Exercise and “Water on the Knee”

Knee in PainHi Chris,

I’m a youthful, energetic senior – 66 years of age. I certainly enjoy your articles and responses. I love to jog, walk and am an avid gardener. Lately, however, I have developed “water on the knee”. It sure is curtailing the above activities. My doctor has advised “wrapping it”, applying ice, and I take anti-inflammatories when it is really bothering me. X-rays were done and no arthritis is present. I realize positions and activities which place pressure on the knee joint should be avoided. I cannot recall any trauma to the knee-maybe the repetitious “up and down” motion involved in gardening is the culprit.

Can you suggest some activities or exercises that may be helpful with this problem ? My doctor tells me there is no quick fix and no doubt she is right. Come spring, would love to be able to continue with my gardening hobby. Can you offer some feedback on this problem? Thanks in advance.

Bev in Nova Scotia

Hello Bev

Sorry to hear about your “water on the knee”. It’s good that no arthritis is present as that can often be the case. “Water on the knee” is a phrase applied to a whole host of conditions which cause fluid build-up and inflammation around the knee joint. As a term, it is only descriptive and does not tell you the cause, much like saying you have “dermatitis” or “inflammation of the skin”. The question then is what caused the condition? The answer to the question will not only help you treat it but will also help you know what to do to avoid it in the future. Your doctor has given you good advice about wrapping and icing the joint. You may also try elevating it when there is new inflammation present. Following the RICE principle (Rest, Ice, Compression, and Elevation) will help reduce inflammation.

As to the cause of the condition, you may have torn one of the menisci in the knee or damaged a ligament. Also there can be inflammation of the busa (bursitis) which can also cause fluid to build up around the knee. Since you don’t recall having injured the knee, it may be more of a “wear and tear” problem, perhaps from gardening or quite possibly jogging. Does jogging irritate your knees at this point? The pounding of the foot onto the pavement, especially if you do not have supportive footwear or have weak ankles, can cause a ripple effect up through the shin and into the knee. It’s something you might want to think about. It may be time to give the jogging a break and try something with lower impact such as using an elliptical trainer or recumbent bike. Another good aerobic exercise which is very forgiving on the joints is aqua-fit.

I suggest that you consider visiting a sports medicine clinic. Your insurance may cover this if you have a referral from your family doctor. Either way, it’s good to keep your doctor informed. A sports medicine clinic will have practitioners such as physiotherapists who may be able to help you determine what has caused the condition and more importantly what you can do to avoid a recurrence. They will be able to prescribe specific exercises you can do that involve stretching to increase mobility about the joint and resistance exercises which will increase the muscular strength supporting the joint, for example the thigh and calf muscles. It is important to progress slowly. Employing light resistance with bands or tubing is a good idea but a good sports medicine clinic should be able to prescribe a set of exercises you can follow.

Your doctor may suggest having the knee drained or other surgeries, which can bring relief. The main thing is that if you choose to have the area drained of the fluid, get to the root of the problem so that you won’t just get a recurrence afterwards. Where there is inflammation, there is protection from stress and strain. You will want to find the source of that stress and strain, try to eliminate it or mitigate it, and develop a strategy to support your joint for the future.

Talk to your doctor again or see a physiotherapist and tell him or her that you want to continue being active but want to find out how to treat the area effectively and keep it from coming back.

Good luck and let me know how you’re progressing.

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Exercise and Knee Surgery

Knee X-rayDear Chris,

I am a 69-year young lady who has gone to pot! I am booked for double knee replacement in March 2007. Please advise what core and quad strenghthening exercises I can do to help with my surgery and my overall health.

Thank you.

Marg, Hamilton, ON

Dear Marg,

You are doing the right thing in planning for your surgery now by performing strengthening and flexibility exercises. The stronger you are when you go into surgery, the faster you will recover. The surgeon will most likely recommend a course of physiotherapy. Once this rehab program is finished, you should get right back into a regular exercise routine.

So, before surgery I would suggest you strengthen the muscles surrounding your knees (quadriceps, as you mentioned) and also the back of thigh (“hamstrings”), as well as both the front and back of calf. I’ve listed common exercises (with alternate names in brackets) for each muscle group.

1. Quadriceps: Knee (or Leg) extension exercises.

2. Hamstrings: Knee (or Leg) curls.

3. Front of calf: Toe Lifts (or dorsi-flexion).

4. Back of calf: Heel raises (or plantar flexion).

I suggest you use resistance bands or tubing for these exercises unless you have access to a leg curl/leg extension machine to do exercises 1 and 2. Regardless I suggest you choose enough weight (or resistance) that you fatigue the muscle after 15 – 20 repetitions. This means choosing a lower weight or resistance level than you would for muscle building. Depending on your current fitness level and the extent of arthritis in your knees, you may be able to start with a blue band but more likely a green or red(lighter resistance) one, assuming you are using Theraband brand. If you purchase this brand of tubing or bands, they often have exercise brochures at the place of purchase. Alternatively, there are good exercises on their website. They even haveexercises specifically for knee osteoarthritis.

Be sure to follow these exercises with stretching. I would suggest you perform the stretches every day, not just on your muscle strengthening days. Be sure to stretch the area for at least 20 seconds. Go into the stretch until you feel a tug or some tension but no pain. Hold the stretch but continue to breathe.

You also mentioned core work. Choosing the most effective core exercises will depend on whether or not you can get up and down from the floor. Many traditional abdominal and lower back strengthening exercises can be done on a chair. Since I don’t know your situation, I cannot safely recommend the best ones to do.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Aerobic Exercise vs Aerobics Classes

Aerobics Step ClassDear Chris,

I am a 58 year old woman with bad knees who is trying to get back into shape. Everything I read tells me that I should be doing aerobics several times a week, but my doctor says that I shouldn’t do aerobics because all the jumping and stepping will wreck my knees. Is there something I can do besides aerobics? How often do I need to do it?

Thanks,

Eva

Dear Eva,

The confusion over aerobic exercise and aerobics classes is a common one. Let me first explain the difference and then comment about aerobics classes.

When we talk about doing aerobic exercise or physical activity, what we are really talking about is doing something which makes your heart pump faster. This type of activity is also called endurance activity and will exercise your heart. And like any muscle, your heart will get stronger with exercise. The stronger your heart, the more efficient it is in getting blood to your lungs and the rest of your body. Having a heart made strong with aerobic exercise will also help protect you against coronary heart disease and high blood pressure.

Aerobic simply means “with oxygen” and this type of exercise makes you breathe faster and harder in order to get enough oxygen to your lungs. This action causes your heart to beat harder in order to pump the oxygen-rich blood it receives from the lungs to the rest of your body. Stated simply, aerobic exercise promotes better blood circulation, making your body stronger and you healthier.

And now a few words about “aerobics” exercise.

Exercise classes featuring activity which causes you to breathe faster and harder are often called “aerobics” classes, although that term has fallen out of use in the past years. Group exercise classes, as they are more recently called, may be entirely aerobic in nature, be mainly for muscle conditioning, help with balance and flexibility, or be a combination of any of these. Many group exercise (or “aerobics”) classes are high intensity but may or may not be high-impact. While some involve a lot of jumping and stepping, something your doctor has told you to avoid, many others are low-impact, use other props instead of steps, and do not involve any fancy footwork. Group exercise classes are a fun and sociable way to get into shape. For many people, it’s the only exercise they do since they choose classes that include resistance and balance training using such things as body bars, free weights, and stability balls.

I highly recommend taking group exercise classes but only take ones where you feel comfortable with the level of activity and be sure you are not doing anything to harm your knees. When in doubt, ask the group fitness instructor about the nature of the class and be sure to tell him or her about your limitations. A good instructor will be up front with you and will recommend not taking a class if he or she thinks that it will be too high-impact for your condition.

Many gyms and recreation centres offer group exercise classes for older adults, which typically are slower-paced and use no impact movements. Sometimes younger people with physical limitations will attend a class for older adults because they can exercise at a slower pace. And some older adults attend classes geared to younger people but they exercise at a slower pace and work within their own limits.

Whether you choose to go to a group exercise class, a small group training class, work with a personal trainer, or workout on your own, be sure to include aerobic exercise in your routine. And don’t just limit it to the gym. Besides exercise, incorporate physical activity that is aerobic in nature every day.

Health Canada recommends doing aerobic (endurance) activity 4-7 days a week, working up to at least 10 minutes at a time and totaling 30 to 60 minutes a day. Some low-impact activities are brisk walking, swimming or aqua-fit, cross-country skiing, cycling, and hiking. For more information, see Canada’s Physical Activity Guide for Older Adults.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Men and Flabby Chests

Dear Chris,

I am 71 years old and have been working out for the past 2 years. I have lost about 20 pounds and feel good. My question is: How do I deal with the flabby chest? It is the only area of my body which has not responded to my work-outs. I am 6.1 and weigh about 190 lbs and about 15 is pure fat “boobs”. Thanks for any advice.

Bill

Dear Bill,

It’s great to hear that you are working out regularly and have also lost some weight. Your question about flabby chest is a good one. As we age, there is both an increase in fat and a redistribution of that fat, even though our body weight may not increase or even decrease somewhat. That is because with the increase in fat, there is a natural decrease in muscle and bone mass. What you are doing when you do resistance exercises (weight training) is slowing down that process so keep up the good work.

However, some of the decrease in muscle is due to changes in our hormonal balance, which also happen as we age. So, although you are combatting the changes that occur with disuse, you can’t entirely reverse the clock. I’m assuming that you have put on some muscle as you’ve increased your physical activity. Are you increasing your muscle size, firming up the muscle you currently have throughout your body, or just working on certain areas? You should be exercising all of the major muscle groups regardless if some areas have more fat than others.

One way to help combat the “flabby chest syndrome” is to work on your pectoral (or chest) muscles. Although you can not “spot reduce” in any one area, you can continue to lose fat by being active and you can firm up and even increase the size of the muscles that are hidden underneath the fat. That combination of bigger and firmer muscles along with continued fat loss will reduce the flabbiness in your chest area.

How is your mid-section? Do you still have excess fat around your gut? This is more important than in your chest area since fat in that area is very portable and can play havoc on your blood cholesterol levels. Fat in the chest is more of a nuisance than anything else. If you still have excess fat overall, you may not see the flabby chest reduce much unless you lose a bit more weight. Don’t get me wrong, 190 lbs is not bad for someone who is 6′ 1″, but you may still be 15 or 20 lbs overweight (depending on the size of your frame). If you continue to lose the weight gradually and if you build up the pectoral muscles, you should notice a change in the flabbiness. You may not ever get in to a perfectly firm chest, but you should see continued results even at 71.

So, let me know what you are doing for your chest in terms of weight training. That will help me determine a little more if you can be doing specific exercises to help firm that area up. Maybe you could also tell me roughly what your weight loss pattern has been say in the past few months. Are you losing consistently and if so, roughly how much per week? Are you eating a balanced diet? These are all important factors to consider.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Body Composition Changes and Exercise

Baggy PantsDear Chris,

There is so much talk today about losing weight. What about retaining weight and muscle? I am an energetic, healthy 66 yr. old female. It seems of late my appearence is changing. I have lost fat from my posterior or “rear” but overall weight hasn’t changed. Are there specific exercises that I can do to firm up in these areas ?

Bev

Dear Bev,

The changes you are seeing are changes in body composition, the make-up of our body mass, primarily as fat, muscle, and bone. Even with physical activity, changes in body composition occur as we age. One of the biggest changes we notice is the redistribution of fat and the decrease in muscle mass (sarcopenia). For women in their 60s, fat starts to form in the mid-section as it does with men at a much younger age, even if they were not overweight previously. The distinction between the female “pear-shape” and male “apple-shape” becomes less pronounced by the 7th decade. However, subcutaneous (under the skin) fat tends to decrease in the limbs in both genders. There is also notable bone loss in post-menopausal women. With all of these changes to body composition, body weight often stays the same or even goes down a bit. This is why body weight (measured on the scales) is not a good way to judge body composition and overall health.

During this period of gains, losses, and redistribution, it is very important to be physically active and exercise regularly. Many of these changes come with higher risk of illness (morbidity) and loss of function and independence. Fat in the mid-section, for example, has a high potential to be released into the liver, becoming a risk factor for high cholesterol and Type II diabetes.

A lot of these changes were not that relevant in generations past because life expectancy was lower. Now with most people living well into the 70s and 80s and many living into their 90s, it is important to lessen the impact of these changes so those extra decades can be lived as comfortably and vitally as possible.

Bev, you are well on your way to good health by being active already. Just make sure that your activities are varied enough so that you are getting cardio-vascular, muscle conditioning, balance, and flexibility training. You asked about specific exercises you could do to firm up the areas which seem to have lost some muscle tone.

I recommend doing wall squats and other thigh and buttocks exercises. These will not only give you a firmer buttocks but will greatly assist you with activities of daily living.

Doing a wall squat:

  • Stand against a wall, ideally with a soft 8 inch ball at top of buttocks.
  • Stand with your feet shoulder-width apart and toes pointing forward.
  • Move your feet out about 2 1/2 times your foot length from where you were standing.
  • Keep back straight and abdominal muscles tight, with knees slightly bent.
  • Slowly squat towards the floor as if sitting on a chair, shifting your body weight back onto your heels, and keeping your upper body parallel to the wall.
  • Lower yourself until your thighs are parallel to the floor. (Do not go further than this. You can go less, if you have any knee pain.)
  • Take note of the position of your calves. When you are in the seated position, they should be perpendicular to the floor (straight up and down, not leaning forward). If not, move your feet further out from the wall. This will ensure that you do not put undue strain on the knees.
  • Make sure that your feet are pointed forward so that your knees are in line with your shoe-laces.

To help reduce the fat you may have gained, make sure that you are active aerobically by doing such things as vigorous walking, cycling and everyday activities like gardening and housework. It’s also a good idea to add formal, structured exercises, by going to fitness classes, swimming, using a treadmill, elliptical trainer, or stationary bike. A variety of these activities is best because they all challenge the heart and lungs differently. By burning extra calories and not compensating for that loss by over-eating, you can expect to lose weight that will stay off–unlike the yo-yo effect that comes with so many of the commercial diets.

Additionally, incorporate resistance training to help you build back the muscle you are losing with age. I mentioned wall squats for the thighs and buttocks. You can also do leg raises and thigh “kick-backs” lying on your side on a mat. You will be surprised that just lifting your leg slowly and controlled against gravity, especially if you relax your foot as if it were a dead weight, will provide enough resistance to strengthen the leg. Alternatively you can add ankle weights or use resistance bands (my favourite). If you have access to gym equipment, you can do leg presses, hip extensions, leg curls, and knee extensions on the machines there.

It is also important to strengthen the core (abdominal regions and lower back). While lying on your back, you can do abdominal curls, or try lifting a stability ball by squeezing it between your ankles with your knees bent. This will do wonders for firming up the tummy. And don’t forget your lower back — you will want to strengthen the muscles which support it by doing exercises such as alternate arm/leg lifts while lying on your stomach.

Walking is a great way to not only strengthen the heart and lungs (provided it’s a vigorous walk) but also to reduce bone loss in the lower body. (Bones that bear weight grow stronger.)

So, the main message to improve your body composition is:

  • Incorporate aerobic activity into your daily life to help burn more calories, especially calories from stored fat
  • Do resistance training to increase muscle mass and help curb bone loss

You may not see any weight loss, but you will start noticing body composition changes: less fat in the areas which pose health risks, stronger and firmer muscles, and stronger bones. Apart from an aesthetic improvement, you’ll feel better and be healthier for it.

As always, talk to your doctor first before beginning any exercise program to ensure that you make the modifications needed if you have medical or health conditions which could be worsened by certain types of activity. I’d also recommend hiring a personal trainer if you want some specific instruction or help with motivation.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Exercise and Heart Disease

StethoscopeDear Chris,

Am I more prone to heart attacks and other coronary issues if I exercise when I’m older?

Steve in Toronto

Dear Steve,

Engaging in cardio-respiratory or aerobic exercise will actually reduce your chances of having a heart attack or developing coronary Heart Disease. This type of exercise will make your heart stronger, help reduce your resting blood pressure, and keep your circulatory system running smoothly. However, this type of exercise does come with some risks and reducing those risks depends a great deal on your overall health. The risk of developing coronary heart disease or having a heart attack does increase with age. However, the conditions that lead to coronary heart disease are more related to lifestyle factors (and sometimes genetic ones) than to the aging process itself. Often people don’t know they have coronary heart disease until they suffer a heart attack, especially if they had not exhibited symptoms like angina before or were never diagnosed with it.

That being said, there is a small risk of suffering a heart attack while exercising. There are definitely things you should keep in mind when starting an exercise program at any age but especially as you get older. If you’ve been sedentary or are overweight, chances are your heart is not as healthy as it should be. You should first see your doctor and let him or her know that you want to be more active. He or she may order a stress test to determine what your target heart rate should be. If your doctor has some concerns, he or she may give you a safe target heart range within which to exercise. Otherwise, there is a formula you can use to calculate it (see below). Either way, proceed slowly.

If you haven’t been active, don’t try to make up for lost time and jump into your program full force. Unless your doctor has given you other instructions, warm up for 5-10 minutes first at the low end of your target heart rate zone (see below). As your body warms up and your heart gets ready to exercise at a stronger intensity, you can gradually bring your heart rate up higher. Much of what you determine to be a safe exercise intensity zone will depend on your own health as well as medications you may be taking (some medications can affect your heart rate).

There are different ways to calculate your target heart rate zone. Here’s a common and conservative way, ideal for beginners:

  • First, subtract your age from 220. This will give you your age-predicted maximum heart rate. For example, if you are 65, then your age-predicted maximum heart rate is 155 beats per minute (220-65).
  • The lower limit is generally 60% of this number. For a 65-year old, this would be 93 beats per minute (155 times 60%). Your warm-up heart rate should not exceed this lower limit, and in any case should never exceed 100 beats per minute.
  • The upper limit is generally 80% of the age-predicted maximum heart rate — in this case, 124 beats per minute (155 times 80%). You should not work out above this rate.

Using a target heart rate zone is only one way of determining safe exercise intensity levels. There are other measures such as the Talk Test and the Rate of Perceived Exertion. When I am working with clients, I always ask them to say a sentence out loud (and I don’t mean two words!). During the warm-up, they should easily be able to speak conversationally. They should also describe their exercise intensity level as “light” on the Rate of Perceived Exertion scale (I’ll talk more about this in an upcoming column). Once they are past their warm-up and are exercising more intensely, they should need to take a breath at the end of a sentence but they should not be feeling uncomfortable (nauseous, dizzy, lightheaded). Similarly, they should describe their level of exertion as “somewhat hard” or “hard” on the Rate of Perceived Exertion scale.

The most important thing to remember is to give your heart a chance to get stronger gradually. It needs time to adjust to this new level of demand you have placed upon it. But with patience and perseverance, you will reap the benefits of a strong and healthy heart.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Is exercising a pain?

Neck painDear Chris,

How does one know which comes first – the chicken or the egg? If you’ve got a painful elbow, or a creaky shoulder, how does one decide whether or not it NEEDS exercise to resolve it, or whether exercise will exacerbate it?

Vicky

Dear Vicky,

Many people wonder if exercise will help or hinder their ailment, especially if they are new to an exercise program. When people feel aches and pains in their joints, especially if they have been there for quite some time, they want to be sure that exercise won’t compound the problem.

Exercise, if done correctly, will not hurt you. In fact, exercise can strengthen the muscles which surround the joint and promote flexibility in the joint itself, thus protecting it from injury. Exercise can, however, put undue stress on joints if done incorrectly, especially if those joints are already hurting from wear and tear, trauma, or arthritis. Exercise may need to be modified for your particular condition because, at all times, it must be done safely.

If you have an ache or a pain that just won’t go away, it may be something serious and you should talk to your doctor. You also may choose to go for physiotherapy, chiropractic, or other treatment. When you see your doctor, be sure to tell him or her that you are interested in pursuing exercise. Otherwise your doctor may think you are only interested in taking medication and not discuss other options with you. If you and your doctor agree that some medication is warranted, exercise can still go a long way to not only alleviate symptoms but correct underlying problems. It may possibly mean that you are able to take fewer medications because you will have less pain. As always, proceed slowly but keep an open mind to the possibilities exercise can bring to painful joints.

Many people have a hard time distinguishing an exercise “pain” from other aches and pains. To protect a joint, the muscles surrounding it need to be strong. The process of making a muscle stronger will in itself cause some soreness. That soreness means that you are working the muscle hard, often causing little micro-tears in the muscle, which will cause it to repair itself and get stronger in the process. That type of soreness should not last long, however. If the soreness lasts more that a couple of days, is throbbing, or a shearing pain, then you have probably overworked the muscle and may have sprained or put repetitive strain on the joint.

If you experience pain while you exercise, you should be able to tell if the pain is acute (sudden onset) or chronic (long-term) by asking yourself the following questions?

  • Did the pain come on all of the sudden or was there a slow and gradual onset of signs and symptoms?
  • Was it the result of a single event or gradual continued abuse?
  • Was it a moderate or sharp pain, or did it start out a mild discomfort which developed into long-term pain, perhaps because you didn’t get it treated right away?
  • Did I sprain a muscle or ligament or have a I had a pain in a joint for quite some time?

If you have suffered an acute pain, back off from doing that particular exercise and help yourself to some RICE.

That’s right, RICE, which stands for Rest, Ice, Compression, and Elevation. Rest will allow the damaged tissue to heal and keep you from further aggravating it. How long and to what degree of rest you require will depend on the injury itself. Ice is used to reduce inflammation, which usually occurs after an acute episode as your body’s way to tell you to stop what you are doing. However, after you have stopped the activity, the inflammation remains and can be the cause of further and longer lasting pain. Ice is best used within the first day or so of an injury and must be applied frequently and consistently for best results. Compression of the injured area with an elastic bandage or other type of tension will also reduce swelling. Finally, you need to elevate the area above the heart (hopefully with ice and compression) to help fluid move away from the injury and thus alleviating some of the pain caused from the inflammation.

Chronic injuries are usually harder to look after. They often started out as something acute long ago and we often forget what caused the problem in the first place. These are the types of conditions that can be made worse by exercise if a person has forgotten about them and then done something to aggravate the condition.

Often a chronic condition is the result of muscle imbalance that has gradually developed over time. Improper posture and movement can often be the cause. If someone is exercising with poor technique, they could be placing more stress on an already strained joint, muscle, or ligament. Other times a person over-exercises and does not give themselves time for rest and repair. Regardless of the cause, chronic injuries should be examined by a health care professional to see if they can be improved by properly performed exercise and possibly other therapy.

Once your program is over and you see improvement in your condition, you will want to make a lifestyle of exercise, where I would suggest you initially work with a personal trainer and let him/her know what aches and pains you’ve been treated for. That way he/she can prescribe an exercise program that takes these areas into consideration to ensure that your former aches and pains don’t come back. A good trainer will communicate with your health care practitioner about your program to ensure that the exercises he or she does with you are cleared by the practitioner.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Self-conscious

Fit Mother and DaughterDear Chris,

As an elderly beginner in personal fitness training I take note of reactions from friends and family. Sometimes it is politely concealed amusement. Other times, it can be gently patronising approval. I am undeterred by this as I am convinced about the end product, but it occurs to me that moving on to group exercising may help to overcome any reservations born of self-consciousness. Have you found this to be so?

Jay, Toronto

Dear Jay,

First of all, good for you to have taken the step and gotten a personal trainer to help you get into an exercise regimen. The reactions you are getting from friends and family could reflect preconceptions that many younger people have about older people exercising. Things like:

“Don’t you know that these are your twilight years?”
“You should be putting your feet up granny and taking a load off!”
“Don’t do any exercise, you might break something!”

…are all common reactions, but fortunately people are starting to get the message that muscles can be made stronger at ANY age.

As for comparing individual personal training with a group exercise class, I can’t say which will make you feel less self-conscious. It really comes down to your goals and fitting exercise into your lifestyle. Many people prefer the individual attention they get working with a personal trainer, especially if they are new to exercise or have health conditions which warrant exercise modifications. Many people feel shy about exercising, but they’ll feel less so knowing that no one is focusing on them besides their trainer. However, others prefer the camaraderie and social benefits of exercising with a large group. If you’re at all self-conscious, you may stand a better chance of blending in with the crowd. Believe me, people are too busy keeping time with the music and counting off their own repetitions to notice anyone else in the room.

By the way, if you are looking to blend in with the crowd, don’t hide too far from the instructor. He or she needs to see that you are performing the exercises correctly, especially the balance and muscle conditioning portion of the class.

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Memory Loss

String around fingerDear Chris,

My mom just turned 91 and really is in great shape for her age. The one thing she finds most frustrating is memory loss. Sometimes she just can’t remember something that used to come so easily. Obviously it comes with age but is there something she can do to assist with this, maybe exercises for the brain? What are your thoughts?

Johnny, Toronto

Dear Johnny,

As you have noted, some memory loss is expected as we get older. Studies have shown, though, that a large part of forgetfulness is really only the result of an accumulation of things to remember. Let’s face it. Your mom has had to remember a lot of things over her 91 years. However, you may be concerned that it’s more than just absent-mindedness, that it might be early stages of dementia or Alzheimer’s disease. The Alzheimer’s Society of Canada offers some good advice to help determine if memory loss is simply forgetfulness or something more serious. They suggest that if memory loss affects someone’s day-to-day functions and is coupled with lack of judgment and reasoning, or changes in communication abilities, they should see their doctor to determine the cause of the symptoms. Regardless of the cause of the memory loss, being aware of it can itself be stressful and operating under that stress will make a person even more forgetful and absent-minded.

There are some practical things your mom can do to help her memory loss. One of the best things to do is to reduce stress. Does your mom take time out of her day just for herself? A common misconception is that older people who are no longer in the workforce are idle. The truth is that many say they’ve never been busier. While that can be a good thing, no one should be so busy that they don’t take time out to relax. There are many ways to relax, from formal techniques to recreation and leisure activities.

Besides relaxation, one of the best ways to reduce stress is through exercise. Regular, moderate-intensity exercise has been shown to have a positive cognitive effect as well as a physical one. A recent study revealed that regular exercise can reduce brain tissue loss associated with Alzheimer’s Disease and dementia. Another study published last year showed that older women who walked two to three hours a week performed significantly better on cognitive tests than those who walked less than an hour. In yet another 2004 study involving 60 unfit adults, half participated in a walking programme, while the other half did only stretching and toning. By the end of the study, those in the walking programme had much better short-term memory and other cognitive functions than those in the other group.

Memory aids are also a good thing to have. My father used to carry a small notepad with him. As a kid, I found it amusing. But now I understand why he did it. There is just so much to remember, it seems. Your mom is probably at an age where she has more appointments than someone your age and having to remember those things can crowd an already busy mind. Just make sure that if she uses a notepad, she writes the date beside each entry, otherwise she won’t know if her doctor’s appointment is up and coming or came and went! Maybe her son could buy her a pocket day planner for Christmas!

Your mother will remember things even better if she gets into the habit of saying things out loud a few times before she writes them down. That way she isn’t just relying on the notepad, and has a pretty good back-up in case she misplaces it.

If you want to learn more about memory loss as we age, check out Memory Loss With Aging: What’s Normal, What’s Not”.

To your mom’s health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

Group Class or Personal Trainer

choosing between optionsDear Chris,

I see groups for seniors and mature people in all sorts of places. I am an active working person and wonder if those groups are really beneficial or if there is something more to be gained from a mixed-age group. I think I would feel older in a specially-made-for-the-older group. The other question is simply how do you start if you have never really worked out and find yourself ready for freedom 55?

James, Toronto

Dear James,

Regarding separate vs inclusive groups, there really is no right or wrong answer. Some people prefer to work out with a group of people of similar age and ability, while others like the idea of “mix and mingle”. Either works as long as you are comfortable in your group.

The reason that older adult groups were formed in the first place was to address different concerns than groups with a younger membership. Most of the trainers and fitness instructors I know who work with younger clientele say that their clients’ focus is on athletic training, weight loss, attaining the much coveted 6-pack (abs, that is), the tight butt, or just feeling better about themselves. There is nothing wrong with these goals but most older people I talk to want to feel more energy, compensate for lack of physical activity since retiring or moving into an apartment, and remain independent. Ask a 40 year-old what the importance of a squat is and he will say that it’s to have a tight butt and strong thighs. Ask a 75 year-old and she might say that it’s to help her get in and out of a chair by herself. Between these extremes are people just starting to notice that many of the leisure activities they did when they were younger are not as easy to do. At 50, a lot of people start noticing that their clothes don’t fit quite the same, that keeping the tight abs takes more work than it used to, or that their 9-to-5 is taking it’s toll on their posture. They may start to feel reminded of these things when they attend a step class with people 20 years younger. Others find the youthful classes invigorating.

Remember, too, that in a city the size of Toronto, older adult groups are often further segmented, not always based on age, but ability. I’ve seen 70 year-olds with as much energy and muscular strength as some 55 year-olds. While they may be a generation apart in interests and experience, they may share the same fitness goals. In the end, you’ll have to decide where you’ll feel most comfortable. If you decide to attend an older adult programme, make sure that it encompasses aerobic conditioning, muscle conditioning, balance, coordination, and flexibility, all crucial for maintaining independence and quality of life.

To answer your second question, might I suggest hiring a personal trainer to get you started. Do I sound like I’m pushing my services? Of course I am. I believe that hiring a personal trainer even for just a few sessions can go a long way to starting, what will hopefully be, a lifelong lifestyle. A personal trainer will help you to set goals, do a baseline assessment of your fitness level, and design a programme to help you reach those goals. Getting started is hard to do. We all find it easier to form bad habits than good ones. Exercising is a good habit. You just might need to hire a personal trainer to get you “hooked”!

To your health

Chris


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.