Month: June 2014

Three equipment options better than the BOSU for mature clients

The BOSU has quickly become one of the most popular and beloved pieces of fitness equipment with trainers today and frankly that baffles me a little bit.  I’ve watched many videos and presenters showing hundreds of “creative” uses of the BOSU that just leaves me scratching my head because I just don’t get what they are trying to accomplish.  They use all of the right terms, such as balance, proprioception and reactive stability, to support their choice of exercise movements but usually I see a physiological disconnect between what they are saying and what the movement actually accomplishes.

In my personal opinion the BOSU is more of a toy than a tool.  Now don’t get me wrong there are definitely some beneficial movements that can be performed on the BOSU but they comprise just a fraction of all of the movements that are actually performed with it.  This is all doubly true for mature clients.  The BOSU, and instability training in general, seem to be overused and misapplied with this population.  For example, I recently completed the BOSU Mobility and Stability for Active Aging program (home study materials) and, as someone who has studied mobility and balance extensively for older adults, I was completely underwhelmed.  A large portion of the exercises either didn’t use the BOSU or could have used any number of other pieces of equipment in its place with the same result.  And while several components critical for balance and mobility are addressed in the program (e.g. hip and leg strength, ankle stability) others are either insufficiently addressed (e.g. multisensory training; center of gravity control) or not addressed at all (e.g. postural strategies).  However, the program could potentially be useful as a basic introduction to balance training for instructors who are new to these concepts.  I am concerned, though, because it does not fully nor accurately represent the individual balance components included in a comprehensive program since the focus is on using the BOSU.  (I would also state that none of the exercises presented in the program were inherently dangerous or “wrong” for mature clients and I am sure participants would get some results by doing the program but it is generic and sub-optimal.)

Unstable (or labile) surfaces, like the BOSU, need to be used purposefully and selectively with mature clients.  Their best use is for vestibular training because in order to fully engage the vestibular system you either need to reduce/remove both somatosensory and visual input OR move the head quickly.  A compliant surface reduces somatosensory input so its use is warranted in this situation.  Another beneficial use is for ankle and hip stabilization (although some argue against this).  Instability definitely turns on the proprioceptors and causes muscular co-contraction.  This can be beneficial for those that have deficits in these areas although the proprioceptors can also be turned on using stable surfaces and muscular co-contraction is not always a good thing.  So there are pros and cons.  The bottom line, though, is that there are other equipment options, like the ones I’ve identified below, that, in my opinion, are more beneficial than the BOSU in accomplishing these tasks.

Number One:  High-Density Foam Pad

There are two primary advantages to using foam pads over the BOSU.  The first is that foam pads provide a broad, flat surface as opposed to a curved surface.  As many before me have stated the curved surface presents some concerns for the ankle and knee joints and its functional relevance is questionable.  The flat surface allows for a variety of stance positions including shoulder-width, narrow, side-by-side, semi-tandem, tandem and one-legged.  It creates equal instability in all directions instead of “from the center out” with the BOSU.  The variety of stance positions possible and the equal instability is really critical in effective vestibular training because we are able to scale/modify the base of support according to the individual’s needs.

Airex Balance Pad

The second advantage is the lower level of instability with the foam pad.  The BOSU has a greater degree (moderate level) of instability compared to the foam pad.  The foam pad will be more appropriate (and much safer) for those who have more severe balance deficits.  To increase the amount of instability two foam pads can be stacked together so the instability can be easily and quickly modified.  This is very important when working with a group who has varying levels of balance and fall risk.  In my opinion it is typically much more appropriate to perform dynamic movements with lower levels of instability compared to moderate or high levels of instability for this population.  Performing the mCTSIB test (modified Clinical Test of Sensory Interaction in Balance) also requires stacking two foam pads to assess vestibular control.

Number Two: SPRI Step 360

What I really like about the Step 360 is the broad, hard, flat surface which provides somatosensory feedback in addition to instability.  Plus, it allows for a number of different stance positions while providing multi-directional instability which is much more akin to a wobble board.  However, it is a little more stable than a wobble board.  Some people would argue that the BOSU can be turned hard-side up as well.  However, there are some challenges with using the BOSU in this position.

SPRI Step 360


For one, just like a traditional wobble board, mounting and dismounting are difficult because it tilts quite easily and to a significant degree.  This is not the case with the Step 360 which can rather easily be mounted by placing one foot closer to the middle of the stepping surface to reduce instability, stepping up with the other foot and then adjusting foot position as necessary.  Because of its unique design it doesn’t tilt nearly as much nor as easily.  Secondly, there is more of a “dump out” risk.  That is, when users allow the BOSU to tilt too far in a given direction (especially forward or backwards) there comes a point where recovery is impossible and the person gets “dumped out”.  They must step off the BOSU in order to maintain their balance.  This poses a significant fall and injury risk for lower-level clients.

(For more details on the Step 360 visit

Number Three: The Floor

Yes the floor is one of the best pieces of equipment (if not THE BEST) you can use for comprehensive balance training.  It is a broad, firm, stable surface and functionally relevant.  We can effectively work on most components of balance with using only the floor and the client’s own body weight.  Postural strategies (ankle, hip and step), static and dynamic center of gravity control, multisensory (visual, somatosensory and some vestibular), lower body strength (including ankle, knee and hip stability), gait enhancement, mobility and more can all be trained safely and effectively just by using the floor.  It’s not very sexy.  It’s not a cool toy or widget.  It doesn’t get a whole lot of credit.  But it absolutely works!

Ankle Strategy
Ankle Strategy on Floor

As I stated earlier, unstable surfaces are really overused and misapplied.  Plus the scientific evidence demonstrating their effectiveness for most people is really lacking.  This is also true for mature adults.  Don’t get swept away by all of the “creativity” that goes into selling a particular piece of equipment when typically the basics are all you really need.  Remember that for every “fitness expert” pushing pieces like the BOSU there are just as many other experts who would advise against them.  There is really no end to the creativity of fitness professionals but creativity must be balanced with a strong physiological rationale and, ultimately, scientific evidence.

Take Home Message

So, should trainers throw their BOSU out the window?  Certainly not.  It is important to have tools (not toys) that meet the diverse needs of their clientele and the mature population is the most diverse clientele of all.  The BOSU, like many other pieces of equipment, must and can be used safely, purposefully and effectively.

If you want to learn more about evidence-based functional training methods for mature clients then become a certified Functional Aging Specialist.  The course is packed with over 10 hours of online content that will teach you how to develop safe and effective functional aging exercise programs.  Earn CEU’s from ACE, ACSM, AFAA or NFPT.

How YOU can compete with Silver Sneakers

I recently received an email from a trainer with a common challenge facing many fitness professionals who work with mature clients.  Here is her comment:

My clientele are mainly 50 plus, but what I have been running into is the Sliver Sneakers program that many seniors are wanting instead of paying a Trainer. What are your thoughts and can this program you offer help me overcome this situation.

First off, YES this challenge can be overcome and actually used to your advantage.  Here are three key areas that need to be addressed if you are going to be successful.

#1 – Realize that competition is a good thing because it helps you to communicate your distinctiveness.  If you run a high-quality personal and small group training program based on the Functional Aging Training Model then you can confidently say that there really is no comparison between your training and Silver Sneakers.  Free use of a fitness facility does not typically lead to meaningful results because the responsibility for developing the fitness program, sticking with it, overcoming barriers and working around injuries is all on them.  The group exercise option is not customized to their individual functional needs so it too will limit results.  We all know this so the tendency for most trainers is to make direct comparisons between Silver Sneakers (or any competitor) and themselves but what you really need to do is position yourself as a “category of one” so that there really is no comparison.  The best way to do this is to identify and communicate all the ways that make you and your facility/program unique (environment, equipment, training methods, assessments, education, trainers, nutrition, etc.) without referencing any other facilities or programs.  For example, saying that your trainers are Certified Functional Aging Specialists who understand how to get great results for someone like them (age, gender, physical condition, goals, etc.) will demonstrate a distinctive credential.  And whatever you do NEVER speak negatively about another facility or program (older adults are really turned off by it) and don’t say you are “better” than something else (it is too ambiguous and infers a comparison).

#2 – Know who your ideal client is.  We tried Silver Sneakers in our facility for a short time and quickly realized that those who opted for the program were NOT our ideal clients.  Our ideal client, among other things, is interested in really improving their health and function, has little to no experience with exercise, has several age-related physical conditions (arthritis, joint replacement, overweight, etc.), is moderately affluent AND sees the value in paying more to get those results.  Income or net worth alone do not distinguish our ideal client because many mature adults with lots more money only want the cheapest or free option.  When you know who your ideal client is you stop fretting so much about losing potential clients because your goal is NOT to be everything to everyone.  Develop a laser-like focus on your ideal client and start working hard to find and get those types of clients in your program.  In general the Silver Sneakers client is not going to be your ideal client either just like the regular gym-goer won’t be your ideal client either.  (PS – It’s okay to have more than one ideal client – we have three)

#3 – Demonstrate incredible value in the language of your ideal client.  If you are not closing a very high percentage of potential clients (80+%) during the sales process then you have a major issue that is typically one of the following errors:

  • Your marketing failed to attract your ideal client
  • You failed to show value that is meaningful to the client during the sales process
  • You failed to ask confidently for the sale

I want to focus on the second error which is failing to show value that is meaningful to the client.  Values drive almost all human behavior.  What you value (rather than what you say you value) will determine what choices you make on a daily basis.  If you do not understand what your ideal clients value then you will NOT be able to communicate with them appropriately.  For example, a potential mature client walks in saying that one of their goals is to lose weight.  You make the assumption that they want to lose weight in order to look better so you talk about how your programs will help make them lean and muscular and they will be able to fit in their “skinny jeans” again, etc.  However, what you failed to understand is that they want to lose weight to reduce their risk of cardiovascular disease because they have had several friends die from heart attacks over the past year.  You assumed they value aesthetics when, in fact, they value health.  So they walk out the door without signing up because they need to “think about it”.  However, in their head they have concluded that you don’t really understand them and this is not the right place for them.

In general, mature adults value: altruism/giving back, family and relationships, faith and spirituality, health, functional ability and life experience, to name a few.  You can use these values to your advantage BUT you need to explore these areas with your potential clients first (ask the right questions and listen more than you talk) to find out what their “hot buttons” are (what really motivates them).  Doing so will greatly enhance your ability to close a sale.

The Functional Aging Specialist certification will give you a distinctive credential and help you understand mature clients better.  It is THE premiere program for creating safe and effective functional exercise programs for this population and can be completed entirely online.

The Advanced Functional Aging Specialist certification will help you take your business to the next level by teaching effective marketing, sales and business methods that are critical to success with the growing mature population.  Spend two days (July 25, 26) being mentored by Dan and Cody in their facility on how to build and grow a successful business.

Why the world needs YOU to become a Functional Aging Specialist

A new report highlights why more trainers need to specialize in working with older adults.  The study, presented at an international conference*, showed that health care costs are 50% higher for people with a musculoskeletal condition such as osteoarthritis, osteoporosis and low back pain compared to any other single occurring condition.  There are more than 150 conditions that affect the muscles, bones and joints and their prevalence increases with age making them the main cause of disability among the elderly.

With the rapid rise in the aging population globally we need more trainers who specialize in working with mature adults, especially those with musculoskeletal conditions, to help improve their function and decrease their disability risk.

The Functional Aging Specialist Certification will prepare you to work with this HUGE and RAPIDLY GROWING population of clients.  Not only will you be able to position yourself as an expert and grow your business BUT you will also be helping people live a long, healthy and functional life.  There is not greater satisfaction than using your skills and talents to make someone else’s life better.

Build a strong business while helping other people…what an awesome combination!

Click HERE to find out more about the Functional Aging Specialist Certification and check out our schedule of upcoming workshops in Woodland Hills, CA (LA area), Raleigh NC, Ocala FL, Chicago IL, New York, and others.

*2014 European League Against Rheumatism Annual Congress

Older Adults should NEVER twist their spine!?

Here is a question one of our recent workshop participants sent us:

I teach water and land and chair exercises to a 80 + population (98 being the oldest). I have always erred on the side of caution so when a lady in my water class objected to a SLIGHT twisting motion that I was teaching, she interrupted and said NO, my doctor said no twisting for anyone our age or with osteoporosis.

If you work with an older clientele then this sort of thing happens all the time. It is inevitable that one of your clients will tell you that their doctor told them that someone of their age should NEVER do “this” or NEVER do “that” particular exercise or motion. While I respect the hard work and expertise from medical professionals but the truth is that most of them know next to nothing about exercise and even less about biomechanical loading.

This advice is not very practical (how can you get out of a car without twisting your spine??) and also smacks of ageism. Older adults are very diverse so saying that NO ONE over a certain age should or should not do something is irresponsible. While there is typically a nugget of truth somewhere in these kinds of recommendations they go a step too far.

So is twisting “bad” for an older adult or someone with osteoporosis? It depends…

Twisting by itself is not very problematic. However, twisting torque is much more of an issue and leads to much higher levels of spinal loading and therefore much higher chances of injury. Torque is created when resistance is applied to the twisting motion. The further away from the neutral position you get the more risky torque (loading) becomes.

Sometimes it doesn’t take very much external resistance to create a lot of torque. Swinging a golf club or softball bat also creates a lot of torque…especially at the end of the motion. Most people will hurt their backs at the end of the swing when their trunk (and the club or bat) are moving quickly and their spine gets loaded quickly to stop the swing.

Many functional activities require twisting at the spine.  Even a typical gait pattern depends on spinal twisting.  However, our approach to training will either help people improve their low back pain, enhance functional movement and decrease risk of future injury….or the opposite.

Here are some guidelines that I recommend that you follow with your mature clients in regards to spinal twisting:

  1. Build three-dimensional stability and endurance first:  In the neutral spinal position (which must be taught) apply resistance in all directions.  For transverse plane (rotational or twisting plane) stability I like to have clients hold a cable or resistance tube at waist height with arms slightly extended and the line of resistance perpendicular to their arms.  This creates a rotational force (torque).  Have the client hold their neutral position for 10-15 seconds while breathing lightly.  Rest 10 seconds and repeat for a total of 3 sets.  Turn around 180 degrees and repeat for 3 sets on the other side.  Other ways to create torque (that I love) in the neutral position include the standing 1 arm chest press and standing 1 arm row.
  2. Teach stability with the hip hinge:  It is very difficult for most mature clients to understand how to lean forward without flexing their spine.  Obviously this is a critical aspect of being able to perform everyday functional movements while keeping the spine safe.  After teaching spinal neutral and building some endurance it is important to translate that into real-life movements.  The hip hinge is a great way to help them keep spinal neutral while bending, reaching, lifting, etc.  Many older women, I find, do NOT want to use their glutes so it takes some creative teaching to get them to slide their hips back and load their glutes in order to hip hinge effectively.
  3. If you perform “full” twisting motions do so without load and under control:  Gentle spinal motion should not be an issue for most people (unless they have severe Osteoporosis or a specific injury).  Have them twist slowly (avoid ballistic movements) to almost full range of motion.  I say almost because the goal should not be to stretch further and further but rather to provide a gentle rhythmic motion for the spine.
  4. When introducing load reduce the twisting range of motion:  Think of yourself standing in the middle of a clock face with 12:00 straight ahead.  When using twisting load keep range of motion in the 11:00-1:00 area which represents about 30 degrees to the right and left.  This is typically a pretty safe and functional range where some moderate loading is okay.  However, I do not recommend that you exceed this range while under load and I don’t see much of a functional purpose in doing so anyway.  Of course you must always keep the individual’s needs in mind.  Some clients may not be able to load from 11:00-1:00 without discomfort.
  5. Avoid flexion and twisting at the same time:  Here is where I follow the NEVER do this type of rule simply because simultaneous flexion and rotation puts the spine in a very compromised position even under minor loading.  There are so many other great ways to train the core safely and functionally that there really is no need to perform a movement that would require flexion and rotation.

In our Functional Aging Specialist Certification course we teach fitness professionals how to develop safe and effective exercise programs for mature clients that lead to improved functional outcomes.  Become an expert in working with the exploding aging population and position yourself for many years of success in the fitness industry.


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