Developing an Exercise Program for Healthy Aging
FITNESS
Charles L. Blum
DC
Developing a healthy lifestyle is important for healthy aging. The choices we make today will affect our health, capacity to function, and ability to enjoy our lives as we age. While there are many aspects of a healthy lifestyle (not smoking cigarettes, having a healthy weight, limiting alcohol intake, partaking in a healthy diet and lifestyle, etc.) this article will focus on one of the most important of these, exercise. 1
Biological aging takes place regardless of what we do or don’t do, however, we can minimize the biological effects of aging with regular exercise. Regular exercise can “increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions.”2 There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription should include aerobic exercise, muscle-strengthening exercises, and flexibility exercises. Being physically active in younger years translates into a higher likelihood of being both physically and mentally healthy as we age into our 80’s, 90’s, and even into our 100’s. Ultimately this means as we age our quality of life and activities of daily living do not have to precipitously decline.3-6
There are three important factors when considering developing a healthy exercise lifestyle, and these include:
1. Performing aerobic, muscle strengthening, and flexibility exercises (covered in part one of this article).
2. Developing symmetry in muscle use and function - strength and flexibility (covered in part one of this article).
3. In part two of “Developing an Exercise Program for Healthy Aging,” we will cover understanding your body type and what proportion of aerobic, muscle strengthening, and flexibility exercises should be performed based on individual strengths and weaknesses in these areas.
Understanding your body type and whether amounts of aerobic, muscle strengthening and flexibility exercises are evenly distributed or unequally weighted.
How might the individuality of our body type affect our aerobic, strength, and flexibility exercises? Why would one’s body type dictate the type, amount, and proportion of exercise activities we should optimally perform?
While there can be many factors utilized for directing the development of an exercise program, two major issues that should be considered involve conditions related to obesity and generalized hypermobility syndrome (GHS).7 Understanding your body type can help determine how to balance the optimal percentages of aerobic, strengthening, and flexibility exercises.
“Obesity is a multifactorial disease that results from a combination of both physiological, genetic, and environmental inputs”8 and “has become a major public health concern in the United States and the rest of the world.” Obesity is associated with adverse health consequences, including type two diabetes mellitus, cardiovascular disease, musculoskeletal disorders, obstructive sleep apnea, and many types of cancer.9-12
Even recent research is finding an adverse relationship between obesity and long-term brain function and cognition.13 The good news is that the “probability of developing adverse health outcomes can be decreased with maintained weight loss of 5% to 10% of current body weight.”14
While we may be aware that weight loss is important for our health, it is not an easy task to lose weight since there can be many psychological factors making the process challenging. This is usually the case with dietary modification, so in some instances, it may be easier to initially focus on exercise when starting a weight loss program since exercise may be a more important factor for weight loss than dietary control.15
The mitochondria are the part of our body’s cells associated with energy production and utilization and are vital for maintaining metabolic homeostasis.16 Current research “strongly suggests that the lower mitochondrial capacity associated with obesity, type 2 diabetes and aging is not an irreversible lesion. However, weight loss does not appear to affect this response, even when weight loss is extreme. In contrast, increasing physical activity improves mitochondrial content and perhaps the function of the individual mitochondrion.”17 Advancing age and increased adipose tissue contribute to the development of sarcopenic obesity, where there is an increase in fat cells found within muscle tissue. Weight loss solely related to dietary control does not tend to affect sarcopenic obesity, whereas exercise does.18 It is crucial to understand when performing the necessary moderate-intensity aerobic exercise program to facilitate weight loss that the process will take approximately six to twelve months to induce a modest reduction in weight and waist circumference.19
Generalized joint hypermobility (GJH) is a hereditary connective tissue disorder characterized by lax joints and the presence of musculoskeletal symptoms. The syndrome has been under-recognized and has only recently been taken more seriously.20'22 The research suggests that GJH may be found as a normal variant in 20% of the population with a greater prevalence in women than men. Those with GHJ tend to prefer flexibility exercises (e.g., yoga) whereas those without commonly prefer strengthening exercises (e.g., weight lifting). An easy way to determine if you have GJH is if you give a positive answer to any two questions in the following five-part questionnaire.7
• Can you now [or could you ever] place your hands flat on the floor without bending your knees?
• Can you now [or could you ever] bend your thumb to touch your forearm?
• As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits?
• As a child or teenager, did your kneecap or shoulder dislocate on more than one occasion?
• Do you consider yourself “double-j ointed”?
Does flexibility training involve important considerations such as which joints are best to focus on with our stretching? The type of joint and its function gives clues to this answer. Ball and socket joints such as the hip and shoulder generally need to maintain good flexibility for walking, balance, and upper body use. Hinge joints such as the knee and elbow usually are not a region we will need to focus on flexibility. Saddle joints like the ankle and wrist are a bit complex due to the ankle joint being an important weight-bearing joint, whereas the wrist is not. Most commonly we want to maintain adequate ankle forward bending (dorsiflexion) as a means to keep our Achilles tendon flexible for walking. Ideally, we need to focus on maintaining good hip ranges of motion, good shoulder ranges of motion (particularly at the front of the shoulder), and good ankle dorsiflexion.
The spinal column is also an important region of the body to maintain flexibility but it is crucial to maintain a high degree of exercise awareness and caution in the process. With all spinal movements that involve flexion and extension and right and left lateral flexion or rotation the first concept with stretching should be to focus upon the feeling of our body lengthening. It is important that before we stretch the spine we initiate any motion by first attempting to lengthen our spine and then move as if we are using the whole spine, from head to tailbone, and not focusing solely on one segment or portion.
When considering a stretching program it is important to focus on the joints to determine where to best focus our attention and how to maintain a manner of stretching that will optimize the body and spinal column’s health. While joints are one region of focus for stretching, when most people think of stretching they tend to associate it with muscles. Many muscles of the body need attention when developing a flexibility based exercise program and each body has its own unique patterns and symmetry issues. One important factor is that when stretching muscles it is important to feel the stretch in the muscle and not within the joint. For instance, when stretching the hamstring we don’t want to overstretch the knee and hyperextend, or when we are attempting to stretch the hip joint we don’t want to inadvertently overstretch the weight-bearing sacroiliac joint.
Developing a general strengthening and stability exercise program is especially important for post-menopausal women and anyone with GHS, but also of value for healthy functioning in the general population. One important caution is lifting weights in a manner that overloads our sacroiliac joint, vertebral discs, and even the vertebral bodies. When beginning a strengthening program it is usually best to start with low weight and then increase the weight over time. This gives both your muscles, joints, and bones the ability to adapt to the new loads. It is also helpful to use activities that utilize your own body’s weight or incorporate springs or stretch bands for resistance. One key factor to consider is that it is better to have an eclectic exercise program that uses different parts of the body in different ways so that the body is challenged differently each day.
When developing an exercise program it is important to determine if you need to focus on weight loss and/or a program that involves more stability versus flexibility training. If obesity is an issue then aerobics will be an essential part of a lifestyle exercise program. If GHS is a factor then you would want to limit excessive stretching and focus more on strengthening and stability training. On the other hand, if you have reduced flexibility and ranges of motion you may want to limit your strength or stability exercises and focus more on stretching or flexibility training. Whatever type of training you find best for your body it is always a good idea to vary your activities so you are stimulating your myofascial, skeletal and neurological systems in a manner that will not cause repetitive trauma to your body over time.
Conclusion
Exercise is an important part of a healthy lifestyle, which can be used for disease prevention and sustaining a good quality of life and the ability to perform activities of daily living later in life. While exercise is important, tailoring the exercise to address any asymmetries, weaknesses, and personal physiological limitations is key.
tice search Charles Santa Monica, for Sacro L. Blum, California, Occipital DC is Technique in director private of Orgapracrenization - USA, adjunct research faculty at Cleveland Chiropractic College and teaches the Sacro Occipital Technique (SOT) elective class at Palmer College of Chiropractic-West and Southern California University of Health Sciences. Contact Dr. Blum at 310-392-9795 / www.drcharlesblum.com
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