Daily strengthening saves lives

and you can be a life saver

You may have seen a previous article I wrote regarding using a daily approach to prevent falls.  In that piece, I briefly touch on weakness as one of the contributing factors to someone losing their balance.  Our culture has a tendency toward anticipating that as one ages, they lose strength and endurance as part of the aging process.  What if I told you that this does not have to be the case? Research is showing that strength training just 2 times a week for those over 65, contributes to longer life span, as seen in JAMA network research letter on the association of muscle strengthening and aerobic physical activity

The benefits of strength training exceed muscle strength, as a research study on stronger muscles linked to lower risks of Alzheimer's reflects on its greater benefits. I have worked with so many elderly individuals who are beyond 90, some over 100, who are fully independent in their mobility. They also happen to be some of the most cognitively intact patients that I work with. When the mind continues to serve the body, the body is more able to participate in functional activity. It is common to watch such patients who are hospitalized quickly restore to their baseline and be discharged home versus to a short term rehabilitation.

How are these folks keeping up with their strength training? For the most part, they remain strong and active because of their functional mobility that they apply to everyday activity and they make a point to walk beyond the average distances for most elderly people. They are carrying household items, cooking, doing their own self care and working in the yard or in the garage. When these types of activity are not possible for someone, avoiding inactivity should be a goal according to the Physical Activity Guidelines for Americans.  

It is common for people to become more sedentary as they age and over time the average steps per day that were once between 2,000 and 9,000 declines to less than 1,000.  It is common for the patients that I see in the hospital, the ones who come in due to a fall or generalized weakness related to other health decline, to only be walking household distances. What does that mean?  Household distance is what is required to get from one’s bedroom to the bathroom or from the living room to the bathroom or kitchen. Usually around 30 feet maximum. This short distance does not provide much time to build up any time of endurance or strength.  

The role of purpose driven activity 

A decline in mobility usually occurs as a lack of purpose driven activity and a lack of social opportunity. When a person begins sitting more than they are standing, they stop leaving their home, getting dressed for a daily routine and stop having a daily goal for completion, their mobility begins to seize and strength begins to decline.  So, one of the most important things to have each and every day is a purpose.  The purpose, the activity, doesn’t have to be outside of the home every day, but that does help dramatically in terms of strength, endurance and mobility.  When there's a purpose that requires them to be alert, ready and moving, they remain consistently engaged in mobility, which allows their muscles the opportunity to be engaged, and even challenged. 

How to start? Focus on creating opportunity for mobility and activity versus stagnation throughout daily activity related to the basic self care routine. 

- Walk more inside the house and outside whenever possible to get those steps in. 

- Build strength with a  minimum of 10 minutes at least 2 days a week while using a video (there are many on Youtube), using soup cans or bottled water as a resistance or free weights if available.  

Daily strengthening options

Isometric exercises have great benefits as well and they do not require any equipment at all as shown in this isometric exercise video that might be helpful to use daily. Isometric exercises are also very effective and arthritis friendly. According to The Mayo Clinic, the effectiveness of isometrics for strengthening can then lead to the ability to perform additional exercises and also help to reduce pain.  

Building in a daily routine of stretching and strength training can be life changing.  Here is an example on how to start. Before getting out of bed, activate each joint from toes up to the neck by giving them a wiggle and a roll and then tightening the muscles around the larger joints (ankle, knee, hip, shoulder) with the use of isometric contractions that are held anywhere between 3-30 seconds. 

Once seated at the side of the bed, before standing up, lift the upper body toward the ceiling with a full stretch and inhale that expands the lungs, rolling the shoulders back and then turning the upper body into whatever available rotation can be achieved to both sides.  Repeat this a couple of times. Prepping the body to work is often overlooked and is a simple way to see improved quality of movement. Learning some basic Yoga breathing and stretching techniques can be very beneficial and easy to do without any equipment.  

Plan on strength training two times a week and put it on a written schedule or calendar so that it doesn’t get missed.  Remember, you only need to make 10 minutes of time for this to be effective.  Depending on the capabilities of the body, seated, standing, or even combined ground level training is an option. Finding a YouTube channel that fits your loved one’s needs can give them some independence in completing these exercises.  

In addition to the two days a week of 10 minute exercises, aim to have your loved one engage as much of their physical body in their daily care routine as possible. Here are some areas that can be optimized: 

-standing at the sink to wash up vs sitting down

-sitting at the side of the bed when getting dressed vs laying in bed or having you or another caregiver do the majority of their dressing for them

-stop using bedside commodes during the day and start walking to the bathroom for more ambulation

-start walking to the dining table or the kitchen area to eat vs eating at the couch or the bedroom

-get washed up and dressed every day (including wearing shoes)  vs staying in pajamas

-use the right balance device to build confidence and possibility to walk further inside and outside of the home routinely

When you keep in mind that the body is working the joints and muscles every time it is in motion for basic daily activity, you will find so many opportunities to strengthen and build endurance for your loved one. You will also find that the more they are doing for themselves, the less burden is placed on you. They will be getting stronger and more capable instead of relying on others as they progress.  It is a win-win for both of you.