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I want to thank you, my clients, for bearing with me as I’ve transitioned to a new online appointment scheduling system. After 2 decades of pen and paper documentation, I’ve finally taken the leap. There are the inevitable road bumps and you’ve been so patient during my learning curve. I anticipate more hiccups and ask for your patience as we charter this new territory together.

Below are 3 separate video tutorials I’ve created to help you navigate the new system. Each video is dedicated to the type of class you’re interested in whether it be New Client Welcome packages, Group Classes, or Private Sessions.  I hope you find them helpful but as always, I’m only a quick email away to lend a helping hand!

Step by Step Tutorial for booking online virtual classes

This tutorial above targets orienting New Clients to the new online scheduling system, those of you who have never taken a class from me but are curious.  Perhaps you have one of my DVDs, like my teaching style, and want to try out a Zoom class.  There are some amazing Welcome Packages for newcomers and a Free Consultation to answer your questions and discuss your goals.

Need a gift idea? Welcome Packages can be purchased as Gift Certificates to print or share electronically ranging from $25-$50, They make an exceptional gift of health for a friend or loved one. Details in this video. Single group class certificates are also available for $20 and a 3 pack of Express Private Sessions are available for $175

 

 

 

Follow along as I guide you in the steps to purchase/register for Virtual Group classes on my new online scheduling platform at  bonesmartpilates.as.me

This is for those who are taking group classes with me and need a little extra guidance to navigate this appointment software. This is also appropriate for those of you new to my group classes and who are ready to commit to an active aging class.

 

Online Scheduling for Private Clients of BoneSmart Pilates

Need a little help booking your Private Appointment? Follow me above in this step by step tutorial on how to purchase and book private appts with my new online scheduling system located at BoneSmartPilates.as.me

 

Woo Hoo!  So here it is, almost 10 months after I started this ReCode (Reverse Cognitive Decline) Clinical Trial.

Allow me to back up for a moment and share with you what got me concerned about my brain health in the first place. Back in 2019 and before, I noticed I was forgetting people, appointments, names, why I was holding the object in my hands, and so on.  True it’s common for that to happen occasionally but it was happening more and more frequently. I have a strong family history of Alzheimer’s disease and I was worried.

Through clinical study genetic testing, I learned that I carry the ApoE4 gene, that sucky one that makes me susceptible to Alzheimer’s disease. The good news from the book “End of Alzheimer’s”  written by Dr. Dale Bredesen from which this clinical trial is based, is that your genes are not your destiny.  I believe that is true really of any genetic predisposition you might have for whatever disease. The genetic gun may be loaded but you have the power and choice to avoid the triggers that will tip the balance that puts you over the edge.  Those are the secrets I learned in this trial. How not to pull the trigger.

Time to celebrate!

What are my key learnings from this clinical trial that might help you?  I’ve experienced improvements in cognition, weight loss, sleep, gum health, and overall energy.  When reading the recommendations given to me, keep in mind that many of the nutritional supplements and hormone choices were selected for my unique biochemistry so the type and dosage may not translate to you. Best to consult with your own wellness practitioner for customization.

My Cognition Improved
The Recode protocol which includes a combination of a Ketogenic diet, Intermittent Fasting, exercise, nutritional and hormonal supplementation, brain training, and mindfulness training has helped me to crawl out of the abyss of cognitive decline.

  • Cognitive function tests have all markedly improved since baseline testing in December of 2019 to the point of testing “out of the range” of cognitive decline to normal levels.  I was in the range of “cognitive decline” for my initial testing.

I lost considerable weight

  • I lost 15 pounds on this diet, with a noticeable improvement around my waistline. I’ve lost fat but not muscle as evidenced by the physical testing that I underwent at the beginning and end of the study and by Body Mass Index (BMI) testing on special equipment.  For me, I believe the aspects that contributed to weight loss were the intermittent fasting (no nighttime snacking), no sugar, high fat/low carb ketogenic diet which includes no bread. Exercise is also very important but I was doing that already. It was the food and fasting that were the new variables.

I’m Sleeping Better

  • Since I’ve been in this study my sleep has markedly improved.  I used to get up repeatedly to go to the bathroom and at times would have difficulty getting back to sleep. I now sleep through the night and when I do get up, I can fall right back asleep easily.
    From my understanding, the following that I’m taking positively affects my sleep. Remember it may look very different for you and your body.

Over the counter supplements:

    • NeuroMag by Designs for Health 3 capsules at bedtime  (=144 mg magnesium)
    • Melatonin SRT by Designs for Health 1 tablet bedtime (6mg)

Prescription meds

    • Progesterone 200mg cap (Costco has it the cheapest)
    • Naltrexone 3mg tablet

Improved Gum Health

  • Dentalcidin toothpaste with Biocidin by Bio-Botanical Research is the natural toothpaste that I’ve been provided to use for the entire clinical study. My dental hygienist asked me what I was doing differently as my gum health improved significantly. I told her about the study and apparently, the change in diet and toothpaste resulted in this improvement.  Marie, one of my Pilates students, started using this same toothpaste after my mentioning it and she shared this with me. “I went to my dentist yesterday and got a great review on how well my gums looked after using this natural toothpaste.”

Reflecting on this clinical trial I found further evidence of the efficacy of a multimodal approach to cognitive decline and the prevention of Alzheimer’s Disease.   Doctors often tell patients at high risk of Alzheimer’s due to having pre-dementia conditions—such as Mild Cognitive Impairment (MCI) or Subjective Cognitive Impairment (SCI)—that there is really nothing that they can do other than wait and monitor. A recent study from Australia suggests that advice may be out of date. Researchers found that modest lifestyle changes (e.g., a nutrition plan, a physical exercise plan, and BrainHQ brain training which was all included in my clinical trial plus more) significantly reduced Alzheimer’s risk after only eight weeks. You can read a news article about the study here.

As I contemplate life after ReCode, I know that I’ll continue brain training, sauna, intermittent fasting, and will continue with the Dentalcidin toothpaste. I’ll maintain aspects of the ketogenic diet, and will add some carb cycling in.  I miss things like my brown rice and beans, bananas, and sweet potatoes. I don’t really miss bread and will choose to keep that at bay. I believe dropping bread and sugar contributed to my weight loss.  As I prepare to have my final clinical study doctor appt on Oct. 8, I’ll be advised then on how to smoothly transition out of clinical study mode with guidelines on what supplements to continue and what I can drop.  I’ll fill you in on the details next month in my epilogue!

The countdown is on for my Recode clinical trial. 

For those not familiar, I’m embarking on the final month of a 9-month clinical trial for preventing and reversing cognitive decline.  This clinical trial follows Dr. Dale Bredesen’s approach that includes a ketogenic diet, intermittent fasting, nutritional and hormonal supplementation, detoxification, online brain training, and mindfulness training.
and is being conducted by a medical doctor, a physiatrist, a nutritionist, and an exercise coach.  It has been a journey of self-discovery, determination, new insights, memory improvement, and weight loss.

I am so thankful for having the opportunity to be included in this study. Having the accountability of keeping data charts and having regular meetings with the doctor and nutritionist helped me to stay on target. I knew that if I faltered or had questions, I could reach out for support. That is invaluable.

 

Now, how has my brain been faring through all of this given that brain function was my ultimate focus in joining this clinical trial?  My different milestone cognitive tests along the 9 months have all displayed an upward trajectory, meaning my brain is clearer and the test numbers prove it!

I’ll have final cognitive testing done the first week of October to wrap things up including another MRI and a slew of other tests.  I’m hoping a lot of the junk in my system that was discovered like herpes zoster, Lyme, and mold will be cleared out with the various interventions the doctor has added to my protocol.

 

Brain Fun Fact – Learning Changes the Brain     
Every time you learn something new or create a new memory, your brain physically changes. New connections are forged between neurons to represent the new thing.

That explains why the brains of people who have expertise in a certain field look a little different from the brains of people without that expertise. For instance, London taxi drivers traditionally had a larger hippocampus than the typical person, because their brains were specialized to know all the complex intricacies of the London street map. Bilingual people and musicians, too, show brain growth in areas corresponding to language and playing music, respectively.

Each one of us has unique brain maps, reflecting our own life experiences!  Pretty cool right!  This underscores the fact that our brains are plastic, and are able to make new connections throughout our lifetime. Let’s keep learning new things and keep those connections going!

Pour on the olive oil and oil your brain!  Keep in mind that not all olive oil is created equally.  It should be extra virgin, relatively fresh, and used raw or cooked only to low temperatures; otherwise, you may be missing out on some of the nutritional punch.

Why olive oil?
There’s a fair amount of scientific evidence that olive oil is good for the brain. For starters, it’s rich in polyphenols and vitamin E, both of which have been shown to protect against cognitive problems. What’s more, it’s a key part of the Mediterranean diet, which multiple studies suggest is good for cognitive function. Martha Clare Morris, Ph.D., includes olive oil as one of the 10 essential brain-healthy food groups in her MIND diet (designed specifically for cognitive health) which has been shown to reduce the risk of Alzheimer’s disease by as much as 53%.

This is just shy of the 7 month mark-2/3 of the way through my Recode clinical trial.

I continue to feel strong, alert and energized.  The lead investigator was thrilled with the improvement in my recent 6 MONTH cognitive testing.

I’m at and maintaining what I feel is an optimal body weight for my frame and I’m happy to have finally lost my belly fat with this program. I’m even comfortable wearing crop tops and athletic bras, something I would not have considered a year ago.

 

Adjustments because of osteopenia
With my recent diagnosis of osteopenia, my doctor has added Vitamin K (specifically Designs for Health Tri-K, vitamin K in three synergistic forms that help the Vitamin D keep the calcium in the bones) to my already existing Vit D supreme (also Designs for Health brand) which is important for Ca++ absorption.

Because my spine is more compromised than my hips which are just over the borderline into osteopenia, I’m adding more spine extension exercises into my repertoire to address this deficit.  Think the Bird Dog exercise on all 4’s with opposite arm and leg reach and the following 2 extension exercises.

Because this clinical trial does not allow dairy, I’m hard-pressed to get sufficient Ca++ through my diet as I’m not a big fan of sardines or tofu, two non-dairy high Ca++ options. In addition to my oat milk which has a decent amount, I’m independently adding Bone Builder Forte by Metagenics, a good bioavailable Ca++ supplement.

My blood ketone levels are finally consistently at the ideal levels of over 1.0  for the study. This is thanks in part to the addition of exogenous ketones, specifically Designs for Health Keto-Nootropic.

I belong to a local Keto lifestyle support group where we learn from each other as we share our trials and triumphs. Some of the topics we recently discussed I thought might be of interest to you.

What am I eating?
I start the day with an oat milk latte (which has a good amount of Ca++)

Lunch is typically an omelet with veggies and salmon or sometimes a slice of bacon and a whole avocado drizzled with plenty of olive oil.  Other times it’s a soup with extra olive oil for the increased healthy fat with an avocado.  A Sunday brunch favorite is almond flour waffles topped with crushed berries and nuts.

Dinner can fluctuate between chicken, fish, sometimes beef, with a side of veggies and salad.  Our zucchini crop is abundant so I’m having a lot of zoodles (zucchini noodles) with various toppings like ragu sauce or pesto.

 

Sauna
There are studies linking positive cognitive function with regular sauna use.  I’ve been without a sauna for the last 3 months as a result of the COVID lockdown. My friend recently invited me to use his own far infrared sauna so I’m adding that back in which feels wonderful.  I’m grateful for this detox opportunity.

 

“What do you think is making the most difference?” is a question I get asked a lot.

Honestly, I believe it’s a combination of many factors including:

  • Improved quality and quantity of sleep
  • The addition of targeted supplementation and balancing my hormones
  • Intermittent fasting for regulating my metabolism
  • Getting the junk out of my diet!
  • Consistent and varied exercise has been key including my Pilates, HIIT workouts 2x/week, dancing, walking, and biking.
  • Online brain training because I’m seeing objective improvement and I can see my focus and processing speed improving.

So can I point to one thing?  No. That’s why the Recode Protocol is a multi-modal approach and why a single pill will not address cognitive decline.

 

I wanted to share a question that one of you had which as requested, I posed to my doctor.

“If you have osteoporosis, can the Keto diet be followed? Everything I read is that it is acidic and you need an alkaline diet”

The doctor’s response:
“If you follow the keto diet according to our protocol, then it will be fine because ours is more of a Plant-Based diet with less emphasis on meat, especially red meat.  This keeps it less acidic.”

What I’ve learned independently is that eating too much animal protein also can leach calcium from your bones, so if you have osteopenia or osteoporosis, you should limit red meat to two times a week and keep portions small – 4 to 6 ounces.

A study published in Advances in Nutrition in January 2017 found that cutting down on red and processed meats as well as soft drinks, fried foods, desserts, and refined grains all had a positive impact on bone health.

According to the research, the best diet for the prevention of osteoporosis includes plenty of fruits and vegetables, low-fat dairy, fish and poultry, nuts, and legumes.

 

After this study is over
With my DXA results, I will personally be adding pasture-raised dairy and A2 milk back into my diet after the study is over, to support my bones.  I’ll also be checking in with my doctor on which supplements I should stay on for the long-term to support my cognition.

Let me know how you’re incorporating Ca++ into your diet and if you have any questions you want me to share with my doctor about the keto diet. Remember I’ve got a direct line.

If you’re on or starting the Keto lifestyle or the Mediterranean diet, share your struggles and wins here.  I’d love to learn from and celebrate with you!

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

 

 

Penny Eckert

I have a passion for helping people to age strong. That goal can only go so far if there isn’t follow through by the participant during the hours and days that occur outside of class. Penny (Penelope) Eckert is a distinguished linguistics professor at Stanford where she first took a class with me over a decade ago, then later with private lessons at my Mountain View studio.

What impresses me most about Penny is her commitment to her health and her drive and determination to apply the principles and exercises we work on in class, into her daily routine. She’s one of the clients who I design home programs for who actually follows through and does them. Because of her tenacity, she’s overcome various physical obstacles and I’m proud to say she is a great example of someone who is aging strong.

The following is an interview with Penny.

What’s your line of work?
I’m a professor of Linguistics at Stanford University.

What inspired you to try Pilates? 
I was having back pain and I’d been reading about Pilates. Then I sat next to a woman on a plane who did Pilates and raved about it, so …. I signed up for a Pilates class at Stanford. My back pain was gone by the end of the quarter. Then I signed up for a class with Teresa and it was a revelation. Her classes were an amazing workout and her eagle eye made sure every move was precise. I swear she can see under my clothes. I’ve been addicted to Pilates with Teresa now for fourteen years.

What was an AHA moment you had in Pilates?
I think the biggest AHA moment was when I realized I was in charge of my body, and that I knew what to do at every moment to keep it strong. 

What are the most potent movement principles that you apply to your daily life?
The key to well-being is making sure my core feels strong before I leave the house in the morning, reminding myself to sit and stand tall and relaxed (the key to keeping my shoulders down and released) throughout the day, and striding rather than walking in little steps. 

Which is your most challenging exercise and why?
At the moment my most challenging exercise is your Standing Clocking exercise.  It’s challenging because I seem to have pretty lousy balance but I love it. But then … the Iliotibial band stretch is challenging because It hurts and I HATE it!

Which is your favorite exercise and why?
Since the classic hundreds is not safe for me to do anymore, I enjoy the modified standing hundreds because it warms me up and gets my core firing.  I also love just about anything on the reformer and TRX. 

What is your greatest physical challenge and how have you addressed it?
My back pain came from a messy spine, and I’ve had two spinal fusions since I began Pilates. My surgeon told me that the success of such surgeries depends on the patient’s preceding physical condition, and there’s no question that having a strong core has made all the difference for me. My recovery was fast and once the fusion was complete, I went back to Pilates rather than doing regular physical therapy. I’m six months out from my second surgery and my back feels amazingly strong. 

What improvements and benefits have you noticed during your life outside of class?
I feel much stronger, balanced, and centered. I stand and walk taller. I’m pain free.