I Got Your Back

Most of us have probably had that conversation at some time where someone begins talking about a problem with their back while throwing out seeming random letters and numbers: “L5!” “C2!” “T11!” At any moment you almost expect someone to yell “Bingo!” What do these letters and numbers mean?

There are a total of number of bones in stacked together in the back is 33. They are divided into a number of different categories based on their location on the spine. The topmost part is called the cervical spine; it has 7 bones that serve to support the skull and help with a variety of movements. The 7 bones are numbered from top to bottom; C=cervical, so it is C1, C2, C3, and so on. The middle part of the back is the thoracic spine; it has 12 bones and connects to the ribs while providing stability. The 12 bones are numbered from top to bottom; T=Thoracic, so it is T1, T2, T3, and so on. Next is the lumbar spine with 5 bones; they are the largest of the vertebrae and help to support much of our weight. They are also numbered from top to bottom: L1, L2, etc. Below this is the sacrum with 5 fused bones that connect the pelvis to the back. Finally, the coccyx is at the very bottom with 4 fused bones (although sometimes there are 3 or 5) that provide attachment points for pelvic floor muscles.

This seems like a lot of information, but the most important part to remember is that there are three main sections each with their own purpose, and two sets of fused vertebrae at the bottom that also have their own role. All of these bones are supported by muscles that provide stability; they are called intrinsic muscles. There are also extrinsic muscles that sit on the back but whose jobs are to control the arms and shoulders.

It is important to maintain the strength and flexibility of each part of the spine. The most important exercise for cervical spine health is the chin tuck, which I have blogged about in the past; looking over your shoulders in each direction is also a great exercise. For the thoracic spine, try foam roller extensions, standing torso rotations, and side-lying (open-book) rotations. For the cervical spine, the best exercise include cat/cows, glute bridges, child’s pose, and bird-dogs. Of course, if you have an injury or other concerns, consult with a medical professional so as not to do damage to this most important part of our bodies.

In the future, I will talk more about our backs, but the terminology seems so intimidating that I felt it important to demystify what we talk about when we throw out those Bingo-sounding letters and numbers.

Don’t Just Sit There…Grab a Snack

And it is not what you think.

When I meet with new clients, part of the intake process involves getting to know their exercise habits (or lack thereof). This includes whether they spend a lot of time sitting or on their feet. This is a question asked by many physicians as well.

A recent article in the JAMA Network Open from 2023, “Dose-Response Associations Between Accelerometry Measured Physical Activity and Sedentary Time and All-Cause Mortality,” explores the risk of long-time sedentary behavior–in other words, being a couch potato. The article shows that this kind of behavior can have serious negative health consequences even when a person is engaged in regular exercise. What is important is the total amount of movement on average each day–not just how long a workout is. The effects of sitting on the couch or at a desk for prolonged periods of time cannot be “out-exercised.” That is why it is important to take regular breaks (every 30-45 minutes) to take a short walk, do a mobility exercise, or just stand.

This brings us to the snack. In the past I have blogged about “quickies,” short bursts of exercise that still have a positive influence on our fitness. The new cool term for this is according to the British Journal of Sports Medicine is an “exercise snack.” The general guideline is that we should engage in 150 minutes of exercise weekly. That could be five 30-minute workouts, or two 45-minutes + two 30-minutes, or any other combo. Research shows that even snacks of five minutes can be effective; the research in BJSM indicates that as little as 30 seconds has an impact. When done regularly, these “micro-workouts” can move the needle to greater fitness and health. If setting aside 30 minutes five times per week seems daunting, this can be a great way to work toward the goal of 150.

The most important take-aways are that being sedentary has negative effects that are often difficult to overcome. One of the ways to counteract the couch potato effect may be as simple as grabbing a snack–just make sure it is an exercise snack and not a giant bag of cheese puffs!

Five-Year Kidney Donation Anniversary

It has been five years today (May 25) since I donated a kidney to someone whose profile I saw on Facebook who was looking for a kidney. Although he and I were not a match, my willingness to donate meant that we could be part of a paired exchange; my kidney went to someone who was a match, while he received a kidney from someone who was a match for him. Altogether, there were three donors and three recipients. We will be celebrating our five-year anniversary in a few weeks with a lunch in Cleveland.

Unfortunately, the person who received the kidney that I donated passed away 15 months after the surgery, but not from kidney disease. I did feel somewhat cheated that he and I did not get to know each other better; the surgeries took place during the COVID years and it was difficult to meet up. Over the last few years since his passing, I have stayed in touch with his family; my wife and I even went to visit them at their second home in France. I also know that the time after his surgery was transformative for him and his relationship with his family. I do not feel like my donation was “wasted.” There are no guarantees in life.

The person for whom I donated is doing great. He continues to be in wonderful condition. We talk a few times each year by telephone and when he is in Cleveland we try to get together for lunch–although without too much success. It is OK that we are not “besties,” as I did not do this so that I could get something out of it; I just wanted to help someone if I could.

As for me, after the first month or two, I felt myself really coming back to “normal.” My kidney function levels have continued to improve as the remaining kidney his grown to pick up the slack. There were a few side-effects–one that required a minor outpatient procedure–but otherwise I am in good health. I work out at least five times per week and my lab results are normal for my age.

People ask me if I would do it all over again. The answer is “no;” that is, of course, because I only have one kidney left and I need it for me! I am glad that I did it; it was one of the most difficult and rewarding experiences of my life.

It is not often that we get the chance to save a life. I encourage those who might consider this to do some research; you can contact me as well. It won’t be easy, but you won’t regret it either.

Paying Attention to Mental Health

This display from Minnesota is a reminder that today is the first day of Mental Health Awareness Month. May has been set aside since 1949 to raise awareness about mental illness and fight the stigma surrounding it.

Of course, mental health is important in every stage of our lives, but there are certain aspects that are of particular interest to older adults. It is estimated that about 7% of older adults worldwide are affected by mental illness, often related to decline in physical health, loss of loved ones, and social isolation. Up to twice as many suffer from anxiety that can manifest itself in many ways. Dementia is not considered a mental illness but depression can often mimic the symptoms and/occur along with it. Finally, there is growing concern that older adults may misuse alcohol and prescriptions drugs.

The risk factors for mental illness in older adulthood can stem from conditions that appear later in life–both physical and otherwise. Chronic health conditions, disability, uncontrolled pain, and other physiological issues can challenge a person’s mental well-being. While adults are living longer, they often do so with a greater sense of loneliness and isolation coupled with a loss of independence. Add to this major life transitions such as retirement, loss of a partner, or moving to an assisted living facility, and older adults find their mental health can be quite fragile.

Look many physical conditions, mental health can be treated. There are options such as talk therapy as well as medications. The best treatment, though, is prevention. As we age, the more involved we are in social settings, the more we exercise and eat properly, and the more regularly we visit our health professionals, the more likely we are to stave off mental illness or be able to treat it if it does occur.

May is a good time to reflect on how we are doing, and how those around us are doing. Get educated and make sure to talk to a medical professional if you are worried about your mental health or that of a loved one.

Have a great May everyone!

Exercise and Parkinson’s Disease

April is Parkinson’s Awareness month. This disease affects nearly 12 million Americans, and April is the month set aside to learn about Parkinson’s Disease (PD), its treatments, and the people who are affected by it.

I have blogged about this in the past–especially after I attended a personal trainer’s conference in Denver in March, 2025, where I attended a session about PD and exercise. In the interim, I have done more research and am still hoping to be able to get special certification to better serve clients with PD.

While there are medicines and even medical procedures for delaying the progression of the disease, exercise still remains a powerful strategy for helping those living with PD. Exercise works best when it is part of a consistent program that involves aerobic exercise, strength training, balance and agility, as well as flexibility. Recommended activities for aerobic/cardio exercise include brisk walking, cycling (either outdoors or on a stationary bike), swimming, water aerobics, and dancing. Strength training can use various modalities such as resistance bands, light free weights, and weight machines. Tai chi, yoga, boxing (non-contact), and dancing can help with balance and agility while preventing falls which are a big risk for those with PD. Finally, activities like stretching, yoga, and Pilates can all help with flexibility. In line with generally accepted guidelines for healthy individuals, those with PD should aim for 150 minutes of moderate-to-vigorous exercise each week.

Many communities have agencies that provide structured exercise activities for those with PD. Other gyms may also provide some programming. In either case, it is essential that trainers have the necessary training and certification to work with those who have PD. In some instances, those with less severe symptoms can function well in classes aimed at the regular population.

If you or a loved one is living with Parkinson’s Disease, talk to your physician before beginning any new programs of exercise. A good neurologist or movement disorder specialist can recommend the best course of action. Exercise is a powerful tool for a better quality of life with PD. This month in particular, be aware of what you can do to help yourself and your loved ones.

How Not To Completely Blow It Over the Holidays

Once again, Passover and Easter coincide on the calendar, and many people are wondering how they can make through the holidays without completely blowing healthy eating habits out of the water. I have posted about how to best prepare for holiday eating in the past as well as how to respond when the efforts fall short, but I want to focus on one issue in particular: alcohol consumption.

From my limited knowledge of Easter observances, it does not seem like drinking is a big part of the celebration. Those taking communion may have a small sip of wine, but there is not Easter equivalent to spiked Eggnog or champagne enjoyed during the December holidays.

In Judaism, however, the drinking of wine (and other intoxicants) is baked into the observance of every Shabbat and holiday. It is the very way that these special days are sanctified. Passover brings it to a whole other level; participants in the Seder meal are “required” to drink four glasses of wine. Why? Wine is a symbol of joy and each glass represents the joy of the four different way God redeemed the Hebrews from Egyptian slavery (according to the Torah).

I am a firm believer in moderation, but four cups of wine hardly seems moderate! Of course, this is only two nights out of the year, but is there a way to keep it under control? This year, I am going to go for wine-tasting pours. If you have ever been to a winery and had a tasting, you know that the pours are relatively small–especially when compared with what you would get when you order a glass of wine with a meal. Since I have been working really hard at eating healthy and managing my weight, I do not want to drink so much that I begin to make poor decisions about what I am eating–how much Matzoh can you eat anyway? I find that I eat more moderately if I do not drink, so the Seder is always a challenge.

Aside from the way that alcohol can affect the choices we make, drink intoxicants can have other dietary effects. Alcohol is what is often referred to as empty calories; they are high in calories and do not bring a lot of nutritional value to the table. When we imbibe, our bodies also prioritize metabolizing the alcohol over burning fat which can stymie fat loss for over 24 hours. It really is a double-whammy in this regard. We may eat more than we had hoped and our bodies are less likely to burn it.

Wine is delicious, and I certainly enjoy it. I like a good cocktail now and again too. We should, however, be cognizant of how alcohol consumption figures into the bigger picture. Moderation is fine but on nights when we know there may be extra temptations, we should be aware of the pitfalls and plan for them.

Whatever you celebrate (or don’t), wishing everyone all the best for Passover and Easter!

Fitness Through Life

Do you remember the game of “Life?” As a kid I remember playing this; it was not until I was older that I realized just how adult of a game it really was. The basic premise was that each player gets to choose their path in life but unexpected twists and turns happen with each turn. It was marketed as a fun game, but it pretty closely resembles “real life” for many of us.

I have written many times in the past about how the choices we make today can affect our health and fitness tomorrow. I see it all the time with my clients; eating healthier, exercising, getting plenty of rest, and avoiding risky behaviors usually provide a more positive outcome. I use the work “usually” because there are many things in life that are simply out of our control. An accident can leave us with life-long injuries. Diseases can limit our ability to do the things we want. A financial downturn can change our priorities. The death of a dear one can alter our psyche.

Is it possible to continue to make good health and fitness decisions despite the obstacles that life might throw our way? I remember when my mother passed away 18 years ago, a friend gave me these words of advice: “Take good care of yourself, this will be harder than you think.” I have shared these words with grieving individuals ever since. The bumps along the road are a natural part of life and they should not disrupt long-term the decisions we make about our own well-being; in fact, making good choices is one of the things that can help us survive and thrive in the face of challenges.

When life throws us a curve ball, we may not be able to stick with the same plan to which we may have become accustomed. On the contrary, we will most likely have to make adjustments. Personal trainers and other health professionals can play an important role in helping us navigate modifications that need to be made–either temporarily or long-term. We should not view these changes as defeat or giving up; rather we should look at them as a sign of resilience. There are many ways to achieve better health and fitness. What worked in the past may not work today. The main thing is to recognize the changes as a part of life. What happens during our lives is not totally up to us, but how we respond is totally under our control.

I Heart You

It is just a few days until St. Valentine’s Day. Coincidentally (or maybe not), February is also American Heart Month.

This is a time of the year when we should be especially thinking about heart health. What are the most important things for older adults to know about our tickers?

The most important steps we can take to keep our hearts healthy are:

Getting regular medical checkups. Monitoring blood pressure, cholesterol, weight, and glucose levels need to be done routinely. At the same time, all prescription medications should be reviewed, and if still appropriate be taken regularly.
Make the appropriate changes in lifestyle and diet. Aim for 150 minutes of moderate activity each week as well as routine strength training. Diet should include more healthy foods such as fruits, vegetables, whole grains, lean protein, and fish; keep sodium, sugar, and fats to a minimum. Keep hydrated and get enough rest (7-9 hours per night).
Avoid risky behaviors. This does not mean skydiving, but rather if you are a smoker, kick the habit. Limit alcohol consumption. Manage stress; make self-care a part of your life. Built-in relaxation, mediation, social time, and hobbies can all help reduce stress.
Know the warning signs of heart attack and stroke. Chest pain, shortness of breath, unusual fatigue, numbness, and confusion can all be symptoms. Get prompt medical attention.

What is the best Valentine’s Day gift? The gift of health and fitness! Take some time to step up your game. Your heart will thank you, and so will your loved ones!

How’s That Resolution Going?

It’s almost a month into to the New Year and I am wondering: how’s that resolution going? When I used to be a regular gym-goer (I now work out at home) and later as a personal trainer at a gym, it was somewhat entertaining to watch the surge of new people who joined the gym in late December or early January. At first, the gym would be way busier than usual, but within a few weeks, it was back to the regulars with perhaps a few newbies still hanging in there.

Many folks have an all-or-nothing attitude to their New Year’s resolutions. If they do not hit success immediately, they simply give up. A more helpful approach is to take a step back and try to figure out what is not working and why? Ideally, when making a resolution in the first place, one should examine what has worked in the past, what has not worked in the past, what are the obstacles to success, and what is the best path toward achieving the goal. After the fact, though, is also a good to ask these questions. If the visits to the gym have petered out, why is that? Is it too hard to fit it into the schedule? Is the atmosphere too intimidating? Do you feel judged? Is it boring…or just too difficult? Answer those questions and then figure out how to overcome it. The solution could be to set a time (or times) on the weekly calendar that is dedicated to fitness. How about grabbing a friend who is willing to be on the journey with you? What about asking for help?

This, to me, is perhaps the most important point. Our fitness and health are too important to just give up. Get some help. That could be from a fitness professional–at a gym or who (like me) comes to your home or trains on-line. Contact a friend who is into fitness and can give you advice and encouragement. You may even be in touch with your physician who can refer you to providers who can help you meet your goals. It is tough to ask for help–especially when we like to think that we are strong enough to handle our own “problems.” Many times, however, reaching out can change the trajectory.

Do not give up on your goals (fitness or otherwise) just because it is not going as you hoped in the new year. January is not over yet; there are 11 months to go. Get some help, and let’s make 2026 a year of good health and fitness!

My Video Course is Live!

It is official! My video course: “Senior Strength for Better Walking” is now live on in the world wide web!

The course is comprised of four 20-ish minutes videos that focus on building lower body strength to help with walking. Each video has a warm-up as well as stretches at the end. It is designed for individuals who are not regular exercisers, or who have never exercised, but have decided that they would like to be able to keep walking for a while longer. As you go from one video to the next, the exercises become more challenging. Learners can focus on Video 1 for a while and then go on to Video 2 once they feel ready, or the videos can be played in a rotation. The only equipment needed is a chair, a mat, a water bottle, and some light dumbbells (not required).

Click here to go to the course. Watch the introductory video and let me know what you think. I am really proud of the work that has gone into this project. Please feel free to share it widely with those whom you think might benefit from an effective and fun lower body workout!