The Loss of Balance Fear Spiral

Balance, like most other aspects of fitness, falls under the “use it or lose it” category. As we age, we tend to be less active. With that decrease in activity comes sarcopenia, a wasting of muscle that causes a drop in resting metabolic rate, increased fat weight, loss of strength, and functional abilities. A drop in activity can also decrease flexibility and balance. We notice these things, of course. We can’t do the things that we used to be able to do. So, when it comes to balance, the “What if I fall?” question that we start to ask ourselves is followed by fear and anxiety.

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That fear and anxiety causes us to start to hedge our bets when it comes to balance. If you try to stand on one leg, right now, I’ll bet that you fall inward, toward the midline. Having worked with many older adults, I’ve found that this is almost universal. Why is that, you might ask. I believe (yes, this is my humble opinion, although based on years of working with the issue) that the fear of falling has started making people play it safe. If I stand balanced on one leg and lose my balance, which direction would be safer to fall? If I fall outward, I might not be able to catch myself and I could get hurt. If I fall inward, I simply catch myself with my other foot and all is right with the world. So, rather than take the chance of falling outward, I begin to pull back on my balance, never quite getting on top of the leg. This guarantees that I fall inward.  The same is true in falling forward or backward. If I lose my balance and fall backward, I could really hurt myself. However, if I fall forward I’ll either be able to get a foot out in front or at least be able to break the fall with my hands. Hence, we start to lean forward… just in case.

What’s the harm in playing it safe? Well, as we start to hedge our bet, never really balancing on one leg or standing up straight as we walk, our strides become shorter as we fall inward. We’ve decreased the balance challenge, which decreases our actual ability to balance, which we start to feel, which makes us hedge our bet more and challenge our balance even less, and… the vicious cycle continues. Before you know it, your walk has turned into a sequence of short steps, falling forward and inward. You’re now doing the old person shuffle.

The good news is that you can both prevent the loss of balance and/or regain it once you’ve started to lose it. This, like other aspects of fitness, comes from regularly challenging it. As you challenge it and start to see improvement, you become more confident, with increased confidence, you feel comfortable challenging your balance more and… you’re on an upward spiral toward greater balance and functional abilities.

Next week, I’ll talk about some specific ways to safely improve your balance.

 

Mindfully Changing An Overeating Habit

Like any action that we have repeated over and over again through the years, much of our eating has become habitual. And habits are things that we have done so often that they are automatic responses. That mind-less nature of these responses is what can make them difficult to change.

Becoming mindful of what you are doing is the first step in changing it. What’s the old saying… “Knowing you have a problem is the first step in curing it.”, or something like that. If we want to change our eating habits, we need to take a look at what we are currently doing, before we can come up with a strategy for changing it. Keeping a journal is best way to do this. While, ongoing journaling can help you continue to change and stay on track, even just journaling for a couple of days can help reveal trouble areas.

distracted-eating

One of the most common overeating issues is when we eat while distracted. If we have a bag of chips in front of us while watching TV, they seem to disappear without us realizing it until the bag is empty. The same is true if we have snacks at our desk while working on our computer. By not paying attention to our food, we are unaware of how much we’re eating and we’re not even really enjoying the flavor of the food.

If this happens with you, ask yourself why. Are you actually hungry, or it just something you always do (habit)? Do you snack while watching TV because you need to do something with your hands? Understanding why can help you find a solution.

mindful-eatingIf you are hungry, stop what you are doing. Turn your TV off or leave the room or your desk. Get the food you want. Take the time to enjoy the food and think of it as an eating meditation. Experience it. Look at it, smell it, place it in your mouth, notice the texture, the feel. How does it taste? Food will be a lot more enjoyable and you will eat less if you eat mindfully. Then you can go back to whatever you were doing. Sometimes, this mindfulness can even help you make decisions to eat better food. If you really pay attention to the taste of those lousy chips you’ve been eating, you might say to yourself, “Hey, these chips taste awful.” and find something better (dare I say healthier) to eat.

If you find that you are eating because you needed something to do with your hands, find something else to do. It could be knitting, doodling, coloring, making things with modeling clay (or Play-Doh). These may not sound like things you normally do, but you will be surprised how well they work. (If you have other things that work for you, share them with us in the comments below.)

 

What are your eating habits? Do you find yourself eating without thinking about it? Do you know how much you are eating and how the food tastes? Keep a food journal for a few days and see what your eating habits are. If you find that there are times that you are eating without really paying attention, try these approaches to control those mindless moments.

What a Pain!

Pain is a funny thing. For personal trainers, we have been taught that when a client feels pain it is a red flag. Stop what you are doing and send the client to a doctor. But pain is not redflag1always that simple. First, everyone perceives it differently. I’ve had clients that, after a few reps of an exercise, said that it hurts. ? OK, do I stop and send them to a doctor? Well, I do stop. But then we talk about what they are really experiencing. Where does it hurt? In the joint? In the muscle? OK, it’s in the muscle. What does that feel like? Is it sharp or stabbing? Is it dull or achey? Is it tension and fatigue? You’d be surprised how many people are unused to feeling muscle fatigue and report that as pain. I’ve also had clients that would tell me that their backs hurt when they did abdominal crunches (back when I used to have them do crunches). We’d discuss what they were sensing and determine that they were feeling a stretch tension in their lower back. This was neither harmful nor uncommon as one of the limiting factors in how high someone could crunch was the flexibility of the low back.

My point here is not to support the common declarations of “No pain, no gain.” or “Pain is weakness leaving the body.” Rather, I bring this up to make you aware that there are many sensations when you are working out that are often lumped into the pain category and to take a moment and analyze what you are really feeling.

“Pain”, like Baskin-Robbins ice cream, comes in many flavors and depending on the flavor and where it is located, can help you understand its severity. First, let me say that joint pain is always more concerning than a muscular pain. With muscles, you can feel a burning fatigue, stretch tension, acheyness, soreness, cramping, etc. All of which are really more discomfort and, while not pleasant, they are not that concerning. A tearing feeling or pop, on the other hand, you had better pay attention to (stop what you’re doing and see your doctor). Joint pain should rarely be ignored. If ysevere-knee-painou have diagnosed arthritis or are just stiff and achey, maybe you can keep on keeping on. However, if you feel a sharp, stabbing sensation, a radiating pain, or even a strong ache in a joint, it is cause to stop what you are doing and seek medical attention. Joint issues can be very serious and should be addressed before returning to activity.

Backtracking a little, if there is any chronic pain that you are experiencing, no matter what flavor,  you should see your doctor. It’s always better to know what you’re dealing with. The diagnosis will let you make an informed decision as to what you can safely do or not do.

So, while some discomfort is expected in a fitness program, being able to discern between what might be considered normal and what is potentially a real injury, is important in keeping your body healthy. Listen to your body and get to know your flavors.

 

What’s Really Affordable Care

As I write this, the Affordable Care Act (aka ACA or Obamacare) is being dismantled for who knows what as a replacement. Although I personally think that the ACA was a great, first attempt at finding something better than a health care system that was already too expensive for most Americans, it does have it’s issues. aca-logoBut, you can never know all of the problems until something is actually put in place. In my humble opinion, we should now be focusing on correcting the things that don’t work with the ACA. That said, what I really wanted to talk about was the most affordable care… preventative care.

According to the CDC, 75% of health care costs are on people with chronic conditions. These chronic conditions include heart disease, stroke, cancer, diabetes, arthritis, obesity, and respiratory diseases. Furthermore, the CDC estimates that eliminating these 3 risk factors – poor diet, inactivity, and smoking – would prevent:

  • 80% of heart disease and stroke
  • 80% of type 2 diabetes
  • 40% of cancer.

cover-chronic-care_281731694While I know that the majority of smokers know that smoking is hazardous to their health, I believe that benefits of exercise and eating healthfully are too often thought of as just a way to look better. Many people don’t understand the magnitude of health benefits that also come with them. Managing your diet and physical activity really is a health intervention. See Exercise is Medicine!

Going forward, whatever health care system is developed or put in place, it must promote preventative care or we as a nation will never manage health care costs. Of course, you don’t have to wait for that to happen. Take charge of your heath today.

Without concerted strategic intervention, chronic diseases and their risk factors can be expected to cause more harm—and be more costly to society. We cannot effectively address escalating health care costs without addressing the problem of chronic diseases.” – CDC, The Power of Prevention

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Paying Attention to Posture

You may not think too much about your posture, but, in today’s society, it’s easy to find yourself in habitually bad postural positions. We sit all day with our backs rounded over and our heads looking up at a computer screen or down looking at a device. skeleton-with-acs-webPoor posture can lead to numerous problems as we get older. Muscles that are in shortened positions for long periods of time become tight, which will prevent our joints from being able to return to their ideal stretched position. In example, when in a forward rounded position, the muscles in the front of our bodies become tight and make it difficult to stand up with a neutral spine.

Tight hip flexors will pull and tip the pelvis forward which can create low back pressure and pain.

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Tight chest muscles may cause the spine to round forward which then create a posture that forces an increased curve in the neck when trying to look forward or up. This, in turn, can create neck pressure and pain.

The rounded posture can also put more pressure on the diaphragm making it more challenging to breathe.

To prevent or counteract these postural deviations, like most aspects of fitness, is very personal depending on your strengths and weaknesses. Stretch this. Strengthen that. However, I’m going to let you in on a simple solution. Sit talls.

Sit on the edge of your chair avoiding touching the chair back. Sit tall and then imagine I offered you $50,000 to sit 2″ taller. As you try to stretch your spine up, pushing the top of your head further toward the ceiling, you engage your core muscles. This will help strengthen your weaker postural muscles, such as your abs and upper back. It can also help stretch tight, front torso muscles. Sit talls can also be performed as stand talls, trying to stand as tall as you can.

Of course, even if you build strength and flexibility, you then need to create the habit of holding good posture. I tell clients to set their watches to chime on the hour and, when it goes off, check your posture and make sure you are sitting or standing as tall as you can. Hold it. You’ll forget after a while, then the chime goes off again. You correct your posture again and bit by bit you create a habit of holding better posture.

 

 

Free Weights, Machines, Tubing, or Body Weight?

Should your resistance workout include free weights, machines, tubing, or body weight exercises? The answer is “yes!” It should and could include any or all of those various resistance training forms. The choice you make depends on a few things. These include what you are training for (your goals), what equipment do you have access to, and what have you been using (variety is the spice of life). Let’s talk about what each has to offer.

First, let me note that all are means of adding resistance to movement and, in doing that, have the potential to build muscle size, strength, and endurance depending on the repetition range and volume (a post for a later time). Yes, you can body build with tubing alone. Your muscles don’t know what form of resistance you are using. They only know, “Is it hard?” and if it is, your muscles will adapt.

designFree weights (a constant, external weight) have been around forever. Anything we grab and lift is a free weight. There are many physical professions that produce strong people because they lift heavy things as part of the job. In fact, some of the strong man/woman challenges are taken from these, such as the farmer’s walk and yoke carry. One of the major benefits of lifting free weights is that can replicate the demands that we face in our activities of daily living (ADL). This is typically what is called functional training. Lifting with free weights can make you deal with balance, stability, and gravity in a similar way as lifting something in “real life”.

Machines typically have a pin selected weight stack, seats that need to be adjusted to fit your body, and handles that you either pull or push. The good and the bad? Changing weights are quick and easy. Machines support your body weight so you don’t need to. This makes it less like activities of daily living. However, that support can also allow you to work around injuries and not all exercises need to be directly related to ADL. Additionally, most machines offer variable resistance. Where free weights are always the same (a 10lb dumbbell is always 10lbs), through the use of different shaped cams, machines can increase and decrease the resistance. This helps you to work through “sticking points” to maximize resistance within a full range of motion.

Tubing (elastic tension) offers the advantages of being highly portable, very versatile, and simple to change the direction of force (up, down, horizontal, etc.) by changing the anchor point. It can provide significant resistance both by changing to a heavier gauge tubing or by simply moving further away from the anchor point. The biggest downside to tubing is that you are never sure how much resistance you are using. This makes replicating the tension, from one workout to the next, challenging. Without that measurable progress marker, some people may not be as motivated.

Finally, there is body weight exercise. Using your body weight (BW) is certainly functional, we have to move our bodies around all day long. No external equipment is needed, so it’s a handy portable workout. There’s also an ego advantage. Who doesn’t like the idea of being able to handle their own BW. Push ups, pull ups, and dips are long time fitness standards. We can’t alter our weight, though, to suit the exercise. I watch some guys crank out pull ups and have to note, “Well, you only weigh 150. Try that at my weight (212 as of yesterday, btw).” Sometimes your BW is not enough. BW squats, if challenging now, will rapidly become too easy. You need to be creative to give the whole body the right amount of resistance. (See push up progression here)

So, when the question of which mode of resistance training is best for you arises, you know the answer is “It depends”. What tools are available, what is your goal, what things do you like doing? The important thing to note is that all of these can provide very effective workouts and your body will not respond differently because of the type of resistance you use.

The Problem With New Year Resolutions

The new year is coming up and with that come the new year resolutions that rarely get accomplished. We’ve had enough new years come and go and most of us have experienced that feeling of the unachieved promise we made for the new year. Why do you think resolutions are so hard to keep? I have a few thoughts about it that I’m going to share with you.

newyearresolutionResolutions rarely come with a plan. They are typically announced (even to ourselves) as a platitude. “This year I will… lose 40lbs, start my own business, quit smoking, spend more quality time with my family, etc.” These are well intentioned statements that, when not accompanied by a detailed plan, can put huge pressure on an individual. They are also highly unlikely to be achieved which leaves us feeling like losers.

Resolutions should also, like any goal, be set using SMART guidelines. SMART stands for Specific, Measurable, Attainable, Realistic, and Time Bound.

Specific is the details of the goal. If your goal is to lose weight, how much and how are you going to accomplish that. I will lose 40lbs by creating an exercise routine that consists of 30min of cardio and 30min of weight lifting three times per week. I will also track my calories using myfitnesspal app and stay within my allotted calorie range.

Measurable, is that specific goal measureable? Well, the more specific it is, the easier it is to measure. Did you workout or not? Did you track your calories or not? Having said that, it may be a better choice to not be black and white about it. Give yourself a percentage ranking for the tasks. I worked out twice this week instead of three. So, I scored 66%. Now, what can you do to get yourself to 100%?

Attainable is a reality check. Is this something you can actually achieve? We can achieve most things, but if I were to say that I wanted to play pro basketball (at age 59), it is highly unlikely that I can make that happen.

Realistic, Well, this has always bugged me a little. It’s really the same idea as Attainable. Is this goal realistic? Honestly, having been born and raised in Maine, I prefer to go with the Maine version. Mainers would pronounce smart “smat” (dropping the r sound) which works just as well as a goal setting guideline.

Time bound is simply putting a deadline on reaching your goals. Without a deadline, it becomes easy to put things off. As the  Parkinson’s law states, “work expands so as to fill the time available for its completion”. The longer you give it, the longer it takes and with no deadline, it will unlikely get done at all.

Our resolutions should also come with a strong and detailed Why. Why is attaining this goal so important to you. Why is this goal important to you? Losing weight is not about looking better or being healthier. It might be about feeling more self confidence when you feel you look better or it may be about being healthier so that you will live long enough to see your grandchildren grow up. Write dow the real, deeper reason why your goal is important.

To top off our chances of success, we should have someone that we are accountable to. Maybe you ask a friend or family member to help keep you on task. Check in as often as you need, but set a regular schedule. Every day at 8pm, or every Monday at 7am. You could even set a time that you check in with yourself. The key is to set a time to objectively evaluate how you are doing.

So, if you want to win at the resolution game, be SMART, know your why, and be accountable for your meeting your steps toward your goal.

Keeping Your Brain Fit

As we age, there are changes that occur that we typically expect to face. These might include some hearing loss, impaired vision, and general aches and pains. These are annoyances for the most part and not things that need to diminish our quality of life to any great extent. However, for many, a big fear and source of anxiety is the possibility of suffering from Alzheimer’s or some other form of dementia. Alzheimer’s is the sixth leading cause of death in the US and the second most feared (after cancer). Who could blame fearing it? It can rob us of our memory to the extent that we don’t remember our loved ones, and, to date, there is no cure for it. That said, there are things we can do to keep our brains as healthy as possible for as long as possible. Brain fitness programs have been explored to help people maintain healthy brain tissue and function.
fit_brainThere are five main elements that we can engage in to help our brains working optimally.

  1. Physical exercise has been shown to improve blood flow to the brain, as well as stimulate the production of brain derived neurotropic factor (BDNF) which has been described as “Miracle Grow for the brain”.
  2. Proper nutrition, healthy foods in healthy amounts (especially those high in omega 3 and antioxidants) helps to keep the brain’s tissues functioning optimally.brainfitness-elements
  3. Cognitive challenge is essential and more than just doing crossword puzzles and Sudoku. Look for learning opportunities that involve multiple senses such as learning to play an instrument or learning to speak another language.
  4. Stress management can have a big effect on our lives. Stress elevates cortisol levels (stress hormone) which, if it is chronic, can destroy brain cells making it harder to remember and think clearly. Try activities that can reduce stress such as exercise, meditation, or other things that draw your attention away from your stressors.
  5. Socialization is also important. Studies have shown that people with many social connections, that they interact with on a regular basis, experience a slower rate of memory decline.

These elements of a brain fitness program don’t need to be addressed separately. In fact, one of the best things you can do is to layer various elements together. Fitness classes are a great example of the possible layering, exercise, cognitive (following and/or learning choreography), stress reduction, and socialization with others in the class. Another example could be taking an Italian cooking class where you also learn Italian (cognitive, socialization, possibly nutrition). As I think about it, there’s a very popular one at the moment, the social painting classes (socialization, cognitive, stress reduction).

We can make a difference in our brain’s health and function. The mind is a terrible thing to waste. (I think I heard that someplace 🙂 ) Don’t let yourself slide into mental decline if it can be prevented or even delayed. Try to integrate these 5 elements into your life. Mix and match them. They are what make life richer and help keep it that way.

 

 

Eating to Build Muscle

Building muscle, whether young or old, keeps us able to do the things we want in life. That may be playing sports or carrying groceries. It also, being a more metabolically active tissue than fat, helps us keep fat off. The more muscle we have, the higher our resting metabolism, which means we burn more calories at rest than someone with less muscle. Now, to build muscle, we need to challenge them so they need to adapt and grow. This is most effectively done through resistance training (i.e. weight lifting). Most of us understand that. What a lot of people don’t know is that eating the right foods in the right portions is equally important.

Let’s start where everyone’s mind goes first, protein. Protein, by itself, does not build muscle! Resistance training stimulates muscle growth. However, if you don’t have adequate protein to help with tissue synthesis and repair you will not gain muscle and will likely even lose it.

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So, how much protein do we need? Often, the RDA (recommended daily allowance) is looked at for guidance. You would think that would make sense, right. But, the RDA is about surviving, not thriving. They are minimal allowances. To build muscle, we need more. Alan Aragon, nutrition researcher and educator, in his book with co-author Lou Schuler, The Lean Muscle Diet, recommends 1 gram of protein per pound of Target Body Weight (TBW). So, say you weigh 240 pounds and wish to weigh 200, 200 lbs is your TBW. That means that you should eat 200 grams of protein per day. This is equivalent to 2.2 grams per kilogram, almost 3x the RDA which only recommends 0.8 grams per kilogram. Now, Aragon is not being age specific with his proposal. Yet, several studies that looked specifically at older adults, recommend increased protein intake from 0.8 to between 1.2-1.5 grams per kilogram, still less than Aragon’s. I believe (yes, this is me giving you a judgement call) that, from all of the research I have read and presentations that I have been to, the amount of protein for muscle gain (thriving, not surviving) lies on the higher end of the spectrum, probably between 1.8 and 2.2 grams per kilogram.

Now, muscle-building nutrition is also more than just about protein. We need adequate carbohydrates and healthy fats AND … enough total calories. If we are eating too few calories our bodies may turn to our muscle to break down into fuel. Obviously this is counter productive if we are trying to gain muscle. I’ve worked with many, so-called, hard gainers (those that can’t seem to gain muscle). More often their difficulty stems from one of two things or a combination of both. Either they are not challenging themselves appropriately with their weight lifting program or they are not eating enough to support muscle growth.

Quick approximation of Daily Caloric Needs (DCN): there are many formulas to determine DCN and all are ballpark guesses. I tend to start with the Harris-Benedict equation to determine the resting or basal metabolic rate (BMR) add in activity level and thermogenic effect of  food. Then I will tweak it up or down as we monitor results. You can use this link to get you started – Harris-Benedict calculator. Take your BMR number and multiply it by your activity level (1.2 for couch potato – 1.75 for high-end athlete). Now add in 10% of your BMR for the thermogenic effect of  food. This will give you an approximation of your DCN.

If you want to gain muscle at any age you need the growth stimulus (resistance training) and the support for growth by getting enough protein and total calories. Now go put on some muscle!

Building Muscle After 50

In a recent article in the New York Times, Can You Regain Muscle After 60, author Gretchen Reynolds discussed research done in which “men and women in their 60s and 70s who began supervised weight training developed muscles that were as large and strong as those of your average 40-year-old.” This is important because what keeps us able to do what we want as we age, is muscle. Strength, power, and your resting metabolism depend on gaining, or at least not losing, muscle. So, how do we do that?

karl-on-deck

Metal sculptor, Karl Stirner at 82 years old

Let’s start with the idea of not losing what you have. In a previous post, How Many Years Do You Have Left?, I mentioned sarcopenia, or the physical declines that come with muscle loss. Sarcopenia is predominantly caused by a lessening of physical activity as we get older. One of my favorite examples of someone not slowing down as he got older, was my father-in-law, Karl Stirner. Karl was a metal sculptor (he passed early in 2016 at the age of 92). He hauled iron around on a daily basis until he was almost 90. His strength always amazed me. That continued physical activity kept him young and physically capable of living life on his terms. The same can be true for you. If you are physically active, stay that way. If you’ve had a physical job all of your life and you find yourself retiring or changing jobs, find other ways (maybe more fun ways) of staying active.

What if you’ve never been never been active or worked out or it’s just been a really long time since you have? You need to start to build muscle. The best way to do this is resistance training. This includes free weights, machines, tubing, body weight, etc. As long as the exercise is challenging to you within a general repetition range of 8 – 20 repetitions, it’s going to help you build strength and muscle. However, start small, start light. With the prospect of doing this for the rest of our lives, we can take our time building the intensity and the volume of the program. This will help minimize the risk of injuries. I will often only give 5 or 6 exercises to someone just starting out. One set of 12 repetitions for each of the exercises on day one and then see how they feel the next day. If they are not too sore and have no issues, we can start to progress the program. Ultimately, the program has to become very challenging or you won’t have enough stimulus to build muscle.

Finally, you need to support muscle growth by eating enough calories and enough of those calories coming from protein. That will be my next post. In the mean time, know that you can (and should) build strength and muscle no matter what your age.  If you’re doing it, keep doing it. If you’re not, get started. It’s never too late.

Please, if you have any questions, feel free to ask them in the comments.