Earning the Brains & Balance Past 60 Certificate Part 3: Balance, Mobility & Function

This is part 3 of 4 parts covering the Exercise Etc seminar I attended on Saturday, October 18, 2014

Part 1 Forever Young: Secrets of the Older Mind     Part 2: Balance, Stability & Fall Prevention

 

After lunch it was time to get back onto our feet.  (If we wanted to)

Guy began session 3 by discussing what he considers to be functional exercises.

First he covered what should be the goals of Ambulation Drills:

     * The goal of any balance and fall prevention program should be to get the participant out of their chair and on their feet.


     * If independent living and a high level of function are the goals, the client must walk, carry things, weight shift, react, respond, slow down and stop, all while staying upright.***

***If you have been reading my blog post in the past you know that these are the focus of all the training programs my clients use.

What is Functional Training?

     * "If you can't logically define it, don't talk about it" Gray Cook

     * The problem with Functional Training is the lack of a standardized definition.  It has been trendy in the fitness industry to talk about Functional Training. 

     *  Function may mean different things for different people, but there are fundamental principles to help guide us.  I like the way my mentor Vern Gambetta  has defined it. To paraphrase Vern: Training is functional if it develops whatever it is you want to develop. 

What are the elements of Real Functional Strength Exercises?

    * Stand without support

     * Maximize joint mobility 

     * Stabilize the torso 

     * Integrate joint actions (perform movements requiring multiple joints to be used at the same time) As Vern Gambetta would say. "Train Movements, Not Muscles"

     * Focus on developing strength and power instead of endurance.

Practical Applications:

Exercise            Functional Activity Effected

Getting up         Can save your life if you fall. My Mentor Dan John explains why
off the floor:

Squats               Sitting up from any seated position including: chairs, toilets, couches, etc

Lunges              Getting out of the bath tub, off the floor, climbing stairs

Deadlift             Picking up items off the floor such as laundry baskets or a child

Pushing             Pushing a lawnmower or heavy door

Pulling              Raking leaves, removing clothes from the dryer, pulling the lawnmower cord

Rotating            Shoveling snow, grabbing a purse from the back seat, grabbing food from a  
                          grocery shelf 

Examples of how I build my clients strength levels can be found here. 

 How do you physically prepare for retirement Part 6

How do you physically prepare for retirement Part 7A 

 How do you physically prepare for retirement Part 7B

Next Guy covered what I would considered how to improve the most functional activity of all: 

Walking 

He began by covering using correct posture while walking. For more information on my thoughts on the subject look here:  MAST Fitness Blog Posts covering Posture

Next Guy covered some drills to improve gait: How do I improve my clients gait?  MAST Fitness Blog Post covering Mobility

Loaded Carries are one of what I consider the most functional exercises of all. Think about how much carry over there is to practicing walking while carrying weights at your side or overhead.  
MAST Fitness Blog posts covering Loaded Carries 

Agility: The ability to change directions, stop and start movements and react to changes in how the weight of our bodies are shifting

We then spent the the rest of session 3 performing a variety of drills. there where so many that it would take multiple blog post to describe then them all.  

Some examples of agility drills: Resisted Walking, U-turn drill, Mirror Lateral Shuffle, "Herding Cats", Jack Rabbit Agility Drill, Weaving Agility Drill, Obstacle Course, Stepping Stone Drills, Hurdle Stepping, Step Ups/Step Downs, Balance Beam Challenge, Lateral Shuffle

In addition the these some of my personal favorites that I use with my clients: Clock Steps, Teeter Totters, Leaning Tower, Cross Over Lunges, Forwards and Backwards Weight Shifts, Moving One Legged Hip Hinges. How do you physically prepare for retirement Part 5 

Next weeks post will cover the 4th and last session: Making Connections: Challenging the Older Brain.

 






 

Earning the Brains & Balance Past 60 Certificate Part 2: Balance, Stability and Fall Prevention

This is part 2 of 4 parts covering the Exercise Etc seminar I attended on Saturday, October 18, 2014

In case you missed Part 1: Secrets of the Older Mind

After a 15 minute break it was time for Guy Andrews to begin Part 2. This is were we began to spend a lot more of the seminar on our feet.  (If we wanted to)

First Guy covered some statistics about falls. 

I would venture to guess this information is from the CDC since I have seen most of this on their web site.

     * 1.5 million falls occur each year

     * 80% of fall go unreported

     * Over the age of 65 the risk of falling is 33% (Think about that: 1 of ever 3)

     *  Risk of falling increases 300% in the year after a fall.

     *  95% of hip fractures are caused by falls

     * The most common sites of injured due to falls are:
               - Hips
               - Patella
               - Distal Radius/Ulna (Wrist area)

Breaking a hip is by far the hardest injury to overcome because you might have to avoid weight barring with that hip until it has recovered. You are also going to be spending most of your time sitting down since it is almost impossible to stand on one leg for very long. If you are already weak, you might never recover from this. 

I happen to have had a client that broke each of her hips a couple of years apart. The Doctors and Physical Therapist where amazed at how well she recovered from each broken hip. The main reason she recovered so well was she had been squatting for years (The heaviest amount of weight I ever had her use, was a #8 dumbbell in each hand.) before she broke the first one and once she was able, continued squatting after each break.

Now you know that a good percentage of seniors are going to fall every year, what can be done to lessen the chances it happens to you?

The parts of a Fall Prevention Program

     *  Get educated about what it takes to prevent falls. You have already begun this if you are reading my blog.

     *  Exercise on a regular basis. (2 - 6 times per week depending on the activity)

     * Have your vision checked and improved (ex. have cataracts replaced if needed) 

     *  Have a home hazard assessment done to see what modifications are needed. (examples: remove throw rugs, attach handles in shower, add a railing on steps, etc.)

     *  Talk to your Dr. or Pharmacist about your medications.  Some meds highly increase the chances of falling.

     * Use a cane or walker if necessary. Make sure they are set up at the proper height for you.

Next Guy went over how to land if you do fall and how to get off the floor afterwards.

     *  Try to land on your ass since it has the most padding compared to your hip, knee or wrist.

     * Do a self assessment before moving. Ask yourself if you feel any pain. When in doubt, don't move.

     *  If you feel alright the next step is moving until you are laying on one side. If you can do this reassess how you feel. When in doubt, don't move.

     *  Next you get onto your hands and knees. If you know you can't get up without holding onto something crawl to get to something sturdy you can hold onto and then get into a lunging position with your stronger leg in front since it will be the one you use to finish getting up off the floor.

     *  A point I brought up is be sure to look up when getting off the floor because our body will follow our eyes. (look down to stay down, look up to get up)

I have my clients that are able practice getting up off the floor in front of me.  It is also a great way to build overall strength. Think about that . You are lifting your entire body weight off the floor each time you practice this.

We then went over how your meds can effect your sense of balance.

The 6 most common types that impair balance are:

      *  Antidepresants
      *  Anti-anxiety drugs
      *  Antihistaimines
      *  Blood pressure and other heart meds.
      *  Pain relievers (over the counter and prescription forms. (especially narcotics)
      *  Sleep aids (over the counter and prescription forms)

What do our bodies use to remain balanced?

There are 3 systems our bodies use for balance.

      *  Somatasensory (definition by Neuroscience Online:) informs us about objects in our external environment through touch (i.e., physical contact with skin) and about the position and movement of our body parts (proprioception) through the stimulation of muscle and joints. or in my words: The brains ability to feel where your body parts are in relation to each other) (ex. relationship of shoulder to hips, knees, feet, etc.) This is the system that training has the greatest effect on.

      *  Visual (using your eyes to see how your body is positioned in relation to your surroundings.

      *  (inner ear) What the position of the head/brain is in relation to the rest of your body.

We then went over how different joints effect balance.

We tried leaning forward from the ankles, then the hips, and then the knees from a forward lunging position.  These happen to mimic some of the exercises I use with my clients.


How can you progress as you work on your balance? Change how you perform the exercises.

      1.  Seated
      2.  Seated on a unstable surface
      3.  Standing
      4.  Standing on a unstable surface
      5.  Moving
      6.  Moving on a unstable surface.

I have had success skipping the seated versions of the balance exercises with most of my clients.  They might have to hold onto something like an chair or counter top before doing them without holding on.

I have also found that increasing the speed on the movement creates a big enough challenge that unstable surfaces aren't needed. Another way to increase the challenge if a clients is ready for it is to try performing some of the exercises with their eyes closed. I make sure to be so close to them that I can catch them if necessary.

We then spent the rest of the session performing many different drills covering the topics we had just gone over.  We even used the game Rock, Paper, Scissors during one of the drills.

It was them time for our lunch brake.  Since I was raised in Berkeley MO. I knew where to get a bite to eat. I man named Jim from Washington MO, and a Women named Cathy from Mexico MO took me up on my offer to drive since they weren't sure where to go get lunch. There are many places on Natural Bridge Rd. to chose from. We decided on Arbys.

Next weeks post will be Part 3: Balance, Mobility and Function.

Earning the Brains & Balance Past 60 Certificate Part 1: Forever Young: Secrets of the Older Mind

On Saturday, October 18th I attended an Exercise Etc. seminar titled:

Brains & Balance Past 60.

This is at least the fourth seminar of theirs I have attended. Since the NSCA requires 60 hours of continuing education every 3 years, I am always looking for seminars with topics I find interesting.

The B & B P 60 seminar was taught by Guy Andrews, the founder of Exercise Etc. Guy did a great job not only educating the group (of around 35) but managed to entertain us at the same time.

We had the opportunity to spend around six of the eight hours trying out the various drills he uses when working with seniors down in Florida. He said that this program has really taken off with all the seniors living down in Florida. With our aging population there is a huge need for this type of program.


The seminar was broken up into four 2 hour sessions.

The first session was titled:

Forever Young: Secrets of the Older Mind.

The focus of the first 2 hours was on how we are changing the way we think that the brain ages, and what can be done to change the way the brain is aging. I sum up the two most important points a this:

1. Cognitive decline is no longer believed to be inevitable.
2. Proactive Training can minimize the risk of falling.

Most of this advice applies to preventing or improving the mind due to Vascular Dementia and not Alzheimers' because they probably have two different causes.

How do we proactively go about working on this? 

"Train the Brain"

The brain is like our muscles in the fact that it responds to training by becoming better at functioning. This is called Neuroplasticity. (Increases in neural pathways due to changes in behavior, increases in stimulation, or adaptations to the environment)

Active people work on this every day even if they don't realize it. The older you become, the less active, the less demand on your brain. In the long term this inactivity can really cost you. DEMENTIA. 

There are many programs out there that you can use. Lumosity is one of the most famous ones.
Programs like this will help strengthen your brain.

The part of the brain most effected by this type of training is the Cerebrum. This is the part of the brain responsible for thinking and voluntary movements. It is also involved in developing and retrieving memories.We have all heard when someone is smart they are very cerebral.

Another part of the brain called the Hippocampus works with the Cerebrum when it comes to long and short term memory.

However that is only one part of the best way to improve brain function. Physical activities that require balance, strength, and concentration can improve brain function even more. The Cerebellum is where coordination, posture, fine motor skills and balance are controlled.

Combining challenging the Cerebrum, Hippocampus and Cerebellum at the same time will give the best results. The goal is to strengthen the way the different parts of the brain work together. 

Specific examples of this will be given in the next 3 post on my blog.

Up until recently it was thought that the brain stopped growing after the age of 30. There is a growing body of research that points out that the brain keeps developing will int middle age and beyond with the correct types of stimulation.  Without the correct types of stimulation the older brain can:

1.  Have difficulty multi-tasking (Men even more than Women)
2.  Concentrating
3.  Making decisions.

Where is the proof the "Train the Brain programs work?

According to the Journal of American Geriatrics Society January13, 2014 All 3 can be improved with physical training and mental stimulation. 

Even more exciting: 3000 adults (average age 72) who participated in 12 weekly (60-minute train-the-brain sessions) performed better than untrained counterparts 5 years later. 

Senior Exercise Recommendations: 

Increase Blood Flow = Improved Cognition

The brain is 2% of the adult body weight but received 15% of the blood and consumes 20% of the oxygen.

*  Like anyone else Seniors should get their physicians approval before starting their "Train the Brain" program.

*  High intensity exercise is associated with lower rates of depression and cognitive decline and better health.  Exercise should be done to the point of breathlessness. 

How much and how often?

Cardio Training:

4 - 6 times per week

30 - 60 minutes per session

Balance Training:

At least 3 times per week: Daily is even better

Strength Training:

At least twice per week. Complex movements (using more than one joint at a time) while standing are the most effective.

Drills and Games:

Can be done separately or at the same time as the above activities depending on the frill and/or game. 

Next time I will cover session 2: Balance, Stability and Fall Prevention

 

 



 

How do you physically prepare for retirement? Part 8: How I begin building my clients Lower Body Strength. Part B. Stationary Split Squats

Split Squats and Lunges help you to do this.

Part 7 A: Squats

____________________________________________________________

What you will find is we will use some of the same exercises for improving posture, mobility and strength. The difference is how the exercises are performed. 

Why do I begin with posture and mobility before strength? I want my clients to maximize the gains, while minimizing the risks they will make from the complex movements I use to make them stronger. The results will be much better if they can stabilize what I want stable and move with control what I want mobile.

______________________________________________________________

WHEN WORKING ON ANY OF THESE EXERCISES, NEVER FORCE YOUR BODY INTO A POSITION. The focus should always be on how you are controlling the muscles and joints and the movements they are making. The pace of each movement should be slow. Perform from 5 to 10 reps of each. The goal is to get the muscles turned on as opposed to tiring them out. If you feel fatigue in the muscle when you are done, you have done too many.

______________________________________________________________

What exercises you perform are important. How you perform them is more important.

_____________________________________________________________

Before attempting any of the following exercises, be sure to get the approval of your Physician. Especially if you have ever had ANY JOINT OR BACK PAIN or INJURY.  If you aren’t sure how to perform any of these exercises, have someone show you that knows how to teach you.

___________________________________________________________

After my clients have learned their posture, mobility and balance exercises we begin focusing more on strength.  They still use the posture, mobility and balance exercises as their warm up.

___________________________________________________________

Lower Body Strength: Part B: 

Lower body strengthening exercises should only be done once or twice per week since it is harder for legs to recover than upper bodies since the legs are used every day for weight bearing.

___________________________________________________________

Stationary Split Squats: 

I love teaching clients how to perform Split Squats because they are even more challenging than squats. They require more hip mobility, balance and strength.

A few of the things I have them focus on:

Pushing through the front heel.

Focusing on lowering and raising the hips.

Keeping a tall torso.

__________________________________________________________

Much like squats, if Stationary Split Squats are too difficult I let the clients learn how to use their arms until they don’t need their arms to help.

__________________________________________________________

Stationary Split Squats with assistance from the arms:

I have the client stand next to a counter top or sturdy chair. They place the foot farthest from the counter top or chair in front and the foot closest in back. This keeps torso rotation to a minimum. 

I have them drop their hips towards the floor using their legs to control as much of the movement as possible. They are allowed to use the hand as much as necessary until enough leg strength is built. I have them take from 3 – 10 seconds to descend. If they need to they can rest between each repetition before lower the hips again. The goal is to build up to 12 – 15 repetitions. They get up using the hands to help as little as necessary.

Once they can perform 12 – 15 reps during 2 consecutive workouts, it is time to begin relying less on the hands and more on the legs.

_____________________________________________________________

Split Squats without assistance from the arms:

I have them drop their hips towards the floor using their legs to control as much of the movement as possible. I have them take from 3 – 10 seconds to descend. They pause at the bottom.  If they need to they can rest between each repetition before lower the hips again. The goal is to build up to 12 – 15 repetitions. 

Once they have mastered this we move onto holding the bottom position.

They lower their hips like they have been except this time they hold the bottom position for longer periods of time. (5 – 10 seconds each) They might have to rest between each rep, but the goal is to build their strength so they can perform from 10 – 15 reps continuously.

_________________________________________________________

Once I feel confident the client has enough strength and coordination, I might have them move from split squats to various types of lunges. 

_________________________________________________________

Step Ups without extra resistance.

Other exercises I love to teach are Split Squats with the rear foot elevated (also known as Bulgarian Squats) and Step Ups. Step Ups are a great way to increase a clients confidence around steps.  

My favorite Lower Body strengthening exercise. You get a huge improvement in hip mobility and stability while building strength and balance at the same time.

_____________________________________________________________

This is the last post dealing with the basic movements I use to build my clients strength. This is the foundation which all their training is based on. As they progress different versions of the exercises can be added depending on what will benefit the client. If they need it, do it. If they don't need it, don't do it. 

How do you physically prepare for retirement? Part 7: How I begin building my clients Lower Body Strength. Part A. SQUATS

Bret Contreras know that a set of goblet squats per day keeps the doctor away. 

Bret knows squat, do you?

 Previous two post:

Part 5: How I begin working on my clients Dynamic and Stable Balance.

Part 6: How I begin building my clients Upper Body/Middle Back Strength.

____________________________________________________________

What you will find is we will use some of the same exercises for improving posture, mobility and strength. The difference is how the exercises are performed. 

Why do I begin with posture and mobility before strength? I want my clients to maximize the gains, while minimizing the risks they will make from the complex movements I use to make them stronger. The results will be much better if they can stabilize what I want stable and move with control what I want mobile.

______________________________________________________________

WHEN WORKING ON ANY OF THESE EXERCISES, NEVER FORCE YOUR BODY INTO A POSITION. The focus should always be on how you are controlling the muscles and joints and the movements they are making. The pace of each movement should be slow. Perform from 5 to 10 reps of each. The goal is to get the muscles turned on as opposed to tiring them out. If you feel fatigue in the muscle when you are done, you have done too many.

______________________________________________________________

What exercises you perform are important. How you perform them is more important.

_____________________________________________________________

Before attempting any of the following exercises, be sure to get the approval of your Physician. Especially if you have ever had ANY JOINT OR BACK PAIN or INJURY.  If you aren’t sure how to perform any of these exercises, have someone show you that knows how to teach you.

___________________________________________________________

After my clients have learned their posture, mobility and balance exercises we begin focusing more on strength.  They still use the posture, mobility and balance exercises as their warm up.

___________________________________________________________

Lower Body Strength: Part A:
 

Lower body strengthening exercises should only be done once or twice per week since it is harder for legs to recover than upper bodies since the legs are used every day for weight bearing.

_________________________________________________________________

SQUATS: (aka, the King of all exercises) 

Why do I like teaching my clients how to squat? I believe learning how to squat properly give my clients more bang for their buck than any other exercise. You can develop posture, strength, mobility and balance from this great exercise. There are many ways to squat. 

Three things I have my clients focus on are:

1. Controlling their descents.
2. Starting from the bottom position.
3. Holding the bottom position with the glutes just above the chair. 

Each of these 3 focus points develops different types of strength.

One to the biggest reasons people fear squatting is it can become a very tough exercise. I love to teach clients how to adapt squatting to their current ability. Of course the goal is to increase this ability through training.

Another reason people don’t want to squat is they think squatting is bad for their knees. To quote my mentor Dan John, “Squats don’t hurt your knees, how you squat hurts your knees.”  

A few of the things I have them focus on: 

Pushing through their heels.

Keeping their knees apart.

Keeping a tall torso.

__________________________________________________________

How do I teach clients how to squat if getting out of a chair or couch is a challenge? They use their arms to help until they don’t need their arms to help.

__________________________________________________________

Squats with assistance from the arms:

I have the client stand with the backs of their legs in front of a chair with sturdy armrests. I have them sit down using their legs to control as much of the movement as possible. They are allowed to use their hands as much as necessary until enough leg strength is built. I have them take from 3 – 10 seconds to descend into the chair. If they plop into the chair before their bottom hits the seat, I will add a pillow in the chair until they gain enough strength to descend into the seat without it. If they need to they can rest between each repetition before getting out of the chair. 

The goal is to build up to 12 – 15 repetitions. They get up using the hands to help as little as necessary. 

Once they can perform 12 – 15 reps during 2 consecutive workouts, it is time to begin relying less on the hands and more on the legs.

_____________________________________________________________

Squats without assistance from the arms:

I have the client stand with the backs of their legs in front of a sturdy chair. They slowly lower their hips into the chair. They pause for a couple of seconds and then stand up while focusing on keeping the shoulders up and lifting from the hips. They repeat this for 5 – 15 reps. 

Once they have mastered this we move onto holding the bottom position.

They lower their hips like they have been except this time they don’t sit down between reps. Think about the glutes hovering just above the chair. They start by holding this position for a couple of seconds. 

As they get stronger I have them work on holding this bottom position for longer periods of time. (5 – 10 seconds each) They might have to rest between each rep, but the goal is to build their strength so they can perform from 10 – 15 reps continuously.

_____________________________________________________________

Other forms of squatting I might add:

Goblet Squats, Lateral Squats, Jumping Squats.  

_____________________________________________________________

Once the client has mastered squatting we move onto various types of lunges, split squats and other unilateral exercises. I will post more about them next time.