of the most efficient ways to stimulate the nervous system. Since our foot is also the gateway to proprioceptive stimulation I recommend doing your WBV activation barefoot and using PowerPlate which is a multi-planar harmonic vibration platform.

A 2007 study by Lohman showed that just 3min of WBV at 30Hz enhanced skin, nerve and tendon micro-circulation resulting in enhanced tendon tensile strength and decreased arterial stiffness. All of which is a very powerful response before any workout.

Learn more about WBV and PowerPlate at powerplate.com

To learn more on this topic you can view the following webinar below:

Biohack #3 – Improve your core strength with barefoot foot to core sequencing

The core. The center of stability and the center of power. When it comes to any dynamic movement or exercise – core strength and stability are critical to the way force is generated or transferred through the human body.

The foot. The base of stability and only contact point between the body and the ground. Studies have shown that it is more efficient to strengthen the core via the foot in what EBFA calls “foot to core sequencing”. The access into foot to core sequencing is via an exercise called short foot.

To learn more about short foot and how to integrate it with exercises please see below:

Biohack #4 – Improve your balance with small nerve proprioception

Postural control and dynamic stability require the integration of four input systems – visual, vestibular, joint proprioceptors and plantar foot skin. Of these four one of the most important but often overlooked systems is the skin on the bottom of the foot.

The skin on the bottom of the foot contains thousands of small nerve proprioceptors all of which are sensitive to different stimuli. One of the most important stimuli coming into the foot is vibration (see WBV above). We use vibration not only to know how hard our foot is striking the ground but also in the maintenance of dynamic balance.

As soon as we put on our shoes our nervous system inherently becomes slower. This delayed neuro stimulation of the foot is small or micro which means it is hard to detect by the average client or patient – however it is happening. Accumulatively this results in micro-trauma and micro-compensation.

To biohack your nervous system whenever you are barefoot training integrate small nerve plantar stimulation with Naboso Technology. Whenever performing barefoot exercises such as short foot or any foot to core sequencing this is the perfect opportunity to pull out your Naboso Barefoot Training Mat.

If you want to bring this stimulation to your shoes, Naboso Technology also makes small nerve proprioceptive insoles which have been shown to improve postural control and stability


Dr. Emily Splichal, Podiatrist and Human Movement Specialist, has dedicated her medical career towards studying postural alignment and human movement as it relates to foot function and barefoot training. She is the Founder of the Evidence Based Fitness Academy, offering continuing education with a focus on foot fitness and barefoot training. Courses included Barefoot Training Specialist®, Barefoot Rehab Specialist® and BARE® Workout Certifications for health and wellness professionals.

Originally printed on the Barefoot Strong Blog. Reprinted with permission from Dr. Splichal.

weights-water

Taking it Slow. Not Every Fitness Goal Needs to Be Fast and Hard.

Go big or go home? We all want to see fantastic results from our hard work and dedication to any fitness program. If we maintain nutrition, eat well and work as hard as we can, we are going to see results: that is inevitable. But, do we have to train as hard as possible each and every time we workout, each and every day? Sure, we fit in a rest day, but what else can we do to make sure we are restoring our bodies and minds?

Fitness goals are most easily reached when they are part of every aspect of our lifestyle and not compartmentalized into a few hours of the day. We have limited energy sources no matter how healthy we are, so it is important to maintain awareness about how each of our decisions & actions influence our wellness and choose accordingly.

From a physical aspect, we can slow down some of our workouts to build strength. This works in a variety of ways. By increasing resistance, continuing muscle exertion over a period of time and working muscles beyond the support of initial momentum, strength can be gained, even with relatively light weights or by using the weight of the body alone. This can be true of some weight training programs and is something you can discuss adding to your fitness routines with a certified personal trainer. It is also one of the key elements of building strength through yoga practice and asanas (yoga postures). An additional consideration from a holistic health perspective is the effects of the stress hormone cortisol on weight loss. By taking part in calming physical activities such as restorative, gentle, yin and meditative yoga practices, it is possible to reduce stress, allowing the body to shed weight, heal and be at top capacity for more intensive strength and cardio training when you are working with your personal trainer or in other group fitness programs. By taking time to slow down, you can actually optimize performance and fitness results.

Nourishing your mind can also come in handy, as a way to promote your health when you are not busy exercising or working. Take time to read, learn, talk with fitness experts, organize your time and plan your meals. A wealth of free information is available online to support you in your fitness goals. Blogs with entries from personal trainers and other fitness experts are a great place to start, like the MedFit Network blog. Many personal trainer certification organizations (like ISSA or ACE) also maintain blogs with a variety of advice for personal trainers and fitness enthusiasts. You may also get inspired and decide to take your fitness goals one step further. Once you get involved learning more about fitness, biomechanics and how amazingly capable your body is, you may even get inspired to become a personal trainer or group fitness instructor yourself!

No matter where you are at in your fitness journey, don’t forget to take some time for yourself. Slow down sometimes to speed up your progress!


John Platero is the founder of National Council of Certified Personal Trainers (NCCPT), which has certified thousands of personal trainers both nationally and internationally.

Article reprinted with permission from John Platero.

stretching

The Importance of Stretching

I remember the first time I figured out what my piriformis was, and how having a tight piriformis and IT band affected my movements. I had just started running hard core. As a former dancer, we stretched our hamstrings, inner thighs, the “dancer muscles”. But a piriformis or IT band was not something a DANCER experienced as this was not a muscle that was targeted in ballet, or other forms of dance.

The PAIN, was a knot in the right side of my hip/tush. It began to radiate all the way down the side of my right leg. It even affected my lever length so that the right leg felt “shorter”. I eventually learned how to do stretches such as “parvritta trikonasana”, and a bastardized version of pigeon on my back to target this muscle group (the external rotators).

Also, as a swimmer, and runner, my calf muscles will get super tight. This eventually pulls on my achilles tendon. Having torn my right achilles tendon in a freak accident in 2002, I can tell you keeping the achilles tendon happy can make the difference between being able to walk or not. Hand to foot calf stretches both standing and supine, as well as forward bend, and parvritta trikonasana, will take care of the problem. I also flex my foot against a wall before starting my run.

If my knees ache, it is usually because my quads are tight. I start with alternating kick ups from down dog into lunges to warm up. I also do natarajasana, which provides me an open angled quad stretch.

My students will often have problems targeting their abdominals. Tight hamstrings and hip flexors are usually the problem. I will do a “half lunge” where they press through the psoas to release it, then stretch the ham/calf in a forward bend while flexing the front foot, and keeping the standing knee right under the hip.

For other hard to read groups, such as under the shoulder blades, nothing beats a foam roller. I body surf along the foam roller, and hold until the knot dissipates. I have a chapter in “Healthy Things You Can Do In Front of the TV” complete with photos to describe how to target key muscles.

Stretching is often a forgotten, and yet necessary part of fitness. It makes the difference between proper kinesthetic alignment and gait, or movement that is off-balance, which can cause injuries. Not to mention, it just feels good before or after an intense workout. It also aids in recovery, so that you can be ready for your next challenge. Even die-hard couch potatoes need to stretch. And many stretches can be done at work or at home. See my lovely book for more examples of how to keep your body functioning at its best.


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, Barnes & Noble, and Kindle.

healthy middle aged man workout at the beach

The Aging Athlete

If you’re reading this you are likely interested in beginning or improving in a recreational activity or sport. You might want to train for stadium football, a rec team, fun runs, obstacle courses or something as major as a triathlon. While you may be anxious to jump right into a training program there are a few things you should consider such as your current activity level, current physical condition (i.e. chronic conditions, aches, past surgeries, injuries), and knowledge of physical fitness programming.

Who is the Aging Athlete?

The aging athlete can be anyone who needs to rethink their recovery strategy as it relates to the rigors of the desired/continued activity due to the aging process. Likely this is any athlete or recreational athlete in their 30’s, 40’s and beyond. The National Strength and Conditioning Association (NSCA) states, that while the cardiovascular endurance and muscular strength of older competitors or athletes are truly exceptional, even the most highly trained athletes experience some decline in performance after the age 30. As such participating in recreational sports or activities fully depends on your health and preparation and the sport or activity you are pursuing.

Before you begin you should consult with your primary health care provider (PHCP). If you’ve been cleared but inactive for any period of time complete a physical activity readiness questionnaire (PAR-Q) to ensure nothing has changed. Additionally, if you have a chronic condition, chances are your PHCP has already discussed exercise with you, and most likely gave you some general guidelines. A chronic condition defined by the Center for Disease Control and Prevention (CDC) is a condition that lasts one year or more and requires ongoing medical attention or limits activities of daily living or both. This does not preclude you from participating in recreational sport or activity necessarily, but it is a factor to be taken into consideration. You may be asking yourself, is this something I can do? Is this something I can do on my own? Do I need a trainer? How do I know what trainer I should go to?

Is this something you can do on your own?

The answer is yes, with this caveat. Unless you have a background in exercise, likely there will come a point when you will need someone to reach out to for advice. If that happens reach out to a professional with the appropriate qualifications. Frequently, I have heard gym members echo comments questioning the validity or worth of paying someone to do something they can do on their own. They often do not realize or recognize that hiring a professional who is educated and experienced in strength and conditioning is more than just programming exercise, it’s also injury prevention. Activities, movements, or lack of recovery may not have caused injury in the past, but as we age the dynamic changes, and to remain healthy and injury free, we must change. Commonly people just work around injuries, avoid certain exercises, or reduce intensity and accept that’s just part of aging, so they press forward. However, if they would have consulted with a fitness professional they may have found a better more comprehensive solution.

Working around past injuries is a useful and worthy approach, if done correctly. However, the truth is that most of those injuries are a result of their habits. Perhaps they have been predominantly inactive, spending much of the day sitting. Perhaps they were training hard without any or little variation in intensity, without any or little variation of joint movement, and without any or little variation in program design. These all add up to repetitive stress injuries. Common repetitive stress injuries often appear as bursitis, arthritis, tendonitis, and lower back pain/injuries.

That is not to say you cannot do this on your own nor that you need a trainer or will always need a trainer. It is to communicate the point that we do not inherently know how to exercise properly. Many in their youth have participated in sports, and the programs they were taught may be missing some crucial elements to keep them healthy and pain free. These elements are missing sometimes because years ago we did not have the information we have today. Sometimes it’s because we only remember some of what we were taught, and other times it’s because we have aged, or our physical needs have changed and require a change in programming.

If you’ve never exercised before, it’s recommended you either take a few classes (not a fitness class such as spin, but an instructional class offered at a gym, YMCA, or college) or hire a trainer for a short period of time. Perhaps you are on the fence on taking a class or seeing a trainer. If that is the case, ask yourself these questions:

Are you developing aches and pains that are lasting for longer periods of time?
Do you know what a plane of motion is, and how to exercise your joints in each plane of motion?
How often do you change your program? Do you have a chronic condition?
Are you developing lower back, knee, or hip pain?

The answers to these questions can give you a good sense of whether you may benefit from seeking professional assistance or instruction.

The Key is Individualized Programming

Assuming your destination is recreational sports and activities or even occupational activities the program should be appropriately progressed in intensity, duration, and specificity to get you to your desired destination.  Repetitive stress injuries occur because one set of tissues in the body/muscle/joint continue to be challenged in the same way at the same spot over, and over again. By taking your occupation, past activities or recreational sports into account your program can be structured to bring the proper balance of strength, and flexibility to the areas that may be neglected or strained. Below is a list of general guidelines if you’re choosing to do this on your own:

General

  • It is recommended you undergo a health screening by your PHCP prior to beginning
  • Cardiovascular and resistance training are both recommended, intensity in both depend on your medical clearance, training status, and sport of choice
  • Perform exercise through a full pain free range of motion, and do not exercise if the joint is in pain or inflamed3
  • Listen to your body, and when in doubt seek guidance from a qualified fitness professional

Resistance, Cardio and Sport Specific Exercise

  • Warm-up for 5-10 minutes with low-moderate aerobic activity and calisthenics, and perform static stretching after the warm-up and at the end of the workout2
  • For cardiovascular/endurance perform 20-60 minutes of large-muscle aerobic activity most days at an intensity of 60%-90% of age-predicted heart rate1
  • If you have been sedentary or are just beginning, resistance train no more than twice a week, allowing 48-72 hours to recover, as you progress you can workout daily with different muscles groups at different intensities each day2
  • Focus on mastering basic resistance exercises then implement exercises that are more sport specific, as well as balance, free weights, multi-directional, multi-joint, and power/agility exercises2
  • Begin doing 8-12 repetitions of a weight that is equal to 50% of your maximum weight and gradually increase to up to 80% of your maximum weight, weight should be lifted and lowered in a controlled manner, and at a slower speed in the beginning (2 seconds for the lifting phase, and 2 seconds for the lowering phase), for 1-3 sets2
  • Take 1-3 minutes of rest between sets3
  • Avoid holding your breath during exercise2
  • Once you’ve advanced to power/speed training, perform 1-3 sets per exercise at 40-60% of your maximum weight and 6-10 repetitions at a high (but controlled) speed2
  • Train each joint in multiple directions (ie. planes of motion). For example, the hip can perform flexion, abduction, adduction, or circumduction.

What Should I look for in a Trainer?

If you elect to see a trainer there’s a few things you want to look for. You want a trainer with verifiable experience, an accredited certification/college degree, and liability insurance. The fitness industry is largely unregulated and there is some debate among which certifications are the best. A good place to start is the MedFit Network as trainers have to meet professional criteria in order to be listed. Additionally, it is important that their experience and background suits them to your specific needs. If you have a chronic condition, dealing with pain or have past injuries these are areas you want to be confident they can serve. As you are either engaged in athletic activity or want to engage in athletic activity it is important that the trainer have a solid foundation of periodization, and athletic performance. Quack science and self-professed gurus have no place here. The trainer’s practices should be founded in the principles set forth by the American College of Sports Medicine (ACSM), and the National Strength and Conditioning Association (NSCA). Most trainers offer a free assessment, which gives them an opportunity to learn about you, and you to learn about them. Be sure to meet with several trainers and ask for client references. This is a reasonable request and a quality trainer will not take offense. Lastly, if something feels off, seek a second opinion.

When undertaking rigorous activity and sport, there are other services you may want to consider, or discuss with your PHCP such as massage therapy, nutritional counseling, or chiropractic care depending on your needs. Remember one size does not fit all and by keeping your health in balance now you will be able to continue to enjoy the activities and sports you love for years to come.


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. Jacobs, P. L. (2018). NSCAs essentials of training special populations. Champaign, IL: Human Kinetics.
  2. Haff, G., & Triplett, N. T. (2016). NSCAs essentials of strength training and conditioning. Champaign, IL: Human Kinetics.
  3. Brown, L. E. (2017). Strength training se/National Strength and Conditioning Association. Champaign, IL: Human Kinetics.
Walk Park

The Hijacking of Exercise

I have been involved in exercise personally and professionally since I was in grade school.

My introduction to exercise was initially through sports.

I remember doing the President’s Council on Physical Fitness assessments while in grade school in the late 1960’s. (I know, I know – I’m getting old). For those readers as ancient as I, can you remember those tests?

Max pull-ups
V-sit-and-reach
Sit-ups (one minute)
30-foot shuttle run
One-mile run

There were comparisons for each test that placed the individual in some percentile of a normative value system. This set of supposed tests of fitness were the standard in schools for decades. They underwent some changes in the 80’s and I think are now known as “Let’s Move”.

The idea that fitness is attached to some performance standard is alive and well. In the modern philosophy of exercise process, known as “Functionalism”, the exercise and fitness enthusiast are all considered “athletes”. This notion of exercise being an athletic endeavor, and that all exercisers are treated like (and should consider themselves) as athletes, dominates the fitness and – even physical therapy – landscape.

I think sports has hijacked exercise.

I think this is a mistake.

Now, don’t get me wrong. I understand and support that athletic individuals participating in sports need to exercise. I understand that athletes working to achieve high levels of physical capabilities use the exercise process in ways that a non-athlete might never even consider, let alone need, to achieve a modicum of fitness. But, athletes seem to accumulate physical injury. When the exercise process expects the exerciser to push their limits in order to squeeze out ever-increasing physical performance feats, an injury is not far behind. Getting injured using exercise for general fitness is not fitness. Why would a non-athlete want to pursue exercise under these conditions?

It sometimes seems as if the modern message of “everyone is an athlete” coming from the exercise and fitness community to the general population, most of which are not athletes and have no interest in sports, dissuades the non-athlete from pursuing exercise. The images used to promote exercise are composed of athletes pushing their physical limits and expressing the pain and discomfort that comes with that pursuit. This can be intimidating to the non-athlete. The exercise processes used to exercise individuals under the “everyone is an athlete” paradigm are high risk and unnecessary for general fitness and wellness.

My thesis is this: The message and delivery of exercise and fitness as an athletic endeavor truncates the already difficult process of getting more individuals to start and maintain an appropriate lifelong exercise process that achieves the powerful benefits regular exercise can bestow.

My answer is this: The modern message needs to be more balanced in order to avoid stereotyping exercise as only for those that are athletically inclined. One that presents images of average everyday folks exercising and enjoying non-athletic physical pursuits. It is our responsibility as exercise and healthcare providers to stimulate and inspire more of the general population to engage in a regular and reasonable process of exercise. One that does not tell them that they have to be an athlete, nor will be treated like one during exercise whether they like it not. Let’s create messaging that encourages and exhorts participation at all levels for all classes. Let’s move away from just offering a protocol based athletic exercise process. Let’s customize the process to not just the client’s physical needs but their mental perspective of self and how they want to experience exercise.


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. 

spine on clipboard

Protecting the Spine from Kyphosis

People with bone loss in the spine are often concerned about changes in the spine or the backbone that cause it to curve forward. This curve is called kyphosis. It can happen when a person with osteoporosis breaks several of the bones that form the spine. These bones are the vertebrae. When they break, they are called vertebral or compression fractures. There are also other conditions that cause kyphosis. Kyphosis causes a person’s posture to look stooped or hunched and the person loses height. As more bones break in the spine, the spine becomes more curved. When it is severe, some people call kyphosis a dowager’s hump. Fortunately, people can take steps to protect the spine, maintain height and posture and prevent kyphosis.

Broken Bones in the Spine

Breaking one or more bones in the spine can cause sharp back pain that does not go away, or sometimes, there can be no pain at all. After having several of these breaks, people may start to have a curved spine and lose height. When there is no pain, many people do not know they have broken a bone in the spine. After becoming shorter by an inch or more in one year’s time, some people realize there is a problem with the spine. Because of height loss and changes in the spine, clothes may start to fit poorly.

For some people, kyphosis causes constant pain. This pain happens when the spine becomes more curved and the muscles, tendons and ligaments of the back are strained and stretched. Sometimes nerves are also pinched. Severe kyphosis can reduce the space for internal organs. It may also cause the stomach or abdomen to push forward and appear to stick out. As a result, it is harder for some people to breathe or eat, and they may not get enough food and nutrition for their health. Severe kyphosis may also affect balance and cause falls.

Tests to Look for Spine Fractures

People with osteoporosis who have back pain should see a doctor or other healthcare provider trained to treat osteoporosis. Most healthcare providers will want to check for a broken bone. The dual energy x-ray absorptiometry machine (also called a DXA machine) that tests people for osteoporosis can be used to look at the spine to find broken bones. This test is called a lateral vertebral assessment. A lateral x-ray of the spine is another way to find a broken bone in the spine. These two tests used to look for spine fractures are also called vertebral imaging tests.

People with osteoporosis should have their height measured once a year preferably at the same healthcare provider’s office each time. NOF recommends that healthcare providers consider performing a vertebral imaging test to look for spine fractures in the following individuals:

  • All women age 70 and older and all men age 80 and older if the T-score is -1.0 or below.
  • Women age 65 to 69 and men age 70 to 79 with a bone density T-score of -1.5 or below.
  • Postmenopausal women age 50 to 64 and men age 50 to 69 with specific risk factors, including:
    • Height loss (e.g. 1.5 inches or more from young adult height or rapid height loss in a short period of time)
    • Recent or ongoing use of steroid medicines (such as prednisone or cortisone)

Moving Safely

It is important to protect the spine by moving properly during exercise and daily activities. Activities that place stress on the spine can increase the likelihood of breaking a bone. For example, people with bone loss in the spine should not:

  • bend over from the waist with straight legs
  • do toe-touches, sit-ups or abdominal crunches
  • twist and bend at the torso (trunk) to an extreme
  • carry packages that are too heavy
  • bend forward when coughing and sneezing
  • reach for objects on a high shelf

For some people with a lot of bone loss, simply hugging a friend or picking up a grandchild can cause a broken bone in the spine.

Seeing a Physical Therapist

People with osteoporosis may want to speak with their healthcare provider about a referral to a physical therapist (PT) who understands osteoporosis. PTs can help people protect their spines. For example, PTs can help people limit the amount of kyphosis by teaching proper posture and exercises that make the back muscles stronger. They can also show people how to safely sit, stand and move.

Taking an Osteoporosis Medication

A person who has broken one or more bones in the spine is at very high risk for breaking more bones in the spine. All people with these fractures should speak with their healthcare provider about taking a medication to treat osteoporosis. NOF encourages people to look at both the risks and benefits of taking or not taking a medication. Other healthy lifestyle behaviors, including getting enough calcium and vitamin D, not smoking or drinking too much alcohol and maintaining a safe exercise program can also help individuals reduce the chance of breaking bones in the spine.


Susan Randall RN, MSN, FNP-BC is Senior Clinical Advisor for the National Osteoporosis Foundation (NOF) in Washington, DC,