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Health and Disease Spans: Can You Change It?

/13 June 2024/ All MFN blog/

Sam is a 90-year-old client of mine who comes into the clinic every day, walks for 30 minutes on the treadmill, then jumps on the elliptical for 15 minutes following by another 15 minutes on the stationary bike. After he’s done with his cardio, he knocks off 10 pull-ups, unassisted, and then he finishes the rest of his strength program. He feels energetic and enjoys spending time with his family and friends. On the other hand, Bob, a client who came in a few months ago, is 62 years old, sleeps in a recliner most nights because his back pain is too severe to stay in bed. He is an attorney working long hours with high levels of stress. His long hours keep him from exercising on a regular basis, he is a borderline diabetic and has recently started Lisinopril to control his newly diagnosed hypertension.

What’s the difference between my two clients? Sam has experienced a long and successful health span. At 90, his disease span has barely started to show. Bob, on the other hand, has an early onset disease span. He is losing his function and productivity while experiencing a slow and steady decline into the abyss.

There are several factors that influence the onset of one’s disease span. Factors such as genetic predisposition, lifestyle choices and sleep patterns are just a few examples that will influence the shape of your disease span curve. Often, the interrelatedness of influencing factors dictate our life’s outcome. By understanding our history, recognizing the triggering events that have occurred over time and managing mediators affecting our health, we are in the unique position to have a positive impact on our health/disease span curve.

Regardless of your previous lifestyle choices, you can create a big change. It is amazing how quickly our bodies respond to positive changes. In as little as 30 days, I have seen people decrease their need for medication, increase their energy, improve their sleeping habits and become more engaged in their personal relationships.

Remember Bob, in 45 days he was off his pain medication, sleeping in bed and played 9 holes of golf which is something he hadn’t done in 5 years. It is essential to understand your lifestyle history to take the necessary steps in making a well-rounded change. Success begins when you work with the right professional to re-write your story which will in turn elongate your health span, shorten your disease span and result in dying young at a ripe old age.

Jim Herkimer, DPT, MS, ATC  has been involved in health, fitness and rehabilitation for over 35 years. He is currently the CEO and Executive Director at Sports Conditioning and Rehabilitation (SCAR) in Orange, California. SCAR is a wellness and rehabilitation clinic providing a continuum of care for individuals through the life span. Throughout his career, he has had the opportunity to help a variety of athletes and individuals from all walks of life reach beyond their potential. 

Stroke-Brain-MRI

Trainer Challenge of Stroke

/23 May 2024/ All MFN blog/

A stroke is an obvious turning point in most survivors’ lives. In a best-case scenario, it can be as minor as a mild concussion. At worst, it is a disabling brain injury that leaves the person incapable of caring for themselves—or even breathing on their own. In any case, stroke clients can provide a significant challenge to a trainer wanting to help them, once medical care and primary rehabilitation has plateaued. This is especially true considering the variety of experiences a survivor can have, following a stroke.

Seniors with trainer in gym at sport lifting barbell

4 Tips to Help Your Clients Reduce Their Risk of Falls

/26 March 2024/ All MFN blog/

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!

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.

Specialized Education for Fit Pros

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Break It Down – KISS Principle (Keep it Simple for Seniors)

/21 March 2024/ All MFN blog/

Teaching proper and biomechanically safe movement patterns takes a keen understanding of each pattern.  What muscles and joints are involved?  What skills are required for good execution? What deficiencies does the client have based on your preliminary movement assessments?  Begin with the simplest version of each fundamental movement pattern and build on the complexity and intensity slowly.  

Adjust accordingly, and encourage the client to give honest and precise feedback as they are learning.  Find out if there is discomfort physically and/or psychologically.  Adjust again.  You want your client to feel successful and excited about their accomplishments during the exercise session and overall.  They need to feel confidence in their ability to learn and improve, and enjoy the learning experience while they get stronger and more functional.  Learning to exercise properly and safely is hard work for our clients.  We must progress them gradually and with well thought out, logical, and achievable progressions.  Knowing when they need to rest and reset is essential to building trust with the client, and creating a positive learning experience for them.

Fatigue and the Body/Brain Duo

It is critical that researchers consider the brain as well as the body when examining fatigue development and its impact on the body.  By looking at brain and muscle function simultaneously, they will see that when participating in highly cognitive tasks, brain resources are divided which may speed up the development of physical fatigue. Processing and executing detailed and complex exercise instructions can accelerate the onset of body fatigue.

A study conducted by Ranjana Mehta, PhD., assistant professor at the Texas A&M Health and Science Center School of Public Health, evaluated the interaction between physical and mental fatigue and brain behavior. The study showed that when we attempt mental tasks and physical tasks at the same time, we activate the prefrontal cortex of our brain.  This can cause our bodies to become fatigued much sooner than if we were only participating in a physical task. (Study published online as:  Human Factors: The Journal of the Human Factors and Ergonomics Society This study was co-authored by Raja Parasuraman, Ph.D., professor of psychology at George Mason University in Virginia)

When we are working with geriatric clients, and one of our objectives is educating them, we must be cognizant that the lesson material must be “dosed-out” in absorbable amounts.  Keeping the instructions simple and concise for maximum understandability is advised. When combining actual physical movement with the processing and following the instructional cues, the client is working extra hard and fatigue can set in sooner than you had planned.  You may notice them starting to lose attentiveness or move slower.  They may abruptly stop what you have them doing.  They may look a bit frustrated or flustered.  They have detached from the workout experience. The brain is full.  The body feels tired.  They need a break.

Taking pause to re-assess and re-set allows time for the client to recover mentally and physically.  It is also a good time for the trainer and client to decide how to adjust and move forward in the session.  Switching to less physically demanding, easy-to-do exercises feels like a relief to the client.  They experience ease and a sense of control as their body and mind restore.  

You can resume the previous exercise if the client wants to.  If they are done with that hard thing, they are done.  Save it for the next session to practice or learn again, and celebrate the effort and attention that the client gave the exercise that day.  Educate them on the facts surrounding fatigue levels after learning and practicing complex physical movement.  Tell them the cognitive benefits of combining cognition with physical effort!

Fit Pros: Guide Older Clients as a Geriatric Fitness and Lifestyle Specialist

Millions of people over age 65 looking for guidance from fitness professionals who are knowledgeable in exercise, nutrition and lifestyle principles that can help them improve functional mobility, while also preventing and managing chronic conditions to live their highest quality of life. The Geriatric Fitness and Lifestyle Specialist online certificate course will give you insights, strategies and tools to be a successful professional in this rapidly growing market. Learn how to be a valued part of clients’ continuum of care, working with the medical team to improve functional outcomes and positively impact people’s lives.

Holly H. Benson, BS, is a veteran in the Recreation and Fitness industries with over 35 years of administrative and technical experience. She holds two bachelor’s degrees, Corporate & Community Fitness and Recreation Administration, and numerous fitness certifications. She has developed thriving fitness programs for special populations and has passionately focused her career on the much older adult.  She currently owns and operates Moving Strong Medical Exercise, LLC in Lakewood, Colorado and provides in-home and virtual fitness training to older adults and persons with chronic medical and orthopedic conditions.

Senior-Woman-Balance-Yoga

Why We Lose Balance and How We Fix It 

/16 March 2024/ All MFN blog/

It’s no secret that balance tends to decline with age. Your clients may notice they are swaying a bit more while standing and walking, or feeling weaker or less steady. We all want it, but what is balance? We need to understand what it is in order to restore what was lost, safely, effectively and efficiently. 

Balance is the ability to maintain the body’s center of mass over its base of support. Your center of mass is a few inches below your belly button or can be thought of as your trunk. Your feet are your base of support (unless you are performing a handstand!) 

Balance is the ability to stay upright when standing (static balance) or when moving and performing activities like walking or climbing stairs (dynamic balance). The most common question I hear from older adult clients is, “Why am I losing balance?”  Let’s find out why. 

What is Balance?

Balance is a sense that lives in the brain. Balance relies on information constantly flowing into the brain from three main sensory systems including our visual, vestibular and proprioceptive systems. Moving properly depends on the ability of the brain to gather and interpret the sensory information provided by eyes, ears and joints.  This is essential because the brain then tells the body how to respond to stay upright and balanced.

The quality of the sensory input gathered directly impacts the quality of movement. The stronger the sensory signals sent to the brain, the more accurate the instructions sent to the body will be. On the flip side, as sensory signals become impaired, movement quality dwindles, as reaction time becomes slower. 

Making Sense of Balance: The 3 Systems

Let’s explore the sensory systems that make up balance.

Visual System: Your eyes tell your brain about where your body is relative to the environment, whether you are walking inside your home, in a busy airport, or strolling on the beach. With aging eyes, a great many people don eyeglasses to function day to day, and as our eyesight weakens, so too does the quality of the sensory input.

Vestibular System: The ears relay information to the brain about the motion and position of the head to adjust posture to maintain balance. Semicircular canals in the inner ears  contain fluid and tiny hair cells. As the head nods up and down, moves left to right, or tilts to the side, the fluid in the inner ear moves and the tiny hair cells sense the speed and direction the head is moving in. 

By age 70, it’s typical to have lost 40% of those sensory-detecting hair cells (Zalewski 2015).  

Proprioceptive System: Proprioception, literally meaning “sense of self”, is your sense of body awareness and is a prerequisite for balance. It’s how you understand the parts that make up your body, where they are located, how they feel and even what they can do. It’s the way your body communicates with itself so you can walk without looking at your feet. 

Proprioceptors are sensory nerves that live in and around joints, in ligaments, joint capsules, tendons, muscles and connective tissues. They sense and send signals to the brain about joint position and motion, as well as the muscle force involved in movement.  

As we age, our sense of body awareness is impaired leading to poor joint function, body alignment, control and coordination. The result: poor balance and higher risk of falling. 

Losing and Restoring Balance

As our eyes, ears and joints lose their sensory capabilities, this is why balance is gradually lost. 

To regain what was lost, we apply the SAID principle (Specific Adaptations to Imposed Demands) to improve function with targeted training. Up to 70% of the sensory input for balance comes from your joints (Peterka 2002), so improving joint function can be a highly efficient way to improve proprioception at any age so clients can enjoy better balance and more confidence to prevent falls. 

Most Efficient Balance Training

I start each balance training session using the MoveMor® Mobility Trainer to warm up clients’ lower body, restore ankle mobility and foot stability while increasing proprioception. Clients are thrilled to experience improved functional abilities so they can save themselves in time to prevent falls.  

With 12-points of resistance, MoveMor® makes it simple to restore joint flexibility and strength in less time than any other tool, all from a safely seated position! This wakes up proprioceptive sensory nerves essential for balance while stimulating motor nerves for quicker reflexes. 

You can get started with training clients on their journey to feeling steadier, stronger and more confident by visiting MoveMor.com/exercise-programs. There are 7 exercise programs to choose from that vary in length from 5-30 minutes. Our Take 10 to MoveMor exercise program is proven to improve balance, ankle flexibility, strength and more in just 10 minutes! An exercise guide makes it simple to identify weaknesses and tailor exercises. 

MoveMor® seamlessly integrates into your balance and fall prevention training to accelerate functional outcomes and satisfaction so your clients can enjoy better balance and an extra spring in their step today!

Cate Reade, MS, RD is a Registered Dietitian, Exercise Physiologist and Functional Medicine Practitioner candidate on a mission to improve functional mobility and health span utilizing the power of lifestyle medicine. She has been teaching, writing and prescribing healthy eating and exercise programs for over 25 years. Today, as CEO of Resistance Dynamics and inventor of the MoveMor™ Mobility Trainer, she develops exercise products and programs that target joint flexibility, strength and balance deficits to help older adults fall less and live more.

Large group of fit and active people resting after doing exercise in nature.

Exercise Outdoors: Cross Training & Hydrate

/12 March 2024/ All MFN blog/

Exercise outdoors when it’s hot can be a challenge. Cross training exercises are a good way to mix up your workouts and give yourself time to cool off, drink water and stay hydrated in summer heat. 

Although I’m away from home, in the mountains, and not as affected by this huge triple digit heat wave, I did get a wake-up call of my own that I thought would be important to share.  I was shooting an exercise video this week in 90-degree heat. It was hot, but I got on a roll and forgot about the time. Less than an hour in, I started to swoon. Not a good shot on an exercise video. I realized immediately what had happened; I’d gotten so involved, I forgot to drink water between takes. I can say from experience that it creeps up on you. So you need to take steps to keep yourself cool and well-hydrated when you exercise outdoors. Cross-train with strength exercises mixed in with your cardio gives you a lower intensity interval so you can drink water, stay hydrated and cool off.

According to the American College of Sports Medicine losing more than 2 percent of your body weight through dehydration puts your body at risk for heat illness. This is serious business. We’ve all read the stories of team athletes who have actually died.

When you exercise in the heat you can lose up to five cups of water per hour. So it’s important to drink water before, during, and after vigorous exercise. The rule of thumb is to drink 2 cups of water a couple of hours before you start exercising so you are fully hydrated. Remember to bring that water bottle with you and drink a cup of water every 15 minutes or so while you are exercising. Don’t wait till you’re thirsty. If you’re thirsty, you’re already getting dehydrated.

But you’re not done yet. You need to drink another 2 cups over a two-hour period after exercise.

Sounds like a lot of water. It’s not. It’s just making up for the water you lose when you exercise in the heat.

Pouring water over your head during exercise won’t help you rehydrate, but it does make you feel better. A study at Cal State Fullerton with trained athletes showed that athletes exercising in 92-degree heat in a controlled setting felt cooler and that the workout was easier to perform.

But you know what Noel Coward said about “mad dogs and Englishmen.” Give yourself a break. If you can, exercise outdoors when it’s cooler, early mornings or late afternoons when the sun is less direct. Try finding shady areas.

Instead of keeping up your brisk pace for the whole workout, break it up. Go at normal pace for a bit, do a short light interval and then pick up your speed again.

Another idea is when you exercise outdoors do cross training exercises. Add intervals of strength training between shorter bouts of cardio. You’ll get a chance to drink and pour some water over your head too! Stop at a wall, a tree or a fence, and do these five exercises: two for your upper body and three for your lower.

Exercise Outdoors Video

Here is an Exercise Outdoors video with some easy cross training exercises to tone you up, no equipment necessary.  (Please subscribe to my YOUTUBE channel; I have several more health & fitness videos!)

Exercise Outdoors: Strength Exercises Using Your Own Body Weight

With all these Strength training exercises, remember to exhale on the exertion.

Standing Push Ups: Stand facing a surface with legs hip width apart and place hands shoulder width apart. Keeping your body straight, lower yourself down to the surface and then push back upright again. Muscles Worked: Chest, Triceps, and Shoulders

Calf Raises: Face surface and hold on for balance. With feet together pointing straight ahead, slowly lift your body up on to your toes, while tightening calf, abs and buttocks muscles. Then slowly lower yourself back down again.

Muscles worked: calves, abs, and buttocks.

Squats: Face surface, legs hip with apart. Hold on for balance. Shift weight back into heels. Keeping back straight, abs pulled in, gently bend at the knees and squat to about a 90-degree angle. Hold for a moment, then, using just your leg muscles, return to an upright position.

Muscles worked: Front of thigh (Quads), Back of thigh, (Hamstrings) Buttocks, Abs

Wall Sit: Stand against surface for back support. Holding on as needed for balance, slide down to a sitting position against wall, knees at about a 90-degree angle. Pull your abs in and hold for 10 to 30 seconds.

Muscles worked: Thighs and Abs

Upper Back Squeeze: Stand with your back to the surface, feet shoulder width apart. Place hands behind you on surface. Straighten your arms behind you and squeeze your shoulder blades together. Hold for 10 to 30 seconds.

Muscles worked: Back, Shoulders, Back of arms (Triceps)

Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities in the health and wellness industry. Her customer top rated exercise videos are now available online 24/7 at on her website for Age-Onset health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes, Orthopedic Issues & more. Mirabai also offers one-on-on Health Coaching as well as a NEW Weight Management 8 Week Course Lose To Win™ on ZOOM or Phone. For more info, visit mirabaiholland.com. Contact her at askmirabai@movingfree.com