Personal Fitness Professional - Spring 2017 - 16
and working with
The role of a fitness
itness professionals in non-clinical environments will encounter
a broad spectrum of prospective
clients, each with his or her own
needs, issues and abilities. While
it is possible to specialize in young, healthy
adolescents and adults, it would be foolhardy
to discount the middle-aged and older market
out of fear or ignorance. There are many issues
and concerns the latter bring to the gym, but
don't think you won't run into at least one of
those in the young and healthy: arthritis.
According to the Arthritis Foundation (www.
arthritis.org), there are more than 50 million
adults and 300,000 children with this joint
disease. Arthritis can be categorized by four
basic criteria: infectious (e.g. STD, Lyme's disease), metabolic (e.g. gout), inflammatory (e.g.
rheumatoid, psoriatic) and the most common,
degenerative [e.g. osteoarthritis (OA). The first
two are treatable and oftentimes curable; the
latter two are manageable but not yet curable.
A common feature of any type of arthritis is
| WWW.FIT-PRO.COM | SPRING 2017
that the movable joints, which are enclosed in a
synovial pouch and cushioned by articular cartilage, get inflamed, they ache, hurt to move, and
reduce their pain-free ranges of motion. The
cartilage deteriorates in the presence of chronically-inflamed synovia, eventually exposing the
underlying subchondral bone to greater and
more asynchronous forces. These cause both
softening of the bone as well as bony growths i.e. osteophytes and spurs and sometimes cysts.
One consequence of inflammation, pertinent
to fitness professionals, is that it impairs neural
input to the muscles around the joint(s) which
has short- and long-term consequences. The
short-term consequence is the muscles are not
as capable of providing support and attenuating
impact forces to the articulating surfaces. With
continued force production and shock absorption, from daily living or recreational pursuits,
this leads to further deterioration of the joint.
The long-term consequences are further
weakening of the muscles as well as compensatory or decompensatory firing of the muscles
that can impact function at the joint or create
dysfunctions elsewhere along the kinetic chain.
Thus, not only will the stability of the affected
joint be compromised, but now neighboring
joints or even the entire musculoskeletal system may be compromised.
Compensatory muscle actions may alter
primary functions at the affected joint, imposing greater demands on other structures. An
arthritic neck, for example, may flex forward
more than usual, creating greater loads along
the posterior thoracic and lumbar spines. A
ready example of decompensation is the limp
produced by weakness of the muscles around
an arthritic lower extremity joint - ankle, knee
or hip. We can observe how turning the foot
out, or keeping the knee locked, or externally
rotating the hip can torque the lumbo-pelvic
region, eventually creating low back issues.
Risk factors for arthritis
With more than 100 types of arthritis, there are
innumerable risk factors for fitness professionals