AFTER A SPINAL CORD injury, it’s no surprise that life changes. Even daily tasks, like getting dressed in the morning, may become more difficult. Depending on a patient’s injury, however, certain exercises can help those with spinal cord injuries improve function and adapt to using a wheelchair.
By Len Canter | Article Featured on US News
Exercise is a great way to stay youthful and even turn back the clock on aging. If you’re new to exercise or simply want a fitness reboot, here are ideas by the decade.
In Your 20s: Experiment with different workouts to find what you enjoy. Make exercise a regular habit that you won’t want to give up, even when career and family make heavy demands on you.
In Your 30s: Short on time? Try three 15-minute walks spread throughout the day. To stay fit and retain muscle, do cardio just about every day and strength training two or three times a week. If you’re new to exercise, take classes or have a personal trainer create a program for you.
In Your 40s: Enhance your weekly routine by doing both low-intensity exercise, like yoga for stress relief and flexibility, and high-intensity workouts, like interval training or a spin or kettlebell class, to boost calorie burn and muscle elasticity. Expect longer recovery times after high-intensity workouts, so make sure to get enough sleep.
In Your 50s: Regular exercise remains a must, but ask your doctor for modifications if you have any chronic conditions. Varying your workouts or taking up a new sport will engage your brain as well as different muscles. Get in at least one or two high-intensity workouts a week and try to take active vacations that include favorite pastimes like biking, hiking or even walking tours.
In Your 60s and Beyond: Stay fit and strong to stay independent longer, and stay socially engaged by taking group classes. Stick with strength training, but consider using machines rather than free weights for more control. Water workouts may be easier on joints, too, especially if you have arthritis. But always keep moving. Try tai chi for flexibility and balance, and go dancing for fun and fitness.
The American Council on Exercise has more, including nutrition and sleep requirements by decade.
By Len Canter | Article Featured on US News
Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.
The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.
Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.
Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.
Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.
Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.
You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.
The American Council on Exercise has more on exercises targeting the back muscles.
Article Featured on Science Daily
Exercise helps to prevent the degradation of cartilage caused by osteoarthritis, according to a new study from Queen Mary University of London.
The researchers show for the first time how mechanical forces experienced by cells in joints during exercise prevent cartilage degradation by suppressing the action of inflammatory molecules which cause osteoarthritis.
The study, published in the journal Osteoarthritis and Cartilage, demonstrates the benefits of exercise on the tissues that form our joints and how this is down to tiny hair-like structures called primary cilia found on living cells.
During exercise the cartilage in joints such as the hip and knee is squashed. This mechanical distortion is detected by the living cells in the cartilage which then block the action of inflammatory molecules associated with conditions such as arthritis.
The researchers show that this anti-inflammatory effect of physical activity is caused by activation of a particular protein, called HDAC6, which triggers changes in the proteins that form primary cilia.
Pharmaceutical drugs that blocked HDAC6 activation prevented the anti-inflammatory effects of physical activity, whilst other drug treatments were able to mimic the benefits of exercise.
Changes in length of the primary cilia, which are only a few 1000th of a millimetre, provided a biomarker of the level of inflammation. Cilia got longer during inflammation, but treatments that prevented this elongation successfully prevented inflammation.
Mr Su Fu, PhD student at Queen Mary University of London and study author, said: “We have known for some time that healthy exercise is good for you — now we know the process through which exercise prevents cartilage degradation.”
Professor Martin Knight, lead researcher of the study added: “These findings may also explain the anti-inflammatory effects of normal blood flow in arteries which is important for preventing arterial disease such as atherosclerosis and aneurism.”
The researchers hope that these findings will help in the search for treatments for arthritis which affects over three million people in the UK causing stiff and painful joints.
The researchers suggest the results may lead to a whole new therapeutic approach known as mechano-medicine in which drugs simulate the effect of mechanical forces to prevent the damaging effects of inflammation and treat conditions such as arthritis.
BY STEVEN REINBERG
Exercise has countless benefits, even in small doses. And new research suggests the payoffs might extend to colon cancer patients. Short sessions of intense exercise may slow the growth of colon cancer, Australian researchers report. “We have shown that exercise may play a role in inhibiting the growth of colon cancer cells,” said lead author James Devin, from the University of Queensland.
ABOUT 50 YEARS AGO, THE average life expectancy for men in the United States was around 67 years, and for women, it was approximately 74. Today, American men live to about 77 years old on average; women, to about 81. There’s no question that the average life expectancy has increased over the last several decades. Men are living approximately 10 years longer and women about seven years longer. But how can we maintain this positive trend, or even better, increase both the quantity and quality of those years?
DOES YOUR FAVORITE PAIR of jeans fit more snugly around the waist with each birthday? Is your favorite dress a little tighter with each passing year?
Research suggests that many people gain weight as they advance in age from young adulthood into middle age. Between ages 29 and 39, women typically gain about 7 pounds, and men put on an additional 15 pounds, according to the U.S. Department of Health and Human Services. Conversely, losing weight in your 30s and 40s is more difficult than when you’re a young adult. (Men and women tend to put on little or no weight after age 40 and lose weight in their 70s, according to HHS.) For a variety of reasons, it’s tougher for men and women to drop pounds as they transition from young adulthood into middle age than it is to shed weight during young adulthood, experts say. The factors behind middle-age weight gain are biological and related to lifestyle.
Beginning in your 30s, you lose muscle mass every decade, research suggests. That muscle mass is replaced with fat. This happens even if you exercise regularly, whether it’s working out at the gym, running, swimming or playing in a pickup basketball, softball or volleyball game. Since muscles use more calories than fat, less muscle mass and more fat slow your metabolism, which means you need fewer calories, says Kimberly Gomer, a registered dietitian and director of nutrition at the Pritikin Longevity Center + Spa in Miami. “As we age, unless we work at it, we lose muscle mass,” Gomer says. “Fat needs very few calories to exist.”
Women and men face other biological challenges to losing weight in their middle-age years. Because of changing hormones and a loss of estrogen, women typically gain 15 pounds around the time of menopause, says Dr. Kathryn Boling, a primary care physician with Mercy Medical Center in Baltimore. She’s also board-certified in obesity medicine. Women going through menopause tend to gain weight around their tummy, Boling says. Men going through middle age face a different issue: the loss of testosterone, which can cause the diminution of muscle mass, Boling says.
In addition to biological issues, changes in lifestyle can be a factor that causes some people to put on pounds in their 30s and 40s. Many people become parents during that phase of their life, and they’re less physically active because of family responsibilities. Career demands can also cause many people to become more sedentary than they were when they were young adults, says Jessalynn Adam, a primary care sports medicine physician with Orthopedics and Joint Replacement at Mercy Medical Center in Baltimore. “Your schedule isn’t your own at that point,” Adam says. Gomer agrees. “Many of us are very active when we’re younger, running around carefree with few responsibilities,” she says. “In grade school, high school and college, we participate in sports, walk more and run more. As we age – maybe get a desk job, have a family – our free time/leisure time gets decreased.”
Exercising less can lead some people to bad eating habits, Gomer says. Physical activity releases endorphins, neurotransmitters in the brain that block pain and can help you feel calmer and happier. Eating foods that are salty, fatty and sugary can have a similar effect. Consuming such foods leads the brain to produce surges of dopamine, a brain chemical that’s released when we experience pleasure. Some people who miss the feelings of well-being associated with exercising may turn to unhealthy foods as a substitute.
While you can’t do anything to slow the passage of time, there are steps you can take to lose weight as you age. Experts recommend these strategies:
In Your 30s, 40s and 50s
Learn to cook and plan your meals. Have you ever picked up a quick dinner of burgers and fries from the nearest fast-food outlet because you had to work late to meet a deadline? Fast food is typically highly processed and poor in nutrients. It’s also often high in calories, sugar, sodiumand unwanted additives, Adam says. Consequently, eating meals from fast-food outlets won’t help your efforts to shed pounds. If you learn to cook and to plan your meals out a few days in advance, you can avoid impromptu stops at greasy burger joints, Adam says. She suggests taking a cooking class to learn how to prepare healthy meals that focus on fresh vegetables and healthy sources of protein. Learn how to make enough food for more than one day at a time; you can refrigerate the food so you’ll have healthy meals prepared, and no need to make a spur of the moment fast-food run.
Do weight-bearing exercises. Lifting weights helps you maintain muscle mass, which becomes increasingly important as you move from young adulthood into middle age, Boling says. Maintaining your muscle mass helps you burn more calories. “If you have less muscle mass, you burn fewer calories,” she says. Maintaining your muscle mass also helps cut down the chances of sustaining injuries. She recommends doing exercise with free weights and resistance machines.
Make physical activity a family affair. Having a spouse and children doesn’t have to interrupt your exercise regimen, Adam says. For instance, if you’re part of a pickup hoops game, shoot baskets with your significant other or child before or after the contest. You can ride bikes with your partner or with your kids. Look for opportunities to make exercise a family activity. For example, some triathlons also have a “fun run” for kids. Introducing your kids to exercise could also encourage them to adopt their own workout regimens that they’ll continue into adulthood. In the long run, this can lead to lower obesity rates, Adam says.
Monitor your caloric intake. You might be able to get away with not counting your calories in your 20s. But as you move into your 30s and 40s, and the number of calories you need drops, it’s a good idea to keep track of your caloric intake, says Audra Wilson, a clinical dietitian with the Northwestern Medicine Metabolic Health and Surgical Weight Loss Center. A typical sedentary 60-year-old woman should consume 1,600 calories daily, while a sedentary man of the same age should have 2,200 calories a day, according to federal government dietary guidelines. Your ideal weight range depends in part on your height. The National Heart, Lung, and Blood Institute has an online tool that you can use to calculate your BMI and check whether you’re overweight for your height. To keep track of calories, read food labels and check restaurant menus for calorie counts per item. Some grocery store hot bars and salad bars also post calorie counts for prepared items. There are free apps, like MyFitnessPal, that help keep track of daily calorie intake.
In Your 60s, 70s and Beyond
Split entree portions at restaurants. Going out to eat remains a major part of socializing for people in their 60s, 70s and beyond. Unfortunately, many restaurant portions are large, particularly if you’re at an age where you need fewer calories, Gomer says. “Eating out is a disaster,” she says. “Restaurants give us giant portions laden with salt, sugar and fat. (They offer) lots of (highly caloric) wine, bread, fried foods and dessert.” When you dine out, split your entree, particularly protein servings, with a fellow diner, she advises. If you’re eating alone, ask for a half-portion and take the rest home in a box. Servings of animal protein shouldn’t be more than 4 ounces per meal.
Don’t dine out when you’re (too) hungry. Hunger can sabotage the best intentions, so before you go out for a meal, eat something healthy, Gomer advises. Munching on a piece of fresh fruit or a handful of nuts can help you avoid temptation while you’re hungry. Or, “order something healthy as soon as you’re seated, such as a salad, a crudité (a raw vegetable) or fruit as soon as you’re seated,” she says.
Order a healthy dessert. You don’t have to abstain from dessert while your fellow diners order cake, pie or ice cream, Gomer says. Many restaurants have healthy dessert options, like fresh berries, a fruit cocktail or sorbet with fresh fruit. Order a healthy dessert option “to avoid tasting from other people’s high-fat and sugar-laden choices,” Gomer says.
Remain active. As they move beyond middle age into their later years, many men and women have to contend with chronic health issues, such as diabetes, high blood pressure, heart disease and depression, Adam says. In that phase of life, you may not be able to maintain the same level of physical activity you did in middle age, but you can and should keep moving, Adam says. You can make adjustments, like playing half-court hoops instead of full-court or walking vigorously in place of running. Take advantage of special discounts for older athletes. For example, some ski facilities offer free lift tickets for skiers older than 70. And you should continue to do weight work.
Maintain good eating habits. Whether you’re still cooking or not, you should keep a healthy eating regimen. That means consuming lots of fresh vegetables, fresh fruits, healthy carbohydrates (like whole-grain foods) and adequate amounts of protein, Adam says. Don’t give up on the idea of staying in shape. “I’ve seen lots of super-healthy 90-year-olds,” Adam says.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque, New Mexico contact New Mexico Orthopaedics at 505-724-4300.
Gentle movement that’s easy to incorporate may help you live longer and healthier.
STUDY AFTER STUDY HAS shown that exercise can help improve cardiovascular health, stamina and bone density while reducing the risk of chronic diseases like diabetes and obesity. These findings hold especially true for older adults who, by the very nature of aging, are likely to lose muscle mass, strength, bone density, agility, endurance and balance as they age.
It’s a fight against gravity and time, but staying fit over the long term is a goal worth pursuing. Older adults who exercise regularly enjoy more independence and health than those who don’t. So how can older adults incorporate more activity into their lives and what are the best exercises for them? The key is to find enjoyable activities that you can stick with. These can be anything from walking or water aerobics to yoga, dancing, tai chi or simple stretching.
Regardless of the specific activity you may choose to pursue, one key thing to focus on, says Douglas Ebner, a physical therapist at The Ohio State University Wexner Medical Center, is functionality. “I like to make sure that the exercises we do are able to carry over to regular life.” It’s all well and good to do seated stretching exercises, but when it comes time to get up out of the chair, do you have the leg strength to do that? Are you able to negotiate the stairs that lead into your house.
Cultivating the strength needed to complete these everyday tasks can be achieved through the use of various leg exercises, such as using a leg press machine or completing squat exercises, which are elements Ebner says he focuses on with his patients. “Depending on the person, I’ll try to give them some weight to hold onto so that way we can load their muscles to elicit the response we want.”
In addition to focusing on lower body strength to ensure walking ability and reduce fall risk, Ebner says some older adults may also want to incorporate other functional exercises into their routine. “If they’re stronger, then we can work on a motion where they’re picking up a medicine ball or a kettlebell from the ground, as a simulation for picking up items from the ground that they might need to do in everyday life.”
While exercising, another important consideration is avoiding falls. Ebner says falls are a big concern because there’s a direct correlation between falling later in life and life expectancy. A 2017 study in the Journal of Internal Medicine found that one-third of adults over age 50 who fracture a hip die within 12 months of that injury. Hip fractures are also very painful and greatly reduce mobility.
But reducing falls while encouraging exercise raises a dilemma, says Dr. Tanya Gure, section chief of geriatrics and associate clinical professor in internal medicine at the Wexner Medical Center. “There can be this tension that starts to develop when patients are having increased falls. How do you improve mobility without increasing fall risk?”
Particularly for older adults living in an assisted living community or other long-term care facilities where it may be more difficult to engage in exercises with the support of a therapist in a one-on-one situation, balancing the risk of falling with the need for mobility can be a delicate calculation and a challenge that many assisted living facilities must meet daily. “Sometimes having a concern about falls and a whole system that’s really geared up to reduce falls can ultimately reduce the amount of walking that patients do. That’s a dilemma. You want to encourage mobility and encourage residents to maintain their walking,” says Gure. That’s why it’s important to find the right level of physical challenge with the appropriate level of safety.
Here’s where Gure says families can play a key role in helping a senior stay as active as possible for as long as possible. “Families play a critical role in being there and serving as partners with staff at a facility” and helping keep seniors active outside of organized exercise classes and events. When the family is there, you can ensure that your family member walks more. This kind of support and encouragement can go a long way toward helping a loved one maintain mobility and independence. “To the extent that it can be optimized, families can play a critical role in keeping that going,” Gure says.
In finding the right exercise routine or activities for your loved one, a match also needs to be made between the individual’s abilities and interests. Sue Johansen, vice president of partner services with A Place for Mom, a senior referral service based in Seattle, says “it goes back to ensuring that the activity level of the resident is in sync with the programming at the community. If someone is in a walker, do they have a sponsored and hosted group that goes walking every day? Different levels of care may mean different things; there are some senior communities that have resident-led walking groups in the morning. For those for whom it’s appropriate, it’s great. They can decide where their walks are going.”
But she notes participating in certain exercise groups isn’t always as straightforward a prospect as it might seem on paper. “Senior communities often act like a high school – there are cliques and joiners and people who are leaders. So, for active people, they tend to self-select and gravitate to others that they feel comfortable doing activities with.” This is great if your senior is outgoing and active already. But if you’re trying to encourage an aging adult to get moving more, that might require a little more effort on the part of the caregiver to draw that person into more activities and exercise groups.
And exercising with peers should be part of the program. Gure says exercise is about more than just getting the blood moving and maintaining range of motion – it’s about social interaction, too. Exercise has been shown to be helpful in combating depression, and so has reducing social isolation.
Group exercise classes for seniors often involve stretching or yoga – gentle movements that provide benefits through relaxation as well as improved range of motion. “The degree of intensity of that would depend on where you are (physically) and what kinds of programs are available. I would characterize it as being on the lighter side,” Gure says.
However, some residents in assisted living communities and nursing homes need more intensive rehabilitation before they’re ready to engage in group exercise events. In these cases, Gure says she will discuss with families “concerns about limitations in that person being able to engage in an exercise program.” An assessment of current ability and what it’ll take to get the person’s physical status up to a level that allows them to participate with other residents can be a smart way to help them integrate into the community and get back to a more regular exercise routine.
The goal of any exercise program for older adults should be on improving or maintaining day-to-day function and quality of life. Because of this, many communities will offer exercises that are geared toward helping people maintain mobility while reducing the risk of falling. Seniors who are a fall risk may be able to engage in modified exercises while seated.
In nursing homes, because residents tend to have more health needs than residents in assisted living facilities, the type of exercise you’ll find may be more limited. The focus in nursing homes may be more on providing physical therapy to help residents recover from an illness and become stronger and more independent. But that all “depends on where the person is in their long-term stay,” Gure says. “When a patient initially comes in, sometimes the reason for that is subacute care, where physical therapy services are part of the benefit. The patient is there to gain strength. If there is a decision to either not continue in that subacute care setting because benefits have run out or there’s not an additional benefit needed through rehab, then that long-term resident has more of a restorative exercise program.”
Gure says that physical therapy may be helpful for some patients depending on the situation. “Many times, those patients are at baseline and not physically able or have other limitations cognitively that would make it more difficult for them to engage more independently in an exercise program than a resident who’s in an assisted living facility.” In these instances a “more structured setting where there’s more supervision and a dedicated schedule for that tends to be more what you see when it’s a long-term care resident.”
That said, many nursing homes do have recreational programs that have “wonderful activities that residents can participate in,” Gure says. “There may be some patients in nursing homes who have more free use of the gym to maintain their fitness, but exercise tends to be a much more structured activity in nursing homes.”
When determining what aspect of fitness needs the most focus, Ebner says he evaluates patients first, but that this evaluation doesn’t vary much from what he would conduct for a younger person. “I’ll check to make sure that all the joints are moving the right amount and make sure that their muscle strength is appropriate. Depending on what I find, I may give them specific stretches and exercises to work on that impairment.” But as far as the evaluation itself goes, “it really doesn’t change much between older adults and younger people. I always look at how the joints and muscles are working.”
Ebner says a focus on strength training is important, but that cardiovascular exercise is also beneficial, especially for older adults who have to face a lot of stairs in day-to-day life. Whereas navigating a couple of steps to get into the house might rely more on strength, climbing a longer flight of stairs to the second level may also require some stamina and endurance that cardiovascular exercise can help build.
No matter the specific needs, the name of the game with exercise is to make it a lifelong habit. Ebner says the seniors who do better are those who’ve been active all along and aren’t starting from scratch in building strength and endurance later in life. “The more they can do proactively to keep from losing their strength, the better.” Strength training, balance work, yoga, walking – any and all of these activities can help you lead a longer, less frail life, because having “optimal strength will prevent them from having any major injuries or a fall.”
Even being bedridden is no excuse to skip the sweat session, Ebner says. “Anything can be valuable. (Bedridden patients) are going to be limited in what they can do, but the main thing is you want to get them weight-bearing,” or working to build up the strength to be able to get up out of bed. This may require intensive one-on-one physical therapy sessions, and “if they’ve had surgery they may not be able to. But a lot of times it’s just getting them to do whatever they can do.” It seems when it comes to exercise, no matter your age, something is always better than nothing.
“The big thing is that the more people can strength train at a younger age, I think it sets them up for better success down the road,” Ebner says. While there might be a negative cultural connotation associated with strength training as being only for body-builders and “meathead” types, he says this isn’t what strength training is about. It’s about helping you maintain function as long as possible. “The stronger you are, the more likely you’re going to be able to have longevity.”