This workshop is for you if you’ve been diagnosed with osteopenia or osteoporosis or if you have healthy bones and want to keep them that way! In this 90 minute session you will discover how to move safely with bone loss.   You’ll learn to find your ideal posture, how to lift safely, what exercises help with hip and spine bone strength, and how to avoid fractures.

I’ll share my easy to remember BoneSmart ABC’s for bone health, which will be the foundation for you to live a  bone healthy life.

Bonus:

Along with the workshop, you’ll get free access to my Private Forum on the BoneSmart Pilates website.  You can ask any exercise-related questions that you have on the forum. Your password will be emailed to you when you register.

This workshop is presented by Teresa Maldonado Marchok, licensed PT, nationally certified Pilates teacher, former professional dancer, ambassador for the national organization American Bone Health and creator of the award winning DVD series BoneSmart Pilates®

This workshop is a great balance of research and information, along with exercise and practice. I highly recommend this workshop if you are 50+ whether you have osteoporosis or not. Brilliant!

– Linda A.

Purchase the workshop here!

 

Do you ever wonder how the hunchback of Notre Dame got his hump? And do you worry that you are heading toward the same fate?  If you spend too much of your time sitting, driving, doing computer work and/or texting, you just might be. Or, if you’re a breast cancer survivor experiencing surgical tissue tightness across the front of your shoulders, you might collapse your chest in subconscious protective posturing.

These activities all promote a forward flexed spine which can restrict our mobility, impair our balance and breathing, and cause all kinds of problems we don’t want to deal with—including the dreaded hump!

How often do you extend (bend backward)? Unless you change lightbulbs for a profession, I bet not very often. Extension is especially crucial for those with osteopenia or osteopososis-a silent disease of low bone density.  Decreased bone density can lead to a forward flexed spine due to common undiagnosed spine compression fractures.

Extension exercises will help to decrease that forward curve inclination. Those with decreased bone density are more susceptible to fractures, especially from falls. Upright posture is associated with decreased falls and studies show extension exercises build stronger bones in the spine. Added bonus, extending the spine just feels great!

In this workshop, discover the secrets of spine extension exercises to

  • Improve your posture and prevent falls
  • Build bone in your spine
  • Promote healthy aging to continue to do what you love

Learn how to do spine extension correctly, avoiding common pitfalls.  Experience simple extension exercises in multiple body positions, to unleash your optimal posture and bone health throughout the day.

You’ll receive a printable follow-along guide that you can also reference afterward to remind yourself of all the things you’ll learn in the workshop.

Extend Yourself!

PURCHASE HERE

With over 80 active participants from several countries this virtual event was a resounding success!  Thanks to your support, we collectively raised $1,625 to benefit the national organization American Bone Health, a nonprofit that I’ve volunteered with for the last 8 years to increase community bone health awareness and fracture prevention.

It is with gratitude that I express to you my thanks for showing up, being engaged, and asking thought-provoking questions!

Two questions from the chat that I wanted to answer here are:

1) Is walking considered a bone-building exercise?
2) Should I use a weighted vest?

1)  Walking is not considered bone-building exercise but it is great for your heart if you keep up a good pace.   It’s also good for osteoporosis in terms of bone maintenance, helping to prevent further bone loss. So keep walking and if you can add hills and vary speed-even better. Keep in mind that we experience about 0.5-1.0% of bone loss yearly. The rate of loss due to menopause can jump to a 2-5% loss those 5-6 years post-menopause due to the dramatic drop in estrogen.  If your T score remains the same over time that’s a good thing, you’re preventing loss as what you’re doing is offsetting the natural 0.5-1% yearly loss.

(Palombaro KM. “Effects of walking-only interventions on bone mineral density at various skeletal sites: a meta-analysis.” J Geriatr Phys Ther. 2005;28(3):102-7.)

 

2) A lot of people with osteoporosis ask about using weighted vests. Some designs are not suitable for those with osteoporosis including ones where the vest sits on the shoulders with the majority of weight in the upper trunk. This can put undue downward pressure on the spine promoting hyperkyphosis (an exaggerated rounding of the upper back) that puts the spine at risk of increased fracture.  Weighted vests should not be used by those with hyperkyphosis or spine fractures.If you are cleared by your healthcare practitioner to use a vest, make sure the vest has a snug fit, is weighted throughout the trunk with the majority of weight close to your hips. Start with a small amount of weight and make sure to use the spine sparing hip hinging technique we practiced in my Osteoporosis Do’s and Don’ts Workshop to avoid rounding your spine.Weighted vests with lunges, squats, step-ups, side lunges and small jumps 3x per week build bone in the hip according to Christine Snow’s bone research lab at Oregon State University.

 

(Long-term Exercise Using Weighted Vests Prevents Hip Bone Loss in Postmenopausal Women by Christine M. Snow, Janet M. Shaw, Kerri M. Winters, and Kara A. Witzke Journal of Gerontology: 2000, Vol. 55A, No. 9, M489-M491)

While there are no definitive studies on how much weight a vest should have, experts recommend anywhere from five to ten percent of a person’s body weight. This recommendation is based on studies on maximum weight allowances for backpacks. Too much weight can result in injury.

Back extension exercises are great for the spine.   

Remember that back extension exercises (lying on your belly lifting your chest and head slightly, improve the strength of the muscles in your spine and don’t carry the risks of a weighted vest. The pull of the muscles on the bone stimulates bone growth. A study by Dr. Sinaki from the Mayo clinic showed fewer fractures even 10 years after the study in the group that did back extension exercises vs the control group.

 

(Sinaki, M, et al. 2002. “Stronger back muscles reduce the incidence of vertebral fractures: A prospective 10-year follow-up of postmenopausal women.” Bone, 30 (6), 836-41.)

 

(Sinaki, M., et al. 1996. “Can strong back extensors prevent vertebral fractures in women with osteoporosis?” Mayo Clinic Proceedings, 71 (10), 951-56.)

 

Have you ever contemplated getting studio Pilates equipment for your home workouts?

What if I told you that you may already own something that lends itself wonderfully to Pilates work? This month I’ll share with you a Pilates workout that I designed to be performed on…an Ottoman!

Perhaps you don’t have the money or inclination to purchase big Pilates equipment for home use. Well I’ve discovered to my delight that my padded ottoman is the perfect surface for so many Pilates exercises. Here’s a way to do some Aging Strong Pilates® in the comfort of your home and notch up the level.

The video below is my personal quick and dirty ~15 min workout that I do in my bedroom before or after a shower about 2-3x a week. I do it in my underwear for maximum skin to leather traction so I have good grip and don’t slide. Some of the exercises are extremely challenging so proceed with caution. They are safe but difficult, so listen to your body and proceed at a level and pace that matches where you are today.

At the end of this blog post I’ve included a full written list of the exercises so you can print it and repeat on your own with your choice of music.

Note: Your ottoman should not be on wheels or have a base that swivels.

My ottoman has a slope to it. Depending on the direction your lying on it, the slope can make a particular exercise easier or harder. If your ottoman is sloped, try and drape yourself on it in the same angle I do in the video. I demonstrate the exercises at the angle that facilitates each movement.

For example, for the beginning chest lift core series I’m positioned on my back with my buttocks on the low edge and the lower tips of my shoulder blades at the top of the slope. This is the easier orientation but you’ll see quickly that it is by no means “easy”. If your ottoman is level, that’s fine as long as it has nice padded edges so it doesn’t dig into you. If you choose not to do it in your underwear then add a shelf liner to the surface so you don’t slide.

This workout includes all ranges of motion, Flexion (just from Extension (back bending) to Neutral (straight line) so it’s safe for conditions where flexion is contraindicated) Rotation, Side Bending, and Extension. I incorporate wonderful stretches after working the muscles in all these planes of motion.

I have to admit this is one of my favorite routines. It’s a Bad A_ _ Core workout that energizes me and makes we feel worked in a short amount of time!

The planks are extremely challenging but if you have stiff feet or bunions that make it difficult to curl your toes under for planks on the floor, having your feet elevated makes that part actually easier since you don’t have to tuck your toes under. Remember, the more leg you have on the ottoman, the easier it will be, so position yourself wisely.

 

The two sections that I do face down (opposite arm and leg reach, swimming and swan) are great for strengthening the muscles that strengthen the hips and support good posture. Firing those upper back muscles has the added benefit of stimulating bone growth in the spine.

 

Here’s a full list of the exercises so you can repeat them on your own with your favorite music. Note that as you see in the video – you don’t have to do a lot of repetitions to make it count. If you want to get feedback from me on your technique, purchase a 30 minute online Skype session and I’ll ensure you’re moving safely and effectively!

Go slowly. Be Precise. Breathe. Have fun!

Ottoman Pilates Exercise List

On your Back (face up)

  • Big X Stretch
  • Chest Lift Series
    • Center
    • Oblique twisting toward the lifted tabletop leg
    • Advanced: knees lift, lift, lower, lower, alternating lead leg
  • Finish with Big X Stretch to lengthen the abdominals

On Your Belly

  • Opposite Arm leg reach (ottoman under pelvis and belly)
  • Swimming
  • Final extension hands interlaced reaching toward feet-rotating head as you breathe w/ease
  • Child’s pose/Rest position (knees open wide if you have osteoporosis or herniated discs)

Side Lying

  • Leg lifts (bottom foot on floor, top leg lifts and lowers) Waist positioned at middle of ottoman
  • Side Kick top leg, keep hips stacked vertically.    Shift body so hips at middle of ottoman
  • Hover body parallel to floor and hold (head in line with spine)
  • Top leg lifts and lowers
  • Side-Lying Stretch (shift yourself so it’s comfortable for you, grab top wrist with bottom hand)

Repeat above on the other side

Face Down

  • Planks (first with lower thigh and shin on ottoman) Hold position
  • Add pushups if desired
  • Walk further out so less leg on the ottoman-increased challenge
  • Side Plank (one on each side-move slowly and hold/breathe)

Face Down

  • Swan (begin with breasts/chest hanging over the front edge, hands on the floor, feet on floor against base of the wall) Activate core and legs then Inhale as  you rise, Exhale as you lower
  • Child pose/rest position

 

 

Imagine a studio in 2004 at the El Camino YMCA filled with tiny dancers wiggling joyously as their hair bounces wildly to the beat of the music. With smiles beaming on their six-year-old faces, they giggle while holding hands and twirling in circles. To the side is another beautiful, highly active child. This child is different. She has yet to learn how to talk, loud sounds make her prone to outbursts, and rather than controlled little arms, they often flail, accidentally hitting some of the other children. Integrating this precious child is a challenge, for in the eyes of the others, she is not like them. But as the weeks progress, the children begin to see her as one of their own, one to protect and love. The child’s mom looked on and wished all children like hers could have an experience like this—an experience where they feel cared for, accepted, and free. Oh, the beauty of childhood innocence when looking beyond the visual and embracing not just the person, but the soul.

Today there is a space where young and old alike gather to experience the same joy of movement to music with no judgment, no criticism, and no fear. All levels learn at their own pace and are given the freedom to express themselves with no preconceived idea for perfection. This all-inclusive setting has parents dancing with their child with special needs alongside those labeled “normal.” All feel welcomed, included, and safe. This is pure magic—this is Dance for All.

In 2014, Teresa Maldonado Marchok and Mercy Forde, both fitness instructors, teamed up to create this delightful program. As fitness enthusiasts, they know firsthand how important physical activity is for everybody, no matter what age. As mothers to special needs children, they found it difficult to find classes for their children that were not separate from the community because of their challenges. Their children, just like all children, brimming with equal capability. All they needed was an opportunity to participate. And so, Dance for All was born.

The dance class is run similar to other fitness classes, with Teresa and Mercy demonstrating and instructing a variety of movements and techniques that develop and improve core strength, flexibility, and balance. Students not only learn current dance moves in rhythm with the latest music, but there’s also Pilates mat work, and a closing meditation that allows all to center themselves before leaving the studio. Participants are not only welcome but encouraged to interpret the moves as the music flows. Though they might not all be synchronized, they are all united in spirit and fun.

The program’s mission is “Connecting the Community through Movement,” and this inclusive class allows the unique twofold beauty of the program to shine. First, Dance for All gives the special needs participant the tools to conduct themselves in a movement class, thus enabling integration into other classes as well as a sense of belonging to society as a whole. Second, the class creates a fun environment for the typical fitness participant to learn more about and interact with this precious sub-set. Despite initial perceived differences in thought process and language, the typical student begins to see that each member of the class has dreams and desires, just like anyone.

Dance for All is celebrating its fifth anniversary. What started as a dream has morphed into a beautiful weekly event and a studio packed with participants. Whether dancers come alone or with their children, the feedback has been overwhelmingly positive.

Margie Pfister, who attends class with her adult daughter Ellen, summed up their experience, which many can relate to.   “Amidst the ups and downs of our days, Dance for All has been a positive welcoming spot from the moment we entered the class and are greeted by name.

Through the warm-ups, dance, and cool-down, my daughter and I are inspired to be our best as we encourage others to do as well. With the positive music, and Teresa’s and Mercy’s kind encouragement, we not only feel a sense of belonging, but our posture has improved in our daily activities. By the end of class, we feel a sense of accomplishment, have met new friends, and this world feels like a better place, and we feel better in it.”


As for that bright-eyed child in that dance class so long ago, she is Teresa’s twenty-year-old daughter, Katelyn, and I was privileged to be her dance teacher. Today, she takes all kinds of classes at the YMCA and is a joy to watch as her face still beams while dancing. How fortunate is our community to embrace such a program where students come together as equals and friends. Just as Margie said, this experience makes the world feel like a better place, and all feel better in it.

 

If you want to participate in a joyful experience, come check out Dance for All every Saturday from 1:00-2:00 pm at the El Camino YMCA/ 2400 Grant Road, Mt. View. Ages 8-88 gather in the multipurpose room and unite to elevate awareness, promote community acceptance and just have fun.

 

 

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Written by Jackie Madden Haugh

Critically acclaimed published author, former columnist for The Los Altos Town Crier,  realtor, dance instructor, devoted mom and grandma…and a dear friend.

 

 

 

 

 

______________________________________________________

 

 

Written by Jackie Madden Haugh

 

Critically acclaimed published author, former columnist for

The Los Altos Town Crier, realtor, dance instructor, devoted mom and grandma…and a dear friend.

Do you know someone who seems to have 80 hobbies and are always looking for the next one? Maybe you’ve thought, “They must just have too much time on their hands.”  The truth is, they probably work hard at making time for hobbies. Learning a new skill offers a slew of mental, physical and social benefits for people in all walks of life. 

Whether you’re in school, in the middle of your career, living in your golden years, recovering from substance abuse or anywhere in between, finding a good hobby can keep you healthy and enjoying life. Here are five mentally engaging hobbies that can be learned online or with a group of friends.

Learn an instrument

One skill that is good for the mind and helps people express their thoughts and feelings is playing a musical instrument. It can also increase your capacity for memory, strengthen your dexterity and coordination, lift your mood, and boost your self-confidence. Furthermore, developing musical comprehension can improve your communication skills, and playing in a group can strengthen your interpersonal skills. A lot goes into choosing the right instrument, so do your research and pick one that interests you and fits your personality. 

Read

Besides the entertainment aspects, reading is beneficial for people of all ages. Along with being a critical part of child development, reading a variety of topics and genres is an effective way of gaining general knowledge and expanding your vocabulary. It has also been proven to reduce stress and improve cognitive function by boosting memory, concentration and focus, as well as strengthening analytical thinking and problem-solving skills. Reading a traditional book promotes healthy sleep. For those who are interested in writing, reading also helps you become a better writer. 

Write

Similar to reading, writing is beneficial for any age, whether it’s done traditionally or digitally. It engages and stimulates your brain, sharpens your focus and provides an outlet for creatively expressing unresolved thoughts and feelings. Writing can even slow down the aging process, calm the nerves, and ease anxiety and depression symptoms. Additionally, there is a plethora of different forms and subjects to write about, so there’s something for everyone. If you’re looking for a good excuse to unplug from our tech-driven world, opt for writing some of your material by hand

Dance

If you’re looking for a hobby that’s more kinetic in nature, dance may be the one for you. Some of the many benefits include improved mood, positive self-image, increased energy and more neural connections, a big plus as we age! 

There are many ways to increase your skill in dance, whether by taking a class or just dancing to music in your living room. For the former, active agers may have access to dance classes if they’re signed up for a qualifying Medicare Advantage plan. SilverSneakers, a program specializing in senior-focused fitness activities, is included in many Medicare Advantage plans offered by health insurance companies like Humana. Your local YMCA is a valuable resource for Zumba and other movement-oriented activities. The Y offers programs for people of all ages and abilities and always has something fun for those ready to take up a new fitness-focused hobby. 

Volunteer

While volunteering is a great way for retirees to stay physically, mentally and socially active, it has just as many benefits for people in other age groups. Volunteering at a nonprofit (e.g., food pantry, animal shelter, church, museum, etc.) is a great opportunity to step out of the stresses of your personal life and help others. It can also be a base for socializing and building new friendships, enhancing school and college experience, providing better job opportunities, and reducing the risk of Alzheimer’s while helping you age gracefully.  

Keeping your mind engaged is not only helpful, but it’s also essential for anyone who wants to live a long and healthy life. Reading, writing, playing an instrument, dancing and volunteering are all mentally challenging activities that are worth trying, no matter your age or life circumstances. Whether you opt for local classes or go online for free tutorials, find a hobby to make a lasting difference in your quality of life.

Photo Credit: Unsplash  

Cheryl Conklin

www.wellnesscentral.info

We’ve known about the perils of tech neck and texting thumb. Now we have budding phone horns?

Our mobile devices can seem like a godsend-until they wreak havoc on our necks and backs. There’s been a recent buzz about the research out of Australia. It shows that there are bony horn-like protuberances growing at the base of our youth’s skulls as a direct result of the forces on the neck from Tech neck, that extreme forward bent position of the neck while using one’s phone.  Whether or not the research on the “phone horns” will be replicated and further validated, that forward flexed posture should be of concern to all of us long term for the impact on our spine, especially as we age.  You can read the full article here.

Bony phone horn protuberances seen in the Australian research

Bad posture can lead to early joint wear and tear and possible future surgeries.  According to research done by Dr. Hansraj chief of spine surgery at NY Spine Surgery and Rehabilitation Medicine, looking at a phone at a 60-degree angle is about the same as applying 60 lbs of force to your spine.  That’s roughly the weight of an 8 y/o child. It’s easy to see in the illustration below how the more forward bent the head is, the greater the forces and stress on the spine.

You can circumvent these problems with a little adjustment to your posture when holding your devices!

The following videos I’ve created, demonstrate practical strategies to hold your mobile phone/iPad efficiently in various positions:

  1. Standing

2. Sitting

3. Lying in bed reading (research shows that the blue light emitted from using a mobile device at night in bed interferes with melatonin production and sleep quality but if you choose to do so, please follow my postural guidelines)

I’d love to hear in the comments section if these tips help you, your kids or grandkids.

We all have our postural faults, especially if we lose focus. Mine is rib flaring, that tendency to jut the bottom ribs forward in a faulty attempt to open the chest or lengthen the body. This often results in excess back tension and pain.

With mindfulness and an awareness of this tendency, I can better control this common error and so can you!

The secret is, no surprise, “connection”.  I like to use the image of 2 vertical bungee cords connecting my front bottom ribs with my pelvis.  Watch the video to test if you’re a rib flarer and learn 2 exercises to help fix it.

For those of you nowhere near me or former clients that have relocated, there is a viable way to create or keep our connection through Pilates!

I’ve been using Skype to reach my clients when they’re on vacation as well as to work with new clients. I particularly enjoy working with users of my BoneSmart Pilates® DVD’s who want some encouragement or personal feedback on their form and technique.

Virtual Skype Pilates means that you can literally do Pilates whenever and wherever you like, while having a qualified instructor like myself, guiding you through your workout, demonstrating as needed, and checking to make sure you’re moving correctly and not risking injury.  You’ll quickly realize that the 2-way conversation is far superior than watching a video. We have an open dialogue and a few laughs in the process. It’s like having a coach and workout buddy in one!  

In addition, you’re not wasting your time searching for just the right workout only to find in the middle of the workout, that it’s the wrong level for you.  You might discover midway that you really don’t like the instructor and there’s no modifications offered for your sore back, shoulder, knee or wrist. You may find that many of the exercises are too easy or too difficult. Having me there to give you feedback live through Skype is a game changer and mitigates all those issues I just mentioned.  As a physical therapist and certified Pilates instructor for the last 20+yrs, I can modify or change the workout to meet your mood, desires, fitness level and health status.  

Still on the fence?  As a summer incentive – I’m offering 15% off for Skype sessions purchased through June 15, 2019. (sessions purchased in this time frame can be used after that date)  Enter code “SKY” at checkout.”

In my 2 decades of running my business I have discounted my products but have never discounted my coaching time.  This is a one time golden opportunity.


You can do this in 3 Easy Steps:

1) Purchase either one or maximum two 30 min sessions at this discount. Each online coaching session is either 30 min or combine two 30 min sessions for an hour long appt. 

2) Schedule your appt. via email with Teresa to secure a mutually convenient time.

3) Download the Skype application to your computer if it’s not there already then at the time of your session – make sure you’re logged in to Skype, grab your mat, have your questions (if any) ready and let’s do it!

So if you don’t know, know you know”!   (from my beloved Broadway show “Hamilton”)

I hope to see you in the SKY(pe)

Age happens, regardless of the physical standards you achieved in your youth. Perhaps you were involved in high school or college sports, part of an organized community team, maybe an elite athlete and in great shape. Perhaps you’re still pushing hard but the reality of an aging body that doesn’t rebound as quickly as before, stares you in the face.

We are part of a generation that realizes that we have control of certain aspects of aging and that inactivity plays a huge role in how we feel. Dr. DiNubile, an orthopedic surgeon in Philadelphia, notes that “We have doubled our life expectancy in the last 100 years, but our frames are not designed to last that long. There’s a mismatch between longevity and durability. It becomes a matter of how do you extend the warranty on your frame.”

In 1998, according to the U.S. Consumer Product Safety Commission, boomers – those born between 1946 and 1964- sustained more than 1 million sports injuries, leading to nearly $19 billion in medical costs. Exercise and sports in our best and final act, becomes a dance of injury management where party conversations are peppered with tales of back pain, rotator cuff problems, herniated discs and anything ending in an “itis”. 

The upside of age includes being comfortable in our skin, gaining insight, wisdom, and fostering lasting relationships. In the physical realm, certain things, whether we like it or not, are diminished with age including muscle strength, bone health, balance and flexibility.  Old sports injuries frequently rear their heads as problems later in life, especially arthritis.

Understanding what to do, what to avoid and how to pace ourselves, is essential for remaining strong and healthy over time.

I’m a former professional dancer who pushed my body beyond its limits for decades. Contrary to the image of ease and invincibility presented on stage, dancers, or as Martha Graham used to call us, “Athletes of God”, spent many a night post performance nursing painful body parts with ice packs in hotels around the world. 

As an aging athlete, I’ve had to navigate acute and chronic injuries including rotator cuff rupture and low back disc herniations. In order to continue to do what I love, I’ve learned how to modify movements in Pilates, dance and Bikram yoga, as well as during activities of daily living to spare my spine.

In Bikram yoga, participants tackle the standing head to knee pose which involves holding one leg straight in front of you parallel to the ground with a deeply rounded spine, a difficult task (and one that should be avoided for anyone with low bone density or herniations). I stand instead like a stork with one knee bent in the air, my spine long and vertical. This avoids further debilitation of my spinal discs while still benefitting from single leg weight-bearing balance. 

In that same class, participants perform transitional straight leg sit ups between mat exercises where they explosively round up and do a “double jerk, double exhale” percussive ballistic forward flexed bounce. I’ve modified this instead into a log roll to my side to safely transition to the next exercise.  Medical wisdom now directs us to ditch crunches and straight leg sit ups and choose other, smarter spine sparing techniques, which I’ll share shortly.

I think we all want to keep our bodies as safe, strong and mobile as they can be for as long as possible. How do we work around aging and injuries? 

When I had rotator cuff surgery 3 years ago, I used Pilates to continue to train the rest of my body while avoiding the injured shoulder.  I worked on core and leg strength, flexibility and balance. The beauty of the spring assisted Pilates environment is that it is so modifiable. It’s easy to accommodate for injuries and work around your limitations safely so you can remain fit.  In the following video, I’m one-week post rotator cuff surgery and you can see how I’m able to still get a decent workout despite my arm being in a sling. 

Get Smarter About Exercise

My belief is that we need to physically train to get older. Getting older is not for sissies. We need to get smarter about exercise.  What does smart exercise look like? 

Disregard that old adage of No Pain No Gain.  It’s important to heed the warning signs of any injury. Pain is your body’s signal to back off and give yourself time to recover.  Don’t push through those pain signals or you’ll slip into a continuing loop of pain and inflammation.

Warm up before you exercise and allow more recuperation and stretching time after exercise.

Train smarter not harder which means not overdoing it.  Tom Brady, the aging Patriots winning quarterback has a workout regimen that is 90% focused on resistance bands, not heaving heavy weights.  If you’re planning an intensive golf weekend, practice some swings and controlled spine rotations and ensure good mobility leading up to it. Don’t walk in cold. 

Form and alignment is critical not only with exercise but also with your activities of daily living like how you pick things up off the floor or how you hoist your carry-on luggage into the overhead compartment of a plane. All the little things that you do on a daily basis add up, and if you’re doing them wrong, you’ll experience cumulative insidious injury – the math will work against you.

If you’re like most people, you might have a chronic injury or are dealing with vulnerabilities that put you at increased risk of an injury.  I’ll cover just a few of the common areas where we should demonstrate more caution and care.

Feet/Ankles/Calves

Common conditions I see as a PT working with aging athletes include plantar fasciitis, stiff feet/ankles, and tight cramping calves.

Our feet are what support us and get us from point A to point B.  We need mobile, strong and malleable feet to support a strong and stable body. What do most of us do with our feet during the day? We provide sensory deprivation as we shove them into ill-fitting or stiff shoes that prevent intrinsic movement of the feet. Instead of functional feet, many of us have clubs at the end of our ankles. The feet have the highest percentage of proprioceptors in our body, telling our brain where our body is in space.  If those proprioceptors signals are muffled and under stimulated it creates balance issues and a tendency to lose our footing. 

Tips for Feet: Walk barefoot, use full tennis balls or any of those nubby textured foot mobilizers to massage the different areas of your feet, increasing flexibility and improving healing blood flow and circulation.  Use ½ tennis balls for a gentler safer alternative that won’t roll away. Use resistance bands around the sole of the foot, holding the ends like reins as you slowly point and flex the ankle, strengthening all those underused small foot muscles.

For cramping calves check with your medical professional to see if you have a potassium or magnesium deficiency and supplement accordingly.  Also make sure you’re drinking enough water. Lack of adequate hydration often leads to leg cramps.

Finally be sure to stretch both regions of your calf muscles. Stand at the edge of a step with one heel lowered. The gastrocnemius (the meaty calf muscle that is more superficial and visible) is addressed when the stretching leg has the knee straight.  To stretch the deeper soleus calf muscle, you must bend that knee slightly while stretching the calf.

Knees
Painful knees are often the byproduct of weak leg muscles, tight calf and leg muscles as well as faulty alignment when you bend your knees.

What to do? 

Check your mobility-can you touch your toes with your knees just slightly unlocked?

Can you put the ball of your foot on a step and lower your heel down below the step with ease?   Can you pull your foot behind you to your bottom for a quad stretch with good alignment or do you stick your bottom out behind you when you try this? 

Some of the key remedies for avoiding knee pain include ensuring you’re tracking your knees over the center of your foot every time you bend your knees. Since bending your knees is something you do every time you get up and down from a chair, toilet, car seat etc. it’s imperative that it’s performed with ideal alignment each and every time. This will prevent potential torqueing of the knee.

In addition, strengthening the muscles that attach to the knee is essential as the stronger your leg muscles are, the more they will support and decompress the knee joint.  Include closed chain exercises that incorporate the hamstrings (back of your legs), the quadriceps (front of thighs) and the calves. This is particularly helpful if you’re suffering from pain or arthritis stemming from previous injuries.

One good example is wall sits: stand against a wall with your feet about 6-12in from the wall. Then bend your knees to a point that’s painfree (up to a 90 degree angle) keeping the back of your pelvis, upper back and head in contact with the wall. Hold that position for 30 sec’s slowly increasing the duration over time and varying the degree of knee bend.

If your pain is due to old injuries, notice what movements or activities trigger your pain and try and remove or minimize those triggers.

With aging athletes, studies point to targeting power to improve strength. So, for example rising from a chair explosively (without locking your knees) then slowly lowering your bottom to a hover over the chair and repeating that with good form will create gains.

Be sure you’re stretching your hamstrings, quadriceps and calves on a daily basis to keep them healthy and mobile. This will help mitigate knee problems.

Back Pain

Intermittent or chronic back pain is a common complaint for many aging athletes particularly dancers, gymnasts and other athletes where they are asked to move their spines in ranges that were not intended for the spine.  Keep in mind that the spine is designed for stability with the hips and shoulders created for mobility.

Most people in their lifetime will experience some type of back pain typically caused by injury or degeneration.

Examine what you’re doing on a daily basis and how it might be affecting your spine. 

Are you sitting excessively? This will shorten the muscles that cross the hips affecting the spine.  Do you find yourself commonly in a slumped posture?  This will compress your discs and may cause nerve compression resulting in numbness and tingling down the legs.

Might you have an undiagnosed spine fracture? Be sure to get a bone density (DXA scan) if you’re over 65 and notice any of the red flags like a loss in height greater than 2 inches, being a female with a small frame or if your mom had osteoporosis. Some modifiable risk factors include smoking, drinking excessively and inactivity.

Are you still doing crunches? Dr. Stuart McGill, a Canadian PT, researcher, and world-renowned spine expert recommends avoiding crunches due to the excessive loads placed on the discs and ligaments of the spine during movements involving loaded spine flexion. His book “Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you”, is a practical easy to understand resource for how to find your pain triggers and clear steps to help you improve.  Keep in mind also that if you have low bone density crunches can predispose you to spine fractures and if you have spinal disc compromise, sit-ups and crunches can lead to disc herniations.

Healthy alternative? Instead choose core exercises that keep the spine in a neutral position like planks including forearm, straight arm and side planks. 

Remember to use the spine sparing technique of hip hinging where you fold at your hips, for any lifting or bending to avoid rounding your back. Doing your daily activities including exercising with a neutral-stable spine will spare your back. 

Keeping an injury-free edge as we exercise in middle age

Be willing to modify and accommodate for your body.  If you’re asked to do lunges in a class done barefoot and your metatarsal (toe area) joints just don’t bend that way due to arthritis or surgery, put on your tennis shoes or supportive shoe wear to provide the support needed to accomplish this excellent exercise.

Mindfully improve mobility with flexibility exercises while maintaining good alignment. Give Pilates or Yoga a try.

Cross train to give your body a break from repetitive motions.

Strengthen your core muscles including your abdominals, back, pelvic floor and diaphragm, to support your spine.

Work on your dynamic balance, not just standing still on 1 leg. Most people don’t trip and fall while standing like a stork. Try this exercise to challenge your dynamic balance.

Ignore the mantra “No Pain, No Gain” and replace that with “Feel Pain, Be Sane”

Get enough restorative sleep and pay attention to nutrition.

Prioritize alignment and form during exercise as well as during daily activities.

Warm up thoroughly before your chosen activity.  I’ve noticed that it takes me much longer than before to warm up sufficiently enough to prevent injury before physical endeavors.

Post-exercise static stretching is a useful tool for promoting relaxation (by increasing parasympathetic nervous system activity which controls rest and digestion) and improving flexibility (by causing changes to the mechanical properties of the muscle-tendon unit.)  Research shows minimal effect on reduction of muscle soreness 1-7 days post exercise.

Don’t underestimate the benefit of regular massage to relax muscle tissue. It may also help with reducing pain and improving function.

Work around your injury. If you’ve injured a particular body part, say your foot, don’t ignore the rest of your body. Find ways to incorporate core training and other exercises that work your heart and uninjured areas. It will not only help your body but also your mind and spirit.

If you have low bone density, be sure you’re including weight bearing resistance and impact exercise. Avoid forward bending (flexion) of your spine as that can increase your risk of fracture.

Foam rollers are a popular and effective tool for the aging athlete.  They work with your weight and are easily used on most parts of the body. In addition to massaging tight muscles, rollers can help with myofascial pain by compressing trigger points. They can also improve hydration in your fascia, the connective tissue that acts as a saran wrap around your muscles and organs.  If your fascia develops adhesions, where disorganized tissues don’t glide freely over each other, this can manifest as pain or stiffness. Rolling has been particularly effective for the upper back, the gluteals, and various regions in the legs including the iliotibial band (ITB), a trouble area for runners and often a difficult area to release when tight. View some of my top foam roller exercises.

Small firm balls of all kinds are an inexpensive and handy aid in trigger point release. For instance, placing a ball under the center of one glute and putting your weight into it can release a tight piriformis muscle, a common cause of sciatic pain.

Despite some controversy, ice continues to be a safe and effective alternative for pain management and is still the modality of choice for acute injuries. Pain and swelling can inhibit muscle strength. Cryotherapy continues to play a key role in rehabilitation.

Trust your intuition and your own body wisdom.  No one knows your body and its particular quirks better than you.  If it’s telling you to back off, listen.

We all eventually slow down as we age and we need to recalibrate our expectations creating new goals that keep us motivated and functional.

Whatever it was that drove you to be an athlete in the first place, hold onto that feeling. You can still keep an active lifestyle as you age and maintain that feeling of health, fitness and joy of being alive!

Author-Teresa Maldonado Marchok MPT

Licensed physical therapist, PMA certified Pilates instructor, conference presenter, ambassador for the national organization “American Bone Health“, creator of the BoneSmart Pilates® Method and AGING STRONG Pilates® DVD series and a former soloist with the Martha Graham Dance Company. She’s been affiliated with Stanford’s Health Improvement Program since 1998 as a lecturer and Aging Strong Pilates® instructor. www.BoneSmartPilates.com