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Using Total Gym for Spinal Stabilization #3

Elizabeth Leeds

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How to Develop a Spinal Stabilization Program, Part 3:  Adding Complexity

This last blog will further discuss complexity. If you missed the previous blogs you can catch up with Part 1 and Part 2.

Adding complexity is done via increasing the tri-planar aspect of an exercise and/or changing the tempo.  A tempo change will encourage a different intent. It is common that clients develop a habit of performing the same exercise over and over with the same tempo each time. Unfortunately, we are not creatures of consistent tempos. For example, when ascending two flights of stairs it is very likely that each flight will be taken at different speeds.  We change pace when we walk and we even eat at different speeds depending on how much time we have. Recognizing that tempo changes are important for proficiency within ADLs is key so it would be beneficial for clients to incorporate tempo change into their routine.

Tempo changes can be as simple as instructing a client to move quickly in an exercise. It can also be emphasizing different phases of an exercise to enhance strength, such as moving slower during the eccentric phase of an exercise. Tempo changes can be one set fast, the other set super slow. Tempo can also reflect overall pace of the routine. A routine performed one exercise after the next will feel very different than if a 40-60 second rest is provided between sets and/or exercises. There is not a set tempo protocol when it comes to developing stabilization programs, rather it is something we sometimes forget to tweak. And sometimes a little change in tempo is all one needs to breakthrough stabilization and strength barriers.

As mentioned above, complexity can also occur with increasing tri-planar aspect of an exercise. Taking a linear movement such as squats. Adding arm movements of shoulder abduction and adduction and/or a tweak of the toes inward or outward starts can infuse more planes of motion.  There is no recipe to which plane should be added in first, rather add in another plane and assess if the client is able to maintain technique. Then within the next set, session or even sessions infuse more planes of motion into the exercise. Below are ways you can infuse greater planes of motions into the exercises you learned in blogs one and two.


About the Author

Elizabeth Leeds, DPTElizabeth Leeds, DPT, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues. Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.


Using Total Gym for Spinal Stabilization #2

Spinal Stabilization on Total Gym PartII

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How to Develop a Spinal Stabilization Program, Part 2:  Variations

With an appreciation of how intent can change the emphasis of an exercise, as well as an array of spinal stability exercises on the Total Gym GTS, let’s look at the previous exercises in Part 1 and how we can tweak them with strength and mobility. Strength adjustments may be increasing the intensity to muscle building or decreasing to fine-tune precision and control. Mobility may encourage greater range of motion, as well as exercises that inherently encourage more of a stretch, like a Pullover.

Side Lying

Single Leg Squat

The intent of the exercise is to progress neutral to anterior pelvic tilting during a squat. This movement may also prep the body for lunging.

> The foot, knee and hip are aligned. Note there is a compensatory tendency to place the foot too high on the squat stand.

> Observe the thoracic and cervical spinal alignment. A common compensation is sinking into the glideboard and flexing forward at the upper thoracic and cervical spine.

> The bottom leg can self spot, move forward or backward depending on pelvic positioning and client’s comfort level.

> For safety, ensure the pelvis is a hands distance away from the side edge of the glideboard.

Lateral Trunk Flexion

The intent of the exercise focus on the frontal plane movement of  lateral flexion. Although this is a unilateral planar movement, it is harder the trunk lateral flexion with rotation.

> The legs may be scissored, stacked or the bottom leg hooked over the top leg in a figure 4 position. The latter being more challenging as it is anchoring the hip.

> To modify, the top and/or bottom arm may assist. To progress, the arms may be crossed at the chest, or one to both arms reaching overhead.

> Observe the pelvic alignment. The tendency is to rotate backward.

> For safety, ensure the pelvis is a hands distance away from the side edge of the glideboard.


Alternating arm and leg extension

> The intent of the exercise is to challenge spinal stability while moving both upper and lower extremities. The exercise inherently strengthens both the anterior and posterior fascial slings.

> Observe the stationary arm and leg’s alignment. Avoid hyper-extending the elbow and pushing the hip out to the side. Cue to pull the heel of the hand and the inner knee toward one another to increase anterior fascial sling activation and improve alignment.

> Ensure the shoulders are sliding away from the ears and the pelvis is parallel to glideboard. Note that changing the height of the glideboard may or may not make the exercise easier for a client. If bringing the board to parallel, the pulley and incline height may have to be adjusted.

The chart below are the exercises in Part 1, as well as the addition of side lying squat, lateral trunk flexion and quadruped alternating arm and leg.




About the Author

Elizabeth Leeds, DPTElizabeth Leeds, DPT, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues. Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.


Using Your Total Gym for Spinal Stabilization


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With time being of the essence with patients, having a means to efficiently and effectively implement a therapeutic exercise routine can be challenging. Having a good comprehension of Total Gym’s mechanics has allowed me to create exercise routines that move a client through in as little as 15 minutes. To review these mechanics, see Total Gym Physical Therapy Video In-Service. Oftentimes the exercises look similar between clients, so the learning curve is less for both you and the patient, BUT the difference lies in the INTENT of the exercise. For example, squats may focus on leg activation or pelvic alignment and core activation depending on the needs of your client.

With low back being one of the most common diagnoses seen, this blog and the next two subsequent ones will address how to develop and progress a spinal stabilization program via enhancing mobility, core activation in varying positions, and postural awareness.

How to Develop a Spinal Stabilization Program – Part 1

Being a Physical Therapist, there lies an assumption that we all have a good foundation on neutral posture and core activation.  When initiating a spinal stabilization program, I start with simplicity and then move into what I call “complex simplicity.”  At first the movements are more linear allowing for the client to draw awareness of posture and core activation. Use this opportunity for you, as the PT, to observe if there are changes in form or activation with movements performed in sagittal, frontal or transverse planes. And, since the movements are less complex, reiterate that the focus is on the client learning about his/her posture to allow him/her to be able to achieve improved movement with ADLs. During this time, movements may also move from short to long levers, allowing the client to feel changes in level of activation. Can s/he feel the difference between a Lat Pulldown versus Lat Pullover? Using this movement, I will harness the opportunity to address levers in real life situations, like lifting groceries or children out and into the car.

Within this initial stage, remember that not all clients are comfortable with equipment, and time to learn how to move his/her body on the machine is needed to feel successful in the movement. The routine involves various positions to help train the body for the diverse movements of ADL. It is thus important, to teach the client how to transition between or enter and exit the machine safely between exercises.

Inverted supine

Heel slides and/or marching

The intent is to teach pelvic and lower body dissociation, as well as pelvic stabilization with lower body movement, i.e. load transfer through the pelvis.

> Use socks on the rails or a towel under the shoes to allow for less friction.

> The inverted position helps to passively position the spine, which may be needed for stabilization as the lever increases in this exercise.

> If the lower ribs are hyper-extending, use a wedge or pillow to allow for more ideal alignment.

> If your client cannot tolerate the inverted position, the bring the board to parallel or incline.


Squats with or without monster band

The intent is to either maintain the pelvis in neutral with a squatting action, or with the buttocks off the edge of the glideboard, the pelvis moving from neutral into anterior tilt back to neutral.  

> Ideally the buttocks is at the lower edge of the glideboard, however this may require strength to enter into the position, as well as move through this range of motion.

> Use of the theraband may allow for increased activation of the hip complex to help stabilize the pelvis and promote ideal knee tracking.

> Most clients want to push the low back into the glideboard to initiate the movement, especially moving from a squat to an upright position. Cue to activate core and lower body.

> For some, allowing the pelvis to naturally move into an anterior tilt may allow for less pain and improved activation. If able, have the client move the hips off the edge of the glideboard and let the buttocks drop in between the rails.

> To vary the exercise, have the client perform varying sets of squats with the feet in different positions. For example, neutral, externally rotated, staggered, or wide.

Lat Pulldown without or without bridge

The intent of the exercise is to draw awareness of how the upper body movement effects thoracic positioning. The supine position allows for the spine to be fully supported and provide feedback for when or if the lower ribs hyperextend.

When first teaching this exercise, teach it as two separate exercises to ensure the following

> The upper traps are not over activating. Cuing draw the scapula down the back assist with scapulohumeral rhythm and improved activation patterns.

> The lower ribs are remaining in contact with the glideboard, especially as the arms reach overhead.

> During Bridging, ensure the client is not riding back onto the cervical spine. Cuing for the knees to reach over the toes and keep the heels aligned with the sit bones and knees aligned with hips allow for improved activation and alignment.

Lat Pullover

The intent of the exercise is awareness of moving from short to long lever, and dissociation and stabilization between the trunk/spine and upper extremity.

> As the arms pullover, cue to end at the mid-thigh to maintain tension on the cables.

> Lengthening of the arms increases the lever, which changes the strength and flexibility demands.

> Watch for compensatory patterns such as pressing into the glideboard with the feet to over activate the glutes and not the core. Observe the rib cage as the arms move overhead toward the tower, as they may hyper-extend if the LATs are tight.

Seated Forward

Low Chest Press

The intent of the exercise is to improve awareness of alignment in sitting, as well as increase strength of posture during upper body movement.

> Glideboard may be inclined or parallel allowing for changes in hamstring flexibility and spinal alignment. An incline board accommodates decreased hamstring flexibility.

> Alternate to begin and increase to bilateral chest press.

> Ensure shoulders are pulling away from the ears.

Overhead Press

The intent of the exercise is to teach spinal stabilization as the arms are reaching overhead.

> Lean slightly forward to assist with balance. Note this will also require greater spinal work.

> Assess for excessive upper trap over activation.

> Alternate to begin and increase to bilateral chest press.

Upright Prone

Upper back Extension

The intent of the exercise is to strengthen the upper thoracic spine to assist with posture.

> Allow the chest to lie at the top edge of the glideboard.

> The pulleys are allowing for a feedback mechanism of when to stop lifting.

> The focus is to press gently into the pulleys as the upper back extends. When the glideboard moves, this is the end of extension.

If a person cannot avoid initiating or over activating his/her low back, then use a pillow under the hips or enter a low kneeling position.

Pull up heel squeeze / gluteal activation

The intent of the exercise is to activate the posterior fascial sling for spinal stabilization.

> To first teach this exercise it can be broken into two parts

  1. Teach a pull up with focus on scapular depression and core engagement.
  2. Teach gluteal activation without over activation of the low back.With the hips externally rotated, knees bent and heels squeezing together, gently squeeze the heels together as the client pulls up and lowers down.

> The focus is on gluteal activation, however, some may hyper-extend the low back to compensate.

> The exercise can also be done with hips in parallel and/or extended.

Standing facing the tower, with or without squat stand.

Sprinter Start 

The intent of the exercise is gaining the hip extension and while rolling through the ball of the foot.

> The client can be resting on his/her forearms or hands.

> The option of the squat stand is dependent on the client. Some clients prefer it off because it is more stable and requires less mobility. Other clients prefer the squat stand on as it allows for a greater surface area.

> Observe the alignment of the stationary leg as well, ensuring the knee and hip are alignment.

An incline glideboard will assist with upper body stabilization. If the glideboard is moved into a parallel position, then incline and squat stand height may have to be adjusted accordingly.

About the Author

Elizabeth Leeds, DPTElizabeth Leeds, DPT, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues. Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.


5 Ways to Strengthen Legs with a Bad Back

How to Strengthen Legs on a Total Gym with a Bad Back

Modern technology can be a total paradox. On one hand technology makes life easier, on the other hand it has caused us to become more sedentary by allowing us to push buttons for work instead of performing manual labor. The human body was made to move, not remain seated all day. In another paradox, too much time spent NOT moving could be a possible cause of low back pain.

Low back pain is no fun and can have a negative impact on the quality of life. If one experiences pain for more than a couple of days in a row it could be a sign of a serious injury and it is important to see a medical professional for a proper diagnosis and treatment. However, like many people, instead of ongoing low back pain one may experience occasional periods of discomfort. When these flare-ups do occur don’t let them interrupt a normal exercise program.

It can be difficult to identify the specific cause of lower back pain; it could be related to a lack of mobility in the hips, or overall strength in the legs. The structure of the lower back, the lumbar and sacral segments of the spine, where they meet the bones of the pelvis, is designed to provide stability. The hips, on the other hand, are designed to be mobile. One possible cause of low back pain is that sitting for too long can cause muscle imbalances in the hips which can significantly restrict the range-of-motion of the joints, changing how they move.

When the hips lose mobility, the muscles and joints of the lower back which sit above the hips, will try to create the necessary motion for many movements. Since the lower back is not designed to have an excessive amount of motion this can be a potential mechanism of injury. If leg muscles aren’t that strong when lifting an object off of the floor, one is more likely to use the back muscles. Improving mobility of the hips and strengthening the legs can help improve overall function and possibly reduce the risk of damaging the lower back.

If your Client’s back is bothersome it may be a little uncomfortable to strengthen the legs (NOTE: discomfort is okay–it means the muscles are working. STOP immediately if a feel sharp pain is felt) but strengthening the lower body could reduce the amount of discomfort. In an effort to help reduce the risk of developing lower back pain and improve the ability to enjoy one’s favorite activities here are 6 ways to use a Total Gym to strengthen legs and improve hip mobility.

When standing upright gravity pulls the upper body into the hips which can help reduce motion in the joints. To strengthen legs without harming the back or making any existing discomfort worse, it is important to remove the effects of gravity. We can’t just turn gravity off, although that might be fun if we could, but we can place our body in different positions to significantly reduce and minimize the impact of gravity. A primary benefit of the Total Gym is that moving on an inclined plane reduces the effects of gravity which can immediately help improve hip mobility.

Total Gym Squat


NOTE:  Total Gym helps keep the lumbar spine stable when lying on the back.  This allows your client to focus on the muscles responsible for moving the hips, knees and feet. The closer the Total Gym is to the ground, the less gravity will effect the body. If the back is currently bothering them, have them start with the glideboard as low as possible and increase the height of the glideboard as they feel stronger and more comfortable.

Stationary Squats: Have them lie on their back with their feet hip-to-shoulder width apart, so that their toes are close to the top edge of the squat stand. Have them lower their bottom down until their knees are about 90 degrees. They hold that for 30 seconds or until they fatigue. They then rest for 30 seconds and repeat 2-to-3 times.TIP: As they hold the squat, have them press their feet into the board and squeeze those thighs to engage the muscles.

Outer Thigh Lifts. Have them lie on their right side with their right leg straight and their right foot pressed into the squat stand.  Have them lift their left leg up in the air so that both legs are about 6-to-8 inches apart and hold for 3-to-5 seconds before slowly lowering  back down. Repeat for 10-to-12 reps and switch sides, rest 45 sec. after both sides, complete

Total Gym Sprinter Start

Sprinter Start

2-to-3 sets.

Sprinter Start. Have them kneel on the glideboard on their hands and knees so that they are facing the top of the Total Gym and their feet are close to the squat stand.  Have them place their right foot on the squat stand and keep their left knee under their hip.  Have them tighten their abs as they push their right foot into the board to move you closer to the top and return to the bottom slowly.  10-to-12 reps and switch legs, rest 45 seconds and repeat 2-to-3 times.

Step-ups. Set the rails on the lowest level.  Have them stand facing the bottom of the Total Gym so that their one foot can step up on to the glideboard pressing their foot down to move the glildeboard closer to the bottom, which will help it remain stable during the exercise.  They can pause for 2-to-3 seconds before slowly lowering themselves down.  Repeat for 8-to-10 reps, switch sides to alternate legs, rest for 45 seconds after both legs and repeat for 2-to-3 sets.

Step Up

Step Up

Squats. Have them lie on the glideboard with their feet on the squat stand so that their toes are close to the top.  Have them squat down for a 3-count, pause for 1 sec. then push back to the top. Repeat for 12-to-15 reps, rest for 1 min. and complete 2-to-3 sets

If these exercises are done at least 2-to-3 times a week there is a good chance that you will see improvement in the strength of the legs and reduce risk of low back pain.

Here’s a final paradox; yes, exercising when the back is bothersome can be uncomfortable but not exercising can actually make the discomfort worse which can turn a minor problem into a major one. Even after almost twenty years of being a personal trainer and group fitness instructor I may not know what causes low-back pain, but I do know that improving strength and flexibility in the lower body can help reduce the risk of letting it impact quality of life.

About the Author

Pete McCallPete McCall is an educator, performance coach, personal trainer, author, consultant and host of the All About Fitness podcast. Based in San Diego, CA, Pete holds a master’s degree in exercise science and health promotion, completed a Fellowship in Applied Functional Science with the Gray Institute, is a Certified Personal Trainer and a Certified Strength and Conditioning Specialist. Currently Pete is an adjunct faculty in exercise science at Mesa College, a master trainer for Core Health and Fitness, a blogger and content contributor for the American Council on Exercise (ACE) and online instructor for the National Academy of Sports Medicine (NASM).

Consulting with organizations like the World Bank, Reebok, 24-Hour Fitness, Core Health & Fitness, the Institute of Motion and Fit Pro, Pete has experience identifying needs and delivering solutions. Frequently quoted as a fitness expert in publications such as The New York Times, Washington Post, U-T San Diego, SELF, Glamour, and Shape Magazine and featured as a fitness expert for TV news outlets including WRC-NBC (DC), Fox News, Fox 5 San Diego, and NBC7 San Diego, Pete is a sought-after media resource for accurate, in-depth insight on how to get results from exercise.



How Total Gym & Pediatric Care Go Hand in Hand

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The Total Gym GTS Helps Children with General Body Strengthening

Here at Cindy Miles and Associates, we are a private out-patient therapy practice specializing in pediatrics. We are dedicated to providing individual, high quality, hands on physical, occupational and speech therapy. One of our primary goals is to build on each individual’s strengths, allowing them to achieve their maximum potential.

Total Gym treats patients with spina bifida

Improving Muscle Strength

No matter what their ability, age, or genetic make-up, individuals make important progress with the Total Gym and have fun doing it. Our primary focus is on the pediatric population, from birth through to young adult, including young athletes with sports injuries. We strive to build on strength to allow them to achieve their maximum ability and provide accessible equipment where individuals can work on their physical performance; including muscle strength, cardiovascular endurance, functional ability and mobility. This allows each individual to be the best they can be! For us and the children, Total Gym is a huge part of that process.

We upgraded to the Total Gym GTS about 8 years ago and we made sure to purchase the extra wide Squat Stand.  The GTS is great for loading lower extremities to get the glutes to work.  We even use the GTS for babies as young as 6 months old for strengthening as they love to jump.  For the orthopedic kids that we treat with Cerebral Palsy, Spina Bifida and Autism we put anti-skid pieces across the glideboard so their feet don’t fall and that gives them a different sensory input.

Total Gym helps children with Cerebal Palsy

Lower Body Strengthening

We treat several different needs:

> Brachial plexus injuries

> Cerebral Palsy: Hemiplegia, Diplegia

> Spina Bifida

> Hypotonia

> Hypertonia

> Developmental Delay

> Down Syndrome

> Children with autism who need deep pressure

> Young athletes with sports injuries

We can treat patients for a year or an ongoing basis, dependent on their type of disorder.  For children with Cerebral Palsy we might see them one or two times per week or more. If they have had surgery they are going to visit more.   We have individuals who are patients from birth through to their 30s – these cases keep making progress so we continue to see them especially in their formative years.

Here are some examples of exercises/activities we use on the Total Gym.


> Hands on “uprights” with squat stand removed with nose close to hands to complete push-ups moving into elbow extension.

> Prone to pull down on triangle bars into shoulder and elbow extension.

> Prone pull ups at horizontal bar with hands pronated or supinated.

Total Gym helping children with Spina Bifida

Hands on “Uprights”

Seated/Seated lateral

> Level glideboard working on static sitting so clients can touch the floor.

> Pull across trunk, holding both triangle bars.

> Holding triangle bar pull down using shoulder adduction/abduction.

> Seated rowing, using triangle bars.

> Sitting with both legs over same edge and triangle handles held together, keeping elbows extended and rotating trunk and bringing hands together to one side to work on core activation.


> Pull down over head, holding triangle bars return.

> Total knee extensions, progress to jumps.

> Work on squat to stand with support.

> Post op – prop one leg while the unaffected leg works on strengthening.

> Introduce jumping to clients who lack the strength to tolerate full body weight jumping.

> Bilateral LE jumps, unilateral jumps, jumps while playing catch.


> Kneeling to perform bicep curls and seated rows.

> Tall kneel: and work on scapular retraction or shoulder extension while keeping abdominals contracted to maintain balance.

Standing Upright

> Standing next to unit, with foot on platform and lunging forward to push glideboard up incline.

> Small toddlers use the glideboard to learn to walk up the incline.

The GTS is a great adjunct to any child’s program.  I teach a two-day course around the country and I tell everybody that Total Gym is one of the most important pieces of equipment that you can buy because of its versatility.

Pediatric clients love Total Gym and Pediatric Physical & Occupational Therapists love the versatility for all ages and abilities use it in their daily treatments. Pediatric therapists can do what they do best:  invent games, diversions and make therapy fun!

About the Author

Cindy MilesHaving served the pediatric population since 1977, Cindy Miles, PT, PhD. PCS, CNDT established her pediatric private practice in 1981. Dr. Miles is a graduate of the University of Pittsburgh, School of Health Related Professionals and East Stroudsburg University with a Master of Education in exercise physiology. She also holds a PhD in Pediatric Science from the Rocky Mountain University of Health Professions. Her doctoral research was on potential risk factors related to the diagnosis of Torticollis. She is Board Certified by the American Board of Physical Therapy Specialties as a Pediatric Clinical Specialist, specializing in treating children from birth through to young adults. Dr. Miles held the title of  SOP Treasurer and Treasurer Elect and is presently the Co-Chair and Meeting Planner for the Academy of Pediatrics Physical Therapy Annual Conference (APPTAC). She presents nationally on the pediatric private practice and reimbursement as well as nationally and internationally on Torticollis, Plagiocephaly, and Fitness for All Abilities. She has published in peer review journals and written books on topics related to pediatric physical therapy. or


Perform Better: Performance Equipment Provider

Perform Better Really Does Perform Better!

If you are in the fitness industry –  whether you’re a gym owner, a personal trainer, a coach, a physical therapist, an athletic trainer or anything else that speaks functional training, fitness or rehab, and you need to find equipment, then Perform Better is the place to get it!

Experts in functional training, rehabilitation and sports performance, Perform Better will not only sell you any type of quality commercial grade exercise equipment, from a Total Gym Jump Trainer to a Lebert Equalizer Bar but they will advise you on which is the best equipment for your facility and they will also advise you on how to set up your facility and even design it for you!  Oh and they offer top notch delivery and installation services as well.

Jacob A. Guajardo

Jacob A. Guajardo

We recently caught up with Jacob A. Guajardo in the sales department of facility design to get the scoop on Perform Better and find out what they were up to these days.  He told us some interesting stuff.

“MFAC started as a heel cup manufacturer which most podiatrists around the world still use. From this origin, the company, led by Bill Falk, grew as a leader in the track and field community. Perform Better was established in 1992 and now is a leading provider for quality equipment for the fitness professional.  Currently, there are Perform Better divisions in Germany, China, Japan, and the Middle East. And they are still growing! Their main audiences are fitness professionals, college and professional sports teams, along with mainstream fitness enthusiasts. In addition, Perform Better offers a very unique educational platform which helps strength coaches, personal trainers and/or physical therapists become experts in functional training.”

Original Plan

Original Plan

Jacob got into the fitness industry 26 years ago while in college in Nashville, Tennessee. His first job was setting up various types of fitness equipment. When he moved to Massachusetts, he found a job setting up and delivering the same types of products for a similar company. After working for that previous company for 13 years, he moved to Perform Better sales and facility design and has been with them for over 11 years.

We asked Jacob about the facility design segment of the business and how the process worked.   Here’s what he told us:

“The staff at Perform Better brings a wide range of skill sets with some being former athletes and some of the staff still compete competitively. Every person in the company has been involved in athletics in some capacity which makes us a very well-rounded, trusted, and knowledgeable operation.

Regarding facility design, we started this service about ten years ago. Initially it was in a 2D format and was primarily used to figure out how we would layout turf or rubber or maybe give an idea of how a room could be laid out. Today the facility design team can create virtual products, provide 3D walk through movies of a proposed facility, and provide high resolution images for customers marketing grand openings or “coming soon” images.

3D Plan

3D Plan

The facility design process is very simple, yet effective:

We always like to start with a layout of the facility like this one from a recent install we completed.

This picture illustrates the initial idea or vision that the clinic had for the renovation of a local church.

Of course they met with the town building inspectors, builders and then presented it to Perform Better. We aided the customer by providing them with a conceptual drawing of their initial ideas (see the color 3D plan above).

Before and After

Before and After

Luckily the customer was local, so I was also able to attend meetings with anyone from the clinicians to the building personal, architects and the contractors. I was able to view the facility prior to design and was able to modify the design on the fly when a problem came up.”

Jacob continued with photos, “this one shows a before and after.  Well, more a “during” installation and after, for this very cool physical therapy/sports performance clinic.  You can see there’s quite a transformation.

The facility design department has grown to have 4 full time designers, meaning 4 people that know how to use the program, but every sales person on staff has the ability to help layout and give advice or lead buildout for all interested customers. The bottom line is facility design is just another way we can continue a conversation with a potential customer and then they be able to use our design when communicating to their investors, clients or staff.”

Jacob continued, “We’ve recently started to put together an online interactive map.  It shows locations of facilities we have designed over the years which we think is pretty impressive if you are looking to see how experienced we are.”

Perform Better Interactive Map

Perform Better Interactive Map


Perform Better also offers is a series of specialized Functional Trainer Summits across the US that are designed to provide trainers, coaches and therapists hands-on expertise through a combination of speakers, lectures and learning experiences by many top professionals in the industry.

Here’s a video showing a recent Perform Better 3-Day Functional Training Summit in Long Beach, CA.


New Microsoft PowerPoint Presentation

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Perform Better have established themselves as the “go to place” for fitness, rehab and education.  Staying at the forefront of customer service, a Facebook Review couldn’t have put it better, “When you deal with Perform Better, they try to make sure it’s a good experience each and every time.  It’s great to see companies that do well by doing good!


Open and Closed Chain Exercises on Total Gym

When to Use Open or Closed Chain on Total Gym?

Simply put, open chain exercise is where one end is fixed while the other end is free. Raising the arm up overhead or knee extension are open chain exercises. A closed chain exercise is when both ends are fixed. For example, push-ups and squats are closed chain exercises. Open chain exercise is easier to implement when isolating a single joint. For example, the elbow joint is isolated with biceps curl and the knee is isolated with hamstring curls. In rehabilitation, when weight bearing, strength and range of motion are impaired or injury is acute, open chain exercises may be easier to implement. With that said, open chain exercises can place greater shear, stress, on a joint, making closed chain exercise more desirable.

Wide Rear Fly - Open Chain

Wide Rear Fly – Open Chain

Closed chain exercises increase joint stability, decrease acceleration forces, and increase muscular activity to help resist large forces. Due to nature of the exercise, closed chain exercises tend to incorporate more joints. For example, a squat involves movement at the ankle, knee and hip. A push up involves movements at the wrist, elbow and shoulder girdle. Due to increased muscular and joint activity in closed chain exercises, stability in a joint may be enhanced. Thus, in rehabilitation, closed chain exercise may be a more ideal exercise in clients with instability. Note instability may be present with swelling or post injury as in the case of a knee ligament tear.

If weight bearing is not restricted, squats may be an optimal way to help with stability and increase range of motion. In a fitness training, closed chain exercises are a great way to address a multitude of muscles in a small amount of time.

Lunge - Closed Chain

Basic Lunge – Closed Chain

Closed chain exercises can also provide a great way to increase weight bearing on to bones, which is important in the prevention of osteoporosis.

Understanding the Rationale

So when constructing your workout or rehab routine, what should you do more of…open chain exercise or closed chain exercise? Unfortunately, it is client dependent. However, if you can understand the why behind a philosophy then you can decide what exercises work for you. Note that most routines have a combination of open and closed chain exercise.  Here are some examples of exercises, general rationale and open or closed chain in nature.  To watch the exercises, click here.

Open.Closed Chain Exercises on Total Gym

About the Author

Elizabeth Leeds, DPTElizabeth Leeds, DPT, owner of Seaside Fitness and Wellness, combines her background in physical therapy, personal training and Pilates in her practice and teaching. As a pelvic floor physical therapist working at Comprehensive Therapy Services in San Diego, her passion for pregnancy and postpartum is seen in her mission to empower women with knowledge and understanding of their physical changes, and how to address them to prevent future issues. Additionally, Elizabeth is a Master Trainer and developer for Total Gym’s GRAVITY education.

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