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  • Why Getting Certified Should Be Your Next Step

    by Greg Margason | Jan 20, 2023
    Why Getting Certified Should Be Your Next StepSeven years ago I got my first job out of college as an exercise therapist at a local hospital, where I worked in the rehab department. I taught aquatic exercise classes and land-based classes for different types of people — older people, people with heart problems, those who had neurological conditions and so forth.  

    It was at that point in time in my career I found out that there was so much more that I wanted to learn and there was also so much that I didn’t know. I was faced with a client who had so many comorbidities that I was unsure of how to go about treating them, what exercises worked best for them, and how those exercises would help or hinder their progress. This prompted me to want to know as much as possible how exercise affects chronic diseases and what the potential outcomes were. Fast forward to today: I have worked in three hospital systems and seen thousands of patients, and I still feel there’s more to do and learn. Through the years I learned from watching others and asking questions, and then I decided that it was time to challenge myself and test everything I have learned through practical experience. 

    The ACSM-CEP® certification represents a gold standard for exercise science and fitness professionals and allows us the opportunity to grow in our careers, with chances for advancement and to work in other areas of allied health like cardiac or pulmonary units, oncology and other chronic conditions. I find cardiology fascinating, and having worked with many patients with different cardiac issues, I find this certification can help educate me in all there is to know about specific conditions like cardiovascular disease, post-MI rehabilitation and congestive heart failure. This certification will give me a sense of accomplishment and the knowledge and practical understanding of how to best go about training these populations. This certification will also allow potential employers and colleagues in other disciplines to take me seriously as a clinician and give me the ability to choose the environment I would like to work in and the type of patient or client I would like to work with.  

    I have always been a person who loves to learn, and I feel sitting for this exam gives me the best opportunity to do that and test my knowledge of this field that I have been in for the past seven years.  

    If you are on the fence about whether you should go for this certification, I would say that so many doors will open after you obtain it — you will practically be able to work in any setting you want, from hospital-based outpatient rehab to cardiopulmonary rehab to cardiology. Not to mention fitness-related areas like a fitness director or health and wellness coach. The options you will have are endless, and the sky is the limit. This is going to be the standard in the future, and if you want to have a career that pays you fairly based on your education — and to do what you love and what always challenges you — then I would highly recommend you branch out and learn the things that you don’t know and continue to grow as both a professional and student of this profession. 

    Related Content: 
    Blog | How ACSM-EPs and ACSM-CEPs Can Advance the Profession’s Recognition, Compensation
    Austin Cooper
    Austin Cooper is an exercise physiologist and master’s student at American Public University (’23) studying sports and health sciences. He is a certified strength and conditioning specialist, nutritionist and wellness coach experienced in spinal cord rehabilitation, weight management and the prevention of cardiovascular disease through lifestyle interventions.  
  • Bring the ACSM Annual Meeting into Your Classroom

    by Caitlin Kinser | Jan 10, 2023

    Recorded lectures enhance learning opportunities

    acsm annual meeting videos in the classroomAs educators, we endeavor to facilitate meaningful classroom learning experiences. A perennial topic of discussion among educators within ACSM is this: How can we engage our students in ways that will drive connection, deepen their knowledge and align with the things that matter to them? Incorporating scientific and professional development content from the ACSM Annual Meeting into classroom instruction is a way to start, and an accessible way to do this is by mindfully embedding conference session recordings into course activities.

    How did I arrive at this opinion?

    In 2011, I brought the first of many groups of undergraduate students to the ACSM annual meeting. They were not college seniors traveling to present research as a culminating experience in their undergraduate career. Instead, they were second year students taking their first exercise physiology course during an accelerated “maymester” academic term. As part of the course, they attended conference sessions and then processed their experience in assignments aimed to help them integrate new information into their understanding and perspectives on course concepts.

    In response to their experience at the annual meeting, students expressed increased motivation to learn, confidence in their growing expertise, interest in conducting research and commitment to pursuing careers related to exercise and sports sciences. Yes, the experience of being at a professional meeting among scholars and practitioners was impactful, but they also pointed to the “a-ha” moments they experienced when attending conference sessions as particularly influential.

    Obviously there was no way to scale this experience beyond one small group of students every May. If only I could bring a little of that “a-ha” magic to all of students during the academic year. I discovered that ACSM had a YouTube channel where presentations from the annual meeting, health & fitness summit, and other ACSM meetings were posted—a small goldmine of presentations by preeminent, engaging scholars. I curated a collection to incorporate into one of my courses for required viewing, and titled it the “Keynote Lecture Series” in the syllabus. The response from students was beyond my expectations.

    What are some ways you can bring ACSM conference “magic” to your course(s)?

    The resources available to ACSM members has expanded tremendously. There is now a platform on the ACSM website where we can access keynote, named lecture, clinical track and nutritional track sessions.

    There are so many ways you can use these recordings to enhance the educational experiences of your students. First, choose a conference presentation that relates to an important course concept and watch the presentation together or assign viewing outside of class, and then use the viewing as a jumping off point for discussion or course assignments.

    Here are a few ideas you can use to leverage the experience of watching a 2021 or 2022 ACSM conference recording:

    • Take a “What, So What, Now What?” approach. Instruct students to take notes during their viewing on the below topics, and following their viewing discuss their responses to these questions in class or in a reflective writing assignment.
      • What are the key points of the lecture and how do they connect to what they’ve been learning in the course?
      • So what? Does the session expand their existing knowledge? Challenge conventional thought? Redefine their understanding? If so, how?
      • Now what? Is there a real-world application of these findings? What new directions could they propose for research in this topic?
    • Prompt students to search for the scholarly publications cited in the presentation and choose one or a handful for presentation or discussion in class. This is a great idea for group presentations or journal club-style discussions that students can lead. You could even use this as a jumping off point to assign a narrative review or annotated bibliography.
    • Prompt students to find press coverage of findings presented in the conference session. Lead learning activities to evaluate the press coverage for accuracy and bias. You could even assign students to write their own news article about an aspect of the research presented.
    • If recommendations are made within the conference session, assign students to create social media posts communicating those recommendations to the audience for whom they are intended, such as the general public or clinicians (e.g., Twitter, Instagram, TikTok, Facebook).

    Have these ideas started the gears turning in your own head? The possibilities are endless!

    Keynotes and featured lectures from the 2022 and 2021 ACSM Annual Meetings are available for ACSM members at no additional cost. They are available to nonmembers for a fee. CECs are available with the 2022 Annual Meeting content and additional recorded content from the 2021 Annual Meeting are both available at a member and nonmember rate. 

    ACSM's 2022 Annual Meeting Keynotes and Featured Lectures (FREE for ACSM members, $200 for nonmembers)

    ACSM’s 2022 Annual Meeting Keynotes and Featured Lectures | 12 CEC-version ($150 for ACSM members, $300 for nonmembers)

    ACSM’s 2021 Annual Meeting: Keynotes and President’s Lectures (FREE for ACSM members, $150 for nonmembers)

    ACSM’s 2021 Annual Meeting: Clinical Sessions ($75 for ACSM members, $150 nonmembers)

    ACSM’s 2021 Annual Meeting: Nutrition Sessions ($75 for ACSM members, $150 nonmembers)

    Kimberly ReichKimberly Reich, Ph.D., ACSM-EPis an associate professor in the department of exercise science at High Point University in High Point, NC where she is the supervisor for HPU’s Exercise is Medicine on Campus Leadership Team. Dr. Reich’s research focuses primarily on health behavior in individuals and communities. Her work explores resources designed to aid in the adoption and maintenance of physical activity and healthy eating. She is a former chair of the ACSM Exercise Science Education Special Interest Group, former SEACSM executive committee member, and currently serves on the ACSM Annual Meeting program committee.

  • Preparing Students for Success on the ACSM Exercise Physiologist Certification Exam

    by Caitlin Kinser | Jan 09, 2023
    Preparing Students for Success on the ACSM Exercise Physiologist Certification Exam

    As a professor, I get a great sense of joy from seeing my students succeed: from seeing them do well on an exam, to graduating, finding that first job, getting into graduate school or passing a certification exam. Every year I hear stories from our graduates regarding how having the ACSM Exercise Physiologist (ACSM-EP) certification in addition to their BS in Exercise Science helped them to land a job.

    I have been teaching at Liberty University (LU) for 22 years now and this is the 14th year that our exercise science students have been taking the ACSM-EP certification exam (formerly the Health/Fitness Specialist certification). During this time, we have made changes and modifications to our curriculum and how we prepare the students for the certification exam. Over the course of the last five academic years, we have had a 95% pass rate (91%, 95%, 100%, 95%, and 93%) with 343 students passing the ACSM-EP exam during that time. I trust you will find the following tips on preparing students for the ACSM-EP exam to be of benefit for you and your students.

    I hope that your school’s exercise science program has been accredited through CAAHEP*. If so, great—the program should be covering all of the Job Task Analysis (JTA) items, which are found online in the ACSM Certified Exercise Physiologist Exam Content Outline. If it is not accredited, I would recommend doing a brief self-study to determine if your program is addressing all of the Job Task Analysis items. This can be accomplished in a relatively short time frame and can be very helpful in assuring that your students are well versed in the material that will be covered on the ACSM-EP exam.

    A number of times we have had students that want to jump the gun and take the ACSM-EP exam before they are truly prepared to succeed. I have to remind the students to stay with the course sequencing. At LU the ACSM-EP exam is part of the curriculum (EXSC 485 Exercise Physiologist Workshop and Certification) and the students take it during their last semester of coursework. The ACSM-EP exam also serves as a gateway to internships. If sitting for the ACSM-EP exam is not built into your curriculum, encourage your students to take it at the end of their course work.

    Prior to the ACSM-EP exam your students should be doing some sort of focused study. At LU in the students’ final semester of coursework, they enroll in EXSC 485. In this course the students have weekly readings for the ACSM’s Guidelines for Exercise Testing and Prescription, 11th (or current edition) and the ACSM’s Recourses for the Exercise Physiologist, 3rd (or current edition). Also, each week the students take one or more quizzes and complete a total of 20 quizzes during the semester. The students are required to earn an 80% or higher on each quiz and the quizzes can be taken multiple times. ACSM also has study tools available for students. One is an online course, ACSM Exercise Physiologist Certification Preparation Course, and the other is an interactive, online quizzing platform, PrepU for ACSM’s Resources for the Exercise Physiologist, 2nd Edition.

    For the last phase of student preparation for the ACSM-EP exam, I would recommend holding an in-person ACSM Exercise Physiologist workshop.  At LU, we host a workshop the first weekend of November and April every year and have been doing so for 10+ years. The workshop serves as a great review for the students, and it lets them know how much they actually know as well as some areas to focus on during their final bit of study. The week following the workshop the students sit for the exam.


    *Beginning in 2027, the ACSM-EP certification exam and the ACSM Clinical Exercise Physiologist certification exam will require a baccalaureate degree (or higher) in Exercise Science, or equivalent, from a regionally accredited college or university and CAAHEP accredited program for eligibility. Learn more.

    Learn about the programmatic accreditation process, benefits and associated costs.

    Read FAQs about programmatic accreditation.


    james schoffstallJames E. Schoffstall, Ed.D., FACSM, ACSM-EP, ACSM-RCEP, has been a teaching at Liberty University for the past 20+ years and holds the rank of Professor. He has served in the roles of Director of the Human Performance Lab, Director of the Exercise Science Program, and is currently the Chair of the Allied Health Professions Department. Dr. Schoffstall is certified as an Exercise Physiologist and Clinical Exercise Physiologist through the ACSM, and is a Fellow of the ACSM. He has served as a Director of the ACSM Exercise Physiologist workshop for the past 10 years. He has served as an Associate Editor of ACSMs Resources for the Exercise Physiologist, 2nd Edition. Dr. Schoffstall has also served as an exercise physiology curriculum designer for the Chinese Association of Sports Medicine.

  • Active Voice | Running for Two: Pregnancy, Training and Return to Performance for Elite to World-Class Runners

    by Greg Margason | Jan 09, 2023
    Running for Two Pregnancy, Training and Return to Performance for Elite to World-Class Runners

    There are a variety of resources that exist to advise individuals on best practices for exercising throughout pregnancy. International evidence-based health guidelines typically recommend at least 150 minutes/week of moderate-intensity physical activity in those without contraindications during pregnancy. While these recommendations guide physical activity during pregnancy in the general population, they are not developed — or possibly suited — for high-performance elite athletes.

    Elite athletes are thus left to seek guidance from their own personal team of health and prenatal care providers, online sources or fellow elite female athletes. This circumstance holds one major caveat: There is a significant lack of research and published data examining elite athletes’ approaches to training throughout pregnancy and subsequent postpartum athletic performance outcomes. This is especially true as it pertains to runners.

    This paucity of information has been identified by the International Olympic Committee (IOC)’s expert group on pregnancy as a gap that needs to be addressed. Similarly, the authors of the 2017 ACSM Team Physician Consensus Statement Female Athlete Issues for the Team Physician reported on a number of matters, including sport-specific details around exercise throughout pregnancy.

    Our study, published in the January 2023 issue of Medicine & Science in Sports & Exercise, centered on two primary focal points: training and performance. Included among our participants were 42 elite to world-class female distance runners (>50% have competed at the Olympics/World Championships — including medalists — in distances from 1,500 m to the marathon). Via questionnaires, first we collected information on elite runners’ training before (one year prior), during (first, second and third trimesters) and after pregnancy (including volume, intensity and type). Second, we analyzed elite runners’ performance data pre and post pregnancy (in the one- to three-year period prior to pregnancy compared to the one- to three-year period post pregnancy — thus omitting the one year during pregnancy).

    There were several key takeaways from this study. From the first to the third trimester, the participants decreased their training in terms of both running volume and intensity. Additionally, when compared to pre pregnancy, the participants’ average training pace was significantly slower for all time periods during pregnancy.

    Notably, coupled with the decrease in running duration from the first to third trimester was an increase in time spent cross-training. However, even at the third trimester, which marked the lowest level of training (i.e., approximately 300-350 minutes of exercise/week, most of it cross-training), these athletes were still engaging in a much greater degree of physical activity than recommended in guidelines for pregnant individuals. Furthermore, our participants returned to some level of exercise approximately six weeks postpartum and reached 80% of their pre-pregnancy training volumes by three months (although this was highly variable depending on the individual athlete’s context of injury, time and/or performance goals).

    Another crucial piece to acknowledge is injury. Though 50% of our participants reported an injury in the year postpartum that delayed their return to training/competition, there was no relationship between any specific approach to training nor type of delivery (vaginal or caesarean) to predict risk of injury.

    The most novel element of the study was the actual “in race” competition performance analysis. From a performance standpoint, of the participants who intended to return to equivalent performance levels post pregnancy (60%), we found no significant difference between pre- and post-pregnancy performances. In addition to this, nearly half (46%) of these athletes improvedperformances post pregnancy. Our results thus paint a clear picture that female athletes may not only come back to an elite/world-class level after giving birth — many come back faster and, on average, not slower. 

    It is our hope that this study provides important and much-needed insights into the training volumes and intensities elite to world-class runners undertake throughout pregnancy, as well as expectations and timelines for post-pregnancy return to training and competition. In addition to benefitting athletes themselves, such implications may be practical for those who play critical roles in guiding elite pregnant athletes through the several phases of conception, pregnancy, postpartum and return to performance, including coaches, health professionals, athletic sponsors, athletic governing bodies and policymakers.

    We echo the sentiment that was put forward by the IOC’s expert group on pregnancy that the return to training postpartum for elite athletes should be one that is individualized, both across and within specific sports. While our findings may serve other pregnant elite athletes outside of running, we encourage future research to explore the potential of employing a similar study design within different sports. Such research is crucial to address equity in sport research and to challenge the historic assumption that pregnancy/motherhood impede female athletes’ pursuit of athletic excellence. 

    Francine Darroch, M.Ed., MPH, Ph.D., is an assistant professor in the Department of Health Sciences at Carleton University in Ottawa, Ontario. She is an interdisciplinary researcher with expertise in mixed-methods health research, inequities in pregnancy and elite sport/physical activity, and maternal health. As founder of the Health and Wellness Equity Research Group at Carleton University, she leads community-based participatory research endeavors, including research with a team of Parenting Track and Field Olympians and interdisciplinary colleagues to examine issues of importance to the athletic community such as training during pregnancy (advocacy for sport-specific guidelines) and gender equity in athletic governance and sponsorship.

    Trent Stellingwerff, Ph.D., FACSM, serves as a senior advisor for research and development at the Canadian Sport Institute Pacific in Victoria, Canada. His primary sport and research focuses are in the field of physiology and nutrition interactions, with emphasis on female health and performance, as well as environmental (altitude and heat) expertise. Trent has been an invited expert presenter and author for many international nutrition consensus statement meetings with the IOC, FINA and World Athletics. Over the years, Trent has attended and serviced athletes and sports at four Olympic Games, four Commonwealth Games and more than 15 World Championships. He coaches several elite Olympic runners — including a few who have run faster post pregnancy.

    Viewpoints presented in ACSM Bulletin commentaries reflect opinions of the authors and do not necessarily represent positions or policies of ACSM. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for The ACSM Bulletin.

  • Waste No Time: A standardized approach to the collapsed athlete

    by Caitlin Kinser | Jan 05, 2023

    Man performing CPR on young boyAs emergency medicine and sports medicine physicians, we have advocated for all sideline providers to not just be basic life support (BLS) certified but consistently prepare themselves mentally to manage the complex and emotionally charged scene of the collapsed athlete. All sports medicine providers and sideline personnel should reflect on the event that unfolded on Jan. 2 during Monday Night Football and recognize it is not a matter of if, but when. When you find yourself in that moment, your actions need to be reflexive and efficient, and your mindset needs to be algorithmic. Every second matters to optimize not just the athlete’s survival but also their neurologic outcome. Here, we present three critical steps to standardize the care of the collapsed athlete.  

    A-C … AED 

    A: Airway — Modified Jaw Thrust 

    The first step is action, and while this may in concept seem easy, it is hardest part of the algorithm. Athletes in cardiovascular collapse may exhibit myoclonic jerking or agonal respirations, which can be confused with purposeful movement and can lead to delays in intervention.  

    modified jaw thrust demonstration

    Overcoming the mental hurdle to proceed to CPR is difficult. The first step in recognition should be an objective, efficient maneuver to identify the athlete’s consciousness: the modified jaw thrust. This maneuver is done by placing two fingers just superior to the angle of the mandible and just inferior to the tragus of the ear. You then displace the mandible anteriorly.  

    This is a powerful maneuver that serves two purposes: First, it is a means of allowing passive ventilation by removing obstructed oropharyngeal tissue when an athlete is unconscious. Second, and most importantly, it is a significant pain generator. If the athlete does not grimace, take a breath or respond purposefully to this intervention, you need to immediately get yourself and your team on the same mental model that this is a critical situation.  

    It is easy to become distracted and not take the right steps in cardiovascular collapse, but if everyone on the resuscitation team agrees that the modified jaw thrust is not intact, then you commit to progressing to the next step of the algorithm. 

    C: Carotid Pulse and Continual Compressions 

    The next step is to immediately drop your hands from the angle of the mandible just inferiorly and anterior to the sternocleidomastoid muscle to feel for the carotid pulse. The carotid pulse is the last pulse to be lost, so it should be the only pulse we use precious time in order to palpate. It can be difficult to determine if it is present or absent in cardiovascular collapse, so don’t spend more than five seconds searching for it.  

    If the modified jaw thrust is abnormal and you can’t feel a pulse, the next step is to start compressions. Good-quality compression entails a rate of at least 100 beats per minute and should compress the chest two-and-a-half inches at the mid-sternal location. During the first few minutes of cardiac collapse in athletes, your goal is to perfuse the myocardium and the brain as efficiently as possible, and that is done through minimizing disruptions in compression. Sudden collapse in an athlete deviates from standard BLS in that the primary etiology in a young, healthy athlete is most likely a non-perfusing cardiac arrhythmia, and emphasis should be placed on re-establishing perfusion; therefore, rescue breaths can be delayed until after the first shock with an AED. In fact, with a persistent modified jaw thrust maneuver, athletes can go minutes in apnea before they become hypoxic. Perform compression-only CPR until the AED arrives. 


    The underlying cause of sudden cardiac collapse in athletes is complex, but during a resuscitation, the specific cause does not matter: Sudden cardiac collapse on the sideline results from a non-perfusing rhythm, either pulseless ventricular tachycardia or ventricular fibrillation. Therefore, the role of the sideline provider is to rapidly get the AED on the athlete so they can be cardioverted back to a perfusing rhythm. In the first few moments of a resuscitation, it is that simple. Every minute that defibrillation is delayed, the chance of survival decreases by 10%. AEDs must be on the field, and every sideline provider must be efficient in equipment removal and AED placement.  

    We emphasize that the constant cognitive practice of the A-C … AED algorithm is imperative so that when you find yourself in that critical moment, there is no delay and no distraction but instead confident commitment to: 

    A: Airway — Modified jaw thrust (Call for an ambulance and the AED.) 

    C: Carotid pulse and compression-only CPR 

    AED: Get a perfusing rhythm back.


    Kristina "Kristi" Colbenson, M.D., is an assistant professor of emergency medicine and sports medicine at the Mayo Clinic in Rochester, Minnesota. She is also an associate program director for the Emergency Medicine program. Dr. Colbenson has served as a team physician for numerous high school, collegiate and semiprofessional teams, including USA Nordic. 

    Neha Raukar, M.D., M.S., is a practicing physician in both sports medicine and emergency medicine, and is active in education, clinical medicine, legislation and research. Her sideline experience spans the breadth from high school, collegiate and Olympic athletes. An associate professor at the Mayo Clinic, her research interests include injuries and life-threatening diseases in athletes, including head injury, heat illness and sudden cardiac death. 



    Fowler R, Chang MP, Idris AH. Evolution and revolution in cardiopulmonary resuscitation. Curr Opin Crit Care. 2017;23(3):183-7. 

    Harmon KG. Incidence and causes of sudden cardiac death in athletes. Clin Sports Med. 2022;41(3):369-88.

    Harmon KG et al. Pathogeneses of sudden cardiac death in national collegiate athletic association athletes. Circ Arrhythm Electrophysiol. 2014 Apr;7(2):198-204.

    Marx JM, Hockberger R, Walls R. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis (MO): Mosby; 2002. Chapter 5.  

    Peterson DF et al. Aetiology and incidence of sudden cardiac arrest and death in young competitive athletes in the USA: a 4-year prospective study. Br J Sports Med. 2021 Nov;55(21):1196-1203.

    Rank W. AHA update: BLS, ACLS, and PALS. Nursing. 2021;51(6):22-7.

    Sweeting J, Semsarian C. Sudden cardiac death in athletes: still much to learn. Cardiol Clin. 2016;34(4):531-541. doi: 10.1016/j.ccl.2016.06.003. Epub 2016 Aug 28. PMID: 27692222.