This is not your typical ‘Best Exercises over 50’ article.
I’m not going to give you a generically broad answer like ‘try swimming’ or ‘try Pilates’. Often those articles end with some form of the phrase ‘find what works for you’ and fails to give you much direction. INSTEAD, I’m going to give you 5 specific exercises that I highly recommend based on my expertise as one of the Top Physical Therapists in Ohio. But first a simple question…
What’s the worst mistake you can make in 2020?
Picture this… You are enjoying life, you’re kids are successful, maybe you’ve retired early, perhaps you’ve got a few adorable little grandkids visiting every so often.
BAM! A fall… Broken hip… Hospital… Surgery… Nursing home.
Or, WHOOPS! A few incontinent moments… A UTI… Kidney infection… Hospital… Nursing home.
This is the WORST time (maybe in history) to go to a nursing home or rehab unit. ‘Why?’, you ask. The answer is simple. It’s a five-letter word that we hear multiple times each day… COVID.
The exercises I’ll prescribe and describe will not get you 20 inch biceps or 6 pack abs. They are designed to keep you out of the hospital, out of a nursing home, and safe at home.
If that’s all you need to hear then skip to the exercises. If you need more convincing then read on…
Hospitals and nursing homes were never on anybody’s top 10 list of places to visit. Nowadays, any kind of inpatient admission will involve a 10 to 14 day quarantine and isolation period. No outside visitors are allowed, even for emergencies. Common areas are off-limits and socialization with other residents is restricted if not completely prohibited.
At this point most of us know of a family with a relative that died alone in a facility. They don’t even get a chance to visit with their loved ones in their last days.
End-of-life services, funerals, cremations, and burials are being postponed indefinitely and limited in the number of attendees. COVID is not only a way of life now, but also a ‘Way of Death’.
Next, consider this…
The Health and Retirement Study (an ongoing nationally representative longitudinal study of health, retirement, and aging sponsored by the National Institute on Aging) analyzed data on 1,817 nursing home residents who passed away. The average length of stay before expiring was 13.7 months
One quarter of all deaths in the United States occur in nursing homes, and that figure is expected to rise to 40 percent in the year 2020
Alexander K. Smith, MD, MS, MPH, a palliative medicine physician at SFVAMC and an assistant professor of medicine in the Division of Geriatrics at the University of California, San Francisco
The natural defense seems obvious… STAY OUT OF HOSPITALS AND NURSING HOMES AT ALL COSTS. But sometimes that is easier said than done as we age. So how do we give ourselves the best chance? By addressing the most common risk factors.
According to the National Organization of Health Data, the top two reasons that people enter long-term care are:
- Broken bones resulting from a fall.
- Recovery from an infection.
These top two are then followed by:
- Recovery after a hospital stay
- Alzheimer’s Disease
- Multiple Sclerosis
- Parkinson’s Disease
- Heart Disease
- Stroke
- Head Injury (from a fall)
- Obesity
Armed with this knowledge, it is clear what we have to do to stay out of long-term care facilities: Stop falling and Avoid infections.
Both are obvious and simple to avoid, but SO MANY people fail to take the necessary steps to do so. I can say this with authority because I see it first-hand every day. So let us now address some keys points.
The two biggest things you can do to avoid infection at home are wash your hands and stop peeing your pants. Yes, you read that correctly.
Firstly, wash your hands. ‘Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water.’ – The CDC. Washing your hands reduces respiratory illnesses by up to 21%, reduces diarrheal illness by up to 58%, and reduces other gastrointestinal illnesses by up to 57%. So wash your hands correctly, just do it.
Secondly, don’t pee your pants. Lots of American’s are incontinent, approximately 17 million according to the National Association of Continence. They also note that almost 33% of people over 45 years old have urge incontinence (can’t get to bathroom in time) and over 37% of women over 45 years old have overactive bladder. Ultimately, sitting in urine significantly increases the chance of developing a Urinary Tract Infection, which can lead to a Kidney Infection, both of which can lead to hospitalization. This risk is nearly double in women compared to men.
Falls are the other big issue. Each year 37.3 million falls are severe enough to require medical attention, according to the World Health Organization. Fall risk dramatically increases with age and ‘older people’ are at a major risk for subsequent long-term care and institutionalization.
As a therapist I often note very specific deficits in people who are older and/or have suffered falls:
- 1.) They can not perform and sustain a calf raise and therefore have insufficient ankle control.
- 2.) They can not stand on 1 leg for more than 3-5 seconds and therefore have reduced functional balance.
- 3.) They can not get up from low and/or soft chairs, indicating they have poor posterior chain strength.
- 4.) They can not climb steps without pulling up with both hands and/or taking a staggered step.
All of these indicate poor functional strength and a clinically significant fall risk.
Here are the 5 best exercises to address these issues and keep you at home:
1. Vacuum Pose
- Why: A weakened transverse abdominus contributes to back pain, pelvic floor disfunction, and breathing difficulty.
- How to do it: Lay on your back with knees bent up and feet on bed or floor. Try to drop your belly button to the floor. Hold 5-10 seconds.
- How often: 3-10 repetitions, 2-3x every other day.
2. Kegel Squeezes
- Why: A weakened pelvic floor greatly contributes to incontinence and is a HUGE risk for Urinary Tract Infection (UTI)
- How to do it: Imagine trying to stop the flow of urine mid-release. Squeeze those muscles together and hold 5-10 second
- How often: 5+ repetitions, at least 3-5x DAILY.
3. Calf Raises
- Why: The foot and ankle is the first line of defense when it comes to fall prevention. When we start to lose our balance (and depending on the degree of loss) our body tries to correct FIRSTLY by adjusting at the foot and ankle, then we may bend our knees, then bend at the hips, and finally we will take a corrective step if needed. The foot and ankle is the first link in that chain and must be kept strong.
- How to do it: Stand with hands on counter top or back of chair. Keep knees straight and raise up on toes as high as you can, brief pause at top, then lower to ground. Bonus points if you can do it without holding on.
- How often: 3 sets of 10-20 repetitions, 1-2x a day, every other day.
4. Single Leg Stance
- Why: (see above, fall prevention) Multiple pieces of clinical literature state that the risk of falling is doubled(!) in people who can not stand on one leg for 5-10 seconds. This is a common screening tool for fall risk. Aim for 30 seconds each leg.
- How to do it: Stand by kitchen counter or back of chair, but try not to hold on. Look straight ahead as you lift one foot off of the ground. Do not brace that foot against the stance leg, that’s cheating.
- How often: At least once a day. More often if you can’t hold for 30 seconds. Practice makes perfect.
5. Step Ups
- Why: Quite simply, you need to have anti-gravity strength. As a physical therapist, I see too many people who can not raise their body against gravity. They can not step up so they compensate in a dangerous way. Oftentimes this is a use-it or lose it situation. So practice now and don’t lose it.
- How to do it: Using an exercise block or the first step in a stair case, hold on to the counter or railing, raise the ‘working leg’ to the step and simply step up. Make sure you are using the ‘working leg’ to lift up and not trying to boost or jump up with the trailing leg. Repeat 10-20x and switch legs.
- How often: At least daily. Split into smaller sessions of 3-5 repetitions if this is a weakness of yours.
Do these daily. Impress your friends that you can stand on one leg. Climb steps without difficulty. Most importantly… reduce your risk of falling and infections. Stay healthy, stay happy, and join the Rehab Revolution!
Dan Kristoff PT, DPT is recognized as one of the Top Physical Therapists in Ohio. In his 10+ yrs as a physical therapist, he has helped thousands of patients recover from illness and debility. His company, Rehab Revolution, is less than a year old and has already helped hundreds of clients take back control of their health.
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