Functional Fitness 101: Is a Workout-Therapy Hybrid What You Need?

Ever thought about hiring a personal trainer but worried you’d be too inflexible — or in too much pain — to make it worthwhile? Millions of people feel pain doing everyday tasks like going up and down stairs, reaching overhead or bending to pick something up off the floor — even some who think they’re in great shape.

Whatever is keeping you (or someone you know) from moving as comfortably as you’d like — injury, arthritis or other chronic conditions, overtraining, joint surgery — functional fitness may help.

You may have heard this personal training buzz term. Functional fitness has made headlines in The New York Times, on MSNBC, and in SHAPE and other fitness magazines. And both the American College of Sports Medicine and the American Council on Exercise named it one of the biggest fitness trends of 2007.

So what is functional fitness, and could you benefit?

Functional fitness defined

Best known for bridging the gap between personal training and physical therapy, functional fitness is designed “to restore yourself back to how you were designed to move,” says biomechanics expert Katy Santiago, M.S., director of the Restorative Exercise™ Institute in Ventura, Calif. She developed the Restorative Exercise series as part of her goal to educate the public and the healthcare community about “proactive, biomechanical holistic exercise that enhances movements needed to keep our body machinery working as long as possible.”

“Functional fitness training gives you the ability to do everything you need to do in your daily life without pain,” agrees Indea Leo, a trainer at Sam Iannetta’s Functional Fitness and Wellness Center in Boulder, Colo. In short, it’s exercising to improve the way your body works.

How are functional fitness exercises different from other workouts?

The link between functional fitness and physical therapy may conjure images of being strapped into clinical-looking contraptions — but the tools of a functional trainer include familiar equipment you’ve seen at the gym: stability or balance balls, medicine balls, kettlebells, wobble boards, half-balls, foam rollers, hula hoops, yoga blocks, resistance bands or tubes, and standard free weights.

Some of these tools of the trade hint at one way functional fitness and restorative exercise are different from standard workouts: They place a lot of emphasis on balance, requiring the body to activate smaller stabilizer muscles not used in many other forms of exercise.

Functional fitness differs from standard workouts in two other important ways: Rather than emphasizing a certain number of repetitions of each exercise, a functional fitness trainer will likely focus more on your level of effort, comfort and improvement of any physical conditions or limitations. And functional fitness emphasizes working several areas of the body at once, rather than isolating a particular muscle or group of muscles, as with bicep curls.

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You may do exercises that combine upper- and lower-body movements, for instance, or require lifting and twisting at the same time. Or you may do a rowing exercise from a standing, bent position rather than seated with your chest against the pads, so the movement activates core stabilizer muscles as well as back and arm muscles. The goal isn’t just to gain strength, but also to improve flexibility, range of motion, joint alignment and proprioception, or body awareness based on sensations received by nerves called proprioceptors.

Other examples of restorative or functional exercises:

Rocking on a yoga block and doing diagonal leg stretches with a yoga strap help correct spinal misalignment and tight hamstrings that can result from extended periods of sitting, such as while doing desk work.

• “Snow angels” address shoulder misalignment that can lead to injuries like a torn rotator cuff. The client lies supine atop a foam roller, or a towel rolled lengthwise along the spine, making the sweeping arm motions with palms face-up.

Standing exercises and resistance exercises that help build bone density and help patients with osteoporosis.

What conditions can functional fitness help address?

California photographer Cecilia Ortiz was a self-described “mess” before she began working with Santiago. “I had a history of back pain, chronic headaches, foot pain, a torn left meniscus and bouts of sciatica, and my back was always ‘going out.’ I was an ibuprofen junkie.”

Ortiz had seen chiropractors, general practitioners, neurologists and orthopedists; and she’d tried physical therapy, cortisone injections and painkillers to no avail. But restorative exercise brought her almost immediate relief — and after six months of weekly sessions, she was pain free and “clearly physically stronger and more flexible,” she recalls. “I had better balance and less stress. I also went down one dress size.”

Functional fitness has also been shown to help with aging-related loss of mobility. A recent study at University of Wisconsin–La Crosse commissioned by the American Council on Exercise found that older adults who did functional fitness training showed a 43 percent improvement in shoulder flexibility as well as greater improvements in strength, cardiorespiratory endurance, agility and balance than those who stuck with a traditional exercise program of walking and aerobic dance. Each functional fitness session included a circuit of 12 functional exercises — including moves such as wall push-ups, lunges, and “chop and squats” while reaching diagonally across the body.

Leo points out that a functional fitness regimen is also more an alternative to other treatment approaches for people with injuries or reduced mobility. If your doctor recommends a joint replacement, even though you know you’ll be in physical therapy afterward, consider functional fitness as a way to prepare for surgery.

Mark Cameron became a client of Leo’s after a cycling spill “totally wrecked” his left knee — a painful joint already affected by degenerative arthritis. His doctor said he needed a total knee replacement.

“My wife’s friend had been training with Indea, and she thought it might help me recover faster from the surgery if I did some functional training beforehand,” says Cameron, 46. “Turned out they had a special regimen designed specifically for my situation. So I started seeing Indea once a week and doing a 40-minute daily routine she gave me to do at home.”

Even before the surgery, Cameron says, his pain level started to diminish — and he credits his sessions with Leo for his quick recovery post-surgery. He went back to work in six weeks, no small feat since he’s on his feet all day managing a restaurant in downtown Denver. He says he’s gone from thinking of functional fitness as “a fancy term for working out” to being a “big believer.”

Many clients also continue functional training to meet new goals. Leo tells of one client who first came in to resolve chronic hip pain brought on by training for a marathon — then later stayed on to lose weight for her wedding and stay in shape through two pregnancies.

What if you're already in great shape?

Restorative or functional training can also help people who consider themselves very fit. "Some people can lie down on a leg-press machine and press 500 pounds, but they don't have the muscular control for a one-legged squat because they don't have the stability or the muscles working together," biomechanics consultant Greg Roskopf, M.S., told WebMD. Roskopf has worked with athletes from the Denver Broncos, the Denver Nuggets and the Utah Jazz. “That's why, when we walk down stairs or reach up to get something out of a high cabinet, a lot of us have pain.”

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Both experts and clients say if you’re healthy, don’t wait for an injury to start a functional fitness or restorative exercise program. Mobility loss and misalignment occur from daily and repetitive movement and the aging process, something Cameron wishes he’d recognized earlier. “Once you start working full time you begin to lead a more sedentary life,” he says. “If I had known about functional training sooner, I might have done preventive work and fixed certain problems to lead a more active lifestyle all along.”

Functional trainers also agree that the workouts themselves are ultimately only half the battle if you don’t change the way you move in everyday life, too.

Functional fitness experts will typically ask a slew of questions about your lifestyle to sleuth out ways you’re compensating for pain or misalignment in certain areas. Based on that, he or she may advise you to make small changes that can make a big difference. To correct spinal misalignment, you may need to wear different shoes, get out of the car differently or move your wallet to your front pocket, for example.

How to find a qualified functional fitness instructor

What should you look for in a functional fitness trainer? While the field is still relatively new and has no industry-wide certification standards, Santiago suggests working with a professional who is not just a certified fitness instructor, but also has formal training in physiology, kinesiology, biomechanics, neuromuscular therapy or functional conditioning.

Santiago holds a master’s in kinesiology and biomechanics, and this year her Restorative Exercise Institute is certifying its fifth class of Restorative Exercise Specialists.

Or try functional fitness training at home with a DVD like Santiago’s Restorative Exercise series from Gaiam. The series addresses three issues she sees frequently in her clients — foot problems, pain or injury arising from spinal misalignment, and bone-loss-related problems. Santiago guides and demonstrates exercises to increase bone density and reduce risk of falling. As Santiago notes, “When used together, the DVDs are a great anti-aging package in that they restore the major areas of the human machine: neurology, bone and the foundation — the feet!”

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