The Sickness-Wellness-Fitness Continuum was created by Greg Glassman in a six-part series that defines what fitness truly means. This model is part 4 of 6.
When I graduated from nursing school in 2020, I began my journey as both a coach and an RN simultaneously. I distinctly remember sitting down for my Level 1 CrossFit certification and reading the Sickness-to-Fitness Continuum on the whiteboard. I was struck by how elegantly Greg defined fitness and how well this model captured the concept. I felt an immediate connection to it and believed more people needed to hear about it.
Over the past three years, I’ve worked not only as a coach but also as a nurse alongside some of the most brilliant doctors at 4 Elements Direct Primary Care. Here, doctors have the opportunity to create real, lasting change in their patients’ health and well-being, fostering deep and meaningful relationships with every patient who walks through the door.
During this time, I’ve worked with patients across the entire continuum—from sickness to wellness to fitness. What I’ve learned is that fitness is about much more than what you see on the outside or the performance that comes with it. Fitness represents the ultimate version of health, or as Seminar Staff Trainer Enn Hunter-Marshall puts it, “Super Wellness.”
From sickness to wellness to fitness, we can measure values of health over time to ensure we are building a hedge against chronic disease—one that encourages the physical, mental, and emotional well-being of each individual.
Both the role of a nurse and a coach are crucial in a patient’s journey. I’ve noticed that my role as a nurse comes into play more for those who are sick. With the help of a doctor, my role slowly evolves over time, as I support patients as they transition into the continuum of wellness and eventually fitness. Seeing these changes in real-time is truly special and, in my view, represents what the meaning of this journal is all about. The bridge between fitness and healthcare.
Outside of the traditional healthcare setting, coaches work to help those who are well enough to exercise in the gym improve their fitness and overall quality of life.
When Glassman first introduced this model of fitness, he referred to doctors as lifeguards and trainers as swim coaches. He simply stated, “When you need a lifeguard, you need a lifeguard—not a swim coach.” In other words, those who are sick need doctors, not coaches.
Through my work with 4 Elements Direct Primary Care, I’ve seen numerous patients transition from sickness to wellness to fitness, all because it started with their doctor. This model creates an environment conducive to change—one that doesn’t focus solely on treatment-based healthcare, but rather on discovering an individual’s fitness across a lifespan.
Coach Paul, RN BSN
