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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.  


Change, Habits, Comfort Zones and the Power of Fear

I am a creature of habit. I have always struggled with change throughout my life. I fought it and rarely embraced it until I was forced to acknowledge I was on the wrong path and needed to make a change. In my personal life, I held onto my marriage long after it ended creating unnecessary pain and anguish for all of us. I have learned that to RESPOND to the changes in my life is a far less traumatic way to live than always REACTING to the “fluid” circumstances and uncertainties of life.

Comfort zones, habits, and fear – the “Big 3” of life’s impediments to lasting and positive change in our lives need to be embraced for what they are: “False Evidence Appearing Real” – FEAR.  I see this today as I have seen it repeatedly over the past 2 decades with my clients. We seem to end up being FORCED to change our ways rather than willingly and knowingly taking the steps necessary to move us forward to a more fulfilling life. Let’s take a look at a model for change that has begun to work for me.

The principle behind change is that the universe is always in a state of flux. Nothing in this reality remains the same – especially as we age. One of my former teachers stated that “the only constant in the natural order is change” and yet we fight the changes in our lives and often label them “bad” or “good”. Even positive change brings new stresses into our lives – stresses that can fuel our creative “juices” and enable us and empower us to grow in ways that we could barely imagine. Being willing – and ready – to embrace change allows us to imagine with feeling what is possible. This can create new paths to a future that can embolden and encourage not only ourselves but others as well.

We all have to understand that we can’t control what is NOT ours to control and “let go” while embracing what it is that we DO have the power to influence. The next steps in my journey are being written RIGHT NOW as I type these words. The same holds true for each of us so let’s be BOLD and embrace change as a friend and see what can happen when we partner with change for a higher purpose.

Habits and comfort zones rely on each other to keep us from fulfilling our promise. I have lived for years with the notion that I didn’t possess the “right stuff” to leave a lasting mark on this world.

My daughter Lisa is a “big thinker” and strives for excellence in all aspects of her life even as she has had to struggle over the past three years with life’s inevitable challenges at a very crucial time in her life. I am proud to say that she is confident and hopeful and continues to trust her instincts making me feel very proud of her at this critical moment in time in her life. She has what I didn’t have at her age – an indomitable spirit that continues to believe in her own innate ability and talent. To her comfort zones are only “resting places” – not residences.

I have learned that my fears were of my own making and today I know that we can only improve our lot in life if we are willing to risk acting “in spite of our fears”.  Remember that fear is nothing more than “false evidence appearing real” and our clients need that reassurance every day as they attempt to change something significant in their lives.

We need to KNOW deep inside ourselves that we indeed CAN make a difference and move our clients – and all those we want to serve – one step closer to their OWN new reality. May we each benefit from the changes that we are experiencing right NOW in our OWN lives so that we can help others achieve their own victories 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.

seniors at gym

Treat the Person, Not the Scan

“MRI’s are just anatomic pictures of structures. They do NOT tell me if someone is having pain from MRI findings. I tell patients that it is similar to having your portrait taken. The picture just shows what you look like, not how you are feeling.”

Dr. Derek Ochiai

“For example, many people have “stuff’ on their scans that can sound scary, even if these things are relatively normal and not closely connected to pain. This includes things like bulging discs and degenerated discs, which have a lot in common with grey hair and wrinkles – they are more common as we get older, without being dangerous.

Unfortunately, people with back pain are often told that these things indicate their back is damaged, and this can lead to further fear and distress or lead people with back pain to rush for procedures like surgery when they are not needed. Therefore, you should think twice before getting a scan.”

Kieran O’Sullivan, PT

“MRI scans show two patients with herniated lumbar discs.  One is a small herniation; one is a large herniation.

Q: Which patient needs surgery?

A: Neither.  Both patients have minor symptoms and are doing well with physiotherapy and anti-inflammatory medications.

“Treat the patient, not the MRI”

–Ali A. Baaj, MD

I hope you find encouragement in the previous quotes. What is to be inferred from them?

You can be injured, have structural or tissue damage to the muscle-skeletal system, and not have very much pain or discomfort – sometimes no pain at all!

Let me repeat – be encouraged by this!

The message that tissue damage must always result in pain can be wrong.

This is not an indictment of X-Ray and MRI scans and the accompanying radiological reports. They are certainly valuable tools. For example: one of my colleagues on a recent Facebook post shared that an MRI showed that her shoulder joint doesn’t properly fit together due to repeated dislocations and that she is prone to future dislocations.

Of course, this is valuable information. It can help us understand whether we should, and if so how, to exercise the shoulder for strength training. It also sets up the expectation for outcomes for any process employed to help the individual.

On the same post, another colleague mentioned that a scan of his neck showed a herniated cervical disc was pressing on a nerve root. The scan took place after the numbness in his left arm had already disappeared. He mentioned he never had any pain in his neck or arm.

Should scans be done every-time someone is complaining of pain? Physicians have to make this decision on a regular basis often knowing that the scan might show something, or it might not. Whether or not what the scan shows has anything to do with the patient’s complaint is another matter.

It’s a conundrum for the doctor and the patient. Of course, each wants to know the cause … the reason for their pain. The pain needs to be blamed on something specific that can be seen. It has to be given a name like arthritis, tendonitis, or herniation. Unfortunately, the scan can’t show that whatever image is produced is what is causing the pain directly.

So, the insistence by the patient or doctor to get a scan is balanced against the hesitation to order a scan because it is expensive and may not shed any light on the problem, or possibly prompt a surgery that isn’t necessary.

The patient may leave the doctor’s office discouraged. They don’t want surgery, they don’t want to take drugs if they can avoid it, but they can’t live the rest of their life with chronic musculoskeletal pain. Drugs and surgery may even compound the problem by creating new issues.

It’s time to ask a few questions: What else can someone do to help the situation? Is there a more conservative approach to try before taking the risks of drugs and surgery?


The answer – exercise.

Too many people have given up on trying to work conservatively via exercise to move better in order to feel better by looking for quick fixes that may carry negative long-term consequences. (can anyone say opioid epidemic?)

If you are feeling discouraged by musculoskeletal pain and are trying to avoid drugs and surgery – try exercise. Get a thorough assessment and have a professional develop, and implement, a personalized and precise exercise-based strategy that is unique to your needs.

Remember those quotes in the beginning of this blog, “Treat the Person, Not the Scan!”

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. 

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Save the Date: Global Employee Health and Fitness Month, May 1-31

Employers and Employees everywhere can show their support for healthy living by participating in Global Employee Health and Fitness Month (GEHFM) sponsored by the National Association for Health and Fitness (NAHF) and MedFit Network. This outstanding worksite initiative is held from May 1 through 31 each year to celebrate National Employee Health and Wellness Month. The new and improved website for a healthy, active workplace can now be accessed 12 months a year and a company can choose not only the month of May, but any other month in the year to improve well-being and to increase human movement.

Since the founding of Employee Health and Wellness Month in May of 1989, there have been significant strides in documenting the evidence of the value of investing in employee health. Employee health is a powerful strategic  component of an organization’s human capital management. Progressive employers understand that their greatest asset is their workforce and an investment in their employee’s health is essential to managing health costs, improving organizational productivity and employee morale.

The amazing strategic partnership between GEHFM, NAHF and MFN resulting in the new and improved Global Employee Health and Fitness Month website is truly historic in the arena of workforce wellness.  Business and industry can encourage positive behavior change in the supportive context of workplace policies and culture and provide support that assists today’s workforce with their daily struggles. Through GEHFM we will achieve the optimum result of a more physically active, healthier population – one healthy moment and one healthy group at a time.

All you have to do is create and share “Moments, Groups and Projects for Health” such as preparing a healthy meal, organizing a recurring walk or bike ride with colleagues or participate in a clean-up day with your community.

It’s time to make “healthy the norm” in American and this game-changing initiative is a powerful effort toward the realization of this goal.

Visit the website, healthandfitnessmonth.org

Seniors with trainer in gym at sport lifting barbell

4 Tips to Help Your Clients Reduce Their Risk of Falls

No matter how fit and healthy your older clients are, there is one thing that can change their lives forever: a bad fall. Every year, almost 1/3 of older adults fall and many cause injuries that will affect them the rest of their lives.

As a fitness professional, you need to be well-prepared to deliver the most effective fall prevention exercise programming to your clients. You can find excellent guidance on assessment and program design at www.mobilitymatters.fit. But you also should be providing advice to your clients on how to reduce their fall risk in other ways.

Have them do these and keep them on their feet!

1. Many falls happen outside where there are lots of potential hazards. Advise your clients to avoid walking on loose gravel, metallic/painted surfaces and cracked sidewalks and avoid being outdoors in bad weather (e.g., rain, sleet, snow). Appointments can always be rescheduled, but a trip to the ER should never be the reason!

2. Indoors, advise your clients to make sure that their path from the bedroom to the bathroom is free from obstructions (e.g., pet toys, rumpled rugs) prior to going to bed at night – that way a trip to the bathroom will not include a trip and a fall!

3. Advise your older female clients to never wear high heeled shoes outdoors. Put their heels in a canvas tote bag and walk outside in sneakers or flats instead. Nobody looks good falling, no matter how stylish the shoes!

4. In the bathroom, advise your older clients to line the floor of their shower/tub with textured adhesive strips. These are less likely to cause a slip or a trip than a rubber bath mat that might slip or bunch up. They also give a nice pedicure!

Are you a fitness professional interested in learning more on this topic? Check out Dr. Thompson’s 4 hour course with PTontheNet, Essentials of Older Adult Exercise Assessment and Program Design for Preventing Falls.

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.


The Health Benefits of Better Sleep

The more that time goes on, the more evidence there is that sleep is our friend – possibly one of the best! Do you find that drifting off into sound slumber among today’s full-on society is something that is slightly out of reach for you in your life?

If you’re nodding your head as you read this, and you want to find out how sleep can have a positive impact on your life, then you’ve come to the right place.

Over the course of this article, we’re going to elaborate on the health benefits of sleep and how it can make a difference in your life!

Heart Health

Did you know that the chances of suffering a heart attack or stroke are higher in the early morning hours? [1] It’s thought that this is because of the way sleep interacts with our blood vessels.

If you are experiencing a lack of sleep, then you are considered among those who are more likely to be associated with issues surrounding blood pressure and cholesterol. These are defined as high-risk factors for both stroke and heart disease.

You’ll benefit from a healthier heart if sleep between seven and nine hours every evening, as recommended by health professionals.

Body Repairs

Sleep is your body’s time to be at its most relaxed. This is also the period in which the body busies itself repairing any damage developed from a range of factors, including stress.

When you’re asleep, notably deeper stages of sleep, [2] your body works to repair muscle, organs, and other cells. Chemicals that operate to strengthen your immune system begin to circulate in your blood.

Your body’s cells are able to produce more protein, and these protein molecules are at the root of the repairs your body needs to overcome daily stressors.

Less Stress

When you don’t receive adequate amounts of sleep, your body moves into a state of stress. This means that your body’s functions are put into ‘high alert mode’, with the effects of this ranging from high blood pressure to the increased production of stress-related hormones.

Avoiding high blood pressure is important, because high blood pressure can increase your heart attack and stroke risk. What’s more, when we factor in stress hormones and how they make it harder to fall asleep, it soon becomes clear that sleep is vital to stay for health.

More Energy

High-quality rest gives will make you feel energized and more alert the following day. You’ll be more active and use up the energy you’ve rewarded yourself with, which subsequently opens the door for a good night’s sleep that evening, too.

This knock-on effect creates a healthy cycle that is hard to not enjoy, especially when you are waking up feeling refreshed and ‘full of beans’ to accomplish whatever lies ahead each day.

Enhanced Memory

During sleep, as your body is resting and repairing itself, your brain is hard at work processing the things you have learned that day.

It’s like a filing process, whereby your brain is sorting all the things in their rightful place, creating connections between events, memories and feelings, for example.

The ability to move into a deep sleep is absolutely essential for your brain to form links and memories, and the better quality of sleep you experience, the better your memory will become.

Weight Loss

Some experts believe people who sleep under seven hours each evening, are more likely to be classified as overweight or obese. Researchers believe that this is due to the balance of bodily hormones that affect the appetite of sleep-deprived individuals. [3]

The body’s hormones leptin and ghrelin are both responsible for the regulation of your appetite, and when sleep isn’t at a suitable level, these hormones become disrupted.

The result of the disruption with these hormones is that you will eat more than necessary, and when you eat more than you need to, losing weight – and even maintaining it – becomes a difficult task.


As you may have realized throughout this article, sleep has the ability to have a bearing on many of the chemicals and processes that help your body to function. This is what makes sleep such an important function in all of our lives.

Sarah Cummings writes for The Sleep Advisor (sleepadvisor.org), a site dedicated to helping people improve their sleep habits. Her love of exercise has always been a big part of how she leads her life, and finds that her keen approach to a healthy diet, daily yoga and dedication to high-quality sleep helps her offer sound advice to others all over the world!


  1. https://www.nhs.uk/news/heart-and-lungs/heart-attacks-worse-in-the-morning/
  2. https://www.huffingtonpost.co.uk/2014/03/07/your-body-does-incredible_n_4914577.html
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519150/


quitting as self care

Quitting as Self-Care

A few years ago the term self-care appeared as a means of describing anything that a person does to take care of themselves, like getting a massage, meditating, going for a walk in nature, or taking a relaxing bath in essential oils. All of the above are great ways to improve your physical and emotional health; however, they are often used not as a way to improve health, but to undo the damage caused by underlying stresses and simply restore one’s previous level of health.

Take meditation. It’s a practice that has been used for millennia as a means of trying to reach an enlightened state. But what do we often use it for now? As a means to calm ourselves down after an argument with a significant other or a way to gain a glimpse of equanimity before what we know will be a tough day at work.

In the above instances, meditation isn’t being used to take us to a higher place, it’s being used to get us back to baseline. And then the next day, when our job or our toxic relationships drag us back into sadness or anxiety, we use it again to bring us back up.

This is akin to using Tylenol to treat cancer. Cancer causes pain, so we take Tylenol to relieve the pain. This treats only the symptoms and ensures that we’re going to have to take Tylenol again and again each time the pain arises.

How would we stop that cycle? By curing the cancer.

Similarly, you can’t massage away a bad job and you can’t journal away a toxic relationship. In both instances, you’re merely treating the symptoms.

What’s the cure? Quitting.

Quit the job that’s taken your sanity day after day. Quit the relationships that have led you to the negative self-talk that requires hours of journaling and meditation to sort out.

Because all of the above self-care tools are amazing in their own rights, but are so much more helpful in improving your physical and mental health if you’re starting from a more stable baseline — which requires taking a good look (often through journaling!) at what is disturbing your peace.

So next time something has you anxious or depressed, grab that journal and write down what led to that feeling. Then start analyzing whether the cause can be quit. You may need a job-ectomy, or to have some toxic friends surgically removed from your friend circle.

And after you do, be sure to light some candles, throw some essential oils in a bathtub, and meditate your way to enlightenment — free of whatever was holding you back!

Learn more about strategic quitting for your health… register for Dr. Morski’s upcoming webinar:

Article reprinted with permission from Lynn Marie Morski.

Dr. Lynn Marie Morski is a Quitting Evangelist. She helps people to and through their quits through her book “Quitting by Design” and her podcast Quit Happens, along with speaking and coaching. She is also a board-certified physician in family medicine and sports medicine, currently working at the Veterans Administration. In addition, she is an attorney and former adjunct law professor at Thomas Jefferson School of Law. Visit her website, quittingbydesign.com


Aging Well By Eating Well

Our health and how we age are not only dependent on our genes, exercise and a positive attitude. What we eat has a major influence on how well we look and feel as we head into our golden years. Simple changes to the choices made on a daily basis can make aging well something to look forward to.

One vitamin (really a type of hormone) that most of us are deficient in, but is essential to optimal health is vitamin D (specifically, vitamin D3 or Cholecalciferol), and many longevity experts call it the miracle anti-aging vitamin.

A lack of D3 is thought to be a factor in many health problems, from increased cancer risk to inflammation and osteoporosis. Our bodies make vitamin D when our skin is exposed to sunlight. Ten to fifteen minutes per day between the hours of 10am and 3pm on unprotected skin is all you need. However, increased time is necessary for those who are older, have darker skin or are obese. By using sunscreen to prevent the risk of skin cancer after a thirty-minute sunbathe, not to mention wrinkles, or if you happen to live in northern regions (37 degrees above the equator or basically north of Atlanta, GA) during the winter months, you are unlikely to get sufficient sun exposure to produce enough. Since our vitamin D level decreases with age, and it can be difficult to get adequate amounts from the food and beverages we consume, the majority of individuals take it in the form of a supplement. A simple blood test can determine if your vitamin D3 level is within the recommended healthy range; ideally between 30 and 60 ng/ml. In the meantime, you can eat more fatty fish, mushrooms, and fortified dairy, juice and cereal products.

We also tend to become deficient in B vitamins as we age, especially B6. Thankfully, this vitamin is one you can easily get through food by choosing poultry and other meats, as well as fish including cod, salmon, halibut and tuna. Fruits and vegetables such as avocados, red bell peppers, spinach, yams and potatoes with the skin on, asparagus and green peas are also excellent sources of this essential vitamin. Snacking on unsalted sunflower seeds, chestnuts and pistachios will supply a good dose of B6 too.

If you want to age well, there’s no better strategy than loading up on the veggies. They provide essential minerals and vitamins. Plus, they are chock full of natural antioxidants. Strive to eat a “rainbow” of colors, as the darker the pigment in the food, the more minerals and vitamins it contains. Choose dark green leafy greens including kale and Swiss chard, orange and red foods such as carrots and tomatoes, purple fruits and veggies similar to blueberries and beets, as well as yellow foods like peppers and squash.

Fat is not the enemy when it comes to aging well. Good fat from omega-3 fatty acids, that is. Two crucial ones – EPA and DHA – are primarily found in certain fish. Two to three servings of fish a week is adequate, since so many types are contaminated by mercury, PCBs, dioxin or other toxins, so more is not necessarily better. This warning about fish is true especially for children and pregnant women. Another omega-3 fatty acid, ALA (alpha-linolenic acid), is found in plant sources such as nuts and seeds like walnuts, chia and oils from flaxseed. These all support heart health and brain cell function, among other anti-aging benefits. They are also thought to be important for cancer prevention and reducing the risk of autoimmune disease, which can increase as we age.

An additional strategy for nutritionally aging well is to increase your fiber consumption. Although we need a little less as we get older, most of us never reach the recommended 21-38 grams per day. Aim for two servings of fruit, three vegetables and three to four portions of whole grains daily. Remember to gradually increase your fiber intake, as well as your water to prevent any gastro-intestinal discomfort.

Most everyone can drink more water. It is essential to cellular function and organ health, including adequate digestion and glowing skin. Who doesn’t want that? Increasing your water intake gradually is the key to establishing a new habit. Start by drinking one glass for every caffeinated beverage you consume. Then slowly begin to replace other liquids like diet drinks, fruit juices or sugary beverages to work up to a minimum of eight glasses a day. Be sure to consult your physician or a Registered Dietitian Nutritionist if you have a heart, kidney or lung disease as your fluid intake may need to be limited.

Last, but not least, don’t skip breakfast. It is the most important meal of the day for fueling your body and maintaining your metabolism. Choosing your breakfast foods wisely will give you the energy needed to start your day on the right track. Reserve fast food, high-fat options, pastries, and high-sugar cereals to infrequent emergency situations.

Hopefully, by implementing the suggestions offered you will begin aging well by eating well.

Curious if your levels of D3, B6 and many other micronutrients are within normal range? Order a test HERE and MedFit members will receive 10% off the analysis consultation with promo code MEDFIT.

Regina Saxton is a Registered Dietitian Nutritionist specializing in intuitive eating behaviors helping women develop a healthy relationship with food and their bodies while managing weight and disease for optimum health. She has a private practice out of Georgia and offers virtual nutrition coaching nationally. Visit her website for more information, reginasaxton.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.