Sunday, April 22, 2012

Is Pilates Good For Your Back? Or Will It Make Your Back Pain Worse?

Note: I originally wrote this for the general public, so tried to make it as non technical and clear as possible. In doing this I have not put in any references, as this may interrupt the flow, but as always, everything can be referenced.

Is Pilates Good For My Back?

Pilates popularity does not seem to be waning. In fact it seems to have become the ‘go to’ class for anyone with any type of injury. (Full disclosure: I qualified to teach mat based pilates about 6-7 years ago, so am aware of what the training consists of and why people are told to go and do Pilates). I have noticed more and more people being recommended to do Pilates for a range of conditions. Doctors, Physiotherapists, Osteopaths, Chiropractors and Consultants have all suggested their patients and clients do Pilates to help them with a whole host of injuries and problems. I’ve had people referred for knee injury, hip replacement, whiplash, shoulder problems, chronic fatigue and most commonly lower back pain. Some of these people were unable to get down onto a mat or kneel down or lie flat, but had been recommended to do mat based exercise. One person came to me after sciatica, back surgery and hip surgery and the only exercise advice she had received was 'to do Pilates'. Pilates has become the universal panacea!

The fact that medical and health professionals are recommending anyone to do exercise should be seen as a good thing. It could also be a sign of an over burdened physiotherapy service, where patients are being told to do classes because the one-to-one physiotherapy they need is not available. In my experience, most people recommended to do Pilates due to some type of injury, are following the advice of their GP. Having said that many physiotherapists are now promoting their own back pain classes and are jumping on the Pilates bandwagon, they are advertising the fact that these exercises are specifically based on the Pilates method. Despite no evidence for its benefits. As we shall see, Pilates methodology may not be the wisest choice for those with lower back pain; and as for those with knee pain and neck pain, it's not clear why it's being recommended at all.

It is a positive that physios and osteopaths are trusting fitness professionals and their knowledge, it would also seem curious that they are passing on patients and clients that they could and should be rehabilitating themselves. However, it seems mostly there is a lack of understanding among medical professionals and the general public as to what Pilates actually is.

For those of you who are unfamiliar with the history of Pilates and how it came to be the universal panacea, here is a brief history. Joseph Pilates was born in Germany in late 1800’s, in the early 20th Century he came to England and while interned on the Isle of Man during the first world war was working in a hospital. Around this time he started to develop a series of mat based exercises and novel equipment like the Reformer ( a cable, pulley, sled type machine ) and the Cadillac and other equipment. His choice of exercises and the equipment he developed was very much informed by his gymnastic background and possibly even the circus, where he had performed. It is also likely that many of the exercises would have been influenced by other disciplines and fitness ‘gurus’ at the time. Although, we think of fitness crazes as a modern phenomenon, they are not, and there were a number of fitness ‘gurus’ around at the time and before, like Arthur Saxon, Eugene Sandow and many more who had their own fitness systems and equipment. Joseph Pilates later moved to America where his studio obtained a steady following amongst dancers especially. Joseph Pilates carried on teaching until the 1960’s.

Jospeh Pilates teaching someone on one of his many pieces of apparatus

Pilates stayed more or less as a fitness footnote until ten or fifteen years ago, when various individuals and schools of Pilates started to emerge and expound its virtues, especially in the UK. This also coincided with an explosion in so called ‘functional fitness’, the use of swiss balls and the concept of ‘abdominal hollowing’ (more on this later). This did help the fitness industry out of a rut, which had become stuck using static machines. Suddenly the public and instructors had a whole new range of concepts and exercises to use.

Over recent years Pilates has grown and grown to become more of a brand than a clear cut exercise system. Go to any Pilates class today and it unlikely you will see any instructor doing Joseph Pilates original sequence of mat work exercises, which from a back care point of view may be a good thing. The original exercises can be very challenging and not the gentle exercise for the de-conditioned individual that most people think they are. Pilates has become the class to improve your ‘core’ or ‘posture’ or in Pilates parlance your ‘powerhouse’ and help you get ‘longer muscles' (of course, longer muscles are impossible as the attachments are set). These days, it is very hard to say what Pilates is, even most of the official Pilates courses have modified the original exercises or broken them down into various levels of difficulty. For example, see the pictures below, one of the original ‘swimming’ exercise and the modified 4 point kneeling version, which is a standard rehabilitation exercise called 'Bird Dog'. The original swimming causes massive loads on the lumbar spine, whereas the 4 point kneeling version does not.

Classic Pilates Swimming exercise - causes massive amounts of compression in the lumbar spine. Say goodbye to your facet joints, you'll miss them when they explode. And your cervical spine (neck) wont like you to much either
Modified Pilates Swimming exercise aka The Bird Dog aka quadruped contralateral arm & leg lift aka your facet joints wont explode

And herein, lies the problem with Pilates as an exercise for lower back pain. You may have lower back pain and have been told to do some Pilates because it will help. You may go to one class which is staying true to the original exercises and do an exercise which is possibly going to make your back worse and you may go to another which is using any of the modified exercises and it is going to possibly help your back. And in another class, an instructor may be throwing in some of the original exercises, some modified ones, and then some general core and toning exercise they’ve picked up along the way because after all that’s why most people come to the class, to tone up and if you do have a lower back problem all that abdominal work is going to help, right? Wrong!

One person may go to Pilates and it helps with their back pain, for another person it may make no difference or make it worse. This doesn’t only apply to Pilates, but Yoga and many other general fitness classes. This also applies to a whole host of injuries, your shoulder/ hip/knee injury may get better but then again it might not, you are not doing a set of exercises specifically designed to help. The problem is Pilates is not specifically designed for lower back pain, and the person teaching it may have no background in it. You may go to a class and be able to do 90% of the exercises, but 10% of the exercises may actually make your back pain worse. You may not have access to a specific lower back class or rehabilitation program where you live and this leaves you with a conundrum - should I do the class or not? Of course, your first port of call is the physiotherapist, though I’m sad to say you may end up with nothing more than advice to do some Pilates and an exercise sheet consisting of knee hug stretches and knee side to side mobility. On the other hand you may get a first class rehabilitation program that is specific to your needs, evidence based and progressive. However, the lack of consistency in this area, means you may need to educate yourself.

With this in mind, here are some ways to modify and avoid certain things that may make your back pain worse. These are all evidence based strategies and proven to work. In each example, I will show the most common way an exercise is taught and how you can modify to help spare your spine and strengthen the muscles.

The Spinal Roll
Modified Spinal Roll in Pilates - may not be the best idea if you have lower back pain

The spinal roll is almost universal in Pilates as a warm up exercise and a way to get down to the mat. However, look at the position of the spine, it is fully flexed, it is in a rounded, bent position. Now, evidence shows that repeated spinal flexion can lead to a disc prolapse or injury. The load is not important, it is the amount of times you do it, and the amount of times you do it before it causes injury is purely individual. Imagine a credit card, if you keep bending it back and forward, eventually it will snap in the middle. Also holding a spinal roll position can cause the muscles in the back to switch off and the back is hanging on the ligaments between the vertebrae in the back.

In adults aged 20-50 years old nearly all back pain is forward flexion intolerant and discogenic. In other words, round the back and bending over makes it worse!

Avoid any exercise that may round the lower back and especially if it is rounded under load. So in Pilates terms this also means you need to avoid the Roll Up and Rolling Like a Ball (see below for pictures and video and to be fair on the Pilates course I attended, they did say to avoid rolling like a ball if you have scoliosis).

Pilates Roll Up - avoid if you have lower back pain and also promotes poor posture

An alternative to the spinal roll is the hip hinge. See my article here, for a full explanation of the hip hinge. In this movement you will keep your back in a neutral position and hinge from the hip by pushing the hips back as you fold forward. This movement spares the spine, works the muscles either side of the spine and gets the muscles around the hip working as they are supposed to.

Abdominal Hollowing

This has become almost universal advice in all classes, in the gym and in Pilates. Joseph Pilates original work was also very much about pulling in the stomach muscles, hollowing, engaging the internal corset. Of course, doing this can immediately make your waist look smaller and more sleek. The explosion in popularity of Pilates also coincided with some Australian research that showed people with lower back pain weren’t firing off their transversus muscles (the internal corset). However, this study only measured the transversus, it didn’t measure any of the other core muscles, and it only measured it on one side when people were told to lift their arm over head. With lower back pain we need to get the whole core working to protect the back. Not just focus on one muscle.

Other muscles around the core are just as important, the obliques, quadratus lumborum and rectus abdominis. These are best engaged by bracing the abdominals. Hollowing actually causes the lower back to be less stable. Imagine the difference between a tent where all the guide lines are taught and spread out, and one where the guide lines are loose and close in, which one is going to stand up?

Brace wherever possible, this engages all the core muscles. Brace as if you are going to punched. It is important to not try to pull in or push out your abdominals, keep the circumference the same.

Lateral Breathing

In Pilates you are instructed to breathe laterally or thoracically. This probably stems from a couple of factors. Firstly, Joseph Pilates came from an era when those involved in Physical Culture pulled their stomachs in and puffed out there chests, it is almost a classic Westernised idea of what good posture should look like. The guys and strongmen especially wanted to make their chests look bigger and their waist look smaller. As do women as well I guess!
Joseph Pilates - note, the abs are being pulled in, the ribs are flaring, the diaphragm can't do its job. And I have no idea what that machine is!

Secondly, if you are practicing abdominal hollowing you can't breathe using the diaphragm because you can't push your abdomen out. In fact, Pilates states that abdominal breathing is wrong. However, if you look at breathing anatomy, to breathe properly your diaphragm must push down to let the lungs fill and that will push the abdomen out and also give you a more stable core.

If you breathe laterally, you should breathe laterally using the diaphragm, which means you should feel the area between your lower ribs and hips (your obliques) expanding sideways. But you should also fell the front of your abdominals and lower back pushing out and expanding as you breathe, like a cylinder.
The diaphragm pushes down when you breathe in
This type of abdominal breathing is practiced in yoga, meditation and most Eastern martial arts. They were onto something.

Spine Twists

This is an exercise where the details matter. A lot of classes will finish by lying on your back and rotating the knees from side to side in a windscreen wiper fashion, this exercise is still given out as a rehab exercise for the back. However, the lumbar spine isn’t designed to rotate that much, your back is designed to rotate through the thoracic (middle back) and hips, therefore sparing the spine. Many people with lower back problems think they need to stretch out their lower back and improve the flexibility in this area. In reality, many of these peoples lower backs are already too mobile and unstable, they need to work on having a ‘stiffer’ core and getting mobility in the middle back.

The modified Pilates spine twist is ideal for doing this. In the video below the modified Pilates spine twist is shown, as well as a tall kneeling version. I use this modified spine twist all the time with people; there are elements of Pilates which work well for back pain, it is just knowing which ones.
The classic Pilates spine twist is much harder, as the arms are out straight to the side and the legs are straight to the front. The modified one fixes the head and rotates with a neutral spine, the classic version can end up being flexion and rotation.

Also, there is a Pilates exercise called The Saw which is flexing and twisting to do a toe touch - one of the worst things for those with back pain. We know one of the worst actions for the back and tearing up the discs is the action of bending and twisting. So we can see how one version of this exercise is beneficial whereas another version is not.

The Saw - most people are going to end up twisting and bending through their lower back.

Crunches and back flattening

There are very few crunching movements in Pilates, to its credit much of the time you are trying to keep a neutral spine. In some exercises though, the back is flattened or rounded into the floor or mat. In Pilates this is called 'imprinting' the spine or back. This is just really forward flexion again but with your body on the floor, same as the standing versions. Repeated crunches or imprinting/ flattening of the back can damage the lower back tissue and are not that effective at activating the muscles in the core and can result in poor upper body posture. Try not to flatten or over extend the back, keep it in a neutral position with a natural curve. Your lower back is strongest when it has a natural curve in it, not flat or excessively curved but neutral. This is where the grey area of what is Pilates comes in. Pilates itself doesn’t have many crunching movements, but instructors may be adding these in.

Classic exercise Neck Pull. Doesn't really get done anymore in classes, but if you think crunches are somehow safer or better then think again
Curl Up - flipped onto its side. Some Pilates courses teach the curl-up. Even if imprinting and flattening the lower back didn't cause problems look at the posture this promotes - head forward, shoulders rounded, hips flexed. Most people spend all day in this posture anyway, they don't need to practice it


As mentioned earlier, people with lower back pain often feel the need to stretch out their lower back or are advised to do a knee hug stretch. This is not a Pilates exercises but is often done, as is rolling like a ball, which is one of the original exercises. Stretching the lower back muscles can be detrimental to the spine, as it makes the lower back less stable.  The muscles may have become permanently switched on and in ‘spasm’ but there are other ways of switching these off and helping them to relax that don’t involve stretching. This doesn’t mean stretching in general is bad, other tight muscles in the body may benefit from stretching.

Pilates originally attracted quite a few dancers, this group is naturally very flexible and in many cases way too flexible and unstable. An exercise that may be easy for them may impossible for you. Plus their incidence of back pain is the same as everyone elses, they just end up with different types of back pain.

In summary

Hopefully, this article has cleared up some of the issues surrounding back pain and Pilates. The term Pilates has become so general that really there is no set definition anymore. This article shouldn’t discourage you from taking part in classes, nor does it mean Pilates wont help. Following the guidelines above should help. Remember, this article is aimed at people with lower back pain,

  • Avoid forward bending with a rounded back, you should hinge from the hips
  • Abdominal bracing is superior to hollowing to strengthen the core
  • Avoid lateral or thoracic breathing, breathe using the diaphragm, this will activate your core and  protect your back
  • Try to avoid rotating through the lower back, you should rotate through the middle back and hips
  • Keep a neutral spine and avoid pressing your back flat or doing traditional crunches
  • Avoid stretches like the knee hug stretch, but other muscles like the gluteals & hip flexors may be tight and need stretching.

You may think, that if you do all these things, then you are no longer doing Pilates. The truth is you probably weren't doing classic Pilates in the first place, but a hodge podge of things mixed together. If however, you go to a class, it makes your back feel better and you enjoy it, does it really matter what it was called?

Lastly. Ideally try to attend a specific class for chronic lower back pain or have an individualised program. If you have other injuries like hips and knees, again a specific individualised program specific to your needs will be more beneficial than attending a class where possibly only one or even none of the exercises are going to help you.

*I originally wrote this article over 2 years ago, but never got around to taking the photos for it or publishing it. I have had added a few extra bits, but this is pretty much how I wrote it 2 years ago, the principles in it all hold true. I wasn't going to publish it, as I thought all this information was out there and quite well known. Turns out I was wrong, last weekend I was on a course with Physios, Osteos and Chiros, when the issue of abdominal hollowing and back pain came up it was a revelation to the majority of the people in the room - about 30 - many of whom had been referring patients to Pilates for back pain, as one of the physios/osteos asked at the time 'does this mean Pilates is wrong?' In this case, I'm afraid it is. The mantle of back pain & injury cure-all got projected onto Pilates, and turned it into something it never initially claimed to be. For lower back pain, the evidence is clear and despite over a decade of research showing that many of the Pilates concepts should at least be modified or reversed or in some cases completely replaced, they continue to be taught.

Saturday, April 7, 2012

'No Joining Fee'. The Fitness Industry Epic Fail.

Fourteen years ago the first health club I worked for had a leaflet offering 'no joining fee'. Last week I got a leaflet through my door from Virgin Active, and guess what the offer was, yep, 'no joining fee'. In over a decade the fitness industry hasn't moved on, its still churning out the same unimaginative, trite messages that have been proven to not work.

Even a company like Virgin Active that must have whole teams of marketing personnel and more money to spend than the average club regurgitates and persists with a failed strategy.

In this article, I'll look at what the fitness got wrong and continues to get wrong and may be come up with a few answers and suggestions for a better way. I don't pretend to have all the answers, but there just might be a better way.

(Note: this is a long post, if you don't feel like reading the whole thing, I've done a handy summary at the end, though you will miss out on some top notch info and references).

Why is there a joining fee in the first place?

Whether you call it a joining fee, an admin fee, a starter fee or whatever, most clubs which contract you in can't come up with a good reason why they have one. Probably twelve years ago, no joining fee offers seemed like good value to the public and consumers. The industry was still expanding, everyone was following more or less the same health club model and it seemed there was money to be made.

The joining fee is no more than a sales tool now, the public got wise to it. Joining fees and price presentations are the tactics of double glazing salesmen ten years ago. Everyone now knows that as soon as the sales advisor/person/ manager panics about not meeting their sales target for the month there will be a no joining fee offer. Sure enough, last weekend of the month, the offer banner will go up, no joining fee weekend, the text messages will go out to the prospects, a few people will join and the cycle will begin again.

Here's, the first thing the fitness industry can do now. Have transparent pricing. Have faith in your product and pricing. Stop discounting. If people know you discount, they will wait until you discount to join.

These days, everyone is fond of using Apple as a model for success (unless you happen to be one of the people working in their Chinese factory, then you probably don't feel so great about it, see here ). So throughout this article, I will post the question every so often, what would Steve Jobs do? Well, firstly, as you've probably noticed, Apple rarely discount products, ever. Their products aren't cheap to begin with, and often cost much more than their rivals products, but they still don't discount, because they have faith in the quality of their product.

If the customer wants your product, then price will not be the barrier.

Never forget Steve Jobs also came up with the $10,000 folly that was the Apple Lisa

Transparent Pricing

In a recent Fit Pro business (fitness trade magazine) article a company that does mystery phone calls said that the number of calls being answered in 5 rings or less was down to 60% and worst of all, most operators were committing the cardinal sin of telling the enquiry the price over the phone. In the same magazine, the open comment article says that the fitness industry's market penetration is still only 10%. And in the Editors commentary we find out that management expert Nic Jarvis believes a customer-centric approach will be the next big thing (hang on, no one thought we should be customer-centric before-hand?!)

Anyone, see the disconnect here? We treat our product like a secret organisation, putting up barriers. Oh, you actually want to know how much our gym costs? Oh, we couldn't possibly do that, we have to get one of special Sales Advisor guides to show you the secret room first, the secret room full of machines.

Obscure film reference: on the way to the room in the zone in Stalker, when they get there the room is a cardio theatre

You can go online now and buy just about everything, whether it be Amazon, or booking a holiday or hotel, the price of the product is there and plain to see. But for some reason, the fitness industry is still appallingly bad at this. (It also still thinks phone call mystery shops are valid, when most customers go to the internet first or come into the club, in fact, the only people who really enquire by phone anymore are mystery shoppers!).It was only a few years ago that some of the budget clubs changed the game, by giving customers the opportunity to join online and by actually stating what the price was. Despite this, very few health clubs or gyms actually show you what their prices are on their website, and even fewer allow you to actually part with your cash and join online.

In his book Winning, Jack Welch outlines the key behaviours of a company called Bank One (who lets face it are probably owned by the tax payer now, but the statement still holds true)

"Always look for ways to make it easier to do business with us"
 If you think about the fitness sector, we actually make it very hard to do business with us. In most cases, you can't join online, no one will tell you the price unless you book a secret tour of the special room of machines. And even if you do turn up to have a look at the gym , there's no guarantee that anyone will actually let you look at it. For example, me and my colleague tried to mystery shop a Virgin Active in the city of London, except we weren't actually allowed to see the club. We were told by the receptionist, that the sales advisor was in a meeting (no doubt discussing with his area manager how he was smashing targets but still needed to do a no joining fee offer that weekend) and couldn't show us around. Could anyone else show us around? No. that was a negative, no one else had the magical powers to say 'look. here's a treadmill'. Could we just go and have a look ourselves, again, that was a negative, there was no way we could be let into the secret citadel without a sales guide, what the hell were we thinking?! Now, if I was a real customer I would have probably gone and joined Bannatynes down the road, because at least they gave us a tour. However, at Bannatynes, the sales advisor had taken the museum tour concept to a whole new level, at one point he said 'here is a water fountain'. Thanks buddy, good to know that my £60 a month entitles me to some tap water. It might be owned by a dragon, but it doesn't mean they are any better than the usual suspects.

Most of the public don't consume our product and don't want our product, and yet, when they do, we actually make it hard for them to do business with us.

We must put ourselves in the mindset of potential customers. I find it very hard to imagine what it would be like to walk into a gym for the very first time, because I do it all the time. So I have to think of a scenario where I wasn't comfortable. I have been to Selfridges on Oxford St in London but once, if you've never had the misfortunes to go into Selfridges or Primark on Oxford St its like a cross between a shopping mall, Bladerunner and the Tokyo subway, in short I wanted to get the hell out of there, stat. And that's exactly how most of the public feel when they enter a gym.

You don't have to be a Six Sigma black belt like Jack Donaghy to figure this stuff out

Most high end health clubs are rubbish, in fact, 99% are.

Most high end gyms are crap. You pay £80-100 for one crappy program written by a guy making minimum wage, and despite the fact you are already paying £100 a month, they try and sell you personal training immediately, and if you're not interested you are persona non grata, just waiting for your 12 month contract to end, so you can leave, join somewhere else and get treated exactly the same all over again.

Don't be fooled into thinking higher price means better service, the fitness industry doesn't work this way. In the same way that the most exclusive clubs don't necessarily have trainers any better qualified than the guy working with his clients in the local park.

But don't worry, at least you get to have Molton Brown when you use the showers.

And nearly all health clubs have followed the big room full of machines model...

All watched over by machines of loving grace

Okay, Adam Curtis didn't have treadmills in mind, but you get the idea
This paradigm was set in the 1990's, and for the commercial fitness industry it hasn't changed that much. Get a room and fill it with cardio machines, and some resistance machines, and minimal free weights. Hopefully this will attract the 'right type' of clientele. This is also a minimal coaching model, because you don't need much coaching ability to show someone how to press quick start on a bike, therefore the company then saves money by paying staff minimal amounts because you don't need a strength and conditioning coach to be in the gym making sure people do something that might actually work.

I've been to a few brand new facilities, and they still get the model the wrong way round. Rather than thinking what does the customer need, and then choosing the equipment and then designing the appropriate space for this need; they still get a big room and see how many bits of kit they can fit in it. These facilities have had impressive swimming pools, and tennis courts and studios but the gym space was poorly designed; still almost an afterthought in terms of layout, size and flow. Just the usual depressing regimented rows of machines.

What would Steve Jobs do then?

In another article entitled Think Different in the Apr/May/Jun 2012 Fit Pro business magazine a guy called Derek Barton rightly states

"The health club industry has not figured out how to deal with the fact most people don't want its memberships. Even when people do join, many don't come back after 30 days."

But then in saying what he thinks Apple would do I think he misses the point. Barton thinks that Apple would build fantastic, cool, easy to use gym equipment that would attract people. He confuses the equipment with the product. Yes, Apple do control all aspects of their product from the machines, to the software to the Apple stores they are sold in. But, they don't control the music of the musicians that go on the ipod, and the computers used at Pixar were just a tool so a creative vision of film making could be realised. In the fitness industry, the machines and the equipment are just the tools.

If we followed this idea, then why don't Life Fitness and Technogym open their own gyms?

They already build the machines. And to be honest, if walking along on a treadmill while playing sudoku is your thing then they have done a pretty good job. (And don't get me wrong, some people want to come to the gym and plug in and watch TV while doing 40 minutes of cardio). Current cardio machines have touch screens, and TVs, and games, and ipod docking stations and internet connection. They've ticked all the boxes.

Probably, the main reason that Technogym and Life Fitness don't open their own gyms is that they are not stupid. Operating a health club is low margin business. The current Technogym top of the range treadmill costs over £11,000 off the shelf without discount, even with a 50% discount, that's a £5000 piece of hardware. A large chain gym can have 20-40 treadmills, so spending over £100,000 on treadmills alone is not uncommon. Set up costs are high, and margins are low in this business model.

Room full of treadmills: That's a 100 grands worth of treadmills right there
 And for a while everyone was happy

When the health club expansion first happened everyone happy, the equipment companies were selling warehouses full of machines, the clubs got to fill their big rooms with a cornucopia of machines to dazzle the public with, and the public got to do their 20-30 minutess of steady state aerobic exercise that everyone had told them to do. The clubs got to control the flow of people in their big rooms,, if someone is on a cardio machine for 20 minutes and the another one for 10 minutess and then another, there is a perceived value to the experience because of the length of time in the gym. Whereas no club was ever going to buy 20 latpulldowns or 15 chest press machines, that would be ridiculous. If members only did the weights circuit workout they were recommended they would be in and out in less than 20 minutess, no perceived value; also too much queuing for the resistance machines if that was emphasised. As resistance machines were built along the lines of one machine for one body part. Unless you were a serious weight trainer then it was all about the body part splits.

Cardio machine, fat loss machine, ab machine & conditioning machine for less than £50

But then, the health clubs became unsure of themselves. They weren't get anymore members and some of the big ones closed down or got taken over. And the companies didn't know oif they were giving the public what they wanted or what they needed, but they couldn't change. And the members of the public who had grown up in the health club boom and had always been told that they needed to do cardio, and lots of it, and you needed machines, and resistance machines too. And the disconnect happened, the public wanted health clubs with machines because it had always been so, and the health clubs kept building them. 

Because the health clubs had become confused, they had turned into showrooms for Technogym, Life Fitness, Cybex, Precor and all the others. The instructors were merely custodians, pointing the public to the best machines for their aerobic workout or their chest day.

Strength machine. Unlike a resistance machines that costs £3000, this one can do multiple things, but it takes up a lot less space in the big room, so the room may look a bit bare, but hey, maybe people could run up and down in the room

The machines weren't inherently bad, they were after all just machines, they more or less did what they said they would do, but the cult was over.

The members, in general, weren't getting results. And like many things in the 21st Century the industry started to fragment, and smaller PT gyms opened, and some people were getting results and they didn't have any equipment and some of them didn't even have a room. The old paradigm was starting to falter.

However, in recent years a couple of examples have shown that another paradigm is possible. British Military Fitness and other bootcamps have shown that people are willing to pay to train when in fact you have no equipment and you don't even have a gym space. (see my thoughts on bootcamps here). Zumba, has done the same, the instructors and the public realised that they didn't need to work in a gym or join a gym, all you needed was a big village hall and some music. Overheads are basically zero, and you target a specific market.

Don't try and be all things to all people

Health clubs have tried to be all things to all people, and in essence have failed to do this. Yes, there is a wide price spectrum, but you can write the mission statement for all of them by re-arranging the following words 'fitness, fun, family, service, customer focused, flexible, personal, blah blah', its all generic and doesn't mean anything in reality. In trying to attract everyone, they weren't really sure who they were attracting.

They have to attract as many people as possible, because they've got a problem,  the set up cost is high, running a facility with swimming pools and saunas and steams rooms costs a fortune, and people keep leaving.

I think it was Mark Rippetoe who said this industry doesn't make money. If you open a power-lifting, olympic weight lifting, hard core lifting facility, even in a relatively large town there won't be enough people to support the business. And in a small town it will be you and 10 of your friends lifting weights, while your business leaks money. Rippetoe says, you need that person who comes in and pays there dues every month, may be you don't like the fact that they just sit on a bike or stroll away on a treadmill, but at least they are doing something unlike most people, and they are paying for the business. Large commerical facilities rely on this idea to a much greater extent.

Both LA Fitness and Fitness First have garnered a lot of bad publicity recently in the UK via twitter, print media (see here) and TV because they make it hard for people to break contracts. This moment has been a long time coming, the sales and contract procedures in the fitness industry are so amateurish and poorly thought out I'm surprised it took this long. But the companies need these contracts, because they know most people are going to drop out, they need to compel you to keep paying.

And other sectors don't get the same level of bad publicity for a simple reason, because people perceive they need the product, that 2 year mobile phone contract, it's open to fat and lazy as well as fit and motivated people. Mobile phones, and ipads attract all types of people, and even when people lose their job they still perceive their phone and internet connection as essential.

But there are lots of other products that have to position themselves in the market place. This is why using Apple as a model is mistaken, because in many ways it is an anomaly. All types of social groups, demographics, and income groups are willing to part money for an iphone or ipad. But not all business work like this.

Positioning - Commit to a proposition 100%

All sorts of business have a specific focus, newspapers for example, all aim at specific markets, and newspapers that try to be all things to all people generally fail. Supermarkets, whether it be Asda or Waitrose have specific customers in mind, as do car manufacturers (this doesn't mean that all these business are successful or that they have a quality product).

But the fitness industry, as stated earlier is a bit more generic, a bit less sure of itself. You're just as likely to find a business man in the budget club as you are in David Lloyd.

Much is made of customer service in fitness, but little is done about it. Ritz Calton is always used as an example, because I guess they do have exceptional customer service, which you pay for. But what if your gym is the equivalent of Travel Lodge or Premier Inn, stop trying to be Ritz- Calton when you obviously aren't.

Budget Clubs brought this model to the table. If all you do is go to a room and get on some machines, why pay £80 a month, why not pay £10 month to walk on a treadmill. Or, to take it to its logical conclusions, why not just go for a walk for free outside.

A statistic I recently heard was that 40% of all budget gym users have never used a gym before. Spending £10 a month is a low risk option. As my colleague, Nick, pointed out though, this means 60% of all budget gym users have been to a gym before. For whatever reason the rest of the industry failed them. It wasn't good enough.

'Churn' is common industry term. With few new customers buying the product, most customers are churning between clubs, dropping out, re-joining, dropping out, re-joining.

Health Club Management magazine in a recent issue stated that the most common complaint in the industry was to do with cleanliness. There are two schools of thought on this, either 1) Health clubs really are a health hazard, and people fearing for their lives leave or 2) The member didn't get the results they wanted, needed to get out of a contract, needed to justify why they were leaving and cited cleaning as the reason.

At a recent workshop I was at, the presenter did say something that struck me that most of the industry doesn't do, and that is, have a proposition and then commit to it 100%

Crossfit & budget clubs

Budget clubs have committed to their proposition. And another example is crossfit. Regardless of what you may think about their training methods, they have stuck to their guns and their model. They have thrived on the hardcore image, they have recently garnered features in the British national press. Even things that would be considered to be bad publicity, like the mythical 'Rhabdomyolysis', have been used to create an aura around crossfit and attract people. They haven't tried to be all things to all people.

They found a niche, and now Reebok have jumped on board as well, because crossfit has differentiated itself.

The golden fleece of weight loss

Quite a few people in the industry have been talking about weight loss and how we need to tap into that market. Most people join a health club for weight loss, which the health club normally fails to help them with (normally because as the research shows, for people with a lot of weight to lose, exercise doesn't make much difference, its about what they eat and non exercise energy expenditure in everyday life).

The fitness industry wants to tap into the weight loss market of weight watchers, slimmers world and their ilk, but it still hasn't done it convincingly. The reasons are cultural, as much as they are about the product. I'm sure weight watchers have the same level of churn as health clubs, they just haven't spent £500,000 on a room full of equipment as well. Continuous government campaigns like Change 4 Life, don't seem to have made much of a dent on peoples activity levels or nutritional habits.

The weight loss market is the golden ticket, but the hardest to attract it seems. Could it be that most people are just lazy? Are we wasting our time with it?

GP/ Exercise Referral - a case study

You would think that people who had been referred to exercise by their GP would stick with it, but their drop out rates are the same as everyone else, despite the fact that they are more closely monitored than most other gym members and pay less (Orrow et al, BMJ, 2012).

So even though these people might have high blood pressure, or diabetes or heart disease and they will literally die if they don't start exercising and change their lifestyle, most of them fail to do so. If you can't motivate this group, what chance do you have with the average weight loss client. Now, a lot of these GP referral clients say they can't afford the gym, and as much as I want to believe they are hula-hooping in the back garden with their kids or going for a country hike like a Change 4 Life advert, lets face it, they're probably sitting on their arse eating a pizza.

So could it be time to focus on segments of the population who you can actually affect change with, rather than spending a lot of time and money trying to attract people who will drop out almost as soon as they started. After all, this is a business that has to make money, its not a public service.

Steve Jobs was right- but this is health & fitness - so think different

The fitness industry has been scrambling around trying to please customers. Steve Jobs, didn't believe in market research - 'because customers don't know what they want until we've shown them'. (Of course, Steve Jobs never went to a gym either, he went for a walk instead).

No customer ever asked for an iphone or a kettlebell or a TRX.

We must break the current paradigm, smash it and find a new one that works.

An integrated gym model, where the customer experience flows effortlessly from purchasing the product, to booking their first appointment, to their first entry into the club, their first encounter at reception and their first meeting with a fitness coach. And it should flow spatially once they enter the facility, they should never feel lost or intimidated. The product should make sense to them immediately both in its spatial layout and their experience and the results they will get from it.

The idea of an integrated product is an Apple stalwart. And one that can be applied to the fitness industry. Yes, in computing it does have its drawbacks (and for the record, I don't own any Apple products, but man-alive I want an ipad, damn, that marketing really does work!), but in the fitness business it makes perfect sense. And the final quote from Jobs

"Simplicity is the ultimate sophistication."

In Summary

If you made it this far, well done. This was a lot longer than I expected. If you just skipped from the beginning, these are the key take home points

Integrated gym model

  • product driven, not sales driven
  • build a results based gym
  • transparent pricing
  • make it easier to do business with us
  • commit to a proposition and stick to 100%
  • don't try and be all things to all people
  • customers want experts to do things for them, so they can focus on other things, offer three levels of product 1) program writing 2)small group training 3) personal training
  • have faith in your price and your product
  • stop discounting
  • yes, customers want someone to talk to but they all also want someone who knows what they are talking about
  • its not about the machines
  • its about behaviour change
  • its about coaching
  • use space wisely
  • break the current paradigm
So that's that,  and if anyone from Fit Pro Business or Health Club Management magazine is reading, you can have this for free.

Do I have all the answers? No. But it's a start.

Sarah Lund: You don't need to be a detective to figure this out, so why hasn't any big fitness company?

Steve Jobs by Walter Issacson
Winning by Jack Welch
Fit Pro Business Magazine Apr/May.Jun 2012, Various articles & editorials,
Orrow et al, Effectiveness of physical activity promotion based in primary care, BMJ 2012:344:e1389
Health Club Management Magazine
30 Rock Season 5

Sunday, April 1, 2012

Micah True is Gone. Caballo Blanco Runs Free.

Sundown on canyon
Running on the waters edge
Morning Spring arrives

Copper Canyon - Mexico

Micah True is dead.

If you follow ultra running you already know they found his body in New Mexico this weekend. See here.

I had the good fortune to attend a talk by Caballo Blanco last year in London. Documented here. I like to think the comment on my article was from Caballo himself, may be it was, may be it wasn't, doesn't matter.

Caballo Blanco in London last year

I've never spoken to him directly, so a person I have never spoken to died in a place I've never been too, but like a lot of people the news of Caballos death affected me.


As he said himself,

"If I were to be remembered for anything at all, I would want that to be that I am/was authentic. No Mas. Run Free!"

He was authentic, he embodied the spirit of a sport. In an age when rampant commercialism has overtaken most sport, when most people have become disconnected from themselves and their environment, he represented an alternative.

He stripped it down to essentials. We all become enamoured by the details, which shoes should I wear, I need a garmin, and a heart rate monitor and a hydration strategy and this supplement. But you don't need any of this. The most important thing is to run. To practice running you must run. Human beings move, human beings run.

His friend and journalist Michael Sandrock said of him

"He's just authentic and genuine. ... Micah is a guy who follows his bliss,"

As Joseph Campbell said, the most important thing is to follow your bliss in life.

He was the distilled essence of why we run.

Most men (and women) live lives of quiet desperation. Somewhere in their life, may be in their teens or their twenties or later, they lose track of themselves.  The daily grind of going to work, and making mortgage/rent payments, and buying things they don't need in shops they don't like to put in a house in a place they don't want to live; and they wake up one day and can't remember who they are.

Caballo was the antithesis of this, be true to yourself.

You get to a certain age, and you don't have heroes anymore, but there are still people who teach you a thing or two, open a door to a room you never knew existed.

Sometime ago.

Back in early 2009 I walked into Foyles book shop in London. A few weeks earlier I had agreed to take part in an Ultra run the next year with my Dad & brother. Even though I had done some running in the past, I'd never run further than half marathon distance, never done a marathon and hadn't entered any type of formal running event since I was a kid. I had read Dean Karnazes Ultramarathon Man at some point, and even though it was a good read I had no intention of running anywhere.

On the shelf of the bookshop was the book Born To Run. It had only been published a few days earlier in the UK, and by shear luck I had stumbled across it while looking for a book on ultrarunning. As you probably know, the book introduced us to Caballo Blanco, became a best seller, probably single handedly started the barefoot running craze/ debate (though Caballo himself was pragmatic when asked about barefoot running), and is probably also responsible for a surge in popularity of ultrarunning.

But back then no one knew any of that was going to happen. I had already started running again, and the book introduced me to a whole world I knew nothing about, Leadville, Tarahumara, Scott Jurek, and running for the joy of running. Something I'd lost along the way. Running just to run. Running the trails, running the wilderness. In essence reading that book, and running ultras changed me.

Don't let me die in Charlton

A long time ago, a guy I knew, started getting chest pains while driving in London, he then realised he was in Charlton, the place he grew up and hated. Despite his sense of impending doom he deliberately kept driving to get out of Charlton, to another part of London because he didn't want to die in Charlton, where he had started.

In the end I guess it doesn't matter where you die.

But it seems Caballo Blanco was in the right place, on the trail, in the wilderness, out running.

'He was a friend of mine, he died on the road'. - Bob Dylan

Yes taken too soon. But his spirits lives on, Micah True is dead but Caballo Blanco runs free in all of us.

Be all you can be. Run because you want to, run because you need to.

"There is no test to hand in at the end of life, so there is no way to fail." - J. Haidt (The Happiness Hypotheses)

Keep on running, I'll see you on trail somwhere, someday.

Adios amigo.


In the high seat, before dawn dark,
Polished hubs gleam
And the shiny diesel stack
Warms and flutters
Up the Tyler Road grade
To the logging in Poorman creek.
Thirty miles of dust.
There is no other life.

Gary Snyder - Turtle Island 1974