The Purpose of the MedExPRO Skills Progression

Every Medical Exercise Professional (MedExPRO) begins with enthusiasm—but professional confidence comes from skills, systems, and repetition.

The 52 core MedExPRO skills define the technical, analytical, and communication foundation of our profession. These skills evolve through three tiers of competence:

1. Essential Skills – Safety, screening, and foundational assessment
2. Intermediate Skills – Integration, documentation, and program progression
3. Advanced Skills – Case management, interdisciplinary communication, and outcomes tracking

CLICK HERE TO REVIEW AND COMPLETE THE MEDXPRO SKILLS CHECKLIST

1. Essential Skills (Months 0–12): Building Competence and Confidence

At this level, the MedExPRO focuses on safety, assessment, and basic documentation—the building blocks of every effective medical exercise program.

🧩 Core Focus:

• Risk management
• Medical screening
• Functional baseline testing
• Accurate documentation and communicati...

 As a Medical Exercise Specialist (MES), you are positioned at a pivotal junction in the care continuum. After surgical rehabilitation for a total joint replacement, many clients emerge medically cleared yet still functionally limited. This gap—between ‘therapy ended’ and ‘full functional return’—is your professional opportunity. The upcoming surge in joint replacement volume is only going to increase the demand for skilled MedExPROs who can manage these clients back to meaningful movement, independence, and quality of life.

The Scope and Scale of Total Joint Replacements

• Current data from the American Joint Replacement Registry (AJRR) show the registry has captured millions of hip and knee arthroplasty procedures in the U.S. to date. 
• Estimates suggest that in 2020 there were approximately 5.7 million Americans living with a total knee replacement (TKR) and 2.9 million with a total hip replacement (THR). 
• The annual incidence is large and rising. For example, one study estimated
...

For decades, Medical Exercise Training (MET) existed in the gray zone between therapy and fitness—important work, but often unrecognized by healthcare and insurers. That’s changing.

Insurance carriers are now open to reimbursing MET services—but only when documentation, CPT coding, and professional ethics align. This is where many MedExPROs fail: they want medical recognition but operate with fitness-level documentation.

CPT Codes: The Language of Legitimacy

CPT codes are the language of healthcare billing. For Medical Exercise Professionals, they don’t represent treatment—they represent structured, medically necessary exercise.

The core MET codes include:

• 97110 – Therapeutic Exercise: Progressive strength and mobility work
• 97112 – Neuromuscular Re-education: Balance, coordination, motor control
• 97530 – Therapeutic Activities: Functional movements that improve ADL performance

Each session must justify the use of these codes with measurable outcomes and a written referral. W...

You’ve earned your credentials. You know how to assess, design, and progress exercise safely for clients with medical conditions. But let’s be honest — great sessions alone don’t build great businesses.
At this stage of your MedExPRO journey, you’re not just managing clients… you’re managing a practice. That requires a different skill set — one built around systems, communication, and predictable revenue.

This post recently appeared in the Business Tier of the MES Network — the place where you learn to run your practice like a business, not a hobby.

1. The Shift in Mindset: From Sessions to Systems

Every successful MedExPRO eventually reaches the same turning point: “I’m good at what I do, but I’m tired of chasing clients.”
This tier teaches you how to make your business run on systems, not sweat.

Start with clarity:

• Who are your top three referral sources — or who should they be?
• What are your top three measurable business goals (monthly revenue, referrals, retention)?
• What
...

Most fitness and rehab professionals look at grip strength as a measure of hand or forearm endurance. But what if I told you your client’s hand strength might be the window into their brain’s health?

1. Grip Strength Is More Than Muscle

Research from multiple gerontology journals has confirmed it:

Lower grip strength is consistently linked to faster cognitive decline, memory loss, and a higher risk of dementia.

Every 5-kilogram drop in grip strength can raise dementia risk by as much as 15–25%.
Why? Because grip strength isn’t just a mechanical output — it’s a neurological signature.

When a client squeezes that dynamometer, you’re not just testing muscle fibers; you’re measuring the efficiency of the nervous system, the integrity of neural pathways, and even cerebral vascular health.

2. The Neurological Connection

The correlation runs deep:

• The prefrontal cortex governs both fine-motor control and executive function.
• Vascular insufficiency limits oxygen delivery to both
...

Introduction: Beyond the Title

Becoming certified as a “Medical Exercise Specialist” is a significant step — but it’s not the destination.
Many professionals stop at the certification, believing a credential automatically makes them a medical exercise professional. But a title alone doesn’t make you a MedExPRO. It’s not just what you know — it’s how you think, document, communicate, and deliver outcomes that healthcare understands.

This is the difference between a fitness trainer with a certification for medical conditions and a true Medical Exercise Professional.
One has information. The other has infrastructure — systems, documentation, communication, and a mindset rooted in professionalism.

1. The Fitness Origin: Where Most Begin

Most MedExPROs start as personal trainers. Their early success comes from helping clients lose weight, build strength, or improve mobility.
But as clients age and medical conditions increase — hypertension, diabetes, joint replacements, balance defici...

What separates a fitness technician from a true Medical Exercise Professional isn’t passion — it’s professionalism.

Let me tell you about Josh, a trainer who had the heart but not the systems.

He had clients with knee replacements, diabetes, and chronic back pain. He cared deeply — but without documentation, risk management, or communication systems, he couldn’t earn the trust of physicians. When a doctor once asked for a progress report, Josh didn’t even know where to begin.

Like many of us, he was working hard… but not professionally.

Part I: The Struggle – Passion Without Professionalism

Josh was a certified personal trainer with more than a decade of gym experience. He was enthusiastic, friendly, and knew every new exercise trend before anyone else. His social media was full of “mobility hacks,” “HIIT for arthritis,” and “core activation for back pain.”
But behind the reels and hashtags, Josh was frustrated.

He had clients with total knee replacements, diabetes, and chronic b...

The MedExPRO Crossroads

If you’ve been in the health and fitness industry for 3–5 years, chances are you’ve worked hard to develop client trust, achieve esthetic goals, and keep people motivated. But you’ve also noticed something: the future of your profession isn’t in six-packs or PR lifts—it’s in outcomes that matter to healthcare.

Clients are living longer with chronic conditions, managing multiple diagnoses, and often leaving physical therapy or medical care without clear next steps. This is where Medical Exercise Training (MET) steps in, and where you, as a MedExPRO must evolve.

Transitioning from a personal training business to a true Medical Exercise Training practice requires more than passion. It requires systems, standards, and communication that meet the expectations of physicians, therapists, and insurance carriers. This article outlines the roadmap.

Step 1: Shift Your Professional Identity

Most fitness professionals start by selling workouts and sessions. MedExPROs mu...

In Tip #43 of the MET 101 series, Dr. Mike highlights an often-overlooked but incredibly effective strategy for building a thriving medical exercise practice: creating referral relationships with massage therapists and naturopaths. While many MedExPROs focus only on physical therapists, chiropractors, and physicians, this tip expands your network—and your impact.

Naturopaths are especially valuable when working with clients dealing with immune dysfunction or gastrointestinal disorders, two areas often underserved in conventional settings. Dr. Mike points to Glenn Gerald, an MES and naturopath in New Jersey, as an excellent example of the power of combining these disciplines. He encourages every MedExPRO to identify a trusted naturopath in their area and begin exploring partnership opportunities.

Massage therapists, on the other hand, are an ideal complement for clients suffering from chronic pain, such as arthritis, spinal issues, or failed back surgery syndrome. Dr. Mike strongly re...

Most Medical Exercise Professionals (MedExPROs) enter the field with passion for exercise, functional outcomes, and client care. But passion alone isn’t enough.

Healthcare is not simply a doctor’s visit, a prescription, or a referral slip. It is a massive, interconnected system shaped by insurance policies, licensure laws, provider hierarchies, and reimbursement rules. Behind every referral, every progress note, and every claim sits this fabric.

The key to your success as a MedExPRO is understanding this system—not to replace doctors or therapists, but to know where you fit, how to communicate, and how to deliver measurable outcomes. Let’s walk step-by-step through the system you are entering.

Step 1: See the System Behind the Care

Think of healthcare like a relay race. Clients move through multiple stages:

• Acute care: Hospitals treat immediate problems.
• Subacute care: Rehab facilities transition patients post-hospitalization.
• Outpatient care: PT clinics restore function over
...