Flexibility: How it Impacts More than Your Muscles

Flexibility: How it Impacts More than Your Muscles

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

Whether you attend the gym or sit in the office daily; you probably have tight muscles and may know little about flexibility. Do you experience neck or back pain? Do you feel aches and tightness when moving your arms and legs? Many people are unable to perform simple movements and thousands are suffering from back and neck pain. Please keep reading; your flexibility is more important than you realize.

In the Foundations of Strength Training and Conditioning book, the American College of Sports Medicine (ACSM) defines flexibility as a joint’s ability to move through its full range of motion (ROM). Enhanced joint flexibility can reduce the risk of injuries, improve your muscle balance and function, increase performance, improve posture and reduce the incidence of lower back pain.

According to the Human Kinetics website, a fitness and human movement organization, flexibility is necessary to perform your daily activities; getting out of bed, lifting objects and sweeping the floor require some level of flexibility, but unfortunately it deteriorates with age. Over time you create body movements and postural habits that can lead to reduced ROM in your joints, but staying active and stretching regularly can help prevent the loss of mobility. Being flexible significantly reduces the chance of experiencing occasional and chronic back pain.

Poor flexibility means more difficulty when performing your daily activities and can cause joint stiffness, muscle tightness, lower back pain and other postural, and health related problems. A study posted in the American Journal of Physiology has associated poor flexibility with arterial stiffening. Arterial stiffening is called arteriosclerosis and it influences how hard your heart has to work to pump blood through your body. Myocardial infarction (heart attack) and stroke are both a direct consequence of atherosclerosis.

Flexibility training can help you maintain appropriate muscle length. According to the ACSM, muscle shortening can take place over time and flexibility training helps improve muscle balance. If you’re sitting for long periods daily then you may have tight and shortened hamstring and hip flexor muscles that could be causing you lower back pain. Flexibility training helps improve muscular weaknesses and is thought to reduce the risk of injury. It can also improve your posture and your ability to move, relieve stress and reduce the risk of low-back pain.

ACSM suggests the best method for improving flexibility is to perform activities in their full ROM and to engage in a safe stretching program. It’s ill-advised to stretch when you haven’t warmed up, so stretching after your body is warmed up or at the end of a workout is ideal. A simple warm-up could consist of running in place for a few minutes, or by performing some other low level activities that increase your body temperature.

According to Full-Body Flexibility, the book explains how static and dynamic stretches are the most common techniques you can use to improve your flexibility. For static stretching, you merely stretch your muscles by holding the position for 10-30 seconds. Stretching should be done carefully, and with proper technique and breathing; never force yourself into positions or hurry through your routine. Take your time.

Dynamic stretching is another form where you mimic the patterns and movements of the exercise or sport you’re about to perform. If you’re about to play a sport or lift weights you would perform the activities with low resistance first to get your body ready for the real work.

Static stretching and dynamic stretching are your safest options. You can perform stretches alone or have a trained partner take you through the movements. I suggest you stretch your entire body, but pay special attention to your tighter muscles; for many of you this means your hamstrings, hip flexors, rear, lower back, wrists, shoulders, rotator cuffs and neck.

Flexibility means moving a joint through its full ROM and improving flexibility is also strongly associated with managing back pain. Warm up before you stretch and try using dynamic and static stretching techniques. Flexibility means balance; poor flexibility could result in loss of basic function and could lead to health and posture related problems.


  • Ratamess, Nicholas A. “Warm up and Flexibility.” ACSM’s Foundations of Strength Training and Conditioning. Michigan: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012. Print.
  • Yamamoto, K., Kawano, H., & Gando, Y. (2009). Poor trunk flexibility is associated with arterial stiffening.American Journal of Physiology, 297(4).  doi:10.1152/ajpheart.00061.2009. Epub 2009 Aug 7.
  • “The Importance and Purpose of Flexibility.” Human-kinetics. Can-Fit-Pro. Web. 31 Aug. 2015.   humankinetics.com/excerpts/excerpts/the-importance-and-purpose-of-flexibility.
  • Blahnik, Jay. “Stretching Basics.” Full-Body Flexibility. 2nd ed. Library of Congress Cataloging-in-Publication. 2011. Print.

Overtraining: Are You Exercising Too Much?

Overtraining: Are You Exercising Too Much?

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

Our exercise goals are important to us. We strive and struggle through so much to reach our markers. Many believe that no pain no gain is the answer and the more you train the better your results. The problem with this belief is that you could be putting your body through more stress than needed and you run the risk of sickness and overuse injury.

Are you overtraining? How would you know if you’re overtraining and just exactly what is it? In an article by University of Maryland Medical Center (UMM), overtraining is described as burnout, staleness, a term used by professionals to describe fitness enthusiasts and athletes who suffer impaired performance and increased fatigue due to excessive training routines

 Overtraining is often confused for overreaching; according to Overtraining Syndrome: A Practical Guide, overreaching refers to an accumulation of training loads that lead to performance decrements that require days to weeks for recovery. Overreaching is sudden, it can be as simple as drastically increasing your workout load and feeling exhausted to the point where you need to take some serious down time.

Overreaching followed by rest can be positive, but when it’s extreme and combined with additional stressors then Overtraining syndrome (OTS) can occur. OTS usually occurs as a result of rigorous training schedules that dramatically or suddenly increase, lasts for sustained periods of time and are performed at high volumes or high intensities without a sufficient recovery period.

According to the American College of Sports Medicine (ACSM), one of the best ways to avoid overtraining is to pay attention to your exercise program. Excessive volume or intensity may produce less than optimal results and could impair your performance. If physical performance continues to suffer for extended periods of time and you require long recovery periods then overtraining has occurred.

While increasing exercise intensity and volume are positive for your development, ACSM stresses that you adhere to a proper exercise program that provides sufficient volume and intensity i.e. following a workout program that meets your needs, but allows for recovery time and respects your current fitness level. While there are phases within your training program where you may experience short-term performance decrements these can be overcome with several days of decreased exercise stress.

You know you’re overtraining when you can’t seem to perform right, you’re excessively tired, you need longer periods of recovery between workout routines and just don’t feel like exercising. Overtraining syndrome comes with the risk of injury and illness and ACSM says that overtraining has other physiological effects also. Altered resting heart rate, blood pressure and respiration patterns, decreased body fat and post-exercise body weight, chronic fatigue, menstrual disruptions, headaches, muscle soreness and damage, joints aches and pains, and gastrointestinal distress are a few of the effects listed.

While overtraining syndrome is the extreme, many overreach and burn out after going for weeks without proper recovery. There are many exercise programs that have risen to fame because they boast about the fat blasting effects of their workout, but many of the people who need to lose the weight and get into shape can’t aptly perform these programs. Some avid exercisers have also found these programs to be too much and after a few days fall off the program. I watched a personal trainer put his clients through a popular routine and it was cringeworthy watching their body language after barely making it through a routine that wasn’t designed for their fitness level. Some of those clients no longer work with that trainer.

Overtraining yourself is a real dilemma; you’re exposed to so many stimuli and made to believe that harder, faster, heavier are better at the expense of proper nutritional habits, proper alignment and body mechanics and adequate rest time. The results of this are usually suboptimal; if you’re not careful you could become sick and/or injured. Please consult a professional about designing a workout program that fits your needs and pay close attention to the way you’re feeling during and after a workout. You don’t have to train seven days a week to see results and despite what popular voices may say you must ultimately follow a program that suits your specific needs.


  • Kinucan, Paige, and Kravitz. “Overtraining: Undermining Success.”Overtraining: Undermining Success. University of Maryland Medical Center. Web. 28 July 2015.
  • C. Fry Ph.D., Andrew. “Overtraining with Resistance Exercise.” Current Comments. American College of Sports Medicine. Web. 28 July 2015.
  • Kreher, Jeffrey B., and Jennifer B. Schwartz. “Overtraining Syndrome: A Practical Guide.” Sports Health 4.2 (2012): 128–138. PMC. Web. 27 July 2015.

How Your Nutritional Habits Affect Your Posture

Hey everyone,

Here’s this month’s article. Ever wondered how your diet is affecting your posture? I explore the relation in this month’s article.

How Your Nutritional Habits Affect Your Posture

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

Have you ever thought that your eating habits are affecting your posture and body alignment? You probably know that age, height, fatigue and occupation affect your postural alignment. There are so many other factors that impact your posture, but what about nutrition? In this article, you’ll learn how and why your nutritional choices could be leading to postural misalignment.

To learn more, I consulted Registered Dietitian, Certified Diabetes Educator and Certified Nutrition Support Dietitian, Melissa Halas-Liang, M.S. to discuss the subject. “The right diet helps avoid excessive weight,” was her opening statement. She continued, “The more weight you’re carrying is more detrimental to your posture.” Melissa explains that your lumbar curve maintains your upright posture and supports the weight of your body.

Excess weight places stress on your bones, muscles and joints and can cause an unnatural curvature of the spine. “Extra weight in the stomach pulls the pelvis forward and strains the lower back, creating lower back pain.” You read that correctly, your diet might be affecting your lower back, but it’s not just weight gain that’s affecting your posture, your nutrient intake and eating practices during meal times are also creating an issue.

Vitamin D and calcium are crucial for bone health and posture. In addition to maintaining a healthy weight, Melissa urges that you get enough vitamin D and calcium in your diet. “Vitamin D plays a major role in calcium absorption, bone health, muscle performance, balance and risk of falling,” she says. Sun exposure is also an important source of vitamin D, but you also need to ensure you’re receiving enough from your diet. While calcium can be found in dairy products, fortified foods and dark green leafy vegetables, vitamin D can be found in fortified milks and cereals, egg yolk, salt-water fish and liver. UV-treated mushrooms are a good plant source.Not convinced? Have you heard of kyphosis? It’s an exaggerated forward rounding of the back and while it has several possible origins one cause of kyphosis is when osteoporosis weakens and compresses the spinal bones. “Among the lifestyle factors that increase osteoporosis risk are low calcium intake and vitamin D insufficiency,” says Melissa.

Older adults are at higher risk for vitamin D deficiency; anyone who has limited sun exposure or kidney issues also needs to be aware of this information. Please consult your physician if you’re unsure whether you’re not receiving adequate calcium and vitamin D in your diet. Do not take supplements until you ascertain this information.

The National Osteoporosis Foundation’s (NOF) website explains that excessive alcohol, caffeine, coffee and soft drink intake is detrimental to bone health because they interfere with calcium absorption and could contribute to bone loss. For you soft drink lovers, not every soft drink is bad for you. The NOF explains that colas, but not most other soft drinks, are associated with bone loss. “The carbonation in soft drinks does not cause any harm to bones. The caffeine and phosphorous commonly found in colas may contribute to bone loss. Like calcium, phosphorous is a part of the bones. It is listed as an ingredient in colas, some other soft drinks and processed foods as ‘phosphate’ or ‘phosphoric acid’.” By getting enough calcium to meet your body’s needs, you can make up for the loss.

So what about meal times? It often feels like the bulk of our problems originate from our habits around food and our meal times, but how does posture come into play? Melissa explains that eating while watching TV or on the computer means that people are usually slouched on their couch or slumped over their screens; neither are correct sitting positions for good posture and body alignment.

Additionally, you may be eating more calories while using social media and when enjoying some form of entertainment; this will lead to excess weight gain that could impact your postural alignment. Melissa blames late night, mindless eating of fatty, salty and sugary foods. You need to eat at a table, sit up with your back straight and your shoulders back without distractions (Implement NPI’s Four Points of Posture™); prevent mindless eating by becoming more mindful of your eating habits and food choices.

Your nutritional habits during meal times and your food choices affect your posture and body alignment. Ensure you’re receiving enough calcium and vitamin D and please consult a physician before taking supplements. Remember, be aware of your posture while eating and avoid eating mindlessly, you’ll look more confident and save yourself excess weight gain.


  • Halas-Liang, Melissa Personal interview. 11 February 2015.
  • “Food and Your Bones.” Food and Your Bones. National Osteoporosis Foundation. Web. 10 Apr. 2015. <nof.org/foods>.

To see the article and other articles from our website, see the link here

Know your risk

Hey everyone, here’s another short, but great read for all the fitness and non-fitness pros. This month I covered an article relating to risk stratification. It’s published on the National Posture Institute’s website, but I wanted to post it below as well for easy access. Still, check out their resources and Facebook page, they have tons of certifications, CEC/CEU opportunities and educational material to help health/medical and fitness professionals.

Without further ado:

Health Screening: What You Should Do When Starting a New Exercise Program

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

All of my new clients must perform a health screening process. As a personal trainer and NPI-Certified Posture Specialist™ it’s important that I perform some form of assessment and risk stratification to ensure that my clients are able to meet the demands of the new regimen. Sometimes, clients aren’t able to dive into a new routine because they are considered “high risk” due to a health related issue. In this article, you’ll learn more about the health forms and criteria that can determine your risk levels and what you need to do if you’re considered “high risk”.

If this is the first time you’re reading about health screening or assessments then this is the perfect opportunity for you to learn more. Every personal trainer and health/medical professional should take you through an assessment process. The American College of Sports Medicine website states that fitness assessments will help in the development of individualized training programs and can be used to check for heart disease and other chronic diseases.

 Assessments include Medical History forms, a Physical Activities Readiness Questionnaire (PAR-Q), a Cardiovascular Risk Factor form, Informed Consent and a Physician Clearance form. A PAR-Q will determine your readiness to exercise. A medical form will ask for detailed information like blood pressure, obesity, cholesterol levels, heart disease and stroke. It may also ask what medications you’re currently taking.

If you’ve never taken any of these assessments and you’re working with a trainer I suggest you ask them to conduct assessments because they don’t have a solid idea of who you are and run the risk of putting your health in danger.

The American College of Sports Medicine (ACSM) has created a risk stratification form that allows the professional to determine whether you’re low, medium or high risk and in need of modifications or further medical evaluation before beginning your new program.

The ACSM form examines age, family history, cigarette smoking, sedentary lifestyle, obesity, hypertension, diabetes and dyslipidemia (related to cholesterol levels) as criteria for assessing your risk level. In ACSM’s Guidelines for Exercise Testing & Prescription if you have symptoms of cardiovascular disease (CVD), or you’ve been diagnosed with a known cardiovascular, pulmonary or metabolic disease then you’re considered “high risk” and require a physician’s approval before starting an exercise program.

If there are no symptoms of CVD or a diagnosed disease, but you have less than two risk factors then you’re considered “low risk”. If you have two or more risk factors then you’re considered “medium risk”. If you fall into the low or medium risk areas then you don’t require a physician’s approval, but it’s always advised that you still see a health professional if you’re unsure about your wellbeing.

Confused about your risk? Here’s an example: If you’re currently a smoker, obese, live a sedentary lifestyle and may have hypertension and be pre-diabetic, you’re considered “medium risk”. If you have only one symptom—sedentary lifestyle or you’re a cigarette smoker— then you’re considered “low risk”. However, if you have heart disease, chest pain, known heart murmur or other signs or symptoms suggestive of a disease then you’re considered “high risk” and need to see a doctor before committing to a program.

If you’re starting a new exercise program I highly suggest you urge your professional to conduct a health screening process to find out more about your medical, fitness and health information as it will give you both a better sense of how your needs can be met while avoiding a problem. Safety is your best bet and knowing your health status is applying that principle.

Personal trainers and health professionals need to conduct a health screening process before starting a new program. If you have a known disease like CVD, or show signs and symptoms of a major problem then you’re considered “high risk” and need physician clearance. If these symptoms and diseases are absent then you could be low or medium risk. It’s advised that you still consult a doctor if you’re starting a new program or you’re unsure about your medical history.



  • Percia, Matthew, Davis Shala PhD, and Gregory R Dwye. “Getting a Professional Fitness Assessment.” ACSM | Articles. ACSM, 10 Jan. 2012. Web. 12 Mar. 2015. .
  • Thompson, Walter R. ACSM’s Guidelines for Exercise Testing and Prescription. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2010. Print.

National Posture Institute’s 2015 State of Industry Survey

Hi everyone,

I had the privilege of working on the National Posture Institute’s 2015 State of the Industry survey. For all the fit professionals who want to see the review, I’ve posted the link and the information below.

National Posture Institute (NPI) Survey Report

2015 State of the Industry Survey:  Posture, Health, and Fitness Report

The National Posture Institute (NPI) believes that posture, exercise performance, injury prevention, and education surrounding body alignment and exercise selection are important areas of concern for fitness and allied-health/medical professionals. NPI created its 2015 State of the Industry Survey to determine whether professionals were prepared to work with clients on posture correction/exercises and to review the current state of the industry and upcoming trends. This report will review NPI’s State of the Industry’s 2015 Survey results.

NPI surveyed personal trainers, physical therapists, physiotherapists, group exercise instructors, athletic/sports performance specialists, P.E. teachers, chiropractors and other allied-health, medical and fitness based professionals for this study. The majority of our respondents work as personal trainers/exercise professionals in settings such as health clubs/fitness facilities, home-based training, private practice training, corporate offices/fitness centers and college/universities. An additional group of respondents work as physical therapists, chiropractors, ergonomic specialists, athletic trainers and other allied health/medical professional in hospitals, medically-based fitness sites, sports performance sites and private clinics.

Respondents indicated that they work with a diverse client age group from young children (29%) to (80+) older adults (51%). Respondents stated their client base includes children/adolescents, stay at home moms/dads, corporate executives, office workers, athletes, academics, retirees and health/medical professionals.

As indicated on the survey, clients/patients “sometimes” inquire about posture and body alignment and 78% of professionals are actively educating them on the subject. Professionals also indicated that they generally conduct assessments on their clients. When asked about conducting posture assessments, 75% say they conduct posture assessments on a regular basis. Balance/agility skills, muscular strength and endurance assessments are also predominantly being used by professionals. When asked about corrective exercise programs, 53% say they use them. However, when asked whether corrective exercises for posture related injuries are being administered the responses were almost tied.

The survey shows that 69% of respondents have received training on how to conduct and create programs that focus on posture and body alignment. While some received little training from personal training organizations, others note that they learned some information about posture through books and/or magazine articles. The majority of respondents received educational training from the National Posture Institute (NPI); It was listed as the primary organization to learn about posture education, assessments and exercise movements.

Professionals indicated that they prefer using free weights, suspension and body weight training as opposed to commercial strength training/circuit training equipment when working with their clients/patients. The most popular exercises mentioned were: squats, lunges, step-ups, bicep and triceps curls, back rows, push-up variations, frontal/lateral raises and planks. It should come as no surprise then that exercise tubing, stability balls, body weight exercises and free weights/dumbbells took top spots when asked about the modalities being used while training.

Professionals believe that the most prevalent postural deviations seen in their clients are “forward head posture,” “rounded shoulders,” and “muscular imbalances”. They also indicated that the most common injury sites are the “lower back,” “rotator cuff,” and the “knees”. Respondents believe that the programs that could most likely cause an injury are power lifting, heavy lifting, Olympic style lifting, Crossfit and plyometrics.


The results show that fitness, health and allied-health/medical professionals are becoming more aware of posture, body alignment and exercise selection. They are actively developing programs for their clients/patients with posture and body alignment in mind. Professionals are predominantly working with clients/patients that range from ages as young as 5 (five) to 80+ years old. Respondents stated their client base includes children/adolescents, stay at home moms/dads, corporate executives, office workers, athletes, academics and health/medical professionals.

Professionals are conducting fitness and posture assessments; many of the respondents have learned to perform postural assessments and corrective exercises from the National Posture Institute. Clients/patients “sometimes” inquire about posture, but professionals that responded to this survey are actively educating them on the subject.

Fitness, health and medical professionals must continue to learn about posture and body alignment. As professionals, being aware of these areas allow for greater vigilance when selecting programs, methods and exercises for clients/patients. Professionals must continue taking the initiative and actively discussing the subject of posture with their clients/patients. Though their current responsibilities are great, professionals must not overlook the negative effects of poor posture and body alignment. Lastly, professionals must take an active role in becoming strong role models that can educate the public about proper posture, alignment and exercise performance.

http://www.npionline.org/survey/2015 (For more information on posture, certifications related to fitness/nutrition/posture and more, check out the rest of their website.)

Accountability: Even the Fitness Industry Needs It

Hi everyone, hope your 2015 is turning out well. If not, hang in there and work for what you need to happen. Here’s a good one for you. How do you when the fitness pro is performing the technique correctly? Generally, you won’t. So even the fitness industry and its professionals need to be held accountable. I discuss this in my first article this year, published on the National Posture Institute website here, but you can read it below also:

Accountability: Even the Fitness Industry Needs It

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

It’s the start of a new year and many of the old year’s habits need to be left behind. How do you know when a fitness professional is performing an exercise in good form and body alignment? You don’t; If you’re not exercise savvy then the likelihood of being misled is high. Fitness organizations and professionals need to be more aware of form and body alignment when posting exercises.

Last year, after opening a monthly newsletter from a major fitness organization I noticed the model’s posture and body alignment was off. Her head and neck were lurching forward as she sat up, frozen in place. The fitness model from the newsletter was trying to work her abdominals while simultaneously putting her neck and spine at risk. It wasn’t the first time I saw something like this; I’ve seen professionals performing techniques with improper form and body alignment. It’s time that organizations and professionals in the fitness industry take account for these problems. The public will emulate these techniques.

According to an article by Nikitow Chiropractic, one of the most common posture problems is forward head posture (FHP). Repetitive computer, TV, video game, phone and backpack usage, alongside poor exercise form can force our bodies to adopt this problem. Repetitively lurching the head and neck forward can strengthen nerve and muscle pathways to move that way more readily. In short, repetition of forward head movements combined with poor ergonomic postures can lead to FHP. Was the professional, and the organization, aware of FHP when they posted that image?

Incorrect Correct

Dimitri Onyskow and I spoke about the problem. As the Educational Fitness Solution’s Director of Academic Relations, he deals with these issues: “I think most organizations do not want to acknowledge the fact that they have been promoting poor technique,” he says, “If they did, they would be admitting they were wrong. Instead, they choose to ignore it in hopes that no one else will notice.”

Dimitri says that the problem exists in major fitness organizations that offer corrective exercise programs: “What most don’t understand is if a client is doing a ‘corrective exercise’ movement in poor alignment, all they are doing is adding strength to an already imbalanced frame. And this will lead to injury down the road. It is imperative that proper technique is taught throughout.”

Michele, a fitness club manager, also had a similar experience and shared her utter distaste for some major fitness brands. She says that people are quick to follow these teachings even if they are dangerous. She believes that one of the major problems with these brands is the bad form of their followers: “They often have people doing pointless motions with incorrect form and at ridiculous weights.”

Michele believes that many of the people following routines from these brands have no clue what they’re doing and they think their form is correct. Many are closer to a hospital visit than achieving their results and refuse help when approached about their form.

So can you tell when you’re being misled? It’s difficult to tell, so sometimes you need to seek a second opinion. Keep in mind that every trainer and fitness organization isn’t trying to mislead you, but even the experts get it wrong sometimes. If you’re unsure about a technique, don’t feel it working, or you’re concerned about the danger level then by all means ask questions. Always ask questions, research the topic and pay attention to who is providing the advice.

Good form and proper body alignment should be the goal of every exercise. Organizations and professionals in the fitness industry need to be aware of their form and body alignment while performing exercises. The public won’t know the difference between right and wrong. It’s up to the fitness industry to teach the public the correct methods and to be accountable for their actions.


  • Nikitow, D. (2014). Damaging effects of forward head posture. Retrieved from denvertechchiro/files/fhp_revised.pdf
  • Michele. Personal interview. 7 January 2015
  • Onyskow, Dimitri. Personal Interview. 6 January 2015

Why Delayed Onset Muscle Soreness (DOMS) Doesn’t Equate to Physical Success

Here’s another one of my articles that’s posted on the National Posture Institute. It deals with the idea that some people equate being sore to overall goal success. It’s a false belief folks. Not every workout will make you sore, and you shouldn’t focus on being sore as the measure of a good workout. Focus on goal attainment, focus on performance, focus on a better body and a sound mind, and you’ll be much closer to your goal.

Why Delayed Onset Muscle Soreness (DOMS) Doesn’t Equate to Physical Success

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

I recently read an article about muscle soreness as a new workout goal. It seems being sore after a workout is more important than the effectiveness of the workout in helping one achieve their overall goal. Muscle soreness doesn’t equate to an effective workout and it’s not something you should use to gauge your workout, or to strive to achieve in every training session.

When was the last time you performed an exercise or activity and woke up sore the following day? Did the soreness remain even after a few more days? Did your muscles feel achy and was it difficult to move? That sore, uncomfortable feeling when you move is called delayed onset muscle soreness (DOMS). The soreness you feel doesn’t hit you until the day after a strenuous workout and that’s why it’s considered “delayed onset.”

An article written by John David Maes and Len Kravitz mentions that DOMS is typically experienced by all individuals regardless of fitness level; it’s a normal physiological response to increased exertion. Delayed soreness typically begins to develop 12-24 hours after you exercise and may produce the greatest pain between 24-72 hours

If you’re doing physical activities that are unfamiliar or more intense than your usual routine or you are just starting to exercise; then there’s a higher chance of experiencing DOMs. Alongside soreness you may also experience muscle stiffness, swelling, tenderness to the touch, temporary reductions in strength and in movement, and decreased joint range of motion.

The American College of Sports Medicine (ACSM) states that the exact cause of DOMS is complex; it’s commonly associated with lactic acid accumulation in the muscle, but it appears to be a side effect of the repair process that develops in response to microscopic muscle damage. In case you were worried about the microscopic muscle damage allow me to put your mind at ease, the micro trauma that happens in muscles after a workout isn’t dangerous and it’s actually a part of the process for building them.

So how did DOMS and feeling achy become the gauge for a workout’s effectiveness? There are many fitness professionals, trends, fads and programs that advocate for higher intensity routines. These programs boast phrases like: “gut busting,” “fat torching,” “muscle building,” “hardcore” and “high intensity” in their descriptions. These programs can make you so sore you’re unable to walk or move properly the next day, but is that really the goal and is it helping the general exerciser achieve their goals?

Muscle soreness isn’t a gauge for success, but it’s common to hear people chatting about their soreness and discussing how they felt days after. While some programs encourage working till you’re sore and try to instill a “no pain, no gain,” mentality, they miss the point of why you’re training in the first place.

While constantly pushing yourself to the limit sounds ambitious, it’s dangerous if you push yourself too hard, too often; you may incur a serious injury in which case you won’t be training any time soon. Muscle soreness is just that; it doesn’t mean that your workout was effective toward achieving your personal goals. Think about the program you’re on and examine if it’s helping you achieve your results.

The American Council on Exercise (ACE) website says that training more aggressively doesn’t equate to faster results. While the body does require a certain degree of overload to improve its fitness, training too much and too hard can cause lack of motivation, overuse injuries and overtraining syndrome.

So what should you focus on and how do you deal with it? You need to complete both a fitness and goal assessment first. Think about the reasons you’re doing your program and be open about your current fitness level. Make sure you warm-up before your workouts and seek to progress steadily through your program. If you do become sore, rest is your best option.

The ACSM website explains that you could use ice packs, massage and oral pain relievers while sore. Please understand that these methods reduce pain, but your body still needs to recover; don’t be afraid to take a day or two off if the soreness is too much.

Muscle soreness should never be the goal of a workout and doesn’t equate to an effective exercise session. Remember the reason you’ve started exercising and proceed at your own pace. If you do become sore, rest is your best option. Be honest and open about your capabilities and with patience you’ll be on your way toward goal achievement.


  • Sforzo, Gary, and William Braun. “Delayed Onset Muscle Soreness (DOMS).” American College of Sports Medicine. American College of Sports Medicine, 1 Jan. 2011. Web. 3 Nov. 2014.  delayed-onset-muscle-soreness-(doms).pdf>.
  • Maes, Johndavid, and Len Kravitz. “Treating and Preventing DOMS.” DOMS. University of New Mexico, 1 Jan. 2003. Web. 3 Nov. 2014. <unm.edu/~lkravitz/Article folder/domos.html>.
  • McGrath, Christopher. “Myths and Misconceptions: Muscle Soreness.” ACE Fit. American Council on Exercise, 9 Dec. 2013. Web. 3 Nov. 2014. <acefitness/acefit/healthy-living-article/59/3654/myths-and-misconceptions-muscle-soreness/>.

Hip Bursitis

Hey everyone,

Here’s an article I wrote and was posted this month on Hip Bursitis. If you’re afraid of it; have it and want to avoid, then give it a read. It’s great to know more about these issues and what you can do to get better. It’s posted on The National Posture Institute’s website.


Hip Bursitis: The Most Common Hip Problem

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

As an NPI Certified Posture Specialist, clients have expressed concern about developing hip pain. The most common hip related problem is hip bursitis. If you’re suffering from hip bursitis then moving around will be painful; you may require medication, rehab sessions, or surgery if symptoms become unbearable.

According to the American Academy of Orthopedic Surgeons (AAOS) website, bursae are small, jelly-like sacs that contain small amounts of liquid that are located throughout your body. They are positioned between bones and soft tissue and act like cushions to help reduce friction. Your shoulders, elbows, hips, knees and heels have bursae. When any of your bursae suffer from inflammation, it’s known as “Bursitis.”

The AAOS explains that there are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this area is called tronchanteric bursitis. The other bursa is located at the illopsoas (groin area) of the hip. Tronchanteric bursitis is seen more frequently, but both are treated in a similar manner.

Every hip pain is not related to bursitis; the Mayo Clinic website offers some pointers on how you can identify symptoms of bursitis. If you currently have bursitis your hip joints may experience achiness and stiffness. It may look swollen and red, and may hurt when you move or press on it.

Mayo Clinic advises you see your physician when the joint pain is disabling, if it remains for more than one to two weeks and if there is excessive swelling, redness, bruising or a rash in the affected area. If you experience a fever and sharp, shooting pains especially while exercising, or exerting yourself then please see a physician,

Hip bursitis can affect anyone, but is more common in women and middle-aged or elderly people. The AAOS mentions factors that could lead to hip bursitis. If you have an overuse injury, pelvis alignment issues, a spine disease (including scoliosis and arthritis), leg-length inequality, a current hip injury, rheumatoid arthritis, previous surgery and calcium deposits then you may develop hip bursitis.

While all this information is overwhelming and can seem terrifying, treatment begins with trying to reduce the inflammation. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) website, explains that you’ll need lots of rest, ice, compression and elevation if you’re experiencing basic symptoms. You may also require anti-inflammatory medicines, but if conditions worsen, or the bursa become infected then your physician may prescribe special antibiotics.

So how do you prevent hip bursitis? According to NIAMS, to help prevent inflammation, or reduce the likelihood of its occurrence, consider exercising regularly, stop sitting for long periods, strengthen the muscles around the joint and stop activities that might be causing you pain. Consider using a stand-up desk if your job requires long days using a computer. If you have a physically demanding job that requires heavy lifting and repetitive motions you’ll need to take breaks, and practice good posture and body alignment.

It’s all about behavior and lifestyle modification.  The National Posture Institute’s (NPI) certified professionals can educate you on those lifestyle modifications and design exercise programs that center around making things easier. A professional will assess your posture while you engage in different activities and will make you aware if you’re harming yourself. It may be as simple as adjusting the way you walk — especially for those who shuffle their feet — and you may need to opt for shoes with better cushioning. If you’ve already started exercising after a hip related issue then consult an NPI professional to ensure your posture and body alignment aren’t safe.

Hip bursitis is the most common hip related problem and can seem scary. Your best move is to modify the way you perform activities, add cushioning where possible, and perform exercises in the correct position for your hip as part of your regular daily routine. Hip bursitis can get worse so please see a physician if you’re worried about any pain or show symptoms.



  • “Hip Bursitis.” Ortho Info. American Academy of Orthopedic Surgeons, 1 Mar. 2014. Web. 27 Sept. 2014. <orthoinfo.aaos.org/topic.cfm?topic=a00409>.
  • “Bursitis.” Mayo Clinic. Mayo Clinic, 20 Aug. 2014. Web. 27 Sept. 2014. bursitis/basics/definition/con-20015102>.
  • “Bursitis and Tendinitis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health, 1 June 2014. Web. 27 Sept. 2014. Bursitis/>.

I live

Hey Folks,

It’s been a long time. I’m alive. I promise. Here’s one of my health articles. It was posted on the National Posture Institute’s website:


Cumulative Trauma Disorders: How Your Work Could Lead to Injuries

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

If your job requires repetitive and stressful activities while you clock long hours, then you need to think about the possibility that you could suffer a work related injury. Have you ever experienced pain and discomfort after a long, hard day at work? What if I told you that your work is slowly harming you? Whether you work in an office, or in manufacturing you could be next person to seek professional help and rehabilitation due to a cumulative trauma disorder (CTD).

The National Institute for Occupational Safety and Health (NIOSH) defines Cumulative trauma disorders (CTD) as diseases and injuries that affect your musculoskeletal, peripheral nervous and neurovascular systems. CTDs, also known as overuse syndrome, repetitive motion injuries, or work related musculoskeletal disorders, are mainly found in the hands, shoulder, neck, lower back and hips.

CTDs are caused, or aggravated by occupational exposure to ergonomic (work related) hazards. You might be currently feeling the effects of a creeping CTD after weeks, months or even years of repetitive work related stress and strain on your body.

According to the New Jersey Department of Labor (NJ DOL), CTDs can be painful and sometimes crippling. Carpal Tunnel Syndrome, tendinitis, lower back disorders, thoracic outlet syndrome (compression of the nerves and blood vessels between first rib, collar bone and muscles) are a few of the problems you could already be experiencing. If your work causes you to perform repetitive tasks, forceful exertions, vibrations, mechanical compression (your body presses against hard surfaces) or consistently find yourself in awkward, or bad postural alignment, then at any moment you could suffer a disorder if you aren’t currently suffering the effects of one already.

The NJ DOL lists symptoms of CTDs as follows: numbness, decreased joint motion, burning, weakness, clumsiness, redness, pain, swelling, aching, tingling and cracking or popping of joints. If you suspect, or are currently suffering from any of these, or from any of the disorders listed in this article then I suggest you speak to a doctor as soon as possible before it worsens.

Sitting in the office is also problematic; the Oklahoma State University EHS Safety training program mentions that sitting for long periods can also lead to CTDs, specifically lower back ailments, forward head posture, carpal tunnel (repeated bending of the wrist from typing) and tendonitis due to repetitive and long hours of typing, or using a mouse.

Janitors, carpenters, machine operators, housekeepers, wait staff, and even musicians are also at risk for CTDs due to the repetitive nature of their work. If your work requires consistent, repetitive motions and you maintain bad postural alignment, then please be advised this could be in your future. Please keep in mind, failing to take breaks and maintaining bad postural alignment, or the same alignment over a long period can contribute to CTDs and could worsen a current problem you’re experiencing.

CTDs can stay with you for your entire life and you may need medication or surgery to manage them. However, there are ways to treat CTDs before they become a bigger problem. The NJ DOL suggests you take breaks, and make adjustments your workspace. You will need to change the way you perform your activities, and pay attention to how long you’re engaging in them. If you work at a desk all day, then you’ll want to take breaks from typing and stretch your hands and wrists every hour. You could also maintain good postural alignment by adjusting your chair and workstation to make it easier on you.

Worried about CTDs yet? The National Posture Institute suggests starting an exercise program with proper supervision and approval from your health providers. Our Certified professionals can help you design resistance training and posture correction programs that will help you manage your postural alignment while you work. These programs will educate you more on proper lifting, walking and work related techniques to ensure that you’re maintain proper alignment, and that your is strong enough to complete their tasks.

Exercise, good nutrition, rest and learning to adapt your habits so that you can maintain good postural alignment will help you avoid CTDs. The price of incurring a CTD is costly; you can expect medical bills, and neurological and muscular rehabilitation causing you to lose work days and time with your family if you don’t start taking this issue seriously.

CTDs are painful and could lead to host of other problems that will cause you to lose work days and time with your loved ones. Please don’t wait until it becomes worse to seek medical attention; if you suffer from a CTD, or suspect that your job could be leading you in this direction please speak to a health provider, or find an NPI-Certified professional as soon as possible.

“Office Ergonomics.” Ergonomics: Cumulative Trauma Disorders. Oklahoma State University, 1 Jan. 2006. Web. 26 July 2014. Retried from ehs.okstate.edu/modules/ergo/CTD
Proctor, Bea, Shiro Tanaka M.D., Vern P. Anderson Ph.D, Katharyn A. Grant Ph.D, Ron Schuler, and Rodger L. Tatken. “Cumulative Trauma Disorders in the Workplace bibliography.” National Institute for Occupational Safety and Health (NIOSH), 1 Sept. 1995. Web. 26 July 2014. Retrieved from cdc.gov/niosh/docs/95-119/pdfs/95-119.pdf
McGreevey, James E. , Clifton R. Lacy, M.D., and Albert G. Kroll. “Cumulative Trauma Disorders in office workers.” New Jersey State Department of Labor, 1 Feb. 2003. Web. 26 July 2014. Retrieved from state.nj.us/health/peosh/documents/ctdib.pdf

Health articles


I haven’t been completely open with you…so here goes ! I’ve been writing health articles for a magazine and for my organization for quite some time now and I haven’t posted any -hides-. My bad ! Here’s the latest one I wrote for the National Posture Institute about Osteoporosis and it’s effects on posture. Enjoy !



Effects of Osteoporosis on Posture

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

Osteoporosis is one of the most common bone related diseases in the United States and it can have a direct impact on postural alignment as you age. The National Osteoporosis Foundation states that 52 million Americans suffer from osteoporosis and have low bone mass. One in two women and one in four men aged fifty and older will break a bone due to osteoporosis. Experts predict that by 2025 osteoporosis will be responsible for three million fractures and $25.3 billion in health care costs per year.

According to the National Osteoporosis Foundation, osteoporosis is a bone disease that causes you to lose bone mass, making the bones more fragile and weak. When placed under a microscope healthy bones have a honeycomb structure but osteoporosis makes the holes and spaces much larger.

If your bones lose their density then they become weaker and more susceptible to breaking. Osteoporosis is difficult to detect; breaking a bone may be your first sign of having the disease. If you have osteoporosis then it means your bones have lost density or mass and the structure of your bone tissue is abnormal.

Weak and thin bones could break from minor falls, or from simple actions like bumping into things or sneezing. Osteoporosis can cause areas like your hips, spine, and wrists to break, and can cause severe pain that may not subside. It can also cause you to lose height because it affects the spine bones. The spinal bones, or vertebrae, will break or collapse affecting your posture which will cause you to look hunched, or stooped over.

According to Dr. Kathy M. Shipp, without attention to good postural alignment the slumped forward, or stooped over posture that is often associated with older adults can happen to you. With this stooped/hunched over position, you could lose up to 1.5 inches (3.8 cm) of height. If you have suffered a spinal fracture from osteoporosis then you are more at risk for developing this condition and this 1.5 inches, or greater height loss during your adult years could be an indication of an osteoporotic vertebral fracture.

Dr. Kathy also explains that spinal/vertebral fractures cause height loss because the fractured vertebral bodies compress. Most osteoporotic vertebral fractures cause height loss either from a full compression fracture ( i.e. where the entire vertebral body compresses) or from a wedge fracture (where the front of the vertebral body is most compressed).

With either of these fractures, the thoracic spine, or your mid back, increases causing  hyperkyphosis and the natural curve in your lumbar spine area, or lower back, decreases causing hypolordosis. After spine fractures from osteoporosis, the hyperkyphosis in your thoracic spine and the hypolordosis of your lumbar spine will result in your head, shoulders, and upper back being positioned more forwardly.

Neither the height loss in your intervertebral discs nor the height loss in your bones after a fracture can be recovered, but Dr. Shipp suggests that attention to posture and targeted exercises can prevent you from worsening your posture. The National Posture Institute’s Certified Posture Specialists are trained to develop targeted programs to help you with your posture so that you avoid such an issue.

The National Institute of Health (NIH) Senior Health explains on its website that Osteoporosis can be treated and prevented with healthy lifestyle choices. The NIH suggests that you maintain a proper diet, exercise, and consider medications, because these options will help you prevent further bone loss and reduce the risk of fractures.

The Mayo Clinic, a non-profit health organization, explains that adequate amounts of calcium, vitamin D, and regular exercise will help keep your bones intact. Strength training combined with weight bearing exercises, or exercises that involve lifting weights, helps improve your muscles and bones. Consider walking, jogging, running, stair climbing, skipping rope, and skiing to develop the bones in your legs, hips, and lower spine.

Osteoporosis is a serious disease that affects millions of Americans. With proper postural alignment, a balanced diet, and regular exercise you could avoid a painful future. Speak to a doctor if you’re unsure, or if you think you may have symptoms, and consult an NPI-Certified Posture Specialist to help you develop a program that will ensure you maintain good postural alignment.


  • Mayo Clinic Staff. (2013, June 21). Osteoporosis. Retrieved from mayoclinic.org/diseases-conditions/osteoporosis/basics/prevention/con-20019924
  • The National Osteoporosis Foundation. (n.d.). What is osteoporosis?. Retrieved from nof.org/articles/7
  • NIH Senior Health. (2013, March). Osteoporosis. Retrieved from nihseniorhealth.gov/osteoporosis/whatisosteoporosis/01
  • Shipp, D. K. (2011). Changing the way we age: Improve Posture. Functional U9(3), Retrieved from Improve_Posture_ICAA_FunctionalU2011_MayJune[1].pdf

You can find more of my articles here: