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THIS ISSUE:
Getting Started in Fitness
Swedish Institute on-line newsletter for our students, faculty and community.
The June 6 issue of Time magazine was devoted to fitness, with a 21-page special report called "Get Fit".
According to a poll conducted by Time, 72 percent of Americans say they exercise every week, with most saying they wished they could exercise more. Their number one reason for exercising is to improve overall health, with cardiovascular fitness a close second.
In an article on exercise for people who have been sedentary ("Couch Potatoes, ARISE!", p.52) Barry Franklin, chairman of the American Heart Association's Physical Activities Committee, advises a pre-workout physical and then a slow start up. Author Jeffrey Kluger points out that even a small change—such as walking just 15 minutes a day—can be rejuvenating, and improve overall measures of health within three months.
Kluger suggests in his article that people beginning a new fitness regimen might seek help from a qualified professional. "Try to work with a personal trainer at least some of the time—someone who can rein you in when you're doing something wrong, applaud when you're doing something right," he says. "Trainers are also good at knowing which muscle groups you need to strengthen for a sport you may be considering trying, and helping you exercise them into shape."
A balanced exercise program, the editors feel, should do four things:
1. Clear your mind (yoga, tai chi, Pilates)
2. Exercise your heart (Swim, walk, cycle, jog, kickbox, aerobics)
3. Build up muscles (weights, calisthenics)
4. Provide rest (giving muscle tissue time to repair and rebuild)
The benefits of doing exercise, says Harold Kohl, lead epidemiologist at the Physical Activity and Health Branch of the Centers for Disease Control and Prevention, are continually being borne out in research studies, which show greater heart health, better bone density, less depression and anxiety, greater cognitive function in old age, and possible prevention of some types of cancers ("The Shape of a Nation", p. 48).
It is not uncommon these days to read advice about health and fitness that is conflicting; today's story about benefits can be tomorrow's report on risks. What can someone do in the face of contradictory advice on fitness?
Vincent Metzo, Director of the Personal Training course, replied that exercise science, by virtue of its name, is a research-based practice. "As professionals we have to know how to evaluate a research study," Metzo explained. "Is it a reliable source? Did many people participate? Was it controlled? People starting a fitness regimen may not know about the latest research, but the personal trainer should, so we can best guide clients to the exercises that will help them reach their goals.”
At the core of the Personal Training curriculum are methods to assess the individual client. "We want to know his or her status in the areas of strength, flexibility and cardio-vascular capacity," Metzo said. "It’s also very important that clients define their goals—do they want to feel more energetic, have more strength so they can lift their kids or grandkids, build bone density or compete in an athletic event? Everyone is different and a fitness regimen has to be created for specific needs. People who are starting an exercise program may, indeed, benefit from some assistance from personal trainers in sorting through their options."
In fitness, as in most other efforts, the outcome will be determined by the foundation that is established.
After more than 20 years of running on hard city streets, the client, Gary, starting suffering from serious foot pain. He continued to push himself through the pain despite his physician’s objections, because, he admitted, "Running was the only way I knew how to stay fit." But two years and thousands of dollars spent on orthotic devices later, Gary finally surrendered to the debilitating pain of bilateral heal spurs, plantar fascitis and intermittent bouts of sciatica. He retired from exercise and settled on the couch with "the remote and a box of Krispy Kremes.”
Although his injury improved with combined interventions by his doctor, chiropractor, physical therapist and massage therapist, his pain continued. Gary’s eating habits deteriorated, and his exercise routine consisted primarily of walking to a taxi. In two years, he gained close to 50 pounds and developed elevated LDL cholesterol – terrible news for a man in his mid-40s with a family history of heart disease. Gary finally heeded his doctor’s advice and agreed to get in shape. He opted for personal training after several failed attempts to exercise with a buddy.
A friend of Gary's referred him to a personal trainer who could work with him at his building’s fitness center. After a meeting where they discussed goals and negotiated terms, they kicked-off their relationship with the signing of a fitness contract that committed Gary to the gym three mornings a week for the next six weeks, one day with his trainer and two days on his own. Gary, a sales professional, valued the contract and said, "it underscored the level of commitment I was making.”
Assessments were done to establish a baseline, set goals, and provide markers to measure the efficacy of the routine. To Gary's surprise, many rankings were higher than he expected, although his body composition, flexibility and cardiovascular fitness definitely showed room for improvement. As weight loss was one of Gary’s primary goals, the trainer taught him how to read nutrition labels, wrote out basic food guidelines, and asked Gary to keep a food journal.
The training cycle combined cardiovascular exercise, strength training and stretching routines. The program emphasized burning calories, while respecting, and hopefully improving upon, the limitations of Gary’s previous injuries. Specific goals included a one-pound per week weight loss and overall 10-15% increase in exercise intensity over the next 6 weeks. His trainer promised to modify the program as needed to prevent boredom, and Gary agreed to watch calories, eat lots of whole grains, and stay away from bad fats.
Gary lost 3 pounds in the first two weeks and 8 pounds by the end of the 6 weeks. Equally motivating were across the board improvements in his fat-to-muscle ratio, cardiovascular endurance and strength. The stretching routine proved to be his nemesis. While trainer-assisted stretching sessions have helped his feet and legs, he admits to skipping the stretches after exercising on his own.
His pain is vastly improved, though it is difficult to attribute the reduction in pain to any one modality. Gary continues to see specialists, a physical therapist and a massage therapist. The exercise program was designed to provided a fitness routine that would not aggravate any of his existing injuries, however, it is likely that the weight loss, stretching, and strengthening exercises, particularly the core strength training, have assisted in the pain reduction.
Key to the success Gary has had is weekly accountability for both his exercise routine and eating habits. He also enjoys the collaborative relationship that keeps his routine fresh and prevents boredom. Now in his second exercise cycle, Gary says, "I feel better than I have in years. I wish the weight would come off faster, but I’m seeing results and my trainer tells me this pace will lead to long term changes." While Gary still hopes to return to running one day, for now he’s content to use the eliptical machine, expand his exercise regimen and make time for his renewed commitment to long-term health.
Bill Hughes is not working in the field of social anthropology, his major at Harvard, but now finds himself taking part in a powerful movement that is changing the social fabric of America. A graduate of
the Massage Therapy Program and Personal Training course, Bill plans to be active in shaping a new paradigm for health and wellness, as a provider of complementary care.
"My path is the result of my own personal evolution," Bill explained. After eight years as general manager of an executive recruiting firm in New York, he was ready for a career change. He was looking for a way to become involved in people's health care in a way that was personal and nurturing, as well as contribute to solutions for national health care concerns. "I also wanted to become as healthy as I could be," he added, "and needed to address some issues that were developing around my training in running." He left his full-time career, and decided to enroll full-time in the Massage Therapy Program.
Toward the end of the 16-month course of study to become a licensed massage therapist, Bill enrolled in the Personal Training course. "It seemed like the two would work together so well," he said, "especially for the population I want to work with, which is athletes and people recovering from injury. As a personal trainer, I can work with clients to establish short-term and long-term goals we'll try to achieve together. For instance, do they want to be pain free, or simply manage pain? This way, clients aren't passive receivers, but become active in the process. The client's participation is an important element in the emerging paradigm of health care." In addition, Bill says, "we’re facing a health care crisis because there is not enough appropriate education, or one-on-one care. With massage therapy and personal training I can make a positive contribution to people's need to understand their own bodies."
Bill completed the Massage Therapy Program successfully earlier this year. While he waits to take the New York State licensing exam for massage therapy, he is working under the supervision of another practitioner. He is already seeing clients as an independent personal trainer. In some ways, the future he is weaving uses threads from his past. It was during a class in medical anthropology at Harvard that he first encountered the health maintenance system used in Traditional Chinese Medicine. "It has always been part of Asian health care to address the personal need to exercise, reduce stress and maintain the body with natural, non-toxic methods. What I believe is happening today is an attempt to take the old models, turn them into something that reflects modern cultural norms, and integrate the two into a new model of wellness. I hope to grow such a practice, working with a collective that would include massage therapy, personal training, yoga, chiropractic, acupuncture, nutrition, or any kind of complementary modality that addresses the desire to optimize health."
To contact William Hughes, go to our Locate a Practitioner feature, which allows visitors to search for licensed graduates.
Two recent studies published in the Journal of the American Medical Association demonstrate the benefits of regular walking and indicate how much walking is necessary, in order to protect cognitive function in older people. One research studied tracked 2,257 physically capable men between the ages of 71 and 93 over a period of two years. Those who walked less than a quarter-mile a day were almost twice as likely to develop Alzheimer's or other forms of dementia as men who walked more than two miles daily.
A study of over 18,000 nurses between the ages of 70 and 81 conducted over the course of two years, found that women who walked at an easy pace for 1 ½ hours a week had better cognitive function than women who walked less than 40 minutes a week.
(JAMA, September 22, 2004, Vol.292, No. 12)
http://jama.ama-assn.org/content/vol292/issue12/index.dtl
Professional organizations which may provide reliable research information:
American College of Sports Medicine (www.acsm.org)
American Council on Exercise (www.acefitness.org)
National Academy of Sports Medicine (www.nasm.org)
National Strength & Conditioning Association (www.nsca-lift.org)
“The art of exercise prescription is the successful integration of exercise science with behavioral techniques that result in long-term program compliance and attainment of the individual's goals.”
Guidelines for Exercise Testing and Prescription,
American College of Sports Medicine, 2006