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The Wisdom of Frank Part II

“Keep Your Legs In The Game”

I met my friend Frank when I was 21 years old and working out at a local gym.  Frank was sixty-eight years old and in great condition.  He had been a professional boxer, army fitness instructor, and then a physical education teacher.  Frank was an incredibly well read student of fitness and human performance.  He was stronger, more agile, and fitter than most people in their twenties.  Success leaves footprints, so I was eager to learn from a master.

Frank would work through some stretches, warm up and start in on the jump rope.  He was amazing with the rope.  Frank said an athlete was “nothing without his legs”.  “Power comes from the ground” and strong arms were useless without legs that could react.  He told me that keeping the “pop in your hop” was critical to successful aging.

Recent research on lower extremity power production and aging has proven Frank correct.  As we age, we lose lower extremity power nearly twice as fast as we lose strength.  Power production is what keeps us competitive on the field of play and safe during our daily tasks.  The current area of interest in exercise science has been the “discovery” of the benefits of lower extremity power training with older clients.  One of the best books on this subject is Bending the Aging Curve, by Dr. Joseph Signorile.  I read this book in 2011 and thought to myself, I heard all of this from Frank in 1979.

Michael S. O’Hara, P.T., OCS, CSCS

The New Year brings millions of people back to the gym, determined to make exercise a consistent part of their life.  Six to eight weeks later, they start arriving in the physical therapy clinic with sore lower backs, aching knees, post-surgical shoulders, and painful feet.  Injury is the number two reason people stop exercising.  Lack of results is number one.  In an effort to make everyone more successful at reaching his/her 2015 fitness goals, I have some suggestions:

Do less of what you are already doing

Most of us have occupations or hobbies that place far too much stress on one area of our bodies.  If your day consists of multiple hours of driving in a car, sitting at a desk, slumped in front of a computer, or planted in a recliner, do not go to the gym and sit.  If you use your hands all day to grip tools, pull on handles, or build widgets, do not perform 100 repetitions of resisted wrist and elbow exercises.  If you bend over and lift for a living, do not perform more forward bending during your fitness program.

Consider your posture

The question mark spine is as common as Under Armour in today’s fitness centers.  It is probably related to an overall lack of fitness and/or our newfound love of staring at social media.  It is a pain-producing problem that keeps physical therapists and surgeons busy.  If you resemble a human apostrophe, do not go to the gym and perform activities that pull you further into that posture.  Drop the medicine ball rotational crunches, stop doing the extremely slouched over barbell rows, and leave the “ab circuit” alone.  Perform activities that pull you up and out of the position.  Find a physical therapist or trainer for instruction on these activities.  Six weeks later, you will move, look and feel better.

It is always better to do too little than to do too much

Most fitness related injuries occur when training volume is ramped up too quickly.  Many of the internet and late night television fitness programs play a role in this all too common problem.  Rampage, Infinite Hypoxia, and the Warrior Death Workout have been wonderful for the physical therapy business, but they are less than ideal for the deconditioned person returning to fitness.  Remember, you are not a Navy Seal.  Have an honest conversation with a qualified trainer and let him/her help determine where you are on the strength and mobility spectrum before adding more to your program.

Have some respect for pain signals 

Physical Therapist: So, how long have you had that hip pain?

Patient:  Eight months.

Physical Therapist:  How did it start?

Patient:  Running on the treadmill.

Physical Therapist:  What do you currently do for exercise?

Patient:  I run on a treadmill.

In my work as a physical therapist, I have a version of this conversation once a week.  It has been my experience that the fitness beginner is more prone to this problem.  Ignoring pain and training through symptoms is a fantastic method of taking a fairly manageable problem and turning it into an inflammatory nightmare.  Pain is not “weakness leaving your body,” it is the disc bulging in your lower back, the meniscus being shredded in your knee, and the abdominal hernia evolving in your groin.

Set reasonable and worthwhile goals

If you watch infomercials for fitness products, you are bombarded with incredible fat loss testimonials.  Please remember the best body composition changes occur slowly and steadily.  Make those body composition goals, but also set performance goals such as being able to execute a full and pain-free squat, hike with your grandchildren, or do ten perfect push ups.  Consistent exercise can produce life changing improvements in health.  I can think of no better goal than being able to reduce blood pressure medication, normalize blood sugar levels, or decrease the use of anti-inflammatory medications.

Have someone help you

You know what they say about the lawyer who represents himself or the doctor who treats himself.  Losing fat, gaining muscle, and moving better are some of the hardest things to do.  Lots of people want to become more fit, but few people succeed.  If you have been away from exercise for some time consider hiring a qualified trainer to evaluate your present physical capacity and develop a training program.  A trainer will help you manage present physical limitations and make plans to conquer prior fitness challenges.  The people who enlist in some help do much better in developing and maintaining the fitness habit.

-Michael O’Hara, P.T., OCS, CSCS

Chair Check Up

How Functionally Fit Are You?

Image chair testCoaches, trainers, and scouts all want the number of inches in an athlete’s vertical leap test.  The athlete simply jumps up and taps a lever that indicates how many inches he or she can jump straight up off the ground.  This test has proven to be an excellent indicator of how well an athlete will perform in the competitive arena.  NBA players hit impressive vertical leap numbers, so we understand how simple it must be for them to elevate over the rim.  The equivalent test for the 60-year plus population is the Chair Stand Test (CST).  The score you get on the CST is a very reliable indicator of how well you will perform in the game of life.  

Leg power, strength, and lower extremity functional mobility are measured with the CST.  The ability to repeatedly move through the sit to stand transfer without the assist of the arms pushing down on the legs or the armrests of the chair is an important skill everyone needs to maintain an independent lifestyle.  An improved CST score creates carry over to other functional skills. Patients who improve their CST scores develop better gait patterns and standing balance.  

Chair Stand Test: You need a stopwatch, a stable chair with a 17 inch high seat, and an evaluator to monitor your performance and start and stop the timer
1.    Sit in the middle of the chair.
2.    Place your hands on the opposite shoulder with the arms crossed over the chest.
3.    Keep your feet flat on the floor.  
4.    Keep your back straight and your arms against your chest.  
5.    On the order “GO”, rise up to full standing and then sit back down.  
6.    Repeat for as many repetitions as you can in thirty seconds.  
7.    If you are halfway to a standing position when time expires, count that as a repetition.  
8.    Record your results and be concerned if you score below average.

The age adjusted scores for the CST listed below are a composite of the data gathered from several research studies since 2001.  The CST has proven to be a reliable assess-ment of fitness in older adults for over a decade.  Individuals who score below average on this test are more likely to suffer falls and require assisted care in their advancing years.  For the older fitness participant, knowing your Chair Stand Test score is just as important as knowing your blood pressure numbers. 

Men’s Results
Age                    Below Average       Average       Above Average
60-64                       < 14                   14 – 19                > 19
65-69                       < 12                   12 – 18                > 18
70-74                       < 12                   12 – 17                 > 17
75-79                       < 11                    11 –17                  > 17
80-84                       < 10                  10 – 15                 > 15
85-89                       < 8                     8 – 14                  > 14
90-94                       < 7                     7 – 12                  > 12

Women’s Results
Age                    Below Average       Average       Above Average
60-64                       < 12                   12 – 17                > 17
65-69                       < 11                   11 – 16                 > 16
70-74                       < 10                   10 – 15                > 15
75-79                       < 10                   10 –15                 > 15
80-84                       < 9                      9 – 14                > 14
85-89                       < 8                      8 – 13                 > 13
90-94                       < 4                      4 – 11                 > 11

Michael S. O’Hara, P.T., OCS, CSCS