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Fitness training for those of us past 40 years of age is more complicated.  Physical performance and recovery capacity are dramatically different.  If you need proof, look for the forty year olds in the NBA or NFL.  The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime.  I have compiled a collection of tips for the forty plus fitness client. 

Train Like A Bodybuilder: Build More Muscle Mass

017It is rare to sit down with new clients who list building muscle mass as one of their primary goals and this is quite unfortunate.  The most common goals include:  tone up, lose weight, continue doing the activities I enjoy, improve balance, and build strength.  It’s important to know that every one of these goals is enhanced with more muscle mass.

The first thing people need to understand is that building muscle mass is not an easy process, and the older you get, the more challenging it becomes.  However, this goal of building or maintaining muscle mass should be at the forefront of your fitness journey.  Having more muscle mass will make you stronger, improve your balance, protect your body from traumatic injury, and better support/stabilize your joints.  More muscle mass (assuming no increase in body fat) will lead to a more toned looking physique, even without losing body fat.  A larger amount of muscle mass will increase your resting metabolic rate which will make it easier to decrease body fat and allow you to eat more without accumulating more body fat.

Muscle hypertrophy (the process of increasing muscle size) is primarily in response to training volume (sets x reps x weight).  There are a variety of ways you can go about accomplishing this goal, but the general idea is that training volume will need to increase over time–the weight you lift, the number of sets, or the number of reps. It is important to note that along with needing enough total training volume you will also need to have sufficient protein intake.  For most people, 0.7-1g/lb of body weight is recommended for this purpose.

-Jeff Tirrell, B.S, CSCS, Pn1

Halos And Around The Worlds Are The App For That

halosMuch like the collision avoidance computer systems built into automobiles, our brains run neural software that prevents us from overloading and damaging the spine.  If we are unable to adequately stabilize the spine, our neural injury avoidance system prevents us from loading the arms and legs in positions that will produce a spinal injury.  Developmentally, we master the capacity to control the muscles in the middle of the body first.  What this means for the average fitness participant is that hip/shoulder exercise activities have little value if we do not possess adequate spinal/pelvic girdle stability.  Training that enhances the coordinated control of the “muscles in the middle” enables our neural system to produce more efficient, graceful, and pain-free movement.

Halos and Around the World drills improve the coordinated control of the pelvic girdle and spinal stabilizers.  They act as a “neural reboot” of the software that controls stabilization of the spine and pelvic girdle.  These exercises are easy to learn and require minimal equipment.  An Airex pad under the knees makes the exercise more comfortable and you can use a kettlebell, sandbag, or an Iron Grip weight plate for resistance.

Kettlebell Halos in Tall Kneeling
Assume a tall kneeling position on the Airex pad.  The knees are under the hips and the toes should grip the floor.  Grip the kettlebell by the horns in an inverted position.  Make the shoulder girdle muscles active by pulling out against the horns of the ‘bell.’  Brace the gluteals and abdominal muscles and maintain a tall and stable posture during the exercise.  Start with the ‘bell’ in front of the chest and circle the kettlebell slowly around the head in the shape of an angel’s halo.  Perform three to five halos in clockwise and then three to five counter clockwise.

Sandbag Around the World
Assume a half-kneeling position on the Airex pad.  The left knee is under the hip and the toes of the left foot should grip the floor.  The right knee is in front of the hip and the foot is flat on the floor.  I like the unstable “shifting resistance” provided by a sandbag for this exercise but you can also use an Iron Grip weight plate.  Make the shoulder girdle muscles active by pulling out against the handles of the sandbag or Iron Grip plate.  Brace the gluteals and abdominal muscles and maintain a tall and stable posture during the exercise.  Start with the bag or plate in front of the body at belly button level.  Take the implement around the body in a very slow and steady fashion.  Each repetition should take at least six seconds to complete.  Do not permit the body to shift or shake.  Perform three to five cycles in clockwise and then three to five counter clockwise.  Switch the leg position and repeat with the right knee down and the left leg forward.

For the next six weeks, perform one of these exercises at every training session.  It is surprising how many people report improved capacity to squat, lunge, overhead press, and get off the floor with some dedicated neural retraining of the “muscles in the middle.”

Video demonstration of kettlebell halos and sandbag around the worlds can be seen here: https://youtu.be/LGodn9ImRqc

Michael S. O’Hara, P.T., OCS, CSCS

Bear_PawGetting up and down off the ground is a movement skill we need to maintain.  It is the functional exercise activity that keeps us safe and independent for a lifetime. Developing proficiency in getting up and down off the ground has multiple benefits.  It takes away fear, builds confidence, and increases activity in other areas of life.  Your fitness training should involve activity that makes you better at moving gracefully in and out of the positions necessary to get up and down off the ground. 

Getting up and down off the ground is largely a neural activity.  Nearly everyone has enough strength, range of motion, and balance—you just need some practice.  Physiologically, we know that movement practice makes transmission of neural signals more efficient.  Research on motor learning has taught us that repetition, ascending challenge levels, and coaching produces the best results.  The bear paw exercise is a good starting point for improving from the ground up movement skills.

Bear Paw Performance

You need a medicine ball and some open space.  Get down on the ground in an all four stance with the medicine ball under the left hand.  Brace the abdominal muscles and lift the knees up off the ground about six inches.  Maintain that suspended position and roll the ball forward and backward with the left hand, like a bear pawing the ground.  Keep the right shoulder blade down the back and the neck free of tension.  Perform ten repetitions, lower down, and rest.  Switch to the right hand and repeat the drill.  Perform three times on each side.

View video explanation of the bear paw exercises here: https://www.youtube.com/watch?v=gGcsbv-BqfU

Michael S. O’Hara, PT, OCS, CSCS

Fitness training for those of us past 40 years of age is more complicated.  Physical performance and recovery capacity is dramatically different.  If you need proof, look around for the forty year olds in the NBA or NFL.  The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime.  I have compiled a collection of tips for the forty plus fitness client. 

Manage Eccentric Muscle Loading

sledDuring the concentric portion of a lift, the muscles shorten as the load is moved.  In the eccentric phase, the muscles gradually lengthen as the load is lowered in a controlled manner.  Eccentric muscle activity (lengthening under tension) produces more muscle micro trauma and, therefore, requires more recuperation time.  It is the eccentric aspect of a resistance exercise that creates delayed onset muscle soreness.

Older fitness clients do not possess the same recovery capacity as younger individuals.  Utilizing exercise activities that reduce eccentric stress is a valuable training tactic.  Concentric biased training allows older trainees to perform a greater volume of work and be ready a day or two later for the next training session.
Sled work is my favorite “concentric only” fitness activity.  The muscles shorten to propel the sled and never have to lengthen against resistance.  You can push, pull, row, and press a sled at fairly high levels of exertion and still sufficiently recover between training sessions.

Loaded step ups are a predominantly concentric contraction, lower extremity strengthening exercise.  It teaches balance, core control, and improves single leg strength. The eccentric aspect of a loaded step up is minimal and this makes it an essential exercise for older fitness clients.

My favorite upper extremity eccentric only training device is the Surge 360.  The Surge provides resistance through a series of multi-directional pistons.  All exercise activities on the Surge are concentric only.

Resistance tubing is another tool that can help manage eccentric muscle activity.  The force curve (increased load as the tubing is lengthened and decreased as it gets shorter) helps reduce muscle activity during the eccentric aspect of many exercises.
-Michael S. O’Hara, P.T., OCS, CSCS

In an effort to get back into shape, Monica added some stadium step running to her fitness program.  She went to the high school stadium and made twenty trips up and down the bleachers.  The initial sessions went well but after the first few weeks her knees started aching and the pain began to interfere with activities of daily living.  Monica tried some anti- inflammatory medications and ice but neither produced any relief.  She recently arrived at our physical therapy clinic for some help with her knee pain.

Running stadium steps is a demanding exercise activity that will produce a strong metabolic response.  Unfortunately, stadium steps are too stressful for most people.

Risk/Reward Ratio of the Stadium Steps
shutterstock_385922764For deconditioned individuals, stadium steps fall on the risk side of the risk reward ratio.  Most overweight and “out of shape” fitness clients have tight and weak hips.  They are inefficient in the skill of decelerating their body down the stairs and that skill deteriorates as they fatigue.  They need to use training methods that reduce orthopedic stress and limit biomechanical overload.

Stadium steps are a high level fitness activity.  It is the calculus of mathematical learning.   Deconditioned and overweight individuals need to start with basic algebra before venturing into quantum physics.  The better approach is to get fit first and then add stadium steps to your workout after you have improved strength, body composition, and mobility.

Run hills instead.  I have switched many stadium stepping physical therapy patients to running up and walking down hills.  It is a more forgiving form of fitness training than stadium steps and the benefits are superior.

Your Inner Gladiator
If you insist on stadium step training, I have some suggestions.  Spend six weeks strengthening your hips.  Most deconditioned folks, sit all day and have poor strength/strength endurance in the hips.  Weakness in the hips permits the knees to collapse inward on your downward bound through the steps.  I like bridges, hip lifts, mini band squats, and walking lunges.  See my recent article and video on my favorite gluteal strengthening exercises.

Foam roll the outside, inside, back, and front of your hips, thighs, and hip rotators.  Most stadium stepping pain patients are a big basket of myofacial restrictions.  They writhe around on a soft roller and look at me like I am crazy.  Restoring the mobility of the fascia that encapsulates the deceleration muscles of the hip will help improve performance.

Run up and walk down, softly.  It is the step descent that causes the biomechanical stress on the muscles and joints.  As you travel down the steps, think about actively engaging the gluteal muscles and decelerating with the hips and not the knee.  The louder the impact on the descent the more likely you are an inefficient decelerator.  Have someone watch you as you travel down the steps.  If your knee collapses inward, you need to get off the steps.
Build up slowly.  Do not start with twenty flights.  Start with three trips and gradually build up your work capacity–once a week is more than enough for most folks.  Find other training modalities that are less stressful.  Being too aggressive with a training program is one of the big reasons people fail with fitness, and it keeps me busy in the clinic.

Monica was, by her own account, twenty pounds overweight.  Her hip mobility was less than ideal and she had prior history of hip pain problems.  She had diminished hip range of motion and limited strength in her hamstrings and glutes.  During assessment of her deceleration skills, Monica tended to land in a collapsed inward knee position.  We had Monica perform a program of mobility and strengthening exercises for both hips and rest from all “cardio” activities.  Her knee pain resolved and she was able to return to a program of fitness training.
-Michael O’Hara, P.T., OCS, CSCS

A physician friend sent me this recently released research article on the benefits of maintaining strength and muscle mass as we age.  I think everyone should take the time to read this article.  We are keeping people alive for longer periods of time, but how well are they living?  The discussion of the extension of life span compared to enhancement of health span is worthy of consideration.  Improving muscle mass and strength dramatically improves quality of life, a factor often not given enough consideration.

10522_2015_9631_Fig1_HTMLAge-related sarcopenia is the loss of muscle mass as we age.  Sarcopenia and functional disability travel hand in hand.  Combating sarcopenia has become a hot research topic as greater numbers of the American population pass through old age and the cost of their care becomes an issue.  The good news is that age-related sarcopenia is a very treatable condition.  The bad news is that it takes some education and effort.   When discussing the need for strength training, these are the top questions/concerns I get from physical therapy patients and fitness clients:

OK, how much, how difficult, and how often?
After the eye rolling, this is the question I get from most of my sarcopenic patients.  The research training programs that successfully reversed age-related sarcopenia involved four to seven progressive resistance exercises performed for a total of twelve to twenty sets.  The participants trained two or three times a week and the level of perceived exertion fell into the mild to moderate regions.  You are looking at 90 – 150 minutes a week of mild to moderate exercise.  The important, and often completely missed, aspect of progressive resistance training is that you increase the resistance or load lifted as you become stronger.

Can’t I just do yoga, golf, tennis, hot yoga, swim, walk, chair yoga, tiddly-wink, Pilates, underwater yoga?
I am sorry but the research studies have not found that these training modalities produce the necessary stimulus to combat age-related sarcopenia.  You can still perform all of these activities– just include a consistent program of progressive resistance strength training.

I don’t know what to do…
Poor exercise selection and beginner’s enthusiasm are the biggest reasons people fail with progressive resistance strength training.  Exercise is like medicine, administer the correct prescription at the proper dose and the results will be good.  Just like a visit to your physician, it all starts with an evaluation.  You need to start at a level that makes you better and not broken.  Get instruction from a qualified coach and follow his/her plan.  A big warning- the world of fitness is filled with many “certified experts” -–it took them a full weekend to complete their training.  These experts keep us busy in the physical therapy clinic.

You can view the research article here: http://link.springer.com/article/10.1007%2Fs10522-015-9631-7
-Michael O’Hara, P.T., OCS, CSCS

treadmillFitness training for those of us past 40 years of age is more complicated. Physical performance and recovery capacity are dramatically different. If you need proof, look for the forty year olds in the NBA or NFL. The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime. I have compiled a collection of tips for the forty plus fitness client.

Manage Spinal Compression

As we age, changes occur in the joints, discs, and muscles that make up our spine. A lifetime of driving and sitting at a desk can create soft tissue restrictions and postural flaws. Statistically, the primary predictor for a future injury is a prior injury. By the age of 45, over 80% of the population will have lived through either a lower back or neck pain problem that was so severe it required medical attention. If you are older and have a history of lower back or neck pain, you should manage the level of spinal compression during your fitness program.

Compressive forces are at work on our spine from the moment we stand upright in the morning until we retire to our bed for a night of sleep. In the world of industrial ergonomics, we work to limit compressive forces that workers experience at the job site because we know increased compression produces more injuries. Recent dynamic imaging tests of lower lumbar and cervical spines placed under compressive loads have revealed surprising changes in disc dimension and spinal position. Rehabilitation and fitness professionals are now more aware than ever that the daily compressive forces our spines encounter is a major driver of pain and disability.

One third of our spinal length is made up of intervertebral discs—that is why we get shorter as we get older. Intervertebral discs are made up of compressible tissue. Under normal loads the discs can deform and then bounce back to their normal height, but inappropriate loading can damage the discs and alter their ability to absorb forces and create motion. Thinner discs create greater intervertebral joint stress and the environment for “wear and tear” breakdown of the spinal joints. Smoking, diabetes, and occupational sitting are some of the health and environmental factors that make you more susceptible to the damaging effects of excessive spinal compression.

Most people are unaware of the many fitness activities that create compressive forces on the lumbar spine. Treadmill running (greater if you hold on the treadmill handles), leg press, rowing machine, crunches, and leg lifts all create a compressive loading of the lumbar joints and discs. Be aware of the accumulated level of compression you place on your spine during a week of exercise. If you are uncertain which activities place a compressive load on the lumbar spine, you need to work with a physical therapist or an educated trainer.

-Michael S. O’Hara, P.T., OCS, CSCS

Fitness training for those of us past 40 years of age is more complicated.  Physical performance and recovery capacity are dramatically different.  If you need proof, look for the forty year olds in the NBA or NFL.  The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime.  I have compiled a collection of tips for the forty plus fitness client.

Reduce Sitting in Your Life and Never Sit Down and Exercise

trainingMost of us already spend too much time in a seated position.  The last thing you need in your fitness program is more sitting.  Movement happens in an upright, standing position.  “Seated exercise” is an oxymoron.  If you want to improve how your body functions, you must stand up and defy gravity.
Injuries happen in an upright position.  I have never treated someone with a recliner related anterior cruciate tear or an office chair induced ankle sprain.  Nearly every sport is performed in a standing position.  If the goal of your exercise program is to improve how your body functions and reduce the risk of an injury, then your exercise activity should be performed in a standing position.
“But Mike, what about all those fancy machines?”  Seated, prone, and supine exercises are devoid of core stabilization and balance demands.  Isolated muscles are trained and the remainder of the body is neurologically asleep.  Seated exercises also reinforce poor postural habits and diminish your capacity to move.   I call it the “illusion of exercise,” and it will always be highly visible in commercial gyms because it is easy to sell.
Researchers on health and longevity have labeled prolonged sitting “the cigarette smoking of fitness.”  Prolonged sitting produces all sorts of spinal and joint restrictions that contribute to the postural flaws that are rampant in offices across America.  The more worrisome issue is that those of us who spend more time sitting are statistically more likely to die earlier.  All things equal, the people who stand more are healthier.  They have better blood lipids, less hypertension, and fewer vascular problems.  Unfortunately, you cannot undo the ill effects of eight hours of daily sitting with two or three visits to the gym a week.
Make an effort to stand more during your day.  Ditch the ergonomic wonder chair in your office and throw out that recliner.  Try using a chair that physically reminds you it is time to stand up and move around every twenty minutes.  I am a big believer in stand up desks and have created many happy converts.
-Michael S. O’Hara, P.T., OCS, CSCS

Mr. V had pain inman_falling his lower back and right hip. The problem had been present for over a year and he had been diagnosed with spinal stenosis. He was sent for physical therapy by his family physician because he was having difficulty climbing the stairs and walking in his home. Mr. V was 78 years old and lived with his wife Miriam. Miriam reported that her husband had mild dementia and had fallen three times over the last month. Mr. V stated that he often felt dizzy when he got out of bed, but he was not sure why the falls happened. Miriam stated that they did not bother to tell the doctors about these falls.

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PDFIn this month’s issue, Mike O’Hara discusses hypermobile joints and exercise, 4 steps to fitness success are given, and information on how to stop back pain from disturbing sleep is presented.  Check out page three for a description of the latest class offered at Fenton Fitness– Suspension Shred.

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