Pickleball: Yay or Nay for Older Adults?

Have you caught Pickleball fever yet? It seems like it is spreading faster than COVID. Pickleball is an indoor or outdoor racket/paddle sport where two players (singles), or four players (doubles), hit a perforated hollow polymer ball over a 36-inch-high net using solid faced paddles. The two sides hit the ball back and forth over the net until one side commits a rule infraction. Although the sport has been around since the mid-1960s its rates of participation have grown significantly over the last few years–aided in no small part by the pandemic, which made outdoor activities more popular.

I have been interested in picking up the game myself even though I am not real good at sports that involve a ball; I am more of a runner, cyclist, fitness kind of guy. There are concerns, though, about how safe the game is for older adults like myself. According to a recent article in The New York Times, there were 19,000 pickleball injuries in 2017 (before the sport boomed), with 90% of those being over the age of 50.

The most common injuries are those related to the rotator cuff tendon in the shoulder according to the Baylor College of Medicine. Other injuries include miniscus tears, tendon ruptures, and exacerbation of arthritic knees. The best way to prevent injuries is to warm up before a game; such a warm-up should include some light cardio like jogging, cycling, or walking briskly to the point of a light sweat, as well as stretching. A cool down should include additional stretching. Of course, if there is soreness after playing, cold can be applied and over-the-counter anti-inflammatories can be taken. If a condition persists, it is best to consult a medical professional.

All that being said, should older adults avoid pickleball? While 19,000 seems like a lot of injuries, it is well below other sports such as basketball or riding a bike (which is where most injuries are for those over 65), there are many advantages to pickleball. It is relatively easy to learn and more and more venues are available to play. It also has benefits for the cardiovascular system; it provides a good aerobic workout which can help lower reduce the risk of high blood pressure, stroke, and heart attacks. Pickleball is great for boosting hand/eye coordination and can help with balance. Perhaps most important, Pickleball is fun and social; this means that participants enjoy the experience and are therefore more likely to stick with it, making the game part of a good strategy for senior fitness.

Will I give it a try? If the opportunity presents itself I will. I am aware of the risks and will take the appropriate steps to keep myself away from injuries. It sounds like fun and a great workout!

Rest is Additive

Those who follow my blog know that I often talk about the importance of 3 main factors in maintaining good health: exercise, nutrition, and rest. In this post, I will focus on the last one.

A couple of weeks ago, I tested positive for COVID-19. Even though I was double-vaccinated, double-boosted, and wore my mask consistently while indoors, I still managed to contract the virus. I was fortunate to test positive on a Thursday night and have a prescription for the anti-viral medication in my hands by lunchtime on Friday. My case was a mild one, not requiring hospitalization, but I did find myself pretty wiped out. Two weeks later, I am still taking short cat-naps during the day; I am told that this could persist for a few more weeks.

I had a conversation with a client a few days ago who had recently recovered from COVID. She told me that her doctor said something wise to her about her recovery: “rest is additive, not subtractive.” What does that mean? Those of us who lead busy lives think of rest time as being non-productive; if I take a nap or go to bed earlier (or sleep in late!), it means there are things on my to-do list that will not get done. We think of resting as subtracting from our productivity and our lives. What her doctor reminds us is that it is, in fact, the opposite. Resting is additive! When we rest properly it allows us to fully recover more quickly.

This is not unlike Stephen Covey’s example of “sharpening the saw.” In his book The Seven Habits of Highly Effective People, he tells the story of a person cutting down a tree with a saw; it is taking him/her a long time to cut the tree because the saw is dull. Another person comes along and asks why s/he does not sharpen the saw. The response: I am too busy sawing to take time to sharpen the saw. Covey’s point is that highly effective people take the time to metaphorically sharpen their saws; they do what needs to be done to be more effective–even if it seems like it will slow things down in the short-term.

Resting is just like this. Even though we may have to slow down to recover, in the end it allows us to recuperate more quickly so that we can back to doing all those things on the to-do list more efficiently. We are of little use when our metaphorical saw is dull.

Whether we are recovering from COVID, surgery, or an injury, rest is a key component–as it is when we are healthy. Our bodies use additionally energy in the healing process; if we syphon away that energy being active, it cannot be put toward recuperation. It takes a lot of energy to heal, and one of the ways to give our body that energy is to rest and not expend it in other ways.

In the final analysis, then, rest is truly additive and not subtractive. As I have noted in my blog before, it is important to listen to our bodies. They will tell us when we need to rest, and we should not ignore the message. So if you will excuse me, I have a nap that is calling me by name….

At Home Senior Fitness is Growing!

It is just over two years since I trained my first client at At Home Senior Fitness. At the time, I was still working as a Personal Trainer at a local gym, but had decided that I wanted to branch out on my own. I worked both jobs for two months before giving my 2-week’s notice at the gym; I knew that in order to make my business successful, I would have to jump in with both feet.

Although I have always been busy, in June I got to the point where I could not take on any new clients virtually or in-person. I had all but stopped advertising since word-of-mouth was my biggest source of referrals, and I did not want to take out ads and then be unable to offer a spot on my schedule to those who would make inquiries. I began to consider whether I should hire someone to work with me. I was working with my SCORE (Service Corps of Retired Executives) mentor to strategize and was about ready to make the move when “fate” intervened.

I mid-July I received an unsolicited inquiry from a certified group fitness instructor who was also studying for ACE certification as a Senior Fitness Specialist. After many years of working with older adults, she was interested in transitioning her career into fitness and wanted to talk to me about the work that I do. We set up a Zoom conversation and, after speaking, we both understood that working together could be a great fit (pun intended!). It was fortuitous for both of us.

I am very pleased to welcome Sam Kalamasz to the At Home Senior Fitness team! Sam will be training virtually as well as in-person in territory that I am unable to cover (Medina, Strongsville, and Brunswick, OH). Sam begins with her first client today! Over the coming weeks, we are looking to build her client base, so if you know people who might benefit from working with a kind, compassionate, and skilled personal trainer–either on-line or in her territory–please refer them to http://www.athomeseniorfitness.net.

I am so excited for this new stage for me and AHSF…and for Sam. We are honored to be able to help older adults live their best lives with improved strength, mobility, and independence!

Are You Your Beloved?

This evening at sunset begins Rosh Chodesh Elul, the observance of the new month of Elul on the Jewish calendar. It is the last month before Rosh Hashanah, the Jewish New Year.

There are many observances connected with Elul. In order to “wake us up” from our complacency, it is traditional to blow the shofar (ram’s horn) each morning during the month except on the Sabbath. We also recite Psalm 27 every evening and morning. These practices are aimed at preparing us for the difficult and sacred work of repentance that takes place during the first 10 days of the New Year.

The name of the month is also quite special. It is an acrostic in Hebrew for Ani L’Dodi v’Dodi Li, which is based on the verse from the Song of Songs and means “I am my beloved’s and my beloved is mine.” Traditionally, the Song of Songs is seen as an allegory for the love between God and the Children of Israel; the name of the Hebrew month reminds us of our relationship with God and that we should be especially cognizant of repairing and strengthening our connection with the Holy One.

Because this verse is often recited at a Jewish wedding, it also refers to relationships with our loved ones and partners. This is a month when we should work on repairing and strengthening our human connections too.

Additionally, we should be concerned about our relationship with ourselves. Do we make an effort to treat others right but not afford the same to ourselves? We all know the famous verse, V’Ahavta l’Reacha Kamocha, “Love your neighbor as yourself.” What if you really do not love yourself? What if you pay lip service to self-care (in all its many forms) but do not take action when it comes to being the best version of yourself you can be? How can we love others if we do not learn to love ourselves first?

This applies to fitness, but many other areas as well. The High Holidays are all about forgiveness, but sometimes the person with whom we are the least forgiving is ourselves. We beat ourselves up for making missteps. We compare ourselves unfavorably to others. We always put the needs of others ahead of our own to our detriment. It is not a luxury or conceit to care for one’s self. We are supposed to love our neighbors as ourselves, but to do that we must first love ourselves. This requires concrete action. During the month of Elul, this is our focus. Not only should we concentrate on how we interact with others and God, but also with how we treat our own souls. Beyond contemplation, we plan for how to change in concrete ways in the coming year.

Wishing everyone a great month ahead. Whether you are Jewish or not, observant or not, this is as good a time as any to refocus and remember to be beloved to ourselves too!

The Core of the Matter

If you were to ask anyone who participates in my group fitness classes or does personal training with me what are the top 3 phrases I use, one them would certainly be “engage your core!”

We hear a lot of talk about the core, but what exactly is it and why is it so important? The core is made up of the muscles surrounding your mid-section (sometimes called trunk); it includes the abdominals, obliques, diaphragm, pelvic floor, trunk extensors, and hip flexors. Some people define it as the area between the mid-thigh to just below the pectoral muscles.

The core important because it provides stability for doing many of the tasks of daily living, and supports everything above it. A weak core can lead to overloading other muscles, which often leads to back pain. Most of the activities in which we engage–both in the gym and out–depend on us having a core that is strong enough to support the movements required.

When I say, “engage your core,” what does that mean? I usually follow this term with the instruction to keep shoulders back, chest up, and belly button pulled back to the spine. This is an oversimplification, but it is a signal to my clients that they need to be aware of their posture. I often tell them to imagine the drill sargeant is about to come by and they need to stand at attention.

There are a number of exercises that help to strengthen the core. A popular one is doing abdominal braces. Basically, this involves tightening the muscles of the mid-section all at once. Imagine that someone is about to punch you in the gut; what muscles would you tighten to lessen the impact of the punch? This is what you do in a bracing exercise. There are all kinds of bracing exercises, many of which you can find with explanatory videos by using a simple internet search. Doing these exercises will give you a good idea of just how strong your core is (or isn’t!).

Other exercises to help strengthen the core include: Ab crunches, glute bridges, bird dogs, planks, side planks, and superheroes (formerly known as supermans). None of these exercise requires any kind of equipment; they can be done at home on a mat or other soft, but sturdy surface. If you want to make use of dumbbells you can add in: deadlifts, russian twists, wood chops (that also work the arms and shoulders), and over/unders. At the gym, there are machines that will also work the core and allow for varying the amount of resistance being used; ask a trainer or other employee to show you which machines they are and how to use them.

Getting to the core of the matter is an essential part of any exercise regimen. Lots of people like to focus on upper body and arms, as well as legs, but often leave out core. This is like building a home but leaving out the foundation. You cannot build a strong body without a strong core to support it all. Next time you are exercising, I hope you imagine me reminding you to “engage your core!”

Too Much (or Not Enough) of a Good Thing

The most recent issue of AARP Magazine [August/September 2022] addressed the issue of what we assume to be good habits to stay healthy that can actually be harmful in some cases. I would link the article, but it is not yet posted to their website; it is entitled “Good Habits That Might Age You Prematurely,” by Leslie Goldman.

Goldman addresses five habits that, in general, are good but call for either moderation or at least some counterbalance.

Staying out of the sun. I recently blogged about this; when we are outside it is very important to use proper sunscreen and other protections to prevent skin damage and/or skin cancer. Avoiding the sun altogether, however, can have negative effects. Circadian rhythms (similar to our biological clocks on a daily basis) are set by the sun; they keep all our systems and organs on 24-hour cycles. When we have little or no exposure to the sun, those rhythms can get messed up and make sleep difficult; sleep, of course, has many benefits. Goldman suggests at least 15-30 minutes each day outside in the morning and late afternoon/early evening, or to make use of a light box at a consistent time each morning.
Eating nutrition bars. As the author notes, it may sound healthy but many are loaded with sugar; the same is true of smoothies and fruit juices. This can lead to all kinds of problems like high blood pressure and heart disease. How can you know if your bar is healthy? Add up the number of grams of proteins and the number of grams of fiber. If that number is higher than the number of grams of total sugar, it is not problematic. Consider other ways to get protein that are not loaded with sugar or overprocessed.
Drinking when you are thirsty. If you wait until you are thirsty, you are too late. Estimates are that 70% of adults between the ages of 51-70 may be chronically dehydrated. This increases the risk for all kinds of problems from urinary tract infections to colon cancer to diabetes. Goldman suggest drinking enough so that you have to urinated every 2-3 hours; additionally, it is a good idea to eat foods that have high water contents like celery, cucumbers, tomatoes, watermelon, and peaches.
Walking every day for exercise. I have blogged about this too. Walking is great, but as we age we need to make sure that we vary our exercises and include weight training as well. Weight training helps to rebuild muscle mass that is lost with aging and can also strengthen bones. By the way, the more muscle you have the greater ability you have to store water (see #3 above). Get at least 150 minutes of moderate exercise each week, or 75 minutes of vigorous exercise. Work in 2 days of strength training; a fitness professional can help you do this safely and effectively.
Constantly wearing supportive shoes. This was a shocker to me; and I have blogged about this too. Our feet send messages to our brain that help us to keep our balance. If we wear shoes all the time with lots of padding and support, our brain does not get enough sensory stimulation from the feet–and the nerves can lose sensitivity too. Goldman recommends going barefoot for 30 minutes each day, especially while doing activities where you move around so that the whole foot gets stimulation.

As always, if you have questions or concerns, consult with a medical professional that you trust. It is true that moderation and balance are important guidelines–not only in our relationships, leisure pursuits, and diet, but in our other health habits as well!

Thrown Your Back Out?

There I was, minding my own business on Saturday night, pulling down a shade on the back window, when I “threw my back out.” At the exact moment it happened, it took my breath away and the pain was intense. How did this happen? I had just pulled down two other shades–as I do every night when it gets dark–without incident. What actually occurred?

What exactly is throwing out one’s back? It is the acute onset of low back pain (in the lumbar spine). It can be caused by a number of things: muscle spasm, arthritis, a slipped or ruptured disk, or sometimes for no reason at all (like closing a shade!). Most of the time the condition is temporary, lasting only a few days or weeks. If it lasts longer, it is worth consulting a medical professional as it could be something more serious like a muscle tear, herniated disk, or even a kidney stone.

This is–as they say–not my first rodeo. As someone who is very physically active, this happens every couple of years or so; most of the time it is a result of something silly like this time. My rule of thumb is that if the pain and lack of mobility in my back do not resolve in a few days, I contact my doctor. That happened only once and I was refered to a chiropractor; it took a couple of visits, along with some exercises to finally get back to normal.

Here are some things that can help with a back that has been thrown out:

Treat the pain. Ibuprofen and Naproxen work well to reduce swelling; if you cannot use non-steroidal anti-inflammatory drugs (NSAIDs), use acetamenophin (Tylenol). Pain patches can help as well. Always follow label instructions carefully.
Apply cold. I usually use a cold pack wrapped in a towel and find it brings relief.
Apply heat. Many people swear by this because they feel the cold causes the muscles to contract and cause more discomfort.
Apply cold and heat interchangeably. It works for some people!
Exercise. The common practice used to be to immobilize the back; the latest research indicates that exercise and stretching can shorten the time it takes to recover. It is best not to overdo it while working out (I have been using lighter dumbbells than usual), but the activity can prevent the muscles from stiffening up further. Certain stretches can help as well: Cat/Cows, Cobra Pose, Child’s Pose, Windshield Wipers (keeping feet on the ground), Supine Knee-Ins, and Pelvic Tilts.
Rest. While your body recovers, it uses a lot of energy; be sure to give your body the chance to recharge.

It is Tuesday, and each day I feel better. Interestingly, many of the same exercises and stretches that I use with my clients who have chronic lower back pain are the same ones I am using now. Hopefully, I will feel myself again in a day or two. If not, I will contact my doctor.

In the meantime, is it a problem to leave the shades up at night?

Stop Slouching!

One of the biggest issues with which I deal in my work with older adult clients is posture. While some clients stand up straight, many others have a slouched posture and a neck and head that often protrude forward. You have certainly seen this yourself–perhaps when you look in the mirror.

Several years ago, I began to experience numbness and tingling in three of my fingers on my left hand. I went to see my physician who referred me to a physical therapist. Much to my surprise the issue was not my fingers but rather my cervical spine; three fingers was a tell-tale sign that it was caused by an impingement. The issue was that my posture had put things out of place and it was time for me to correct that. I was given a few exercises to do each day and within a few weeks the symptoms disappeared; I still continue to do some of the exercises on a regular basis to keep myself and my posture in tip-top form.

The causes of poor posture are many. Some are structural such as scoliosis or joint degeneration. Otherwise, there is a kind of chicken/egg scenario; bad habits such as slouching and a sedentary lifestyle can cause muscle fatigue that will lead to poor posture. In other words, slouching leads to more slouching. Another cause is the tightening of chest muscles over time and the weakening of upper back muscles–and other core muscles; the chest muscles pull the shoulders forward and the back muscles are not strong enough to keep them in place. Of course, weak core muscles also play a major role in compromised posture.

So, what if we are living with poor posture> Are we stuck for life? In some cases, the damage may not be 100% correctable, but improvements can be made almost at any age. There are three exercises that I do and that I have my clients do as well; they make a real difference.

Chin Tucks. I have blogged about this exercise in the past. To do a chin tuck stand or sit up straight, pulling your head back. The best way to think about this is it is as if someone is coming in to give you a kiss and you want to avoid it; you simply draw your head back and away. Do not put your chin on your chest or tilt your head back. This can be held for 30 seconds or 12-15 reps if you prefer. I do this several times a day to combat the effects of looking at my phone, peering over my prayerbook, and simply being lazy.
Scapular Retractions. There are a number of ways to do these, but I suggest standing straight, relaxing the shoulders (no shrugging), bending the elbows at your side, and then slowly bringing the elbows together behind your back; do not worry if they do not touch! This can be done as a 30-second hold or 12-15 reps. I do scapular retractions several times a day as well. This helps to stretch out the chest muscles that pull the shoulders forward while putting the shoulder blades back in their proper position.
Wall Hand Sliders. Stand as close as you can to a wall without picture, moulding, etc.; I do it with my nose and tummy literally touching the wall. Do make sure that you are not so close that you will lose balance and fall backwards. Place the palms of both hands on the wall at shoulder height, then slide the hands up the wall as high as possible; bring them back down to shoulder height and repeat 12 times for 2 sets. This is another great chest stretch that also helps with raising the arms overhead, which becomes difficult for many as we age.

If you are experiencing very poor posture associated with pain, make sure to talk with your physician as there could be structural or other issues that should be addressed in addition to, or instead of, these exercises. Otherwise, incorporate these exercises into your daily routine and you may just find that you are standing a little taller, a little straighter, feeling less achy, and looking better in the mirror. It takes some adjustment, but just remember what your mother used to say: “stand up straight!”

Have You Got Skin in the Game?

We know that as we age there are lots of changes that occur in our bodies. It makes sense that the largest organ in our bodies, our skin, would be affected as we grow older. And it is about more than just wrinkles. With age, our skin thins out, loses fat, and does not look as “full” as it used to. As the skin thins out, it is easier to see bones and blood vessels underneath the surface. Injuries take longer to heal. Exposure to sun over a long period of time can lead to wrinkles, dryness, age spots, and even cancer.

The National Instutes of Health (NIH) offers great information about what happens to our skin and what we can do about it. For instance, dry and itchy skin can be treated with moisturizers; even a humidifier in the room can help. It also helps to take fewer baths/showers, using warm water instead of hot, and bathing with mild soaps.

Another condition is more frequent bruising that may take longer to fade. If bruises appear and you do not know how you got them–especially if they are in areas that are usually covered by clothes–consult a doctor to make sure it is nothing more serious.

There are many factors that cause skin to wrinkle: gravity, smoking, exposure to too much sun, etc. There are many products that claim to reduce the “appearance” of wrinkles, but most are not really effective. The only way to treat wrinkles requires a trip to a dermatologist who specializes in medical procedures and injections; these can be quite costly and may have only limited impact.

Age spots and skin tags are unsightly and show up more and more in the elderly. To prevent the appearance of more age spots, use appropriate sunblock and protective clothing. Skin tags are growths that rise above the surface of the skin; they are harmless, but if they are bothersome or in an area that causes concern of discomfort, they can be removed by a professional.

Finally, skin cancer is quite common as well. I blogged about this in 2020 and also last month. I am a skin cancer survivor several times over. Know the signs of skin cancer: Assymetry of a growth, Borders of the growth that are irregular, Color changes or more than one color, Diameter greater than that of a pencil eraser, and Evolving (meaning that the size, color, shape, or symptoms are changing). Check yourself regularly (once/month) and have regular checks with a dermatologist. Caught early, many skin cancers can be quickly and efficiently treated.

There will be changes in our skin as we age. Even so, we can still take care of this organ so that it will take care of us. Use sunscreen, avoid tanning, wear protective clothing (hats, coverups), and limit sun exposure. We only have one set of skin, so make sure it lasts! After all, we’ve all got skin in the game.

Balance and Longevity

Can you balance on one foot for 10 seconds? Aging adults recognize that as we get older we may experience muscle loss, decreased stamina, and issues with flexibility; balance, however, usually remains unaffected into our fifties and then begins to deteriorate with some rapidity after that. A test of balance that I often use with clients–and this is fairly standard in the fitness world–is a single-leg stance, also known as balancing on one foot. My goals is to get my clients to be able to balance on each foot for 30 seconds; for many of my clients this may never be attainable, but we work our way up as much as we can.

Past research has shown that those who can balance for longer periods of time on one foot are much less likely to experience falls. For older adults, falls can have especially serious consequences as healing takes longer and inactivity takes a greater toll. Falls can also lead to a loss of independence.

The results of a new study published in the British Journal of Sports Medicine suggests that the inability to balance for 10 seconds is linked to nearly double the risk of death from any cause within the next decade. In other words, if you can balance on one foot for 10 seconds you cut your chances of dying in half over then next ten years. A recent article on cnn.com discusses the results. Previous research had linked the inability to balance with fall risk and cognitive decline, but never before with longevity. Of course, the ability to balance may be affected by a number of other health factors; those who failed the test were more likely to be obese, have heart disease, high blood pressure, and type 2 diabetes.

The study does not reach any conclusions about causality. If you practice every day and are able to balance for 10 seconds, does that mean that your longevity will automatically increase? More research will be needed to determine this. More likely, those who are in a normal weight range, have blood pressure and blood sugar under control, and have healthy hearts may engage in more healthy patterns of diet, exercise, and rest. Those who take better care of themselves may therefore be better able to balance on one foot and also live longer. Causality is not yet determined, only linkage.

What does this mean for us? Try the test and see if you are able…or if you are even close; always perform this test near a piece of furniture or kitchen counter, or with someone nearby, rather than in the middle of an empty room in case you fall. If you are unable to pass the test, it may be worthwhile to talk with a medical profession about ways to improve health outcomes. In the meantime, it could not hurt to practice balancing, eat right, exercise, and get plenty of rest; these all contribute to longevity and great enjoyment during those years.