I am from North Dakota. North Dakotans are often suspicious about feelings. Logic usually takes precedence over feelings when it comes to making decisions. My Dad used to say, “Don’t go with how you feel when making a decision.” He believed that feelings aren’t usually an accurate depiction of reality, even though they may seem so at the time. When they do, that’s your mind playing tricks on you.

When I think about exercising, I often don’t feel like exercising. I sometimes think I’m too tired or lazy or some other feeling like that. My mind tells me I don’t want to exercise.

I often think that if I made a decision to exercise based on how I feel before exercising, I would never exercise again.

I have also found that when I do decide to exercise, a few minutes after starting to exercise, I almost always choose to continue exercising. It’s like my mind is telling me it doesn’t want to exercise, but my body is telling tells me it does—once I start exercising. But my body doesn’t speak up until after I start.

The lesson is, do not base your decision to exercise on how you feel before you start. You will probably not feel like it. These feeling are most likely not accurate, and your mind is probably playing tricks on you. Start exercising for a few minutes, then decide if you want to exercise or not. Your body usually wants to exercise, it just doesn’t tell you until after you start.

I enjoy boating, and as a careful boater, I make sure to have redundancy systems on board in case some systems break down while I’m out on the water and away from help. Two engines, two GPS systems, two radios, and at least two people on board give me a feeling of security.

Scientific research tells us that our bodies function in a way similar to a careful boater. Our bodily systems and organs have redundancy. We have two eyes, two ears, and two of a lot of other things. If we lose one, we have a backup. Other bodily systems, including brain function and muscular strength, have about 70% of extra capacity too.

Obviously we can fall below capacity as well. If we run low on strength, we can still function—that is, until we reach around 30% of capacity. When we drop to 30% of normal muscular function, pain and injury occur, and function is seriously diminished. When we drop to 20%, we are near death.

Reduced muscular function to 30% not only causes severe functional problems, it causes immense insecurity as well, especially as we get older. Building and keeping a good reserve of strength restores function and gives you a feeling of security for daily living. You are never too old to keep your muscle strength reserves up.

Note: This posting was intended to precede my previous post from February 9. Sorry for the confusion!

“Little Things Mean A Lot” is the name of one of my favorite songs from the 1950s, and I think this idea is especially relevant when it comes to preventing anterior knee pain problems, which we see a lot at our clinic.

Certain harmful behaviors that contribute to anterior knee pain include the following:

1. Prolonged Sitting. Prolonged sitting is said to be “the new smoking” because it is so bad for your health. Break up sitting by standing up and moving around a few minutes after 20 minutes of sitting.
2. Sitting with your knees bent more than 90 degrees. Sitting with your legs curled up under you or sitting on a low chair can cause anterior knee pain. I recommend sitting on a bar stool-type chair when possible. (I am sitting on a high stool as I write this posting.) Another option is to sit with your knees extended as much as is comfortable.
3. Walking with your head and upper body hanging forward. Walking like this can contribute to anterior knee pain. Push up your chest before walking and be mindful of good posture.
4. Squatting. Especially deep squats can be a problem. I recommend no squatting at all for people over 40.

Being mindful of little things like these can mean a lot when it comes to preventing and eliminating anterior knee pain.

Did you ever think it was possible for you to fail your joints?

In the recent March, 2012 issue of Runners World (no web link available), runner J.R. Havlan writes a humorous but insightful letter from his knee to himself called “From Knee to You: An Open Letter from a Long-Suffering Leg Joint to its Negligent Owner.”

The back story is that J.R. goes to his physician complaining of problems with his right knee. The doctor checks it out and tells him his right knee has failed. The doctor’s explanation is that muscle weakness and cartilage and ligament damage over time have resulted in the destruction and failure of his joint.

So J.R.’s right knee becomes angry and (in his funny letter) tells J.R. that it’s not the knee that has failed, it’s J.R. who has failed his right knee. J.R.’s inactivity and lack of awareness of the problem were what caused his knee to fail. J.R. did not know he “failed his knee,” but he did.

The message is: Your joints rely on you to treat them responsibly, and you can, to a large extent, prevent joint failure. You just need to know what to do and then do it.

Last week I discussed little things that can be done to prevent knee pain. Little things mean a lot when it comes to keeping your joints from failing you. In my next post, I will start a discussion on preventing knee failure and keeping your knees fit for life. Stay tuned.

A few weeks ago, my 87-year-old mother received a brochure with her AARP newsletter titled “Walking: The Easiest Exercise.” Maybe some of you received the brochure too.

I got a little upset with the information in the brochure, especially where it stated:

“Walking may be the single best—and easiest—exercise you can do to improve your health in 2012.

Walking may be amongst the easiest exercises you can do, but walking by itself is not going to lead to optimum health. By reading this article, I’m afraid people will come away thinking that walking is the only type of exercise they need.

Just about every day, I see patients who are regular walkers with musculoskeletal problems that are easily corrected by doing some simple strengthening or flexibility exercises. I see many others who benefit greatly with balance-type exercises.

The fact is, with today’s lifestyles, almost all of us, regardless of our age, need to engage in a balanced exercise program that includes aerobic, strengthening, flexibility, and balance exercise to maintain musculoskeletal health. Walking is not enough!

The older you are, the greater the benefits you’ll reap from exercising. These are just four of the many benefits:

1. More rapid improvement in strength from strength training.
2. More improvement in endurance as a result of aerobic exercise, with less intense exercise required.
3. Prevention of disabilities as a result of aerobic training.
4. A 60% reduction in your chance of getting chronic diseases (such as Alzheimer’s disease) as a result of aerobic exercise and a good diet.

Many people say they are too old to start exercising. A physician I admire responds to this by saying “you’re too old not to exercise.”

I recently read about a guy who ran his first marathon at age 100—and he started training at the age of 87. Impressive! It is never too late.

Aerobic exercise reduces the incidence of most of the chronic diseases that occur with advancing age. The incidence of Alzheimer’s disease, colon cancer, and stroke are just three examples of a long list of diseases that occur less often in those who engage in exercise. For example, studies show that you’re 60% less likely to get Alzheimer’s disease if you engage in physical exercises combined with good eating habits.

The effects exercise has on preventing chronic diseases tells me that exercise benefits increase as we get older. Why? Because young people usually don’t get these diseases, regardless if they exercise or not. For example, 90% of all cases of colon cancer occur in people over 50. The issue is, as Dr. Bortz says in his book The Roadmap to 100:

 “You are not too old to exercise, you are too old not to exercise.”

My conclusion is that the benefits of exercise are immense for all ages, but even more so for those who are older because of its effects on chronic disease prevention.

Most people I see exercising are young—at least younger than me! This especially seems to be the case when it comes to aerobic exercise. I do not see that many people over 60 running or jogging. When I sign up for 10k or half-marathon runs, my age group (over 60) is almost always very small. I find this unfortunate, because so much of the science out there points to the benefits of aerobic exercise as we become older. In fact, these benefits, including the prevention of disabilities and chronic disease, actually increase as we age.

I highly recommend a book that elaborates on these benefits titled Roadmap to 100 by Walter M. Bortz II, MD. In one example, Bortz describes a 20-year Stanford University study of the health of older runners compared to the health of non-runners in the same age group. Both groups were followed for 20 years, and the median age for the start of the study was 59 for both groups.

Dr. Bortz notes a startling discovery of this study. “For those runners who encountered disabilities during the study period, those disabilities set in a full 16 years later on average than they did for the non-runners.”

16 years! And that is just one of the benefits demonstrated by these senior runners!

Did you know that the older you get, the faster you’ll improve in strength when you engage in strength training exercises? Did you know that the weaker you are, the less exercise you need to get stronger? These are just two interesting facts that our performance-oriented culture does not talk about. In fact, I believe that our society totally overemphasizes the idea that advancing age is associated with weakness and loss of function. This pessimistic viewpoint ultimately results in the loss of health and strength in our older population. Changing these false assumptions is something I am challenged with every day in my practice.

Today I am starting a discussion on the realistic and positive effects that the right types of exercise has on an aging body. It seems that every time I pick up a health-related magazine or journal, I find articles on this topic. New research pertaining to the relationship between exercise and aging is really exciting, and I’m anxious to share information on this topic with you in the days ahead.

The most effective tip I give patients for improving their walking is to “walk tall.” Habits like sitting at a computer for long periods or bending forward a lot cause our bodies to assume a forward position, and this translates to how we walk as well. This forward positioning may contribute to pain in the spine, knees, and shoulders. It can impact balance and diminish walking endurance. Usually people are not aware of this tendency so it goes uncorrected.

By pushing up your upper body when standing, a better alignment can be achieved as illustrated here:

For further reading, this article in Running Times makes a great case for the importance of staying “tall.”