Guest Columnist: Janet M. Caputo
Soft drink consumption has increased rapidly in the general population in recent years. Since carbonated beverages are now the preferred beverage, calcium intakes in North America fall short of current recommendations. Intake of carbonated beverages was associated with reduced bone mass and increased fracture risk both later in life and in children and adolescents. Colas were more strongly associated than other carbonated beverages.
Colas in particular may be associated with lower bone density for several reasons. First, individuals who prefer to drink colas substitute these beverages for more nutrient-rich sources such as milk and juices. Also, the caffeine in colas has been identified as a possible risk factor for osteoporosis. Moreover, colas contain phosphoric acid which has been shown to interfere with calcium absorption and contribute to other imbalances that lead to additional losses of calcium. Furthermore, the high fructose corn syrup used to sweeten carbonated beverages may negatively affect bone.
Consuming colas and other soft drinks from an early age can increase the risk of osteoporosis. Athletes and adolescent girls who consumed carbonated beverages had a greater risk for fractures because they were more likely to substitute soft drinks for milk and juices. The amount of bone mass obtained during youth determines skeletal health as an adult. Developing strong bones during adolescence protects against osteoporosis later in life. Normal bone growth requires proper nutrition including adequate intake of calcium, vitamin D, and protein as well as fruits and vegetables. Calcium is important because it is the main component of bone. Vitamin D and protein help the body absorb calcium. Fruits and vegetables limit the body’s excretion of calcium and provide other nutrients that contribute to greater bone density.
Colas that contain caffeine may contribute to osteoporosis. Bone loss was accelerated in elderly postmenopausal women who consumed more than 300 mg of caffeine daily (approximately 18 oz of brewed coffee). Caffeine interferes with the body’s ability to form bone cells, depresses the intestinal absorption of calcium and increases the urinary excretion of calcium. The deleterious effects of caffeine are more pronounced when the dietary intake of calcium is inadequate (less than 1000 mg per day) and less harmful when dietary intake of calcium is higher.
Although phosphorus is an essential nutrient, excessive amounts may be detrimental to bone. Increasing dietary intake of phosphorus stimulates the secretion of parathyroid hormone. Excessive parathyroid hormone increases the concentration of calcium in the blood by leeching it from the bones. Diets high in phosphorus and low in calcium are attributed to osteoporosis. Phosphorus intakes have risen 10% to 15% over the past twenty years because of the use of phosphate salts in food additives and cola beverages. Daily intakes of phosphorus in adults range between 1000 mg and 1500 mg, levels well above current recommendations of 700 mg/day.
Diets high in fructose and low in magnesium reduce calcium retention and produce greater losses of phosphorus. These dietary changes are of concern because the intake of magnesium has decreased appreciably over the last century while fructose consumption has been increasing rapidly since the introduction of high fructose corn syrup in 1970. This trend seems to be the most dramatic in children in the U.S. who are consuming large amounts of soft drinks containing high fructose corn syrup at the expense of foods containing adequate amounts of magnesium (whole grains, vegetables, nuts, and seeds) and calcium (milk and other dairy products). Magnesium deficiency decreases bone strength and volume, results in poor bone development, reduces bone formation, and increases bone loss.
Prevention of osteoporosis begins during childhood. Children need diets that focus on calcium, vitamins C, D & K, and protein. Adults may require supplements for these nutrients. Regular exercise using resistance training and weight bearing activities will maximize bone development and health. Consuming alcohol and soft drinks in small amounts is recommended. Avoid smoking and a lower than average body weight (Body Mass Index of < 18.5).
If you missed it, read Part I of this two-part series on osteoporosis, which defines osteoporosis and its causes.
Guest Columnist: Janet Caputo, PT, OCS, is associate at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she specializes in the practice of orthopedic and neurological physical therapy. She is currently a doctor of physical therapy student at the University of Scranton.
Definition of OsteoporosisOsteoporosis means porous bone (osteo means bone and porosis means porous). It is a disease in which bone loses mass or density, which leads to structural deterioration. Over time, this fragile bone is not strong enough to withstand the forces of gravity and changes may occur in the shape of the bone. In the spine, vertebrae which are normally shaped like square blocks, deteriorate and change shape to resemble a codfish. Then, the spine as a whole, changes shape and develops a forward curve called kyphosis. Kyphosis can cause a “hunch back” appearance. The deteriorated bone is more susceptible to fractures, especially in the spine, hip and wrist.
Osteoporosis is a very common problem. According to the National Osteoporosis Foundation, 55% of people over 50 years of age have osteoporosis. 80% of those with osteoporosis are women. One in two women and one in four men over age 50 will have a fracture related to osteoporosis in their lifetime. It accounts for 1.5 million fractures per year at an annual cost of more than 18 billion dollars.
Bone loss silently occurs without symptoms. If not tested, most people are unaware of bone loss until severe deformity, loss of height or fracture is noted. However, several risk factors should encourage regular testing:
Osteoporosis can be detected early by a painless and quick test called a Bone Mineral Density (BMD) test. Medicare and most other health insurers pay for the test every two years. If you are concerned and have several risk factors talk to your family physician about a BMD test.
While there is no cure for osteoporosis, being proactive can prevent, retard or stop the progression of this disease:
1. Well - Balanced Diet – rich in calcium and vitamin D
Calcium Rich: milk, leafy green vegetables, soybeans, yogurt and cheese
Vitamin D: produced in skin via exposure to sun, also in fortified milk
2. Healthy Lifestyle – avoid smoking and excessive alcohol use
3. Weight –Bearing Exercise – such as walking, biking, hiking, and cross-country skiing for the lower body (3-5 times per week 30-45 minutes) Wall or table push- ups and chest-press, biceps/triceps (light/moderate weight 10-15 times 3/week) for the upper body.
4. Start Early – the best prevention for osteoporosis begins in childhood with a healthy diet and lifestyle with exercise as above.
5. Continue Good Habits for Life – to maintain bone health but as you age talk to your doctor about calcium supplements with vitamin D. An adult under 50 years old requires 1000mg of calcium and 20 IUs of vitamin D. 1 cup of vitamin D fortified milk contains 302mg of calcium and 50 IUs of vitamin D.
6. Get Tested – talk to your family physician about Bone Mineral Density Test
7. Medication – in some cases medications are important to maintain healthy bone. Talk to your doctor about the most appropriate option for you. Currently the following medications are approved by the FDA for the prevention and/or treatment of osteoporosis:
Read Part II of this series on osteoporosis, which discusses the connection between osteoporosis and cola.
If you have been to a Lackawanna Trail High School football game in the past few weeks you might be wondering why running back, Josh Dixon, has not been on the field very much in the second half of the game. His father Brad recently contacted me, asking for advice. Josh has suffered from severe muscle cramps in both calves that were controllable in the first half of play with stretching and massage. However, after the halftime break his problems worsened. He was unable to play with and consistency in the second half. The cramps were so painful that he could not run two plays in a row. However, I am happy to say that he is improving each week. This problem is also common in endurance athletes. Participants in yesterdays Steamtown Marathon will surely relate to this column.
A muscle cramp is defined as an involuntary contraction or spasm of a muscle that will not relax. The tight muscle spasm is painful and debilitating. It can involve all or part of the muscle and groups of muscles. The most common muscles affected by muscle cramps are: gastrocnemius (back of lower leg/calf), hamstring (back of thigh), and quadriceps (front of thigh). Cramps can also occur in the abdomen, rib cage, feet, hands, and arms. They can last a few seconds or 15+ minutes. They can occur once or multiple times. It can cause a very tight spasm or small little twitches.
Although the exact cause may be unknown at this time, there are several theories why muscle cramps occur. According to the American Academy of Orthopaedic Surgeons, when a muscle is flexible and conditioned, the muscle fibers are capable of changing length rapidly and repeatedly without stress on the tissue. Also, overall poor conditioning or overexertion of a specific muscle leads to poor oxygen/carbon dioxide exchange and build up of lactic acid and cause a muscle spasm. Also, this process can alter muscle spindle reflex activity and stimulate the spinal cord to send a message to the muscle to contract. If uncontrolled this leads to cramps and spasm.
Muscle cramps are more common in hot weather due to loss of body fluids, salts, minerals, potassium, magnesium and calcium. This leads to an electrolyte imbalance which can cause a muscle to spasm.
See you family physician if cramps persist or worsen. There are other medical reasons for persistent cramps and spasms.
Read Dr. Mackarey’s Health & Exercise Forum – every Monday
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of Scranton, PT Dept.
Recently, while picking up my mail at the Dalton Post Office, I ran into Norm Brauer, town historian, author, friend and reader of my column. He said, “Hey Doc, I’ve been reading your column and want to know if you have any advise for old age?” I told him that he could probably give me advice about the merits of a healthy lifestyle and aging with dignity. Those who know Norm are well aware of his active lifestyle. Although he is well past the age most people retire, he keeps his body fit by walking several blocks to his office from his home every day. Furthermore, he benefits from life in a small town by walking to the town bank, post office, pharmacy, library, grocery store and deli. He keeps his mind active by reading, researching and writing articles and books on local history. He keeps his spirit healthy by sharing conversation with people who have known and respected him all his life.
However, Norm’s question is a good one. It raises many current issues. Is there a secret to a long and healthy life? Do genes control our destiny? How does lifestyle impact our health? According to the National Institutes of Health (NIH), while genes play and important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.
Physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity.
Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:
Some simple suggestions for beginning an exercise program are:
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.
Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.
Perform postural exercises throughout the day. Most of the day you are sitting, standing and reaching forwards flexing your spine. These exercises are designed to stretch your back in the opposite direction of extension. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day. One, tuck your chin back to bring head over shoulders. Two, pinch your shoulder blades together. Three, while standing, put your hands behind back, extend lower back 10-20 degrees. Four, lying on belly, prop up on your forearms to extend you back.
Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are: lying on your back and performing a pelvic tilt as you flatten you lower back into the floor; lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel; perform arm exercises such as biceps and triceps with light weight; while trying to hold an isometric contraction of your abdominal and lower back mucles.
Avoid sit-ups! Limit repeated flexion and torque on the lower back by
using core stabilization techniques to strengthen abdominal muscles.
When sitting, use an ergonomic chair and work station with a lumbar support and adjustable heights. Get close to your keyboard and monitor. Stand up and perform above postural exercises every 45-60 minutes.
When lifting, think twice. Be mindful of the weight, size and shape of the object. Also, consider the height of the object, handles or grips, location to place object and foot traction prior to the lift. First bend your knees and arch your back. Then, brace your abdominal muscles. Bend your spine forward as little as possible to pick up the load. Use legs, turn with feet, and do not twist spine with load in hands. When possible, get help to lift very heavy loads and push rather than pull. Immediately following the lift, stand up straight and stretch lower back into extension.
If you walk or stand most of the day, wear good shoes. Avoid high heels and shoes without adequate support like sandals.
If you drive long distances, use a lumbar support to keep an arch, sit close to your steering wheel to prevent bending forward and stop to stretch using the above postural exercises every 45-60 minutes.
Performed 2-3 times per week, 20-30 repetitions with light weights through full range of motion
Avoid spinal loading from overhead lifting such as military or overhead press
3-4 times per week for 30-45 minutes at moderate intensity.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Contributing Author: Janet Caputo, PT, OCS
A bad marriage, an unhealthy relationship, a cruel boss, and a troubled economy are all potential causes of stress because they can produce feelings of anger and depression. There are physical, mental, emotional, and behavioral signs associated with stress:
Physical signs: dizziness, general aches and pains, grinding teeth, clenched jaws, headaches, indigestion, muscle tension, difficulty sleeping, racing heart, ringing in the ears, stooped posture, sweaty palms, tiredness, exhaustion, trembling, weight gain, weight loss, and upset stomach.
Mental signs: constant worry, difficulty making decisions, forgetfulness, inability to concentrate, lack of creativity, loss of sense of humor, and poor memory.
Emotional signs: anger, anxiety, crying, depression, feeling powerless, frequent mood swings, irritability, loneliness, negative thinking, nervousness, and sadness.
Behavioral signs: bossiness, compulsive overeating, critical attitude of others, explosive actions, frequent job changes, impulsive actions, increased use of drugs or alcohol, withdrawal from relationships, and withdrawal form social situations.
We will continue to rid the roller coaster of life until we die. Managing emotional stress will not only make this ride an enjoyable one but also protect us from heart disease!
Contributing author Janet Caputo, PT, OCS, is a physical therapist specializing in the management of orthopedic and sports injuries with a special interest in vestibular rehab and falls prevention at Mackarey Physical Therapy in downtown Scranton. She is presently a completing her doctor of physical therapy degree at the University of Scranton.
Read Part I of this two-part series on stress and heart disease.
Contributing Author: Janet Caputo, PT, OCS
My father had a cardiac arrest ten years ago. Luckily, he survived but he required coronary by-pass surgery. I could not figure out why my father had heart disease but did not have any of the “risk factors” typically associated with heart disease: heredity, obesity, diabetes, high cholesterol, high blood pressure, and smoking. I remember wondering if “stress” was a significant factor. My father does not cope with stress very well and he is a “Type A” personality. Medical researchers are not sure how stress increases the risk of heart disease but more and more evidence suggests a relationship between the two.
There are different types of stress. For example, physical stress such as exercise and other forms of physical exertion can place good demands on heart. In fact, the lack of physical stress (e.g. a sedentary lifestyle) is a major risk factor for heart disease. However, emotional stress, if severe and chronic enough, can also cause heart disease.
Emotional stress can be caused by many factors including minor daily hassles to major lifestyle changes: illness, death, screaming children, nagging boss or spouse, new job, unemployment, traffic, pregnancy, crowds, legal problems, and financial concerns. Our emotional responses to these and many other situations determine if we are experiencing good stress or bad stress. If we feel that we are in control of our lives and our destinies, we are in a better position to manage stress when faced with a difficult choice or when placed in a challenging situation. However, if we feel that the circumstance or situation controls us, our responses, we will feel out of control and experience bad stress. Also, our personality can be a factor in our perception of stress. If we have a “Type A” personality (e.g. time-sensitive, inpatient, chronic sense of urgency, tendency toward hostility, perfectionist, and competitive), we may be creating our own emotional stress! For example, a simple trip to the grocery store will be filled with episodes of bad drivers, poorly-timed traffic lights, crowded aisles, ignorant check-out clerks, and thin plastic bags that rip too easily.
Researchers are not sure if emotional stress is a direct or indirect cause of heart disease. As a direct cause, emotional stress has been shown to constrict coronary arteries, cause blood to clot more readily, increase heart rate, and raise blood pressure. Also, emotional stress can trigger an increase in cholesterol levels by causing the body to produce more energy in an attempt to adequately respond to increased stress. Increasing the body’s cholesterol, raises HDLs (good cholesterol) as well as LDLs (bad cholesterol). Furthermore, emotional stress increases the production of cortisol. Cortisol stimulates fat and carbohydrate metabolism for fast energy in addition to insulin release for maintenance of blood sugar levels. The end result of these actions is an increase in appetite. Emotional stress that stimulates your appetite may cause weight gain. Moreover, cortisol can affect where you put on the weight. Cortisol tends to cause fat to deposit in the abdominal area rather than at the hips. This type of fat deposition has been strongly correlated with the development of heart disease.
As an indirect cause, emotional stress can cause people to participate in bad habits that are associated with heart disease. Overeating may be an attempt to fulfill a psychological need. People that overeat because of stress often binge on “comfort” foods that are high in fat, cholesterol, and sugar. These foods are associated with significant weight gain. Also, emotional stress can trigger depression. Depression can not only cause indulgence in comfort foods but also reduce motivation for physical activity and exercise. Moreover, an individual experiencing emotional stress may attempt to reduce stress by participating in dangerous activities such as smoking and alcohol abuse.
No one can escape from emotional stress because it is a normal part of everyone’s life. We must learn to manage stress effectively so that stress can be used as a motivational tool rather than as an implement of self-destruction.
Contributing author Janet Caputo, PT, OCS, is a physical therapist specializing in the management of orthopedic and sports injuries with a special interest in vestibular rehab and falls prevention at Mackarey Physical Therapy in downtown Scranton. She is presently a completing her doctor of physical therapy degree at the University of Scranton.
May is National Women’s Health Month! No topic may be more important to woman’s health than menopause. According to the North American Menopause Society (NAMS), 1.5 million American women reach menopause each year. The median age is 52, but some women will reach menopause as early as 40 or as late as 58. Recent research revealed that women who engaged in three hours of exercise per week for one full year reported improved mental and physical health.
Menopause begins when women’s ovaries are depleted of healthy eggs. Typically, women are born with 1-3 million eggs which are lost over the course of a women’s life through ovulation and other natural means. Under normal conditions, a reproductive hormone called follicle-stimulating hormone (FSH) stimulates the growth of the eggs during the first half of the menstrual cycle. As a women approaches menopause, the eggs become more resistant to FSH. Additionally, the ovaries produce significantly less estrogen, a hormone that affects the blood vessels, heart, bone, breasts, uterus, skin and brain. Many of the symptoms associated with menopause are due to the loss of estrogen. These symptoms include: hot flashes, irregular or skipped periods, insomnia, mood swings, fatigue, depression, irritability, racing heart, headaches, joint and muscle pain, decrease sex drive, vaginal dryness, and loss of bladder control. While not all women get these symptoms. Most women experience various degrees of some of these symptoms.
As stated above, a recent study in the April 2006 Journal of Advanced Nursing, found that women who engaged in 3 hours of exercise per week for one full year reported improvement in mental and physical health as compared to the control group. The program consisted of cardiovascular, stretching, strengthening, and relaxation exercises.
In another study in the April 2007 Annals of Behavioral Medicine, researchers found that women who walked or performed yoga reported improvements in quality of life with less anxiety and stress related to their menopause symptoms. It is believed that exercise stimulates a release of endorphins in the brain and this is the primary mechanism by which exercise relieves symptoms associated with menopause.
Consult with your family physician before you begin an exercise program, especially if you have health issues. Exercise to control menopause symptoms does not have to be extreme. A simple increase in daily activity for 15 minutes 2 times per day or 30 minutes 1 time per day is adequate to improve your symptoms. This can be simply accomplished by walking, swimming, biking, and playing golf, tennis, or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes 4-5 days per week with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for 5-10 minutes, 2-3 times per day. Then, add 1-2 minutes each week until you attain a 30-45 minute goal.
Visit your doctor regularly and listen to your body.
You are never too old to exercise! This is the second of two columns dedicated to appropriate exercise for the elderly. Last week I discussed basic strengthening exercises. This column will address three additional components necessary for independence in the elderly: flexibility, balance and endurance. While it may not be as valuable for those fortunate to be over 75 years of age and capable of running, skiing and playing tennis, you may still find a noteworthy pearl of wisdom.
Why would someone 75 or 80 be interested in a basic exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
Remember, for most people it is more harmful not to exercise, so contact you physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Flexibility Exercises involve moving the arms, legs and trunk through comfortable range of motion to give you more mobility in order to improve your ability to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. Best if performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with slight stretch sensation and no pain. No bouncing or overstretching!
These exercises are to be performed while sitting in a chair with a backrest, slowly, 5 repetitions, 3-5 times per week.
To Be Performed While Sitting In A Chair With A Backrest:
Shoulder Raise – clasp hands together, raise arms up to forehead, then above head, as high as comfortably possible
Hands Behind Head – raise arms behind head by first touching ears, then back of head
Hands Behind Back – bring arms behind back by first touching the side pocket, then back pocket and toward small of back as comfortably possible
To Be Performed While Lying On Back In Bed:
Knees to Chest – bring knee toward chest using hands. Right Leg 5 Times – Left Leg 5 Times - Both Legs 5 Times
Leg Spread – Spread legs apart by sliding heels on bed
Leg Cross – Bring legs together touch by sliding heels on bed
Gas Pedals – pump ankles up and down like gas pedal
Balance Exercises involve strengthening muscles that keep the body upright and stable in standing in order to improve your ability to perform daily activities without falling. According to the NIH, 300,000 US hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of chair to hold onto for support.
Examples of Balance Exercises
Sitting Squat – Squat up and down in a chair. First use both arms to assist, then one arm.
Standing March – March legs up and down while holding onto countertop
Standing Scissors – Bring leg out and cross over like a scissors one leg at a time
Standing Squat – Squat down by bending at hips and knees 20-30 degrees while holding onto countertop
Dance – Slow dancing with a partner is great fun and a very helpful exercise to improve balance.
Endurance Exercises involve any activity such as walking, swimming, biking or raking leaves that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only 5 minutes and add 1-2 minutes each week or 2. Wear good and comfortable shoes – no heels!
Examples of Endurance Exercises
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
Walk Around the House – Start walking around the house for 1-2 minutes nonstop every 1-2 hours. Then, add 1-2 minutes every week.
Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.
Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
Recumbent Bike – If balance is a problem, but you can tolerate more extensive endurance exercise, use a recumbent bike (a bike with a backrest)
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
You are never too old to exercise! A reader who described herself as “elderly” asked me if she was too old to exercise. Without knowing her age, I replied that she was not. I did qualify my response with the fact that exercise must be adjusted to meet the individual needs of a person based on age, health status and goals. Her question, however, led me to think of the many “elderly” who may be apprehensive to begin an exercise program for a variety of reasons. Fear of injury and lack of information may be two reasons. Another reason, according to this inquiry, is the fact that so many exercise programs in the media are geared to the young and healthy or baby boomers and few are focused on the needs of those over 75, home bound and weakened by age and inactivity. Those running, skiing, golfing at 75 and over and do not fall into this category, please do not be offended, you are the exception. God bless you!
Why would someone 75 or 80 be interested in an exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
The National Institute of Health (NIH) recommends four areas of concentration for elderly persons to concentrate on in order to maintain safety and independence: strength, flexibility, balance and endurance. It will be the purpose of this column to recommend safe, practical and easy exercises that focus on each of these categories.
Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Strength Exercises involve using the muscles to move the arms and legs against resistance such as a weighted object, dumbbells, resistance bands, and body weight against gravity. Strength is necessary to perform daily activities such as walking, lifting a ½ gallon of milk, transferring to a shower or chair safely.
These exercises are performed while sitting in a chair with backrest, slowly, 5 -10 repetitions, and 3-5 times per week. No weight is used in the beginning, only the weight of the arm against gravity. In 1-2 weeks a light 1-2 pound weight and light resistance band may be added.
To Be Performed While Sitting In A Chair With Backrest:
Shoulder Shrug – shrug top of shoulders up toward the ears
Row the Boat – pull both arms back at a 45 degree angle with bent elbows as if “rowing a boat"
Saw Wood – pull both arms back with arms at side with bent elbows as if “sawing wood"
Elbow Bend/Extend – bend and straighten elbows
Wrist Curl – bend wrist up and down
Grip – squeeze ball
To Be Performed While Sitting In A Chair With Backrest:
Hip Hike – lift hip up 2-4 inches as if “marching”
Hip Spread – with heels on the floor, spread knees apart
Hip Squeeze – with heels on the floor, squeeze knees together
Leg Kicks – extend knee as if kicking the foot forward and up
Heel Raise – raise heel up with toe on floor
Toe Raise – raise toes up with heel on floor
Performed Standing While Holding On To Counter Top:
Standing Leg Curl – facing and holding onto the countertop, bend the knee by bringing the foot back
Once you have mastered these exercises against gravity, then advance to using light weights or light resistance bands. Ankle weights are very inexpensive and can be purchased in 1 pound increments. Light resistance bands are available in yellow and red in colors.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
