Frequently Asked Questions

PT or Movement Specialists work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles, providing services to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing therapeutic treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is central to what it means to be healthy.

Metabolic conditioning simply refers to structured patterns of cardiovascular exercise and rest periods to elicit a desired response from the body. This desired response is usually to maximize efficiency of a particular energy system. The body has several different methods of getting energy. Different ratios of work to rest periods call upon different energy systems and cause specific adaptations. A metabolic conditioning program should be based on desired outcomes and an individual’s level of fitness. In general Fluid Health & Fitness utilizes metabolic conditioning programming in its methodology to improve an individual’s aerobic energy system. This systems development has been proven to improve:

• Weight Management and Obesity: Combined with a healthy diet, aerobic exercise helps you lose weight and keep it off.
• Increase your stamina, fitness and strength You may feel tired when you first start regular aerobic exercise. But over the long term, you’ll enjoy increased stamina and reduced fatigue. You can also gain increased heart and lung fitness and bone and muscle strength over time.
• Ward off viral illnesses Aerobic exercise activates your immune system in a good way. This may leave you less susceptible to minor viral illnesses, such as colds and flu.
• Reduce your health risks Aerobic exercise reduces the risk of many conditions, including obesity, heart disease, high blood pressure, type 2 diabetes, metabolic syndrome, stroke and certain types of cancer. Weight-bearing aerobic exercises, such as walking, help decrease the risk of osteoporosis.
• Manage chronic conditions Aerobic exercise may help lower blood pressure and control blood sugar. It can reduce pain and improve function in people with arthritis. It can also improve the quality of life and fitness in people who’ve had cancer. If you have coronary artery disease, aerobic exercise may help you manage your condition.
• Strengthen your heart A stronger heart doesn’t need to beat as fast. A stronger heart also pumps blood more efficiently, which improves blood flow to all parts of your body.
• Improved Cardiovascular Health Aerobic exercise boosts your high-density lipoprotein (HDL), the “good,” cholesterol, and lowers your low-density lipoprotein (LDL), the “bad,” cholesterol. This may result in less buildup of plaques in your arteries.
• Boost your mood Aerobic exercise may ease the gloominess of depression, reduce the tension associated with anxiety and promote relaxation. It can also improve your sleep.
• Stay active and independent as you age Aerobic exercise keeps your muscles strong, which can help you maintain mobility as you get older. Exercise can also lower the risk of falls and injuries from falls in older adults. And it can improve your quality of life. Aerobic exercise also keeps your mind sharp. Regular physical activity may help protect memory, reasoning, judgment and thinking skills (cognitive function) in older adults. It may also improve cognitive function in children and young adults. It can even help prevent the onset of dementia and improve cognition in people with dementia.
• Increased Longevity Studies show that people who participate in regular aerobic exercise live longer than those who don’t exercise regularly. They may also have a lower risk of dying of all causes, such as heart disease and certain cancers.

Heart rate variability, or HRV for short, is a measure of your autonomic nervous system that is widely considered one of the best objective metrics for physical fitness and determining your body’s readiness to perform.

Heart rate variability is literally the variance in time between the beats of your heart. So, if your heart rate is 60 beats per minute, it’s not actually beating once every second. Within that minute there may be 0.9 seconds between two beats, for example, and 1.15 seconds between two others. The greater this variability is, the more “ready” your body is to execute at a high level. These periods of time between successive heart beats are known as RR intervals (named for the heartbeat’s R-phase, the spikes you see on an EKG), measured in milliseconds.

Although HRV manifests as a function of your heart rate, it actually originates from your nervous system. Your autonomic nervous system, which controls the involuntary aspects of your physiology, has two branches, parasympathetic (deactivating) and sympathetic (activating).

The parasympathetic branch (often referred to as “rest and digest”) handles inputs from internal organs, like digestion or your fingernails and hair growing. It causes a decrease in heart rate.

The sympathetic branch (often called “fight or flight”) reflects responses to things like stress and exercise, and increases your heart rate.

Heart rate variability comes from these two competing branches simultaneously sending signals to your heart. If your nervous system is balanced, your heart is constantly being told to beat slower by your parasympathetic system, and beat faster by your sympathetic system. This causes a fluctuation in your heart rate: HRV.

When you have high heart rate variability, it means that your body is responsive to both sets of inputs (parasympathetic and sympathetic). This is a sign that your nervous system is balanced, and that your body is very capable of adapting to its environment and performing at its best.

On the other hand, if you have low heart rate variability, one branch is dominating (usually the sympathetic) and sending stronger signals to your heart than the other. There are times when this is a good thing–like if you’re running a race you want your body to focus on allocating resources to your legs (sympathetic) as opposed to digesting food (parasympathetic).

However, if you’re not doing something active, low HRV indicates your body is working hard for some other reason (maybe you’re fatigued, dehydrated, stressed, or sick and need to recover) which leaves fewer resources available to dedicate towards exercising, competing, giving a presentation at work, etc.

To look at it another way, the less one branch is dominating the other, the more room there is for the sympathetic (activating) branch to be able to come in and dominate, which is why high HRV suggests you’re fit and ready to go.

AMR – Active Metabolic Rate Assessment:

A VO2 max test is a cardiovascular exercise test performed using a piece of cardio equipment, while connected to a machine capable of analyzing your ratio of expired oxygen to carbon dioxide emission. Your test provides data on how much oxygen you use as you exercise and determines the maximal oxygen you can consume during exercise. This is a gold-standard measurement of endurance.

RMR – Resting Metabolic Rate Assessment:

An RMR test directly measures the concentration of oxygen breathed out by each patient. The patient merely breathes through a simple mouthpiece as all the exhaled air is collected and analyzed through a respiratory machine . Because there is a direct correlation between oxygen consumed and calories burned (4.813 calories for every milliliter of oxygen consumed), an accurate measurement of oxygen consumption is an effective measurement of calorie consumption.

A resting metabolic rate (RMR) test is a noninvasive, highly accurate way of determining daily calories needed to maintain your current body mass. It can be challenging for individuals to know exactly how many calories are necessary to support their goals, whether it be to lose weight or gain weight. Measuring RMR is a beneficial first step to determine how many calories you need to support your body’s basic energy requirements. RMR data will be used to provide you with healthy nutritional guidelines to support your goals.

We complete weekly training sessions that utilize heart rate training zones and Heart Rate Variability scoring. Developed using the U.S. Department of Health and Human Services Physical Activity Guidelines for adults, we provide undulated exercise intensity organized into monthly and weekly macro and micro cycles of cardiovascular development. Using your heart rate zones, we provide cardio based class formats which optimize your body’s energy systems.

Dress comfortably with clothes that allow easy access for the PT or Movement Specialist to examine your problem areas. For treatments, loose fitting clothes that are comfortable for gentle exercises and supportive sneakers are often good choices to wear.

We accept cash, check, debit card, and credit card. We are happy to discuss payment plan options as well. It is our policy that payment is made at the time of service.

Yes, once you have completed your therapy sessions, you will move into our functional wellness pathway. In this program, you will continue to maintain your movement quality as you progress through more challenging exercise progressions. Fluid Health & Fitness provides nine different levels (each 12 weeks long) of exercise intensity through the process. Sessions can be completed privately with a movement specialist, in a group format, or through a combination of both private and group sessions.

A prescription (if needed) for physical therapy from your referring physician, ARNP, or PA.

When necessary bring a copy of laboratory panels and/or images: X-rays, CT-scan, or MRI findings.

Insurance information (we will make a copy of your card).

In case of an automobile accident or worker’s compensation claim, also bring any case manager or insurance adjuster contact names, phone numbers, and claim number.

Please arrive 15 minutes early to complete any remaining paperwork, so you can maximize your time in your evaluation.

Please wear comfortable clothing that allows easy access to your problem areas.

Physical Therapists Physical therapists have years of university level training in anatomy, physiology, kinesiology (study of joint movement), neurology, and many of the other medical sciences. Our physical therapists have graduated from accredited physical therapy programs and are state licensed. Depending on the university, the physical therapy program is either a masters or doctorate level degree. Rest assured, your therapist is well trained to evaluate and treat your condition. Movement Specialists Our Movement Specialists have years of university level training in anatomy, physiology, kinesiology (study of joint movement), as well as nationally recognized accreditation from the National Academy of Sports Medicine in Corrective Exercise. They may also possess advanced certifications in: manual muscle testing and activation neuromuscular stretching and mobility techniques sports specific metabolic conditioning and nutrition coaching As well as population specific credentialing: oncology training giratric training adolescent training sports specialization

While our locations remain open for in-person visits, we are proud to offer Telehealth for individuals who want to take additional safety precautions, who are unable to do in-person visits or would prefer the convenience of a virtual appointment. This is an excellent alternative solution to treat your pain or receive quality movement and exercise guidance.

Telehealth options are facilitated through a secure online video session. Your initial evaluation and follow-up sessions can be accomplished using this method. Connect with a trusted Physical Therapist or Movement Specialist through a live internet video session after your appointment request has been confirmed by our staff. Using a smartphone, tablet or computer with a camera, you can easily and directly connect with a Specialist for your visit.

At this time our Telehealth visits are conducted through our web platform at www.virtual.fluid healthandfitness.com. We use a commercial version of “zoom.com” to complete the session on the platform. Patients can use a smartphone, tablet or computer to access the session. Don’t worry, our specialist will walk you through the use of this program.

You will get an email invite from your physical therapist / movement specialist listing the date and time for your telehealth session. Ten minutes before your appointment time, click on the link that is in the invitation. This will initiate your appointment by putting you in a virtual waiting room. Your specialist will join you at the appointment time and begin your session.

To book an appointment please call 1-844-358-4343, email us at admin@fluidhealthandfitness.com, or send us a message.

Physical therapy is not meant to hurt, but to relieve pain. However, as you restore your mobility, pain levels, at times can fluctuate. You might experience some temporary soreness from using muscles that are weakened or recovering. This is a normal response to therapy treatment. Good communication with your therapist will help minimize any discomfort. We want you on your way to quick pain relief and back to normal activities.

Movement Assessment- We start everyone with a posture and functional biomechanical competency evaluation. The assessment establishes where within a person’s body there are strength deficits or muscle imbalances that impact or limit the individual’s mobility. Individual movement scores are given to the major joint centers and then compared with each other so that a global movement bias can be determined. This establishes an individual’s tendency towards a specific posture or movement susceptibility, which is linked with reduced mobility in that specific pattern. Using the individual joint and global movement bias scores, we offer Smart Class Formats that coordinate the level of exercise quality or intensity in the workouts, with the functional abilities of the user. This is referred to as The Core | 6 Movement System. Our smart class formats include: A. Restorative Mobility Classes – Soft tissue release, targeted strength exercises, and neuromuscular re-education to restore optimal biomechanics and mobility. B. Corrective Strength Classes – Progressively phased strength training that focuses on the qualitative adaptations associated with the individual’s movement bias. C. Metabolic Conditioning Classes – aerobic and anaerobic interval classes to improve metabolic and cardiovascular health. This improves tissue recovery and reinforces optimal movement patterning to improve mobility.

Physiotherapists usually address the source of your pain or injury from either acute or chronic trauma. Their core focus is to address the area of crisis. Our model focuses on the whole body as a system, and how optimized movement reduces or prevents injury cycles from occurring or reoccurring.

Biomechanical Movement Assessment – A baseline posture and movement competency evaluation that provides predictive risk indicators for biomechanical deficits associated with musculoskeletal diseases. Health history questionnaire – goals, medical, exercise and nutritional histories, behavior and psychographics, stress relationships, sleep quality, gut health, Biomarker feedback – Heart Rate Variability Testing – Objective indicator of Autonomic Nervous System activity. Acute Daily Readiness Readings used to optimize exercise, stress, and recovery. Biological Age Indicator. Long term training adaptations and trends analysis. Baselines for stress tolerance adaptability and resilience. Early warning signs for changes in health, overtraining, or maladaptation. Identify the risk of morbidity and mortality. Metabolic Health Evaluation- A graded maximal exertion assessment that provides an estimated maximal oxygen consumption, establishes energy system boundaries and cardiovascular zones, and workload magnitudes and trends. Body composition Analysis – bioelectrical impedance measurement and trends in lean tissue and adipose tissues. Nutritional needs analysis – Basal metabolic rate (BMR), Caloric intakes for weight loss, maintenance or weight gain and macronutrient guidelines based on weekly activity factors.

Specificity, gradual/progressive, restorative, social connection combined with a science-based training protocol, defined objectives/outcomes. Four pillars: Movement, Metabolic, Nutritional, Emotional/Behavioral

Emphasis is placed on mobility and stabilization, Heart Rate Variability for CNS regulation, graded individualized training (regressions and progressions based on a client’s abilities and/or injuries), medical history, diagnostic and movement evaluations.

Health Panels & Assessments Cardio Metabolic Panel: Metabolism, Hormone Levels, Digestive Health & Food Sensitivities, Essential Health Biomarker Panel: Chronic inflammation, Atherosclerotic cardiovascular disease (ASCVD), Progression toward type 2 diabetes, Biomarkers – include: Blood glucose Lipids (HDL/LDL, Triglycerides), Blood pressure – seated & supine to standing Electronic Calorie Calculator – Mifflin-St Jeor estimates: Basal metabolic rate (BMR), Caloric intakes for weight loss, maintenance or weight gain Macronutrient guidelines Metabolic Rate Assessment – precise calorimeter measurement of: Resting energy expenditure, Respiratory exchange ratio (RER), Required caloric intakes for weight loss, maintenance or weight gain

We complete a psychographic evaluation, monitor stress levels using Heart Rate Variability, establish motivational goals, and track emotional disruptions.

Intuitive eating is a reframing of how we think and feel about food and our relationship with it. It’s transitioning from an attitude of negativity and restriction to one of kindness and care for your body. We teach our members to listen to hunger cues and focus on nourishing the body to support the physiological status of the training stimulus, to optimize how they recover, adapt and move.

We have a 95% positive member experience outcome score.