A *Foot*note to the Last Post

In my last blog post, I discussed the importance of taking care of one’s feet. To be honest, my post was motivated by some pain I had been experiencing in my left foot that was to be addressed at an upcoming appointment with my podiatrist. After an x-ray, I was diagnosed with a stress fracture and now have to wear a boot for four weeks. Stylish, no?

What is a stress fracture? According to the Mayo Clinic’s website: “Stress fractures are tiny cracks in a bone — most commonly, in the weight-bearing bones of the lower leg and foot. Stress fractures are tiny cracks in a bone. They’re caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances.” The first time I had a stress fracture, my podiatrist showed me how they happen. He took a regular #2 pencil and tapped it repeatedly on top of my quad muscles; under my quads is the femur–which is the strongest bone in the human body. The doctor told me that if he just kept tapping, eventually he would fracture the femur; it is like erosion that does its job slowly but continually.

I looked at the x-ray this week, and could not really see anything; it is not like a regular fracture where it is pretty obvious that the bone is broken. A podiatrist, however, is trained to identify these tiny cracks. The most common treatment is to immobilize the foot to allow the bone to grow back and heal the fracture. That is why a boot is most often prescribed.

Are stress fractures preventable? Yes, and no. According to the Mayo Clinic, ways to prevent stress fractures are: 1) start new exercise programs gradually so as to allow the bones to strengthen as new demands are put on them; 2) use proper footwear–I discussed that in the previous post linked above; 3) cross train–in other words, exercise different parts of the body in different ways rather than repeating one singular exercise over and over; and 4) maintain proper nutrition to ensure the proper vitamins, minerals, and other nutrients that keep bones strong. The “no” is that even when you do all these things (as I do), it is still conceivable that this can happen. I was on a hike in Arizona recently with a very uneven trail; I rolled my ankle at least a dozen times and I think this may have contributed to the stress fracture.

I will heal. This has happened before and, after some inconvenience, things will go back to normal. In the meantime, I will immobilize my foot as best I can. I will also continue to follow the recommendations about exercise, footwear, and nutrition. No 100% guarantees, but injuries will occur now and again–and they are small price to pay to avoid the negative health consequences of a sedentary lifestyle.

Cover All Your (Muscle) Bases

In youth, there are certain “rules” that many follow when engaging in resistance training. The reasoning goes that for men to be more attractive they need to concentrate on their arms and chest. Women may feel the need to focus on abdominals and glutes. These rules do not apply in the same ways as we enter older adulthood.

Do not take this to mean that older adults are not concerned about their appearance; rather, as we age we need to take a more holistic approach to the muscles we exercise. It is important to pay attention to the muscle groups that help us to perform the activities of daily living (ADL) such as walking, climbing stairs, carrying groceries, bending down to pick up something we have dropped on the floor, etc., not just the ones that get us noticed when we wear tight clothes! After all, what good is having gigantic biceps and a huge chest if we cannot make our way across the room?

A recent article on AARP’s website by Michele Wojciechowski highlights some of the often-ignored muscle groups that deserve our attention and exercise. The author highlights the following areas: 1) The hip area (the glutes and hip flexors); these are key to walking and getting up from a seated position. 2) The core; this part of the body is from the shoulders through just below the hips and serves as support for the entire upper body. Often, older adults with poor posture have weakened core muscles. 3) The knees–which are not a muscle, but a joint; they are supported by the quads and the hamstrings; keeping those strong and limber is key to walking, climbing stairs, standing, and maintaining balance. 4) Ankles and feet; again, vital to walking but also important in maintaining balance and stability; ask anyone who has had feet or ankle problems and they will tell you that it seriously inhibits mobility. 5) The neck; not keeping the supporting muscles strong and limber will literally cause “a pain in the neck.” It is not uncommon at all to see older adults whose heads are perched out well in front of the chests; this causes problems beyond appearance, possibly affecting sleep, posture, and the ability to drive a car. 6) Hands and wrists; while many are hit by arthritis in this area, others simply allow the lower arm muscles to weaken, which limits the ability to perform fine motor skills like writing, eating, typing.

As I age, I am concerned about my appearance. I always want to put the best version of myself forward. For me this means not only working on the “sexy” muscles, but also on the ones that will keep me active and independent. Do not overlook these muscle groups or they will have a way of calling your attention to them in a way you might not enjoy.

Is it the Big One?

redd foxx

Some of you may recall Redd Foxx’s famous line from Sanford and Son (while feigning a heart attack): “It’s the big one, I’m coming to join you Elizabeth!” While this groundbreaking show was one of the funniest in television history, it did distort the reality about heart attacks (also known as miocardial infarctions). It is extremely rare that they are brought on in the way portrayed in the show.

There is still a great deal of misinformation and misunderstanding about what causes a heart attack. It is caused by a blockage of blood flow to the heart; these blockages are caused by fat, cholesterol, and/or other substances that cause a build-up of plaque in arteries leading to the heart. Without blood, the tissue loses oxygen and can die. So it appears that there are other things at play aside from Sanford’s son, Lamont!

CNN Health recently featured a story that touches on another myth regarding heart attacks. Two television characters, Mr. Big from Sex and the City, and Mike “Wags” Wagner from Billions suffered heart attacks after using their Peloton bikes. These kinds of stories feed the misconception that exercising vigorously does not improve our health, but rather leads to our untimely demise. Dr. Andrew Freeman, of the American College of Cardiology notes that “…regular exercise is a wonderful way to stay healthy and well and reduce cardiovascular disease. In fact, I call exercise the ‘fountain of youth.'” This is certainly a very diffent characterization of the effects of physical activity. The fountain of youth is about as far away from untimely demise as one can imagine.

It is no secret to those who follow this blog that exercise–at any age–is beneficial. Do people have heart attacks at the gym or while running or bicycling? Yes, but at no greater rate than those who are engaged in other activities. A regular program of exercise is a great way to reduce risk of a cardiovascular event rather than cause it.

A few words of caution, however. Someone who is about to embark on a exercise program or a “fitness journey,” should consult with their primary care physician first to make sure that it is safe to do so. Certain exercises may be more advantageous/harmful than others given a person’s medical history. Another important point is that beginners should proverbially learn to crawl before walking…and certainly before running a marathon! It is vital to build up one’s strength and endurance in a responsible way; as always, a fitness professional can help with this.

Many people–especially older adults–have stayed away from exercise precisely because they fear the same fate as Mr. Big or Wags. Sadly, that fear may have prevented them from reaping the many health benefits of regular exercise. Chances are strongly in our favor that when we work out, it will not be the “big one” and we will not be coming to join Elizabeth any time soon. On the contrary, we might just encounter the fountain of youth!

Take Care of those Joints

Joint Pain

It is no secret to older adults that one of our trouble spots as we age is our joints (the ones inside our bodies!). According to the Centers for Disease Control and Prevention (CDC), over 50% of those age 65 or older have osteoarthritis. Osteoarthritis is a degeneration of joint cartilage and the underlying bone; it causes pain and stiffness, especially in the hip, knee, and thumb joints. Is there anything that can be done to take better care of our joints?

A recent article on http://www.aarp.org, suggests 6 behaviors that are harmful for our joints.

  1. Smoking. Nicotine narrows blood vessels thus prevent blood from reaching the cells that seek its nourishment; this includes the cells in our cartilage. Additionally, smoking can add to brittle bones which raises the likelihood of fractures by 30-40%.
  2. A Physically Inactive Lifestyle. People who are sedentary are more likely to have difficulty maintaining a healthy weight; carrying around extra pounds puts stress and strain on the joints–especially the knees. Consult with a doctor or fitness professional about which exercises are best for joint health, since some movements can exacerbate joint problems.
  3. Overdoing Exercise. This is all about maintaining the proper balance. Currently guidelines suggest 150 minutes (2.5 hours) of exercise each week. This need not be particularly strenuous (and in some cases should not be); as noted in #2, consult a doctor or fitness professional for how to best put together a program for your needs and condition. Avoid being a weekend warrior as well; do not stay inactive the whole week and cram 2.5 hours into the weekend. A mix of cardio and strength training is recommended.
  4. Carrying Too Much. Literally, this could mean moving furniture, carrying a heavy backpack, etc. This should be avoided, but if it cannot, be certain to use proper posture and lifting techniques. Keep the load closer to your body for less stress on the joints.
  5. Eating the Wrong Foods. There are many foods that are “pro-inflammatory.” These include: red meat, fried foods, and sugary foods and drinks. On the flipside, there are foods that are considered anti-inflammatory such as fishes with high levels of fatty acids (salmon and mackerel), leafy greens, as well as some tree nuts; work more of these foods into your diet.
  6. Too much Texting. The more we text the more strain we put on the joints in our arms and hands. There are some ergonomic keyboards that can help, but make sure to take a break if your work/hobby requires a lot of typing. Most smartphones also have a voice to text option so that you can dictate rather than typing some of the type.

As we age, it is more and more important to keep moving. Of course, we rely on our joints to make that a reality. Treat your joints well and they will last longer, keeping older adults more independent.

What Could Possibly Go Wrong (Part II)

Two Vintage Red Cross Bandage Boxes

In my last blog post, I wrote about ways to keep yourself safe while working out at home–focusing on having a safe and secure workout space.

Preventing injury requires more than just cleaning up a large enough space and getting possible obstacles out of the way. There are factors to take into account both at home, and at they gym to consider. An article in at http://www.aarp.org points out 5 issues to bear in mind when embarking on a fitness journey; these factors are especially relevant for older adults.

  1. Start slowly. With New Year’s Resolutions on the horizon many of us may resolve to start working out more often. Going from 0 to 60 in 3 seconds may be great for a sports car, but our bodies require us to move forward gently–especially if we have been sedentary for a while. Working out for too long, too often, or with weights that are too heavy is a recipe for injury. Muscles need to get used to the new routine; they need to grow and strengthen before we get more intense. Ease into it.
  2. Speaking of going from 0 to 60, every workout should begin with a warm-up. Typically, a before-workout warm-up should involve dynamic stretches or motions; in other words, they should be comprised of actions similar to those you will do as part of the workout, just at a slower, more gentle pace. The goal is to warm up the muscles and get the blood flowing throughout the body. Static stretches can be done after the warm-up, or (as I prefer) after the workout; static stretches are the ones where you hold a certain position for a given amount of time.
  3. Get the right athletic footwear. Shoes are like tires; some work better in different situations, and some only work on certain models. As we age, many of us develop issues with our posture and the rest of our kinetic chain (think of the hip bone connected to the thigh bone…); proper athletic footwear can help us excel, avoid pain, and stave off injuries. Like tires, they also have a mileage limit; if the treads on your shoes are gone, time to get new ones. I recommend going to a shoe store that only sells athletic footwear; their employees are trained and can get you the right fit for whatever quirks your feet might present. Do not let me catch you barefoot or in socks!
  4. Switch it up. Do not do the same exercise day in and day out. First, you will get bored. Second, you may cause injuries due to overuse. It is also important to work all the various muscle groups; varying the workout can help make that happen.
  5. My favorite one: if you are not sure about how to begin, reach out to a fitness professional. Most gyms have personal trainers or other fitness experts who are happy to help; often, an initial session is offered for free so that you can get acquainted with the gym and its equipment. If you prefer to work out online or one-on-one with a trainer at home, there are personal trainers who specialize in these kinds of settings–and you will probably save money not having to pay for a gym membership. A trainer will make sure that you cover most of the points above and will help keep you on track. There’s nothing like a good personal trainer to keep you accountable to your goals.

Of course, injuries do happen. Sometimes there are accidents, and other times we have physical weaknesses of which we are not aware. While there are no guarantees, the points above are certainly excellent guidelines to keeping your workout–at home or at the gym–less likely to cause an injury.

The Most Wonderful Time of the Year?

Thanksgiving Dinner

Andy Williams sang, “It’s the most wonderful time of the year….” The holiday season ushered in by Thanksgiving is wonderful in so many ways: family gatherings, festive meals, joyous music, and fun family traditions. It is for many, though, the most difficult time of the year.

The holidays season puts a lot of stress on us. The continued emphasis on consumerism around Christmas and Hanukkah is not only stressful as we try to get the perfect gifts, but it also puts pressure on our financial situation. There is also the potential conflict that arises in families–you know that crazy uncle who always brings up politics! We may also be worried about meeting year-end goals. It is just a very intense time of the year.

I have blogged in the past about how to try to approach the holidays–and Thanksgiving, in particular–in a more healthy way. Last year, we had the added issue of families preparing smaller feasts given the isolation and reduced gatherings necessitated by COVID-19; for many, that is less of an concern this time around. For most people, this final part of the secular year becomes a battle against overeating; it is exacerbated by an extra busy schedule which might make finding time to exercise and get enough sleep challenging.

There are two key factors that I keep in mind as the holidays near.

1. Plan, plan, plan. Typically, my wife and I plan our menus out a week in advance. We know what we are going to have for each meal, create the shopping list accordingly, and thus avoid (mostly) purchasing foods that are less healthful. I plan as well for those days when I know there will be a lot of food around (Thanksgiving, Hanukkah, football games, holiday parties, etc.) so that I eat moderately the rest of the day; at the “event,” I do my best to drink lots of water and set simple rules for myself like “fill the plate one time only” or “skip the sides and save for dessert,” so that I do not gorge myself. As an aside, try to limit alcohol intake as it is dehydrating and often lessens our resolve to follow our rules. I also take a look at my week and day in advance to figure out when I will be able to work out; I am a personal trainer and I also teach fitness classes so this is a little easier for me, but there are days when I have to simply block out the time to make it happen. This time of the year calls for planning.

2. Be kind and forgiving to yourself (and others). It is almost inevitable that we will have a “bad” day. We may go into that holiday party with the best of intentions, totally prepared and planful, only to take one look at the baked salami, pecan pie, and spinach/artichoke dip and it’s all over. It happens to almost every one of us, including me. I do not beat myself up over it; I do not consider myself a failure. I am only human. Instead, I get back on track the very next morning. In the long run, one bad day is not going to ruin our health. What will be harmful is getting upset at ourselves, giving up, and turning one bad day into a bad week, month, or year. Recognize that there are times when we come up short; that is OK, and we just look forward. Be kind to yourself.

Finally, remember that this time of the year is not about obsessing about our eating habits and exercise. This should be a concern (not obsession) all year round. Take into consideration the special circumstances of the holiday season, but do not get overwhelmed. After all, with the gatherings, music, tradition, and treats–no matter what holiday(s) you celebrate or do not–it is really a most wonderful time of the year!

Weights? We Don’t Need No Stinkin’ Weights!

Pushups

As the pandemic wears on, more and more people who used to be regular gym-goers are realizing that it has been 18 months since they have stepped foot in a fitness center. Some have found other ways to keep fit, but many have simply stopped working out altogether. It is a sad reality, and one whose end is not necessarily in sight.

One of the issue stopping people from working out at home is that they lack the equipment found in gyms. I have been working virtually with clients (first for a local gym, and then in my own business “At Home Senior Fitness”) since the earliest days of the shutdowns in 2020. By now, many of my clients have at least a couple of dumbbells or perhaps some resistance tubes. Even so, I am able to put together workouts for clients that use body weight alone. This is especially helpful when clients are traveling and cannot bring equipment with them.

Is a body weight workout effective? The answer is a definitive yes. To paraphrase the classic film The Treasure of the Sierra Madre, “Weights? We don’t need no stinkin’ weights!”

Of course, there are certain principles that should be followed. As in workouts using weights/resistance, the best results occur when there is a pattern of progression. In other words, either increase the weight being used, decrease the rest period between sets, increase the number of reps and sets, etc. In a body weight fitness regime increasing the weight does not figure in, so it involves getting more creative. There are many ways to make the workout more challenging: single limb exercises, changing the angle, increasing tempo, introducing hybrid exercises, etc.

It should go without saying that this applies to resistance training, but it is also the case in cardio workouts. Treadmill, ellipticals, and stair climbers were created to replicate already existing body movements. Instead of a treadmill, one can walk or run on a street or trail; speed can be varied and (depending on where you live) so can incline. Running or jogging can replace ellipticals, although the impact on joints is much greater. Bicycle riding can replace a stationary bike, and one can simply climb stairs! We have become so accustomed to thinking that we have to go to the gym, but it is possible to be fit–and even “ripped”–without using equipment.

Finally, a body weight workout regime requires a lot of creativity. Every piece of equipment in a gym is designed to work a certain muscle or muscle group; these muscles can be exercised without that equipment as well, but it may take a fitness professional to help adapt them. Finally, a personal trainer can help to ensure that a body weight workout is not only effective and safe, but also fun!

Weights are great, but their absence should not be a reason for avoiding a workout. The good Lord gave us all bodies, and we can use them creatively to keep ourselves fit and healthy.

COVID-19 and the Mental/Physical Health Connection

Couch

Researchers have long known that there is a connection between physical and mental health. Physical activity releases hormones that are mood lifters; exercise is not necessarily a cure-all for emotional or mental ills, but it is a contributing factor in better outcomes.

The COVID-19 Pandemic has taken a huge physical toll in our country–not just in terms of the 600,000+ who have died of COVID-related illnesses, but also in terms of the tens of millions who were sickened by the virus but survived (some with long-lasting effects). Even those who were not infected have suffered stress from the situation. Some of that can be attributed to the relationship between lower levels of physical activity during the pandemic (due to closed gyms, group classes being limited, etc.) and negative mental health outcomes.

Idea Fitness Journal’s September-October, 2021, issue reported on a recent study by McMaster University in Hamilton, ON, Canada; the research looked into why people seemed less motivated to be physically active and what the perceived barriers were. The data showed that those whose mental health had worsened the most were also those who were the least physically active; that same group also showed the most improvement when they became more active.

Based on the study, the article suggested that individuals can become more active (and have better mental health outcomes) by:

–Scheduling activities (to eliminate decision-making and choice

–Do activites they personally enjoy

–Listen to their favorite music

–Train with a friend

–Try lower-intensity activiites

–Get creative; use body weight or whatever is available

–Go outside and be in nature.

Of course, another option for those who are demotivated because of the recent surge in COVID-19 cases, is to turn to on-line classes and training that can be done from home.

The issue is a complicated one and, as I said earlier, more exercise is not a panacea. There can be deeper issues at work that make the thought of more physical activity anxiety-inducing. As always, it is best to check in with healthcare professional if depression or anxiety prevent a person from carrying out activities of daily living, including exercise.

For most people, however, it is just a matter of planning ahead and taking the first step. The rest should come more easily.

Happy 1st Anniversary “At Home Senior Fitness!”

Cleveland Fireworks

I never thought I would own my own business, but here I am one year after At Home Senior Fitness trained its very first client!

What have I accomplished in that year?

  1. I have worked with two web designers to establish a presence on the internet: http://www.athomeseniorfitness.net.
  2. I have been supported by and supported the work of the Cleveland East Senior Network–bringing entertainment and joy to seniors in long-term care facilities, while creating connections with others who serve older adults.
  3. I have built my client list to over 30! The youngest are in their 50s and the oldest in their 90s. They are mostly in Ohio, but I train clients remotely in California, New Jersey, Illinois, and even Israel! I am joined in my fitness classes by folks from the Bronx to Vancouver.
  4. I have turned a profit and been able to re-invest in the business and give charitably.
  5. I have been interviewed for newspapers and radio for my expertise in working with older adults.
  6. I have maintained this blog; it now has over 300 followers.

Through it all, I have gotten to know some pretty amazing clients. The relationships are what make it all worthwhile; I have tried to be there for my clients and they have been supportive and flexible–especially when I was out for a few weeks after my kidney donation surgery.

Most importantly, I have watched my clients progress. They have become stronger and more flexible. Goals are being met. Nothing thrills me more than hearing “I went up the stairs and didn’t even get winded,” or “I walked four miles,” or “people tell me that they notice something different.” Everyone has engaged me as their trainer or group fitness instructor for a different reason; I am honored that they have entrusted me to help them reach their fitness goals.

What’s ahead for Year 2? Lots of exciting and new stuff is planned for the coming 12 months…but let me get through the Jewish High Holidays first!

Thanks to everyone (especially my wife who believed I could do this) for making me and At Home Senior Fitness the success that it is!

Testosterone Therapy or Exercise for Older Men?

Testosterone

The most recent issue of Idea Fitness Journal presented a summary of recent research results regarding the efficacy of testosterone therapy in promoting health benefits–especially cardiovascular–in older men. The article reports on studies from the University of Western Australia in Perth.

Many of us know that there has been a boom in sales of testosterone products for older men; they make all kinds of promises. Some are over-the-counter creams, while others are prescriptions available only through a physician.

The study at UWA looked at whether circuit training (a workout technique using different exercises in rotation with minimal rest, often with different pieces of equipment) had the same, less, or greater effect on men’s health than these products. The test followed 78 men aged 50-70 who had no history of CV disease, larger-than-normal waist circumference, and low-to-normal T-levels. Four groups were compared: T-therapy with exercise and without; placebo with exercise and without. Results showed that exercise increased testosterone levels, and that creams added even more. Most importantly, cardiovascular health improved more in those who exercised regardless of whether they had T-therapy. One of the investigators, Daniel J. Green, PhD., noted that while T-therapy seemed to increase muscle mass in legs, there seemed to be no benefit in arterial health and function.

A couple of take-aways for older men: 1. There is not magic pill (or cream) for better health; exercise, proper diet, and rest are still key. 2. The focus in older adults should be less on building muscle mass (although it is certainly desirable to maintain what is there), and more on maintaining and improving CV health if one wishes to avoid the maladies such as heart attacks and stroke.