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Fitness Professional’s Toolbox: Intermittent Exercise by Joe Giandonato, MBA, MS, CSCS

When it comes to the design, prescription, and delivery of a comprehensive fitness program, the overarching edicts of safety, efficiency, and effectiveness should always be upheld. However, when life happens and clients’ discretionary spending capacity and available time both dry up, novice personal trainers are apt to throw in the towel.

By far and large, working professionals are not professional athletes and therefore should not be held to the same standards. Working professionals log 40 hours or more per week in their respective industries, whereas professional athletes have a plethora of resources at their disposal, which include state of the art facilities that are staffed by teams of sports medicine, strength and conditioning, and nutrition professionals. These gifted individuals have all they need to exercise and ascribe to a healthy diet, since their priority is achieving and maintaining a body that is healthy and capable of high performance.


Working professionals often have a family to support and an assortment of bills to juggle impacting their ability to meet with you regularly and frequently.


As such, they may not be able to adhere to a textbook exercise program — which is ironic, since no textbooks prepare you to support your clients when life interferes with exercise programming.


Say your client needs to pare down their sessions from three times per week to once per week.


Do you write them off? Do you chalk it up to laziness? Do you attribute it to a lack of dedication?


If you answered “yes” to any of those, you may want to re-evaluate your career choice.


Instead, take a deeper dive into their everyday life. If things are growing hectic on the work- or home- fronts, or if their wallet is getting thinner, consider hybridizing their program.


If they can only meet with you once per week, cover the basics in each session: introduce, coach, and perfect fundamental movement patterns. If time and their current level of fitness permit, push them through anaerobic capacity work in the form of traditional strength training, metabolic conditioning, or functional training with a 1:1 work to rest ratio.


If they are only meeting with you once per week and have weight loss or general health goals and are unable to dedicate hours in the gym each week, consider complimenting their session(s) or gym visits with intermittent exercise.


Research has shown that the inclusion of three short bouts of 10 minutes of physical activity via walking was capable of improving cardiorespiratory fitness over two and six week spans (1).


Encourage your client to park to engage in active commuting. Active commuting involves augmenting or completing typically achieved with traditional forms of transportation, such as motor vehicles and trains, with walking or bicycling. And an added bonus is that it’s eco-friendly!


Also, you can encourage your client to take “movement breaks” when allotted a 15 minute break at their workplace as mandated by labor regulations. These movement breaks can consist of walking around the workplace, climbing stairwells, or taking a stroll outside while others mull over unhealthy options at the breakroom vending machine or commiserate with others over tobacco coffin nails.


Additionally, for clients dealing with musculoskeletal pain and begetting muscular imbalances, the workstation can serve as the new “workplace gym”.


In 2016, a Midwestern corporation did just that. Pursuant to having numerous health insurance claims for work-related musculoskeletal disorders, the corporation devised, developed, availed, and promoted an 8-minute stretching program that was based off of the Mayo Clinic’s office stretching program. Over a 60-day period, significant reductions in injuries and missed days of work were noted as was a cost savings in aggregate healthcare spend (2). And though no flexibility measurements were recorded, based off the data, one can easily infer that study participants felt better and likely began moving better during and following their workday.


A sample desk-based program can be found below:


Lengthen and Strengthen


Phase One: Lengthen


Seated Upper Trapezius / Neck Extensor Stretch (1 set x 10 full breaths each side)


– With open palm, gently grasp crown of head and draw elbow downward

– Hold for prescribed number of breaths and alternate sides


Interlocking Hands Pectoralis Minor Stretch (1 set x 10 full breaths)


– Place hands behind head and interlace fingers

– Gently cup crown of head with interlocked hands

– Gingerly tilt head back and drive elbows back

– Think external cue of “getting big chest and driving breastbone (sternum) away from chest”

– Hold for prescribed number of breaths


Reaching Latissimus Dorsi Stretch (1 set x 10 full breaths)


– From seated position, lean forward and grasp edge of desk

– “Pull” torso away from desk and try to achieve a “long spine” (or flat back)

– Hold for prescribed number of breaths


Cross Body Shoulder Stretch (1 set x 10 full breaths)


– Clench one arm within another and draw it across your body

– Maintain erect torso and “big chest”

– Hold for prescribed number of breaths


Torso Supported Calf Stretch (1 set x 10 full breaths)


– Stand up and lean forward onto desk, wall, or other stationary object

– Place one foot near the object and other foot behind you, maintaining flat feet

– Keep a “long spine” and extended hips

– Hold for prescribed number of breaths


Half Kneeling Hip Flexor Stretch (1 set x 10 full breaths)


– Assume half kneeling position, keep shin of front leg and thigh of back leg upright

– Achieve a long spine by keeping core tight and shoulders open and loose

– “Dig” toes of foot of back leg into floor

– Hold for prescribed number of breaths


Deep Squat with Belly Breathing (1 set x 10 full breaths)


Grasp desk, door frame, cubicle divider or other stationary object

– Descend into deep squat position, with feet at shoulder to hip width and fully on floor

– Drive knees outwardly and keep spine long via tight and activated core

– Hold for prescribed number of breaths


Phase Two: Strengthen:


Chin Tuck with Deep Cervical Flexor Activation (1 set x 10 repetitions)


– Position crown of head against wall

– Keep neck straight and neutral

– Drive chin rearward into throat and try to make a “double chin”

– Hold briefly and return to starting position

– Repeat for prescribed number of repetitions


Bent Prone Trap Raise (1 set x 10 repetitions)


– Assume prone position with bodyweight supported via one arm on desk or another stationary object

– Dangle other arm down to the floor

– Pull shoulder blade of free arm back and down, and raise arm with thumb side up

– Raises with left hand will be performed with arm at “10 o’clock” angle and right hand will be performed with arm at “2 o’clock” angle a

– Please do not “shrug” shoulders when performing exercise

– Repeat for prescribed number of repetitions


Desktop Sliding Shoulder Retraction (1 set x 10 repetitions)


– Sitting upright in desk chair, place hands and forearms at shoulder width atop surface of desk

– Keep thumb side up

– Initiate movement by drawing shoulder blades back and down and slide forearms back to torso to complete movement

– Repeat for prescribed number of repetitions


Sit to Stand with Overhead Reach (1 set x 10 repetitions)


– Secure an immovable chair or object that is roughly knee to mid-thigh height and is capable of supporting entire body weight

– Descend into seated position

– Place your hands across your chest

– Rise from seated position, by driving off your heels, extending your hips and rocking onto forefoot (front of foot)

– Raise your arms with your hands overhead and reach for the ceiling

– Put your arms down and slowly descend into seated position

– Repeat for prescribed number of repetitions




  1. Murphy, M., Nevill, A., Neville, C., Biddle, S. & Hardman, A. (2002). Accumulating brisk walking

for fitness, cardiovascular, and psychological health. Medicine and Science in Sports and

Exercise, 34, 1468-1474.


  1. Aje, O.O., Smith-Campbell, B., & Bett, C. (2018). Preventing musculoskeletal disorders in factory workers: evaluating a new eight minute stretching program. Workplace Health & Safety, 66, 343-347.
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Top 5 Secrets to Weight Loss Success in 2019

A decade or so ago, we all believed that most of our calories should come from whole grains and other carbs, and that eggs and other saturated fats gave us heart disease. We were also sure that longer bouts of cardio would yield greater reductions in body fat. But times have changed, and the jury is in. New research shoots holes in just about everything we thought to be true about successful healthy weight loss. 

Here are five weight loss secrets, backed by clinical evidence, to help you succeed in 2019:

  1. Close the window: We once believed that eating small meals and snacks several times throughout the day was a great way to stabilize blood sugar and silence hunger pangs, thereby facilitating weight loss. Not surprisingly, few people who followed that advice actually lost weight. Giving your body a steady supply of energy negates the need to tap into fat stores. Instead of eating around the clock, practice intermittent fasting by eating all your calories within a six to eight hour window, and stop eating at least three hours before bedtime. Watch your energy soar as your fat melts away. Study
  1. Burst out of your plateau: Long bouts of moderate-intensity cardio lasting 60 to 90 minutes will help you burn fat, but it is a huge time commitment that most people cannot sustain. Burst training, aka interval training, speeds up fat loss while giving your metabolism a boost that lasts for hours. To begin, try walking for two minutes, then running all out for 30 seconds; repeat that cycle for a total of 20 minutes, three to five times per week, and watch your body shed its fat layer. You can adjust the walking to running ratio as your fitness level improves, spending more time in sprint mode. Study
  1. Lift heavy objects: There is no doubt about it, resistance training is one of the fastest ways to whip your body into shape and shed unwanted pounds. Use good form, and push yourself beyond your comfort zone. You will be amazed at the transformative results. Study
  1. Manage stress and sleep: Sleep deprivation and stress make a double-edged sword that elevates cortisol levels, encouraging your body to hang onto fat. Your body needs sleep to maintain a healthy immune system and refresh your brain. Chronic stress leads to metabolic disease and weight gain. It is nearly impossible to lose weight when you are always stressed and sleep deprived. Study
  1. Fatten up your diet: A diet low in carbs and processed foods, with moderate amounts of protein and high in healthy fats encourages your body to use fat for fuel, all day long. Avocados, coconut oil, nuts, eggs, salmon, sardines, olives, cheese and other foods high in fat will cut your hunger pangs and give you plenty of energy for your workouts. Study

Losing excess body weight can be a positive step toward better health. However, the scale should not be your only tool for measuring your progress. A well designed fitness program will help you reduce your body fat percentage, lose inches, and increase your overall strength and endurance. Obsessing about the numbers on the scale can undermine your progress and kill your motivation. Instead of zeroing in on a specific body weight, think about your energy level and how well your clothes fit. Looking and feeling your best spells success!


W.I.T.S. has all the tools you need to keep pace with the fitness industry and stay informed about the latest research. Increase your value and tap into a growing market with an Older Adult Fitness Certification. Help your clients manage stress and lose weight with Lifestyle Fitness Coaching. Hone your business skills with our Online Business Management continuing education courses. Stay on top of the latest industry trends and watch your business grow with W.I.T.S.!

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Setup for Success: Top 10 Business Secrets of Super-Successful Personal Trainers

The market for personal fitness services has gradually been shifting in the 21st Century, as technology has introduced multiple options for access to training, and traditional activities like cardio, Group X and weight training have had to make room for a broader spectrum of exercise options like yoga, CrossFit and Functional Training. Yet one-on-one training is still the best way for clients to get in shape and reach their goals, and smart personal trainers can capitalize on PT’s successful track record by adhering to a few simple rules.

Top 10 Secrets to Success

  1. The Proof is in the Pudding. If your clients succeed, you succeed. All the advertising and marketing in the world cannot come close to the word-of-mouth of satisfied and successful clients. Go for the goals, and let your success speak for itself.
  1. Never Judge a Prospective Client: It is easy to make assumptions based on appearances, but they can be deceiving. Don’t put people on a budget based on what you assume they can afford. Make your sales pitch about results, and let your client  worry about the money.
  1. Your Fees Reflect Your Value. Offering below-market bargain rates may attract a certain client demographic, but not the kind that keeps coming back for more. Meanwhile, you will have a hard time making ends meet if you undercharge. If you value yourself and your services, charge what you are worth.
  1. Compliance Equals Success for both you and your client. Showing up consistently is key to achieving goals. Charge your clients for missed sessions and don’t let them make excuses, or you will both fail.
  1. Stay out of the friend zone. All that personal one-on-one time inevitably leads to closer relationships, but you need to draw a line between business and friendship if you want to succeed as a professional. 
  1. It’s not about you. Every minute of every session should be focused on helping your client succeed. Venting or oversharing about your personal life will quickly erode any professional boundaries, and make it harder to manage your client lineup.
  1. Clients Cheat and Lie About It. The sin of omission is common in personal training. If your client has plateaued, go back to their behavior contract and make sure they are fulfilling their end of the agreement.
  1. Go for the long game. Fitness is a process, and there are no short cuts. Sell long-term packages and set realistic goals. 
  1. Be an Innovator. Individualized programming is key to putting the “personal” in personal training. Be creative, and don’t be afraid to think outside the box to help your clients succeed.
  1. If you fake it, you’ll never make it. Education is ongoing, especially in a rapidly evolving field like fitness. Stay up to date on the latest trends and research. Keep your certs current, and get as much continuing education as you can, or you will choke on your competitors’ dust. 

W.I.T.S. has all the tools you need to keep pace with the fitness industry. Increase your value and tap into a growing market with an Older Adult Fitness Certification. Hone your business skills with our Online Business Management continuing education courses. Up your business game this year, and see how far you can go as a fitness pro!

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Programming Tips for Injured Clients

DISCLAIMER:The information disseminated in the passages below is by no means to be construed as medical advice. Fitness professionals are advised to consult their clients’ physicians and obtain medical clearance prior to continuing to provide personal training services.

Two things in life are inevitable: death and taxes. Among active populations, especially those who engage in sports — either recreationally or competitively — injuries are the third inevitability.

Hybrid Online Personal Trainer Course Example

When injuries do arise, whether the consequence of improper programming or something entirely happenstance outside of the gym, personal trainers are faced with a dilemma loaded with logistical, ethical, and potential financial implications.

Before scrapping plans completely and shelving their clients on injured reserve, fitness professionals should take heed to the following recommendations:

  1. Maintain a training stimulus

Provided your client has been medically cleared, you can determine and work within their current scope of abilities. While bilateral exercises — a majority of which are performed with barbell exercises — are off the table if your client has sustained an injury to one of their limbs, they can be aptly substituted with a unilateral variation. For example, your client who recently suffered sprained wrist playing basketball is unable to perform a barbell bench press, which is conveniently their favorite exercise. Luckily, you can salvage a training effect by having them perform a dumbbell press variation from a flat bench or the floor to maintain strength, muscular endurance, and range of motion, in their non-injured limb all the while staving off degradations in strength of their injured, or even immobilized limb made possible via the neurophysiological phenomenon known as “cross training”. Unilateral strength training was found to increase neural drive to contralateral (or opposite) untrained muscles (1).

As it relates to cardiovascular exercise programming, if your client suffered a lower body injury, you can have them perform seated movements involving battle ropes or medicine balls to elicit improvements in or maintain cardiorespiratory fitness. Alternatively, a client could perform rotations on an arm ergometer or rattle a speed bag. Those looking to build up their cardiorespiratory fitness following a layoff could perform these in intervals, initially beginning with a 1:3 work-to-rest ratio before whittling down to a challenging 1:1 work-to-rest ratio. If upper body cardio is performed, fitness professionals should know that it will evoke a greater cardiac response (elevated heart rate and blood pressure) versus traditional forms of cardiovascular exercise such as running and biking even if conducted at similar intensities.

  1. Prioritize neglected fitness qualities

If your client is unable to perform their normal routine involving strength training and/or cardio due to injury, now would be an opportune time to address fitness qualities that may have resting on the backburner such as flexibility, soft tissue quality, and/or mobility/stability relationships of joints. For example, for your uber-competitive and personal record centric clients, you could measure passive or active range of motion of preferably non-injured limbs, program exercises to improve them, and challenge your clients for continual improvement as you would within a traditional program.

  1. Carve out time for rehabilitation

If you client has been prescribed physical therapy and was provided a home program, allocate a portion of your session to familiarize yourself with their exercises and to ensure their adherence to the program that will likely yield improved outcomes.

  1. Recognize that success is not linear

Successful athletes, investors, entrepreneurs have experienced multiple setbacks throughout their careers. Your clients are no different in their pursuit of specific fitness and health goals. Injuries crop up as do competing demands such as familial, occupational, and/or scholastic responsibilities. All can interfere with progress in the gym. Advise your client to step back and recognize that uninterrupted linearity is existent in a handful of things (i.e. age) and rarely in the pursuit of fitness goals.

Working with injured clients carries its own liability risks. Make sure you are protected with adequate insurance before taking on high-risk clients.


  1. Lee, M., Gandevia, S.C., & Carroll, T.J. (2009). Unilateral strength training increases voluntary activation of the opposite untrained limb. Clinical Neurophysiology, 120, 802-808.

About the Author

Joe Giandonato, MBA, MS, CSCS has been an educator with the World Instructor Training Schools since 2010. He also serves as an adjunct professor of exercise physiology electives at numerous colleges and universities within the greater Philadelphia area.

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15 Benefits of Hiring a Certified Personal Trainer in 2019

It’s that time of year again, when our thoughts shift from visions of sugar plums to visions of rolls—I mean those fat rolls that settled around your hips and belly after a little too much holiday cheer. Not taking care of the excess weight right away is a lot like not paying your recurring monthly bills…the longer you wait, the harder it is to get caught up!

Of course, most of us begin the New Year with the intention of doing better in every area of our lives. Prosperity, good will and improved health top the list of most common New Year’s resolutions. However, without a plan, your resolutions are just a pipe dream. If you truly want to manage your weight, improve your health and look your best in the New Year, hiring a Certified Personal Trainer to help you reach your goals is a solid step in the right direction. 

15 benefits of hiring a certified fitness professional in 2019:

  1. Attainable goal setting: Fitness goals are hard to reach, especially if you expect too much, too soon. Unrealistic goal setting is a recipe for failure. A professional trainer can help you set and attain achievable goals for long-lasting results.
  2. Accountability: The mere act of paying for personal training gives you some skin in the game. Knowing you will have to report to your trainer on a regular basis will help you stay the course and reach your goals.
  3. Support system: Friends and family can be your biggest fans, but they can also sabotage your fitness goals—they love you just the way you are! Your trainer is always there to talk you off the edge when you feel like giving up. 
  4. Break bad habits: Most weight issues and health problems come on gradually, the products of multiple daily habits that culminate in sickness and obesity. A trainer can help you identify damaging daily habits and swap them out for healthier options. 
  5. Education: A good trainer is a teacher at heart, and they will help you learn perfect exercise technique for best results and reduced risk of injury. They will also educate you about nutrition and lifestyle behaviors to improve your overall health. 
  6. Avoid injury: Any type of physical activity carries with it inherent risks. Your trainer will monitor your progress to make sure you are ready to take on new challenges, so you can move toward your goals with confidence. 
  7. Reverse aging: Physical activity is proven to be the most important behavior for maintaining youthful vigor and appearance. Increased collagen throughout your body affects your skin, hair and nails, and strengthens your bones and joints. Strong muscles improve your posture and reduce your risk of falls and injury.
  8. Improve immune function: A fit healthy body is better able to ward off invading pathogens and avoid metabolic disorders like diabetes and heart disease. With a trainer, you will see incremental improvements in health, week after week. 
  9. Improve performance: Whether your goal is to be stronger and have more energy for activities of daily living, excel at sports, or run a marathon, a trainer can help you  realize your peak potential. 
  10. Better cognitive function: The adage “healthy body, healthy mind” has endured for centuries because it is true. Your brain benefits from physical activity, helping you to manage stress, make better decisions and perform better at work.
  11. Reduced depression and anxiety: Fitness reduces stress hormones and produces endorphins, the feel-good chemicals that promote a positive mood and outlook. 
  12. Improved appearance: For all its health benefits, the cosmetic benefits of fitness cannot be overlooked. Your trainer can help you sculpt the perfect physique for your body type. 
  13. Increased self-esteem: A trainer will challenge you become the very best version of yourself while cheering your every milestone. With all that positive energy spurring you to greater heights, it is impossible to feel bad about yourself. 
  14. Higher tolerance: What doesn’t kill you makes you stronger, both physically and mentally. As your tolerance for discomfort grows, so does your confidence that you can successfully take on new challenges. 
  15. Improved quality of life: In general, fit and healthy people enjoy a richer, happier, more successful quality of life. Your trainer will stick with you every step of the way, helping you reach your highest potential. 

Best Fitness Certifications in USA

Whether you want to hire a Certified Personal Trainer or become one yourself, W.I.T.S. offers the best fitness certifications in the industry. Fully NCCA accredited, W.I.T.S. teams up with colleges, universities and fitness facilities across the US and Canada to bring you professional lectures, hands-on practical training and on-site internships. Register today, and join thousands of successful fitness professionals certified by W.I.T.S. Together, we can change the health profiles of millions while doing what we love. 

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Fitness Tech-Knowledge-Y: Smart Fashion for Informed Performance


Just when you thought you knew it all, technology for fitness tracking raises the bar with smarter and better wearables. Following are just a few of the more notable options now trending for smart fitness fashion.

MBody Smart Shorts by Myontec: These 3D elastic compression shorts read and report information on muscle load, heart rate data, cadence, speed and distance. Designed for cyclists, duathletes and triathletes, MCell smart measuring tech delivers stats via bluetooth to the MBody Live app on your iOs or Android smart device. Priced at $885 a pair, let’s hope they are washable, because you probably won’t want to buy a spare pair.

LINX Smart Bicycle Helmet by Coros: Wirelessly connect your helmet to your smartphone to listen to music, make and accept phone calls, talk to fellow riders, and keep abreast of navigation and ride data through open-ear Bone Conduction Technology. The helmet is equipped with a precision wind-resistant microphone for clear communication, perfect for commuters who need to stay in touch. At only $200, this helmet may be well worth the investment.

Apple iWatch (Series 4): Probably the best fitness tracker on the market, especially when you consider its many other functions, the Series 4 Apple Watch is a worthwhile investment at just $399. The device is completely waterproof up to 50 m, perfect for swimmers. With a built in GPS, brighter display and a plethora of fitness tracking tools, Apple leaves its competitors in the dust with this iteration of the iWatch.

Zepp Digital Sports Training Device: OK, so this is not technically a wearable, but it does attach to your sports equipment (tennis racquet, baseball bat, golf club or soccer calf sleeve) to give you stats and feedback on your performance, along with video of each kick or swing. At only $99.99, this device may be worth it for anyone working to step up their game.

TUNE Smart Insoles by Kinematix: Place these high-tech insoles beneath your regular running shoe insoles, and embedded sensors will transmit data on your running technique and performance to your smart device. In addition to working with your GPS to track speed, pace and distance, TUNE monitors both feet, measuring ground contact time and heel contact time, helping you to improve running efficiency and reduce injury risk. Available for $199, devoted runners may find the device well worth the price.

Whether quantifying your workouts correlates with improved health, performance or weight loss remains to be seen, but wearable fitness tech will be on the scene for years to come, for those willing to pay the price.


Whether you are training the next American Ninja Warrior or doing balance training with older adults, the fundamental principle of fitness are foundational to safety and results. Staying abreast of trends and new research in sports and exercise is your responsibility as a fitness professional. Get certified with Personal Fitness Trainer, Older Adult Fitness Specialist, Lifestyle Fitness Coach, or Youth Fitness. Then back up your knowledge with continuing education. Extreme training calls for extreme knowledge, and W.I.T.S. has the courses you need to stay informed.

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Balancing Act: Preventing Falls and Injury in Older Adults

Fear of Falling

oa crutches

One of the signs of aging is slower, less coordinated movement and greater instability when standing and walking. Consequently, one of the greatest fears among older adults is taking a tumble that leads to injury. According to the National Council on Aging, falling is the leading cause of fatal injuries among older adults, and the most common cause of trauma-related hospital admissions. However, the NCOA believes that the incidence of falls can be markedly reduced by lifestyle interventions.

Things that Make You Go Boom

Many factors contribute to increased fall risk in older adults. High on the list are medications that interfere with balance and mental acuity. A sedentary lifestyle and excessive sitting bring on postural changes that affect movement mechanics and predispose older adults to falling. Bifocals and trifocals can distort vision, and loss of hearing can interfere with judgement. Loss of muscle mass, called sarcopenia, leads to joint instability and poor balance recovery. Low bone mineral density, or osteoporosis, leads to frail bones that break easily in a fall. If an injury from a fall results in bleeding, blood thinner medications can prevent blood from clotting and can lead to death from blood loss.

Falling and Fitness

wits oa dumbbells

An active lifestyle that includes fitness activities to promote balance is key to reducing the risk of falls among the elderly. Resistance training programs designed to promote optimal muscle tension at the joints can improve posture and boost the ability to recover disrupted balance. Flexibility training can likewise restore healthy posture and increase fluid movement. Water exercise provides a safe workout environment that limits the risk of falling while promoting strength and range of motion. Regular aerobic exercise can reduce disease risk and lower dependency on medications.

Balance Training

Deliberate balance training is another strategy for reducing the risk of falls. Slow deliberate movements like those done in tai chi or qui gong require balance and mental focus. There are a number of balance training exercises geared to older adults that can be easily found on the Internet. There are also many programs that offer certifications for fitness professionals who work with older adults. In addition to balance training, practicing how to get up after a fall can be life-saving.


Educating yourself about older adult health is key to successfully working with this diverse population. W.I.T.S. has got you covered with certification and continuing education courses including Certified Older Adult Fitness Specialist, Able Bodies Balance Training, Certified Personal Trainer, Older Adult Fitness Foundations, and Exercise Program Design for Special Populations.


National Council on Aging: Falls Prevention Facts

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Working with Clients with Chronic Back Pain

Back pain, especially in the cervical and lumbar regions, is a common complaint among otherwise healthy adults. However, the presence of pain does not always indicate structural injuries. Oftentimes pain comes from pressure on nerves due to spinal and pelvic misalignment. 

The presence of back pain in a new client can be a bit daunting for you as a trainer, and you may have concerns about doing more damage than good. But non-specific back pain that is not associated with any sort of trauma is often the result of physical inactivity. 

Common causes of non-specific back pain include: 

  • Excessive sitting
  • Sedentary lifestyle
  • Weak/unstable core
  • Obesity
  • Poor lifting technique
  • Low flexibility
  • Tech neck/text neck 
  • Poor posture

Here are some guidelines for working with clients with chronic back pain:

  1. Always insist on a thorough pre-session warm-up. Back pain often diminishes once the body starts moving, making it easier to perform weight bearing exercise.
  1. Work on core strength early on. A strong and stable core is foundational to all other fitness activities. It is not enough to train the superficial abdominal muscles (rectus abdominis and obliques). You must also focus on transverse and deep core muscles.  
  1. Teach your client to engage the core during exercise. Mastering core stability while lifting will help your client achieve goals faster, with reduced risk of injury.
  1. Teach your client deep breathing techniques and incorporate them into your exercise program. Diaphragmatic breathing pressurizes the abdominal cavity, providing support and protection for the lumbar spine. 
  1. Look for postural issues and address them. Tight hip flexors, lax gluteal muscles, rounded shoulders, tight hamstrings and tight chest muscles all contribute to spinal misalignments that compress nerves and cause pain. Stretch tight muscles and strengthen lax muscles to achieve balance. Teach good posture, especially during exercise. 
  1. Teach perfect technique. No matter how eager your new client is to feel the burn, insist on light-weight sets until they master good mechanics. 
  1. Educate about gut health. Chronic constipation and straining can contribute to pain in the lumbar spine. 

A Word of Caution

Listen to your client if they are complaining about pain, and teach them to distinguish between pain and discomfort. Never insist that they work through genuine pan. Encourage icing or cryotherapy after every session to promote recovery and reduce pain. Monitor your client carefully in the first weeks, and encourage them to seek medical treatment if their pain worsens. 


Keeping up with the latest research and learning about innovative approaches can take your training knowledge to the next level. W.I.T.S. is always here to help you grow your career with continuing education in fitness and business. Visit our online store to browse our course catalog, and see how far you can go as a fitness professional. 

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The Science of Chronic Pain

Compiled by June Chewning, MA

Fitness Learning Systems


Hey!  Did you know that all pain is all in your head?  It doesn’t mean you don’t have real pain when something to cause pain happens, or that chronic pain is not real.  Feelings of pain are very real and are initiated by the brain for a very important basic reason…to keep you safe.

The study of the neuroscience of pain has changed considerably in the past 10 years.  It is now believed that the sensation of pain is a necessary function that warns the body of potential pain or of actual injury. The process starts with the nociceptor detecting a potentially painful stimulus from the skin or an internal organ. Neurotransmitters (chemical messengers) transmit the signals through the nervous system and spinal cord to the brain. In essence, how the brain processes the signals causes an appropriate or inappropriate pain response.


One example is a child falling and skinning his knees.  He gets up and continues to play as if nothing happened.  Then another child or adult reacts to the blood running down his legs, he looks, his brain responds differently to the neurological stimulus, and suddenly there is pain.  Initially the brain did not register the experience as painful, however the next time the child falls, he will probably immediately register the skinned knees as painful. Experience plays a role in the pain response.


The pain response can also be overridden by the brain in circumstances that are life threatening. For example, a soldier who runs to safety with a serious gun-shot wound. The brain, due to past experience, can conversely register the event as much more painful or life threatening than necessary. For example, someone who was bitten by a poisonous snake may brush it off as being scratched by a stick, until they realize they have a life-threatening injury. But the next time they get scratched by a stick, they may respond as if they were bitten by a poisonous snake.


According to Elliot Krane in his Ted Talk “The Mystery of Chronic Pain,” after an injury or surgery, the nervous system can sometimes get what is going on wrong.  Approximately ten percent of the time, the nerves and glial cells (play a vital role in modulation, amplification, and distortion of sensory experiences) that interact in the pain response develop into a feedback loop that can become distorted. This altered feedback can make chronic pain become its own disease.


Dr. Maria Sykorova-Pritz in her course “Application of Water Exercise for Pain Management” describes how chronic pain is not simple, but very complicated.  The body, mind, emotions, and behavior can become entwined in the chronic pain cycle. Pain medication is often prescribed for chronic pain. Rampant prescription of pain medication is believed to play a large role in the opioid epidemic in the United States.  Although pain medication is often prescribed for chronic pain, it does nothing to unravel the combination of physical, emotional, and behavioral factors that are now believed to cause chronic pain.


There is growing evidence that chronic pain is caused by multiple factors including cognitive, physiological, and behavioral factors. If you are working with clients or interacting with a family member with chronic pain, it is important to understand that it is not just simply a physiological response to pain. It is important to effectively influence a client’s attitude, cultural background and belief system-which influences social norms and perceived behavioral control. To achieve the highest positive health/fitness results among the chronic pain population, it is important to know and understand your client as a whole person.


As we start to look for alternative ways to deal with chronic pain and its aftermath, a combination of physical therapy/exercise and emotional/behavioral counseling is emerging as the tools of choice.  Using the practice of yoga and water therapy/exercise to relieve and even cure chronic pain are proving to be viable and more effective alternatives than pain medication. Statistics from the Institute of Medicine indicate that more than 100 million Americans suffer with chronic pain, thus creating a viable niche for those wishing to work with clients with chronic pain. Now that more is known about chronic pain, its potential causes, the chronic pain cycle, and how to treat it effectively, education is key to working with this population in need.  Proper treatment and compassion for chronic pain sufferers can help end the opioid crisis and help people beat chronic pain to live pain free lives without addiction and suffering.


For more information about the psychology and treatment of chronic pain management, see Dr. Maria Sykorova-Pritz’s continuing education course “Application of Water Exercise for Pain Management





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Working with Clients with Knee Pain

New clients come to us with a variety of needs and conditions, many of which can be overcome with focused and consistent training. One of the most challenging conditions  for a trainer to work with is chronic knee pain, often seen in clients who are overweight with sedentary lifestyles. Knee pain poses a number of programming obstacles that can slow the rate of progress and make it difficult to keep your client motivated. 

Causes of Knee Pain

While some clients have already had a medical assessment and are able to specify the nature and cause of their knee pain, such as an ACL tear or other injury, many others have non-specific knee pain, meaning their medical provider was unable to pinpoint the exact cause. 

Some causes of non-specific knee pain include:

  • Core instability that causes misalignment of the lower extremity joints
  • Poor postural habits like locking the knees when standing
  • Muscle imbalances, with underdeveloped hamstrings and overdeveloped quadriceps
  • Tight hip flexors and tight hamstrings, with weak hip extensors, from excessive sitting
  • Excess body weight, with poor overall conditioning
  • Chronic systemic inflammation that causes knee osteoarthritis
  • Ankle instability that affects knee alignment

Most causes of non-specific knee pain can be overcome with targeted exercise and stretching, to promote joint stability and achieve optimal range of motion. 

Programming for Non-Specific Knee Pain

Because the muscles of the pelvic region mediate load transfer between the upper and lower body during physical activity, core training for strength and stability is fundamental to resolving knee pain. It is not enough to train the rectus and obliques: you must train the transverse and deep core muscles as well, to establish core stability. 

It is also important to remember that the quadriceps and hamstring muscles act at two joints: the hip and the knee. Many people have lax hamstrings at the hip joint and tight hip flexors, along with tight hamstrings and lax quads at the knee joint, caused from too much sitting. Establishing balance at both joints is crucial for optimal knee function.

Strategies for improving knee joint integrity include:

  • Always do a general warmup before exercise
  • Establish core stability early on
  • Strengthen the hip extensors (gluteals) and stretch the hip flexors
  • Strengthen the hamstrings from both the hip (deadlifts) and knee (curls)
  • Do extra stretches for the hamstrings at the knee and the quadriceps at the hip
  • Do not overtrain the quadriceps
  • Maintain balance between the quads and hamstrings
  • Educate about posture
  • Encourage healthy weight loss 

During training, it is important to monitor your client’s perception of joint pain, and to educate them to distinguish between pain and discomfort. Never encourage your client to “work through” pain. 


Keeping up with the latest research and learning about innovative approaches can take your training knowledge to the next level. W.I.T.S. is always here to help you grow your career with continuing education in fitness and business. Visit our online store to browse our course catalog, and see how far you can go as a fitness professional.