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massage-therapy-senior-client

Massage for Parkinson’s

The incidence of Parkinson’s disease in the United States is estimated at 1 million, with an additional 50,000 patients being diagnosed every year.

The most common signs of Parkinson’s disease are tremors, muscle rigidity, akinesia (temporary inability to move), dyskinesia (inability to execute specific voluntary movements at will) and loss of postural reflexes. The back posture becomes stooped, and the walk gradually turns to a shuffle as the arms stop swinging.

Can Massage Help?

According to a 2002 study conducted by the Touch Research Institute, massage therapy can improve many PD symptoms and function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina symptoms.

The underlying reduction in the neurotransmitter, dopamine, is the cause of many of the PD symptoms. Massage has been shown to have positive effect on the release of neurotransmitters, enhancing their calming influence.

Other benefits of massage are:

  • Improved Sleep and digestion
  • Reduced Stress, Depression and Moodiness
  • Relief for Cramping and Rigidity
  • Less Fatigue and Anxiety
  • Reduced Perception of Pain

Precautions

  • Give a full medical history, including other injuries and conditions besides Parkinson’s.
  • Use caution in areas with loss of sensation, light touch is best.
  • Be careful getting on and off the massage table, balance issues may cause risk of falling.

What to Expect

Your therapist should take a complete health history, including a thorough list of treatments and side effects such as neuropathy, rigidity and skin problems.

But your therapist should also ask about other conditions or injuries you may have. You and your therapist should agree on goals for the session, and you should have a chance to explain your preferences for pressure, and the massage environment such as temperature, music, lighting, etc.

Disrobing: Massage can be done over your clothing (without oil) if your balance is an issue, and it’s too much trouble to dress and undress. If you decide to disrobe and you are concerned about falling, you can bring an aide with you, or ask your therapist for help.

During the massage, you will always be kept covered, observing your modesty and keeping you warm. Don’t hesitate to request that your therapist, or someone else help you on and off the massage table.

Position and Turning over: Some people have trouble turning over due to rigid or weak muscles. If you feel like a fish out of water lying on your stomach, just ask your therapist to work with you lying on your side instead. In this position your therapist still has good access to massage your back muscles, and you won’t feel helpless or confined.

How to Find a Practitioner

Check with your city or state to find out what the basic requirements are for massage therapists.

Get a few names and numbers and start calling. Your interview should include questions about training and experience in general practice, and also experience with clients like you. Ask about office environment and policies.

Choose a practitioner that has extra training and experience working with cancer patients. A more complicated health history indicates that the therapist’s expertise is more important. Also, in some cases it is best to get your doctor’s approval.

Most of all, massage should never hurt, and if it does, you should say something. A conscientious massage therapist will constantly seek your feedback during the massage to make sure that the treatment is within your comfort zone the entire time. If you don’t feel that your feedback or concerns are (or will be) addressed, you’re not in the right place.

You can search the MedFit Network for a massage therapist in your area, or search the American Massage Therapy Association’s Massage Therapist search.


Kathy Flippin’s passion is to offer excellent therapeutic massage, and educate her clients on how they can take the best care possible of themselves. Kathy is the owner of Dynamic Touch Massage and has been a Sports Massage Therapist since 1997. Her clients include everyone from professional athletes to active grandmothers.

Massage-Therapy-Senior-Client

I have heart disease. Is massage right for me?

According to the Heart Foundation.org about 80 million Americans have heart disease or high blood pressure. The 2010 Heart Disease and Stroke Statistics update of the American Heart Association reported that 17.6 million persons in the United States have heart disease, including 8.5 million with a history of heart attack and 10.2 million with chest pain. The prevalence of heart disease increases with age for both women and men.

Heart disease requires a variety of possible treatments, including various medications and procedures. Some people with heart disease may benefit from regular massage, but there are certain types of massage that can possibly cause serious damage. You need to be sure you’re in a knowledgeable practitioner’s hands to make sure you are safe.

Can Massage Help?

A hypothetical example:

Alex is a 59-year old tax preparer who has moderately High Blood Pressure that is easily controlled with a healthy lifestyle and medications. He is married, enjoys golfing, shooting, and watching football. As Alex’s work becomes busier during tax season, he gets headaches that are frequent and intense.  And when he works too much, he doesn’t have time to take care of himself like he should.

Alex’s doctor recommended that massage could help compliment his treatment plan to stabilize his blood pressure. His doctor referred him to a therapist who is experienced in working with cardiovascular patients. The doctor and therapist agreed that a relaxation massage with some trigger point and stretch techniques mixed in would be safe and beneficial for him.

After a few massage sessions, his headaches decreased. The doctor recommended a massage twice every month, but during busy season, Alex likes to go every week. The routine gives him peace of mind in knowing he’s doing everything he can to take good care of himself. For him, massage is a great antidote to the hours at his desk, and he finds himself less “grumpy” when he gets home after a hard day. When work is less busy, and Alex has more time for golf, he finds that massage gives him great relief for his low back tension, which helps his swing. Alex considers massage as part of his prescribed health routine, just like eating carefully and exercising.

What should you be careful of?

Because there are so many different types of cardiovascular conditions, there is no one-size-fits-all approach. The type of massage that you have seen on TV is not the only kind out there, and in fact, may not be right for you. Your complete health history must be considered before making a decision. You must always talk to your doctor before deciding to embark on a personal massage program:

Blood thinning drugs: Cause the body to be more sensitive and in some cases, even fragile. Deep tissue done on someone taking blood thinners can cause inflammation, bruising, and tissue or organ damage.  Like the wise man said, more is not always better.

High Blood Pressure (Hypertension): Massage may be just the thing to help you manage stress and subsequently your high blood pressure (just like the example above). Low blood pressure is also a concern, and because massage lowers one’s blood pressure slightly, it is not uncommon for individuals taking medication to lower their blood pressure.  This would cause them to get a bit lightheaded just after receiving a massage, until the blood pressure returns to normal.

Blood Clot: Individuals with a history of blood clots (aka Thrombosis) should avoid Swedish Massage. Swedish massage techniques on someone who has a risk of blood clotting could possibly dislodge a clot and release it into the blood stream. In a worst-case scenario, this can induce a stroke or heart attack, or a lung blockage.

Pacemaker: If an individual has a pacemaker, stent, or any kind of apparatus implanted into a vein/artery which is superficial (in the neck and leg would be considered superficial, but inside the rib cage is not), the therapist must avoid pressing over that area so as not to dislodge or damage it or surrounding tissues. But massage can usually be safely done on the rest of the body.

Massage can usually be great for someone who has Arrhythmia or a disruption in the heart rate, if that is the only health concern.

An individual with any signs of Congestive Heart Failure should avoid vigorous Swedish massage or limit Swedish massage to less than 15-20 minutes.  Gentle Massage on head, feet and hands is not a problem.

You must find a therapist who is experienced and knows how to keep you safe. If they don’t ask about your medications or medical history, you’re not in the right office. Interview them on the phone before you go, and check their credentials. You probably want to ask your doctor to consult with your therapist so they can discuss your options. You probably CAN have massage, but it may be different from what you imagined, or what you see on TV.

How do you choose a practitioner?

If you are seeing a cardiologist, you should definitely get medical clearance before you have a massage. You should also get guidance on what kind of massage is best, and what the risks are. You should call your therapist before your appointment to make sure they have a good understanding of what it takes to keep you safe and comfortable. Most Certified or Licensed massage therapists get instruction on working with individuals with heart disease as part of their entry level massage education. However, there are additional classes available, and each therapist has varying levels of awareness and experience. Don’t be afraid to ask questions about the therapist qualifications, and what they’re going to do during the massage. While you’re receiving massage, continue to ask questions as they come up. If at any time during the massage it feels worse than a “hurts good” sensation, then it’s too much, and you should speak up. Your therapist should never encourage you to suffer through anything you don’t like during a session.


Kathy Flippin’s passion is to offer excellent therapeutic massage, and educate her clients on how they can take the best care possible of themselves. Kathy is the owner of Dynamic Touch Massage and has been a Sports Massage Therapist since 1997. Her clients include everyone from professional athletes to active grandmothers.

Trainer-with-senior-client-using-machine

The Roles of a Medical Fitness Specialist: Scope of practice, prevention and interprofessional collaboration

Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.

Scope of Practice

Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.

An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.

Prevention

In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.

Interprofessional Collaboration

Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.

Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.

An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:

  • Knowledge of basic chronic disease pathophysiology
  • The use and side effects of common medications taken by someone suffering from a chronic disease
  • The knowledge to perform and analyze basic assessments related to movement and anthropometry
  • The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers
  • FITT protocols, exercise progressions, and regressions
  • The implications of exercise and activity for individuals with chronic disease
  • Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease
  • Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise
  • The ability to recognize a medical emergency
  • Current CPR and adult AED are required

Personal Trainers & Fitness Professionals: Prevent & Manage Chronic Disease and Collaborate with Clinicians

Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.

For a limited time, save 40% on this course by entering coupon code MFNBLOG40 at checkout.


This article was featured in MedFit Professional Magazine. 

Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program. 

pregnancy-heart

Benefits of Prenatal Massage

Prenatal Massage, Easing the Changes

What better way to show you are dedicated to giving this new life every advantage in the world than to arrange for a pregnancy massage from a specially certified therapist. Each session is designed to focus on the special needs of a mother-to-be as her body goes through the dramatic changes of the child-bearing year, which includes pregnancy, birth, and post-delivery. Massage provides a nurturing touch, which in turn, nurtures the life of your unborn child.

A woman’s body changes a great deal over nine months. Her weight increases, her breasts change, her blood pressure elevates, organs are compressed and pushed up, and the muscles in her abdomen become stretched and strained. Massage can help relieve pressure and tensions created by these changes.

Benefits of a Pregnancy Massage Include:

  • An opportunity for much-needed rest and relaxation
  • Balances hormones (relieving moodiness and nausea)
  • Increases fetal circulation
  • Reduces swelling
  • Relieves back and neck pain
  • Improves skin tone elasticity
  • Deepens maternal bonding
  • Enhances body awareness (making delivery easier)

Benefits of Massage After Birth

  • Post-delivery/Postpartum massage addresses the mother’s stress of carrying and caring for a newborn, speeds recovery and relieves sore muscles.
  • The childbearing year includes not only the three trimesters of pregnancy, but also during labor, and three months after delivery.
  • After delivery, a new mother must gradually regain her postural strength and pre-pregnancy state of of fitness. Your therapist will give you stretches and exercise you can do at home to help your body get back to normal.

How is Pregnancy Massage Special?

The mother-to-be is always carefully supported in several positions. When lying face-up, she is supported with the back lifted, to provide comfort and maximum circulation to the legs and the fetus. While in a side-lying position, special pregnancy pillows support the stomach, which allows the therapists to massage the back and hips. The belly is NEVER compressed by lying face down, nor is the belly left hanging through a hole in the massage table. These methods are less than ideal for the mother’s body and for fetal circulation.

Pregnancy massage addresses the profound changes a woman’s body experiences during the entire childbearing year. During the first months, massage can help her body balance changing hormones, which often cause morning sickness. During the Second Trimester, pregnancy massage addresses the upper and lower back pain that develops from the weight of the new baby. At the end of pregnancy, massage can relieve swollen feet and hands, numbness, hip, low back and sciatic pain. Pregnancy massage is also intended for the three months after the delivery to help the new mother regain abdominal strength, reduce soreness and relax muscle tension, and to offer a brief respite from the new duties of motherhood and caring for an infant

If you are in a “High Risk Maternity” category, or having any complications, you may still be able to have a massage, but you should definitely get medical clearance first. You should also call your therapist before your appointment to make sure they have a good understanding of what it takes to keep you safe and comfortable. Most Certified or Licensed massage therapists get instruction on working with Pregnant Mothers as part of their entry level massage education. However, there are additional classes available, and each therapist has varying levels of awareness and experience. We recommend finding a therapist that has an additional certification in Pregnancy or Prenatal Massage. Don’t be afraid to ask questions about the therapist qualifications, and what they’re going to do during the massage. While you’re receiving massage, continue to ask questions as they come up. If at any time during the massage it feels worse than a “hurts good” sensation, then it’s too much, and you should speak up. Your therapist should never encourage you to suffer through anything you don’t like during a session.


Kathy Flippin has been a Sports Massage Therapist since 1997 is the owner of Dynamic Touch Massage. Kathy’s passion is to offer excellent therapeutic massage, and educate her clients on how they can take the best care possible of themselves. Her clients include everyone from professional athletes to active grandmothers.

 

References

  1. Field, T. (1999). Pregnant Women Benefit From Massage Therapy. Journal of Psychosomatic Obstetrics and Gynaecology, Mar;20(1):31-8.
  2. Field, T. (2004). Massage Therapy Effects on Depressed Pregnant Women. Journal of Psychosomatic Obstetrics and Gynaecology, Jun;25(2):115-22.
kettlebell-sneakers

The Three R’s: Reset. Reload. Reinforce.

Before you can begin checking the boxes off above a baseline needs to be established. What is the best way to set a baseline that isn’t time-consuming? A Physical Therapist can test physical capacity, but will that give them the total picture? What if you are a health care provider such as a Massage Practitioner or a Chiropractor, or a doctor of an individual who wants to start an exercise program? How do you set-up a baseline of indicators to capture dysfunction at the level of the movement pattern, not just muscles/tissues that are weak or injured?

The quickest and easiest way I know of is a Functional Movement Screening and a Movement Assessment Screening. It is a ranking and grading system to measure asymmetries. If there is a pain in any of the movement patterns the activity is stopped and a referral is made. As a Functional Movement Specialist, I can do the movement screening with a printed report and corrective strategy exercises to reinforce quality movement patterns. This establishes a baseline to work from and retesting is done periodically.

The way this effective approach works: Each box needs to be checked off before you move to the next box.

The meaning of the three Rs is…

Reset

When a patient/client goes into a Physical Therapist for treatment, or Massage Practitioner for manual manipulation of muscles/tissues, or Chiropractor for a muscular skeletal adjustment. After the procedure the next step is usually, rest, ice, maybe some stretches and to review or start an exercise program. Ok, if this is the standard procedure followed, what is missing from this picture?

Reinforce

This next step is where I as a Fitness Trainer am highly effective, first with myself and now others. I took my twisted muscular-skeletal frame from a seat belt injury and started retraining the correct movement patterns by reinforcement. It takes about 7,000 repetitions of a movement pattern before it becomes spontaneous. What do I mean by reinforce? Reinforce means you either go back to what you were doing with the same faulty movement pattern and setting yourself up for needing another reset, instead of going in for a maintenance appointment. Keeping the cycle of dysfunction and asymmetries going that lead to dysfunction, pain and injury.

Reload

A combination of corrective exercises and conditioning work, such as using supersets to establish better hip hinging and then doing deadlifts, and then maybe add some kettlebell swings.

Reload the frame with the right resistance that maintains the right movement pattern exercises. I use a wide variety of tools based on the client’s needs and preferences.

Reset, reinforce and reload can be applied to both rehabilitation and exercise. In rehabilitation, Physical Therapist/Health Care Provider is working with pain and dysfunction. Exercise professionals work with dysfunction by setting up a baseline and reinforce correctives and conditioning to help prepare the individuals to return to a full active life.

I have successfully retrained my body after a seat belt injury that caused asymmetry imbalances, and now successfully use these remedial corrective strategies with my clients. I give my clients enough practice to learn how to move efficiently, and believe in open communication, taking after hour calls and making home visits.

Move well, move often, stay fit, live!


The Kettlebell Lady – Leanne Wylet, BA, ACE -NCCA, specializes in Orthopedic Exercise, Functional Movement, Hard Style/High Intensity Kettlebell Fitness, Silver Sneakers FLEX & Tai Chi Instructor works with the aging population. She has come back from a seat built injury that left her disabled and two major illnesses; her body is now restored. Taking the skills she’s developed, plus academic training, she works with individuals in all walks of life from youth to those in their golden years. Visit her website, kettlebelllady.com

Female-Trainer-and-older-male-client

The Commodification of Medicine and Fitness: The Good, the Bad, and the Ugly

The need for medical and fitness services/products continues to grow. In the United States, and around the world. The corporate and industrialized delivery of medical and fitness products/ services continues to grow to meet increasing demand. Innovations in medical diagnostic technologies, surgical procedures, biomaterials, and medicines help individuals live longer, and with a higher quality of life. Technology and scientific research are propelling fitness product/service innovation with digital activity monitoring apps . . .

team hands

Collaborative Thinking in Health & Wellness

Over the past 18 months, I have seen my primary M.D. three times, enjoyed the services of my favorite massage therapist six times, visited my chiropractor nine times, chatted with a local R.D. twice and seen my personal trainer regularly. And not one of them even asked if I was seeing any of the others, much less inquiring what their treatments or approaches to treatments might be. To me, that is like trying to achieve success with a baseball team where the 1st base coach, 2nd base coach, 3rd base coach and pitching coach never communicate with each other.

Success cannot occur in a vacuum, neither can trueindividual health & wellness, yet for decades these medical, fitness & wellness providers have proffered their services in distinct and distinctly separate spaces.

Even as the internet has made access to information easier and facilitated the sharing of knowledge, including private, HIPAA compliant information, these providers continue to operate in “informational silos.”

It is true that in the past some of these providers may have held less than favorable opinions of some of the other providers, but that is, and certainly should be, a thing of the past. No longer will M.D.’s consider Chiropractors “quacks”, R.D.’s claim nutritionists “just don’t know enough”, and Physical Therapists think of Personal Trainers as ”wanna-be P.T.’s who couldn’t hack the education.” Science, knowledge and time have evolved all these disciplines into valuable, useful and incredibly beneficial specialties, each offering specific training and specific methods to apply to their patients/clients. And all those patients/clients typically can benefit from their combined expertise and knowledge.

No longer is it sufficient to simply treat the symptoms. Real wellness needs to encompass the patient/client holistically… address the symptoms, understand the cause, strengthen the mind, examine the diet, resolve the issue and prevent future occurrences. And isn’t that best accomplished by viewing patient/client wellness as a Team Sport?

Over the years I have had the pleasure of knowing and speaking at length with many of these medical, fitness & wellness providers, and not one of them indicated there is anything in their training that says “Thou Shalt Not Collaborate.”

We are not talking about “asking for help.” Rather we are simply saying to include those other practitioners in the conversation. Instead of the M.D. telling the patient to “walk more to improve cardio health”, why not conference call with the Personal Trainer and discuss the walking program that is most appropriate. Let the Physical Therapist inform the Personal Trainer of any specific issues to address or avoid. Allow the Massage Therapist to work with the Chiropractor to ensure optimum results from both. In other words, (and the simplicity of all this may surprise you), just TALK TO EACH OTHER.

So, let’s start to make that happen. For more than 20 years my company has helped health clubs and fitness centers create mutually beneficial relationships with Physical Therapy practices, Chiropractic offices, Registered Dietitians, Nutritionists and Massage Therapists. Now is the time to extend the conversation, and, to return to my baseball metaphor, get ALL the coaches working together to create truly Championship results.


Cosmo Wollan is the Senior Executive at Synergy Cubed, a premiere consulting firm providing customized solutions to the health & fitness, parks & recreation, medical fitness and corporate wellness industries since 1994. His Fitness Industry clients have engaged him as an expert problem-solver in profit center development, retention strategies, customer engagement, sales training, programming design, operational streamlining and health club management.

trainer-resistance-band-senior-woman-client

You Are The Solution

This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.

Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).

While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.

Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”

The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.


This article was featured in MedFit Professional Magazine.

Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com.

References

Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal22, 17–025. doi:10.7812/TPP/17-025

Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning

Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey

U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.

med-fit-client-doctor-exercise

Healthcare Through Fitness

A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.

Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.

If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?

The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.

What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:

  • Regular medical oversight by a medical director
  • Practitioners with nationally-recognized certifications and training in the care of chronic disease
  • Comprehensive health assessments and exercise prescription
  • Exercise classes geared toward specific medical conditions

These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.

The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.

Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.


This article was featured in MedFit Professional Magazine. 

Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com