Taking Control of Your Health and Wellness: Taking Strides Toward A More Fulfilling Life

By: Kerry Wiley and Jason Berner

A Customer’s Perspective

Sometimes interactions with practitioners can feel like a tug of war- due to issues of limited time and having their primary attention focused on clinical issues. I am fighting to get them to pay attention to me- to see me, hear me, and listen to me. When I started working with staff at Plaza Fitness in Albany on developing a plan to improve long-term health and wellness, I did not have to put on the boxing gloves, prove my level of intellect, or feel that I was defined by a clinical diagnosis.

People with disabilities always have to be problem solvers, weigh their options, and make choices about what to do next, especially related to their personal health. My experience with a personal trainer began almost a year ago. I was having a chronic burning sensation in my hands, arms, and shoulders. I visited doctors who completed multiple tests. The burning sensation was determined to be a consequence of Spastic Diplegia, a form of Cerebral Palsy (CP) that causes my leg muscles to be stiff. To compensate for the stiffness in my legs, I was over - using my upper body to walk. To address the discomfort in my upper body, I switched walking devices to try to resolve the issues of the chronic burn. My new crutches had arm-bands that were cumbersome. I visited a physical therapist and she taught me to walk with the crutches, but I kept falling. Falling with the crutch attached to my arm could break it. I knew I needed to take action to reduce the frequency of the falls. I spoke with the physical therapist about the recommendations of the doctors, which included setting up a fitness routine and joining a pool to exercise.

I told the therapist that I needed to take steps to set up the recommended fitness plan. I told her I had to be strategic, the fact that I did not drive directed where I could go to start this regimen. It turned out there was a fitness studio less than a mile from where I live. With my permission, the therapist helped me make a connection and provide necessary information about my needs to a trainer at Plaza Fitness, a fitness studio. A fitness studio is different in many respects from a gym. Differences include supporting health with a holistic approach, developing a customized program toward individual fitness, and offering appointment-based personal training sessions. Personal trainers provide one-on-one focused supervision and guidance throughout the workout.

Personal training at Plaza Fitness looks at health from a holistic point of view. The underlying theme promoted is prevention. Staff at Plaza Fitness exhibited a high degree of professionalism during the intake and assessment of my abilities. Their attitude was customer-focused, and in stark contrast to some organizations that turned me away saying they could not address my needs. Part of the assessment included disclosure of my primary health issues including CP and asthma, determining eating patterns, and what my base function was to exercise. Based on this information, staff at Plaza Fitness created an exercise routine that would strengthen my upper body.

I set a schedule that I would workout a minimum of twice a week. A few weeks passed, and I was working on the compound row, a machine that works a group of muscles in the shoulders and upper back. I was performing the exercise incorrectly. At this point, I met Jason Berner, one of the trainers that walk the floor to support people in their workout routine. Jason worked that day to help me correct my exercise technique and took an interest in my routine. He instructed me on needed corrections to perform the exercise, and had me complete the rotation between the machines. I thanked Jason for his help and indicated that I was sure he had other clients. The trainer replied, “This is my job. I am helping you. You are my client.” When I heard this, I knew I was a customer. Jason asked me why I was there, and I explained that I have CP, and that I have been told to strengthen my arm muscles to reduce pain. For me, the exchange that day increased the level and intensity of my work at the fitness studio. This was due to the trainer’s sincere commitment to quality coaching, a high level of enthusiasm, and an emphasis on client-centered service. This served as motivation for me to do more than I could have imagined possible.

Two or three months after following the exercise routine established for me, the pain I experienced in my upper body decreased as a result of the exercise. I set a personal goal that I wanted to gain function, not lose function as people with my physical issues can. I started to work with Jason more frequently. The original routine that focused on my upper body began to focus on developing additional function in my legs. Jason supported me with education and training on elements like the use of the machines, proper exercise technique and repetitions, and how certain life style choices, for example, what I ate can affect defined health goals. The day came when I admitted to Jason that I was worried about losing function and mobility and that I needed to expand the function that I have. The response was “You can.” I asked, “Have you ever worked with a person with Cerebral Palsy before? I do not like to admit that I have limits.” Jason replied, “There are no limits.” It was that day that I started to work one-on-one with Jason on strength training and a complete fitness regimen.

When people look into joining a fitness studio or a related program, they need to “shop” for the right program that fits their needs and capabilities. When exploring available health and wellness programs, people need to examine what the over-arching philosophy of the program and staff is. Personal fitness goals and program goals have to be in alignment. Finding the right program to meet individual needs means recognizing when there is not a match between individual needs, goals, and program offerings. Some programs may not be able to meet individual needs or goals. If this is the case, it means keep “shopping” for the right fit. I shopped around before I found a match with Plaza Fitness.

Commitment to health and wellness requires taking charge, identifying potential health problems that can emerge, and finding strategies to deal with or prevent them. Once I began working with my personal trainer, important decisions needed to be made about the type of exercise program that I would engage in as well as what other interventions I would explore including using different types of assistive technology, taking medications and undergoing procedures that would reduce the tightness in my muscles, or using a combination of these approaches. Pursuing health and wellness requires seeking the right expertise and keeping up to date on current and up and coming treatment modalities. It also requires flexibility in decision-making and the ability to adapt to changing circumstances and conditions.

Personal Training and Health and Wellness: Ingredients for Success

Inclusion is about making someone belong regardless of a clinical diagnosis. When I dealt with staff at Plaza Fitness, I was not made to feel like I was broken or that there was something wrong with me. The lead staff at Plaza Fitness welcomed me. The label of CP did not matter. Staff assessed what I could achieve and then presented the concept- “there is no limit”. I was treated with respect, like every other customer, and not as a science experiment.

Working effectively with a personal trainer requires trust, teamwork, strong communication, and information sharing. To advance my goals, I had to trust my trainer and disclose personal history and medical information. I authorized release of medical records so that my trainer would understand the “clinical elements” of my mobility issues, treatment, and how I functioned. There is risk and vulnerability in such disclosure. Good trainers understand the concept of confidentiality. Disclosure of personal information never occurs without permission of the client. As part of his assessment, my trainer requested to speak with my physicians. Based on the exchange, medical information, and related documentation, exercise routines were changed and adapted. A good personal trainer always represents you and has your interests in mind.

Baseline goals were set to improve my flexibility, strength, and range of motion. My doctors and trainer had the same goals in mind and endorsed a holistic approach to achieve the defined goals. My trainer was key in implementing this approach. He set up the fitness routine and made connections that other practitioners do not always see. I was questioned about my food intake, sleeping patterns, water consumption, and multiple other factors. Personal trainers like Jason know about the mechanics of the body. From Jason’s coaching, I learned, for example, what the impact of not eating breakfast does to the body. It fell to me to put this education in practice (e.g. change what I ate and perform the developed exercise routines).

A good trainer identifies important clinical elements but still keeps the person first. They show an interest in life outside the 30-minute training session. Jason, for example, came to understand that I was motivated through competition but also learned to distinguish the difference between general muscle stiffness and when I was tense from life stressors. A good trainer thinks outside the box. There have been multiple occasions when I was not able to perform an exercise on the first try. Jason supported me to find another way to do the exercise. Success happens through trial and error. For example, part of my routine to gain improved mobility includes using a pendulum press. This machine is used to strengthen lower leg muscle groups. Foot position is important when you use this machine, or it can cause damage to your knees. Jason saw that I had issues with keeping proper body alignment and put a ball between my knees to keep proper form. For someone with physical issues, it does not take some monumental adaptation for them to perform a task or participate.

Support of site management is important. Plaza Fitness Management fosters a welcoming environment through its staff. I was a customer first and the disability was secondary. There is commitment to client success. My progress toward health and wellness has been achieved by bringing together multiple partners - the doctors, the physical therapist, fitness studio management, and the personal trainer. Each partner offered specific knowledge, technical expertise, and recommendations to support my goals. I had to create a collaborative team that would help me to address my immediate health issues and also support my long-term goal to walk better.

Help Yourself: Seek The Answers And Professional Advice You Need To Live A More Fulfilling Life – A Trainer’s Perspective

When someone contacts Plaza Fitness at Stuyvesant Plaza, chances are they’ve heard about us from a member or have been referred by a medical professional. Established in 2003, Plaza Fitness at Stuyvesant Plaza is a specialized personal training center with more than 600 active members. New members that come to our center make individual lifestyle changes-changes from living a sedentary lifestyle, changes from unhealthy eating habits, or in Kerry’s case, to improve a condition that has limited her ability to use her lower body.

All new members at Plaza Fitness undergo Lifestyle Training Consultations with a certified fitness professional. During the consultations, their current fitness level, nutritional habits, stress management techniques, and other relevant background information is analyzed. A second consultation session includes a comprehensive movement analysis. Research-based recommendations for cardio-respiratory endurance, resistance training, and flexibility are also planned by the fitness professional based upon the individual goals and assessment data. The team of professionals at Plaza Fitness will collaborate with each member to accurately and safely design an exercise program that will best meet individual goals. It has been our experience that Plaza Fitness Member exercise programs are so effective that for every ten new members, eight will elect to seek basic, optimal, or complete support, that is, personal trainer appointments once, twice, or three times per week.

I first met Kerry about a year ago while she was using our strength machines, specifically the Nautilus circuit selectorized strength machines, as part of her workout routine. As a new addition to the Plaza Fitness team, I approached Kerry because I wanted to get to know all of our members on a first name basis and make myself available if assistance was needed. After introductions, I was delighted to hear Kerry talk about how she became part of the Plaza Fitness family, her current workout plan, and her issues from Cerebral Palsy, a physical condition she has had since birth. Although I studied Physical Education at Cortland University I knew little about Cerebral Palsy. It wasn’t until Kerry welcomed me into her life and gave me the opportunity to learn about the condition and her personal experiences with it, that I began to understand its challenges. Kerry and I began to work together, with the aid of other medical professionals, so that she could reach her goal of optimal health.

Kerry’s goal to achieve optimal health and wellness included gaining more functional movement patterns in order to reduce the pain she experienced throughout her upper body when using crutches. She also wanted to maintain her level of progress, in part, because of the potential secondary conditions that can cause potential loss of function for people with physical conditions as they age. After speaking to Kerry about her goals, I observed her gait as well as how she was taught to use the new crutches. During my observation, Kerry seemed extremely tense and rigid as she relied heavily on the crutches strapped to her arms to move. The crutches are designed to give the user more leverage and remove the stress from the upper body. Kerry relied primarily on her upper body muscles to move. Kerry explained that the new devices failed to relieve joint, spinal, and back pain and that the crutches felt cumbersome. The devices trapped her arms not allowing for a quick escape when she fell. The new walking devices increased her risk for injury and seemed to give Kerry minimal benefit.

Kerry consulted with a physical therapist prior to coming to Plaza Fitness. Progressing beyond her work with the physical therapist, Kerry and I worked together on exercises to promote body awareness, that is, to develop her ability to sense the position, location, orientation, and movement of her body including the muscles and joints. I taught her how to fall with the crutches to reduce and prevent injury, and how to recruit muscles throughout the body to improve balance while standing and attempting to walk. For the first several months, we focused on taking smaller strides to walk and muscle conditioning for the whole body. I performed stretching techniques to improve the range of motion in her tight muscles and concentrated on strengthening her weak and under used muscle groups.

Kerry developed more control as she exercised, however she could not successfully adapt to the crutches. This prompted Kerry to find a more useful solution. She consulted with an assistive technology vendor who sent her a pair of walking poles that resemble poles that a skier uses. The walking poles gave Kerry the ability to use more of her lower body to move, with less obstruction. The devices reduced the frequency of falls and inspired hope. They gave her a better sense of safety and a new direction on her journey to walk without any assistance. Kerry spent less time worrying about falling, and more time thinking about conditioning her core muscles which include the Abdominals, Obliques, Glutes, and the lower back, and her leg muscles to contract, relax and stretch.

When someone crosses paths with Kerry Wiley, they will soon discover the assertiveness and determination she has. The walking poles were a break through for Kerry but she still was not satisfied. She decided to look into the latest technologies and drug interventions for individuals with Cerebral Palsy. She learned about Botox, a drug that would paralyze but weaken injected muscles to help reduce involuntary muscular contractions. It does this by blocking signals from the brain to contract where the nerve endings and muscles meet. The end result could be less muscular tension and more muscle control. Kerry thought this drug would compliment her progression toward optimal health and when she met with her neurologist, he concurred. He prescribed a series of injections in the most spastic or tight muscle groups, as well as exercises to improve her walking and overall motor functions. The injection cycle typically occurs at three-month intervals. The neurologist recommended that Kerry develop muscular stretch in the agonist or same injected muscle groups and muscular contraction in the antagonist or opposing muscle groups.

In order for Kerry to maximize the benefits of this new treatment, I designed a workout program that she could do individually outside Plaza Fitness, so that we could concentrate on more difficult exercises that needed to be done at the studio with my assistance. Over time, Kerry’s progress was visible. Kerry told stories about strangers that she would see on her daily commute to and from work that would remark about the changes and progress they observed in her walking. She would come in and comment about “her family and friends being speechless.” When she went in for her second series of shots four months later, the doctor was pleased with what he saw and confirmed that the Botox injections and exercises should continue. This was encouraging news to Kerry and me. Although the doctor’s prescription was helpful, I knew it would not derail Kerry in her pursuit to walk device free.

Kerry continued to perform her exercise routines and researched the latest exercise modalities for her condition. She came across exercises performed in water by people with Cerebral Palsy. She learned how the buoyancy from the water could affect and improve balance. Without any hesitation, she joined a nearby facility to gain pool access and asked me to design an exercise program that she could perform in water. Exercising in the water allowed her to work muscles in her legs while emphasizing her core muscles in her mid-section and around her spine. This work created an enhanced sense of body awareness resulting in better posture and more balance while standing.

Kerry’s next step toward optimal health and wellness would be to take steps on a treadmill. Walking on a treadmill was one of Kerry’s long-term goals toward optimum health and wellness. With her newfound balance and improved walking patterns she successfully took steps that enabled her to keep up with a moving treadmill. She used the muscles in her core and legs to shift her weight from side to side to walk for several minutes at a time. As she performed this exercise, I had her make adjustments so that she could walk more easily but most importantly, safely. After a couple of sessions with Kerry working on the treadmill, I noticed a clicking noise coming from her lower spine region. At my recommendation, Kerry made an appointment with her doctor to find out the cause of the clicking. After speaking to the physiatrist, a physician who specializes in physical medicine and rehabilitation, Kerry found out that the clicking can be caused by muscle tightness. Kerry agreed to try another medication to reduce the muscle stiffness. We hope that with this new medication in combination with the Botox injections Kerry will continue to experience relief from the spasticity or tightness in her muscles. With a reduction in spasticity, Kerry intends to continue to progress to walking device free.

She exemplifies the idea of controlling your own destiny related to heath. Her continuing quest to find new and innovative ways to deal with her CP has made it possible for her to grow at amazing levels of ability that some thought she would never be able to reach. When I decided to pursue a degree in health and fitness, I dreamed of helping people. At Plaza Fitness, member satisfaction is what we strive for. Supporting Kerry to achieve a higher quality of life has been inspiring.

Taking control of personal health and wellness starts from building collaboration between multiple professionals. As exemplified here, it is about finding the right people, expertise, and tools to achieve defined health goals. The foundation for success originates from taking personal responsibility about health choices. It is about continuous relationship building, information sharing, and using creative problem solving to adapt to changes and progress as well as finding the right program and staff match. While there is no one magic formula, we hope we have offered some considerations to promote improved health and wellness for individuals.

About the Authors: Kerry Wiley earned a Masters of Social Work from the State University of New York at Albany and has worked for over ten years with the New York State Developmental Disabilities Planning Council (NYS DDPC). Jason Berner earned a Bachelor of Science degree in Physical Education with a concentration in Sport Management from the State University of New York College at Cortland and has worked as a Fitness Professional for over seven years.

For article inquiries, please contact Kerry Wiley via email at: kwiley01@nycap.rr.com or Plaza Fitness at Stuyvesant Plaza at info@plazafitness.net or visit www.plazafitness.net/.

May 2007

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