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Since I cancelled my cable, I’ve been watching more Netflix.  Recently I was browsing through the “Suggestions for You” category when I found “Gotta Dance” a documentary about the first-ever senior citizen hip hop dance team for the New Jersey Nets.  It’s a story about people being active at any age and against odds… it’s scary how well netflix knows me.

The group was determined to show the world that just because you’re over 60, doesn’t mean you can’t dance.  A member said, ” age is a number I like to ignore.”  They even talked about the importance of exercise in keeping them “young.”  I have a discussion around the topic of exercise in older adults weekly with my clients.  Older people CAN get stronger and fitter.  Unfortunately, there are some that believe this is not possible and it usually takes some convincing on my part to get them on board.  Nothing is more convincing than hearing the stories of the people that joined this group.  Many of them talk about how they felt better, lost weight, and became more confident.

One of the members stated, “People over 60 CAN DO more than sit and watch TV.”  He’s absolutely right, however, if you’re over 60 and all you do is sit and watch TV… well that’s all you’ll be able to do.  Bodies in motion tend to stay in motion.  Find something you love doing or something you have an interest in learning, even if that something is difficult and challenging to your body and your mind.  I did a quick search in Milwaukee and found dance studios and recreation departments holding classes for adults to learn dance or return to dance.  One such company in Milwaukee is DanceWorks.  They have 50+ classes in ballet, tap, and yoga.  Communities should be offering more diverse options for older adults to stay active above and beyond chair exercises and water aerobics.  Although those are good classes and helpful to many, there are older adults who don’t want to slow dow.  Some want to continue to challenge themselves physically, such as those who joined the Netsationals.  The members of the Netsationals were new to hip hop dance, but they were willing and ready to learn something that was unfamiliar and out of their comfort zone.

Exercise is the key to aging gracefully.  Find something you like.  You can dance if you want to. If you know an older adult that falls into the “only sits and watches TV” category, have a discussion with them about exercise.  Life gets much harder for an older adult when their bodies are no longer in motion.  If you are having trouble staying physically active or if everyday tasks are becoming difficult or uncomfortable, the best person to see is a physical therapist.  Find one here.

©2012 Geaux to Physical Therapy. All Rights Reserved.

1. Weak Back Muscles
2. Tight Hips
3. Loss of Balance
4. Low endurance
5. Weak Legs
6. Stiff Shoulders
7. Weak Hips

Most of the exercises below are yoga moves.  I incorporate yoga poses into many of my treatments.  Overall, it is one of the most multitasking activities out there, improving flexibility, strength, core stability, balance, coordination, and stress levels.  I highly recommend you make yoga a part of your workouts to improve health long term.

Chair Pose/ Squats

http://www.youtube.com/watch?v=Ur-W02QtIRU

Triangle Pose: This is great for not only hip flexibility, but also balance, especially when looking up.  Only reach down the leg as far as you can comfortably and without losing your balance.

http://www.youtube.com/watch?v=UVE5zW4RsK8

Child’s Pose: Do this one with your arms extended straight out in front to stretch your arms

http://www.youtube.com/watch?v=NwzE_J-3JOI

Clamshells: You can do this one without the band to start and work your way up to using resistance as you get stronger.

http://www.youtube.com/watch?v=njthA4SVOT8

Rowing: The person in this video gives some good variations on rowing, an exercise to strengthen the upper back muscles, by changing his standing position to incorporate balance.  Though, I would go much more slowly and controlled with the movements.

http://www.youtube.com/watch?v=1SgomK3sb98

Bridging: This previous post gives you lots of variations on the bridge exercise.  This exercise will strengthen the glutes and stretch the hip flexors, which can become stiffer as we get older.

To improve endurance, be sure to incorporate aerobic activities into your workouts.  In other words, exercise that will challenge the heart and increase your breathing.  Swimming and cycling are good activities to work on your endurance and they have lower impact on your joints.  Shoot for 15-30 minutes at least at a time and be sure you feel like you are working hard, though not so hard that you can’t talk while doing it.

When you are designing your anti-aging exercise program it is important to do them regularly, 3 times a week minimum.  Yoga and strength exercises should be done in 3 sets of reps of 8-15 with a good 5-10 second hold for the yoga poses.  It’s also important to make sure that your exercises are a real challenge, because challenging yourself is what will ultimately bring about the changes your body needs.  Don’t just be active, be active in the right ways with the right exercises to avoid mobility problems like inability get out of a chair or step up and down curbs.  If you need more tips on exercises, find a good personal trainer that is in tune with exercising for prevention.  Or you could ask your physical therapist for a good recommendation.

Thanks to ClevelandSGS on Flickr for the picture.

©2012 Geaux to Physical Therapy. All Rights Reserved.

As we age our muscles lose elasticity and strength.  Our joints become stiffer and compacted.  We develop arthritis.  These are things that are inevitable and cannot be changed, however, you can decrease the speed at which these events occur and improve or maintain your mobility throughout life by staying active, strong, and limber.  Did you know that you can improve your strength at ANY age?  Even if you’re 90 years old you can get stronger by doing resistance exercises and lifting weights, even as age is taking strength away!

http://www.youtube.com/watch?v=fTrUrFdepuQ

As a physical therapist, I’ve noticed that there are certain areas of the body that tend to lose flexibility and strength as we get older.  Here’s a breakdown of the most common age-related mobility problems I have noticed in my evaluations.

• Inability to Stand Up Straight/ Increased Thoracic Kyphosis
  • Another term people use is a “hunched” back, where the upper part of the back is rounded more than normal.  This is in part due to poor posture and prolonged positioning, which can lead to a permanent change in spinal and shoulder alignment.  Most clients with this problem mention they have to sleep with 2 or more pillows at night due to this change in the spine.  This can worsen over time and cause problems at other areas including the neck, shoulders, and low back.
• Inability to Raise Arms Overhead
  • Maintaining the ability to reach for things in your cupboard or get a pullover on without straining your shoulder requires good range of motion and flexibility
• Difficulty Getting out of a Low or Soft Chair
  • As leg strength decreases this activity gets harder and harder and most people start to rely more on their arms to push themselves up, or to unsafely use momentum to propel themselves up.  Also hip inflexibilities can make getting out of chairs much more difficult.
• Waddling Gait
  • This may also look like a limp and may be related to arthritis, but when our hips get weak they start to cause a waddling gait which places undue stresses on the hips, knees, and low back
• Feeling unsteady
  • As strength, flexibility, and reaction time declines, so does balance, though balance can be improved through exercise.  Falls is a serious problem among the elderly, so we should all be working on our balance from an early age to combat the risk of falling as we age.
• Inability to take the stairs or get up a curb
  • Weak glutes, hamstrings, and quads in particular will make this activity much harder.  Although there should always be a ramp, some places do not have one or it is not conveniently located, so it’s important to maintain this skill to stay safe and prevent falls.
• It’s hard to walk long distances
  • Aerobic conditioning is very important to maintain through the golden years to maintain endurance for walking, whether it be for several hours to shop or to get all your errands done in one day.  Many of my clients who have this problem have to sacrifice efficiency and plan for much more time to get everyday chores done due to low endurance.

These are the most common problems I have seen in physical therapy related to aging and prolonged inactivity.  The good news is with physical therapy I have helped clients overcome these obstacles through customized exercises to improve quality of life and independence.  If you have one of these problems, find a physical therapist to get a customized plan to make improvements and prevent disabilities!  If you’re looking to prevent these problems and maintain your quality of life, check back next week.  I’ll post exercises and tips to help prevent these commonly-seen problems and help you get started on a plan to maintain your independence and mobility for as long as possible!

©2012 Geaux to Physical Therapy. All Rights Reserved.

One of the reasons that our risk of falling increases as we age is that our balance declines.  This decline is partly due to age-related changes within the body and partly due to changes in lifestyle.  The best way to avoid the complications associated with falls is prevention.  The good news is you can improve your balance and decrease your risk of falling by performing a few simple exercises.  In physical therapy I use a variety of activities to reduce someone’s falls risk including stretching, aerobic conditioning, strengthening, and balance tasks.  The company I work for, HealthReach Rehab, offers specialized programs including falls evaluations and safe home evaluations.

Our balance and ability to stay upright is generally controlled by three things: vision, the inner ear, and the musculoskeletal system.  If there are problems with any of these systems, our balance can decline.  Some people rely heavily on their vision to maintain their balance and as vision becomes impaired, balance can be significantly affected.  You can try a simple test (if safely able): try to stand on one foot then close your eyes.  The task gets harder.  For those who really rely on their vision for balance, staying upright when their eyes are closed is not possible.  How does this relate to everyday life?  Ever get up in the middle of the night for the bathroom?  Had to walk in a dimly lit movie theatre?  Walk outside at night?  Our inner ear and musculoskeletal system need to be strong to compensate in these conditions.

Risk Factors for Balance Impairments and Falls
•    Impaired vision
•    Muscle weakness
•    Inflexibility
•    Decreased endurance
•    Inner ear dysfunction or history of inner ear dysfunction
•    Dizziness or lightheadedness
•    Certain medications

Tips to prevent falls
1.    Stay physically active and include balance exercises in your routine.
2.    Have your vision checked yearly and update your prescription as needed.
3.    Discuss your medication list with your doctor or pharmacist for interactions that may cause balance impairments.
4.    Make your home safer by clearing clutter, loose wires, and ensuring adequate lighting throughout your living spaces.

A good website to check out is the Fall Prevention Center of Excellence’s.  There are lots of resources on identifying whether you or a loved one is at risk for falling and information on options for lowering that risk including fall-proofing the home.

Even if you feel like you have relatively good balance and your vision and inner ear are functioning normally, you can still be at risk for losing your balance if your muscles are weak, tire easily, or have lost flexibility.  If you are experiencing a feeling of unsteadiness, loss of balance, or have fallen recently, talk to your doctor and ask about treatment options including physical therapy.

Resources

Fall Prevention Center of Excellence http://www.stopfalls.org/

©2012 Geaux to Physical Therapy. All Rights Reserved.

Today, compression garments are available in a wide range of colors, styles, and sizes.  There are varying degrees of compression as well, and the intensity of support needed often must be matched with an individual’s ability to get the garments on and off.  There are aids and other strategies available to make putting them on and taking them off an easier task.  As a physical therapist that specializes in the treatment of swelling, I get many questions about compression garments.  Here are the most common ones.

Q: How do compression garments work?

A: The pressure they exert against the tissues helps to keep fluids in circulation instead of collecting in the lower part of your legs.  Compression garments help keep the fluid moving toward your heart instead of out toward the extremities.

Q: Who might benefit from compression garments?

A: Really, just about anyone who struggles with leg swelling.  There are a few conditions where it is not warranted but for the most part, we see people who are on their feet all day, post-operative, or who are aging.  As we age, the valves in the veins in our legs begin to leak a bit.  So, as the day goes on and gravity takes its toll, fluid tends to pool in our ankles and lower legs.

Q: How have compression garments changed over the years?

A: Many of the same fundamental principles still apply.  For instance, compression garments are “graduated”, meaning they have a higher pressure at the foot and ankle and progressively less pressure as they move up the leg.  However, today there are a wider range of “pressures” available, and they often are available in much more attractive colors and materials.

Q: What is the difference between compression garments and TED hose?

A: TED hose are designed to help prevent blood clots in individuals who may be in bed or not moving much for extended periods of time.  This is why you often see people with them on after surgery, while they are still in the hospital.  TED hose are not meant to be worn when you are on your feet for extended periods.  Also, compression garments are not supposed to be worn at night, but rather during the day, when you are up and around.  They are “graduated” in compression, whereas TED hose are not.

Q: I know a lot of people who get compression garments but never wear them.  Why?

A: We find that most often people do not wear them for two reasons.  They either don’t fit correctly or they are too hard to get on.  Typically, both of these problems are avoidable or can be addressed.  Another reason is that people think that the only options available to them are the thick, heavy, beige stockings.  Nowadays, you have lots of styles and colors to choose from.

©2012 Geaux to Physical Therapy. All Rights Reserved.

Risk Factors:

• Gender– women are at increased risk, though men get osteoporosis too!
• Increased Age
• Body Size– a thin frame
• Ethnicity– especially European and Asian
• Genetics—family history of fractures
• Low Calcium and Vitamin D intake
• Smoking
• Alcohol intake (>2 per day)
• Physical Inactivity
• Low estrogen or testosterone levels
• Certain long term medication use, including corticosteroids
• High Caffeine intake

Statistics from the NOF reports, “about 85-90% of adult bone mass is acquired by age 18 in girls and 20 in boys.”  The key to maintaining good bone health is being active and getting adequate nutrition, starting at an early age.  Regular weight-bearing exercise makes our bones strong, while immobility leads to diminished bone mass and weakness.  Some examples of weight-bearing exercise include: walking, running, aerobics, weight training, dance, hiking, and tennis.  It is important in all stages of life to maintain an active lifestyle that includes weight-bearing activities and exercise. You can stimulate bone growth by staying physically active because of Wolff’s Law.

Exercise can reduce your risk of fracture by:

• Building and maintaining bone density
• Improving balance
• Increasing flexibility
• Strengthening key muscle groups
• Correcting faulty posture that can lead to spinal fractures

If you have osteoporosis, it is important to reduce your fracture risk by not only performing weight-bearing exercise (for the lower body, upper body, and the spine), but also by working on your balance and posture in order to reduce falls.  Certain postures or positions should be avoided to prevent spinal fractures, including a flexed posture.  When you are “flexed” or bent over or slouched, you put more load and stress through the vertebrae.  Osteoporotic bone is less likely to handle the load and stress and can fracture.

If you have been diagnosed with osteoporosis, you should avoid the following to reduce fracture risk:

• Bending forward, such as sit ups and toe touches (Make sure you logroll out of bed, never sit up!)
• Twisting at the spine
• Golf and Bowling (mainly because you are twisting in a bent over position)
• Lifting
• Poor Posture

Nutrition and Osteoporosis
Research has shown that a combination of supplemental calcium and vitamin D can reduce the risk of fracture.  You should consume 1200-1500mg per day of calcium and 800-1000 International Units (IU) of vitamin D per day.  Calcium and vitamin D rich foods include: milk, yogurt, cheese, fortified foods or juices, almonds, green leafy vegetables such as broccoli and kale, salt-water fish, and liver.  15-20 minutes a day of sunlight exposure can also increase vitamin D production.  Sodium, caffeine, and carbonated beverages increase calcium excretion, so limit the amount of these items in your diet.  Excess protein increases calcium excretion, however protein is needed for fracture healing, so the key is moderation!  The recommended daily intake for  protein is 56 grams for men and 46 grams for women.

The best way to confront osteoporosis is through education and prevention.  If you are a postmenopausal woman especially, you should ask your doctor about whether you need a bone mineral density (BMD) test.  I continually educate women about osteoporosis and have identified a few people with osteopenia (pre-osteoporosis).  These women were able to be counseled about exercise, diet, and the appropriate supplements to support bone health and help prevent progression to osteoporosis.  The NOF states, “…in 2005, osteoporosis-related fractures were responsible for an estimated $19 billion in costs.”  We can stand to save so much by preventing this disease and its consequences.

References:
Foundation for Osteoporosis Research and Education
http://www.fore.org/

“Osteoporosis and Bone Health” The Burden of Musculoskeletal Disorders in the United States. (2008).
http://www.boneandjointburden.org/

National Osteoporosis Foundation
http://www.nof.org/

NIH Osteoporosis Resource Center
http://www.niams.nih.gov/Health_Info/bone/default.asp

©2012 Geaux to Physical Therapy. All Rights Reserved.