The Annual Meeting is BACK and this year we will be in-person in San Diego, CA! I am excited to share with you the interdisciplinary content that will be presented each day of the 2022 ACSM Annual Meeting in the Biomechanics and Neural Control of Movement topical area.

The Biomechanics and Neural Control of Movement content will kick off on Wednesday, June 1, 9:30 AM – 11:30 AM with a thematic poster session on Running Injury. Our other free communication sessions include: a rapid-fire podium session titled, “Gait Markers of Physical Activity and Health Status” (Thursday, June 2, 9:30 AM – 11:00 AM); a thematic poster session titled, “ACL Injury: Prevention & Rehabilitation Strategies” (Friday, June 3, 9:30 AM – 11:30 AM); a podium session titled, “Aging Interventions” (Friday, June 3, 3:45 PM – 5:45 PM); and 159 posters including poster sessions dedicated to concussions, biomechanics of military health, measuring biomechanics in the wild, sports medicine biomechanics and running performance, among other great topics.

Our showcase highlighted symposium this year will be “Extending Human Movement Research from the Lab into the Field,” on Wednesday, June 1, 1:00 – 3:00 PM. Presenters include Clare Milner, Ph.D., FACSM; Robin Queen, Ph.D., FACSM; Emily Matijevich, Ph.D.; and Kellee Hanigan, Ph.D., PT; chaired by Allison Gruber, Ph.D., FACSM. Technological developments in wearable technology have allowed gait biomechanics to be measured in more natural and ecological environments than the laboratory. However, concerns regarding data accuracy often outweigh the potential benefits of using wearables to measure free living gait for clinical and research purposes. This symposium will address these pitfalls by highlighting the technical and practical considerations of using wearable technology to measure gait out-of-the-lab with in-lab quality, validity and precision. Discussion topics also include differences in gait performed in- versus out-of-lab, considerations for data collection and management, estimating internal musculoskeletal loads from externally worn sensors and accounting for missing data. This session is unopposed by other biomechanics and neural control of movement offerings to give everyone the opportunity to attend.

The other symposia and tutorial sessions for the Biomechanics and Neural Control of Movement topical area include sessions presented across other ACSM topical areas and interest groups:

Thursday, June 2, 2:40 – 3:30 PM: “Epidemic of UCL Injuries in Adult and Youth Baseball Pitchers - Causes and Prevention Strategies,” presented by Rafael F. Escamilla, Ph.D., and Arnel Aguinaldo, Ph.D. This colloquium will evaluate elbow biomechanics during pitching as well as UCL rehabilitation and training strategies to decrease UCL injury risk in adult and youth baseball pitchers.

Friday, June 3, 9:30 – 11:30 AM: “Measuring and Modeling Load Carriage,” presented by Anne Silverman, Ph.D.; Kari L. McKenzie, Ph.D.; Jennifer Neugebauer-Sperlein, Ph.D.; and Karen R. Kelly Ph.D.; chaired by Pinata Sessoms, Ph.D. The amount of load carried is only one of many factors that influences musculoskeletal injury risk and physiological performance. Changes in how load is carried or training programs for service members could reduce injury risk. This symposium will present different approaches being used to analyze load carriage related to injury prevention and the unique information each provides with regards to injury prevention and performance.

Saturday, June 4, 8:00 – 8:50 AM: “Treating the Mechanistic Determinants of Muscles Weakness after ACL Injury: Translating the Science into the Clinic,” presented by Lindsey Lepley, Ph.D., ATC, and Riann Palmieri-Smith, Ph.D. ATC. This session will present the mechanisms by which muscle strength is lost after ACL injury and evidence in support of alternative exercise interventions to optimize muscle recovery after injury.

Saturday, June 4, 9:00 – 9:50 AM: “Tai Chi for Fall Prevention - Application and Critical Factors for Success,” presented by Li Li, Ph.D., FACSM. This tutorial lecture will present the scientific basis and the benefits of integrating Tai Chi practice into a fall prevention program for people among a wide spectrum of different groups.

There are several other sessions that will be of interest to biomechanists and motor controlists that are being presented under other topical areas. Two of these great sessions include: “Preventing Bone Stress Injuries in Athletes: What do we Know and What are the Knowledge Gaps?” (Wednesday, June 1, 3:15 PM – 5:15 PM) presented by Stuart Warden, Ph.D, FACSM; Vanessa Yingling, Ph.D., FACSM; Eimear Dolan, Ph.D.; and Craig Sale, Ph.D. (chair); and “Using an Evolutionary Approach in the Prevention of Running Injuries” (Friday, June 3, 3:45 PM – 5:45 PM) presented by Daniel Lieberman, Ph.D.; Adam S. Tenforde, M.D., FACSM; Irene S. Davis, Ph.D., PT, FACSM; and Jacob Hofer, Ph.D (chaired by William O. Roberts, M.D., MS, FACSM).

The Biomechanics Interest Group (BIG) will be hosting their meeting on site, Thursday, June 2. Stay tuned to their website and Twitter for details about the event as they become available. The BIG meeting will include a social event, awards ceremony and a talk by the 2022 ACSM-BIG Career Achievement Award Winner.

Allison H. Gruber, Ph.D., FACSM, is an Associate Professor of Kinesiology in the Indiana University School of Public Health – Bloomington. She is the Topical Representative for Biomechanics and Neural Control of Movement and a previous chairperson of the ACSM Biomechanics Interest Group. Her research interests include the mechanisms of running-related musculoskeletal injuries, wearable technology and using advanced analysis techniques to better understand biomechanical signals for gait analysis. Symposia, tutorial and colloquium summaries were provided by the submitter.

Wellcoaches created the animated movie How Coaching Works to explain health and well-being coaching when the field was in its infancy. Now with almost 2 million views, the video remains a useful illustration of the best qualities of a helping relationship. This blog series aims to share the psychological underpinnings of the cartoon. This current installment, the second in the series, simplifies the script for coach-client dialogue.

Scene One: MEET

Coach: Hello. Thanks for meeting today. Let’s begin by having you tell me more about what you hope for most for your life. Who would you be if you were at your best?

Client: I would engage in activities that energize me, strive for optimal health, and live life with gratitude and a sense of purpose every day. I’ve been thinking about this for a while, but when I start, it doesn’t last — it doesn’t get done. And when I think about all of the things that get in my way, I’m overwhelmed.

Coach: Wow! That’s an appealing vision, and I hear your deep yearning to get there. Let’s talk about how we can work together. I’ll help you construct a roadmap to your future. You’ll bring a wealth of insight about what works for you and what doesn’t. With the help of my toolbox, you’ll get it done. Let’s explore more about your life today.

Scene Two: VISION

Coach: Tell me more about that vision. What is important to you about it?

Client: Taking control of my life. I’ve let my priorities get out of order.

Coach: Why now?

Client: Life is going quickly, and I realize that I don’t want it to pass me by. I used to have big dreams … and then work and family responsibilities got in the way.

Coach: What will be possible when you achieve it?

Client: I’ll feel proud of myself and have more confidence. I think that’s what I miss most about my younger self — feeling like I can do anything.

Coach: When you are at your best, you are confident and optimistic that you can achieve anything you set your mind to. Let’s expand your vision to address what strengths you’ll apply to get there, your major challenges, and some of the strategies you might use to rise above your challenges.

Scene Three: THE PLAN

Coach: Let’s start working on how you will get to the vision you yearn for. What is the first thing you’d like to be doing in three months that would get you closer?

Client: That’s a good question. The first thing I’d like to be doing in three months is spending time with my spouse most evenings.

Coach: What do you mean by spending time?

Client: We used to play games together; that was always fun. Or, taking walks — I see couples doing that and always think, “How lovely.”

Coach: What would be the benefits of spending more fun time with your spouse?

Client: I always feel less stressed when I take time to relax. And my spouse is my best friend; I always feel better about myself when we have time to be together. We talk about new things to pursue together.

Coach: So, if you were to set a goal around this for the next three months, how would you write it? Let’s make it very specific and detailed. How much time would be enough to energize, relax and inspire you?

Client: By the end of three months, I’d like to spend two evenings and one half day on the weekend together.

Coach: Would you be willing to change the language to say, “I will spend two evenings and one half day on the weekend with my spouse”?

Client: Yes, that sounds great!

Coach: Let’s work on the rest of your plan. What’s the second goal you’d like to pursue in the next three months? (They continue the conversation, addressing additional goals.)

Scene Four: THE JOURNEY

Coach: Now let’s work on the first step you’ll take toward your three-month goals and your vision. What’s a small step you can take next week?

Client: I’m not really sure. I’m so busy with work in the evenings and weekends, and it’s been hard to take time out for myself, let alone spend time with my spouse.

Coach: You’re feeling overwhelmed right now because on one hand, it’s important to you to spend time with your spouse and, on the other hand, you are committed to doing a good job at work.

Client: Yes, exactly. But I know in the end, my spouse and my health are precious, and I feel badly that they are not higher on my priority list.

Coach: Tell me about a time when you and your spouse were taking time for each other. What was happening when you felt really connected?

Client: Let me think about that … when we first got together, we used to take walks in the park near our home every night. After dinner, we would go for a 15- or 20-minute walk, just to digest our food and talk about our days.

Coach: What did you enjoy about that?

Client: Talking, being best friends … it also felt great to get outside at least once a day.

Coach: You loved being connected to your spouse, and you benefited from the exercise and fresh air.

Client: Yes, we never made any plans those evenings until 7 p.m. so we could be sure to walk.

Coach: What could you learn from that and use today?

Client: It seems that what was most important was that it was kind of an unspoken, nonnegotiable agreement that we’d walk every day.

Coach: So, which part of that worked — the agreement, or the walking every day?

Client: It was the agreement we had together. And just taking a short time. Fifteen minutes seems possible.

Coach: What do you want to commit to this week?

Client: I will take a 30-minute walk on Friday after work with my spouse.

(Fast forward: The client attempts the goal but has a setback and “falls off of the ladder.”)

One week later …

Coach: Tell me what went well with your goal of taking a 30-minute walk on Friday after work with your spouse.

Client: It didn’t go as well as I’d hoped.

Coach: Which part didn’t go as well as you’d hoped?

Client: We didn’t actually take a walk, but we did have some time during a car ride to start talking about what we’d like to do together.

Coach: Sounds like just talking about the idea was a great way to connect.

Client: Yes, it was.

Coach: What did happen on Friday?

Client: We ended up being invited to go to a friend’s house; it was a last-minute invite from some friends we hadn’t seen in a while. The downside was that, even though we were both there, we were off talking to other people at opposite ends of the house.

Coach: What did you learn from trying out this goal?

Client: That Friday nights probably aren’t the best night to plan for our alone time together. It does tend to be the night we are most likely to do something with other people.

Coach: Okay, so it’s time to step back and rethink the goal. Take a smaller step, perhaps.

Client: I think it would be more likely to happen if we planned for a weeknight instead of a weekend night.

Coach: What night would be best next week?

Client: Tuesday is the least busy.

Coach: If you’ve chosen the best day, what else will it take to be successful with this?

Client: I need to turn off my phone during dinner so I don’t get caught up in a phone call — my family tends to call in the evening — instead of going on the walk.

Coach: What is your goal this week?

Client: I will take a walk with my spouse on Tuesday evening after dinner, and I’ll turn off my phone so we don’t get interrupted.

Coach: How important is it to you that this happens?

Client: Very. My spouse and I really are looking forward to it.

Coach: On a scale of 1-10, how confident are you that this will happen?

Client: 10!

Coach: Great work thinking this one through! I’m really looking forward to hearing about your success.

Scene Four: Success

Coach: Welcome back! I’ve been really excited to hear about your week. What was the best part of it?

Client: Working on one goal got me thinking about the other areas of my life where I could make some improvements.

Coach: Tell me more.

Client: On Sunday, after having a big dinner, I was getting ready to cut out a big slice of my favorite kind of cheesecake when I remembered our conversation. Remember when I said that my goal is do more activities that give me energy? Well, I was already full from dinner, and it dawned on me that adding cheesecake on top of it was going to put me into a food coma.

Coach: You were really paying attention to the signals your body was sending. What did you decide?

Client: I didn’t eat the cake! I told myself that I’d really enjoyed a great-tasting dinner and that I would appreciate it more if I stopped eating now.

Coach: How do you feel about that choice?

Client: Surprised! I haven’t had that kind of willpower for years.

Coach: It’s pretty exciting when you take control. How did you use that willpower when you worked on your goal of walking on Tuesday after dinner without your phone?

Client: We had such an incredible walk. The weather was perfect that evening, just the right temperature for a walk. We got to talk about our day and even do some planning for the next day.

Coach: What did you most enjoy about working on this goal?

Client: Giving myself 15 minutes to relax, away from the TV, and with my spouse. We laughed a lot.

Coach: Sounds like you felt more energized and entertained than you usually are when you watch TV instead.

Client: Yes, I usually use the TV to wind down, but it never really helps me relax.

Coach: What did you learn about yourself this week?

Client: That I really am ready to make some changes in my life. I can do it!

Coach: I’m certain that you can — and you already are. What’s next?


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A clinical exercise physiologist (CEP) is an allied health professional trained to work with persons diagnosed with a chronic disease for which exercise training has been shown to be therapeutically beneficial. Such conditions include cardiovascular, pulmonary, metabolic, neuromuscular, immunological and orthopedic disorders, among others. Primarily, CEPs work in medically supervised environments providing programs or services directed by a licensed physician. The ACSM Certified Clinical Exercise Physiologist^® (ACSM-CEP) credential is the gold standard certification and has the most rigorous educational requirements in the fitness industry. According to the U.S. Bureau of Labor and Statistics, the 2020-30 employment outlook for exercise physiologists is growing at a faster-than-average growth rate of 13%.

There has been much forward movement with both recognition of the profession and employment opportunities. The Clinical Exercise Physiology Association (CEPA), an affiliate society of ACSM, published the 2020 Clinical Exercise Physiology Practice Survey, reporting certified professionals earned higher median hourly wage than those who were not certified. Over the past few years, ACSM-CEPs earned 17% higher salaries than wages reported in the 2015 salary survey. Additionally, individuals with a master’s degree and ACSM certification reported $7,500 higher earnings than those without certification.

ACSM-CEPs are dedicated to improving clients’ quality of life through individualized prescribed exercise and behavior-change interventions to address and attenuate declines in fitness and health. Working with a wide variety of populations, the ACSM-CEP provides primary and secondary strategies promoting physical activity for children to older adults. Employers range from collaborative care and multidisciplinary teams in hospitals or physician-based programs to self-employed, direct-pay employment settings.

Common areas for ACSM-CEP employment

• Cardiac rehabilitation
• Cardiovascular stress testing
• Exercise oncology
• Diabetes and exercise
• Bariatric and weight management
• Neurological rehabilitation
• Pulmonary rehabilitation
• Pediatrics congenital cardiovascular testing
• Primary prevention programs
• Commercial/community fitness center
• Medical fitness center
• Nonuniversity/clinical research
• Corporate wellness

Current need for certified exercise professionals

The COVID-19 pandemic has amplified levels of habitual inactivity, increasing levels of overweight and obesity and decreasing cardiorespiratory fitness. Many individuals present with physical limitations and chronic diseases (e.g., diabetes mellitus) warranting safe and effective physical activity programming. The pandemic created a shift in the mode of delivery, with many exercise centers and clinics pivoting to virtual, home-based settings and digital fitness. Albeit a common transition during the pandemic, delivering primary and secondary exercise programing continues to grow with innovative infrastructure. Many current job vacancies describe academically prepared exercise professionals with adaptable and flexible skill sets to meet the varying modes of delivery for hybrid workspace to mitigate barriers to exercise adherence.

There is also the potential to see an uptick in ACSM-CEPs employed in clinical settings commonly staffed by registered nurses (e.g., cardiac rehab, cardiovascular stress testing) due to the ongoing nursing shortage. A recent publication supports the idea that ACSM-CEPs are specifically prepared to evaluate the acute and chronic responses to exercise and likely better suited for those roles than other allied health professionals. ACSM-CEPs are among the only allied health care providers specifically trained to develop exercise prescriptions and provide risk-factor modification counseling in the management of chronic disease.

Action items for professionalism

Professional membership can be very valuable during the job search process. Both ACSM and CEPA are key organizations that continually post job vacancies. Some other tips to keep in mind when seeking employment:

1. Craft a well written resume — highlight specific skills and experience
2. Network — contact past employers, professors, internship mentors
3. Social media — use LinkedIn, ACSM Careers, and other job-search platforms
4. Recognize CEP synonyms — some organizations may use terms other than “clinical exercise physiologist” in job titles, including “exercise physiologist,” “exercise specialist,” “exercise trainer,” “health educator,” or “wellness coordinator.” Be sure to read job descriptions carefully prior to applying.

As the profession continues to grow, ACSM-CEPs must advocate for advancement by encouraging other skilled exercise professionals to become certified. Additionally, ACSM-CEPs are eligible for an individual a National Provider Identifier (NPI). Registering for one will help expand recognition of the profession as critical members of health care teams.

Increasing life expectancy continues to fuel the growth of allied health professions, which are projected to grow at more than double the rate of other occupations. ACSM-CEPs’ proficiency at administering chronic disease management commonly found in both primary and secondary settings widens their potential employment opportunities. There’s a lot of momentum behind implementing physical activity and therapeutic exercise! 

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Laura A. Richardson, Ph.D., ACSM-CEP, RCEP, FACSM, president of the Clinical Exercise Physiology Association (CEPA) and Clinical Associate Professor of Applied Exercise Science and Movement Science in the University of Michigan School of Kinesiology. Dr. Richardson is a Registered Clinical Exercise Physiologist^® (RCEP^®) with over two decades in health care working with patients diagnosed with immunological, metabolic, pulmonary, neuromuscular, cardiovascular and orthopedic disorders using exercise as a mode of therapeutic intervention. Her expertise is working with metabolic patients utilizing behavior-modification strategies for lifelong weight management with bariatric surgery, along with advocating for the advancement of the CEP profession.

An appropriate and individualized dose of regular aerobic exercise is recommended to promote and preserve cardiorespiratory health throughout life. The exercise dose is defined by four ingredients: frequency, intensity, time and type of exercise. Among these, intensity is the most elusive term of the exercise “prescription.” It is typically determined from an external load (such as speed, watt or pace) that elicits a desired metabolic intensity (e.g., a fraction of maximal or reserve oxygen consumption).

Whenever this approach is not feasible, heart rate (HR) is commonly used as a convenient intensity measure in both clinical practice and sport. Exercise prescriptions that use HR targets rely on the existence, and constancy over time, of a linear relationship with metabolic intensity. However, during constant-load exercise lasting more than 10 minutes, a mismatch between HR and oxygen consumption emerges over time as a result of a slow rise in HR independent of metabolism. This phenomenon has been known for years under the name of “cardiovascular drift” and, more recently, “HR slow component.” In 2018, Zuccarelli et al. suggested a practical implication of this phenomenon. They showed the use of HR targets for exercise-intensity implementation can lead to an unanticipated and undesired reduction in work rate and metabolic activation during a prolonged session rather than the desired constant training intensity. This phenomenon has been consistently observed in males, both healthy and those with obesity. However, its physiological quantification and relationship with oxygen consumption across exercise intensities and in different populations are missing, along with its physiological underpinnings.

In our study, published in the April 2022 issue of Medicine & Science in Sports & Exercise_®, we tested the hypothesis that an HR increase over time also occurs in postmenopausal women, possibly with an intensity-dependent amplitude. Eighteen postmenopausal women performed several constant-work exercises at relative intensities from 40 to 80% maximal oxygen consumption on a cycle ergometer. During each test, we measured cardiorespiratory responses (HR and oxygen consumption) and body temperature over 30 minutes. This investigation demonstrated that increments in HR over time are present at all relative exercise intensities, their amplitude being larger with increasing intensity. The observed HR slow component was significantly correlated with relative intensity (r² = 0.66) and increase in body temperature (r² =0.52). However, its amplitude was about twice as large as that of oxygen consumption, implying a mismatch between HR and metabolic intensity that becomes larger both with intensity and over time. To deal with this mismatch, we proposed an equation that adjusts HR targets over time based on relative exercise intensity to account for the HR drift.

The take-home message is that whenever the implementation of the metabolic intensity of prolonged exercise is done using HR targets, one needs to be mindful of the mismatch between HR and metabolic intensity that emerges over time. Intensity- and time-adjusted HR targets are needed to assure that the desired stimulus is maintained throughout the exercise session in a given individual. 

Massimo Teso, M.Sc., is a Ph.D., student in exercise physiology at the University of Verona in Italy. His research is focused on the slow component of oxygen consumption and heart rate kinetics and their implications for the exercise intensity prescription.

Silvia Pogliaghi, M.D., Ph.D., FACSM, is an associate professor of human physiology at the University of Verona and an adjunct associate professor at the University of Western Ontario and the University of Calgary, the latter both in Canada. Specializing in sports medicine, she studies the physiological mechanisms that regulate and limit the acute and adaptive responses to aerobic exercise in physiological and pathological conditions.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.

As Women’s History Month draws to a close, it’s a fitting time to reflect on the accomplishments of women in our field and the gains we’ve made, as well as thank the mentors and leaders who blazed a path forward. The American College of Sports Medicine (ACSM) continues to lead in this regard, with accomplished women at the helm of the organization, including President-Elect Dr. Stacy Fischer, Immediate Past President Dr. NiCole Keith and CEO Kristin Belleson.

As a result of initiatives like Title IX, female participation in active pursuits has grown steadily over the decades — 49% of 2022 summer Olympians were female — and with this growth has come an increased focus on identifying and acknowledging the unique needs and challenges female athletes may face. There have been substantial gains in the number of women engaged in scientific research careers and an increase in policies to enhance the engagement, recruitment and retention of women in clinical research. Likewise, more women are being included in in clinical trials, and there’s a growing appreciation for the differences between male and female athletes.

However, there is still an appreciable difference in the amount of sports medicine-related research focused solely on female athletes and health-related research across the lifespan. Costello and colleagues reported that there is a significant difference in the number of males and females included as participants in sports medicine research: 61% and 39%, respectively. We also know that from childhood to older adulthood, the number of females who meet recommended physical activity guidelines is lower than that of their male counterparts, and that girls are less likely to play sports than boys. As the physiological and psychological benefits of physical activity are irrefutable, it is vital that we address this disparity by promoting physical activity and exercise to female participants from childhood to older adulthood. Having a deeper understanding of how to best motivate, train, and treat women for musculoskeletal injuries, pain management, mental health, nutrition, sleep, and pelvic-floor dysfunction while also accounting for the effect of the menstrual cycle can only enhance the impact of research and application to health and wellness for women across the lifespan.

In closing: ACSM recently conducted a Job Task Analysis for each of our core health fitness certification programs, and over 60% of the participants identify as female, demonstrating the commitment and engagement of our stakeholders and the impressive impact ACSM certified professionals are having in their communities. We are making great progress, but there is still much work to be done.


Christie L. Ward-Ritacco, Ph.D., FACSM, ACSM-EP, is the chair of ACSM's Committee on Certification and Registry Boards and is an associate professor in the Department of Kinesiology at the University of Rhode Island. 



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