Although many institutions offer recommendations for exercise, we must question if they maximize physical capacity and have the ability to alter the aging trajectory. The American College of Sports Medicine (ACSM) recommends the following activity levels for older adults.
Accumulate 30 minutes of moderate intensity aerobic exercise on most, preferably all, days of the week.
Perform one to three sets of 10 to 15 repetitions, two times per week for all major muscle groups.
Increase aerobic exercise to 45 minutes to 60 minutes at most, preferably all days of the week, plus do the recommended strength training parameters.
These general guidelines leave room for interpretation and are not specific to individual needs or health issues. Is this is enough to prevent disability in aging adults? Is it enough to maintain normal physiological function well into our 70s, 80s and 90s? Unfortunately, for the majority of us, it isn’t. However we can maximize potential and dramatically alter the aging process.
My job as a trainer is to go much deeper than the general exercise recommendations for the masses and general public. I strive to create a highly individualized plan that will maximize and restore as much functional capacity as possible. The first question I ask is, Does this client lack strength and muscle mass? Does he or she suffer from sarcopenia? If the answer is yes, then research has shown us that people as old as 100 can build muscle through high-intensity resistance training. I would begin to work with that client on a highly progressive total body resistance program. I would spend a great deal of focus on the lower extremities, as they hold the larger muscle groups and will derive the largest value and improvement in function.
The next question I ask is, Is an increase in strength enough to improve function? For some it is, but for others, the answer is no. Strength is vital to activities such as lifting heavy objects, climbing stairs, and playing sports, among others. The issue is that function requires more than strength. How about a client with Parkinson’s disease. He may be able to leg press 400 pounds, yet he may struggle to walk across the room. Has his leg strength increased his function? No. Knowing that strength training is not enough, we must then look at the client’s ability to integrate strength with stability.
A prime example of this is the case of a trip or slip. A normal response is very rapid so that the person can grab an object to catch their balance, or tuck their body into a safer landing position to prevent an injury. For someone who is older, their response time and balance is altered and slow. This can be the difference between a major fall with a significant injury or a “Wow, that was a close call” non-incident. We must work on proprioception, and the reaction time of our clients and their central nervous system. Improving this is key to improving function and quality of life.
The final area of concern is the integration of strength training, and balance or proprioception training. We must use movements that force the client to move multiple muscle groups at one time. We must also challenge our clients to move through multiple planes of movement. All this means is that we have to get our clients away from stable platforms and isolated exercises to movements that replicate the stresses of everyday activity in order to enhance function. An example of this is having clients do a standing single-arm row. Is this the best way to optimize the strength of the upper back and arms? No, the seated row and lat pulldown are superior in that regard, yet this movement in the gym replicates the act of opening a heavy door for our clients, and does a much better job of increasing function. It requires our clients to plant their feet, activate their core muscles, and create a solid base of support to move the weight. This is the answer to increasing function for our older clients.
A sample workout is listed below. This just lists a few exercises, and is in no way a complete workout, but it will provide a reference point on how to train properly in your 60s, 70s, 80s and 90s.
Perform three sets of the following exercises for 12 to 15 reps each.
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