Time to PUMP SOME IRON! September is Healthy Aging Month

WeightsFiona McMahon PT, DPT

The idea of strength training can conjure up many images, like the funny images of  Saturday Night Live’s Hans and Frans, or Arnold Schwarzenegger. It can also be intimidating. The idea of walking into a crowded weight room full of young and fit people, who seem to all know what they are doing can stop a newbie in their tracks. But resistance training has so many benefits, for health, function, and longevity. It goes way beyond looking good in a swimsuit, although it certainly can help with that. In honor of September’s Healthy Aging Month we at Beyond Basics are taking a close look at how adding a safe strength training regimen to one’s daily routine at any age, can boost so many indicators of health and quality of life.

Everyone understands that muscles are essential for everyday tasks like rising from a chair, carrying your shopping, and many other instrumental tasks required for independence. The thing about muscles is they are not static, and as we start to age we lose muscle, especially if we do not work to maintain our muscle mass. Believe it or not, we slowly start losing muscle mass at age 30, (bummer, I know), but after 60 is where things get really crazy. After age 60 we start losing muscle mass at a rate of approximately 15% per year. The less active someone is in their life, the quicker this loss occurs. Low muscle mass is called sarcopenia. You will see this term a lot in this blog. The condition of sacropenia brings with it functional impairments from lack of strength and can put a person in a position where they are more likely to require assistance for everyday tasks. Furthermore, when sarcopenia and obesity occur at the same time, which we often see in the elderly, the functional impairments associated with sarcopenia and obesity are greater than either sarcopenia or obesity alone.

But there is hope. Aging isn’t a slippery slope into weakness and frailty. It is what you make it. Even sarcopenic muscle can respond and strengthen in response to proper training. In fact, it adapts to the demands of strength training at the same rate as younger muscle. Weight training can actually reduce fat and build muscle, helping to reverse the condition of sarcopenic obesity. Many studies indicate that resistance training can prevent and or reverse age related losses in function. Even with all the benefits of strength training. Only an estimated 10-15% of older folks regularly participate in strength training exercise, leaving a huge percentage of the population missing out on strength training’s myriad benefits, which we will cover in more detail below.

Benefits of Strength Training

 

Balance and Fall Prevention

Falls are a serious cause of injury, disability, and death in the elderly. People over the age of 60 have a once yearly fall rate of approximately 30%. Resistance training in combination with balance training under the care of a skilled physical therapist can go a long way to reduce one’s risk of falls. If falling is a concern of yours, please check out our other blog on falls and fall prevention.

 

Pain Syndromes

Pain symptoms in individuals with Fibromyalgia Syndrome improved following a 12 week high intensity strengthening program (Mayer).

 

Osteoporosis

Osteoporosis, a condition characterized by low bone density, increases a person’s risk of fracture. Fracture brings along with it risks of prolonged pain, depression, issues with function, subsequent fracture, and even death. Individuals with vertebral fracture have a 2.7 increased likelihood of death and are likely to have an additional fracture within a year of the original fracture.

There is evidence supporting resistance exercise as a useful tool to increasing bone density in osteoporotic individuals. With people with extreme cases of osteoporosis, there is increase risk of accidental fracture from dropped weights, poor form in transitions and adjusting weight machines. In these individuals, and all individuals for that matter, it is extremely important to work with a physical therapist to construct a safe and beneficial routine.

 

Function

Many studies have found significant improvements in function following a resistance training program. Physical therapists like to use a few specific tests when getting a general idea of someone’s function. A couple of our favorites are the Timed Up and Go (TUG) and the 6 – Minute Walk Test. They measure the time it takes to rise from a chair and the amount of ground covered in six minutes, respectively. Pretty simple, right? In all of the studies I read that were using these outcomes, both TUG and 6-Minute Walk scores significantly improved following strengthening intervention. These tests are really special because they have incredibly strong correlations to functional independence and risk for falls and hospitalization. On top of improving scores in these tests, patient’s themselves also reported improved mobility in their daily lives.

Frequency and Duration

Out of the studies examined, most advised participating in a resistance routine 3-4x weekly in order to see an increase in muscle mass in 6-9 weeks. Continued training will sustain this effect. Most recommended 3-4 sets of 10 repetitions and 65-85% one rep max. Bands and free weights have found to be effective for strength training in older individuals. As stated before, exercise machines tend to have an increased risk of fracture in those with severe osteoporosis and therefore, should be avoided unless one is certain they can adjust the machine with correct form. Repetitions should be slow and controlled. Cardio and weight training are life long commitments.

So Where To Start?

The first place to stop is at your local and experienced physical therapy office. Your PT will be able to determine if you are safe to exercise and what types of exercise will work best for your body and your goals. Will exercise bands work better for you? What the heck is 80% one rep max? When can I progress? Am I doing this right? All of these questions will be answered by your physical therapist. At Beyond Basics Physical Therapy we work to not only improve strength, but also efficiency of movement to allow our patients to get the most from their time with us as well as their time spent doing resistance training. If you think weight training is right for you and are eager to get started, make a call to us at BBPT or to your local PT, to make an appointment today!

Chen M, Jiang B. Resistance training exercise program for intervention to enhance gait function in elderly chronically ill patients: multivariate multiscale entropy for center of pressure signal analysis. Comput Math Methods Med. 2014

Giangregorio G. Papaioannou A. MacIntyre N. Too fit to fracture: exercise recomendations for individuals with osteoporosis or osteoporotic vertebral fracture

Liao C, Tsauo J, Lin L, et al. Effects of elastic resistance exercise on body composition on body composition and physical capacitiy in older women with sacropenic obesity. Medicine. 2013. 96(23)

Mayer F, Scharhag-Rosenberger F, Carlsohn A. The intensity and effects of strength training in the elderly. Dtsch Arztebl Int 2011; 108(21):359-64

PH 101 Something’s Wrong with my What?

 

You’ve waited and waited, now finally Pelvic Health 101 is BACK!

On September 20th, 2017 at 7pm we will be kicking off our fall semester of pelvic health education classes. We have a lot planned this year, so get pumped. In our first class we will be introducing you to the pelvic floor muscles, where they are, what they do, and how they relate to the health as well as the function of your bowel, bladder, and sexual muscles and organs. We will also be covering how things such as alignment, posture, muscle tone, and nerves can affect your symptoms. This course is a great starting point to help you understand your pelvic floor and pelvic floor symptoms.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth101.eventbrite.com

Here is our line up of this and future classes:

Pelvic Health 101 Fall 2017

Pilates Blog: Balanced Muscle Development

Denise Small  PT, DPT

In today’s Pilates’s blog, we will discuss another of the eight movement principles, Balanced Muscle Development. Using the example of the Pilates swan, we can see how both the front and back of the body are benefitting from the movement.  As we inhale and move our spines into extension, the back of the body, including the spinal muscles, glutes, and hamstrings are lengthening down toward the feet, while the abdominal muscles are lifting in and up towards the breast bone.  Both the back and the front of the body work in opposition to create balance in the body.  We give this exercise often in our practice at Beyond Basics to counter the shortening of the abdominal muscles that occurs with prolonged sitting. When the abdominal muscles shorten, they pull on the fascia of the external genitalia and pelvic floor muscles, contributing to their tightness. Have your PT take you through this exercise on your next visit to feel the full effects of the exercise. Or make an appointment with me for a one-on-one Pilates session.  Your body will thank you!

 

Swan
Jessica Babich PT, DPT demonstrating the swan

Pilates Blog – Concentration

DeniseDenise Small, DPT

Every Wednesday the PTs at Beyond Basics are fortunate enough to listen to lectures from medical professionals who specialize in pelvic pain.  One of my favorite lectures was given by Melissa Farmer, PhD,  a clinical psychologist who specializes in how the brain changes overtime in response to chronic pain.  Melissa spoke about a lot of wonderful things that are being found through research; however the thing that was most interesting to me, was not only that the brain can change in response to persistent pain, but, that the brain can change back to its pre-pain functional self! One of the ways that this can be done is through focused movement.  That is, thoughtful, pain- free movement focused around the area that normally causes pain.  This revelation was very meaningful to me, as one of the basic Pilates movement principles is Concentration.  Pilates believed that if your mind was fully focused on performing the given exercise, you would only need to perform a few repetitions to feel the benefit.  This is very important for patients suffering from chronic pain, as they do not need to exercise to the point of pain to see the benefits. One of the exercises that exemplifies this belief is the Pelvic Clock. The pelvic clock both mobilizes and lengthens the pelvic floor muscles while simultaneously bringing tone to the abdomen. In addition, the movement is very small and specific and requires one’s full concentration. So, it is a great way to directly address the potential causes of pelvic pain, without causing pain in the process!

To begin, lie on your back with your knees bent. See, in your mind’s eye, the pelvis as the face of a clock with the top of your sacrum being 12 o’clock and your tailbone being 6 o’clock. Slowly move from each number as smoothly as possible, while seeing your sitz bones widen as your tailbone drops to 6 o’clock and your sitz bones narrow as you move to 12 o’clock. You can also combine the movement and breath as we have in our other Pilates blogs by inhaling as you move to 6 o’clock and exhaling as you move to 12 o’clock.  If you have any questions, have your PT take you through this exercise on your next visit, or come see me for a private Pilates session. Your Body and Brain will thank you.

Pilates Blog: Centering

Denise Small, PT, DPT

In today’s Pilates blog, we are going to discuss the basic principle of Centering.  Pilates used the word centering to refer to the “core” musculature.  He believed that all movements should radiate out of the core for maximum stability.  There is a lot of use of the word “core” in exercise literature. However, no one ever discusses what that actual means. In the Pilates method, the “core” refers to the diaphragm, the pelvic floor, the deep spinal muscles, and the transverse abdominus.  The transverse abdominus is a deep abdominal muscle that is attached to our pelvic bones in a horizontal fashion, from one hip bone to the other. One way to find these muscles is by breathing, as all the core muscles are attached to the diaphragm and ribs via fascial connections.

Try this exercise to find your “core.”  Lie on your back with your knees bent. If you need, you can have a small pillow under your head for support.  Now, imagine that you have a small, helium filled balloon in your abdomen behind your navel.  As you inhale see the balloon expand. As you exhale, imagine the balloon being hugged by your navel and your spine, simultaneously.  On your next exhale keep that image of hugging the balloon as it floats up into your ribcage.   This image incorporates the three dimensions of our torso, aka the “core” of our body.

ballon

There is no need to think of contracting individual muscles. Just keep this vision in mind and you will have a wonderfully functional core.  Go over this exercise with your PT in your next session, or come see me for a private session at Beyond Basics. Your body, and your core, will thank you!

Pilates Blog- Rhythm- Coordination of Breath and Movement

PilatesDenise Small, PT, DPT

Today’s Pilates blog will focus on another basic movement principle of the Pilates method, Whole Body Movement.

In the last blog, I wrote about the importance of breathing three dimensionally, both expanding and contracting your abdomen and ribcage when breathing. Joseph Pilates wanted to help exaggerate these physiologic functions with movement, to help bring better awareness of these functions to one’s consciousness. He did that by coordinating both whole body movement and breathing. For example, when one inhales, the ribs and sternum move up and out, like a water pump or the handle on a bucket. You can feel this action by placing your hands on the outside of your ribcage, or on your sternum, as you inhale. When the ribs move up and out or the sternum lifts, the spine also extends because of the physical connection of the ribs into the spine. So, when Pilates gave a movement that involved spinal extension, like cow pose, he encouraged his students to inhale.

Conversely, when one exhales the opposite happens, and the ribs move in and down. When the ribs move in and down, this helps facilitate spinal flexion, because of the ribs physical connection to the spine. So, when Pilates gave a movement involving spinal flexion, he encouraged his students to exhale.

The result is inhalation with ribcage expansion and spinal extension, and exhalation with ribcage compression and spinal flexion. By coordinating the ribcage and spinal movement with the breath, you can maximize your air intake and expulsion. In addition, by coordinating your breath and movement, your body can more easily access its natural rhythms, calming the nervous system and promoting relaxation and healing.

Give it a try in your seat at work. Or come to Beyond Basics and visit me for a Pilates private!

BBPT Health Tip: How to Adjust your Posture to Avoid Shoulder and Neck Pain

shoulder 6

Tina Cardenia PT, DPT

In today’s society, most of us spend time in front of the computer or other electronics for work, school, or pleasure, which contributes to poor postural habits including rounded shoulders and forward head postures. Being in these positions will cause your muscles around your shoulder and neck to accommodate into that rounded position, resulting in inefficient lengthening of some muscles and shortening of other muscles, which results in an imbalance of strength and stability and high potential for injury. Having rounded and inefficient shoulder stability can cause neck and shoulder pain, and can affect your breathing.

The experienced physical therapists have extensive training on evaluating and correcting postural alignment. They can help with posture by identifying where your limitations are and evaluating your flexibility and specific muscle weaknesses that could be contributing to poor postural alignment. They also investigate what may be causing postural malalignments by evaluating your postural strategies in sitting, standing, walking, sports, and functional activities. Focusing on ways to be in a more balanced position will help put less stress and tension through your musculature and joints allowing for increased ease in maintaining proper posture with various movements.

A good way to facilitate a more neutral shoulder blade and shoulder position is with the exercise “Pivot Prone” (Institute of Physical Art, Johnson and Johnson). To start, first turn your head to the right and then to the left. Notice the excursion of movement and if you find it to be difficult or limited. Now, shrug your shoulders up a few inches, rotate your arms back enough where your pinkies are pointing forward and your shoulder blades coming together. Once you feel that your shoulder blades are back relax your shoulder blades straight down. Now rotate your head again to the right and left and notice if there was a change. You should feel an increase in ease of movement and more range of motion. At this point you should be able to appreciate that when you are in a more neutral alignment there is less stress and tension around your shoulders and neck. A common mistake with this exercise is to want to lift your rib cage up when you bring your shoulder blades back, so make sure that the shoulder blades are the only things moving during this exercise in order to maintain a good vertical alignment.

This photo shows the pivot prone maneuver being done step by step 

This exercise is perfect and simple enough to do throughout the day. For example, when you are standing waiting for the train, waiting on line, and sitting at your desk at work or school. By continuously repeating this motion your body will eventually remember it, and down the line you should notice that you automatically will maintain that position!

 

Check out photos from BBPT’s recent inservice on functional mobilization of the shoulder!