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One day, while stretching my client Jim, I was taken aback when I realized he wasn’t wearing underwear. His shorts were swim trunks with interior netting. I quickly looked away and continued to stretch him. This happened with Jim on several other occasions, but I never mentioned it because I wasn’t sure how to broach the matter. I also didn’t feel that he was doing this intentionally, nor did I believe he meant harm.

I have worked with hundreds of managers in the fitness business. I have promoted most of them from roles such as personal trainer, group fitness director, café manager, massage therapist…

Every Thursday morning, my cycle studio fills with an array of participants, ranging from accomplished Ironman® finishers to preschool moms trying to maximize their minutes—and Nora, a 92-year-old great-grandmother. Together, we pedal like maniacs, laugh, sing a few refrains and walk out soaked through with sweat. In the cycle studio, participants of all ages and abilities can be motivated by being in a group, but riders can still slow down when they need to without sticking out. In fact, my own cycling journey began when I was pregnant and in search of a low-impact workout.

This class is a mega movement multivitamin combining essential core training with restorative self-myofascial release techniques. Every movement recruits trunk muscles, creating a strong foundation for any physical challenge. The foam-rolling section releases fascial adhesions and can help prevent injuries. Participants will leave feeling strong, centered and relaxed.

Participating in a program of regular exercise is a good idea at any stage of life. One of the most popular forms of exercise is walking, and it’s an ideal physical activity for older exercisers because they generally feel confident performing the required movements—after all, they’ve been doing them all their lives (Williamson 2007).

As a fitness pro, you can’t fix the genetic and environmental contributors to bone loss, but you can encourage physical activity and proper nutrition, both of which improve bone health. More than 70% of Americans don’t get the recommended amount of physical activity (Laskowski 2012), and 50% are considered deficient in vitamin D (Karaguzel & Holick 2010). One systematic review rated calcium, vitamin D, dairy and physical activity/exercise as the most important modifiable lifestyle factors that can influence the development of peak bone mass (NOF 2016).

Bone loss and aging are inseparable: “The skeleton is a systemically regulated mass of mineralized material that is born, grows, reaches a more or less high peak, and then declines faster or slower as to develop a correspondingly high or low fracture risk”(Ferretti et al. 2003). Musculoskeletal aging—declining bone and muscle mass, increasing joint pain and stiffness, and decreasing physical mobility—is a normal part of aging. However, how rapidly or slowly bone mass declines depends on different factors.

When working with any clients diagnosed with osteoporosis, you want to maximize the benefit, but you must also take care to avoid unnecessary risk. If mobility and posture are altered after a vertebral fracture, pay close attention to correct lifting technique and avoid pitfalls such as loading the spine in a flexed posture. For example, since exercise machines often require twisting and forward bending, you may need to avoid using them with clients who have osteoporosis (Giangregorio et al. 2014).

Fitness professionals have to be aware of just how great the osteoporotic fracture risk is for women. Worldwide, osteoporosis affects 200 million women, and the lifetime risk of a hip fracture is 1 in 6, compared with 1 in 9 for breast cancer (IOF 2017).

The skeleton is composed of two types of bone: cortical and trabecular. Cortical (compact) bone comprises 80% of the volume in the adult skeleton and forms the outer layer of bone (Lerner 2012). Trabecular (cancellous) bone makes up the inner layer; has a spongy, honeycomb structure; and is mostly found in the skull, pelvis, sacrum and vertebrae. Although peak bone mass is reached in late adolescence, bones never stop changing. An adult skeleton replaces its bone mass every 10 years (OSG 2004).