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<table style="width:100%; border-collapse: collapse;"><tbody><tr><th style="text-align: left; padding: 8px;">Question</th><th style="text-align: left; padding: 8px;">Answer / Findings</th></tr><tr><td style="padding: 8px;">DOES YOUR FOOT POSTURE MATTER?</td><td style="padding: 8px;">• NOT on foot pain (1) • NOT on knee pain (2,3) • MAYBE on lower back pain in women (4)</td></tr><tr><td style="padding: 8px;">DOES YOUR KYPHOSIS MATTER?</td><td style="padding: 8px;">• NOT on your vertebral bone health (5,6) • NOT on shoulder and neck pain (7) • EXCESSIVE kyphosis is associated with lower back pain and more importantly with a negative self image (8–10)</td></tr><tr><td style="padding: 8px;">DOES YOUR LUMBAR LORDOSIS MATTER?</td><td style="padding: 8px;">• The optimal lordotic angle is still unknown and differs greatly between different individuals (11) • Hyperlordosis provides a greater advantage in lifting (12) • Hypolordosis and NOT hyperlordosis is correlated with low back pain (13,14), but people with and without low back pain have very similar lordotic angles (15) • NOT on your lumbar discs’ health (16,17) • MAYBE associated with Facet Joint Arthritis (but not necessarily pain) (18)</td></tr><tr><td style="padding: 8px;">DOES YOUR PELVIC POSTURE MATTER?</td><td style="padding: 8px;">• NOT on low back pain (19,20)</td></tr><tr><td style="padding: 8px;">DOES YOUR SCOLIOSIS MATTER?</td><td style="padding: 8px;">• ONLY in extreme cases (medically assessed) (21)</td></tr><tr><td style="padding: 8px;">DOES YOUR NECK POSTURE MATTER?</td><td style="padding: 8px;">• ONLY in extreme cases (22) and when the duration of sitting posture was excessive (more than 1 hour long) (23,24) • “Abnormal” neck posture and neck pain are probably coincidental and are not well associated (25), even after 10 years follow up (26) • Unlike hyperlordosis, hypolordosis of the neck is correlated with pain (27)</td></tr></tbody></table>As you can see from the table, static posture is not always associated with pain and injury even after 10 years of follow up (26), which means that if you are trying to correct your or your clients’ posture, you may be wasting your time!  More importantly, even in the cases where correlation between posture and pain/injury was found, we need to understand that such correlations mostly exist in severe cases of certain postural dysfunction such as severe thoracic hyperkyphosis and scoliosis (8,9,21).  We should also know that correlation does NOT necessarily mean causality. For example, if we found out that more people eat shawarma at night, and car accident frequency is also higher at night, it doesn’t mean that eating shawarma at night causes more car accidents!  Another question to consider is who existed first: the chicken or the egg? In some of the studies that found correlation between pain and posture (retrospective cohort studies or cross sectional studies), it wasn’t known whether the static posture induced pain, or the existing pain caused a change in posture as a compensatory pattern.  These questions need to be answered before we assume that there exists a bad posture, which is an unsolved question itself (28). In the meantime, we need to realize that static posture is not as important as we once thought, unlike some claims by individuals and organizations that may be driven by commercial purposes only.  In our next awareness article, we’re going to explore how our perception of posture may be a greater source of pain than posture itself. Stay tuned!  REFERENCES  1.	Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Association of planus foot posture and pronated foot function with foot pain: the Framingham foot study. Arthritis Care Res. 2013 Dec;65(12):1991–9.  2.	de Groot R, Malliaras P, Munteanu S, Payne C, Morrissey D, Maffulli N. Foot posture and patellar tendon pain among adult volleyball players. Clin J Sport Med Off J Can Acad Sport Med. 2012 Mar;22(2):157–9.  3.	Kedroff L, Galea Holmes MN, Amis A, Newham DJ. Effect of patellofemoral pain on foot posture and walking kinematics. Gait Posture. 2019;70:361–9.  4.	Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatol Oxf Engl. 2013 Dec;52(12):2275–82.  5.	Katzman WB, Vittinghoff E, Kado DM, Lane NE, Ensrud KE, Shipp K. Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA. 2016 Mar;27(3):899–903.  6.	Ribom EL, Kindmark A, Ljunggren Ö. Hyperkyphosis and back pain are not associated with prevalent vertebral fractures in women with osteoporosis. Physiother Theory Pract. 2015 Mar;31(3):182–5.  7.	Tsunoda D, Iizuka Y, Iizuka H, Nishinome M, Kobayashi R, Ara T, et al. Associations between neck and shoulder pain (called katakori in Japanese) and sagittal spinal alignment parameters among the general population. J Orthop Sci Off J Jpn Orthop Assoc. 2013 Mar;18(2):216–9.  8.	Petcharaporn M, Pawelek J, Bastrom T, Lonner B, Newton PO. The relationship between thoracic hyperkyphosis and the Scoliosis Research Society outcomes instrument. Spine. 2007 Sep 15;32(20):2226–31.  9.	Bezalel T, Carmeli E, Kalichman L. Scheuermann’s Disease: Radiographic Pathomorphology and Association with Clinical Features. Asian Spine J. 2019 Feb;13(1):86–95.  10.	Villafañe JH, Bissolotti L, Zaina F, Arienti C, Donzelli S, Negrini S. Thoracic hyperkyphosis non invasively measured by general practitioners is associated with chronic low back pain: A cross-sectional study of 1364 subjects. J Bodyw Mov Ther. 2018 Jul;22(3):752–6.  11.	Been E, Kalichman L. Lumbar lordosis. Spine J Off J North Am Spine Soc. 2014 Jan;14(1):87–97.  12.	Pavlova AV, Meakin JR, Cooper K, Barr RJ, Aspden RM. Variation in lifting kinematics related to individual intrinsic lumbar curvature: an investigation in healthy adults. BMJ Open Sport Exerc Med. 2018;4(1):e000374.  13.	Chun S-W, Lim C-Y, Kim K, Hwang J, Chung SG. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine J Off J North Am Spine Soc. 2017;17(8):1180–91.  14.	Masaki M, Ikezoe T, Yanase K, Ji X, Umehara J, Aoyama J, et al. Association of Pain History and Current Pain With Sagittal Spinal Alignment and Muscle Stiffness and Muscle Mass of the Back Muscles in Middle-aged and Elderly Women. Clin Spine Surg. 2019 Feb 11;  15.	Laird RA, Gilbert J, Kent P, Keating JL. Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014 Jul 10;15:229.  16.	Schenk P, Läubli T, Hodler J, Klipstein A. Magnetic resonance imaging of the lumbar spine: findings in female subjects from administrative and nursing professions. Spine. 2006 Nov 1;31(23):2701–6.  17.	Pape JL, Brismée J-M, Sizer PS, Matthijs OC, Browne KL, Dewan BM, et al. Increased spinal height using propped slouched sitting postures: Innovative ways to rehydrate intervertebral discs. Appl Ergon. 2018 Jan;66:9–17.  18.	Jentzsch T, Geiger J, König MA, Werner CML. Hyperlordosis is Associated With Facet Joint Pathology at the Lower Lumbar Spine. Clin Spine Surg. 2017;30(3):129–35.  19.	Levangie PK. The association between static pelvic asymmetry and low back pain. Spine. 1999 Jun 15;24(12):1234–42.  20.	Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Phys Ther. 2000 Mar;80(3):261–75.  21.	Ilharreborde B. Sagittal balance and idiopathic scoliosis: does final sagittal alignment influence outcomes, degeneration rate or failure rate? Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2018;27(Suppl 1):48–58.  22.	Brink Y, Crous LC, Louw QA, Grimmer-Somers K, Schreve K. The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: a prospective study. Man Ther. 2009 Dec;14(6):647–53.  23.	Murphy S, Buckle P, Stubbs D. Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon. 2004 Mar;35(2):113–20.  24.	Prins Y, Crous L, Louw QA. A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents. Physiother Theory Pract. 2008 Aug;24(4):221–42.  25.	Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2007 May;16(5):669–78.  26.	Okada E, Matsumoto M, Ichihara D, Chiba K, Toyama Y, Fujiwara H, et al. Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2009 Nov;18(11):1644–51.  27.	Yoon SY, Moon HI, Lee SC, Eun NL, Kim YW. Association between cervical lordotic curvature and cervical muscle cross-sectional area in patients with loss of cervical lordosis. Clin Anat N Y N. 2018 Jul;31(5):710–5.  28.	Claus AP, Hides JA, Moseley GL, Hodges PW. Is ‘ideal’ sitting posture real?: Measurement of spinal curves in four sitting postures. Man Ther. 2009 Aug 1;14(4):404–8.

As you can see from the table, static posture is not always associated with pain and injury even after 10 years of follow up (26), which means that if you are trying to correct your or your clients’ posture, you may be wasting your time! 

Does Your Posture Really Matter?

As we have heard it back when we were teens in the gym, we’re sure you have too. “Do not lift heavy weights in the gym or you will not grow!”, or maybe the notorious “you will hurt yourself”. These sayings are mostly said by the older generation. Nonetheless, we keep hearing it from people of all ages. Nowadays, lifting weights by children and adolescents is still frowned upon, however, ironically, it’s okay for a teen to join the gymnastics or soccer team. It is socially acceptable to enroll your child in any sports activity no matter the incidence rate! During the past years even rugby and similar sports have gained great traction, yet tell someone your child is lifting weights then you can see visible distress on their face. Let’s discuss the myths regarding heavy weight lifting and see how they hold their stance. Children Lifting Weights Will Have Stunted Growth (Growth plate closure) In order to understand this issue better, we will be explaining a bit of anatomy. The epiphyseal growth plate is a cartilage that is found at the ends of long bones. It is the place where new bone material is added, thus making this bone longer. As the child/adolescent goes into adulthood, this plate closes (around 18 to 20 years old)(1). The myth here states that heavy lifting can cause premature closure of the epiphyseal plate and ultimately hindering the growth of the child or adolescent. Things get a bit tricky here regarding this myth. One of the advantages of strength training is bone strengthening which consequently aids in the development of bones especially in young adults. However, lifting here is a double-edged sword. Although it may not cause premature closure of the epiphyseal plate but it can cause epiphyseal plate injury (2). Epiphyseal plate injury does not happen in adults since after a certain age, it closes and fuses with the rest of the bone and ossifies. Thus, this injury is solely related to adolescents (1). Unfortunately, if the extent of damage of the plate was severe it might cause growth problems in that specific bone leading to length mismatch between limbs (3); this does not mean that lifting injuries makes anyone shorter. You may be thinking now that weight lifting does cause injury and may hurt children. To put things in perspective, data on sports related epiphyseal fractures from more than 33 case reports and case series studies showed that most epiphyseal fractures were a result of playing football, soccer and basketball as well as gymnastics. Only three reports out of the 33 discussed these fractures as a result of weight lifting (1). Conclusion: When performed properly, weight lifting in children and adolescent does not cause growth plate injuries and does not stunt growth more than any other sport. Increase Injury Risk Resistance training can be highly beneficial in terms of strengthening the muscle and bone and thus actually reducing risk of injury as well(4). One study showed that the risk of injury from heavy contact sports such as rugby is far greater than the risk of injury from resistance training(5). In addition to that, the risks from lifting can be heavily mitigated by having a qualified coach with a concise lifting program (6). Conclusion: we have to acknowledge that although resistance training does pose a risk of injury, it is not greater than any other sport in which parents are okay with having their children participate in such as basketball (6). Bone Health Cardio-respiratory training has some well-established health benefits for youth and adults alike, but recently resistance training has also showed an array of health, and other, benefits as well. Proper execution of resistance training has shown to help in the strengthening of bones and skeletal muscles(7). The tensile strain and compressive force posed on the bones of teens can be very helpful rather than detrimental since these age groups are at their peak of bone remodeling and this leads to proper bone growth (8). This can significantly help in reducing the risk of osteoporosis later in life (9). Body Composition Another benefit of resistance training in youth can be its positive impact on body composition. There is an obesity pandemic that has been going on for the past decades and it doesn’t seem to be going very well. Resistance training can be a tool utilized to help in mitigating this pandemic by driving the growth of skeletal muscle, movement in general, and in turn lowering fat levels in adolescents(10). Also, since youth are still developing their motor skills, teaching them proper execution of movements would contribute in their motor skill development and proprioception(11). Discipline Adhering to a resistance training program, putting in the needed amount of effort every session can develop healthy habits which are often carried with the child into adulthood. Sticking to a program is not an easy thing to do especially when juggling between school work and social life, and all the temptations of our world. The coach plays a big role here in helping the child focus and be disciplined regardless of any external distractions(12). Also, children can start forming communities within the gym where they influence and challenge each other to get better. Children challenging each other may cause fear of overexertion and potential injury, however, another role of the coach here is ensuring a positive and controlled environment. What You Should Know if Your Child Wants to Lift Weights Proper weight lifting programs have several added health benefits to your child. These benefits range from increased overall strength, increased bone strength, decreased risk of fractures as well as decreased rates of sports-related injuries(6). Risk of injury resulting from weight lifting in children/adolescents does not appear to be greater than other types of sports. Most injuries related to weight lifting in children/adolescents appear to be a result of improper professional supervision, incorrect exercise techniques and heavier loads than what children/adolescents should lift(13). All that being said, it is quite clear that the benefits outweigh the risks when it comes to resistance training for youth, and thus should not be shunned away. It is exceptionally important for them to have guidance on the technicalities of the lifts as well proper execution and programming, so a coach must always serve as a guide to the younger generation. References: 1. Shim KS. Pubertal growth and epiphyseal fusion. Ann Pediatr Endocrinol Metab. 2015 Mar;20(1):8–12.&nbsp; 2. Lipp EJ. Athletic physeal injury in children and adolescents. Orthop Nurs. 1998 Apr;17(2):17–22.&nbsp; 3. Mirtz TA, Chandler JP, Eyers CM. The Effects of Physical Activity on the Epiphyseal Growth Plates: A Review of the Literature on Normal Physiology and Clinical Implications. J Clin Med Res. 2011 Feb;3(1):1–7.&nbsp; 4. Legerlotz K, Marzilger R, Bohm S, Arampatzis A. Physiological Adaptations following Resistance Training in Youth Athletes-A Narrative Review. Pediatr Exerc Sci. 2016 Nov;28(4):501–20.&nbsp; 5. Hamill: Relative safety of weightlifting and weight training - Google Scholar [Internet]. [cited 2020 Dec 23]. Available from: https://scholar.google.com/scholar_lookup?journal=J+Strength+Cond+Res&amp;title=Relative+safety+of+weightlifting+and+weight+training.&amp;author =B.+Hamill&amp;volume=8&amp;publication_year=1994&amp;pages=53-7&amp; 6.&nbsp; Myers AM, Beam NW, Fakhoury JD. Resistance training for children and adolescents. Transl Pediatr. 2017 Jul;6(3):137–43.&nbsp; 7.&nbsp; Faigenbaum AD, Myer GD. Pediatric resistance training: benefits, concerns, and program design considerations. Curr Sports Med Rep. 2010 Jun;9(3):161–8.&nbsp; 8.&nbsp; Behm DG, Faigenbaum AD, Falk B, Klentrou P. Canadian Society for Exercise Physiology position paper: resistance training in children and adolescents. Appl Physiol Nutr Metab. 2008 Jun;33(3):547–61.&nbsp; 9.&nbsp; Guadalupe-Grau A, Fuentes T, Guerra B, Calbet JAL. Exercise and bone mass in adults. Sports Med. 2009;39(6):439–68.&nbsp; 10. McGuigan MR, Tatasciore M, Newton RU, Pettigrew S. Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. J Strength Cond Res. 2009 Jan;23(1):80–5.&nbsp; 11. Behringer M, Vom Heede A, Matthews M, Mester J. Effects of strength training on motor performance skills in children and adolescents: a meta-analysis. Pediatr Exerc Sci. 2011 May;23(2):186–206.&nbsp; 12. Almagro BJ, Sáenz-López P, Moreno JA. Prediction of Sport Adherence Through the Influence of Autonomy-Supportive Coaching Among Spanish Adolescent Athletes. J Sports Sci Med. 2010 Mar 1;9(1):8–14.&nbsp; 13. Faigenbaum AD, Myer GD. Resistance training among young athletes: safety, efficacy and injury prevention effects. Br J Sports Med. 2010 Jan;44(1):56–63.&nbsp; 14. Faigenbaum AD, Kraemer WJ, Blimkie CJR, Jeffreys I, Micheli LJ, Nitka M, et al. Youth Resistance Training: Updated Position Statement Paper From the National Strength and Conditioning Association: Journal of Strength and Conditioning Research. 2009 Aug;23:S60–79.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;

As we have heard it back when we were teens in the gym, we’re sure you have too. “Do not lift heavy weights in the gym or you will not grow!”

Your Children Shouldn’t lift, Or should they?

Whether you are a parent, potential parent, or you know a parent, you should read this. It’s about time we stop hearing the classic phrase: “you’re too young to lift weights”, “lifting weights will make you short”, “lifting weights will damage your bones and joints” … We established previously that resistance training does not make children and adolescents shorter, and we’re going to say it again: you are NEVER too young to lift! As a matter of fact, resistance training has been shown to have numerous health benefits on youth, including (1,2): •	Improved bone health and bone mineral density. •	Improved weight status and body composition. •	Improved cognitive function, especially for youth ages between 6 &amp; 13. •	Improved cardiovascular health. •	Reduced risk of depression and improved psychosocial health. •	More specifically, resistance training can help children (2): o	Build fundamental movement skill profiles&nbsp; o	Improve their strength and power. o	Improve their cardiovascular endurance. o	Reduce sports-related injuries. o	Improve motor skill performance. o	Promote exercise habits throughout adolescence. The improvements in the physiological development that occur in children and adolescents after following an efficient and supervised resistance training program greatly surpass the normal development of the average youth (2,3). For example, bone density can improve four to five times more in resistance-trained adolescents than their sedentary peers (4,5). Even more importantly, the improvement in bone density persists even after training ceases (6). The bottom line is, children and adolescents can and should be doing resistance training as long as it is in a safe environment and under qualified supervision. Make sure that it is always a fun experience to help them MOVE more and lift heavier! References 1.	Physical Activity Guidelines for Americans, 2nd edition. :118. 2.	Faigenbaum AD, Kraemer WJ, Blimkie CJR, Jeffreys I, Micheli LJ, Nitka M, et al. Youth resistance training: updated position statement paper from the national strength and conditioning association. J Strength Cond Res. 2009 Aug;23(5 Suppl):S60-79. 3.	Falk B, Tenenbaum G. The effectiveness of resistance training in children. A meta-analysis. Sports Med Auckl NZ. 1996 Sep;22(3):176–86. 4.	Alvarez-San Emeterio C, Antuñano NP-G, López-Sobaler AM, González-Badillo JJ. Effect of strength training and the practice of Alpine skiing on bone mass density, growth, body composition, and the strength and power of the legs of adolescent skiers. J Strength Cond Res. 2011 Oct;25(10):2879–90. 5.	Nichols DL, Sanborn CF, Love AM. Resistance training and bone mineral density in adolescent females. J Pediatr. 2001 Oct;139(4):494–500. 6.	Specker B, Binkley T. Increased periosteal circumference remains present 12 months after an exercise intervention in preschool children. Bone. 2004;35(6):1383–8.

Whether you are a parent, potential parent, or you know a parent, you should read this.
It’s about time we stop hearing the classic phrase: “you’re too young to lift weights”

You’re NEVER Too Young to Lift!

Whether you are a parent, potential parent, or you know a parent, you should read this. In the age of AirPods and wireless chargers, it’s about time we stop hearing the classic phrase: “you’re too young to lift weights”, or “lifting weights will make you short, look at all the weightlifters”, or “lifting weights will damage your bones and joints”… We can go on with all the myths we hear on a daily basis and the stuff we were exposed to while growing up and it’s about time we set it straight: you are NEVER too young to lift! It is a common misconception that lifting weights is bad for kids and adolescents, because it assumingly puts too much stress on the bones and joints, diverts energy from bone growth so the muscles can grow instead, and the best claim among all is that when your upper traps get bigger, they push your spine down and prevent it from getting taller. The myth that weightlifting stunts growth can be traced back to a misinterpretation of an old Japanese study on children working in mines. Researchers observed that these children were shorter than their peers and assumed the cause was lifting heavy loads. In reality, their reduced stature was far more likely explained by other factors: the chronic stress of harsh labor, poor socioeconomic conditions that affected nutrition and sleep, and spending most of their time underground with limited exposure to natural light. These influences, not resistance training, were the true contributors to their stunted growth. This historical misunderstanding continues to fuel misconceptions, especially when combined with observations about athlete body types in different sports. These claims and misconceptions are supported by the fact that powerlifters and Olympic lifters are generally shorter (1,2). The average height of all weightlifters in the London 2012 Olympics, for example, was 166.6 cm, while the average height of all basketball players in the same event was 192.1cm (3). Basketball players were the tallest in the Olympics, while the shortest athlete was unsurprisingly a weightlifter, Lapua Lapua who is 140 cm tall/short! (3–5). But does this mean that weightlifting makes you shorter while basketball makes you taller? NO. &nbsp; Figure 1 - Average height of weightlifters in London Olympics 2012 The reason these athletes have such contrasting heights is not due to the type of sports they play, and it’s actually vice-versa. To excel in their respective sports, these athletes took advantage of their anthropometrics: basketball players have a better advantage when they’re tall so they can reach the net easily and be able to receive-send better passes, whereas weightlifters have a better advantage being shorter and having relatively shorter limbs, which helps them travel less distance with an incredibly heavyweight. Imagine a 192.1cm weightlifter attempt a snatch vs. a 166.6cm competitor, the taller lifter will have much more distance to travel from the bottom position, putting him in a disadvantage. This doesn’t mean that a tall person cannot become a weightlifter or a shorter person can’t be a basketball player, but this rather just explains why these overall numbers are found (you can read and watch more about the height contribution here). A common concern about resistance training for youth is the injuries caused and delaying growth. But as long as resistance training is supervised and performed in a safe environment, it will not lead to any growth retardation, which is reported by several studies (6–8). As a matter of fact, a 1-year prospective study performed on the incidence of injuries on school children showed that resistance training contributed to only 0.7% of 1576 injuries sustained. The biggest contributors to injury were American football (19%), basketball (15%), and football (2%) (9). Another concern and misconception about youth training is that it may crush the spine and cause injury. This concern was amplified in the 1970s and 1980s when several injuries admitted to hospitals were documented during resistance training (9,10). However, these sustained injuries turned out to be the outcome of very faulty techniques, excessive loading, poorly designed equipment, and lack of adult supervision (9). When performed safely, the benefits of resistance training on kids far outweigh any potential risk. To sum it up, any type of physical activity that kids and adolescents perform in a safe and supervised environment is beneficial and essential for their health. Resistance training should not be feared and can actually improve bone formation and growth that is essential during the development period of a human being (11,12). Make your kids MOVE more and LIFT more! REFERENCES 1.	Keogh JWL, Hume PA, Pearson SN, Mellow P. Anthropometric dimensions of male powerlifters of varying body mass. J Sports Sci. 2007 Oct 1;25(12):1365–76. 2.	Mayhew JL, Piper FC, Ware JS. Anthropometric correlates with strength performance among resistance trained athletes. J Sports Med Phys Fitness. 1993 Jun;33(2):159–65. 3.	Anthropometry of Olympic Athletes 2012 [Internet]. [cited 2019 Jul 29]. Available from: https://www.topendsports.com/events/summer/science/anthropometry-2012.htm 4.	Tuau Lapua Lapua Bio, Stats, and Results [Internet]. Olympics at Sports-Reference.com. [cited 2019 Jul 29]. Available from: http://www.sports-reference.com/olympics/athletes/la/tuau-lapua-lapua-1.html 5.	Tuau Lapua Lapua. In: Wikipedia [Internet]. 2018 [cited 2019 Jul 29]. Available from: https://en.wikipedia.org/w/index.php?title=Tuau_Lapua_Lapua&amp;oldid=825109236 6.	Falk B, Eliakim A. Resistance training, skeletal muscle and growth. Pediatr Endocrinol Rev PER. 2003 Dec;1(2):120–7. 7.	Malina RM. Weight training in youth-growth, maturation, and safety: an evidence-based review. Clin J Sport Med Off J Can Acad Sport Med. 2006 Nov;16(6):478–87. 8.	Burt LA, Greene DA, Ducher G, Naughton GA. Skeletal adaptations associated with pre-pubertal gymnastics participation as determined by DXA and pQCT: a systematic review and meta-analysis. J Sci Med Sport. 2013 May;16(3):231–9. 9.	Faigenbaum AD, Kraemer WJ, Blimkie CJR, Jeffreys I, Micheli LJ, Nitka M, et al. Youth resistance training: updated position statement paper from the national strength and conditioning association. J Strength Cond Res. 2009 Aug;23(5 Suppl):S60-79. 10.	National Electronic Injury Surveillance System (NEISS) [Internet]. CPSC.gov. 2018 [cited 2019 Jul 30]. Available from: https://www.cpsc.gov/Research--Statistics/NEISS-Injury-Data 11.	Vicente-Rodríguez G. How does exercise affect bone development during growth? Sports Med Auckl NZ. 2006;36(7):561–9. 12.	Lloyd RS, Faigenbaum AD, Stone MH, Oliver JL, Jeffreys I, Moody JA, et al. Position statement on youth resistance training: the 2014 International Consensus. Br J Sports Med. 2014 Apr;48(7):498–505.

Whether you are a parent, potential parent, or you know a parent, you should read this.
In the age of AirPods and wireless chargers, it’s about time we stop hearing the classic phrase: “you’re too young to lift weights”

Lifting Weights Won’t Make Children Shorter!

Isometric exercises involve muscle contraction without a change in joint angle and any external muscle movement i.e., without lengthening or shortening the muscle (1). It is performed by holding a static position for a set period of time and can be performed without the need of complex equipment.&nbsp; &nbsp; &nbsp; In this mini article, we will discuss the benefits of isometric training, and whether it can replace dynamic strength training exercises. &nbsp;First, isometric training is often used in rehab settings. Studies have shown that it is suitable for people with injury or any medical condition that restricts movement (2), it also helped in relieving low back pain (3), knee pain (4), and neck pain (5). Moreover, isometric training can improve stability and the ability to hold weight over longer periods (6). Second, Isometric training alone, was shown to be effective in increasing isometric muscular strength and hypertrophy (7,8) while requiring less energy demands than dynamic strength training (9,10). Especially during long isometric contractions (holding position for 30 seconds) which induced more strength and hypertrophy gains when compared to short isometric contraction (holding position for 3 seconds) (8). Nevertheless, it is important to note that even though isometric training can elicit increased muscular strength and hypertrophy adaptations without inducing the same level of fatigue compared to that of dynamic training, these adaptations are less pronounced compared to dynamic training. Hence, isometric training should not replace dynamic strength training (1). Third, isometric training produces length specific adaptations (11). Which means, that the increase in strength and hypertrophy will be specific to the position in which the athlete is holding the contraction. Although this might be considered as a limitation, it can be turned to an advantage if programmed properly. In case, the athlete has a biomechanical disadvantage at a certain joint, adding some isometric exercises at that specific joint can help restore the length-tension relationship. Fourth, although isometric training was previously associated with exaggerated hypertensive responses and contraindicated when training hypertensive individuals. Recent analyses suggested that isometric exercise might reduce BP in greater amplitudes than with cardiovascular and dynamic resistance training (12). However, due to the acute increase in BP as a response to exercise and possible complications, a medical clearance needs to be obtained prior to training and low to moderate intensities should be used to produce safe and minimal hemodynamic responses (13). All the benefits mentioned above are related to the general programming, but what about their effect on dynamic sports performance? The studies in this regard are not 100% conclusive and most of them show better results when using dynamic strength training protocols. Still, as with general programming, performance was improved in some areas. In sports requiring ballistic limb motions such as Muay Thai and MMA, isometric training led to greater improvements in impact force when compared to dynamic core exercises, on the other hand, dynamic strength training was superior in turns on strike velocity (14). Other studies that used multi-joint explosive isometric exercises showed improvement in both countermovement and horizontal jump performance (15). In cycling, isometric strength training led to a decrease in oxygen cost during moderate intensity exercise (16). Which means that the oxygen demands were less for the same bout. This decrease in oxygen cost was mainly attributed to muscle efficiency in extracting oxygen, hence, aerobic capabilities neuromuscular characteristics improved (16). As with other parameters, this improvement was also reported when using dynamic strength training protocols (17). Takeaway Message Isometric training can be added to the athlete’s program as a supplement to regular dynamic training since it helps in: ✓ Acquiring positive neuromuscular adaptations while inducing less fatigue. ✓ Improving strength at a joint that has biomechanical disadvantage. Especially when the length-tension relationship at the joint is altered. ✓ Improving some sports specific movements. ✓ Reducing both systolic and diastolic blood pressure in hypertensive individuals training at low to moderate intensities. References 1.&nbsp; Lum D, Barbosa TM. Brief Review: Effects of Isometric Strength Training on Strength and Dynamic Performance. Int J Sports Med. 2019 May;40(6):363–75.&nbsp; 2.&nbsp; Rosa UH, Velásquez Tlapanco J, Lara Maya C, Villarreal Ríos E, Martínez González L, Vargas Daza ER, et al. [Comparison of the effectiveness of isokinetic vs isometric therapeutic exercise in patients with osteoarthritis of knee]. Reumatol Clin. 2012 Feb;8(1):10–4.&nbsp; 3.&nbsp; Rhyu H-S, Park H-K, Park J-S, Park H-S. The effects of isometric exercise types on pain and muscle activity in patients with low back pain. J Exerc Rehabil. 2015 Aug;11(4):211–4.&nbsp; 4.&nbsp; Anwer S, Alghadir A. Effect of isometric quadriceps exercise on muscle strength, pain, and function in patients with knee osteoarthritis: a randomized controlled study. J Phys Ther Sci. 2014 May;26(5):745–8.&nbsp; 5.&nbsp; Khan M, Soomro RR, Ali SS. The effectiveness of isometric exercises as compared to general exercises in the management of chronic non-specific neck pain. Pak J Pharm Sci. 2014 Sep;27(5 Suppl):1719–22.&nbsp; 6.&nbsp; Lee BCY, McGill SM. Effect of long-term isometric training on core/torso stiffness. J Strength Cond Res. 2015 Jun;29(6):1515–26.&nbsp; 7.&nbsp; Schott J, McCully K, Rutherford OM. The role of metabolites in strength training. II. Short versus long isometric contractions. Eur J Appl Physiol. 1995;71(4):337–41.&nbsp; 8.&nbsp; Balshaw TG, Massey GJ, Maden-Wilkinson TM, Tillin NA, Folland JP. Training-specific functional, neural, and hypertrophic adaptations to explosive- vs. sustained-contraction strength training. J Appl Physiol (1985). 2016 Jun 1;120(11):1364–73.&nbsp; 9.&nbsp; Beltman JGM, van der Vliet MR, Sargeant AJ, de Haan A. Metabolic cost of lengthening, isometric and shortening contractions in maximally stimulated rat skeletal muscle. Acta Physiol Scand. 2004 Oct;182(2):179–87.&nbsp; 10.&nbsp; Newham DJ, Jones DA, Turner DL, McIntyre D. The metabolic costs of different types of contractile activity of the human adductor pollicis muscle. J Physiol. 1995 Nov 1;488 ( Pt 3):815–9.&nbsp; 11.&nbsp; Folland JP, Hawker K, Leach B, Little T, Jones DA. Strength training: isometric training at a range of joint angles versus dynamic training. J Sports Sci. 2005 Aug;23(8):817–24.&nbsp; 12.&nbsp; Carlson DJ, Dieberg G, Hess NC, Millar PJ, Smart NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc. 2014 Mar;89(3):327–34.&nbsp; 13.&nbsp; Williams MA, Haskell WL, Ades PA, Amsterdam EA, Bittner V, Franklin BA, et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2007 Jul 31;116(5):572–84.&nbsp; 14.&nbsp; Lee B, McGill S. The effect of core training on distal limb performance during ballistic strike manoeuvres. J Sports Sci. 2017 Sep;35(18):1–13.&nbsp; 15.&nbsp; Tsoukos A, Bogdanis GC, Terzis G, Veligekas P. Acute Improvement of Vertical Jump Performance After Isometric Squats Depends on Knee Angle and Vertical Jumping Ability. J Strength Cond Res. 2016 Aug;30(8):2250–7.&nbsp; 16.&nbsp; Zoladz JA, Szkutnik Z, Majerczak J, Grandys M, Duda K, Grassi B. Isometric strength training lowers the O2 cost of cycling during moderate-intensity exercise. Eur J Appl Physiol. 2012 Dec;112(12):4151–61.&nbsp; 17.&nbsp; Støren O, Helgerud J, Støa EM, Hoff J. Maximal strength training improves running economy in distance runners. Med Sci Sports Exerc. 2008 Jun;40(6):1087–92.

Isometric exercises involve muscle contraction without a change in joint angle and any external muscle movement i.e., without lengthening or shortening the muscle

Isometric Training

How many times have you been asked by someone if s/he should buy a waist trainer or a slimming belt to lose belly fat? Now that summer is here and the “beach body” epidemic is raging, you’re probably being asked this question even more. Slimming belts are often marketed as aids in fat loss and claimed to help you sweat your fat away. People who wear slimming belts during workouts often notice a significant drop in their body weight after their workout, with most, if not all, of that weight lost as sweat. However, fat is barely lost as sweat (1). In fact and unpopular to common beliefs, fat is mainly excreted as carbon dioxide CO2 (2), and part of the remainder is excreted as water, which can leave the body through sweat, urine, breath, feces, tears, or other bodily fluids (2). The problem in using slimming belts is that the sweat lost during a workout is regained when we drink enough water; hence, the weight lost after a workout due to fluid loss is replaced in 24-48 hours, given proper hydration strategies that are essential for our health and safety (3,4). Moreover, losing excessive amounts of sweat is counterintuitive. During exercise, sweat is a favorable way of regulating our core temperature (5,6). The body releases excess heat through the evaporation of sweat. Since slimming belts are impermeable in which they trap the sweat released from the body, they can create a microclimate that is as hot as our body temperature (5). This may inhibit heat regulation and cause even more sweat to be excreted from our bodies in an attempt to cool itself down. This leads to dehydration, and then a serious heat illness may occur (5,7). So, slimming belts are not only ineffective for fat loss, but they may also induce a heat-related injury if accompanied by dehydration. The only way to lose fat is through a caloric deficit. Takeaway Message The bottom line is, investing money and effort into buying a slimming belt that pretty much does nothing but makes you lose water (that you should regain within the next couple of days) is not worth it. We cannot stress enough on the importance of proper communication and education of our trainees and the general population when it comes to investing in quick fixes, fads, and trends that don’t work. The public needs our help and guidance, and we should INSPIRE them to MOVE more not to buy more! REFERENCES<ol><li>Free fatty acids and sterols in human eccrine sweat. - PubMed - NCBI [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://www.ncbi.nlm.nih.gov/pubmed/2638916">https://www.ncbi.nlm.nih.gov/pubmed/2638916</a></li><li>When somebody loses weight, where does the fat go? | The BMJ [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://www.bmj.com/content/349/bmj.g7257">https://www.bmj.com/content/349/bmj.g7257</a></li><li>Exercise and Fluid Replacement: Brought to you by the Americ... : ACSM’s Health &amp; Fitness Journal [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://journals.lww.com/acsm-healthfitness/fulltext/2013/07000/Exercise_and_Fluid_Replacement__Brought_to_you_by.3.aspx">https://journals.lww.com/acsm-healthfitness/fulltext/2013/07000/Exercise_and_Fluid_Replacement__Brought_to_you_by.3.aspx</a></li><li>Exercise and Fluid Replacement : Medicine &amp; Science in Sports &amp; Exercise [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://journals.lww.com/acsm-msse/Fulltext/2007/02000/Exercise_and_Fluid_Replacement.22.aspx">https://journals.lww.com/acsm-msse/Fulltext/2007/02000/Exercise_and_Fluid_Replacement.22.aspx</a></li><li>American Council on Exercise Personal Trainer Manual, 5th Edition. 5th edition. San Diego, Calif: American Council on Exercise; 2014.</li><li>M. Gleeson. Temperature regulation during exercise. - PubMed - NCBI [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://www.ncbi.nlm.nih.gov/pubmed/9694408">https://www.ncbi.nlm.nih.gov/pubmed/9694408</a></li><li>Exertional Heat Illness during Training and Competition : Medicine &amp; Science in Sports &amp; Exercise [Internet]. [cited 2019 Jun 18]. Available from: <a href="https://journals.lww.com/acsm-msse/Fulltext/2007/03000/Exertional_Heat_Illness_during_Training_and.20.aspx">https://journals.lww.com/acsm-msse/Fulltext/2007/03000/Exertional_Heat_Illness_during_Training_and.20.aspx</a></li></ol>

How many times have you been asked by someone if s/he should buy a waist trainer or a slimming belt to lose belly fat? Now that summer is here and the “beach body” epidemic is raging, you’re probably being asked this question even more.

Are Slimming Belts Useless

Are Slimming Belts Useless?

The Evidence-Based Practice (EBP) model is a framework for decision-making that integrates three critical factors (1,2):<ol><li data-list="ordered" class="ql-indent-1">Best available evidence</li><li data-list="ordered" class="ql-indent-1">Professional’s expertise and experience</li><li data-list="ordered" class="ql-indent-1">Client’s values, preferences, and experiences</li></ol> To excel in the fitness and coaching profession, personal trainers and fitness instructors must balance these three pillars. The process begins with referencing the best available evidence to inform decisions. However, exercise science evolves continuously, with guidelines frequently updated or revised. Moreover, evidence is rarely definitive or universally applicable, which can create challenges for the evidence-based coach. The Role of Professional ExperienceWhile scientific evidence provides a foundation, the professional’s expertise fills in gaps when research is inconclusive or context-specific. However, over-reliance on experience can result in inflated confidence without sufficient scientific backing. This phenomenon has been described as "making the same mistake with increasing confidence over an impressive number of years” (3). Trainers who depend too heavily on anecdotal experience might dismiss new research, resorting to familiar client success stories. This approach risks overlooking important variables and limiting growth. Considering Client PerspectivesClient preferences and beliefs are often underestimated in coaching, based on the notion that “clients do not know what they’re talking about.” While clients seek professional guidance precisely because of limited expertise, their input is crucial. Exercise science ultimately aims to enhance health, safety, and physical independence. Involving clients in the decision-making process fosters trust, commitment, and adherence, helping them fully engage in their fitness journeys. Incorporating Emerging ResearchStaying current with emerging research strengthens the evidence-based coaching process. For example, recent studies on motivational interviewing techniques have shown improvements in client adherence and behavior change (4). Similarly, research on personalized fitness assessments continues to reshape program design for optimal results (5). These advancements emphasize the dynamic nature of evidence-based coaching. Takeaway MessagesEvidence-based coaching combines scientific research, professional expertise, and client input to create personalized, effective fitness programs. Coaches who integrate all three elements can navigate the ever-changing exercise science landscape while fostering meaningful client relationships. References<ol><li data-list="ordered" class="ql-indent-1">Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996 Jan 13;312(7023):71–2.</li><li data-list="ordered" class="ql-indent-1">Luckmann R. Evidence-Based Medicine: How to Practice and Teach EBM, 2nd Edition: By David L. Sackett, Sharon E. Straus, W. Scott Richardson, William Rosenberg, and R. Brian Haynes, Churchill Livingstone, 2000. J Intensive Care Med. 2001 May 1;16(3):155–6.</li><li data-list="ordered" class="ql-indent-1">O’Donnell M. Sceptic’s Medical Dictionary. London: John Wiley &amp; Sons; 1997. 216 p.</li><li data-list="ordered" class="ql-indent-1">Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. 3rd ed. New York: Guilford Press; 2012.</li></ol>ACSM. ACSM’s Guidelines for Exercise Testing and Prescription. 11th ed. Philadelphia: Wolters Kluwer; 2021.

To excel in the fitness and coaching profession, personal trainers and fitness instructors must balance these three pillars. The process begins with referencing the best available evidence to inform decisions.

What is Evidence-Based Coaching

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects a substantial number of women worldwide, estimated between 7% and 15% of all women (1). PCOS manifests with both physical and emotional symptoms, including excessive facial hair growth, acne, irregular or absent menstruation (amenorrhea), and infertility (2). Why Does It Occur? What Are the Complications?Obesity, Insulin Resistance, and Androgen SecretionWhile the exact cause of PCOS remains unclear, it has been linked to obesity and insulin resistance (3). Obesity does not directly cause PCOS, but it can exacerbate its symptoms. Insulin resistance plays a significant role in PCOS pathogenesis (4). Excess insulin triggers the ovaries to secrete more androgens, causing symptoms such as acne, facial hair growth, and menstrual irregularities (2). This hormonal imbalance leads to disrupted ovulation and potential infertility.Women with PCOS often have higher levels of visceral fat, even those who are not obese, increasing their risk of cardiovascular diseases (5,6). Can It Be Treated?Treatment StrategiesPCOS treatment should be individualized since symptoms vary among women (7). While we will not cover pharmacological treatments, proper counseling from healthcare providers such as physicians or pharmacists is strongly recommended. Lifestyle ModificationsThe most effective approach for managing PCOS includes lifestyle changes. Weight loss can significantly reduce metabolic and endocrine symptoms in overweight and obese women (8-10,12). Even without weight loss, exercise improves insulin sensitivity, highlighting its critical role in PCOS management (13-15).Addressing psychological well-being is equally important. About 75% of women with PCOS experience symptoms of depression due to social stigmas, weight concerns, or infertility fears (20). Exercise can enhance mood and alleviate some PCOS-related issues (21). Resistance TrainingWhile there are no specific exercise guidelines for women with PCOS, a general recommendation is 150 minutes of exercise per week, including 90 minutes of aerobic training (22). Resistance training is beneficial for improving insulin sensitivity, increasing metabolic rate, and aiding fat loss (13,23-25).Resistance training recommendations include targeting all muscle groups 2-3 non-consecutive days per week at 60-85% of 1RM. This regimen can be tailored to individual preferences and goals. Takeaway Message<ol><li data-list="bullet" class="ql-indent-1">Polycystic ovarian syndrome is a hormonal disorder linked to insulin resistance and high androgen levels.</li><li data-list="bullet" class="ql-indent-1">Symptoms include excessive facial hair, acne, and menstrual irregularities.</li><li data-list="bullet" class="ql-indent-1">Infertility is a common concern but can be managed with proper treatment.</li><li data-list="bullet" class="ql-indent-1">Lifestyle changes, including weight loss, aerobic activity, and resistance training, are key to managing PCOS symptoms.</li><li data-list="bullet" class="ql-indent-1">Exercise guidelines suggest combining 90 minutes of aerobic training with resistance training sessions.</li></ol> Disclaimer: This content is for informational purposes only and not a substitute for medical advice. Consult healthcare providers before starting any treatment. References<ol><li data-list="ordered" class="ql-indent-1">Aubuchon M, Legro RS. Polycystic ovary syndrome: current infertility management. Clin Obstet Gynecol. 2011 Dec;54(4):675-84.</li><li data-list="ordered" class="ql-indent-1">Azziz R, Carmina E, Dewailly D, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45.</li><li data-list="ordered" class="ql-indent-1">Diamanti-Kandarakis E, Kandarakis H, Legro RS. The role of genes and environment in the etiology of PCOS. Endocrine. 2006 Aug;30(1):19-26.</li><li data-list="ordered" class="ql-indent-1">Legro RS. Obesity and PCOS: Implications for Diagnosis and Treatment. Semin Reprod Med. 2012 Dec;30(6):496-506.</li><li data-list="ordered" class="ql-indent-1">Cascella T, Palomba S, De Sio I, et al. Visceral fat is associated with cardiovascular risk in women with PCOS. Hum Reprod Oxf Engl. 2008 Jan;23(1):153-9.</li><li data-list="ordered" class="ql-indent-1">Dumesic DA, Akopians AL, Madrigal VK, et al. Hyperandrogenism accompanies increased intra-abdominal fat storage in normal-weight PCOS women. J Clin Endocrinol Metab. 2016 Nov;101(11):4178-88.</li><li data-list="ordered" class="ql-indent-1">Ndefo UA, Eaton A, Green MR. PCOS: a review of treatment options focusing on pharmacological approaches. Pharm Ther. 2013 Jun;38(6):336.</li><li data-list="ordered" class="ql-indent-1">Hoeger KM. Role of lifestyle modification in managing PCOS. Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):293-310.</li><li data-list="ordered" class="ql-indent-1">Mahoney D. Lifestyle intervention among infertile overweight and obese women with PCOS. J Am Assoc Nurse Pract. 2014 Jun;26(6):301-8.</li><li data-list="ordered" class="ql-indent-1">Nikokavoura EA, Johnston KL, Broom J, et al. Weight loss for women with PCOS following a very low-calorie diet. Diabetes Metab Syndr Obes Targets Ther. 2015 Oct 14;8:495-503.</li><li data-list="ordered" class="ql-indent-1">Mason C, Foster-Schubert KE, Imayama I, et al. Dietary weight-loss and exercise effects on insulin resistance in postmenopausal women. Am J Prev Med. 2011 Oct;41(4):366-75.</li><li data-list="ordered" class="ql-indent-1">Duncan GE, Perri MG, Theriaque DW, et al. Exercise training, without weight loss, increases insulin sensitivity in previously sedentary adults. Diabetes Care. 2003 Mar;26(3):557-62.</li><li data-list="ordered" class="ql-indent-1">Pericleous P, Stephanides S. Can resistance training improve PCOS symptoms? BMJ Open Sport Exerc Med. 2018;4(1).</li><li data-list="ordered" class="ql-indent-1">Cheema BS, Vizza L, Swaraj S. Progressive resistance training in PCOS: clinical outcomes. Sports Med Auckl NZ. 2014 Sep;44(9):1197-207.</li><li data-list="ordered" class="ql-indent-1">Kogure GS, Silva RC, Picchi Ramos FK, et al. Women with PCOS have greater muscle strength irrespective of body composition. Gynecol Endocrinol. 2015 Mar;31(3):237-42.</li></ol>

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects a substantial number of women worldwide, estimated between 7% and 15% of all women (1). PCOS manifests with both physical and emotional symptoms, including excessive facial hair growth, acne, irregular or absent menstruation (amenorrhea), and infertility