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  • ACSM Hot Topic | First, You: Strategies for Self-Care in Health Care

    by Greg Margason | May 23, 2023
    First, You: Strategies for Self-Care in Health Care

    “Painful feelings are, by their very nature, temporary. They will weaken over time as long as we don’t prolong or amplify them through resistance or avoidance. The only way to eventually free ourselves from debilitating pain, therefore, is to be with it as it is. The only way out is through.”

    ― Kristin Neff, Self-Compassion: The Proven Power of Being Kind to Yourself

    If you’re naturally drawn to caregiving, there’s a chance you’re so focused on others that you don’t spend enough time supporting your own well-being. But your ability to provide the best education, care and coaching to those that you support is contingent upon your state of well-being, both internal and external.

    Here are four strategies for an uplift!

    Consider the good

    Getting to where you want begins with knowing your starting line. One place to begin is through a simple Well-Being Inventory, which gives you the opportunity to reflect on four key areas: mind, body, life and work. Taking an inventory like this enables you celebrate and savor the areas where you are doing well. We tend to be hyper-focused on improvement, gaps and growth while ignoring what is already in place, good and growing. For example, you may score an 8/10 on “I feel confident that I can accomplish what I set out to do.” Don’t just skip over this good news to focus on the lower scores.

    Ask yourself, “What makes me feel proud of this? What are the strengths that I use to accomplish things? Why is this good thing happening for me?”

    You aren’t alone

    Anxiety, fear and a feeling of being overwhelmed can sometimes lead us to isolate, which only exacerbates those unpleasant emotions. Here’s the good news: Emotions are universal. We all experience some iteration of anger, surprise, disgust, enjoyment, fear and sadness. There is also some evidence of a seventh universal emotion — contempt. (Perhaps something or someone immediately sprung to mind with that one!) Even if someone else isn’t going through the exact same situation as you, they can empathize with the emotion you’re experiencing. Talking about it will reduce the intensity of the negativity. Check out Paul Eckman’s work on emotions and expand your vocabulary for talking about emotions with the Atlas of Emotions.

    Ask yourself, “What is the exact emotion I am experiencing and why? Who could I trust to talk about the emotion with? What do I want from the person I share it with: listening, empathy or solutions?”

    Be kind

    It is so important to be kind to ourselves when we haven’t been successful or when we are feeling unpleasant emotions. Instead of adding onto the pain with criticism, flip the script to express compassion toward yourself and allow yourself to notice your emotions. From “You are weak,” shift to “You may not be ready for this yet”; from “You shouldn’t feel this way,” shift to “I wonder why I am feeling this way”; or from “Just another failure, go figure!” shift to “You keep trying hard things, that’s pretty amazing!” You might also consider a self-compassion meditation from compassion expert Kristin Neff.

    Ask yourself, “What do I need right now? What is my body trying to communicate? What is the most kind thing I could do, or say to myself, in this moment?”

    Get real

    This might feel like a tough one. It’s helpful to pause and consider what is fact and what is perception in the situation that is creating anger, surprise, disgust, fear, sadness or contempt. Sometimes we have emotional reflexes based on our past (conflicts and pain from long ago) that jump right back into action at the first sign of danger. They are deeply rooted reflexes, a learned pessimism, that may have served us then by may not be now. Give yourself permission to argue against those negative emotions.

    Ask yourself, “To what extent might I be exaggerating the circumstances? Is there evidence for what I believe is true? Are there alternative perspectives? Is this emotion really helping me?”

    Erika JacksonErika Jackson, M.A., MCC, NBC-HWC is the Chief Coaching Officer for Wellcoaches Corporation, leading the development of training and curriculum to build excellent skills for thousands of coaches around the world. After earning a Master’s Degree focused on Human Resources and adult learning, she led training organizations in Fortune 500 and governmental organizations. With thousands of hours of coaching experience, Erika is a Master Certified Coach and a National Board Certified Coach. She is also a mentor coach and examiner for the International Coach Federation (ICF), serves on the Program Approval Commission for the National Board for Health and Wellness Coaching (NBHWC) and is the Chair of the Health and Wellness Coaching Member Interest Group for the American College of Lifestyle Medicine (ACLM). In addition to her contributions to coaching research, she is co-author of the peer-reviewed Coaching Psychology Manual published by Wolters Kluwer as well as the Behavior Change component of the ACLM Board Review Course.

  • Stepping up Your Fitness Career: From Frontline to Management

    by Greg Margason | May 22, 2023
    Stepping up Your Fitness Career From Frontline to Management

    When enthusiastic fitness professionals get certified as either a personal trainer, group exercise instructor and/or exercise physiologist, they are usually eager to get started helping others with their health and fitness goals. While many fitness professionals knew they wanted to be in this field from high school or college, others decided to change career paths later on. Whichever the case, some may feel they’ve hit their career ceiling.

    However, fitness professionals can continue their career growth in a leadership role. This can be in the capacity of a lead (responsible for a service line like group exercise), supervisor (responsible for one department), manager (responsible for the entire facility) or owner (responsible for the entire business). When I first started my fitness career, I didn’t realize my opportunity in management until my director brought it up to me as an option. You may think you’re not cut up to be in leadership because of the responsibilities that you see your own supervisors or managers carrying out, but if you look closely, you’ll notice that there are many similarities between the characteristics of a fitness professional and someone in management.

    Similarities between Fitness Pros and Leadership

    • Passion for working with people: Fitness professionals interact with people every day. They enjoy helping others improve their overall health. Leaders interact with people every day as well. They just have more variety in the people with whom they interact, such as the employees and members or patients.
    • Ability to motivate: Motivating others is the primary job of the fitness professional. To get someone to start on their health and wellness goal(s) and to continue requires the skill to effectively encourage the person. Likewise, motivating others is one of the skill sets a leader in management must have to ensure that their plans get carried out by their staff.
    • Empathy: There is a reason fitness professionals are referred to as “therapists.” We understand that we need to be compassionate as well as dependable with our clients and class participants. Leaders also need to be able to understand where people are coming from, whether they are clients, employees, investors, or others.
    • Creativity and problem-solving: How many times have you had to think on your feet and be creative when solving a problem your client throws at you? Maybe they forgot to properly fuel themselves before a workout or they got injured while doing a chore and now you must scrap the workout you’d planned and come up with a new one. Being creative allows a fitness professional to be successful with their client or participants, just as leaders in management are always finding new and creative ways to solve a problem; the company’s growth comes from creating new ideas.
    • Communication: Active listening is a skill that all professionals must possess. As a fitness professional, communicating effectively with your client or class participants will lead to their continued success. Outlining the plan of care will ensure that the client or class knows that they’re heading in the right direction. Supervisors and managers utilize this skill to effectively carry out their vision. Whether that’s to let their team know of new policies or offerings, hearing out a member’s concern or molding the culture of the organization, being a good communicator keeps all operations running smoothly.
    • Willingness to learn and stay current with the industry: Education is key to staying up to date with the ever-changing world of health. Successful personal trainers and group exercise instructors must be up to date with the latest research and fitness trends to keep their workouts and classes fresh and relevant. At the same time, they also want to be sure that what they’re still doing is safe for their client or participants. In a similar way, leaders stay updated to know what new service lines or classes to provide in their facilities. Managers and supervisors also network with other professionals in the industry for tips about best practices and warnings about possible downward trends.

    As you can see, what you’re already doing primes you to be a great candidate for a leadership role. Of course, there are some other responsibilities like budgeting, hiring and policy creation that go along with many of these positions. However, your current manager can often teach you these responsibilities if you’re interested. When I took the supervisor position with my organization, I learned those other parts of the job but felt comfortable taking on the role. The experience I had as a fitness professional gave me more confidence when speaking with my team and members because I was able to relate to them. Some of you may be worried that you may have to give up on what you love most — training or teaching! Know that this may be the case, but I was still able to personal train some clients, and when one of my group exercise instructors couldn’t teach a class, I stepped in and taught. Other reasons to look into stepping into a leadership role are having a larger impact on the people you serve, increase your salary and build your resume.

    If you’re interested in continuing your career path and climbing the ladder, talk to your current direct report and ask them if you can help with the next big project. Positioning yourself will help you get noticed.

    Related Content: 
    Blog | A Not-So-Traditional Path to a Career as a Certified Wellness Professional
    Blog | 5 Skills of High Performers in the Fitness Industry
    Resource | ACSM Career Guide

    Douglas Sham
    Douglas Sham, M.Ed., ACSM-EP, ACSM-CPT, ACSM-GEI,
    is the manager of HealthFit – Powered by Sarasota Memorial Healthcare System. He earned his Bachelor of Science and Master of Education from Springfield College. He has stepped into many roles within the fitness and wellness industry as a personal trainer, group exercise instructor, clinical program lead, public speaker and Medical Fitness Association conference presenter.

  • 2023 ACSM Annual Meeting Highlighted Sessions in Environmental and Occupational Physiology

    by Caitlin Kinser | May 16, 2023

    765x370 23 annual meeting_EOPWe’re excited to see you all very soon for the ACSM 2023 Annual Meeting in Denver, Colorado! The Environmental and Occupation Physiology (EOP) topical area offers an exciting in-person program for the 2023 conference with lots of not-to-be-missed sessions. This topical area is highly relevant to anyone interested in topics relating to human health and performance in environmental extremes, including cold exposure, heat, diving physiology, altitude and microgravity. Sessions range from basic science to applications for training, hydration, clothing and policy development in athletes, clinical populations, military, firefighters and related occupations. Many of the sessions will appeal to researchers, athletes, coaches and clinicians, so please join us for some exceptional EOP sessions.

    We are excited to promote the EOP Highlighted Symposium on the timely and important topic of “The Mental Health Crisis: The Impact of Exercise and the Environment on Psychobiological Function” (session B-10, room 205) which will be held on Wednesday, May 31 at 9:30 a.m. This symposium features cross-disciplinary experts from the University of Colorado Boulder, University of Colorado Anschutz Medical Campus and The University of Texas at Arlington, who will discuss the complex physiological mechanisms by which mood and anxiety disorders increase chronic disease risk, with a major focus on the influence of exercise and the environment on psychobiological function. The exciting line-up of speakers includes Christopher A. Lowry, Ph.D., Jody Greaney, Ph.D., FACSM, Kerrie Moreau, Ph.D. and Tracy Greer, Ph.D. The session will be rounded off with questions and discussion so please join us for what will be an excellent series of talks!

    A continuing theme in EOP programming concerns sex-related differences in physiological responses to varied environmental stressors. This provides another timely topic, discussing “Hot in (Her)re: New Insights into Thermal and Fluid Regulation in Women” which will be held at 9:30 a.m. on Thursday, June 1 (session D-24, room 207). This brings together an excellent group of speakers including Orlando Laitano, Ph.D., discussing sex as a biological variable in exertional heat stroke (EHS), Toby Mündel, Ph.D., addressing if ovarian hormones influence EHS and Jessica Freemas, discussing fluid regulation across the menstrual cycle. Gabrielle Giersch, Ph.D., will round up the session highlighting potential sex differences in heat stress in the US military.

    Some other exciting sessions to look out for are “Dehydration: Sweating Out the Details of Multiple System Dysfunction” (session C-50, room 207) on Wednesday, May 31 at 3:45 p.m. co-chaired by Zac Schlader, Ph.D., FACSM and J.J. Duke, Ph.D., FACSM. Topics include the effects of dehydration on renal function, pain, and social determinants and racial differences in hydration with implications for cardiovascular health. For those interested in the effects of a variety of oral supplements and topical applications including menthol and sunscreen on different aspects of thermoregulation, please consider attending Thematic Poster session “From Supplements to Sunscreen: Effects on Thermoregulation” (session E-57, room 706) on Thursday, June 1 at 3:45 p.m.

    For those interested in a broad range of topics relating to heat illness risk and prevention in populations including children, older adults and athletes, Ollie Jay, Ph.D., is chairing the free communication/slide session “It's Getting Hot in Here: Heat Illness Risk and Prevention” (session G-56, room 710) on June 2 at 3:45 p.m. Scott Collier, Ph.D. is chairing a rapid fire platform session on “Occupational and Military Physiology: Sleep” (session C-47, Hall B) on Wednesday, May 31 at 3:45 p.m. which highlights the impact of shift work and related occupational factors in police, firefighters and Navy personnel on different aspects of sleep.

    The 2023 annual meeting also features a comprehensive range of posters covering all aspects of environmental, occupational and military physiology, including physiological responses to heat, cold, altitude, hyperbaria and microgravity. Applied aspects of the EOP topical area also highlight military, police and firefighter relevant tasks and physiological responses. Poster session chairs will be walking around the poster hall and encouraging some fun discussion, so please stop by as many poster sessions as you can!

    We have an exceptional EOP program for 2023 with only a few sessions highlighted here. Please review the full EOP program and we look forward to seeing you in Denver in a few weeks!

    Join us at the 2023 ACSM Annual Meeting

    Caroline Smith HeadshotCaroline J. Smith, Ph.D., FACSM, is an Associate Professor in the Department of Health and Exercise Science, Appalachian State University, NC. She is Director of the Thermal and Microvascular Physiology Laboratory specializing in thermal physiology. Her research program broadly focuses on thermoregulatory responses during exposure to heat and dermal carcinogen exposure in occupational settings. Dr. Smith received her PhD in Thermal Physiology from the Environmental Ergonomics Research Center, Loughborough University, UK, and completed postdoctoral training at Noll Laboratory, The Pennsylvania State University. She is the topical representative for Environmental and Occupational Physiology on the ACSM program committee.
  • Active Voice | We All Need a Good PAL on Most Days

    by Greg Margason | May 09, 2023
    We All Need a Good PAL on Most Days

    Higher levels of physical activity are unquestionably important for maintaining good physical and cognitive health. Surprisingly, however, we know relatively little about the amount of energy United States (U.S.) adults expend in physically active behaviors each day. 

    One way to estimate the amount of energy expended in physical activity is to calculate one’s physical activity level (PAL) as the ratio of total energy expenditure to resting metabolic rate. Higher PALs have been associated with lower mortality risk in older adults, and they are often used to classify activity levels when calculating daily energy requirements. 

    A PAL of < 1.4 is consistent with engaging only in basic activities of daily living and is classified as “inactive.” A PAL of > 1.6 is classified as “physically active.” Extreme PALs have been measured for elite riders during multiday cycling races (PAL > 2.5) and for hunter-gatherers in Tanzania (PAL ~2.0). 

    Surprisingly, we were unaware of PAL estimates from representative samples of U.S. adults, or how much energy they expend in physically active behaviors on a given day. 

    Our study, published in the May 2023 issue of Medicine & Science in Sports & Exercise®, addressed this gap by conducting a nationwide survey of 2,640 U.S. adults (20-75 years of age). The study used a self-administered previous-day recall instrument, Activities Completed over Time in 24 Hours (ACT24), to estimate PALs, and the results are a snapshot of PALs in U.S. adults on a given day. (The ACT24 is accurate for estimating PAL values in comparison to the doubly labeled water technique at the population level and is a freely available tool for researchers and educators to use in their work.) 

    In our study, U.S. adults reported an average PAL of 1.63, and nearly 40% reported being “physically active” (PAL ≥ 1.6) on a given day. Men reported higher PALs (1.67) than women (1.59), and adults who were 65-74 years old reported lower PALs (1.58) than adults 20-34 years of age (1.66). Household and occupational activities were the behavioral drivers of higher PALs in the population, while exercise and recreational activities were instead minor contributors. 

    The balance of time spent sedentary and physically active was a clear driver of higher PALs. Adults who were “physically active” spent 50% of their waking day sitting (8.0 hours/day) and the remaining time engaged in light-, moderate- or vigorous-intensity physical activity, for a total of 8.3 hours/day in daily activity. In contrast, “inactive” adults spent 81% of their waking day sedentary (12.1 hours/day). 

    Our results provide the first estimates of physical activity energy expenditure in a representative sample of U.S. adults and describe the amount of sedentary time and types of physical activity that are associated with higher PALs. 

    So, get up and go find a good PAL to be active with whenever you can. Nearly 40% of U.S. adult appear to be physically active on a given day — find your PAL and join them!  

    We hope our findings spur further research in these areas. 

    Charles Matthews
    Charles E. Matthews, Ph.D.
    , is a physical activity epidemiologist and senior investigator in the Division of Cancer Epidemiology and Genetics within the Metabolic Epidemiology Branch at the National Cancer Institute. His research focuses on understanding the health benefits of physical activity, the adverse health effects of sedentary time, and works to develop new, “better” methods to measure these behaviors in large epidemiologic studies. Connect with Dr. Matthews:

    Pedro Saint-Maurice
    Pedro Saint-Maurice, Ph.D.
    , is a physical activity and sleep epidemiologist and research fellow in the Division of Cancer Epidemiology and Genetics within the Metabolic Epidemiology Branch at the National Cancer Institute. His research examines how profiles of sleep and ambulatory movement throughout the day are associated with cancer risk and mortality. Connect with Dr. Saint-Maurice:

    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. 

  • 2023 ACSM Annual Meeting Highlighted Sessions in Skeletal Muscle, Bone, and Connective Tissue

    by Greg Margason | May 04, 2023
    AM blog graphic

    It is a pleasure to serve as the ACSM topical representative for Skeletal Muscle, Bone, and Connective Tissue. I look forward to seeing everyone this year in beautiful Denver, CO. The 2023 ACSM Annual Meeting will feature a number of outstanding sessions on the interactions between exercise, skeletal muscle, bone, and connective tissue health. There are three sessions that I think will be of particular interest to conference attendees. The first is a highlighted symposium entitled, “Beyond the Weight room: The Importance of Skeletal Muscle in Health and Disease”. This session is scheduled for Thursday June 1, 2023 from 1:30 p.m. - 3:30 p.m.  The symposium will be chaired by Blake Rasmussen, Ph.D. from the University of Texas Medical Branch, and features two other outstanding speakers; Marni Boppart, Sc.D. FACSM from the University of Illinois at Urbana-Champaign, and Nicholas Greene, Ph.D., FACSM from the University of Arkansas. This session will discuss current research on the transcriptomic and metabolic response to early-phase recovery from skeletal muscle disuse in men and women, highlight the contribution of extracellular vesicles on skeletal muscle recovery following immobilization, and discuss the roles of biologic sex and altered muscle metabolism in cancer-induced cachexia. 

    The second symposium I would like to highlight is entitled, “Mechanisms and Considerations for Musculoskeletal Anabolic Resistance in Healthy Adults under Physiological Stress”. This session is scheduled for Wednesday May 31, 2023 from 3:45 p.m. - 5:45 p.m. and features four outstanding scientists. Speakers include Stefan Pasiakos, Ph.D., FACSCM, Jess Gwin, Ph.D., and Julie Hughes, PhD., FACSM from the U.S. Army Research Institute of Environmental Medicine, and Kristin Popp, Ph.D. from Massachusetts General Hospital. This session will highlight the mechanisms contributing to musculoskeletal anabolic resistance in healthy adults exposed to physiological stress in sport and during military training, and will provide considerations for targeted exercise, nutrition, and pharmacologic interventions to overcome musculoskeletal anabolic resistance and promote tissue growth under stress. 

    The final symposium that I would like to highlight is entitled, “Oxygen and Striated Muscle Function” and features four of the leading experts on skeletal muscle metabolism and health. The session is scheduled for Friday June 2, 2023 from 1:30 p.m. - 3:30 p.m. Speakers include, Mike Hogan, Ph.D., FACSM from the University of California, San Diego, L. Bruce Gladden, Ph.D., FACSM from Auburn University, David Poole, Ph.D., FACSM from Kansas State University, Sarah Kuzmiak-Glancy, Ph.D., from the University of Maryland, and Anni Vanhatalo, Ph.D., FACSM from the University of Exeter. This session will recount and discuss: a) oxygen and skeletal muscle function, b) oxygen and lactate accumulation and oxygen uptake on-kinetics, c) oxygen and cardiac muscle function, and d) oxygen and athletic performance. Given the importance of oxygen availability in aging and many chronic diseased states, this session will appeal to a broad audience from basic scientists and those with applied interests. 

    In addition to these sessions there are five excellent Tutorial Lectures throughout the week, an oral free communication session on “Skeletal Muscle and Resistance Training” (Friday 9:30 a.m.), a thematic poster session on “Skeletal Muscle in Health and Disease” (Wednesday 9:30 a.m.), and several poster sessions spread throughout the week. 

    Learn more about the other featured sessions in Skeletal Muscle, Bone, and Connective Tissue and the many other sessions that will be presented at the 2023 ACSM Annual Meeting here.

    Join Us at the ACSM Annual Meeting

    Gordon Fisher

    Gordon Fisher, Ph.D., FACSM
    is a Professor at the University of Alabama at Birmingham (UAB) Department of Human Studies, and holds Senior Scientist positions in the Center for Exercise Medicine, Nutrition and Obesity Research Center, and the Diabetes Research Center at UAB.