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1 EHFA European Health & Fitness Association EHFA Update issue 24 - May 2013 MORE PEOPLE MORE ACTIVE MORE OFTEN 4th annual international standards meeting Budapest Nov 2013 Cutting Edge: Training the Fascial Network Mistery Shopping Caro Club, c è posta per te! EHFA and Deloitte present first ever research report on the leading fitness operators in Europe

2 EHFA News EHFA and Deloitte present first ever research report on the leading fitness operators in Europe. The new report, which covers 2012, was officially launched at EHFA s General Assembly, held in Cologne, Germany. The fitness sector in Europe generates an estimated 22 billion in revenues and the number of people active in health & fitness centers has reached 44 million! There are about facilities, which are mostly single site operated. According to the research, the top 20 operating companies account for 16% of the market in volume. Herman Rutgers, EHFA board member and industry expert comments; With the enormous economic, social and health related value of our industry it is an important goal of EHFA to increase the quality of available research on the sector. Therefore EHFA and Deloitte have invested in this initiative that will hopefully benefit all stakeholders. The agreement for this project is for 3 years and we expect to broaden our partnership to other specific European market research in this time. Top 3 players in the European Health & Fitness sector.the new European Health & Fitness Operators report confirms: Nr.1 is Virgin Active - part of the Virgin Group owned by multi-entrepreneur Richard Branson - with a European turnover of 520 million, realized in 4 countries in the financial year of HealthCity International comes secondwith revenues of about 250 million. The company has its headquarters in the Netherlands and now has operations in 7 European markets and grew fast in the recent past through a string of acquisitions. Fitness First is Nr. 3 with a turnover of about 240 million, based in the 2 biggest European markets: the UK and Germany. The Top 10 operating companies realized a total turnover in Europe of 2.3 billion in Measured by volume/number of members, German operator McFit is #1 with about 1.2 million members. McFit operates in the growing high volume/low price segment of the market with monthly fees of less than 20 Euro. Virgin Active, operating in the other end of the spectrum, i.e. the medium/higher priced market, realizes revenues that are twice as high with only half the number of members. The two small studio concepts Curves and Mrs.Sporty are in the lead in terms of the number of facilities with 980 respectively 567 facilities in Europe. It is important to consider that these two niche players specialize on circuit training concepts for women and are only comparable to a limited extent to the other operators because of a surface of less than 220sqm. Fitness-market also active on the M&A s front. Niels Gronau, who is responsible for the Fitness industry at Deloitte s Sport Business Group further comments,

3 EHFA News The report lists some essential developments in the ongoing transactions in the fitness industry. This includes the reorganisation of Fitness First with the retreat from Benelux, Italy, France and Spain as well as the reduction of the club portfolio in the UK and Germany (Outside of Europe Fitness First grew considerably in the Middle East and Asia/Pacific). A further trend is the strong external growth of key operators like HealthCity, Virgin Active, Sportcity or Holmes Place through acquisitions. The third driver is the continuous interest of private-equity firms in the fitness sector which became apparent through investments in the Northern European market in recent years. The 40-page study can be ordered via the EHFA website and costs 299. To order go to; It provides following information per ultimo 2012; Top 10 operators by revenues Top 20 operators by number of clubs and members A detailed description of all top-20 operators Overview of major mergers and acquisitions Interview with EHFA President Harm Tegelaars on his views on the sector s challenges and opportunities The report gives insight into the many different types of facilities the sector now has, with many different business models, from full service large scale sites with fitness, wellness, spa, sauna, swimming pool, racquet sports, etc, to the micro studios catering for a special target group. Nemzetközi Fitnesz, Szabadidősport és Egészségfejlesztési Konferencia (International Fitness, Leisure Activity and Health Promotion Conference) The First Hungarian Health and Fitness Association (MFESZ) congress was held in Budapest on 10th May with a packed audience including Government and Sport for All representatives, medical practitioners, club owners and operators, from universities, training providers and fitness professionals. There were 40 inspirational and practicable presentations on the day covering the Global fitness sector, Health Management, Sports and fitness professional, and for Health Promotion. The conference was organized by Prof. Dr. Miklos Toth MOB Vice President together with an interesting perspective from Charlotte Monspart and Olympic athlete and vice president of sport-for-all in Hungary. As a special guest speaker and special greetings to the participants Mr. Cliff Collins, programmes director of the European Health and Fitness Association and EREPS who gave an overview of the European fitness sector and future prospects and the how the European Register operates. From the University of Southern Denmark Prof. Dr. Paolo Caserotti gave an interesting summary of research in active aging and the importance of physical activity interventions and Mr. Alexis Batrakoulis the GRAFTS Fitness professional school leader from Greece and gave a successful performance in exercising being the best prevention and treatment of metabolic syndrome. Mr. John Harris, Star Fitness Club owner from Austria helped to set the scene for the opportunities in running a successful club. Dr Laszlo Zopcask, President of MFESZ and an expert on the EHFA Standards Council gave an overview of the opportunities for the development of fitness in Hungary and especially how reggular phisical exrcise can improve levels of health. He emphasized that in

4 EHFA News Hungary there are more than 400 fitness clubs operating around the country, with thousands of qualified fitness professionals needed to carry out work and about 300,000 active health club members performing regular physical activity. The congress becasme the focus for future opportunities in Hungary for all stakeholders interested in fitness and for the start of the national register of fitness professionals as part of the EREPS Programme. The MOVE project is founded on the premise that everybody is entitled to enjoy the many benefits of physical activity regardless of who they are and where they live. With MOVE, ISCA, eight associated partners including EHFA and fifteen collaborating partners have joined forces to take up the challenge of promoting physical activity among socially disadvantaged groups. Taking up a challenge of this magnitude has required a crosssector approach, which is reflected in the broad partnership. The MOVE project aims to collect and qualify good practices that promote heath-enhancing physical activity among socially disadvantaged groups. In this effort, MOVE will focus on experiences that have been successful in targeting the following groups living in disadvantaged urban or rural areas with socioeconomic challenges: youth ethnic minorities and immigrants girls and women seniors Physical activity has proven itself to be one of the single most important determinants for a healthy life. Leading authorities such as the World Health Organization (WHO) have extensively documented the positive effects of physical activity on health and quality of life. However, it has been equally well documented that inequalities in health related to physical activity are also strongly linked to socioeconomic factors such as income, education, employment and ethnicity. People who are poorer, less educated, unemployed or belonging to specific ethnic groups tend to engage less in physical activity and are less healthy. Further details are available at and there will be a summary and presentation of the key findings and outcomes in Barcelona on October at the ISCA 2013 Congress. Standards Council Update New standards on the way... After the approval of the (Pre) Diabetes Exercise Specialist (EQF-level 5) and Pilates Teacher (EQF-level 4) standards the EHFA Standards Council continues its way of focusing on challenging disorders related to fitness and exercise. EHFA European Health & Fitness Association EHFA standards The World Health Organization (WHO) recognizes lack of exercise in combination with overweight and obesity as the epidemic of the 21st century. This is in line with the main outcomes of the International Standards Meeting in Barcelona last year. The Standards Council received very important and productive feedback from the delegates through the sessions and roundtable discussions about the new categories of standards at the EQF-level 5. Moreover, a lot of agreements, disagreements and arguments for many issues, which are priorities in order to develop more standards have been gathered. To apply sustainability of the standards events it was a matter of course for the Standards Council picking that trend up and transferring it into a standards development process, namely by finalizing the (pre)diabetes standards and launching a new project: the Weight Management Specialist (WMS). The standards for the Weight Management Specialist will also appear on level 5 and are strongly connected to the (pre)diabetes standards. These standards will focus on the knowledge, competencies and skills an exercise professional needs to train overweight or obese clients. Without any doubt one of the growing peer groups for the future. The Council currently plans to have publishable standards for the Weight Management Specialist until November. Alongside the metabolic disorders the Council is aware of the importance of musculoskeletal disorders and has developed first thoughts for an occupation specialized in lower back pain. This is also in line with the majority of delegate opinions during the last ISM in Barcelona. To keep abreast of Standards development go to

5 News & views 10 Flabbergasting Costs of America s Obesity Epidemic As was reported in a recent edition of The Motley Fool, obesity is costing the USA big time! Since 1960, the number of obese Americans has tripled. What? Tripled, yes!! And six times more Americans are now extremely obese than 50 years ago. Unfortunately, everyone is paying for this obesity epidemic. How much? Here are 10 shocking numbers related to the costs of obesity: billion -- That s the amount of added medical costs every year that are estimated to stem from obesity-related problems. It s nearly 21% of total U.S. health care costs % -- According to a study conducted by the Brookings Institution, this is the increased amount that obese Americans pay for prescription drugs compared to individuals who aren t obese. 3. $3.4 billion -- Cars are burning around 938 million gallons of gasoline per year more than they would if Americans weighed what they did in $164 billion -- The Society of Actuaries estimates that U.S. employers are losing this amount in productivity each year due to obesity-related issues with employees. 5. $6.4 billion -- Every year, this amount is estimated to be lost due to employee absenteeism related to obesity. 6. $1 billion -- U.S. airlines are consuming an extra 350 million gallons of fuel per year due to overweight passengers. 7. $14.3 billion -- This is how much childhood obesity costs the U.S. each year, according to a published study from the Brookings Institution. 8. $62 billion -- Medicare and Medicaid are spending nearly this amount every year on obesity-related costs. 9. $66 billion -- Columbia University researchers say that if current trends don t change, annul obesity-related medical costs in the U.S. could increase this amount by $580 billion -- The Robert Wood Johnson Foundation predicts that annual economic productivity loss due to obesity could hit this staggering amount by 2030 unless the current situation changes. for the full report go to The Middle East: A Growing Health & Fitness Industry article kindly supplied by Only a few years ago the Middle East was very limited in the Health and Fitness services it had, and even in Dubai, UAE, there were a but a handful of known bootcamp classes, a decent number of gyms and a couple of healthy cafes. Fast forward to 2013, and even since I arrived in the country in 2011, those numbers have grown significantly faster than I ve seen in any other region, despite a slow-down during the economic crisis. The Middle East is a place of high disposable income and convenience now, there is a gym in almost every neighbourhood, a bootcamp taking place at the nearest beach or park, and the latest and greatest training disciplines, such as CrossFit, have well and truly arrived and left their mark on the industry landscape. With this same growth comes the need for greater regulation to protect the public and guarantee a good quality of service is given by professionals. After years with a serious lack of industry standards, an authority for regulating professional qualification standards is now being established here in the UAE - REPS UAE & Infinity Sports Management (Representatives of the Dubai Sports Council) is in the process of setting up protocol and ensuring that qualification standards are implemented and maintained in this fitness industry, a move in which will hopefully follow in the greater Middle East region. So just how much more room there is left for growth here? Well there are very positive signs as statistics show Dubai s population increasing by 5 per cent during 2012 to a record 2.1 million, according to estimates from the Dubai Statistics Centre, things don t appear to be slowing down. With the UAE s diabetes rate being among the highest in the world, offering quality health and fitness education, initiatives and programs is imperative. As such, there are a vast number of opportunities for certified trainers and fitness professionals within the Middle East industry. Many professionals that have made the move here have made a great life for themselves, establishing a developing career within the industry and enjoying the benefits and amazing opportunities that you can find here. If one is looking at making the move to work in the UAE or other Middle East country, I highly recommend that you research via third parties, every and all details of the professional package visas, accommodation allowance, health insurance, annual flight ticket home and expected salary. These are details that should be agreed upon before any agreement is reached.

6 News & views For help when considering or exploring job opportunities within the Middle East, a great place to start is FitnessLink (www.fitnesslink. me), the Middle East s leading online health and fitness community of companies and professionals. FitnessLink features a directory of legally registered companies that gives you a great guide about a company and can also if looking at a position with a company. In addition and more importantly, the site also features the only health and fitness specific Jobs Board for the Middle East, with a variety of different categories and listings of the available vacancies within each. As you can see the health and fitness industry in the UAE and greater Middle East region is a well-established and ever-growing ecosystem, one of which holds any number of opportunities for quality health and fitness professionals. Keep updated and for more information; visit Grant Goes Founder of FitnessLink Physical education is a compulsory subject at school but is commonly perceived as being less important than other subjects, according to a new Commission report on sport education in 30 European countries. The surveyed countries (25 EU Member States and Croatia, Iceland, Liechtenstein, Norway, Turkey) tend to agree on the main aims of physical education: fostering children s immediate and life-long -physical, personal and social development as well as promoting a healthy lifestyle. Among the mandatory physical education activities in schools, ball games are the most common, followed by gymnastics. Although European countries promote the value of physical education and sport in schools, large discrepancies exist in the recommended annual taught time. For example, during the 2011/12 school year, the recommended minimum average taught time at primary level varied between 37 hours in Ireland and 108 hours in France. In addition, the share of taught time recommended for physical education is rather low compared to that of other subjects across all countries. The report covers primary and lower secondary education and provides an insight into the following topics: national strategies and large-scale initiatives, the status of physical education in national curricula and steering documents, recommended annual taught time, pupil assessment, teacher education, extracurricular activities and planned reforms. The report is the result of an in-depth analysis of primary data provided by Eurydice national units and is the first attempt by the European Commission to map the state of play of physical education at schools across European countries.

7 Technical Cutting Edge: Training the Fascial Network (Part 1) By Pete McCall, M.S. article kindly supplied by Over the past 40 years, walking into a health club or gym has left many people feeling overwhelmed and intimidated by the immense variety of exercise machines, each one designed to isolate a single part of the body. In some facilities, it s not uncommon to see a number of separate machines to train the same appendage. The manufacturers of these machines mean well, because human anatomy has traditionally been studied as a collection of individual components, with each one designed to move a specific part of the body. Newly emerging work from two distinct groups of professionals, however, is fundamentally changing the way we think about muscular anatomy. These new findings are related to how the myofascial network what is traditionally called the muscular system functions as a wholly integrated system, and they are dramatically changing the approach to designing and delivering exercise programs to personal-training clients. understand how human tissue, specifically inter- and intramuscular connective tissue, functions at the cellular level. Wolff s law, which states that functional stimulation precedes structural change, was developed in the late 1890s to describe how the structures of the body adapt on the macro level (Siff and Verkoshansky 2009). However, in an emerging field of study known as systems biology or mechano-biology, researchers are finding that on the microscopic level, cells function as individual structures to remodel their architecture in response to applied stresses. These new findings indicate that the fascial sheaths and connective tissue, which surround and connect all structures in the human body, play a more important role than previously thought in adaptation to the applied demands of exercise (Vogel, 2006; Ingber, 2004, 2003). Meanwhile, on the macro level massage therapists and body workers professionals who specialize in working with muscle and connective tissue to improve human movement describe muscular anatomy as an integrated system with specific lines of pull controlling how forces move and dissipate through the entire body (Myers, 2009; Langevin, 2006; Schultz and Feitis, 1996). The Myofascial Network There are two distinct parts of human skeletal muscle: the contractile element and the visco-elastic non-contractile component (Siff and Verkoshansky, 2009). The contractile element of muscle is organized into different layers: The myofibril, or individual muscle fiber, comprised of sections of sarcomeres containing the actin and myosin protein filaments responsible for muscle contractions he fascicle formed by a bundle of individual muscle fibers An entire section of muscle containing of a number of fascicles The non-contractile component includes the fascia or connective tissue, which surrounds each layer of the contractile element: Newly developed technology now allows scientific researchers to observe the function of human tissue at the cellular or micro level. This, combined with the experience of soft-tissue therapists who work with the human form on the macro level, is leading to a new of way of describing human anatomy and muscular function. Scientific researchers have been using advanced technology to The endomysium the connective tissue around an individual myofibril (muscle fiber) The perimysium the layer of connective tissue around a fascicle The epimysium the outermost layer of connective tissue around an entire muscle or collection of fascicles Muscle contractions by the contractile element are generally

8 Technical identified as: Wholly eccentric a lengthening action where the resistive force is overcoming the muscular force Wholly concentric a shortening action where the muscular force is overcoming the resistive force Completely isometric an action where the muscle fibers are contracting but no joint motion occurs Additionally, muscular anatomy is commonly described as being organized into prime mover or agonist muscles, which are responsible for producing a movement at a joint, and antagonistic muscles, which work to restrict the joint motion caused by the agonists. For example, during a knee-extension exercise the quadriceps muscles on the front of the thigh are described as the agonists because they create open-chain knee extension, and the hamstring muscles located on the back of the thigh are considered antagonists because in an open-chain environment (i.e., with the foot not on the ground) they work to move the knee into flexion in the opposite direction. While both of these axioms, which have long been taught in the fitness industry as being the only way that muscles work, are are not wrong, they are incomplete. If you are studying human anatomy from a static perspective, with the body lying flat, the concepts of muscles performing only a single type of contraction or working as opposing pairs makes sense. However, during upright movement, the myofascial network has to organize and control forces entering the body, and a single muscle can have some fascicles that are lengthening while other fascicles are shortening (Schleip et al., 2012; Myers, 2011; Ingber, 2003). When considering the agonist-antagonist model of muscle function, it is helpful to refer to Lombard s paradox, which describes what occurs when muscles on opposite sides of a joint work together synergistically to create motion at that joint (Siff and Verkoshansky, 2009). For example, if both the hamstrings and quadriceps can work together to create knee extension when the foot is planted on the ground, or the gluteus maximus and iliopsoas work together to decelerate hip internal rotation in the transverse plane, then it is time to reconsider the practice of teaching muscle function in terms of agonists and antagonists (Schleip et al., 2012). For many years, exercise science has also focused on describing movement as a function of how the contractile element influences a particular joint. The sliding filament theory of actin-myosin cross-bridging describes how the contractile element of muscle functions to produce movement. As the actin and myosin slide across one another, this shortens the sarcomeres of a particular myofibril; when a number of myofibrils shorten at the same time it causes the distal end of a muscle to move closer to the proximal attachment. As a result it has been thought that the contractile element has the greatest impact on creating human movement. [This approach traces its roots back to the early cadaver dissections to study the human body, which perceived the connective tissue as mere packing material and was immediately removed in an effort to study how the contractile element of skeletal muscle attached to the skeleton (Myers, 2009).] In turn, this approach led to the methodology of training the body as a number of separate individual parts as opposed to one single system, which led to the overwhelming number of machines in the typical health club. It turns out that this approach might be misguided and that the non-contractile connective tissue is more responsible for organizing human movement than originally thought. The Human Body as a Mechanical System Merriam-Webster defines a system as an interdependent group of items forming a unified whole, or a group of interacting bodies under the influence of related forces. The human body is a series of systems interacting with one another to produce and control movement. When a muscle and its involved connective tissue are eccentrically lengthened, it is experiencing a tensile (pulling) force, which allows it to elastically store mechanical energy. When that same bundle of muscle and connective tissue concentrically shortens or compresses, it releases the energy stored during the lengthening phase. Therefore, the myofascial network functions as an integrated mechanical system, balancing competing tensile and compressive forces responsible for storing and releasing mechanical energy. It is easy to see how movements or exercises that isolate a specific muscle group or joint can lead to imbalances, which affect the entire system as a whole. The non-contractile component is comprised primarily of fascia, which is broadly defined as all of the soft, fibrous connective tissue interwoven between all of the cells and organs within the human body (and should be considered an organ in its own right). Recent research suggests that non-contractile connective tissue is the richest sensory organ in the human body, containing up to 10 times as many free nerve endings than the contractile element (Schleip et al., 2012). On the macro level, different bundles of muscles attach to one another via the epimysium, which also becomes the tendon connecting the contractile element to the skeletal structure. The fascia and connective tissue surrounding an individual muscle is responsible for transferring forces between different sections of neighboring muscle. This system, easily visible on the macro scale, repeats itself on the micro level with the endomysium distributing load between individual muscle fibers by forming a lattice-work that connects every single cell in the human body to one another (Schleip et

9 Technical al., 2012). At both the macro and micro levels, connective tissue is directly responsible for organizing how mechanical forces are distributed throughout the human body (Myers, 2009; Vogel, 2006; Galli et al., 2005; Ingber 2004). Studying the attachment points of the contractile element on a static human cadaver lying in the supine position led these early anatomists to theorize that, if a muscle has two attachment points and crosses a joint, then it must work only to move that joint. However, when the human body is alive, upright and moving, it must account for the competing bottom-up forces of ground reaction and top-down forces from gravity; as a result, the myofascial network becomes the primary system for controlling these forces. Whereas the central nervous system (CNS) sends signals via electrical impulses, the fascia and connective tissue create a system that communicates by transferring forces from one section of the myofascial network to another (Schleip et al., 2012; Myers, 2009; Vogel, 2006; Ingber, 2003). Through mechanotransduction, which is the transmission of mechanical forces through fascia and connective tissue to initiate a biochemical response, it is estimated that mechanical vibrations transiting the myofascial network move three times faster than the signals sent by the CNS (Schleip et al., 2012; Vogel, 2006; Ingber, 2004). On the macro level, mechano-transduction is effective at transferring Tendons are bundles of connective tissue attaching muscle to bone; in terms of exercise, the fitness industry commonly considers connective tissue as a passive structure that is uninvolved in actual force production. This is another generalization that requires a closer look, because mechanical stiffness is regulated across the entire myofascial network. When an external force is applied to the myofascial network, the myofibrils and fascicles of the contractile element can shorten and create tension, while the surrounding viscoelastic, non-contractile component lengthens (Myers, 2011; Siff and Verkhoshansky, 2009). During explosive movements, the contractile elements of a muscle will remain in an isometric state to increase the tension on the non-contractile components in an effort to produce higher levels of force. The enhanced stiffness from the contractile component can help the connective tissue rapidly store mechanical energy during the lengthening phase. This consequently produces greater power output during the shortening phase. On the macro level, isometric contractions should be considered an action involved in the initiation and control of all dynamic movement (Siff and Verkhoshansky, 2009). Isometric tension exists down to the cellular level as well, as any external mechanical load is imposed on this pre-existing force balance (Vogel, 2006; Ingber, 2003). At both levels, the role that the non-contractile component plays in force production must be considered during exercise, and programs should feature some rapid velocity movements to properly facilitate the response from this mechanism. The myofascial network is so efficient with transferring force from one section to another that a muscle does not have to cross a joint to create movement at that joint. For example, the soleus attaches to the superior section of the posterior tibia and does not cross the knee. As the body is walking forward during gait and the right leg is on the ground during the ground contact phase as the body passes over the right foot, the right soleus limits the tibia-on-talus dorsiflexion, helping the knee move into extension prior to the early heel-off phase (Neumann, 2010; Siff and Verkhoshanksy, 2009). force from one segment of muscle or connective tissue to another, while on the micro level it initiates chemical reactions that change the structure and biophysical properties of individual cells (Langevin, 2006; Vogel, 2006; Ingber, 2004, 2003). The Biotensegrity of the Human Body It is important to consider the network of fascia and connective tissue as a single, integrated system responsible for establishing a constant equilibrium of forces. It can be easy to forget that a human being grows from a single cell in the embryonic form and experiences rapid growth via cell division during the gestation period. This is important, because throughout a human being s lifespan, all cells and bodily tissues remain connected (Myers, 2009; Schultz and Feitis, 1996). Tensegrity, which refers to the combination of tension and integrity, is an architectural term used to describe a structure that is self-supporting through a combination of tensile (lengthening) and compressive (shortening) forces. Given that the myofascial system is a balance of compression and tension, biotensegrity is an effective term to describe how the body has a natural, structural tendency to balance forces (Myers, 2009; Galli et al., 2005; Ingber, 2003). Traditional anatomy teaches that muscles attach to bones via the tendon; however, following the model of biotensegrity, it is more accurate to say that skeletal structures float within a threedimensional matrix of muscle and connective tissue (Myers, 2011, 2009). Fascia is a living tissue that maintains a constant balance

10 Technical between synthesis of new cells and remodeling of existing cells in response to external and internal forces. The primary regulators of tensegrity tension and compression influence a cell s biochemical response to stress; the biotensegrity model of human anatomy has been shown to both qualitatively and quantitatively predict mechanical behaviors of human cells (Ingber, 2004, 2003). Pulling it all Together There is a continual feedback between cellular sensing of force, rigidity or form and the cell contractility that, together with biochemical signals, co-regulates cell and tissue shape and, ultimately, the shape of the organism (Vogel, 2006). How forces affect tissue change on both the macro and micro scales is important, because when a personal trainer or group fitness instructor delivers a workout to a client or participant he or she is applying external forces to clients bodies. Biotensegrity explains how mechanical behaviors can emerge through multi-component interactions, which make the whole much greater than the sum of its parts (Ingber, 2003). If the system is not properly balanced, then forces such as compression, tension, torsion or shear can change the architecture of cellular structures and the overall function of the body. The key message for fitness professionals is that continued stresses from repetitive movement patterns, movements performed with poor technique, or a lack of multiplanar movement in general affects the body on many different levels and can have a significant impact on the results a client experiences from an exercise program. Diet and lifestyle affect the hydration and, ultimately, the elasticity of muscle and connective tissue. The myofascial network is designed to be moved in all directions at a variety of different velocities. At the macro level, a lack of multiplanar movement and proper hydration can cause layers of fascia to bind and change a body s ability to move efficiently. On the cellular level, force regulation can change the physical properties and biochemical function of a cell (Schleip et al., 2012; Vogel, 2006; Ingber, 2004). It is interesting to note that a wide range of diseases share on common feature: Their etiology and clinical presentation result from abnormal cellular responses to mechanical stress (Inger, 2004). A well-known fitness educator who advocates muscle-isolation training has been known to say that knee extensions do not cause cancer. The point of this discussion is not to suggest that the use of machines or muscle-isolation exercises will cause a deadly disease but it is important for fitness professionals to understand that the exercises performed by their clients affect ALL tissues in the body from the cellular level on up. Exercise is a function of movement. Movement is a function of numerous muscles working together to propel joints through their structural range of motion. Designing an exercise program based on body-part isolation does not take advantage of the mechanical forces produced when numerous muscles and fascial structures work together in synergy. If you have only a limited amount of time to engage your clients in activity, then it is important that the client perform multiplanar, multidirectional movements that include both slow and fast-paced tempos to ensure adequate stimulation of all layers of the myofascial network. Part 2 of this article series will address how to use the ACE Integrated Fitness Training (ACE IFT ) Model to design movement-based programs that address all layers of a client s myofascial network, and that help personal trainers improve the lives of their clients from the cellular level on up. References Galli, C. et al. (2005) Life on the wire: On tensegrity and force balance in cells. Acta BioMed,76, 512. Ingber, D.E. (2004). The mechanochemical basis of cell and tissue regulation. Mechanics & Chemistry of Biosystems: MCB, 1, 1, Ingber, D.E. (2003). Tensegrity II: How structural networks influence cellular information processing networks. Journal of Cell Science, 116, Langevin, H. (2006). Connective tissue: A body-wide signaling network? Medical Hypotheses, 66, Myers, T. (2009). Anatomy Trains (2nd ed.). London: Elsevier. Myers, T. (2011). Fascial fitness: Training in the neuro-myofascial web. IDEA Fitness Journal, Neumann, D. (2010). Kinesiology of the Musculoskeletal System (2nd ed.). St. Louis: Mosby. Oschman, J. (2009). Charge transfer in the living matrix. Journal of Bodywork and Movement Therapies,13, Schleip, R. et al. (2012). Fascia: The Tensional Network of the Human Body. London: Elsevier. Schleip, R. (2003). Fascial plasticity: A new neurobiological explanation (Part I). Journal of Bodywork and Movement Therapies, 7, 1, Schleip, R. (2003). Fascial plasticity: A new neurobiological explanation (Part II). Journal of Bodywork and Movement Therapies, 7, 2, Schultz, R.L. and Feitis, R. (1996). The Endless Web: Fascial Anatomy and Physical Reality. Berkeley, Calif.: North Atlantic Books. Siff, M. and Verkhoshansky, Y. (2009). Supertraining (6th ed.). Denver, Co.: Supertraining Institute. Vogel, V. and Sheetz, M. (2006). Local force and geometry sensing regulate cell functions. Nature Reviews: Molecular Cell Biology, 7, Pete McCall, M.S., an Exercise Physiologist with ACE, creates and delivers fitness education programs to uphold ACE s mission of enriching quality of life through safe and effective exercise. He has a master s degree in Exercise Science and Health Promotion. In addition, he is an ACE-certified Personal Trainer and holds additional certifications and advanced specializations through NSCA and NASM.

11 Technical Exercise woefully underutilized in patients with stable ischemic heart disease January 8, 2013 Michael O Riordan article reproduced courtesy of Albany, NY - If exercise is a miracle drug, as it has been recently described, then it is a drug that is not prescribed enough for the prevention of cardiovascular disease. And if exercise is a central and indispensable component of a strategy in the primary prevention of coronary artery disease, then it is even more valuable in secondary prevention, according to a new viewpoint in the Journal of the American Medical Association [1]. In the article, published January 8, 2013, Dr William Boden (VA Medical Center Albany Medical College, NY), Dr Barry Franklin (William Beaumont Hospital, Royal Oak, MI), and Dr Nanette Wenger (Emory University School of Medicine, Atlanta, GA) argue that despite the known benefits of physical activity and structured exercise for patients with stable ischemic heart disease, it is neglected and woefully underutilized. The mantra here is that exercise is medicine, Boden told heartwire. We focus so much of our attention on modifiable risk factors, such as treating cholesterol with statins, treating blood pressure to target, reducing hemoglobin A1c levels, and getting people to stop smoking, but we don t view physical activity in quite the same context as a modifiable risk factor. So the viewpoint is really a call to arms, to get physicians to look at physical inactivity in the same context as they do with other treatments for other risk factors. In addition, Boden said that if physicians focused on getting patients to exercise 30 to 60 minutes a day, five days a week, it would go a long way toward reducing the prevalence of overweight and obesity in society, which are becoming epidemic. In the viewpoint, Boden, Franklin, and Wenger note that increasing exercise or physical activity and cardiorespiratory fitness can mitigate cardiovascular disease progression, with exercise having known antiatherosclerotic, antithrombotic, anti-ischemic, antiarrhythmic, and positive psychological effects. Secondaryprevention programs that utilize physical activity with optimal medical therapy have been shown to reduce total mortality by 20%, cardiac mortality by 26%, and nonfatal MI by 26% [2]. Despite the proven benefits, many patients, including women, older patients, patients with limited education, and non-englishspeaking patients, are frequently not referred for clinic-based cardiac rehabilitation. I think there are many factors involved, Boden told heartwire. In some instances, physicians are reluctant to recommend exercise or structured rehab programs. There are often uncertainties about whether such costs will be reimbursed by healthcare plans. Cardiologists often see patients for subspecialty referral care, and they view exercise to be more the realm of the internist or the primary-care physician. I think there are reasons why exercise might fall into the category of a missed handoff. Reluctance among patients, conservative docs In addition to some patients falling through these healthcare cracks, Boden said that some patients might be overly cautious or reluctant to participate in exercise programs, as they view an acute coronary syndrome or MI as a life-altering event. Some physicians might also be overly cautious or conservative and not recommend exercise as part of the recovery process. However, low to moderate exercise, such as walking, ideally started in a structured cardiac-rehabilitation program, can promote self-confidence and reassurance so that patients can transition to unstructured and unmonitored programs outside the clinic, he said. We also know that angina is exercise-induced and related to physical exertion, so there might be a fear of undertaking additional exercise because of concerns that it might provoke or exacerbate angina or worsen coronary disease, yet most of the data would support the opposite, said Boden. And one of the things we don t preach enough in training our residents and fellows and younger physicians is the prophylactic role of short-acting nitrates before the activity. This can actually be a prophylactic measure to prevent or forestall angina during exercise. Boden said that most physicians regard short-acting nitrates as a treatment for angina and not as a preemptive strategy. If physicians were aware of this, they might be inclined to better prepare patients for how to manage and live with their ischemic heart disease. Sources Boden WE, Franklin BA, Wenger NK. Physical activity and structured exercise for patients with stable ischemic heart disease. JAMA 2013; 309: Leon AS, Franklin BA, Costa F, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease. Circulation 2005; 111:

12 Technical Mistery Shopping Caro Club, c è posta per te! Come se la cavano i club italiani con la posta elettronica? Come gestiscono i messaggi ricevuti da potenziali clienti bisognosi d informazioni preliminari? A sei anni dal nostro primo mistery shopping di questo tipo, ci siamo nuovamente camuffati. Questa volta da sessantenne iperteso e da neo mamma che desidera rimettersi in forma. Entrambi mai entrati in una palestra in vita loro e bisognosi di essere innanzitutto rassicurati. Sotto queste mentite spoglie abbiamo contattato cento club italiani, scoprendo che di Davide Venturi article kindly supplied by Nel numero 131 de Il Nuovo Club abbiamo pubblicato i risultati della nostra indagine condotta sotto mentite spoglie per misurare l abilità con la quale centralinisti, receptionist e venditori dei club italiani gestiscono le telefonate in entrata. Come avrete sicuramente letto, i risultati che abbiamo registrato sono stati più che positivi, migliori rispetto a quelli del precedente mistery shopping realizzato quasi nove anni prima. Non contenti, abbiamo deciso, a quasi sei anni di distanza, di ripetere un altra indagine in incognito, questa volta per vedere come se la cavano oggi, in piena era Internet, gli operatori del Belpaese con la posta elettronica. E il quadro complessivo che è emerso è sostanzialmente incoraggiante in quanto tutti i rispondenti hanno brillantemente superato la prova. Addirittura la stragrande maggioranza ha superato le nostre aspettative, sorprendendoci per la rapidità con la quale ha risposto, la completezza delle informazioni fornite, la professionalità e, non meno importante, la capacità di instaurare fin dal primo contatto una certa empatia. I meno bravi, ma comunque promossi, sono stati i pochissimi club che hanno fornito riposte brevi e al tempo stesso sufficientemente professionali con le quali hanno invitato il presunto potenziale cliente a presentarsi al club o a stabilire un secondo contatto telefonico per avere ulteriori informazioni. Tutti sappiamo quanto sia importante gestire con professionalità e una certa sensibilità il messaggio ricevuto da un potenziale cliente che chiede informazioni poiché le probabilità che tale contatto ricevuto a costo zero si trasformi nell acquisizione di un nuovo cliente sono molto elevate. Gli esperti di marketing ci hanno ripetuto all infinito quanto sia importante la prima impressione, quanto incida sul rapporto che si instaurerà, o meno, in seguito. La struttura dell inchiesta Abbiamo selezionato 100 club dislocati in ogni regione d Italia, abbiamo visitato il loro sito internet e una volta individuato l indirizzo di posta elettronica li abbiamo contattati, mettendoci nei panni del potenziale cliente desideroso di avere maggiori informazioni. Al primo blocco, composto da 50 club, abbiamo scritto presentandoci come Paolo, un quasi sessantenne fuori forma con il problema dell ipertensione e da molto tempo sedentario, al quale il medico ha vivamente consigliato di incominciare a svolgere regolarmente attività fisica, addirittura suggerendogli di iscriversi a un centro fitness. All altra metà del campione ha invece scritto la nostra Paola, un immaginaria neo mamma che non ha mai frequentato una palestra in vita sua, ora preoccupata per le conseguenze della maternità sul suo aspetto fisico, alla quale diverse persone suggeriscono di incominciare a fare fitness. Entrambi questi potenziali clienti, frutto della nostra fantasia professionalmente deformata, hanno sostanzialmente chiesto di essere rassicurati con qualche informazione preliminare, prezzi e orari compresi. Risposte a tempo di record Sui 100 club contattati, hanno riposto in 61, in un lasso di tempo davvero breve: facendo la media escludendo il solo club che per problemi tecnici ha risposto più di due settimane dopo lo hanno fatto entro 3 ore e 20 minuti dalla ricezione del nostro messaggio. Per essere più precisi, 43 club hanno risposto il giorno stesso, nel giro di poche ore, molti in tempi ridottissimi che vanno dal record assoluto di 2 minuti stabilito da Barbara del Wellfit di Parma a fronte di una risposta che si è dimostrata una delle migliori in assoluto, meritando, al pari di molti altri professionisti, i nostri complimenti ai minuti e alle 3-4 ore. I più lenti, si fa per dire, sono stati i 12 che hanno risposto entro 24 ore, i 2 che lo hanno fatto rispettivamente entro 2 e 3 giorni e la maglia nera che ci ha fatto attendere appena 4 giorni. Un solo club ci ha riposto 16 giorni dopo, scusandosi però per tale ritardo, motivandolo con problemi tecnici riguardanti la posta elettronica, rispondendo in modo garbato e professionale, offrendoci la possibilità di provare il club gratuitamente e chiedendoci un recapito telefonico per un successivo contatto. Il tempo di reazione è senza dubbio il primo dato eccellente che abbiamo rilevato, dal quale si evince che oggi, sicuramente grazie anche alla diffusione degli smartphone e dei tablet, che consentono di accedere alla corrispondenza elettronica in qualsiasi momento e in ogni luogo, l attenzione nei confronti delle è sicuramente cresciuta. E in tempi in cui tutto avviene ad alta velocità è un dato certamente incoraggiante che evidenzia l accresciuta attenzione degli operatori italiani nei confronti dei potenziali clienti. Promossi e... Tutti promossi nella maggioranza dei casi con voti alti i 61 club che ci hanno risposto. A non eccellere, a nostro sindacabile avviso, sono stati i pochissimi che ci hanno risposto in modo telegrafico, senza un briciolo di empatia, con una freddezza che potrebbe allontanare un potenziale cliente insicuro e innanzitutto

13 Technical bisognoso di essere rassicurato e, perché no, un po corteggiato. Qualche esempio? Eccoli: «Bisogna che lei venga in palestra, poi si decide. Grazie per il contatto. Buona giornata», «La invito a inviarci un numero di telefono per poterla contattare», «Siccome sono tante domande, penso che sia meglio se Lei passasse da noi per parlare in modo più dettagliato. O se vuole, mi dia un suo numero di telefono così la chiamo. Grazie», «la invitiamo a farci visita presso i nostri locali e le daremo tutte le informazioni che desidera. Anche perché prima di darle qualsiasi consiglio dovremmo poterla almeno vedere. Cordialità».... rimandati Rimandati, invece, i 30 club che hanno ignorato la nostra richiesta d informazioni e i 9 che non hanno ricevuto il messaggio per problemi tecnici. A questi ultimi abbiamo inviato il messaggio più di una volta, in giorni diversi, verificando con la massima attenzione l esattezza degli indirizzi, ma il server ha continuato a comunicarci l impossibilità di consegnarlo al destinatario. Oltre a queste attenuanti tecniche che comunque meritano un segno meno in quanto il buon funzionamento di ogni dispositivo incide sulla qualità percepita, sulla customer satisfaction e, non meno importante, sull immagine aziendale per questi 9 club, vi sono quelle generiche per i 30 che non ci hanno riposto, ossia il bombardamento di messaggi che quotidianamente riempiono le caselle di posta e i tanti impegni lavorativi che in certi momenti, specialmente nelle strutture più piccole in cui lo staff è chiamato a svolgere più mansioni, possono costringere a trascurare la gestione della corrispondenza ricevuta tramite web. Ci permettiamo però di suggerire ai 31 club che non ci hanno risposto di prestare maggiore attenzione a ogni contatto con i potenziali clienti, in special modo di questi tempi. E ricordiamo che il nostro primo mistery shopping dedicato alla corrispondenza elettronica, risalente al 2007, aveva curiosamente registrato una percentuale di risposte sul totale degli indirizzi contattati assolutamente in linea con questa seconda indagine, leggermente migliore: 63,5% contro l odierno 61%. Chiudiamo la parentesi dei rimproveri menzionando alcune a dir il vero poche che nonostante ci abbiano favorevolmente impressionato per la rapidità con cui hanno riposto ai nostri quesiti, per il calore umano e per l esaustività dei contenuti, hanno peccato di eccessiva informalità. Il tono molto confidenziale, con il quale ci si potrebbe rivolgere a un vecchio compagno di scuola, così come l impiego di molti punti esclamativi e degli emoticon penalizza, a nostro avviso, l immagine del club e dei professionisti che vi lavorano, in special modo agli occhi di un sessantenne e di una neo mamma che non hanno mai frequentato una palestra e non nascondono il loro timore di essere inadeguati. Timori dietro ai quali potrebbero celarsi alcuni pregiudizi sul settore. Anche questo è un peccato veniale che rileviamo comparando questi messaggi, comunque positivi, con quello che reputiamo il modello ideale, la perfezione alla quale bisognerebbe sempre aspirare, pur sapendo che è irraggiungibile. Prezzo, orari e recapito telefonico Sui 61 club con i quali siamo entrati in contatto, la stragrande maggioranza (48, quasi il 79%) ci ha invitato a visitare il club di persona, in molti casi fissando un appuntamento previo contatto telefonico o sempre tramite . Per la precisione, 14 club (quasi il 23% dei rispondenti) ci ha lasciato un recapito telefonico (in alcuni casi il cellulare dell autore dell ), mentre 10 (poco più del 16%) ce lo ha chiesto per essere richiamati, anche in questo caso, promettendo ulteriori informazioni, e in molti casi suggerendo di fissare un appuntamento per un incontro nel club. 18 professionisti (poco meno del 30% del campione che ha interloquito con noi via web) ci ha proposto una prova omaggio un club ci ha addirittura offerto una settimana gratuita, dandoci la possibilità di toccare con mano la veridicità delle loro promesse. Quasi il 38% (23 club su 61) ci ha fornito gli orari, mentre solo un terzo (20 club, corrispondente a quasi il 33%) ci ha comunicato i prezzi, nella maggioranza dei casi entrando nel dettaglio (un club ha addirittura allegato il listino e la programmazione oraria dei corsi), mentre la minoranza lo ha fatto in modo indicativo affinché potessimo avere un idea di massima. La maggioranza di questa minoranza perdonateci il gioco di parole ci ha spiegato che a seconda delle nostre esigenze sarebbe stato possibile individuare la tipologia di abbonamento più convenente e che avremmo potuto farlo proprio in occasione della nostra visita conoscitiva al club. Solo il 3%, appena 2 club su 61, ci ha invitato a consultare il loro sito web per reperire ulteriori informazioni. La maggioranza del campione ha infatti preferito puntare sul contatto diretto, in molti casi su un preliminare contatto telefonico seguito da un incontro di persona. Ritornando alla questione prezzi, eccezion fatta per i pochissimi che si sono limitati a comunicarci che queste informazioni vengono fornite solo di persona, o che hanno semplicemente ignorato la nostra richiesta, la quasi totalità dei rispondenti che non ci hanno fornito alcuna cifra lo hanno fatto in modo gentile, professionale e rassicurante, rinviando la trattativa al momento della nostra presunta visita al club. Di seguito alcuni esempi dai quali emerge il tenore del messaggio recapitatoci: «saremo lieti di poterle dare tutte le informazioni del caso invitandola a visitarci e facendola parlare con un nostro consulente. Sicuramente troverà risposta a tutte le sue richieste con una proposta personalizzata» «L invito a venirci a trovare per farle conoscere la struttura e informarla sui vari abbonamenti, in modo da trovare insieme la soluzione che più si avvicina alle sue esigenze. Vogliamo quindi fissare un appuntamento?...» «Siamo lieti di informarla che abbiamo soluzioni adatte a lei e vogliamo invitarla alla struttura per una prova gratuita»

14 Technical Messaggi motivanti e rassicuranti Molte che abbiamo ricevuto contengono messaggi rassicuranti, che ci hanno immediatamente messo a nostro agio, invogliandoci a contattare telefonicamente il club per ulteriori approfondimenti e addirittura a visitarlo per conoscere di persona chi ci ha riposto. Riportiamo di seguito alcune frasi stralciate dalle che ci hanno maggiormente rincuorato: «è normale che il fisico subisca una trasformazione dopo una gravidanza e sicuramente l attività fisica è la soluzione per ritornare alla forma ideale. Ovviamente, come ti suggeriscono gli amici, prima inizi meglio è» «Molti dei nostri soci hanno sia i suoi anni sia le sue esigenze. Saremmo molto lieti di concordare un appuntamento per approfondire meglio le tematiche in questione» «la voglio tranquillizzare, innanzitutto informandola che da noi troverà massima professionalità e una forma di monitoraggio su quello che sarà il suo programma d allenamento» «non mi ha specificato quanti mesi ha suo figlio, se è stato un parto cesareo e se lo sta allattando. Queste informazioni mi possono aiutare a indicarle il percorso adeguato a lei» Le risposte migliori Anche questa volta, la stragrande maggioranza dei 61 messaggi che abbiamo ricevuto ci ha sorpresi positivamente e i professionisti e i club che meriterebbero di essere citati sono davvero tanti. Ma per ovvi motivi siamo costretti a menzionarne solo alcuni a titolo esemplificativo. Non ce ne vogliano i tanti esclusi con i quali ci complimentiamo per la professionalità e la delicatezza con la quale hanno gestito le nostre richieste. Davvero tante le che ci hanno colpito per la capacità di miscelare la qualità e la completezza delle informazioni con il garbo e l empatia. Purtroppo possiamo citarne solo alcune. Maurizio Tassani, del Body Club di Forlì, oltre a dire bravo al nostro presunto medico, ha spiegato che «Per quanto concerne il suo problema di pressione, la palestra è un ottimo medicinale naturale senza controindicazioni. Basta solo creare un programma ad hoc per Lei. Tra i nostri iscritti ci sono atleti di 80 anni che vengono regolarmente in palestra ottenendo grandi benefici psicofisici» Pamela Febbrili, del centro Le Club di Piacenza, ci ha scritto di aver letto con molto piacere la nostra , informandoci che la loro struttura è in grado di soddisfare le nostre richieste grazie a tipologie di abbonamenti che soddisfano ogni esigenza, programmi personalizzati e istruttori qualificati che ci seguirebbero nel nostro percorso. Ci ha quindi chiesto mezz ora del nostro tempo per conoscerci, mostrarci il centro e trovare insieme la formula di adesione più conveniente e soddisfacente. Anche Fabio Riggio, del club The Body s Center di Aymavilles, in provincia di Aosta, ha usato le parole con sapienza: «Capisco la sua problematica, mi fa piacere che si voglia avvicinare al mondo del fitness e mi permetto di dire che non esistono persone a cui la palestra non sia indicata, esistono semplicemente modi diversi di impostare il lavoro a seconda delle esigenze della persona alla quale ci si trova di fronte». Andy, del club Bodytec di Brunico, in provincia di Bolzano, ha rassicurato il nostro Paolo comunicandogli che i loro clienti hanno una fascia d età che raggiunge addirittura i 90 anni, spigandogli che il club ha sicuramente l allenamento che fa per lui e che potrebbe personalizzarlo insieme a un istruttore che lo seguirà e lo assisterà. Barbara, dello Sporting Club Leonardo da Vinci di Milano, ha trasmesso alla nostra Paola, in allegato, materiale informativo, le ha comunicato prezzi e orari e, soprattutto, l ha rassicurata così: «Ci venga a trovare per una gradita visita e una chiacchierata. La sua richiesta rientra nella normalità. Senza impegno e quando le è più comodo. Cordialmente la saluto e le faccio i miei complimenti e un in bocca al lupo per la nuova Nascita». Luigi Spinnicchia, del club Muri Antichi di Catania, si dimostra empatico e premuroso sin dalle prime righe e alimenta la motivazione del suo interlocutore con naturalezza: «innanzitutto tanti auguri per la sua maternità che sarà certamente splendida. Per il resto non posso che essere d accordo con chi Le suggerisce di fare sport, che fa sempre bene a prescindere dalle motivazioni». Quindi conclude invitando Paola a lasciare un recapito telefonico per poter fornire una risposta articolata a suoi quesiti e raccogliere ulteriori informazioni. Riflettori sui bravissimi Non è stato facile selezionare quelli che ci sono sembrati i sei messaggi migliori. Ce ne sono sicuramente altri altrettanto validi e meritevoli di essere proposti nella loro interezza, ma siamo stati costretti a fare una cernita. Dario, del club Energym di Bolzano, dimostra tutta la sua bravura spiegando a Paolo, in modo chiaro e sintetico, che cos è la sindrome metabolica e il fitness metabolico che consente di curare questa patologia sempre più diffusa, fornendo un immagine del club altamente professionale. Marco Formica, del club SportPiù Club Resort di Curno, in provincia di Bergamo, ha rassicurato in modo esemplare la nostra neo mamma, mettendola immediatamente a suo agio e sottolineando quanto sia importante rimettersi in forma dopo il parto. Le spiega che il club nel quale lavora è il luogo ideale per ottenere questo risultato, motivando in modo convincente questa affermazione. Il messaggio di Giorgio Crotti, del Camuzzago Fitness Club di Bellusco, in provincia di Monza-Brianza, mette in evidenza lo spessore professionale dello staff che opera nel club, spiegando al nostro sessantenne iperteso quanto sia importante stabilire il programma e i tempi del percorso che dovrebbe intraprendere per migliorare il proprio stato di salute e di benessere generale. Con la sua Michela Boscarol, del club Starbene di Ronchi

15 Technical dei Legionari, in provincia di Gorizia, si è dimostrata garbata ed empatica, risultando professionale e convincendo senza fare la ben che minima pressione. È riuscita, in poche righe, a far emergere tutta la qualità, anche umana, del club nel quale lavora. Barbara del club Wellfit di Parma ci ha innanzitutto stupito per la velocità con la quale ha riposto alla nostra (2 minuti!), un vero record che non ha minimamente penalizzato la qualità e il calore del suo messaggio. Altrettanto brava Valeria dello Sporting & Fitness Club di Varese, che si dimostra comprensiva e disponibile e, soprattutto, capace di mettersi nei panni della nostra Paola. Come leggerete nella sua , anche lei sarà mamma tra poco per davvero e ne approfittiamo per farle i nostri auguri più sinceri. La versione integrale dell articolo è pubblicata nel numero 132 (marzo-aprile) della rivista Il Nuovo Club. Per informazioni, copie arretrate e abbonamenti English Section Pilates and the Overweight Client By Peppy Neville, BA, NCEF Tutor article kindly supplied by Introduction Pilates might not be one of the first forms of exercise that springs to mind when working with an overweight client. When you consider that a 1 hour beginners Pilates class burns approximately 252 calories /hour, an intermediate class 360 calories/ hour and an advanced class 444 calories/ hour, (Olsen and Smith, 2005) it would appear that a client would have to be working at an advanced level in order to burn comparable calories with some of the more traditional forms of exercise such as walking at 4.5km/h 441kcal/h, Cycling at 10-12km/h 422kcal/h, low impact aerobics 410 kcal/h, step aerobics - 520kcal/h (Harvard Heart Letter 2004) Benefit to the Overweight Client So why am I suggesting that Pilates could be of benefit to the overweight client who is unlikely to be able to work at an advanced level, at least initially? While the effect of Pilates on body composition has not been studied, most Pilates instructors will know from practical experience that Pilates can have positive effects on quality of life, mood and self-esteem. Once you get control of the body, and of finding the right muscles to put the body into the positions, you realize you can control other things in your life (Sarnataro 2007). So while performing Pilates does not necessarily lead to significant calorific expenditure, the heightened self-awareness it encourages can facilitate lifestyle change and lead to a more active lifestyle. Orthopaedic Health Improved orthopaedic health is another benefit of practicing Pilates for the overweight client. Obesity is one of the risk factors for developing back pain because of the extra stress it places on the joints and ligaments. Excess weight can also lead to postural abnormalities as the body attempts to compensate for a changed centre of gravity. Many Pilates exercises are similar to those prescribed by physical therapists to rehabilitate back pain sufferers. A study of 22 adults conducted at Florida Atlantic University found that a 12 week Pilates Program reduced back pain. (Graves et al. 2005). A person who experiences pain is less likely to embark on a fitness training program so by improving orthopaedic health the client may be encouraged to progress to cardiovascular work. Challenges for the Fitness Instructor Dealing with the overweight client presents its own challenges to the Instructor. Excessive adipose tissue in the abdominal and pelvic area can make it difficult to establish neutral pelvis. They may have difficulty with concentration and developing full body awareness. Faulty movement patterns may have been developed, along with postural imbalances. Addressing these difficulties requires an instructor with exceptional skills. Knowledge, creativity, the ability to communicate and collaborate with the client, and someone who is willing to take responsibility, in conjunction with the client, in bringing about positive change, are just some of the vital skills required of the Pilates Instructor when dealing with the overweight client. Specialist Knowledge Apart from the obvious knowledge that any instructor would be expected to have in relation to correct exercise technique, working muscles during a specific movement, selection of appropriate exercises and the ability to plan and implement appropriate exercise programmes, the Pilates Instructor also requires specific knowledge and an appreciation of the difficulties the overweight client may experience when embarking on a Pilates Program. They may have poor balance, biomechanics and proprioception. They will typically have an accumulation of adipose tissue around the torso and pelvis which means that the bony landmarks we would normally use to

16 Technical determine correct positioning are hidden. They may be forward shifted in posture and yet can be very strong in the legs so it can be difficult to assess their precise muscle imbalances. Initially it will be up to the instructor to determine whether the client is correctly positioned or not, as the client may not be able to distinguish between anterior and posterior pelvic tilt. It will be up to the Instructor to help the client to reconnect with their body e.g. helping them to identify various body parts, like the pubic bone, sacrum, lower ribs, iliac crest. All of these factors require the Instructor to have specific knowledge in order to help the client recognise what is possible for them. However, you also need to be able to use and transmit that knowledge to enable the client to benefit fully. Creativity and Communication Skills are vitally important to the transmission of this information. Adaptations for the Client The overweight client may experience certain difficulties in the practice of Pilates. They may have difficulty breathing when in the supine position. The accumulation of fat could also make some exercises impossible to perform e.g. the Roll Up. So while you may know what exercises are beneficial for correcting a particular muscle imbalance, this is of no use if the client is incapable of performing them. It may be necessary to be very creative in adapting exercises to accommodate your client. Consider adapting exercises so that they can be performed from a seated position or incline rather than supine. Look at using equipment like dynabands, bosu, or stability ball as a means of assisting the client which in addition to helping the client perform the exercise, also gives them something to focus on which in turn improves their concentration. Client Relationship Most overweight clients will not be comfortable with a hands on approach, at least not initially. It takes time to build a relationship where the client will have sufficient trust to be relaxed enough to accept a hands on approach. For the instructor, this means that verbal and visual communication skills need to be especially well developed. Verbal instructions need to be clear and meaningful to the client. Initial instructions need to be simple. E.g. When teaching body awareness, you could ask the client to say what body parts they can feel moving? Or you might have to be more specific and say can you feel the muscles in your abdomen working? When teaching a particular exercise, find out how your client learns best, - by listening to instructions, by visualisation or by doing it themselves. Once you have established this you can then determine the type of instructions you give. For example a client who learns best by listening will respond well to specific instructions. E.g. Raise your arms toward the ceiling. A person who learns best by visualisation or by simply doing it will respond well to a demonstration of the movement and also to the use of imagery eg. Imagine you are lifting a ball over your head. Communication Remember though that communication is a two-way thing. Encourage your client to express any difficulties they may be experiencing with the movements as well as what is working for them. Over time you want the relationship to develop into one of collaboration where you are both working towards a common goal. It is important to approach the client as a wellness professional not just a fitness trainer. Ultimately the client needs to recognise that Pilates is only one step on their way towards weight loss. The Instructor must take responsibility for ensuring their client is aware that weight loss results from a multi-disciplinary approach which includes diet, exercise and behaviour modification. The benefits of Pilates for the overweight client are numerous. The Pilates instructor, by helping their client to develop greater selfawareness and improved confidence, can be instrumental in bringing about positive change, thus encouraging the client to continue on the path towards improved health and well-being. References 1. Graves, B.S., et al Influence of Pilates-based mat exercise on chronic lower back pain. Medicine & Science in Sports & Exercise, 37 (5, Suppl.),S27 2. Harvard Heart Letter, July 2004, Harvard Health Publications. Retrieved November 5, Olsen, M., & Smith, C.M Pilates exercise: Lessons from the lab. IDEA Fitness journal, 2 (10), Rice, R Pilates for the overweight client. Idea Fitness Journal, June retrieved October 17, Sarnataro, B.R Workouts that help you feel better about your body. retrieved November 6, 2012 Peppy Neville is a tutor with the National Council for Exercise & Health Fitness (NCEF). The NCEF is an academic affiliate of the University of Limerick, offering the only university accredited Health/ Fitness Professional Instructor qualifications in Ireland. Certificate, Higher Certificate, Diploma & Degree qualifications are awarded at Levels 6,7 & 8 on the National Framework of Qualifications (NFQ) and at Levels 5 & 6 on the European Framework (EQF). The NCEF is a registered FAS Trainer and is accredited by the European Health Fitness Association.

17 EREPS The European Register of Exercise Professionals ereps Promoting Professional Standards and European Register of Exercise Professionals International Cooperation for Fitness Professionals EREPS provides an independent process that gives trainers the recognition of their achievements as being qualified and competent and which can be clearly understood by customers It is public register that allows anyone to check the qualifications and certifications of its members Trainers can add contact details, blogs and further information with a personal statement for free on the EREPS directory and also the fitness social network site The specially developed EREPS liability insurance scheme gives worldwide cover EREPS helps to provide consistent and developing services which helps member retention and business success It supports the international mobility of professionals and the labour pool of high quality exercise professionals EREPS provides a career structure for lifelong learning and continuous professional development EREPS data generates information and data that can be used to project the future trajectory of the industry and individual companies and to inform governments to help provide financing to raise standards. Operators can promote their business to customers in the knowledge that they have trainers who have met the European standards creating market differential.

18 Events EHFA European Leadership Forum (ELF) 15/16/17 September, 2013 Bilbao, Spain What The European Health & Fitness Association has successfully organised for the last 5 years an annual get-together of top managers/ceo s of leading fitness companies. The objective of the meetings is to explore challenges and opportunities of the sector under the guidance of a business professor and other thought leaders. When September 15th (Sunday evening ) - 17th (Tuesday-noon), 2013 Where This year the ELF is an extra special event with a longer duration and a very unique location - in and around one of the world s most admired and inspiring buildings the GUGGENHEIM Museum in the bustling metropolis of Bilbao. Bilbao is central to all that is Basque, and is a happy-go-lucky hub of history, culture, nightlife, and art and architecture, as well as being home to Spain s best cuisine. World-class museums, art galleries and entertainment make the city a cultural hotspot that ll lead you on fascinating journeys into history and art. While its array of top-notch Michelin-starred restaurants, authentic food and fish markets, and cute little pintxos bars - a sort of Basque version of tapas - will transfix your taste buds and see you travelling to the region again and again. Booking the European Leadership Forum is an Invitation only event Sponsorship Opportunities there are a number of opportunities for sponsoring the European Leadership Forum. If interested please contact Herman Rutgers, EHFA Board member for more information; mobile: Programme of Events Sunday September Event registration Optional tour of the world famous GUGGENHEIM Museum Bus to famous AZURMENDI to visit the wine cellars, wine tasting and gourmet dinner Monday September Lecture and Workshop with IESE Prof. Luis Huete on ACHIEVING ALIGNMENT IN ORGANIZATIONS Lunch in Gran Domine restaurant with view of Guggenheim Retention Tea/Coffee break How Insurance can play a role in your business Opportunity to visit (or do workout) in some world class fitness facilities Dinner in Restaurant Arbolagaña in the Arts Museum Tuesday September Deloitte presentation on latest market figures and EHFA/Deloitte key operators study Presentation TBC Open discussion on general industry issues and EHFA strategy & initiatives and the sector s future

19 EHFA Events 4th International Standards Meeting November, 2013 Budapest, Hungary Join experts from across Europe and around the world at the 4th annual international standards meeting in the beautiful city of Budapest. It is an exciting time for standards development within the European health and fitness sector as we continue to grow and improve, remaining always quality-oriented, motivated and responsive to the opportunities which surround us. After the approval of the (Pre) Diabetes Exercise Specialist (EQF-level 5) and Pilates Teacher (EQF-level 4) standards the EHFA Standards Council continues its way of focusing on challenging disorders related to fitness and exercise. The World Health Organization (WHO) recognizes lack of exercise in combination with overweight and obesity as the epidemic of the 21st century. This is in line with the main outcomes of the International Standards Meeting in Barcelona. In order to apply sustainability of the standards events it was a matter of course for the Standards Council to continue that trend and transfer it into a standards development process by launching a new project: the Weight Management Specialist (WMS). The standards for the Weight Management Specialist will appear at level 5 and are strongly connected to the (pre)diabetes standards. Against the background of these path-breaking decisions the Standards Council made a unanimous decision regarding the upcoming International Standards Meeting 2013 in November in Budapest. This year s motto will be: EHFA European Health & Fitness Association EHFA standards Sedentary Behaviour, Active Living & Exercise: the Role of the Fitness Sector. Watch out for further information on our websites & GRAFTS 22nd Annual National Health & Fitness Congress The 22nd Annual National Health & Fitness Congress of GRAFTS held on April 5-7 in Thessaloniki, Greece and included 3 separate conferences (Group Fitness, Personal Training, Body Spirit) and 6 workshops (Functional Training, Rehabilitation, Pre & Post Natal Exercise, Nutrition, Pilates, Yoga) simultaneously. This event is the oldest and biggest educational fitness event across Greece since 1990 GRAFTS Hellas which is the first Greek Accredited Vocational Training Provider by EHFA, was the organizer and this year 500 fitness professionals across the country participated in this Congress for their continuing professional development. At the Personal Training Conference 3 members of the EHFA Standards Council, Dr. Laszlo Zopcsak (CEO of IWI), Dr. Paolo Caserotti (Assistant Professor of the Southern University of Denmark) and Mr. Alexis Batrakoulis (Personal Training Director of GRAFTS) presented topics related to the latest update and references of periodisation, resistance training and active ageing. Finally the 2 invited International Presenters, Dr. Zopcsak and Dr. Caserotti, received by Mr. Batrakoulis an honorary award for their contribution to the education of European Fitness Professionals. Next Fitness Event by GRAFTS will be the 2nd Athens Fitness Convention the next fall (October-November 2013) in the capital city of Greece, Athens.

20 EHFA Members Despite an uncertain job market, personal trainers have planted their feet firmly as members of one of the fastest-growing professions. Coupled with the global health epidemic and a heightened awareness for the importance of exercise, personal trainers are in high demand not only in the U.S. but across the world. CNN Money ranked the profession one of the best jobs in America for Educated, certified and experienced fitness professionals also ranked first in fitness trends the past five years, according to a worldwide survey of fitness trends. The number of employed personal trainers in the U.S. is expected to grow to more than 335,000 in 2018, or a 29 percent increase in the workforce since 2008, according to the U.S. Bureau Of Labor Statistics. The earning potential for personal trainers is growing, too. honors personal training profession with Personal Trainers to Watch The top 10 percent average $63,400 a year, and since 2005, the average salary for personal trainers increased 19 percent, according to the American Council on Exercise. I started in the fitness industry because I believed that health and fitness could not only change bodies, but it could nurture communities, Joanne Blackerby, Personal Trainer to Watch 2012 Worldwide, the personal training profession is booming, said Chris Clawson, Life Fitness president. Life Fitness, the world leader in manufacturing fitness equipment, is recognizing the movement with the Personal Trainers to Watch program in partnership with the International Confederation of Registers for Exercise Professionals (ICREPs). The program, which is in its third year, aims to reward the world s top personal trainer with a $5,000 prize, international recognition and continuing education opportunities. Last year, nearly 1,000 trainers applied or were nominated. Joanne Blackerby, owner of Spirit Fitness Trainer of Austin, Texas, was named Personal Trainer to Watch in Being named the top Personal Trainer to Watch last year validated what I worked so hard to achieve, Blackerby said. The top 10 finalists will compete in a live global competition, or workshop, this fall to determine the winner. The first ever Personal Trainers to Watch workshop event will bring the world s top trainers together on a global stage to learn new tips and techniques from each other as we celebrate their accomplishments, Clawson said. Ensuring personal trainers are equipped with the industry s best standards is imperative in a world riddled with ballooning obesity rates and irregular exercise habits. More than 40 million children worldwide are overweight. One in every three American adults are obese. Portion sizes are about 63 percent bigger than they were mid-century, and the number of people hospitalized because of weight has tripled in the last five years. The health crisis will cost up to $30 trillion globally in healthcare costs in the next 20 years, according to estimates.

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