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Exos Physical Therapy integrates behavioral health with re-injury prevention

When Katie Redmond* found herself battling chronic knee pain, her primary doctor recommended physical therapy. A quick search of her options turned up a nearby Exos Physical Therapy and Sports Medicine clinic. Having some familiarity with the Exos whole-person approach to performance due to her work in the fitness industry, she signed up.

“My biggest concern was getting back to normal,” Redmond said, admitting that she wasn’t keen on rearranging her daily work and family obligations for PT. “I knew something had to give, though. I was ready to do whatever it took to feel normal again.”

Building a workable therapy plan

What struck Redmond at her first appointment was the detail with which the therapist addressed all forms of movement. Using a proprietary Exos intake process, the physical therapist worked with Redmond to assess the health and range of motion of all her joints – including everything from her ankles to her thoracic spine and how they worked independently and in concert with other joints – in just 20 minutes.

“It really was phenomenal,” Redmond recalled. “I remember thinking that I should maybe point out it was my knee that hurt, but I was curious about what he would find with the assessment.”

Her patience and curiosity paid off. Through an interactive combination of Functional Movement Screening, traditional orthopedic tests, and the 21-step Exos Pillar Pre-Requisite Assessment, Redmond said her therapist found some movement restrictions in her hip and spine that were contributing to her nagging, recurrent knee pain issue.

“He explained everything so well that it made perfect sense,” she said. “In that first session, I learned a set of exercises I could do at home to improve the way I move so that my knee could get some relief. We talked about nutrition and my therapist gave me some great tips for working my PT exercises into my daily schedule. I thought, ‘I can do that!’”

Within just a few days of starting her at-home exercises, Redmond said she could tell her back and hips were moving better. Within the first two weeks, and with check-ins with her therapist on video and in person, she said the knee pain began to lessen. As a team, she and her therapist, physician, and dietitian adjusted her treatment plan to account for her increased mobility to incorporate some strength and stability components.

Three months after that unique first visit, Redmond says she’s confident that her knee issue is a thing of the past.

“Now that I understand what I need to do to move my whole body more efficiently, it’s pretty simple,” she explained. “My knee pain is almost completely gone, and I’ve started the transition to a performance training program to focus on strength and functional movement. I was pretty skeptical of PT overall, but this experience has been different than what I expected. I feel great.”

Positive clinical outcomes begin with a different approach

Redmond’s experience isn’t unique among Exos Physical Therapy patients. Exos Director of Rehabilitation Jim Godin says it all starts with that first visit Pillar Pre-Requisite Assessment.

“Exos has a system in place that allows us to objectively assess each client’s movement, both from a global view as well as from a smaller, more segmental view,” Godin said. He also emphasized that the Exos approach to physical therapy is to focus on the root cause of injury rather than becoming fixated on the painful structure, such as a patellar tendon. Digging deeper during the assessment and identifying both the root cause of the pain as well as the actual painful tissue(s) or joint(s), a clinical team can work together to develop a comprehensive treatment plan along with the patient’s physician, nutritionist, and performance coach.

“It’s an integrative and long-term approach to physical therapy that sets the Exos Physical Therapy philosophy apart,” Godin said. “You might expect that, when you go to physical therapy for knee pain, the therapist will just give you a bunch of ‘knee exercises’ or perform treatment only local to the knee. The Exos approach attacks the root cause(s) of the pain using manual techniques, corrective exercises, and various loading strategies at the hip, ankle, or spine (possibly all of the above) while simultaneously addressing any local joints or tissues that are painful.”

“In general, pain is a great ‘check engine light’ as it allows us to dig deeper into a person’s movement strategies while we rid them of their current pain symptoms quickly. This clears up what’s causing the source of pain so the patient experiences relief and doesn’t get injured again in the future.”

What the Pillar Pre-Requisite Assessment provides

Exos Physical Therapists developed the Pillar Pre-Requisite Assessment to provide consistency at each initial therapy visit with a focus on whole-person movement health. Using the tool, a physical therapist can analyze a patient’s quality of movement, then follow a logical approach to treatment that addresses the patient’s lifestyle and overall health.

“Movement quality impacts sports and performance in everyday life,” Godin said. “For Exos clientele, performance needs range from running a 40-yard dash at an NFL Combine to a mother being able to pick up her child.”

Despite that wide range of physical activity and goals, Godin said the Pillar Pre-Requisite Assessment is applicable to every unique patient, and that the end goal is always the same.

“This tool is universally applicable to all patients,” Godin said. “We want to make sure they can absorb force and propel force while minimizing any energy leaks, and the assessment tool helps us avoid missing anything that could potentially positively or negatively impact their ability to do so pain free”. 

“Using this systematic approach, we are able to differentiate whether it is a tissue or joint that is restricted or if there is a sneaky, underlying inability for the person to actively control their available range of motion, which we term a ‘neuromuscular control’ issue,” he continued. “The results allow us to be more targeted in our treatments and, at the same time, create a theme to follow throughout the plan of care with specific exercises and complementary manual therapy techniques to improve a patient’s movement. We want to respect our clients’ time by being very specific and intentional with all of our rehabilitation strategies.”

A focus on getting back to better-than-normal

Some Exos Physical Therapy clients include professional athletes, first responders, and military special forces personnel. Godin emphasized that developing the Pillar Pre-Requisite Assessment to serve those highly physical individuals has only made it more useful for everyone, at every stage of treatment.

“We use the tool to assess, reassess, and then transition the patient back to their workplace, whether that be the battlefield, the streets, or the boardroom,” he said. “This approach allows us to create a plan of care that seamlessly transitions clients from their injured state all the way back to full performance.”

And, true to the Exos focus on healthy lifestyle and performance, Godin said the team-based integrative therapy approach addresses lifestyle improvements through patient education to improve outcomes.

“We connect all the dots and explain what we’ve found in the assessment so the patient understands why they’re experiencing pain. That creates a level of autonomy that enhances patient compliance so they continue the PT work at home.”

“We give our patients tools for personal wellness and autonomy. It’s a behavior upgrade model that creates healthy habits.”

Post-therapy return to training, made easier

The Exos Physical Therapy rehabilitation approach to lifestyle improvement was built upon the company’s foundational human performance training, so it’s no surprise that the Pillar Pre-Requisite Assessment and Exos PT treatment plans make sense to athletic trainers and coaches.

“Our rehabilitation system is based on absorbing force and propelling force, and we break down those movements to make sure each patient is ready to train using that reciprocal process,” Godin said. “Coaches speak our language, and we work with them to clearly indicate where their clients are so they can manage loads and intensity and get their clients back to preparing for their upcoming season or event.”

That bridge between rehabilitation and performance may look different for each therapy client, but what doesn’t change, Godin explained, is the proven process used to get them there. 

“Exos Physical Therapists can provide return-to-sport rehabilitation, injury prevention strategies, and return-to-occupation rehabilitation, as well as more traditional outpatient orthopedic therapies while working in collaboration with an extensive network of researchers, industry professionals, and partners,” he said. “We do this within a model that allows our therapists to learn about the various aspects of the client’s life so they can design a sustainable plan that fits their goals and lifestyle.” 

“The client gets just the right combination of education, manual therapy, exercise, and movement strategy while the clinician continuously refines and optimizes the plan,” Godin said. “We set them up to succeed, and that’s what it’s all about…ensuring a positive outcome for each individual.”

Learn more about Exos Physical Therapy and Sports Medicine’s approach to long-term patient wellness outcomes and Practice Management Services. Contact us today to learn how Exos Consulting can help your practice reach more patients, focus on proactive injury prevention, and speed recovery through a proven, integrative approach to human performance training.

*Patient name and certain details have been changed to protect the patient’s privacy.

How to remove barriers to youth training and build lifelong athletes

If the fitness industry expects to keep growing, trainers need to start breaking down barriers to performance coaching for youth athletes.

That’s the position Amanda Radochonski has taken since she started managing the Exos Sports Performance vertical, and she says her performance team continues to lead the charge for the benefit of Exos members and the future of the fitness industry.

“Youth and high school athletes have to become a focus for this industry,” Radochonski said. “Kids need performance education that helps them grow and develop in a healthy way. We’ve got to emphasize performance nutrition, a winning mindset, and healthy habits for life.”

Building performance program awareness and education

Overall wellness drives community awareness outreach for the team at Children’s Health Andrews Institute Sports Performance powered by Exos. The Plano, TX, Exos-managed location is home to a staff of four performance specialists and one performance dietitian. Senior General Manager Josh Adams says his team’s grassroots efforts include awareness of the program’s offering for all ages and performance levels, as well as awareness of performance training as an essential foundation for a healthy lifestyle.

“The industry of youth sports has long been heading down the path of early sport specialization and a ‘more, more, more’ mentality when it comes to sport skill acquisition. The reality is that athletes need general physical training, quality nutrition habits, and a focus on sleep and recovery just as much, if not more, in order to stay healthy and ensure the best chance of long-term success,” Adams explained. “Youth and high school performance training should be geared toward establishing a foundation of quality movement and general fitness, while reinforcing a healthy relationship with physical activity.”

It’s an effort that pays off when youth athletes continue their training and multi-sport focus through the Children’s high school, college, and adult coaching programs.

“Burnout, for numerous reasons, is increasingly common amongst younger athletes, so we try to do our part in educating athletes and parents on strategies to avoid burnout, both with their respective sport(s) and training,” Adams said. “We always try to layer in a bit of fun within each of our sessions so they don’t feel as though they are partaking in repetitive and monotonous training, which also aids in retention and excitement about staying active.”

Retention, he said, is crucial to building the fitness industry’s next generation of adult participants.

Balance and diversification prevent injury, build lifelong athletes

Adams mentioned that one big challenge for coaches – and athletes –  is the current trend of youth sports specialization.

A 2020 Orthopaedic Journal of Sports Medicine study found that young athletes who specialize in one sport year-round are more likely to suffer overuse injuries than multi-sport athletes. The prevalence of injuries identified as resulting from overuse due to specialization was higher among athletes who specialized before the age of 12, especially young girls. At the study’s conclusion, 41 percent of all injuries in the responding group were classified as overuse injuries.

Diversification is one lesson Adams and his team incorporate at every age level in the Children’s performance training program. He said the result of encouraging kids to play different sports instead of specializing in one sport builds athletes for life and helps prevent injury.

“When we encourage young athletes to play multiple sports and partake in age-appropriate training with qualified professionals, we allow athletes to figure out what sports and activities they truly enjoy, while also creating a strong foundation of movement quality, strength, speed, and stamina,” he said. “A natural progression of sports interest and general physical development will drastically decrease the likelihood of burnout and injury, while also ensuring that physical activity is a part of their forever lifestyle.”

Radochonski agreed, adding that balance, sports diversity, and education help developing athletes expect more from themselves while also protecting against sports-specific overuse injuries.

“Performance training teaches these young people healthy habits that keep them active for life,” Radochonski explained. “So many adults are trying to re-learn healthy habits or learn them for the first time, and that’s incredibly difficult. Teaching self-discipline and wellness from a young age is essential if we want to grow healthy people.”

The natural progression of performance training

How young are Exos Sports Performance clients? Radochonski said the earliest children should begin training is 7, and at that age, performance specialists like those at Children’s know that they won’t focus on skill development the same way they do with junior high or high school athletes.

“The lifecycle of an individual starts as young as 7 years old in a play-minded approach, which then ultimately leads to body weight exercises and movements, specific activites and exercises to build strength,” Radochonski explained. “We add a nutrition element early so these kids understand how to fuel their bodies in a healthy way. By high school, our coaches incorporate true strength and conditioning and agility work. Our collegiate athlete education includes a full-blown understanding of nutritional supplements and the demands of being a collegiate athlete.”

“You’re looking at 10-15 years to build, not just wellness, but also teamwork, leadership, competition, quality of life, and skills learned particpating in things that are physically good for your body. Ultimately, that whole-person education builds a better future. Discipline helps us be better beings.”

Implementing youth performance training

Fitness professionals who want to expand into youth and high school performance training have a responsibility to focus on healthy development that is age-appropriate, Radochonski said. Exos specialists include coach/trainer selection criteria in their parent education programs at every performance location.

“It’s important for parents to understand what kind of individuals they’re trusting their kids with,” she said. “The industry is unregulated. Credentials and experience are important. We educate parents on the fact that true professionals put health and wellness first.”

Sharing that philosophy of wellness education requires an extensive community outreach effort. It’s a prime directive for Adams and his team. They work diligently on building awareness of program offerings for all ages, also educating and encouraging parents and young athletes to focus on lifelong health and injury prevention through scientifically proven training methods.

It’s a model that builds relationships and trust because of the team’s authenticity and willingness to give back.

“My greatest advice to those that are looking to implement youth and high school training is that you have to start with education and community,” Adams said. “The biggest differentiator will always be the relationships that you develop with organizations and individuals and how you support the athletes when you have an opportunity to do so.”

At Children’s, that support ranges from attending soccer tournaments to offering free nutrition clinics, and also includes providing yearly sports physicals in schools and leading movement sessions alongside team skill coaches. The Children’s program, like many Exos Sports Performance programs, provides for a level of community investment that shares expertise and opportunities for all children to experience the same training trusted by many professional athletes.

Once introduced to performance training and coaches they can trust, it’s up to kids and parents to use that newfound knowledge to commit to training.

“Your athletes have to crave improvement more than you do,” Radochonski said, adding that the financial investment doesn’t have to be a barrier for committed athletes. “Exos coaches can help parents and kids get creative and find options to remove financial barriers.”

Performance coaching powered by Exos

The Exos approach to building relationships and nurturing athletes of all ages and stages has evolved into a balanced, whole-person approach that has proven effective for more than two decades. Learn more about Exos Management and Consulting services and, if you’re considering expanding or improving existing performance training options for youth and high school athletes, reach out for more information.

As Adams pointed out, it takes a lot more than a facility and a time slot to create a performance coaching program that will contribute positively to building the next generation of fitness industry participants.

“A shiny building and a flashy name are great starting points, but will not be successful without great community impact and awareness,” he said. “Sports and physical activity, when approached the correct way, should create a highly positive experience and, hopefully, a desire to be active and healthy for life!”

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Virtual programming strengthens and expands connection

NEW YORK, NY –Before the days of socially distanced workouts, there were days when the fitness industry could promote togetherness and encourage social connection as an essential part of the human experience. We lost some of that in the first days when the pandemic shut down many fitness and community centers, but what Exos-managed Manny Cantor Center soon discovered was that social connection is possible via virtual fitness – and no amount of distance can stop a determined fitness community.

MCC provides so much more than fitness

MCC’s strong and active member community in New York City’s Lower East Side enjoyed frequent (even daily) visits to the center pre-COVID to participate in its many family-focused programs. MCC has always been a hub for the local community, offering its 3,000 members access to community service opportunities, education and kids’ programs, and even art classes. 

Assistant General Manager Sarah Folkins says the community center’s fitness classes were also a big part of its attraction. She explained that human connection is the common thread that makes MCC so popular.

“[MCC is] like a second home,” Sarah said.

The impact of the first lockdowns on a close-knit community

The year 2020 was still full of hope and promise at MCC when March came in like a lion with the arrival of COVID. Fear and illness gripped New York City, and the pandemic shut-down required MCC to close its doors to the members who counted on the center to provide a social gathering place for fitness and connection.

MCC was quick to respond to that need, designing and launching a Zoom-based group exercise schedule and personal training option in just two weeks.

“We shut down March 13, [but] our executive director had already organized meetings with us before the closure so that we could deliver virtual options,” Folkins said. “We knew we had to get virtual classes up and going as soon as possible to serve our community. We have a strong group exercise space here, and we knew we could stay in touch virtually.”

“It’s our job as a community to create connection.”

Staff, member dedication keeps the virtual “doors” open

MCC’s determination to provide its members with digital fitness programming comprised an “all-hands-on-deck” approach that began with some research into delivery platforms. The second week of March, MCC Fitness Manager Michelle Sholtis began researching Zoom conferencing and calling instructors to verify that they could offer classes from their homes. On April 1, MCC launched 20 of its most popular group exercise classes using Zoom, including plenty of variety to appeal to members’ interests, abilities, and how much room they had to move inside their homes.

In the beginning, the classes were offered completely free and didn’t require MCC membership.

“When we first started, members who wanted to keep paying [monthly dues] had that option,” Folkins said, adding that she, Sholtis, and MCC General Manager Michael Gordon called 1,200 members personally to ask whether they would like to keep paying dues and/or make donations to keep the center financially solvent during the shut-down. “We’ve been able to keep many members paying full dues as tax-deductible donations because we are a community center.”

Continued financial support allowed MCC to launch online programs on a much larger scale than many of its counterparts, even while group exercise classes were free to the public. Most importantly, the value of the group exercise classes and livestreamed workouts from Exosathome.com kept membership cancellations at a minimum during those first few weeks, allowing the center to keep the lights on and keep its people employed.

“If we didn’t have online classes, we would have nothing,” Folkins shared. “At least when people call, we have an option. Otherwise, we would have no way to reach out to people. Our group exercise instructors have been employed this whole time, in the middle of lots of furloughs. Without this offering, and the generosity of our members, we would not be here today.”

The evolution of a global fitness community

While New Yorkers began navigating a world where so much was unknown, Manny Cantor Center offered familiar faces and daily opportunities to connect with distant friends. The Zoom classes were structured much like in-person classes, but with added time for socializing before and after the workouts. 

The program’s popularity demanded an expansion of class offerings, so MCC partnered with the 14th Street Y to add more classes. In July, the partnership expanded the class schedule to 27 classes a week as a new format for members-only group exercise. The move required that members pay monthly dues and register for classes in advance, allowing MCC and The Y to track utilization in a way that now informs programming changes and member communications.

“Our only goal was to have things set up for our community to be a part of,” Folkins recalled. But, what she found was that the online class format was attractive to a wider audience than in-person classes could ever be. “One benefit [of online programs] is that suddenly your gym is open to the entire world, essentially. You don’t have to live in New York to be a part of MCC.”

MCC’s digital fitness initiative has proven essential for members who have left NYC since the pandemic began, and has extended the community center’s reach to as far away as London. Folkins said an American expat sought out a virtual fitness membership after learning she could take Sunday yoga classes with her favorite instructor, Leorna.

“She knew Leorna and loved her,” Folkins said, adding that keeping members who move away has been an unexpected benefit of going virtual and could be a game-changer for many gyms nationwide. “To be able to continue the [virtual class] offering to your members no matter where they are, you could keep them for the rest of their lives.”

Forging a new path for fitness beyond 2020’s challenges

“We plan on continuing virtual classes and always having that option for members,” Folkins predicted. “It’s a benefit to us right now in New York City because we’re not allowed to have onsite classes for the foreseeable future. Also, some members may not be comfortable coming in when we are able to be in person. [The virtual class option] allows us to have a form of engagement.”

Folkins said the success of MCC’s virtual community-building has been a bright spot in a year of COVID that she’s excited to help nurture.

“As the world changes and people may be less comfortable working out in person, we hope to still be engaged with [members], especially in the vulnerable populations, and respond to our membership needs and wants,” she said. “I’m interested to see how this changes the fitness industry as a whole, and how many people continue to work out from home.”

The future of virtual fitness programming

Exos Senior Director for Community Center Relationships Leslie Meyers says the future of community center connection is closely tied to the future of virtual fitness for some members.

“What we’ve learned from team members like Sarah is that there are tangible social benefits to creating these virtual options, and that it’s possible to provide connection and build community engagement through online classes,” Meyers said. “We want to provide impactful programs that improve our members’ lives, and at Exos-managed community centers, that programming must include human interaction and relationships.” 

As Exos virtual programs mature and the pandemic abates, Meyers said she and her team will be closely monitoring MCC member participation rates, feedback, and revenue to further refine the Exos community center management model for online program delivery.

“It only makes sense to follow our members’ lead when it comes to providing the programming they want and the feeling of connection they need,” she said. 

That focus on members has certainly made a huge impact on the Lower East Side. Folkins offers sage advice for any community fitness center not already delivering virtual classes and enrichment programs:

“Don’t be afraid to try; just do it,” she urged. “It’s better to have to pull back your offerings because they didn’t work out than to have nothing. So, just try.”

Learn more about Exos Community Fitness Center Management services by visiting TeamExos.com/capabilities/facility-management-and-staffing/.

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Building resilient fitness employees: Exos expands inclusion, mental health, financial health programs

Leadership requires maintaining a delicate balance between business acumen and people skills. The people skills that are most important in the post-pandemic world involve a lot of human resources management – in the form of caring about employees and their experiences, building resources to meet their needs, and recognizing that there isn’t an “easy button” for helping team members approach life’s challenges.

Fitness industry employees have taken an especially hard hit during a time of lockdowns, social distancing, and fear of the unknown. Any personal battles they’re facing – either pre-existing or as a result of these factors – have been amplified by financial hardships and stress. It’s time for fitness industry leadership to step up and provide the mental and financial health resources employees need.

Support begins with a strong local team

Exos team member support has evolved to globally replicate best practices developed and implemented by forward-thinking fitness center leadership, and the process continues. Every day, fitness professionals, general managers, and performance team members work in tandem to solve staffing and morale challenges. These “boots on the ground” experiences inform operational shifts as the larger organization pivots to the most important business focus of all – providing what our people need, when they need it.

Financial health has been top of mind for everyone in the fitness industry during the pandemic age. Mercy Fitness Center GM Eddy Campbell recognized a need to support part-time service providers at the Edmond, OK, fitness center as the financial impact of the pandemic became more apparent.

“As a personal trainer, I was provided some business management guidance in 2011 that really opened my eyes,” Campbell said. “Managing a training business, recruiting clients, and setting and meeting financial goals is not something that certification teaches you.”

Campbell offered training for all part-time and commission-based service providers at the fitness center at the end of September 2020. He and his leadership team worked with staff members to develop individualized business plans to support their training efforts. Much like a personal training approach to a client’s overall fitness improvement, the plans started with “big idea,” long-term career goals. Campbell then helped the participating trainers, aquatics coaches, and massage therapists set intermediary metrics for career success and develop a plan to hit those monthly, weekly, and daily client recruitment and retention goals.

“It’s been extremely well-received,” Campbell said, adding that his team conducts weekly reassessment sessions with participants to gauge what’s working and adjust. “Those who have implemented their plans have grown their session counts dramatically.”

Aside from helping young part-time employees grow their client base and continue to succeed in their field, Campbell said the business counseling program has improved morale, employee retention, and resilience. It’s been especially helpful for those employees who were struggling with work/life balance.

“Once you have a plan and know how many sessions you need each week to meet your financial needs, you can structure your session scheduling around when you want to work,” he explained. “That’s been really helpful for some of our staff members who are single parents and needed some help balancing the time they spend working and the time they spend with their families.”

Growing values and identity-based support systems

The Mercy Fitness Center approach has yielded holistic mental health improvement, but Exos isn’t stopping there. What the company’s people operations team recognized is that employees also need opportunities to belong. That’s where Employee Resource Groups have become invaluable.

These groups welcome Exos employees – including furloughed and part-time team members – to join others with shared life experiences to become part of a like-minded group of individuals and allies who support their cause. Exos ERGs host regular virtual meetups and discussions specific to the experiences and needs of traditionally underrepresented groups as part of a larger effort to address diversity, equity, and inclusion. It’s a movement whose time has come, and has already yielded tangible benefits for employees’ sense of belonging and real employer support.

Bringing together the resources employees need

As an organization, Exos has also continued to add benefits that address employee benefits, mental health, and resiliency:

  • The company has added enhanced Employer Assistance Program (EAP) benefits packages. Communications regularly encourage employees and their families to reach out to EAP counselors any time, day or night, to discuss any mental health or financial concerns. 
  • Employees now also have extended parental leave options to support working caregivers.
  • Exos has added a series of financial health webinars to its employee Homebase platform.
  • Performance training – featuring a focus on building resilience – is now available to all team members as a benefit of employment.
  • Exos university offers personal and professional development workshops throughout the year.
  • Monthly pulse surveys provide opportunities for team member feedback and program adjustment.

These efforts reflect the Exos commitment to supporting its team members and provide a valuable proving ground for similar efforts by other large companies. Many of these programs will continue to grow and develop as Exos integrates employee feedback through its monthly company-wide surveys, leadership powwows, and local check-ins.

“We can’t emphasize enough how important it is for employee retention and business success to provide employee programs that get results,” said Jeff DiBiaso, Exos VP, Community Business. “The entire fitness community is struggling right now from what will be the long-term effects of huge business losses in the last year. The only way to build long-term success is by focusing on the needs of the individual, addressing those needs on a local and organizational scale, and continuing to adjust and invest in valuable team members as a fitness industry.”

“Let’s lift up our people. This has been a tough year, and they need our help.”

Learn more about Exos Community’s approach to fitness center management by visiting TeamExos.com/capabilities/facility-management-and-staffing/.

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