The Exercise Physiology Profession: Clearing Up the Confusion

Dear future kinesiology graduate,

For most of you, “exercise physiology” might be associated with that course you were forced to take in your third or fourth year of undergrad where you had to write way too many lab reports and assignments on complicated topics that you vaguely understood. Or, maybe you’re someone who fell in love with exercise physiology as soon as you heard your first blood pressure sounds (at least, that was our experience). 

Exercise physiology is just one of many subtopics under the umbrella of kinesiology and it’s certainly not everyone’s cup of tea. BUT! If, like us at Your Kines Mentor, you find yourself drawn to it then this is the perfect post for you.

First thing’s first: What is exercise physiology?

Exercise physiology is the study of the human body’s acute responses and chronic adaptations to physical activity and exercise. Understanding the expected acute response of the cardiovascular, respiratory, musculoskeletal, and metabolic systems to various types and intensities of exercise can help us to better understand the chronic physiological changes associated with disease and trained states. 

This knowledge frames how exercise physiologist professionals assess and prescribe exercise for a wide spectrum of individuals with the goals of: Promoting physical health and mental well-being, preventing and managing chronic conditions, optimizing human performance, and improving overall quality of life.

What is an exercise physiologist?

An exercise physiologist is a kinesiologist who has chosen to specialize in order to widen their scope of practice. Certified exercise physiologists are qualified to work safely with all chronic conditions, disabilities or functional limitations across the lifespan. Outside of clinical populations, an exercise physiologist can also work with occupational populations (such as police officers and firefighters) and athletes. Essentially: they can work with anyone and everyone! 

What does an exercise physiologist do?

Explaining to our family and friends what we do is probably one of the hardest parts of being an exercise physiologist (kidding… mostly). We’ve been confused with physiotherapists, athletic therapists, and personal trainers. It’s likely because there is a lot of overlap in responsibilities and tasks between these roles and that of an exercise physiologist. 

The primary roles of an exercise physiologist include: performing assessments, prescribing exercise and teaching exercise programs, and education/counselling. 

Assessment

How an exercise physiologist performs an assessment will vary based on who they work with. For example, an assessment with someone with a chronic condition (heart disease, diabetes, cancer, neuromuscular conditions, etc) may vary greatly from one done on an athlete. It will also largely depend on what equipment is available. Many exercise physiologists will have access to specialized equipment like metabolic carts that allow for more valid measures of aerobic capacity, but many exercise physiologists will need to perform predictive tests outside of a lab. 

The initial part of an assessment consists of an exercise physiologist will sit down with their client to gather information on topics like: Medical history, current medications, lifestyle behaviour (nutrition, sleep, social support), past and current physical activity, and goals. They will also perform pre-participation screening, which consists of taking resting heart rate and blood pressure measures and having the client fill out a pre-screening form (the GAQ is most commonly used by CSEP). From there, the exercise physiologist can move forward to take their client through baseline fitness testing. 

A baseline assessment typically includes all aspects of health and fitness, namely: Body composition, aerobic capacity, muscular strength, muscular power, muscular endurance, balance, and range of motion testing. An example of a testing battery for a client with a chronic condition may be: 

• BMI and waist circumference
• Incremental exercise testing on a treadmill (with ECG monitoring)
• Grip strength
• Vertical jump
• Push-up test
• Single leg balance
• Sit and reach

Importantly: A certified exercise physiologist (CEP) is not qualified to diagnose pathologies based on assessments or observations. Working closely with medical professionals is an important aspect of being an exercise physiologist. 

Exercise prescription and program delivery

After completing an initial consultation and baseline assessment, an exercise physiologist will create an individualized exercise program to help their client reach their health and fitness goals. These programs may be tailored towards improving functional independence, quality of life, athletic performance, or the ability to perform their occupational duties.

The exercise physiologist will guide their client through the exercise program and provide supervision to create a safe environment for someone to exercise no matter their starting point of exercise or health condition. In the field of athletic performance, the role of designing and coaching training programs may be performed by a strength and conditioning (S&C) coach rather than an exercise physiologist. 

Education

Lastly, an exercise physiologist will help their client understand and learn about the benefits of exercise for their given situation as well as provide motivational interviewing to be a part of the support group for the client. In an athletic setting, this may look less like behaviour change and more like informing the athlete about where their performance currently is and where they need to get to in order to succeed in their sport (ie- a gap analysis). 

This aspect of being an exercise physiologist is often an afterthought, but we strongly believe that this is one of the most important parts of the job. Being an exercise physiologist is not just about giving someone a few exercises to follow, but rather, it’s about supporting long-term behaviour change and facilitating the client’s competence and confidence. Someone may work with an exercise physiologist for a handful of hours each week, but what they continue to do outside of those sessions is what makes the biggest difference. A great exercise physiologist will recognize this and emphasize this.

Where can I work as an exercise physiologist?

As mentioned before, there are many populations an exercise physiologist can work with. Although the exercise physiology profession is already fairly niche, there are ways to further specialize within it. Some of the various different areas an exercise physiologist can work within include:

Clinical Settings

In a clinical setting, an exercise physiologist plays a role in promoting and optimizing health through structured physical activity based on a client's medical condition, such as: cardiovascular disease, diabetes, obesity, cancer, and neuromuscular conditions. They may work with other healthcare teams to integrate exercise into a comprehensive treatment plan, all with the goal to improve health outcomes and enhance a clients quality of life.

For example, Calgary has a multitude of different places where exercise physiologists play a key role in interdisciplinary teams. For example, Alberta Health Services employs exercise physiologists to be part of working with renal patients, transplant patients, and children living with obesity. Other areas of work outside of the public healthcare system include: LiveWell Exercise Clinic, cardiac rehabilitation centres, and Spinal Cord Injury Alberta Neurorehabilitation Centre.

Sport Performance Settings

In a sport performance setting, an exercise physiologist focuses on optimizing athletic performance. This is both through physiological (lab) and field testing as well as working side-by-side with sport coaches to prescribe training. Some of the different physiology lab tests may include: Maximal aerobic testing, lactate threshold testing, critical power/speed testing, and hemoglobin mass testing. Outside of the lab, an exercise physiologist may run field tests for speed, agility, strength, and power. Analyzing and using the data from these tests allows for more individualized training prescriptions for their athletes. 

For example, an exercise physiologist working at an organization like the Canadian Sport Institute may work with the National long track speed skating team, running them through regular lactate incremental tests, maximal aerobic power tests, and critical power tests to better individualize aerobic training zones. 

Occupational Settings

In occupational settings, an exercise physiologist aims to enhance the health and occupational performance of individuals whose professions demand physical and mental resilience. Occupations such as firefighters, police officers, and military personnel will have standardized fitness testing that mimic the demands of the workplace that must be passed in order to be considered for hire. Aside from running occupational testing and on-going fitness testing post-hire, exercise physiologists in this setting may design training programs to maintain occupational fitness as well as provide education on injury prevention, stress management, and general well-being. 

For example, the City of Calgary has a wellness program for their firefighters, where exercise physiologists play a key role in yearly fitness testing, health and wellness education, and exercise program design. This is a unique program that ensures firefighters are continuing to keep up with the fitness requirements of their job.

Research Settings

In a research setting, an exercise physiologist will be a part of a research team likely investigating the physiological responses and adaptations to exercise through maximal exercise testing, submaximal testing or general field testing. Aside from testing being a primary driver for this role, an exercise physiologist may also be in charge of analyzing the data collected.

An example of a role would be performing maximal aerobic exercise testing at the University of Calgary for research studies examining the long-term effects of sport-related concussions (Sport Injury Prevention Research Centre). In this example, it is also the role of the exercise physiologist to pre-screen individuals for exercise testing and monitor for any complications during and post-testing. An exercise physiologist may also work in more applied research settings, where they aim to develop scientific evidence from practice (“practice-based evidence”). For example, running a 12-week exercise program for organ transplant patients with pre- and post-testing to determine its efficacy in improving metrics of health, fitness, and quality of life. 

How can I become an exercise physiologist?

In Canada, exercise physiologists are certified professionals. Exercise physiology certifications require a minimum of a bachelor degree in kinesiology (or equivalent). The gold standard certification in Canada is through the Canadian Society for Exercise Physiology (CSEP). A certification through the American College of Sports Medicine (ACSM) is also widely accepted in Canada.

If you’re interested in learning more about the CSEP-CEP qualification process or how to study for the exams, check out our previous blog posts on these topics! 

In conclusion…

Exercise physiology is a multifaceted profession that consists of working with a variety of different populations. Whether it is in a clinic setting to improve health outcomes, optimizing sport or occupational performance, or contributing to research, exercise physiologists play a vital role in the field of kinesiology. Their responsibilities encompass comprehensive assessments, individualized exercise prescription, program delivery, and education, all aimed at fostering physical well-being of an individual. Exercise physiologists show great versatility from their capacity to engage with a broad spectrum of individuals to the various different hats they wear throughout the day from managing chronic conditions to training elite athletes. 

Yeah, we like being exercise physiologists. 

Sincerely Your Kines Mentors,