Physicians Fitness

08/28/2025

Surgery can solve some challenging problems, but also create some...

"Adhesions and Scar Tissue

Approximately 1 in 14 hospital readmissions following abdominal surgery are due to adhesion-related problems (Parker et al., 2001). Every time tissue undergoes trauma, as in the case of abdominal surgery and laparoscopic adhesiolysis to remove adhesions, scar tissue forms. Adhesive scar tissue develops when the layers of tissue do not heal separately but ‘stick’ together causing decreased tissue elasticity, protective postural patterns, changes in proprioceptive input, altered neurovascular activity and complications including pain syndromes (Kobesova et al., 2007)."

Ryan C. Kelly, Michelle Armstrong, Alyssa Bensky, Abigail Foti, Jennifer B. Wasserman, Soft tissue mobilization techniques in treating chronic abdominal scar tissue: A quasi-experimental single subject design, Journal of Bodywork and Movement Therapies, Volume 23, Issue 4, 2019, Pages 805-814,
ISSN 1360-8592, https://doi.org/10.1016/j.jbmt.2019.04.010.
(https://www.sciencedirect.com/science/article/pii/S1360859219301238)

08/27/2025

Does our ability to smell affect our motor function?

Apparently so...

"Abstract

Background:
Among older adults, both olfaction and motor function predict future cognitive decline and dementia, suggesting potential shared causal pathways. However, it is not known whether olfactory and motor function are independently related in late life.

Methods:
We assessed cross-sectional associations of olfaction with motor and cognitive function, using concurrent data on olfactory function, mobility, balance, fine motor function, manual dexterity, and cognition in 163 Baltimore Longitudinal Study of Aging participants aged 60 and older without common neurological diseases (n = 114 with available cognitive data). Using multiple linear regression, we adjusted for age, s*x, race, smoking history, height, and weight for mobility and balance, and education for cognition. We used multiple linear regression to test whether olfaction-motor associations were independent of cognition and depressive symptoms.

Results:
Olfactory scores were significantly associated with mobility (usual gait speed, rapid gait speed, 400-m walk time, and Health ABC Physical Performance Battery score), balance, fine motor function, and manual dexterity (all p < .05). In those with available cognitive data, additional adjustment for depressive symptoms, verbal memory, or visuoperceptual speed demonstrated especially strong independent relationships with challenging motor tasks such as 400-m walk and nondominant hand manual dexterity (p < .005)

Conclusions:
This study demonstrates for the first time that, in older adults, olfactory function is associated with mobility, balance, fine motor function, and manual dexterity, and independent of cognitive function, with challenging upper and lower extremity motor function tasks. Longitudinal studies are needed to determine if olfactory performance predicts future mobility and functional decline."

Tian Q, Resnick SM, Studenski SA. Olfaction Is Related to Motor Function in Older Adults. J Gerontol A Biol Sci Med Sci. 2017 Aug 1;72(8):1067-1071. doi: 10.1093/gerona/glw222. PMID: 27811155; PMCID: PMC5861968.

08/21/2025

Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease

“Age is a primary risk factor for a number of chronic diseases including mobility disability, cardiovascular disease (CVD), type 2 diabetes (T2D), and cancer. Most physical activity guidelines emphasize the performance of 150 min of moderate-to-vigorous or 75 min of vigorous aerobic exercise training (AET) weekly for reduction of chronic disease risk. Nonetheless, there is an emerging body of evidence showing that resistance exercise training (RET) appears to be as effective as AET in reducing risk of several chronic diseases. It may also be that RET is more effective than AET in some regards; the converse is likely also true. We posit that the perceived divergent exercise mode-dependent health benefits of AET and RET are likely small in most cases. In this short review, our aim is to examine evidence of associations between the performance of RET and chronic health disease risk (mobility disability, T2D, CVD, cancer). We also postulate on how RET may be influencing chronic disease risk and how it is a critical component for healthy aging. Accumulating evidence points to RET as a potent and robust preventive strategy against a number of chronic diseases traditionally associated with the performance of AET, but evidence favors RET as a potent countermeasure against declines in mobility. On the basis of this review we propose that the promotion of RET should assume a more prominent position in exercise guidelines particularly for older persons.”

Mcleod JC, Stokes T and Phillips SM, (2019) Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease. Front. Physiol. 10:645. doi: 10.3389/fphys.2019.00645

08/14/2025

Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease

“Age is a primary risk factor for a number of chronic diseases including mobility disability, cardiovascular disease (CVD), type 2 diabetes (T2D), and cancer. Most physical activity
guidelines emphasize the performance of 150 min of moderate-to-vigorous or 75 min of vigorous aerobic exercise training (AET) weekly for reduction of chronic disease risk. Nonetheless, there is an emerging body of evidence showing that resistance exercise training (RET) appears to be as effective as AET in reducing risk of several chronic diseases. It may also be that RET is more effective than AET in some regards; the converse is likely also true. We posit that the perceived divergent exercise mode-dependent health benefits of AET and RET are likely small in most cases. In this short review, our aim is to examine evidence of associations between the performance of RET and chronic health disease risk (mobility disability, T2D, CVD, cancer). We also postulate on how RET may be influencing chronic disease risk and how it is a critical component for healthy aging. Accumulating evidence points to RET as a potent and robust preventive strategy against a number of chronic diseases traditionally associated with the performance of AET, but evidence favors RET as a potent countermeasure against declines in mobility. On the basis of this review we propose that the promotion of RET should assume a more prominent position in exercise guidelines particularly for older persons.”

Mcleod JC, Stokes T and Phillips SM
(2019) Resistance Exercise Training
as a Primary Countermeasure to
Age-Related Chronic Disease.
Front. Physiol. 10:645.
doi: 10.3389/fphys.2019.00645

08/07/2025

For those computing their target heart rate training zones, there is a New Maximum Heart Rate formula - 211 - 0.64 x Age

"Abstract
Maximal heart rate (HRmax ) declines substantially with age, but the magnitude and possible modifying effect of gender, body composition, and physical activity are not fully established. The present study examined the relationship between HRmax and age in 3320 healthy men and women within a wide age range using data from the HUNT Fitness Study (2007-2008). Subjects were included if a maximal effort could be verified during a maximal exercise test. General linear modeling was used to determine the effect of age on HRmax . Subsequently, the effects of gender, body mass index (BMI), physical activity status, and maximal oxygen uptake were examined. Mean predicted HRmax by three former prediction formulas were compared with measured HRmax within 10-year age groups. HRmax was univariately explained by the formula 211 - 0.64·age (SEE, 10.8), and we found no evidence of interaction with gender, physical activity, VO2max level, or BMI groups. There were only minor age-adjusted differences in HRmax between these groups. Previously suggested prediction equations underestimated measured HRmax in subjects older than 30 years. HRmax predicted by age alone may be practically convenient for various groups, although a standard error of 10.8 beats/min must be taken into account. HRmax in healthy, older subjects and women were higher than previously reported."

Nes BM, Janszky I, Wisløff U, Støylen A, Karlsen T. Age-predicted maximal heart rate in healthy subjects: The HUNT fitness study. Scand J Med Sci Sports. 2013 Dec;23(6):697-704. doi: 10.1111/j.1600-0838.2012.01445.x. Epub 2012 Feb 29. PMID: 22376273.

07/31/2025

Our Muscle System Specialists are about understanding...

1) how we as professionals construct our expectations of how the bio-motor system should function (rational),

2) how the system wants to function (the client's fundamental objectives) and

3) the process of strategic sampling of the bio-motor system, via its degrees of freedom, and determining its control over those degrees of freedom (empirical).

We then reconcile these three concepts to make determinations about what to do, or not to do, to the bio-motor control system to potentiate and train it.

This is informed by our totally unique and potent Philosophy of Body...

The human body is an open, finite thermodynamic system, made up of a heterogeneous material continuum, with an intrinsic network control system, excited to life by spiritual force, that primarily uses inhibition and negative feedback loops to govern its configurational capabilities and maintain homeostasis as a bio-motor system.

What is your Philosophy of Body (Body View)?

If you want to know more about this concept, please visit this link for a free PDF that dives deeper into the various body views prevalent in modern medicine and fitness:

Download free resources on our teaching philosophy and approach to transforming your training.

07/30/2025

In-person, professionally supervised resistance training gets better results!

"Abstract
Gavanda, S, Held, S, Schrey, S, Oberwetter, K, Lazzaro, P-GM, Pergelt, M, and Geisler, S. Optimizing resistance training outcomes: comparing in-person supervision, online coaching, and self-guided approaches: a randomized controlled trial. J Strength Cond Res XX(X): 000–000, 2025—This randomized, parallel-group trial investigated the effects of supervised (SUP), app-guided (APP), and self-guided (PDF) 10-week, thrice-weekly full-body resistance training (RT) on strength, body composition, well-being, and supervision satisfaction (S-SRQ) in trained men and women (n = 79, 48% women; 30.7 ± 7.8 years, 1.75 ± 0.1 m, 77.5 ± 17.5 kg). Adherence was highest in SUP (88.2%), followed by APP (81.2%) and PDF (52.2%). At p ≤ 0.05, body mass (+1.8 ± 1.9 kg, p = 0.006) and fat-free mass (+1.4 ± 0.9 kg, p ≤ 0.001) increased significantly in SUP. Muscle mass gains were observed in SUP (+1.4 ± 0.9 kg, p = 0.009) and PDF (+0.9 ± 1.3 kg, p = 0.047). All groups improved squat 1-repetition maximum (1RM) (SUP: +26.6 ± 6.5 kg, p ≤ 0.001; APP: +19.2 ± 11.0 kg, p ≤ 0.001; PDF: +19.4 ± 11.7 kg, p ≤ 0.001) and bench press 1RM (SUP: +9.1 ± 3.5 kg, p ≤ 0.001; APP: +8.2 ± 4.0 kg, p ≤ 0.001; PDF: +7.7 ± 5.8 kg, p ≤ 0.001). Supervised showed significantly greater squat gains than APP and PDF (p ≤ 0.044). Well-being (WHO-5) improved in SUP (+15.7 ± 16.2 points, p ≤ 0.001) and PDF (+9.0 ± 20.4 points, p = 0.032). Satisfaction with supervision was significantly higher in SUP (96.7 ± 4.3%) than in APP (92.0 ± 7.1%, p = 0.005). In conclusion, supervised RT resulted in superior improvements in strength, body composition, well-being, and supervision satisfaction compared with app-guided or self-guided training. Although APP and PDF resulted in some positive effects, their magnitude was generally smaller. These findings underscore the value of in-person coaching in optimizing RT outcomes. However, app-based RT shows promise for maintaining adherence, offering a viable alternative when full supervision is not feasible."

Gavanda, Simon1; Held, Steffen2; Schrey, Sascha1; Oberwetter, Katharina1; Lazzaro, Pier-Gino M.3; Pergelt, Markus1; Geisler, Stephan1. Optimizing Resistance Training Outcomes: Comparing In-Person Supervision, Online Coaching, and Self-Guided Approaches: A Randomized Controlled Trial. Journal of Strength and Conditioning Research ():10.1519/JSC.0000000000005216, July 30, 2025. | DOI: 10.1519/JSC.0000000000005216

07/24/2025

Get your daily calorie requirements dialed in for performance, weight loss, or even weight gain!

We conduct Resting Metabolic Rate Testing here at Physicians Fitness.

Metabolic rate is a measure of how much food or fat is converted into energy in a day. Resting metabolic rate (RMR) is the measurement of the amount of energy required to maintain basic body functions, such as the heartbeat, breathing, and body temperature regulation, while in a state of rest. That energy is expressed in calories per day. An RMR test measures the number of calories you burn at rest, simply by sitting in a chair.

Indirect calorimetry (a measurement of metabolic rate) relies on the fact that burning 1 calorie (Kilocalorie) requires 208.06 milliliters of oxygen. Because of this straightforward relationship between caloric burn and oxygen consumed, measurements of oxygen uptake (VO2) and caloric burn rate are virtually interchangeable.

It plays a crucial role in determining calorie intake needs for increasing, maintaining, or losing body fat.

Call today to schedule your test!

614-442-8100

07/17/2025

Getting older and the immune system...

"Abstract

Human immune function undergoes adverse changes with aging, including development of a relative immune deficiency and an immune dysregulated state. The T cells show the largest age-related differences in distribution and function. The antibody production capacity of B cells also shows an age-related decline. Acute bouts of exercise modulate many immune parameters as seen in peripheral blood. With regard to NK cell activity, a single bout of moderate exercise seems to be well tolerated by the elderly, and the resting NK cell activity of elderly subjects seems to increase with training. Cross-sectional comparisons of immune status imply that habitual physical activity may enhance NK cell activity and check certain aspects of the age-related decline in T cell function. Future studies are required to clarify whether such long-term exercise and resulting improvements of immune function give rise to any beneficial effects on infections, malignancies, and autoimmune disorders."

Shinkai S, Konishi M, Shephard RJ. Aging, exercise, training, and the immune system. Exerc Immunol Rev. 1997;3:68-95. PMID: 9139754.

07/10/2025

Gotta keep those feet strong!

"Abstract
Older adults exhibit reductions in push-off power that are often attributed to deficits in plantarflexor force-generating capacity. However, growing evidence suggests that the foot may also contribute to push-off power during walking. Thus, age-related changes in foot structure and function may contribute to altered foot mechanics and ultimately reduced push-off power. The purpose of this paper was to quantify age-related differences in foot mechanical work during walking across a range of speeds and, at a single fixed speed with varied demands for push-off power. 9 young and 10 older adults walked at 1.0, 1.2, and 1.4 m/s, and at 1.2 m/s with an aiding or impeding horizontal pulling force equal to 5% BW. We calculated foot work in Visual3D using a unified deformable foot model, accounting for contributions of structures distal to the hindfoot’s center-of-mass. Older adults walked while performing less positive foot work and more negative net foot work (p

07/04/2025

07/03/2025

The musculoskeletal syndrome of menopause

"Fifty-one percent of humans are born with ovaries. As the ovarian production of estrogen diminishes in midlife and ultimately stops, it is estimated that more than 47 million women worldwide enter the menopause transition annually. More than 70% will experience musculoskeletal symptoms and 25% will be disabled by them through the transition from perimenopause to postmenopause. this often-unrecognized collective of musculoskeletal symptoms, largely influenced by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density and progression of osteoarthritis, among others. in isolation, it can be difficult for clinicians and patients to adequately appreciate the substantial role of decreasing estrogen, anticipate the onset of related symptoms and actively treat to mitigate future detrimental processes. thus, in this review we introduce a new term, the musculoskeletal syndrome of menopause, to describe the collective musculoskeletal signs and symptoms associated with the loss of estrogen. Given the significant effects of these processes on quality of life and the associated personal and financial costs, it is important for clinicians and the women they care for to be aware of this terminology and the constellation of musculoskeletal processes for which proper risk assessment and prophylactic management are of consequence."

Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric. 2024 Oct;27(5):466-472. doi: 10.1080/13697137.2024.2380363. Epub 2024 Jul 30. PMID: 39077777.