Tuesday, September 4, 2012

What should be assessed before beginning an exercise program?



What do I consider the most important part of a clients exercise program? The initial assessment.

What kind of assessment should they go through? 

I prefer to look at how they sit, stand and move. What am I looking for? How the clients is currently using their muscles and the effect this has on their posture and their ability to move.

To test muscle balance you don't need any fancy equipment or measurement devices. Look at the posture of your client. This will give you everything you need to determine which muscles are weak and which are tight. Analyze your client when they don't know you are doing it. If they know that you are analyzing their posture, they will try to fix it. 

First, take a look at your client from the front while they are sitting and then standing.
 

 

     -  Does your client's head tilt to one side? 

     -  Are your client's shoulders level? 

     -  Are your client's hips level? 

     -  Do they stand with their knees straight, knocked kneed or bow legged?

     -  Does your client have flat feet or high arches? How does this affect the
        rest of their posture?

Now from the side:

 

 

 -   Does your client's head jut forward?

 -   Does your client have rounded shoulders or do they seem to be slouched 
   forward?

 -   Does your client seem to have a pelvis that tips forward or backwards,
   causing excessive lower back curvature or a flat lower back?  

- Does the client stand with their knees locked?                 
 
To assess how a client moves, have them get up from a chair. Watch how their knees, hips and back move from the side and the front. 
 
 
     - Do they lead with their shoulders, hips or knees?

     - What does their spine do when they stand up? 

Next have them perform some marching exercises. Look at them from the front and the side.

  

  
    - How high can they lift their knees, and what do the knees do while they
       are lifting them? 

     - What do their shoulders and torso do while they are lifting their knees? 
       (How stable is their torso)

These are a few examples of what to look at when performing an assessment with a client. Each clients history should determine what to look for when performing these test. 

The answers you get to these questions will help determine what is causing any aches and pains that the client has been experiencing.

Before you go about correcting these imbalances go out and identify the postural imbalances. This will lay a base for understanding the concepts to come.

Tuesday, August 28, 2012

Exercise and Strength Training: It's Never Too Late To Start

One of the reasons I decided to work with older adults to make them stronger was because of a NOVA program I saw over twenty years ago. NOVA followed some researchers from Tufts University in Boston as they went into nursing homes to see if strength training could help some of the residents.

I love watching these older people learn to lift weights. You could say this program planted the seed for my business.

I feel that strength training is the closest thing we have to the fountain of youth. If you want to remain independent, work at it.

The following is an article from The Alliance of Aging Research that makes some great points on why you should start working on becoming stronger:

from: 

Living Longer and Loving It! — Fall 2001 Feature Article 

 
Exercise and Strength Training

It's Never Too Late To Start

The best medicine to combat the vagaries of old age is exercise. And it's never too late to start, says Dr. Maria Fiatarone Singh, professor of Medicine and Sports Science at the University of Sydney in Australia.

Dr. Fiatarone and colleagues at Tufts University developed and tested a strength training program using weights on frail men and women in their 80s and 90s who live at the Hebrew Rehabilitation Center for Aged in Boston. Nearly all have arthritis and heart disease and take multiple medications. Most use walkers and almost all experienced falls. 

Within 10 weeks, researchers saw improvements across the board in their patients. Virtually all of the participants got stronger and were able to walk faster and climb stairs more easily. Those who were depressed became more sociable, and those who took nutritional supplements had improved appetites. 

The non-exercising control group lost muscle mass and received no benefits from nutritional supplements. 

The evidence is clear, and so is the geriatrician's message to the medical community: doctors spend too much time prescribing pills and not enough on encouraging play for older patients.
Here, Dr. Fiatarone elaborates on her studies. 

Q. We all know that physical exercise is good for our health and that most of us don't get enough of it, but what special benefits can exercise provide for the elderly?
A. There is a difference in the reasons for exercise for the elderly and exercise for younger people. An exercise program for the elderly is targeted more specifically for the prevention of disease and disability, while younger people exercise primarily to look better.

Q. What kind of exercise do the elderly need?
A. Not all exercise is good for all purposes. If you are using it like medicine, it's specific in terms of effect. You need to prescribe an exercise in relationship to what it is you are trying to promote. Somebody who has gait disorders - difficulty walking, falls a lot, has osteoarthritis and is susceptible to fractures - needs strength and balance training for the muscles. If the purpose of exercise is to prevent cardiovascular disease, you will need an aerobic exercise. 

Q. Is strength training the best exercise for the elderly? 
A. We looked at strength training for frailty and functional dependency. We looked at causes of frailty. Loss of muscle strength with aging is a cause of frailty. So the kind of exercise needed is strength training. Stretching and walking don't impact muscle size. If somebody is weak and the weakness is contributing to the health status or quality of life, strength training is the way to go. If core balance is the problem, it makes sense to give them balance training. Tai chi and yoga are examples of balancing exercises. Standing on one leg or walking on a balance beam are balancing exercises.

Q. Isn't it enough to walk regularly, or are the benefits of walking overrated?
A. All exercise training should challenge you to accomplish something not normally experienced and to conquer new challenges. When you walk, you normally don't get any better unless you challenge yourself in a more difficult way, like walking heel to toe. However, the epidemiologic literature shows that walking is associated with reduction in mortality and cardiovascular disease, diabetes and stroke. The more vigorously you walk, the better it is. But, you have to look at it like medicine. You can't use the same form, dose, and intensity, for all people.

Q. Isn't exercise dangerous for senior citizens, particularly those who are already frail and have fragile bones?
A. Being a couch potato is lethal. We recommend seeing a doctor before starting any exercise program, but chronic, age-related medical conditions almost always indicate a need for exercise.

Q. Are there mental as well as physical benefits to exercise for the elderly?
A. Depression is well treated with exercise. Weight lifting and aerobic exercise work equally well. Exercise works 70 percent of the time for depression. It's better than anti-depressants because drugs are often less well-tolerated in older people. Nobody knows how or why exercise works. However, there are no good studies that show it can treat dementia. It helps with attention span, and there is some evidence that people who exercise are less likely to end up with dementia, but there is no way to tell if it is causal or not. 

Q. How do you persuade seniors to get out of their rocking chairs and start pumping iron?
A. Independence and quality of life are the driving factors, not longevity. One thing people don't want is to become dependent on others. Strength training effects are evident in just a few weeks. They can see that they get out of chairs more easily and can move around better and that sustains people. Long-term adherence to strength training is quite high, whereas people are likely to drop out of exercising on a bicycle or walking.

Q. Is it ever too late in life to begin an exercise program and benefit from it?
A. It's never too late to start. Lots of people are starting in their 80s and 90s. It's good if you can come to old age with a bit of reserve, but even if you don't, exercise works.


GETTING 'WELL BEYOND 50'
1. See your health problems as a reason for exercise rather than as a barrier to exercise.
2. Look for opportunities each day to exercise instead of avoiding exercise. Turn what comes your way into exercise. Carry something instead of dragging it. Stand on one leg. As you go through the day, you can turn lots of activities into exercise opportunities.
3. Do something you enjoy and can conceive of doing most days for the rest of your life. It must be something you will do on a regular basis. That's what brings health benefits.

Want More? Subscribe to this free webzine and read the rest of the Fall 2001 issue! http://www.agingresearch.org/livinglonger/

Tuesday, August 21, 2012

Are you physically preparing for retirement?

I love this quote

Are you physically preparing for retirement?

If not, it can cost you a ton of money.


Most people know that it is a great idea to financially prepare for retirement. They also know that the earlier they start, the easier it is to build a bigger nest egg.

The same rules apply to being physically prepared for retirement.  The earlier you start, the better. When people picture their retirement, they picture being able to enjoy the freedom to do things like travel, visit friends and enjoy the freedom they deserve. Unfortunately, most people will have too many physical challenges to enjoy retirement like they should.

I don't consider this normal aging, and neither should you!

According to Genworth Financial, nearly two-thirds of people over age 65 will need long term care at home or through adult day health care, or care in an assisted living facility or nursing home.
 

No one pictures this happening to them. What are you doing to minimize the chances that it happens to you? 

Look at the current cost of this long term care. It cost my father around $7000.00 per month or $84,000 per year to live in his private room at the nursing home for the last 18 months of his life. (Annual cost in Illinois average from $16900 for adult day care to $69,350 for a private room in a nursing home. If you really want to be scared you can calculate how much this will cost in the future. 

It is much cheaper to work on your physical abilities before you lose them than to require long term care  

Having worked with clients as old as ninety-five, I have become an expert at what happens to our bodies due to aging and the lack of properly maintaining them.  

How many people work on their ability to extend and rotate their thoracic vertebrae? How many of us work on the ability to squat deep enough to move our knees between our hips? Even though I am fifty years old, I am already working on being able to physically handle the challenges that aging will give me.

 
What are you doing to prepare for your physical challenges due to aging?

Tuesday, August 14, 2012

How are you going to move when you are older?





Prisoner of War Squats

 I use to hear physical therapy students talk about how they would analyze how people move in public once they began studying movement. Now I know what they were talking about. Anytime I am out in the public, I watch how people move. If you want to see what happens to a lifetime of not working on your movements, go the the grocery store when it is packed with senior citizens. You will be amazed at how slowly most of them move.

Some of them will move slowly due to injuries. Most of them will move slowly because they allowed their bodies to get weaker, stiffer and less mobile. Unless you work to minimize the effects of aging, it will happen to you.

Having worked with clients up to 95 years of age, I have studied what changes occur to our bodies due to the aging process with a lack of focus on maintaining a basic level of strength and conditioning.

The two biggest physical changes that I have observed are less reliance on the hips and a loss of proper mobility in the thoracic spine.  Most people don't work on these two areas. This is why I train clients the way I do.

An example of this would be how people are taught how to get out of a chair once it becomes more difficult for them. I have observed many people being taught to have their knees and shoulders move forward when trying to get out of their chairs. This teaches them to use their knees and backs.

When I work with a client, I teach them to use their hips to get out of the chair. (or any squatting or lunging movement) This takes the strain off of their knees and backs.

Why should you care about your thoracic spine? When it moves properly, your shoulders and lower back are protected. If you want to develop shoulder problems, quit using your thoracic spine to reach for things. Want to develop lower back pain, begin bending at the waist instead of the hips when picking something up.
Hip Hinges


The next time you are at the grocery store, observe how the older customers are moving. The choice is yours on how you will move when you reach their age.

Wednesday, May 30, 2012

Can Exercise Enhance Cancer Treatment?


For the first time I am posting an article on this blog from a guest author. 

His name is David Haas of the Mesothelioma Cancer Alliance.

David promotes exercise to help cancer patients deal with such a scary subject. Exercise for cancer patients is one of my favorite subjects. Exercise has helped my wife recover physically and emotionally each time she has had cancer.

Can exercise enhance cancer treatment? by David Haas

Can exercise enhance cancer treatment? Modern research indicates that it can, and the latest national guidelines recommend exercise for cancer patients. In fact, today’s cancer patients are warned to avoid inactivity despite traditional advice to the contrary.

Compelling studies suggest that exercise is safe for most patients, both during and after treatment like radiation and chemotherapy. Even those undergoing stem cell transplants and other complex procedures benefit from physical activity.

Much of the medical community holds to a prevailing attitude that cancer patients should not push themselves during therapy. However, new research reverses this cautionary exercise advice for patients with breast and prostate cancers, gastrointestinal tumors and other cancers.

According to an American College of Sports Medicine panel of experts, cancer patients should strive for 150 minutes of aerobic exercise a week. This is the same guideline recommended for the general public.

Some activities, such as swimming and yoga, are extremely beneficial for cancer patients. Other activities may harm those with specific types of cancer. For example, strenuous weightlifting is not recommended following breast cancer surgery. Vigorous workouts are impossible for people in mesothelioma treatment, and patients with weakened immune systems should avoid public gyms.

Doctors and fitness professionals should tailor exercise plans to individual cancer patients. They must take into account a variety of factors: age, fitness level, diagnosis, cancer stage, treatment plan and more. Nearly all patients can engage in some type of activity, if it is planned with their individual needs in mind.

Change in body composition is a persistent concern for cancer patients. Weight gain and loss are closely tied to cancer symptoms and therapy side effects. Patients with breast cancer, prostate cancer and other hormone-based tumors tend to gain weight during treatment. Those with pancreatic cancer, gastrointestinal tumors and other cancers often suffer extreme weight loss.

Studies indicate that both groups can benefit from exercise. While physical activity burns energy and promotes weight loss, it also maintains lean body mass and improves appetite. The energy it creates contributes to increased strength, endurance and general well being.

Exercise can enhance cancer treatment by addressing quality of life issues, as well. Regular physical activity lifts the mood, reduces fatigue and improves mental outlook. With appropriate and adequate exercise, patients can live and function independently during treatment. This is very important, since cancer takes away so much of a person's sense of independence and control.

Thank you David for such a great article.
Keith Sutorius - Owner MAST Fitness 

Thursday, May 24, 2012

Why train your balance?

A few days ago my daughter and a couple of her friends came in when I heard my wife ask one friend how her mom was doing. The friends response is why I love helping people. She said her mom was really stressed out. Her grandma had fallen and broken one arm and possibly her hip. Now her mom was having to deal with the stress of this situation. We have a good friend who's dad fell and has never been the same. His daughter has had to deal with all the after affects of his fall.


What could both daughters done to make things easier on themselves? They could have hired a personal trainer for their respective parent. I happen to be the trainer that focuses on balance exercises as much as strength exercises with my clients. Very few people work on their balance on a regular basis.



This is what motivates me. If I had been working with grandma she probably wouldn't have fallen. If she did fall, she would have been able to control the fall better and probably not been hurt so badly. Even if she still broke her hip, she would recover much better than the average person.


How do I know this. I worked with a women who ended up breaking both her hips within a few years. The medical staff each time was amazed how well she recovered from each break. I give the credit to all the squats and various hip exercises she had done in the previous six years. Without them she might have never lived at home again.


In this case my exercises didn't prevent hip fractures, but they did allow the client to recover from then much better than if she had never been my client. If she had been younger when I began working with her, she could have performed a more intense routine which would have strengthened her bones more and decreased the chance of hip fractures.


Although is is never too late to begin a well designed balance and strength program, the sooner you begin, the better the results.


Soon I will post ways you can test how good your balance is.

Thursday, April 19, 2012

Soda drinking and your bones

As some of you know my wife calls me an analytical analytical when in comes to my thinking style. I guess that is what I get for being from a family of engineers. (Both Brothers, and my Dad was a Systems Analyst.) Everywhere I go I am constantly analyzing what people are saying and doing.

I happen to ride with a group on Wednesday evenings out of Edwardsville IL It is amazing what you hear people talk about during these rides. Yesterday the subject of weight loss was being discussed. The two women on the ride started talking about diet sodas. What they are failing to realize is combining such an acidic drink with all the endurance activities they do is sucking minerals out of their bones at an alarming rate. (Most people have no idea that one of the primary functions of our skeletal systems is to store minerals for use when our diet isn't providing enough at the time.) Long term this will lead to Osteoporosis.

Since Bicyclist have a greater chance of developing Osteoporosis than non-bicyclist I have studied quite a lot about this topic. There is nothing wrong with drinking an occasional soda. They both mentioned the need for caffeine. If you need that much caffeine everyday, you are probably over-training, not getting adequate nutrition in your diet and/or not getting enough sleep.


Unfortunately both of these women will probably pay the price later in life for these choices that they are making. I can tell by the posture of one of them that her middle and upper back aren't strong enough for her to perform squats or overhead presses correctly without hurting her lower back. She looks like she already has Osteoporosis in her spine.

Most Endurance Cyclist I have talked to just want to ride their bikes. They have no interest in lifting heaving enough weights and adding plyometrics to their exercies routines to build stronger bones.


I have tried sharing some of this information with them, but like a wise man once said; (The people least likely to listen to you are the ones that need your help the most.) I will learn that sometimes it is better not to share what you know with people that aren't interested.