Protecting those Knees

As we age, we hear more and more about people requiring knee surgery or even knee replacement. While the knee is not the most complicated joint, it is one that gets a lot of use and bears a lot of weight. It is important to be cognizant of the proper form while exercising to avoid injury; in particular, doing lunges or squats the wrong way can put a great deal of pressure and stress on the knee.

When we talk about the knee, we cannot just talk about the bones (the femur, tibia, patella, etc.) but also about the tendons, ligaments, and cartilage. All of these are susceptible to strain and injury. Working with a fitness professional is one way to help ensure that knees stay healthier–or at least avoid serious damage.

A new study referenced in the most recent issue of IDEA Fitness Journal reaches some enlightening conclusions about the connection between exercise and the risk of physical harm to the knees. As a runner (although I run less now than I used to), I always worried about the risk to this all-important joint; I assumed that our knees were like tires: they last for certain amount of miles and then they need to be replaced! Researchers at the University of Southampton and University of Oxford (both in England) found that the benefits of exercise–even for the frail and elderly–outweights the risks with regard to our knees. The study focused on the likelihood of developing knee osteoarthritis from physical activity. 5000 participants were followed for 5-12 years and the data suggests that neither the amount of energy spent in physical activity or the length of time were associated with a risk of developing arthritis.

This is good news; my last blog post focused on a related idea. Many people are afraid to work out for a variety of reasons–including injury. Studies show that the more information that can be shared with those beginning an exercise regimen, the greater the chances of success; that information should include debunking myths and stressing the benefits of exercise (versus the risk of not) as well as setting proper expectations of what the process will be like.

My knees have not worn out (yet), but it is good to know that it does not appear that years of running and physical activity might lead to knee arthritis in the future. One more reason to go boldly ahead keeping myself fit for whatever the future brings.

Overcoming Fear of Exercise

On an intellectual level, most people understand that exercising is good for us. On an emotional level, it is a little more complicated. Many of us are afraid to begin a program of exercise because we may think that it is too late, that we will get injured, that it will be too difficult, that it will not make a difference, etc. This becomes even more challenging for older individuals and/or those with long-term health conditions (LTCs).

I was diagnosed with Crohn’s Disease when I was 12 years old. This auto-immune digestive disease has all kinds of “embarassing” symptoms, but one of the main problems for me was that it was difficult to maintain a healthy weight (I was underweight), and my energy levels were lower than normal. As a result, in high school, I was excused from Physical Education classes; this did not set me on a path of healthy habits and fitness. It took over 25 years for me to realize the importance of taking care of my whole body and actually do something about it. Thank goodness, I have been in remission for a long time and am in great physical condition.

A recent statement in the British Journal of Sports Medicine, addresses this issue. The Physical Activity Risk Consensus group at University of Edinburgh in Scotland advises that while the benefits of physical activity for those with LTCs outweigh the risks, work needs to be done to properly prepare these individuals for what they will face when they begin exercising. It is all about setting proper expectations and readying them for how their bodies may react. The statement addresses 8 specific concerns: 1. neuromuscular pain, 2. fatigue, 3. shortness of breath, 4. cardiac chest pain, 5. palpitations, 6. elevated blood sugar levels, 7. cognitive impairment, and 8. falls and frailty. This all sounds kind of scary, right? The researchers say that those with LTCs can be helped to overcome their fears and reticence by having informed conversations with healthcare providers about the risks; this is why we always say, “Talk with a healthcare professional before beginning any exercise program.” Each case is different, so concerns will vary, conditions will not be the same, and point of entry will be unique. Looking at some of the 8 concerns above, it can be explained that some muscle pain is normal and that it will lessen as the body acclimates to the new routine. Fatigue and shortness of breath are normal when exercising. This should be accompanied with a clear description of the benefits of physical activity and how it can lead to reducing the occurrences of these 8 concerns.

Working with older adults, I am constantly reminding my clients of why we are doing what we are doing. I will say things like: “this exercise is strengthening the muscles that will help you walk better,” or “the more you practice doing this activity, the better your balance will be and the less likely you will be to experience a fall.” Fear is real. It stopped me when I was younger–when more physical activity was actually what I needed; I wish that there would have been a doctor who would have prepared me to leave my comfort zone. Thankfully, I eventually did…but it took a quarter of a century.

Manage expectations–both in terms of results and challenges–and most individuals, including those with LTCs, will have a greater chance of better health outcomes. The research backs it up.

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.

Osteoporosis and Weight Training

It has been a long-held perception that as we age we need to be more careful and not “overdo it.” While it is true that older adults should take appropriate caution with physical activities, research overhwelmingly shows that being active–including weight training–is associated with better health outcomes. Sometimes it happens in unexpected and surprising ways.

Osteoporosis is a condition in which bones bones become weak and brittle; this condition is especially prevalent in older women. Under normal circumstances the cells in our bodies are constantly dying and being regenerated; this includes our bones. Osteoporosis occurs when bone tissue is reabsorbed into our bodies at a faster rate than it is replaced. The bones (osteo) become porous (porosis) as shown in the picture above. They become especially susceptible to fracture.

How can it be treated? Proper diet and medications are effective, but so is weight training. Wait! What? We are going to ask people with brittle bones to lift dumbbells?!?! As a matter of fact, this is a great way to strengthen bones. Our bodies respond to stimuli according to the SAID principle. SAID stands for Specific Adaptation to Imposed Demands. What this means is that when we make our bodies act in a certain way, it will change physiologically to accomodate those new requirements. As an example, postal workers who have a walking route (as opposed to sitting in the mail truck) often have stronger legs and amazing calves. Likewise, folks whose work requires them to do heavy lifting of packages will develop larger arm, shoulder, and back muscles. Their bodies have adapted specifically to the demands opposed on them.

How does this work with Osteoporosis? When we train with weights, our bones get the message that they need to work harder and get stronger; the bones respond by creating new tissue at a faster rate. Lower body bones can also be strengthened by weight-bearing exercises like walking.

Is this dangerous? Like any physical activity, there are always risks. Those with Osteoporosis should be aware of their surroundings to avoid injuries and falls which can result in broken bones. They should also avoid high impact activities like jumping or those that require jerky or sudden movements. Otherwise, there are few restrictions with regard to just how heavy those weights can be.

It seems somewhat counterintuitive to put stress on brittle bones but, in fact, it is one of the best things to do for Osteoporosis. As always, consult a healthcare professional before embarking on any new fitness regimen, and let your fitness professional know of any conditions that might impact your health and safety. Otherwise, do not be afraid to pick up those weights; your bones will thank you!

Important Info for Older Adults about Organ Donation

As some of you may know, I just got my brand new “Donate Life” license plate–just in time for National Organ Donation Day, February 14. The plate reads: GV1KP1 (Give 1, Keep 1)–referring to my kidney donation this past May. I am pretty excited to have it on my car, as I hope it will encourage others to consider organ donation.

Those of you read my previous posts know that I was quite surprised that I was able to donate my kidney in the first place; this was because of my past and current medical history. Although I am in good shape, keep myself physically fit, and in a healthy weight range, I am by no means in perfect health. I was also approaching 58 years of age; the surgery took place the day after my birthday. If I am being honest, I was fairly certain that I would not qualify and was somewhat shocked when I did.

When people think organ donation, I believe they mostly consider organs donated when someone has died; this gets a fair amount of press–and rightly so–when something positive is able to come from something tragic. This is certainly a source for many of the organ donations that take place, but it is preferable to have a living donor for certain procedures; obviously, heart donations cannot come from a living donor (or at least one that will survive the operation!). For kidneys and livers, it is preferable to have the tissue come from a living donor.

Is there an age at which one is too old for a transplant? For recipients, the question is a complicated one. Age is a number and there are some 80-year-olds who could not tolerate such major surgery, whereas others might come through it with flying colors. Each hospital system’s transplant program has its own guidelines. When it comes to donating an organ, many of the same factors are taken into account. There are some people into their 70s and even 80s who have been qualified to donate–and the recipients have benefitted from their lifesaving gift.

As I wrote in another blog post, never assume that you cannot make a difference. Do not automatically believe that you are not going to qualify to do something that will save another person’s life or dramatically increase its quality. Age is just a number. The better we take care of ourselves, the more likely we are to live life to the fullest and be able to give to others in meaningful ways.

Interested in learning more about organ donation? Visit http://www.donatelife.net.

I’m a Contributor

It’s official! The latest issue of Northeast Ohio Boomer & Beyond is out and I am proud to be an official “contributor” to this publication on matters of Fitness for Older Adults.

In speaking with the editors several months ago, they told me that they had felt that this topic was one that had been missing from the magazine. Luckily, someone in the advertising department was a client of mine at a gym where I worked previously and recommended me. I have been interviewed for radio programs and articles in the Cleveland Jewish News on older adults and fitness, but this is my first regular gig. Now I will appear in every forthcoming issue; the magazine is published six times per year. Additionally, some of my blog posts will be featured on their website.

I am honored to have been chosen to be a regular contributor. It is always satisfying to be recognized for one’s hard work and expertise.

If you are in NE Ohio, check it out or hit the link above to see the article.

Losing a Client

Most personal trainers worry at some point about losing clients. If they leave for another gym, another trainer, move out of town, or just decide to stop training it can be a hit–not only to our wallets but also to our egos. There are other circumstances, however, when none of that really matters.

Just a couple of weeks ago, one of my clients passed away. When I began specializing my personal training career to only working with older adults, I knew that the day would come when this would happen. This client had a number of health issues; in his younger years, though, he enjoyed athletic activity and overcame some serious injuries. His long-term outlook was not good. In the short-term, however, his family felt he would enjoy working with a trainer at the fitness center where he lived.

Each client comes with his/her own capabalities and limitations, and he was no different. I enjoyed the challenge of putting together different workouts each week for him. I understood that there might not be room for great improvement in his mobility; at the very least, we would be working to maintain the levels where he was. I was impressed by the effort he put in; I know the workouts were not easy, but athletes almost always love and are up for the challenge.

About a month ago, he called me and told me that he had tested positive for COVID-19 so we would have to skip the session that week. I checked back a week later and his wife said that things look bad. A few days later he was gone. I received a text from a family member with the news, and a thank you for having made a difference in the short time we worked together.

In the fitness world (as in most industries), we talk about the importance of results. With regard to our own health and fitness, we know that there is much we can do to influence our own personal situations. In the end, however, we all succumb to the impermanence of our physical state. Does that mean that the work I do with older adults is in vain…or worse a scam? On the contrary, if I can add independence, value, and fun to someone’s life, this means something. We all know what our end will be; what we do not know is what will happen between now and then. I am proud that I am able to help my clients remain more vibrant, capable, and independent so that they can get the most out of that “between now and then.”

The loss of this client was a humbling experience for me. It makes me realize how crucial it is for me to do my work well. It also taught me that the working with clients is about more than just results or the “business;” it is also about the relationships that can be built and the difference that can be made.

Rest in peace, friend. I imagine you are up there somewhere tossing a football around with friends, no longer limited by the toll that time has taken on your body. Thanks for the time and effort you put into our time together. May your memory be a blessing.

It’s Not Your Age That’s Slowing Your Metabolism

Older adults are used to hearing that a natural part of the aging process is that our metabolism will slow down; the metabolic rate is the rate at which our bodies burn calories in order to keep our vital systems functioning and allow us to do the things we do on a regular basis. As we age, most of us find that slowly but surely our weight increases; it seems that as our metabolic rate decreases (assuming everything else stays the same, like exercise and diet) the pounds begin to add up. We are just not burning calories at the rate that we used to.

An article in Science, reports that our assumptions are actually incorrect. Our metabolism is not slowing as we get older simply because we are aging, but rather because a number of other factors come together to decrease our levels of activity. Leading a more sedentary lifestyle due to work, home responsibilities, technology–and even the pandemic–is behind those decreasing metabolic rates.

A recent article on http://www.cnn.com, explains the issues and concludes that this research is good news for older adults. If aging is behind our decreasing metabolism, then there is nothing we can do to reverse its effects; we are simply stuck in a downward spiral. What the research shows is that we actually have it in our control to maintain and increase our metabolism as we get older.

The article suggests four main strategies:

Be active throughout the day. Many of us spend hours at a time at a desk (or on a couch) with little movement. Even little bursts of activity throughout the day can raise metabolic rates.
When you exercise, do the right types for maximum metabolic effect. HIIT exercises are recommended because they raise the metabolic rate and keep it elevated even after the workout is over; check out my blog post on HIIT for more info. Additionally, strength training (working with weights and other types of resistance) has a similar effect.
Make sure to get enough protein in your diet and keep hydrated. The simple act of eating increases our metabolic rate because it takes calories for the digestive system to do its job; consuming proteins (especially after a workout) can help to build muscles which cause us to burn more calories. Drinking water–aside from its other positive assets–can raise our metabolic rate too.
Get plenty of rest. Not sleeping enough can lead to a myriad of health problems. Allowing our bodies to adequately refresh and re-energize can help counteract the negative effect of these maladies. It is recommended that adults get at least 7 hours of sleep each night.

Metabolic rate decreases are not a done deal as we age. There is much we can do to counteract the effects of being sedentary, not exercising enough, eating a poor diet, and being overtired. It is all in our power–not part of some process beyond our control. This is good news indeed!

What Could Possibly Go Wrong (Part II)

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.

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.
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.
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!
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.
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.

One Year as a Self-Employed Trainer

Today marks one year since I left my position as a trainer at the local JCC. I had worked there for over two years and it was the first position I got after my certification. I am grateful for the friendships and experience that I got, and that management was willing to take a risk in hiring an “old guy” like me. Being new to the Cleveland area, it was a great way to connect with the local Jewish community as well.

In late summer 2020, though, I decided that I wanted to branch out and try training privately. It was certainly slow at first, but the pandemic actually helped. Many folks felt uncomfortable/unsafe going into fitness facitilies and either wanted to train virtually or one-on-one at their home. Within a few months it was apparent that I was onto something; there was a need for someone who worked exclusively with older adults, understood their particular needs, was affordable, and convenient. I knew it was a big leap to go out on my own, but I also knew that, as they say in Yiddish, “you can’t dance at two weddings.” In other words, it is difficult if not impossible to grow a new business while still employed somewhere else. If I wanted to At Home Senior Fitness to thrive, I would need to give it my full attention. November 15 was my last day at the JCC and I have not looked back.

I am really happy to report that I have a full book of clients. I am working with a great group of older adults and am gratified to see the progress they are making. I have clients from as far west as the Bay Area in California and as far east as Ashkelon in Israel. I am training virtually, in-home (within 5 miles of my home), and leading a regular fitness class on-line three times/week. My clients range in age from 58 to 93. Some are quite agile and active; others are recovering from strokes and other serious health conditions. A hallmark of At Home Senior Fitness is that the program is never “one size fits all;” each client has a fitness plan designed especially for them that will keep them safe, injury-free, and working toward their goals.

The biggest news is that I was recently tapped by a local publication for older adults to be their “expert” on fitness. I will be a regular contributor with a column appearing in each issue. This is really exciting and a great opportunity to expose many seniors to the idea of keeping fit as we age. I will share more details as I am able.

I look forward to what the next year will bring. Stayed tuned for more exciting announcements about what is planned for 2022.

Finally, a big thank you to my clients and to all those who have supported me on this journey (especially my patient wife!). You all give me a reason to be up and at ’em each day!