Tag Archive for: bone strength

For many of us, getting older isn’t easy. We persevere through stiffness, aches, and pains.

The good news is we don’t have to accept these “inconveniences” of age as inevitable.

The key, my friends, is lean muscle mass.  According to Dr. Allen Mishra, an orthopedic surgeon at Stanford, “muscles are modifiable until the day you die.” And there’s recent research to back this up.

Orthopedic surgeon Dr. Vonda Wright notes that “we do not have to be the victims of the passage of time; we don’t have to go down a slippery slope from vitality to frailty and do nothing about it.”  She states that the number one thing that can save our lives is our lean muscle mass.

Muscles play a crucial role in aging and longevity due to their impact on overall health, mobility, and metabolic function. Here are several reasons why muscle matters for aging and longevity:

 

  • Metabolism and Weight Management: Muscle tissue is more metabolically active than fat tissue, which burns more calories even at rest. As people age, they tend to lose muscle mass, which can decrease basal metabolic rate. This makes it easier to gain weight and harder to maintain a healthy weight, which in turn can increase the risk of various health conditions such as obesity, type 2 diabetes, and cardiovascular diseases. Preserving muscle mass through exercise and a balanced diet can help mitigate these risks.

 

  • Bone Health is a subject I’m passionate about: Muscles are connected to bones through tendons, and when muscles contract, they exert force on bones, which in turn helps to stimulate bone growth. This is crucial, especially for women who are at a higher risk of osteoporosis, a condition where bones become weak and brittle. According to the National Institute of Health (NIH), one in two women over 50 will experience an osteoporosis-related fracture in their lifetime. Engaging in weight-bearing exercises and resistance training can improve bone density and reduce the risk of fractures as people age. And don’t forget impact exercises to “surprise the bones,” which, according to Wolf’s law, stimulates bone growth. If you do have osteopenia or osteoporosis, make sure to find a trainer or physical therapist who has special certification for working with osteoporosis. There are clear guidelines that need to be followed to keep you safe.

 

  • Leg Power Predicts Brain PowerAccording to a UK study by Steves et al 2015, evidence showed that the stronger the legs were, the less risk of dementia and the greater the gray matter in the brain. For those concerned about cognitive decline, this is an actionable step you can take. Strengthen those legs.

 

  • Balance and Fall Prevention: Strong muscles, particularly those in the legs and core, are essential for balance and stability. Falls are a significant concern for older adults, as they can lead to serious injuries such as hip fractures. Having good muscle strength and
    balance reduces the risk of falls and enhances the ability to recover from a loss of balance. Also, don’t forget that having strong arm and shoulder muscles and a strong core can help you avoid a fracture by “catching yourself” before your hips or knees hit the ground.

 

  • Functional Independence: Maintaining muscle mass and strength is directly linked to the ability to perform daily tasks
    independently. This includes activities such as walking, climbing stairs, carrying groceries, and getting up from a chair. As people age, the loss of muscle mass (sarcopenia) can impair these functional abilities, leading to a loss of independence. Regular strength training and exercise can help preserve muscle function and independence.

 

  • Hormone Regulation: We often perceive muscle as something that helps keep us strong or helps us move.  What we might not realize is that muscle also serves as an endocrine-like organ. When muscles contract, they release these molecules called myokines.  Myokines have positive effects on your Metabolic system, Cardiovascular system, Immune system and your Mental function.  Brain-derived neurotrophic factor (BDNF) protects your brain and supports neuroplasticity essential for learning and memory. A 2023 study by Abou Sawan et al showed evidence that “increasing physical activity can affect cognitive function in older adults.”

 

  • Inflammatory Response: Chronic low-grade inflammation is a common feature of aging and is associated with various age-related diseases, including heart disease and Alzheimer’s. Regular exercise, especially resistance training, has been shown to have anti-inflammatory effects, which can contribute to better overall health and longevity.

 

  • Longevity and Quality of Life (QOL): Overall, maintaining muscle mass and strength is associated with a longer, healthier life. Studies have consistently shown that individuals with higher muscle mass tend to live longer and have a lower risk of age-related diseases. Additionally, having good muscle health improves the quality of life in older adults, allowing them to remain active, independent, and engaged in daily activities. If you don’t have the strength to take a walk, get into and out of your chair safely, or play with your grandkids, your quality of life plummets.

 

One of the key findings from the Okinawa Japan Blue Zone is that their environment naturally encouraged strengthening. For instance, a typical home has low-lying tables, and people sit on the floor. Centenarians rise up and down from the floor on average 30 times a day and, in the process, strengthen their hips, legs, and core and hone their balance. That’s a lot of squats and a lot of function!  Okinawan centenarians tend to their gardens most days. They weed, pull, dig, and squat for one to two hours a day. In contrast, falls are one of the top ten leading causes of death for older people in the US. They have weak hips and legs and poor balance because so many of them are sedentary, sitting in chairs and Lay Z Boys.

 

A few Commonsense Thoughts

We are not destined to go from vitality to frailty

Remember, your muscles are modifiable till the day you die.  Commit to continuous improvement to create the best version of yourself every day!  As Dr. Mishra suggests,  “Exercise relentlessly.”  Do resistance training daily.  He proposes you consider resistance training as necessary as brushing your teeth daily.

You don’t have to join a power-lifting club to maintain your muscle.  Just begin today to do some form of resistance training if you’re able. Work with a physical therapist or trainer to help you develop a customized strength training program regardless of your age. Dr. Mishra notes that the higher the weight, the more susceptible you might be to injury, like tearing a tendon. Instead, it’s more important to be consistent.

Here are some simple strength exercises you could begin today.

  • 💪 Biceps curls with hand weights that challenge you without strain. Emphasize slowing down the unfolding (eccentric phase) of the exercise. 8-10 reps

 

 

  • Triceps kickbacks with hand weights, emphasize slowing down the bending portion of the exercise. 8-10 reps

 

 

  • Resistance bands. 8-10 reps

 

 

  • Planks (start with hands and knees-lifting the knees just off the ground, spine straight) Hold 10-15 sec.

 

 

  • Chair Squats (sit-to-stand) Emphasize slowing the descent to the chair to build more control and strength. Start with five reps twice a day and build from there.

 

Muscles are not just about strength and appearance; they are vital for overall health, mobility, and longevity. To get optimal results, be consistent and take responsibility for showing up for yourself, even if you’re working with a trainer or PT.

One tip Dr. Mishra provided was this: even 8 minutes a day of strength training makes a difference!

If you’re short on time, the BoneSmart Burst™ subscription might be the answer. These 5 to 10-minute bone-safe workouts, designed by a physical therapist, are a great way to start your day or break up a day of too much sitting.  Participants say these bone-safe exercise bursts are “bite-sized enough to be doable with a busy schedule” and “the variety is great!”

In conclusion, to promote healthy aging and improve longevity, take agency for your own progress and modify your muscles with consistency and conviction.

 

Exercise can feel like drudgery when you frame it as something you “have to do” rather than something you “get to do.”

As a movement educator and motivator, I’m always searching for ways to infuse joy into the classes I teach. Why? Because it makes it fun. If movement isn’t fun, why do it?  It should feel good and help change your outlook in some way.

The way I teach is informed by science and research. I’m particularly influenced by the research findings of Kelly McGonigal, a health psychologist and author of “The Joy of Movement: How Exercise Helps Us Find Happiness, Hope, Connection, and Courage.”

Across cultures and ages, there are specific movements that both express and elicit joy. Think about hitting a goal, winning a race, or accomplishing something important to you. The universal physical sign for joy is arms thrown overhead in the air. This is seen with young and old, internationally, and even with blind people who’ve never visually seen that movement. It’s a universal physical manifestation of an emotion.

 

 

 

If we listen to music in a group, we might notice people swaying their arms overhead, often in unison, expressing joy and connection.

The feelings you derive from a class can have lasting positive effects. For instance, if you felt strong and capable during certain exercises when you encounter a challenge later in the day, you are already armed with the sense that you are strong enough to handle it. You’ve altered your outlook even outside of class. That’s a powerful way to use movement to foster a positive mental state.

 

Celebrate what you CAN Do!

Sometimes we become so focused on our limitations that we forget to celebrate what we CAN do! Maybe it’s just moving to your favorite music in a way that makes you smile. That’s an absolutely legitimate form of exercise, and you should incorporate whatever kind of movement brings you joy. Movement in any form should be viewed as a gift to celebrate.

Try these Incentives

Use one of these three ideas to feel good during movement: music, nature, and/or people.

Add some motivating music. According to McGonigal, music is a “powerful evoker of joy” and can help release endorphins and dopamine. Endorphins and dopamine are both chemicals in your body that make you happy, but they function in different ways. Endorphins relieve pain naturally. When they attach to your brain’s reward centers (opiate receptors), dopamine (a mood-boosting neurotransmitter) is then released. For example, endorphins will naturally help soothe a runner’s achy muscles.

 

 

“Green Exercise”, working out in nature has an immediate effect on mood and can help people feel calmer and happier, improving mental health.

 

 

 

 

Moving Together
As Barbara Streisand so eloquently sang, “People, people who need people, are the luckiest people in the world.”   As a former professional dancer, I felt firsthand the power I experienced dancing, moving, and even breathing as one in a group. The sensations and emotions you experience, whether they be strength, joy, or discovery, are amplified tenfold in a group setting.

 

 

I’ll never forget my first time back teaching in-person group classes toward the end of the pandemic. One of the participants came up to me with tears in her eyes after class. She shared how deeply moved she was by being able to exercise in connection with others again, breathing, laughing, and moving together. This revelation both surprised and touched her.

Track Progress In a Novel Way

Give your trackers a break for a bit. Maybe be a little less data-driven; find a word that best describes how you feel after a workout. Track that instead to support a mindset of joy.

During one of my recent Signature BoneSmart Pilates® Standing Strong classes that I teach, I asked the participants to note how they felt before class with just one word. Some of their words included: “discombobulated, vulnerable, stiff, tired, flustered, and exhausted.”

After an hour of moving together with beautiful music and supportive cues, they each shared a word describing how they felt. These descriptions included solid, confident, invigorated, hopeful, and free. The evolution that occurred with each individual is a testament to the transformative power of movement to elicit joy and optimism.

In Conclusion
The process of moving (even over Zoom) with a joyful mindset and perhaps some motivating music can be transformative and set you up to have a fantastic day!

 

Depending on where you live the summer heat may be approaching or is already at its height. Staying active becomes a challenge, especially for people over 50. Exercising in hot weather requires additional precautions to ensure your safety.

My aim is to provide a comprehensive guide for my BoneSmarties over 50, offering tips and strategies for staying fit while minimizing the risk of heat-related illnesses.

 

 

 

 

 

 

  1. Stay Hydrated:     Hydration is crucial when exercising in hot weather, as your body loses water through perspiration. Older adults are more susceptible to dehydration due to decreased thirst sensation. To combat this, it’s essential to drink water before, during, and after physical activity. Avoid alcohol and caffeinated beverages, as they can contribute to dehydration. Carry a water bottle with you and sip regularly to maintain proper hydration levels.  Consider infusing your  water with electrolytes or swap out for a sports drink.  Electrolytes help you replenish minerals  lost through sweat. That’s why water alone is not enough if you’re exercising outdoors in the heat.

  2. Time Your Workouts:    When the sun is at its peak, typically between 10 a.m. and 4 p.m., the heat is most intense. It’s advisable to plan your workouts during the cooler parts of the day, such as early morning or late evening. This reduces exposure to extreme heat and minimizes the risk of heat exhaustion or heatstroke.
  3. Dress Appropriately:    Wearing the right clothing can make a significant difference in staying cool during exercise. Opt for lightweight, breathable fabrics that allow air circulation and aid in moisture-wicking. Loose-fitting clothing in light colors reflects sunlight and helps in maintaining a comfortable body temperature. Additionally, wearing a wide-brimmed hat and sunglasses protects against the sun’s harmful rays and reduces heat-related discomfort.
  4. Protect Your Skin:   Exercising outdoors increases exposure to harmful UV radiation. Individuals over 50 are particularly vulnerable to sunburn and skin damage. Choose a sunscreen with SPF 30 or higher with broad spectrum protection against UVA and UVB. Reapply sunscreen every two hours, or more frequently if sweating excessively. Seeking shade when possible or exercising under tree cover can provide additional protection from direct sunlight.

    You should always wear sunscreen when you go outside, but you should be even more diligent about it if you plan on being out during peak hours.

     

  5. Check the thermostat and your ceiling fans:  Most gyms/health clubs set their thermostats so the air conditioner runs often and keeps the humidity (and sweat) out of the air!    If you have your home A/C set to an economical setting, and you’re doing a high intensity class like HIIT – you may want to make sure your ceiling fans are on and lower your AC for the time it takes you to do a class.

Some people are either or people. I believe both have benefits for improving bone health.

When you add resistance to your routine, your muscles release calcium, magnesium, and other minerals that strengthen your bones. Your muscles don’t know whether the resistance comes from bands or weights.  Whatever you are more prone actually to do, that is the mode of choice. If you dislike weights, go for bands.
I personally like mixing things up.

Here’s the thing, though, you need to really challenge yourself for change to occur.

With resistance training, it’s too light if you can breeze through 20 reps of an overhead press. You’re building endurance, not strength. You should feel “worked” after 10-12 reps at a given resistance (whether it be weights or bands) with excellent alignment and good breathing technique.

I tell Pilates teachers to load up the springs on the Reformer for leg work for their clients with osteoporosis. If the springs aren’t heavy enough, they won’t gain strength or bone. (of course, ensuring proper form)

The other thing to remember is that your bone health is not only a reflection of your exercise. It’s also a function of your nutrition, supplementation, daily activities, or lack of…it’s difficult to tease out.

I believe your best shot at optimal bone health is doing weight-bearing resistance and impact exercises, dancing, walking/hiking, sports you enjoy AND also addressing other factors in your life that support bone health. When appropriate, medications may be the right choice.

Most people want a multifactorial approach to their bone health. I get that. In many ways, we are our own laboratory.

I want to share this interesting study from researchers at the U. of Oregon demonstrating how training with resistance bands increases bone mineral density.

“It is sometimes difficult for sedentary people to change their habits, and going to a gym would be more difficult. But elastic bands offer an interesting alternative since they allow enough intensity to stimulate bone mass, and a multitude of exercises are possible. Regular practice of 2 weekly sessions involving work on the main muscle groups of the body will increase bone mineral density.”  Here’s the research study

 

 

Amy SmileyAmy Smiley, Age 62

TELL US A LITTLE ABOUT YOU

I spent most of my life in California, with a short stint in Sweden in the 1970s. My degrees are in Chemical Engineering and I worked in the biotech industry once I got out of graduate school. I loved working in such a new field at the time. As the family grew, I decided to quit my paid job and stay home with the children. As time went on I realized I needed a creative outlet and took up Plein air painting (with the same fantastic friend who introduced me to Teresa’s classes!). After my family and friends, I love the outdoors, science, gardening, and art.

WHEN DID YOU BEGIN SESSIONS WITH TERESA?

I started classes with Teresa in 2012 and have continued with them ever since. Teresa’s Pilates classes are a priority for me because of the physical and mental benefits they provide. I have celiac disease, which causes any number of inflammatory problems and Teresa’s classes are essential to my ability to manage those issues. When something has to fall off my plate it won’t be Teresa’s class!

 

WHAT MOVEMENT OR PRINCIPLE HAS HELPED YOU THE MOST?

I’d like to choose just one movement or body dynamic principle that I learned from Teresa that has helped me but there are too many!  From ribs down to soup bowl to lifting your toes…I am always learning something new, even ten years later.  I think, for myself, as I continue to become more body aware, I continue to learn in each class.  And, as new issues develop as the years march on, I discover new fixes for them.  Everything that I have learned from Teresa applies not only in class but in other activities and my daily movement.  Not to mention that Teresa is so gracious with her time whenever anyone has a question about alignment or movement difficulties.  She always takes time to answer any questions and I learn from my questions and those of others.  What a fantastic tool!

 

Amy Smiley Testimonial for Aging Strong Pilates

WHAT WERE THE EFFECTS OF THE PANDEMIC ON YOUR MOVEMENT PRACTICE?

At the beginning of the pandemic, I dropped the gym and in-person classes.  Although we stayed active, I really missed the benefit and connection of group exercise classes.  I worried about how well I would maintain mobility and strength without the motivation and guidance that Teresa provides.  When Teresa opened her remote classes I jumped right in and was so grateful! Now that some degree of normalcy is returning, having the option of in-person and virtual classes is even better than before.

I absolutely love the energy and camaraderie in the in-person classes.  They are a tonic for the soul.  I can’t think of a single class where I haven’t had a good laugh for one reason or another.  I missed that tremendously until in-person became available again.  But it’s also great to have access to the class online if I can’t make it in person and to have the videos afterward.

 

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. Since the pandemic, class has been mostly on Zoom, but we’re gradually reintroducing in-person classes at the El Camino YMCA/ 2400 Grant Road, Mt. View.   Contact teresa@pilateswithteresa.com to be added to our mailing list and to confirm if we’re on zoom or in person the Saturday you want to join in.

Dance for All – 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.

 

 

 

 

 

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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.

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

 

 

If your feet were on your face would you take better care of them? Our feet are a marvel of architecture, each one has 26 bones, 33 joints and over 100 muscles, tendons and ligaments.  We shove them into all manner of shoes, some narrow and unaccommodating, pound them endlessly and on occasion adorn them with nail polish. They need more than a pedicure! 
Our feet are what connects us to the earth when we stand.  I believe that when we have strong, malleable feet they become the foundation for a strong and stable body.  If our feet are weak, immobile or out of alignment, it can have adverse affects up the kinetic chain to our ankle, knee, hip and even spine.

You’re never too old to improve your foot health. Even if your feet are stiff now, studies show that your flexibility can be improved at any age. Give your feet a breather and walk barefoot in your home. Make daily outdoor walks a regular habit and include foot strengthening and flexibility exercises into your routine. All 3 of my DVD’s include standing and resistance band exercises that improve the strength of your feet and the malleability of your ankles.  

In my first DVD, BoneSmart Pilates: Exercise to Prevent or Reverse Osteoporosis, I introduce myofascial release of the feet using custom cut 1/2 tennis balls. The goal is to improve blood flow, circulation, resilience and to enhance proprioception (the body’s ability to tell the brain where your body is in space).  This is particularly helpful for improving balance and decreasing your risk of falls. The reason I use 1/2 tennis balls and not full tennis balls is two-fold.  The 1/2 tennis ball is pliable, has give, and will compress when you press your body weight on it making it tolerable for those with sensitive feet.  A full tennis ball, has less give and is more resistant to compression so it may feel more painful than using a 1/2 tennis ball.  The other important reason is that since it has a flat underside surface, it won’t roll and will not pose a trip hazard by slipping out from under your foot. That is a risk when working with a full small round ball.

BoneSmart Pilates AGING STRONG VOL I,  introduces you to the Myofascial release ball (affectionately referred to as the “purple pickle”). 

This prop kicks up the stimulation to your feet with a textured surface and an oval shape that molds to the longitudinal arch of your foot. We focus here on both a light, stimulatory massage and a deep kneading motion that heightens sensory awareness of the soles of your feet, shuttles blood back towards your heart and helps prevent conditions like plantar fasciitis. In addition, we introduce inversion and eversion of the forefoot, a gentle twisting motion, that is helpful for preventing ankle sprains and maintaining a resilient foot and ankle. 

Show your feet some love ❤️. Start your day this way and you’ll feel energized, connected and grounded!

 

 

Falls are a concern for many of us, particularly for my readers with bone density concerns and those living in cold climates with slippery conditions. With 2 million preventable fractures occurring every year, don’t be a statistic. Pick up some quick and easy helpful hints here!

Studies show that just 5 minutes of daily balance training will significantly reduce your risk of falls. Practice this unique exercise designed by Teresa Maldonado Marchok, licensed physical therapist and certified Pilates instructor.  Improve your bones, balance, strength and mental acuity!