MUSCULAR SKELETAL SYSTEM. CARDIO VASCULAR SYSTEM. NEURO MUSCULAR SYSTEM. These are examples of systems in our body that need training if we are to maintain optimal function as we get older. If our exercise program focuses on just one system, such as treadmill training for cardio vascular training, and other systems are ignored, our overall function will not be maintained. Our fitness level and functional level will drop. The likelihood of falling and sustaining other injuries will increase.
Advancing age does not stop us from improving our function, but lack of training in any of our body’s systems does result in rapid loss of function as we get older. All of our bodies’ systems need training as we age. That is why I believe exercise is more important for us seniors than our younger friends.
Effective January 1, 2014, you are no longer required to have a physician referral to see a physical therapist. Long waits to see a physician are no longer necessary. By seeing your physical therapist first, you can save money by eliminating unnecessary physician visits and long and expensive time delays.
Seeing your physical therapist first enables you to more quickly access high quality care, safe and effective treatment for relief of pain and restoration of lost function.
Most health care plans will cover physical therapy services without a physician referral.
The following is a quote from a report in the Wall Street Journal by columnist Jason Gay and reporter Chris Herring, who covered the just completed NBA Finals between the Miami Heat and the San Antonio Spurs.
“But what about the Spurs? Do they keep the band together and give it another go? Tim Duncan is 38 and Manu Ginobili will soon be 37, but this does not feel like a team on the verge of dissolution. They didn’t steal the finals, they romped away with it. They’ve shown they can ration minutes and keep the geezers fresh. Why not make another run at this? Give me your next-year Heat and next-year Spurs. And just because I’m annoying, tell me who’s in the 2015 Finals.”
This quote is a demonstration of what older players can do. It also offers, I believe, encouragement and hope to all of us fighting the effects of aging with physical activity. Sometimes “rationing” minutes/activity is a necessity as we age.
When I started practicing physical therapy in the early 1970’s, most of the patients I saw were recovering from accidents or had serious diseases. Many had severe injuries resulting from auto accidents. Many were stroke victims and patients recovering from the effects of Polio. Safer cars, better high blood pressure medicine and polio vaccines have resulted, to a large degree, in the prevention of the devastating effects of these problems.
Now most of the patients I see have problems associated with inactivity and the negative effects of aging. Pills, vaccines and safer cars, which were effective prevention for the health care problems of the past, are not effective prevention for our current health care problems.
So what is the key to the prevention of problems associated with inactivity and the negative effects of aging? Well, the way I see it, engaging in a rehabilitation exercise program and engaging in a preventive exercise program (which is essentially the same program) will have two effects. It will result in effective rehabilitation and effective prevention. How cool is that! The rehabilitation program is also the prevention program.
It is exciting to know that engaging in an ongoing exercise program can prevent most of the health problems current in our modern society.
Exercise can be the best thing out there for improving your health, but if your exercise goals do not match your exercise program, you may not be getting what you need from your exercise program. For example, I have seen discouraged patients with lower back pain engaging in lots of strenuous “crunch” type exercises for the purpose of reducing the size of their stomach. They have found they ended up with just more back pain. Frustrated runners with multiple running injuries have told me their exercise goal is to burn enough calories so they can eat as much as they want to without getting fat. They have ended up with lots of injuries, along with being tired all the time. Others with various aches and pains have told me their exercise program consists of mostly stretching exercises because they believe they are too weak in their arms and legs to do weight lifting.
Exercise motivation alone is often not enough to achieve your exercise goals. Your goals must match your exercise program. If you think your exercise program does not match well with your exercise goals, a professional consultation sometimes can be time well spent to help you get on track to feeling good and being healthy.
Recently, as I was preparing to barbecue some chicken, I felt a sudden, severe, sharp pain in my back. It came out of nowhere, and I needed to lie down just to get somewhat comfortable. My diagnosis: a reoccurring, inflamed, degenerative disc.
In my office, I teach patients how an inflamed disc can cause the spine stabilizing muscles to immediately deactivate or quit working. I tell patients how, to a large degree, spine stability is lost after an episode of acute back pain.
Having had a history of back pain myself, I practice what I preach to my patients and religiously engage in a regimen of back strengthening exercises. I was shocked, therefore, to discover that following this episode of acute pain, I was actually somewhat disabled. I couldn’t run, and I lost the ability to demonstrate even simple exercises to patients. I was personally experiencing the sudden muscle deactivation and loss of strength I had been telling my patients about all these years!
After my acute back pain subsided, I was able to return to my back strengthening exercise program, and my muscles have since reactivated and returned to normal.
Following this experience, I was left with a new realization of the terrible loss of strength that occurs following an episode of acute back pain. I also gained a greater respect for the importance of engaging in a life- long, spine strengthening exercise program to keep these essential muscles activated.
There are still millions of un-informed people who think the body “naturally” will lose most of its strength and deteriorate as it ages. Age does have its effect, but these effects are not as dire as was once thought. The application of some simple scientific knowledge can help you “stay” in the game well into old age. Here is a case in point:
Scientific Fact: Age Effect: Exercise recovery time does takes longer as you get older. Practically, this means you cannot do as many exercises in a given time period when you are older as compared to when you are younger. If you try, you will most likely just get too tired and quit exercising.
Jim is one of my patients who understood this when he cut his work hours back as he approached retirement age. He wants to keep up with his balanced exercise program. He still exercises with the same moderate intensity that he did 10 or more years ago, but he knows he needs more recovery time to keep his program going as he gets older. He knows he cannot do his program as fast as he once could. He is not exercising less, he is not exerting more effort in his program, but he is exercising “longer” to accommodate for increased recovery time.
Why do you exercise? I spend most of my time teaching patients exercises to improve the flexibility, strength and function of their joints. Many of our patients have discovered the amazing benefits of exercise from a broader perspective. Here are a few examples. (First names were changed to protect our patients’ privacy.)
Larry is 74 years old and exercises to maintain his strength so he can continue ranching in the hills above Milpitas.
Gail is 62 years old. She had a spinal cord injury in 1971 leaving her lower legs semi-paralyzed. She exercises so she is able to care for her 1 year old grand daughter, who is a perpetual motion machine!
Gloria is 84 years old and has been through extensive rehabilitation following two dog attacks. She exercises to maintain her strength so she can continue teaching master gardening courses, which she has been doing for decades. She shows no sign of slowing down.
Billy is 74 years old and exercises so he can continue his weekly hikes around the bay area. Many hikes are through the mountains and are a distance of more than ten miles.
Sadly, many people in their forties, fifties and sixties believe they must curtail their active hobbies or interests due to their age. I am on a mission to change that thinking and these are just a few examples of older people living an active, healthy life style.
Have you noticed that your trunk widens and you tend to “compress” as you get older? One loses a little height and it gets harder to stand up from a low chair. Experience tells me that this phenomenon becomes worse in people who spend a lot of time sitting. Back pain may be more of a problem and walking becomes more difficult. Legs get weaker and being active gets harder.
If one takes certain steps, this phenomenon can be mitigated. You can look and feel better. Your strength and function can be restored.
I recommend the following steps:
- Do not sit for more than 20 minutes without standing up and walking around a little.
- Never fall asleep sitting in a chair. (Sleeping in a recliner in the “back” position is okay.
- Be mindful of your erect posture. Push your chest up several times when engaging in walking activities.
- If you are over 50 years old, do a few spine strengthening exercises daily to maintain trunk muscle tone. If you are under 50 years old, do these exercises three days per week.
Have you noticed it is a little easier to button your tight pants after you have engaged in aerobic exercise? According to the charts, you burn in the neighborhood of 500 calories for every hour of jogging. Studies show one needs to burn about 2000 kilocalories to lose one pound of weight. So, this begs the question; why are your pants a little looser if you have only burned 500 calories, or the equivalent of 1/4th pound of weight, after an hour of aerobic exercise?
The answer may lie partially in what is called an “afterburn”, described on page 104 of the book “Thinner Next Year” by Chris Crowley. Studies show a person burns up to 200 additional kilocalories due to heightened metabolism for up to 24 hours after engaging in aerobic exercise. This occurs even if you are at rest. The “fit get fitter” applies. It is like a halo effect for exercisers.