We almost jumped the gun in our November/December issue with our short article about “Strong Body,” Cosi Belloso’s new series of amputee-centric fitness videos. The magazine published on November 1, but Belloso didn’t officially announce the release of “Strong Body” until November 3. Fortunately, it doesn’t appear that we spoiled the big reveal on last week’s COSI Talks show. The episode set an all-time record for viewership, according to Belloso.

If you haven’t heard, “Strong Body” is a subscription-based, fitness program that includes more than 300 videos and a pair of accompanying books. This resource fills the glaring need for a comprehensive, clinically approved workout program specifically designed for limb-different bodies.

“There’s never been anything like this for amputees,” Belloso says. “I consulted with colleagues and asked if they’d seen anything, and they said: ‘Not really.'”

We only had room for a short article about “Strong Body” in the print edition, so a lot (too much) of our conversation with Cosi ended up on the cutting-room floor. Here’s the full Q+A, edited for clarity. If you want more info about Strong Body, check it out at strongbody.cositalks.com.

What was the motivation to put “Strong Body” together?
I’ve been in health care for over 20 years, and the past three years of being a clinic owner really sharpened and narrowed my focus as to what I wanted this to look like. In my own clinic I’m involved in setting the terms of how we support different types of amputee patients and move them through different stages of progress. So it was a matter of streamlining that approach and making it accessible.

What’s a quick description of the series?
The best way I can describe it is that it’s kinda/sorta like Beach Body. You order an annual subscription, and you’ll have access to over 300 videos. These videos are separated into exercises for your arms, legs, core, balance, and flexibility. Then I divided all of these exercises up into phases 1, 2, and 3. It’s meant for beginner, intermediate and advanced, so there are exercises in there for all ability levels. The program is flexible enough to accommodate everybody, from someone who’s fresh out of surgery up through elite athletes.

I tried keeping the cost as low as possible. It’s $14.95 per month for individuals, and if you pay the whole year in advance you get a discount. For clinicians and clinics who decide to buy subscriptions to use with their patients, they also have different rates.

And the videos are accompanied by a book?
Yes, the book might be delayed a few weeks. I have an above-the-knee book and a below-the-knee book. And for every video, every exercise, there is an accompanying page in the book. I’m hoping to make those available both in digital and hard-copy format.

As a therapist, I like to learn in different ways. I like to look at things and read them, and I also like to watch a video that shows the full form of an exercise. That’s why I created both media to complement each other. For clinicians, physical therapists will often download programs or make copies of exercises to give their patients a visual guide. I’m trying to cover all bases.

Any other perks that come with the purchase?
Every week I’m going to be featuring some of these exercises, COSI Talks-style, on Facebook and YouTube. For example, for the bridging exercise, I’ll do a live video demonstration on how a below the knee can do it, and an above the knee. I’ll demo how a beginner can get started and then advance through the phases. I’ll also be answering questions from subscribers who are trying to get the best mileage out of the videos. And I’m planning on adding my lecture talks, including my basic talk on muscle strengthening and physiology, my talk about proprioception, and my talk about gait training and how you should tailor your fitness program to it.  I’ll be adding these through the year.

How did you decide what specific exercises to include?
I started with the questions my viewers have raised over the last couple of years. They tell me what they want and what they need. It boggles my mind that so many of them don’t even have the simplest home exercise program. Even my more advanced viewers who are runners and athletes, they’re missing some of the foundational things. The bulk of it was based on my patients and readers telling me, “This is what I want to see.”

I had one or two colleagues look at everything, including my mentor who wrote the foreword in the book. I ran everything past him and asked him, “Am I on the right path?” I knew he’d give me a straight answer and not sugarcoat anything.

Did you also base some of the content off questions from other physical therapists who needed help working with amputees?
Yes, definitely. In PT clinics, usually you have access to some sort of software where you can download exercises for your patients, and you get those cute little handouts. When I used to do home visits, I’d usually find those handouts shoved under a coaster or under a coffee cup. They weren’t getting used. I wanted to create something that’s just for amputees, and I wanted it to be interesting and fun enough to keep people’s attention.

The book is a full-color book, the photography is amazing, and the descriptions are user friendly and meant specifically for amputees. That being said, any physical therapist can pick up the book and start designing a program for an amputee even if they’ve never worked with one. That happened because I’ve been getting phone calls from PTs who watched my show and told me, “I just had an amputee come into my clinic, and I don’t know where to begin.” I’d find myself giving them material piece-meal—this video from my YouTube channel, another from a talk I gave to this organization, something else from another source. I just needed to be able to give them one thing.

And if I’m an amputee, presumably I can take “Strong Body” to my physical therapist and ask them to work it into my treatment?
I’d encourage that. Throughout the book and the videos, I’m constantly encouraging people to use this material in conjunction with your treatment. In my practice I’ve had clients, both amputees and non-amputees, bring in fitness books they want to work with. I’ll tell them, “Use this exercise and this exercise, but you’re not ready yet for that one.” I have no problem with it if it’s going to get them to do the work.

Are there common mistakes amputees make during their fitness or rehab programs? Or common mistakes that physical therapists make when they’re not used to working with amputees?
Yes. With all due respect, I’ve seen folks out there in the PT community who’ve put out exercise programs for amputees, and I find that they’re very aggressive and can lead to injury. I never discourage an amputee from shooting for a high level of sportsmanship or fitness, but I am insistent that they build their core foundation first. A lot of people want to skip that step. They want to go straight into these incredibly intense exercises that they’re not ready for yet, or that even the average person with two legs who has not been exercising isn’t ready for yet, and that can lead to injury. I see it a lot, and it makes me cringe.

This is a fitness program for amputees that’s been done by a clinician, not by an athlete or an individual amputee. Many of the steps are bread-and-butter exercises, but they work. One of the models who appears in the videos, he bikes 30 to 50 miles a day—the guy is in amazing shape—but he was struggling doing the Phase 1 (beginner) core-building exercises. He was surprised. It just shows you that even someone who’s in great shape, if you started doing a lot of aggressive exercises right off the bat, you might be looking at an injury. That to me is one of the big mistakes. You need to be realistic about where you are in your fitness and build up slowly. It’s not to say you won’t get to the CrossFit gym, but you need to start off in a reasonable place.

And I assume the corollary is that even if I don’t feel like I’m in very good shape, or even if I don’t identify as an athlete, the exercises in Strong Body would still be accessible to me.
That’s what I set out to do with this program. For example, in the videos for Phase 1, many of the exercises are demonstrated with the prosthesis and without. I demonstrated both because I understand there are folks who either haven’t exercised in a long time, or they’re still recovering from surgery and working with their physical therapist. You might be in Phase 1 for legs and Phase 2 for arms. The program is flexible enough for you to piece together a program that works for you, regardless of where you are at.

How did you identify the models? Did you use people from your practice? Did you hold a casting call?
You give me way too much credit! I did this on a shoestring budget. I picked the four models myself. They’re al wonderful people I’ve worked with in different parts of the limb loss community. Some were patients, others were people of met through working with the community.

Jessica is my below-the-knee female model. She was one of my running patients, and she just whups my butt. Robin is my above-the-knee female model. She’s a triathlete, she’s broken a couple of world records with rowing, and she’s on the board for the Mission Gait Foundation. Damon is my male below-the-knee model. He’s a veteran of the 82nd Airborne, and he’s very well known in the local community because he’s a patient advocate for one of the local prosthetist clinics. And Jonathan is my male above-the-knee. I call him Thor. He is my crazy biker. So that’s our modeling team.

We had three days to shoot 300 videos. They were all amazing, but by day three we were all toast. All my models were scattered around my lawn—a leg here, a socket there. Any neighbors driving by would have been really alarmed. In one of the videos, you see Jessica wearing these shades for no reason. She had been wearing them as she was taking a nap, and when it was her turn to film she just forgot to take them off.

We didn’t have time for retakes, and that’s actually one of the strengths of “Strong Body.” You’ll see the models struggling with some of the exercises. You’ll see them making mistakes and see me correcting them during the video, as I would correct somebody in my clinic. Something I hear a lot about other workout programs is that viewers feel they can’t replicate the exercises that are shown in the video, because the model is an elite athlete and they have perfect form. In my videos, the models are all athletes, and they’re very fit and active, but they still make mistakes.

In other words, these videos aren’t going to make you feel bad about yourself if you’re struggling.
We tried to make them fun. There will definitely be a bloopers reel. It was really a labor of love. I started doing COSI Talks about three and a half years ago, and about a year into it I realized that I really love to do this. Releasing these videos is the most proud accomplishment in my career.