AEROBICS

This mode consists of repetitive, long duration, large muscle activity - walking, jogging/running, swimming, cycling, rowing, dancing, etc. For an aging population, aerobic exercise is thought by many to be the single most beneficial exercise mode. And swimming may be the best of them all. It helps with muscle strength and endurance, flexibility, and cardiopulmonary fitness. All of this without significant risk of joint damage. And the buoyancy of the water makes it an excellent exercise medium for the obese (or even for the pleasantly plump). On the downside, there are: 1) swimming seems to do little for weight loss, and 2) not everyone has easy access to a pool.

MUSCLE CONDITIONING

Working on muscle conditioning (primarily by weight training) is very important for the elderly. In addition to helping prevent falls (Accidents are the sixth leading cause of death among the elderly, and falls are a major cause of accidents.), muscle strength is invaluable for simple things like walking or getting up out of a chair or bathtub, or out of a car; not to mention helping to avoid or lessen the ravages of osteoporosis. Muscle conditioning helps us remain vital in our later years.

It is almost superfluous to say, but light weight/high repetition workouts are the obvious choice for seniors; especially for those without prior weight training experience (and that means "yesterday" or "last week," not several decades ago). If, however, the exerciser is in a program in which heavy lifting is included, it is likely to be all right to continue.

Another issue for an older person who is just starting a weight training program is the universal "see a doctor first": routine. But not everyone can go see a doctor at the drop-of-a-hat - economic reasons, you know.

For those of us in that economic condition, be very aware of what your body can't do. Be aware of things like known heart problems, arthritis or other bone/joint problems - any abnormal health conditions. Start gently, and don't tolerate any pain (pain, not just fatigue). Be aware of your physical limitations, and try to improve them.

Equipment

You can get by with none, your body weight will do just fine; however, light dumbbells, rubber tubing or bands, or exercise equipment (gym or home multi-exercise stations, for example) can all be used safely and effectively. A knowledgeable trainer is recommended - to create programs, check exercise form, and act as a "spotter," among other benefits.

Exercise Intensity

Traditionally, weight training programs intensity is measured in terms of weight, repetitions, and sets. Intensity is modified by increasing or decreasing any of those factors, and/or by changing rest intervals.

One set, done until the muscles being worked are fatigued, but not exhausted, is enough. Start with very light weights, and use them until good exercise form is mastered; challenging the muscles is not the real point of the exercise program until then. As the exerciser gets comfortable with the movements, more intensity can be added. First, add more reps, then increasing weight may be appropriate.

Special Conditions

There are some special groups among our seniors (again, these conditions are found in all age groups, so, if-the-shoe-fits, blah, blah, blah) who need some special attention - including victims of lower back pain, osteoporosis, arthritis, and diabetes.

Lower back pain can often be relieved by strengthening the muscles of the abdominal cavity, especially the rectus abdominis (front wall of the cavity), and the erector spinae muscle group (lower, rear abdominal cavity wall). Pay particular attention to avoiding excessive arching of the back (lordosis).

Osteoporosis (decreasing bone density) can be retarded by weight bearing resistance exercise - weight training being the number one example.

Arthritis is common among the elderly, and can be helped by exercise, especially, by streng-thening muscles and tendons around joints. It also seems that strengthening nearby joints helps. When pain is particularly intense, it is recommended that any exercise attempted, be done around afflicted joints. It also seems that strengthening nearby joints helps. When pain is particularly intense, it is recommended that any exercise attempted be done without external resistance (e.g., dumb-bells, bands, machines, etc.). As a general rule, sufferers should rest frequently during exercise. And note that excessively affected joints would be better served by isometric (static contractions) exercises that would strengthen tissues around joints, but without movement.

Diabetics can profit from exercise, but should talk to their physician about what they plan to do/are doing. Insulin/carbohydrate levels need to be addressed. An exercising diabetic should have quick and easy access to carbohydrates. It is important for an exercising diabetic to have a physician as an active partner.

Resistance Exercises

These exercises are similar to what would be done in any fitness program, but with some modifications - less intensity; very often, a shortened range-of-motion; and some added exercises. There is no single program for seniors - individual differences require individual program adaptations. The exercises themselves are organized by body part (no exercise order is implied); and remember that not all exercises are appropriate for each individual. The exercises described herein, may be augmented by those described in the February through July 1995 Newsletters. If you don't have back issues, or access to the Internet (http://www.hinc.com/maf), and are interested in obtaining them, contact me as shown at the end of this Newsletter.

Remember to properly warm-up and cool-down with every exercise session. Stretch exercised muscles (this is a short stretch - hold for 10-15 seconds). These three activities will help avoid, or minimize, muscle soreness.

All right, here we go.

Please note that the positions shown in the accompanying figures are not cast in stone (i.e., if getting up and down is difficult, lying might be replaced by a standing position - do whatever works). Also, in the standing position, it is acceptable to use a chair back, a wall, or whatever, to hold on to for support. Also, nothing but simple body weight may provide adequate resistance.

Hips/Legs

Hip Extension - As depicted, raise your foot high enough to contract one of those big butt muscles (gluteals), squeeze, lower to the initial position. Repeat as desired.

Hip Abduction - Raise the top leg high enough to feel a strong muscle contraction, pause, and lower. Remember, slow and under control.

Hip Adduction - In this case, you are moving the lower leg upward. Raise the leg until you feel a strong inner thigh contraction, pause, then lower.

Butt Squeeze - As the name of this exercise suggests, the action required is to simply contract the buttock muscles, hold briefly, relax; and repeat this sequence, as desired.

Leg Curl - From a standing position, raise one heel toward the corresponding gluteal muscles, pause at the upper end of your range-of-motion and squeeze your hamstring muscles (back of the thigh), and return. Your thigh should remain vertical during the leg curl. Again, ankle weights can be used, and gyms have various machines for this exercise. Do both legs, please.

Heel/Toe Raise - This combination works both the front and back (anterior/posterior) of the lower legs. As shown, there is no external force, just isometric muscle contractions; but these movements can be done on stairs, or towels or bands can be used to increase intensity.

Mini Squats - This exercise is somewhat akin to sitting in a chair, but you may "sit" only a couple of inches, depending on the condition of your hips and knees. The point is to contract the quadriceps muscles in the front of your thighs. Keep your back as vertical as possible, and don't go lower than thighs-parallel-to-the-floor.

Chest

Bench Press - This classic chest exercise, shown here as a floor press, is typically done on a bench, or on a seated press machine; but the basic movement is as depicted. From this position, press the weights straight up, pause, slowly lower to the original position.

Crossover Flyes - From a seated position, with dumbbells in each hand, and arms out to the sides at shoulder level, with elbows slightly bent; move the dumbbells toward each other in an arcing movement (think of the movement as hugging a barrel). But don't let the dumbbells touch. Instead, they cross each other (your barrel has become a keg), and you squeeze the pectoral muscles in your chest. Do about 12-15 reps.

Wall Pushups - Elbows should be pointed out to the side, and hands just outside of shoulder width. To increase intensity, move your feet back farther. Hands on the floor is good, but just do what you can.

Back

Upright Row - Using either a barbell or dumbbells, raise it/them, as depicted, up to chin level. You should basically raise the weight with your elbows - your hands are just "hooks" to hold onto the weights. The pull should be very close to your body, and under your chin, not out in front of your face.

1-Arm Row - This is an excellent choice for anyone who has a "bad" back. Position yourself with one knee on a bench or chair, along with the hand (elbow extended) on the same side. This gives good back support during the exercise. Now, keep your back "flat" (no side-to-side rolling, or "humping" your back), and pull a dumbbell back and up toward your waist as high as you can. Pause, and slowly lower the dumbbell, and move it forward at the same time. The movement of the complete repetition may be characterized as "sawing a log." Repeat on the other side.

"Good Mornings" - Either with a barbell across the meaty part of your shoulders, or dumbbells crossed over your chest; lean forward from the hips until your trunk is approximately parallel to the floor. Then slowly stand up straight. During this exercise, your back should be "flat," and your buttocks pushed back.

Lying Back Extensions - Laying in a straight line, face down; raise your feet/legs or head/chest off of the floor just enough to force the muscles of the lower back to strongly contract. Hold for about 5 seconds, then relax. Perform about 10 repetitions. And keep your face looking down (i.e., don't bend your neck to look forward).

Shoulders

Shoulder Roll - Alternately rotate one shoulder, then the other, in a backwards direction. You can do both shoulders simultaneously, and, also in the forward direction. This exercise is more-or-less a warm-up activity, but, for some, it may be all you can do. Note that this may also be done with arms pointed out to the sides (Shoulder Circles).

Shoulder Shrug - This is more-or-less an "I don't know" exercise. Move your shoulders up toward your ears, and slightly backwards. And force them downwards on the return trip - so you work through a full range-of-motion. Don't bend your elbows as depicted.

Lateral Raise - This exercise has three variations, to focus on the front, middle, and rear fibers of the deltoid muscles, which "cap" the shoulders. The front raise is an arcing motion to the front of your body (to about nose level), and with elbows slightly bent (soft). The side raise is as shown, but should go up to shoulder level if you can. Thumbs should be lower than the little fingers, elbows soft, and the lift should be made from the elbows. The rear raise ( a.k.a. "reverse flyes") is done like the side raise, only from a bent forward position.

Military Press - For our target population, I recommend that this exercise be done in a seated position, and preferably with a back rest. Also, this exercise is often done behind the neck with a bar. I recommend against that form of this exercise. Also, if you can't do 15 reps, your weight is too heavy.

Arms

Dumbbell Curl - With a pair of dumbbells (as depicted), or a barbell; move your hands up toward your shoulders, while keeping your elbows locked into your sides. Pause and squeeze the muscles, then lower the weights, under control.

Hammer Curl - The hammer curl variation is done as above, with the exception that the wrists are rotated so that your palms are facing each other (neutral grip). The exercise movement is much like pounding in a nail.

Reverse Curl - Again, this is the same motion as above, but with the wrists rotated such that, as you raise the weights, your palms are on top of the bar (facing back, then down, then forward as the curl progresses).

Triceps

Overhead Triceps Extension (French Curl) - From a sitting position, with arms held vertical, and with your elbows close to your head; lower a barbell (EZ curl bar is best) or dumbbell until your forearms are about parallel to the floor (90 degrees). Pause, then straighten your elbows without snapping them into a locked position.

Triceps Kickback - This exercise is done as shown, but, if possible, hold your upper arms as nearly parallel to the floor as possible. The upper arms should be held steady; only your forearms move. Pause, squeeze the muscles in the back of your arms, then slowly return to the initial position.

Lying Triceps Extension (a.k.a. "Skull Crushers") - On your back, on a bench or the floor, with a barbell or one or two dumbbells, with arms extended; slowly lower the weight toward your forehead. Lightly touch (or nearly) your forehead, then straighten your arms. Your upper arms remain motionless, and, as before, don't snap your elbows into a locked position.

Wrist/Hands

Hands Up/Down - Perform this exercise as shown.

Thumb-to-Finger Tip - On each hand, alternate pressing the tips of each finger against the tip of the thumb. Go from your index finger to your little finger, then reverse the journey. Repeat this back-and-forth pattern until your set is complete.

Flex/Extend Fingers - With both hands, make a fist, and squeeze. Then open it and spread your fingers apart - forcefully.

Neck

Circles - Turn your head to one side and lower your chin. Now slowly rotate your head to the other side - this movement covers 180 degrees; in a side-to-front-to-side movement. When I was a kid, this exercise was a 360 degrees movement, but sometime during the last decade, or so; the backward roll has been determined by the powers-that-be to be anathema.

Back-of-the-Neck Isos - Now for the back of the neck. You can either clasp your fingers behind your head and create an isometric contraction; or you can use one hand at a time, and create diagonal, isometric contractions.

Now, on to stretching.

STRETCHING

As We grow older, there is a tendency for our joints to stiffen up, and consequently, we lose flexibility; or, stated another way: range-of-motion (ROM) shortens, which can make normal movements more difficult. A stretching program can retard/reverse this process, to maintain or increase ROM.

Special stretching programs can be developed, or working out in water can help maintain or improve ROM. Water lessens gravitational stress, and allows more freedom of movement. But for convenience and results, a good stretching routine, done regularly, can be very effective.

Duration and Regularity

First off, don't over-stretch. Stretching should be pain-free, although some discomfort is not unexpected. Don't force stretches - they should feel pretty comfortable. You should feel "stretched" but not like parts are about to break off.

Slowly move into a full stretch - no ballistic movements (And yes, I know that ballistic stretches are sometimes appropriate, but not here.) - and hold it for 15-30 seconds (Remember, this is a stretching program, not post-exercise stretching, where it should be held about 10 seconds.). Do each stretch three times (You will probably notice that each repetition of the stretch has a slightly wider ROM, and eventually that will become your new ROM.) Please continue breathing while you stretch, and it shouldn't be exaggerated, as during weight training.

A good maintenance routine would be to perform your stretch routine at least three times per week. For ROM improvement, do it at least 4-5 times a week.

As with weight training, special populations - those with bad backs or arthritis or, diabetics, - can benefit from stretching.

Lower back pain can be aggravated by bad posture; which, stretching, along with weight training, can improve.

Arthritis sufferers can benefit from a stretching program, as well as anyone with a condition that tends to reduce ROM.

For those with a reduced ROM, it may be useful to use a towel, or even another person, to assist with stretching.

Stretching for those who are on the obese side of the body-weight continuum, stretching can be beneficial, as it is for other special population groups.

Stretching is (should be) a relaxing activity, and, as such, can benefit anyone.

A suggested stretching routine should include a 10 minute warm-up, followed by 20-30 minutes of stretching. And note that chest stretching should get special attention because aging is often accompanied by shortening of the chest muscles, which can restrict breathing; a significant problem of our aging population.

Recommended stretches follow. Note that not all need be done during each stretch session, but do stretch each body part; and mix up your program - use different stretches for each body part during different sessions.

Oh, oh! Out of space again. And this issue has already gone to 12 pages. The stretches will be published in a special addendum to this issue.

[Go to Addendum on stretching]

Here is an interesting space filler from Kansas State University, on the subject of muscle cramps; specifically, during exercise. According to Prof. Kathy Grunewald, of the Department of Foods and Nutrition, those who sweat a lot are more apt to suffer from muscle cramps because they are often caused by a resulting imbalance between salt and water loss.

Another issue is the infamous "side stitch" that is suffered by many runners [usually, but not always, inexperienced ones]. These are caused by insufficient blood supply (hence, not enough oxygen) to breathing muscles [Often preventable by forceful exhalation.]; or from exercising right after a meal (blood gets diverted from exercising muscles to the digestive tract).

Some preventative measures against muscle cramps are:

1. Drink plenty of agua before, during, and after exercise.
2. Don't eat within about two hours of exercising.
3. If you get cramps, slow down or stop exercising, and massage the affected area.
4. "Side stitches" generally disappear as cardiovascular fitness improves.

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