Clinical Exercise
Working with clinical populations has always been a major driving force in my pursuit of intellectual and occupational wellness as well as overall fulfillment in my career. Aside from my deep family connections to those medical conditions that need exercise the most, I’ve always preferred a challenge and being forced to problem solve and think outside the box. I’m pretty certain I knew this would be important for my career all the way back when I was first settling on a degree path as a 19 or 20 year-old. Having witnessed the many physical and psychological effects of a chronically unhealthy lifestyle, I wanted to enable myself to better understand the life-long pursuit of physical health and wellness. I also knew that by working in the exercise field there would be motivational factors that could help keep my eyes on the prize and stay accountable to my own personal health goals. I knew what I was doing: putting pressure on my future self to practice what I preach. But, more importantly, I knew I needed to find a deeper purpose than the average job can afford. Working with people that have similar struggles to those I’ve watched my whole life seemed to make a lot of sense.
Indiana University (IU) did an excellent job developing a highly technical but practical skillset for exercise and fitness professionals. I went through the same pre-requisite classes medical students would, but then began directing my studies toward a career in exercise that offered various roles in or outside of medicine. Always at the top of my class, I excelled in the more complex subjects of anatomy, physics, kinetics/kinematics, and biomechanics, physiology, bioenergetics, neurochemistry, and motor learning. We prepared for the highest of standards held by the top certifying agencies in the field and put them to practice in real-life settings. The four-year curriculum exposed me to many possibilities in which I could apply the knowledge. My first experience working with special needs, clinical patients was as a freshman when I took a position in the dorms as a residential assistant for a paraplegic student. Similar to that of in-home care, this position wasn’t part of my schooling, but I saw it as a way to begin to understand movement and medicine from a new perspective; it also helped gage my interest for serving and connecting with people one-on-one. Next, a cardiac rehabilitation program offered as a practicum and a culmination of the Kinesiology program’s technical skills and knowledge base; this drove home the importance of continuing education and staying up to date in the evolving worlds of medicine, healthcare, fitness, and wellness.
My work in fitness and athletics gave me the chance to be part of many other rehabilitation programs along my way, mainly musculoskeletal injury-related, and on both the injured athlete and on the trainer’s side. I’ve worked closely alongside the healthcare team on rehab and recovery programs for every level of mover: youth to professional athlete and student desk jockeys to senior, active-agers. In the sports medicine field, I got to work with a young NBA player from my home state in his recovery program after a shattered kneecap. I learned the value and, in my opinion, under-utilization of athletic trainers and soft tissue specialists in both the rehab and performance sectors. I’ve been able to communicate clearly with and coordinate exercise prescriptions through many physical therapists and chiropractors over the years. Now more than ever, I understand the importance of these connections and referring clients or athletes when I knew I’m outside my scope of practice.
After spending a few years in the general fitness and sports performance areas of the industry, I was itching again to find that deeper calling. I had just graduated with a Master’s degree in Kinesiology and finished out my role as the graduate assistant strength coach for a smaller branch of the University of Texas down on the southern border. McAllen had been named number one “Fattest City” in the nation for years on end and I was primed to help out in any manner I could. During those two years I watched as poor lifestyle choices and chronic diseases ran rampant across the Rio Grande Valley, as it was throughout most of the US, and it further solidified my stance on the need for exercise as medicine. I began connecting with clinical weight loss programs and doctors in the region, guest speaking at bariatric and metabolic disease centers, and bridging partnerships between local medical providers and fitness centers. At Doctor’s Hospital at Renaissance (DHR) I worked together with the lead doctor and department head to demonstrate the importance of including physical activity and exercise in their treatment protocols. Just before this, health insurance agencies began requiring bariatric surgery candidates meet certain criteria to lower the mortality risk of weight-loss surgeries. I was tasked to create a business plan around a small, one-room fitness facility idea that would be presented to the hospital’s board of directors. In it, I included ideas for employee wellness programs and incentives; because so many of the hospitals staff – physicians, nurses, and every level of employee – were also battling health issues related to sedentary lifestyles and poor nutrition. Ever the trend setter, health insurance industry initiatives were really starting to push corporate wellness programs and the administration began to take interest in the idea of a healthier workplace environment. Initially, I was told that the doctor-owned hospital had explicitly expressed they were not interested in an exercise or wellness facility. Soon after our proposal for the department’s small one-room glimmer of hope, the hospital was constructing the first exercise department and facility soon after.
Though I could have gone through the application process as DHR built their program, I had also recently married and had plans to relocate outside of South Texas. My search for a position with a deeper calling continued alongside my search for a place to build a family. My wife and I found our way to Northern California, and I carried on dabbling on my own in the fitness realm. I connected with local gyms, chiropractors, physical therapists, sports coaches, colleges and any other lead I could to build up rapport in the area. Eventually, I was referred to a local non-profit, Triumph Cancer Foundation, which raised funds to provide exercise recovery programs at no cost for adult cancer survivors around the Sacramento area. I took the part-time role of Instructor and co-led programs for eight participants per group on a trimester basis. The position required an additional certification as a Cancer Exercise Specialist and a new challenge for analyzing and modifying exercise, but it was the personal connections that pulled me closer to my role. After three years working at that capacity, I was offered the Program Director position. Triumph’s philosophy was so well-aligned with my own, I could not say no. Aside from the value they placed in my skillset and the sense of fulfillment I gained working with their demographic their professionalism in linking with medical care providers was outstanding, the on-going programs and resources for their graduates were holistic and included things my wife and I love to do, and they offered many philanthropic opportunities to make a deeper connection with the Sacramento community.
Accepting exercise as medicine and fitness professionals as a real part of the healthcare team is becoming more realistic for the Western medical industry. There are branches, like bariatrics and oncology, in addition to rehabilitation that are quickly making leaps and bounds in standard of care by including exercise and wellness resources into their prognoses. In lough of our expertise, I liken the various parts of the industry to the human anatomy: as the eyes and the brain, health insurance providers are always processing information and directing commands while also watching for ways to reduce their expenses; health administration’s primary role is to set operating procedures and ensure the quality business of medicine, which I consider the mouth talking the talk; those actually performing the action of practicing medicine – those walking the walk – the health professionals, are the body. It’s becoming harder and harder for the body to do anything the eyes don’t see, the brain doesn’t command, and the mouth doesn’t say. Unfortunately, there is still a stormy sea between the general fitness industry and clinical exercise programs, with sports medicine sitting on an island in between. In the near future we’ll see the primary objectives in the control and reversal the epidemic of chronic lifestyle diseases become a proactive education and prioritization of healthy physical activity, self-awareness, and nutritional/environmental wellness—MUCH more so than any surgery or pill. Educated exercise professionals are going to be called to bridge the gap as Western health networks continue to grow and adopt a more preventative, alternative, and holistic approach to health care.