Sarcopenia and loss of strength

with advice from Daniel Butler, CEP

Sarcopenia and loss of strength

Sarcopenia, the loss of skeletal muscle mass, is a part of what has been called “the slippery slope of aging.”

As people age, they often start to experience sarcopenia, as well as osteopenia and osteoporosis. Having weaker muscles and bones, plus the arthritis caused by years of wear and tear, can make movement more difficult and painful. The pain leads to less activity, which contributes to weaker bones and muscles, making it even more difficult to move. And so on.

Doctors and scientists are still not quite sure what causes sarcopenia, but they have linked a number of factors to its development, according to the Mayo Clinic: age-associated hormone changes, physical inactivity, inflammation, and diseases like cancer and diabetes. Because inactivity can lead to sarcopenia, doctors encourage older adults to exercise more to build muscle mass.

Exercise increases hormone levels, builds muscle mass, and contributes to weight loss.Daniel Butler, a personal trainer and clinical exercise specialist who works at the Take Charge Fitness Program, a wellness facility run by Clinton Physical Therapy Center (a Physiquality network member in Tennessee), is an expert in helping people avoid age-related physical problems. He points out that exercise not only builds body mass, but it also releases some of the hormones that start to dwindle as we age, like testosterone and growth hormones.

In addition, it can help older adults lose weight, reducing the pain associated with arthritis; having more weight on your frame can exponentially increase the pressure on your joints. So activity increases hormone levels, builds muscle mass, and contributes to weight loss. Win, win, win!

If you haven’t been very active and don’t know where to begin, says Daniel, go for a walk. Walking doesn’t take any special skills, and in many areas of the country can be done outside year-round. If it’s too cold outside right now, he adds, there are several places to walk indoors, like shopping malls, commercial gyms and community centers.

Daniel notes that water exercise is a great alternative. Just like walking, it can be done indoors or outside, and the resistance provided by the water is enough to strengthen bones and muscles.

If you’re hesitant about trying a new activity on your own, talk to your physical therapist — PTs can create a walking or exercise program to build muscle mass at a rate that you are comfortable with. Use our locator to find a Physiquality therapist in your neighborhood.

It's important for seniors to avoid frailty.The key to aging well is avoiding frailty, the last step in the “slippery slope.” Daniel recommends keeping an eye on your bone density through DEXA scans, and then taking steps, such as proper diet and exercise, to maintain strong and healthy bones. He also notes that regular balance screenings can detect loss of equilibrium. If loss of balance is present, there are exercise and physical therapy protocols that can help restore balance.

The last point Daniel makes is that it’s important for seniors to be social. Meeting up with friends outside the house, whether you’re going for a walk or seeing a movie together, gets you off the couch and moving — and the more you move, the better you’ll feel.

 

Daniel Butler, CEP Daniel Butler, CEP, has been a personal trainer for more than 10 years at the Take Charge Fitness Program, a wellness facility run by Clinton Physical Therapy Center, a Physiquality network member in Clinton, Tennessee. A former Marine, Daniel holds certifications from the American College of Sports Medicine as a clinical exercise specialist and the Arthritis Foundation as an aquatic instructor, and he completed his B.S. in health administration in 2012.

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Cycling for better health

How are those resolutions coming? Are you cooking more at home? Have you seen your dentist (or at least made an appointment for your annual cleaning)?

If you’re looking for a way to increase your activity, cycling or bike riding is a great way to be active.

Anna Dark, the Fitness Director of the Take Charge Fitness Program (a wellness facility run by Physiquality member Clinton Physical Therapy Center in Tennessee), says that cycling has many health benefits. Cycling is an aerobic activity, which is great for your heart and circulation. Going for regular bike rides also increases muscle strength and flexibility, while also improving joint mobility and bone strength.

Cycling offers mental and emotional benefits that help you cope with stress.Like most exercise, cycling offers mental and emotional benefits that help individuals cope with stress, even when you’re on a stationary bike. “And cycling is a great way to enjoy the great outdoors, which in itself can help individuals feel better emotionally!” Anna adds.

If you’re serious about committing to regular bike riding, Anna recommends going to the local bike store to choose the proper bike. Consult with the staff about the type of bike that might be best for you, a road bike, mountain bike or a hybrid, based on where you’re planning to ride. And, adds Anna, they will make sure that your bicycle is properly fitted to your body.

You must have the proper equipment for bicycling.Anyone new to cycling must have the proper safety equipment if they will be riding outside, as they’ll be sharing the streets with cars, pedestrians and other bicyclists, reminds Anna. Your bike should be fully equipped with safety features like reflectors and flags in order to be visible, especially at night. Check the air in your tires regularly in order to keep them fully inflated. And make sure that you have the appropriate gear to protect yourself, including a helmet, reflective vest and gloves.

When you’re going out on the road, says Anna, be sure to choose a route that you’re familiar with. This will give you confidence while riding, making the ride less stressful. Stay alert and be aware of your surroundings, especially other motorists and traffic. And make sure to use hand signals to let others know where you’re going.

Lastly, have fun! Cycling allows you to enjoy the scenic route while bettering your health. And that’s something to celebrate.

5 resolutions to make for 2017

We all get into bad habits in our life, in one way or another. Perhaps you don’t talk to your grandmother enough. Or you eat too much fast food. Or you stopped working out. Setting resolutions for the new year is a good way to try to work on these bad habits.

There are many habits that can be damaging to your health, but here are five resolutions you can make for the new year to improve your health.

  1. Evaluate your eating habits.

Evaluate your eating habits.Have you been skipping breakfast? Snacking constantly instead of sitting down to dinner? Picking up food on the go instead of cooking at home? These are all habits that can cause us to gain weight and damage our health. Take a look at the latest guidelines recommended by the Department of Agriculture and Health to compare to your eating habits.

If you feel that a complete overhaul is too challenging, change one habit at a time, like making sure to eat breakfast, even if it’s a smoothie or a cup of yogurt. Or pledging to not buy any afternoon snacks for the pantry. Or cooking at least one healthy, sit-down dinner per week; you can always find a recipe that will make leftovers to cover your family for another dinner or two.

  1. Calculate how much television you watch.

A study published last year found that watching more than three hours of television a day correlates with lower levels of mental acuity. Other studies have found that extended hours in front of screens can lead to heart disease and high blood pressure. And if you’re watching with your kids, it’s been shown that children who watch more television at a younger age develop language more slowly and have more problems connecting socially with their peers. If you want to escape into another world, consider picking up a book.

A study found that reading stimulates the brain over time — the excitement you feel when sympathizing with a character lingers for days. Samantha Olson at Medical Daily notes, “Researchers believe this prolonged and measurable brain boost, which was found in the region associated with language and sensory motor skills, could improve brain connectivity over time. It brings using books as an escape to a whole new level.”

Of course, both reading and television are sedentary activities, which leads us to resolution number three:

  1. Increase your daily activity.

Increase your daily activity.We all know the benefits of activity: Being more activereduces our risk for a variety of diseases, keeps our weight lower and makes us feel better. The CDC recommends at least 150 minutes of moderate activity per week, or 30 minutes a day, five days a week.

It might sound like a lot, but they do point out that if you went to see a movie, it would take the same amount of time. And you don’t need to do it all at once; even 10 minutes at a time is better than nothing. If you’re trying to start a new habit, find a friend to do it with you — it’s been shown that if you schedule a class or walk with a friend, you’re much more likely to stick with it. And you get the added benefit of social activity, which improves your mental health. It’s a win-win!

If you’re anxious about starting to work out after a long drought or injury, consult with your physical therapist. A PT can do a wellness evaluation to determine if you’d need to adapt any physical activity, and some even offer fitness programs within their own clinics. Look for a Physiquality member near you with our clinic locator.

  1. Take care of your teeth.

The American Dental Association recommends visiting the dentist for a cleaning and check-up at least once a year, if not twice. You should brush your teeth twice a day and floss daily in between those appointments.

So you’re brushing your teeth and flossing regularly. You don’t have any pain. Why should you go for a check-up? Because dentists can catch problems before they turn into something painful, both as physical pain and economic pain. Look at it this way: Filling a cavity is much less expensive than a root canal.

  1. Get more sleep.

Get seven to eight hours of sleep each night.Most adults need between 7 and 8 hours of sleep a night, but many people don’t get nearly that much. A lack of sleepcan affect your mental and physical health. It is associated with increased risk of obesity, cardiovascular disease, type 2 diabetes and system-wide inflammation. Lack of sleep can also affect our immune system, our cognitive abilities (i.e., our mental capacity), and our mood and mental health. By getting a good night’s rest, your body can recuperate from a hard day’s work, giving you more energy to get up and get going in the morning.

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Stress and back pain

We’ve written in the past about a variety of causes for back pain: poor posture, improper ergonomics at the office, even straining to lift heavy items like a baby improperly. But did you know that stress can also cause back pain?

The experts at Physiquality partner Kiss My Back! point out that any stress — from the home, the office, or the family — decreases oxygen to potential areas of discomfort, like the neck, shoulders and back. If you have a pre-existing condition or a history of chronic pain, this can exacerbate the problem.

Back pain often leads to less activity, which can increase the pain even more.To make it worse, “when someone is experiencing back pain,” says Laureen Dubeau, “they often decrease their activity level,” which leads to weaker muscles and joints — and more pain. A certified strength and conditioning specialist and MERRITHEW™ Master Instructor Trainer specializing in STOTT PILATES®, another Physiquality partner, Laureen cautions against letting the deep stabilizing muscles of the spine to weaken. If these muscles stop working to stabilize the spine, she says, the larger, superficial muscles become tense and overworked, which increases the pain (even more) and restricts movement.

If your stress leads to postural changes, like hunched shoulders, this will add to your muscular tension throughout your back. And if you start to lose sleep because of the stress, not only will you be crankier during the day, but your body won’t have the chance to recuperate and heal overnight, leading to… tense muscles and more pain.

So how can you break this cycle of stress and pain? Your physical therapist is an excellent resource for the best methods. In addition, being mindful of what is causing the stress and how you are handling it is vital. Kiss My Back! reminds readers that a lot of stress is caused by lack of or miscommunication. Talk to your colleagues or your family about what is creating the stress, and discuss ways to reduce the problems that are causing it.

Using a mind-body exercise like Pilates or yoga can allow you to strengthen your internal focus on your body, which calms the mind.Making time for exercise can also reduce both stress and pain. Laureen notes that increased activity will strengthen the muscles that support your back, while producing endorphins and increasing oxygen flow in your body, reducing pain in your back and elsewhere. Using a mind-body exercise like Pilates or yoga can also allow you to strengthen your internal focus on your body. This calms the mind, which improves your ability to deal with stress. In addition, she says, “the focus in Pilates on restoring ideal posture and reducing the force on joints can help restore a sense of support and control.”

Physiquality partner PowerPlay points out how important it is to be aware of your environment. Pay attention to how your desk is laid out at work, and make sure that it’s ergonomically correct. If you sleep on your stomach, consider sleeping on your side or your back, as it’s better for your back muscles, or read through these tips from the Mayo Clinic on how to improve your sleep posture when you have back pain. You may also need a new mattress or one that is more firm; if you haven’t bought one in the last 10 years, it’s time to start shopping. And don’t forget to think about what you wear every day — supportive footwear and a bag that is worn cross-body vs. over one shoulder can affect your back muscles as well.

In the short term, cold therapy, or even cold + compression therapy, can help to relieve pain, reminds Shawn Hickling, a physical therapist assistant and the founder of ActiveWrap, another Physiquality partner. If the back muscles are spasming, heat therapy, or a combination of heat and ice, may be better. Over-the-counter anti-inflammatories, known as NSAIDs, may also help to relieve pain, but beware of using them over a long time due to their side effects.

 

What is minimalist running? Is it safe?

Trends come and go in fitness, and running is no exception. Minimalist running has been growing in popularity over the last decade, but some runners still question its safety. Barefoot or minimalist running is running that occurs either WITHOUT footwear, or with footwear that lacks high cushioned heels, stiff soles and arch support, a.k.a. minimalist footwear.

Lee Couret, a physical therapist and the owner of Southshore Physical Therapy in Louisiana, says there are many benefits to barefoot running. For example, he says, running barefoot can reduce the impact of the footfall when running. This is because most barefoot runners avoid landing on their heels, because it hurts! Landing with a heel strike is believed to be a potential cause of injury. A study published by the Skeletal Biology Laboratory at Harvard Medical School found that those runners that land on their heels while running were much more likely to suffer injury than those who land on the forefoot, or the ball of the foot. And Lee explains that reducing the impact can reduce running injures, as studies have found that people who run with greater impact often have more injuries.

Barefoot runners may actually be stronger.Aside from fewer injuries, barefoot runners may actually be stronger. Running without shoes can strengthen the muscles, tendons and ligaments in the foot while also stretching and strengthening the calf muscles, notes Lee. It can also improve balance and proprioception via activation of the smaller muscles in the legs and feet. And minimalist runners may experience increased efficiency, he says, as barefoot running requires less energy and oxygen consumption.

But don’t rush to throw out your running shoes without considering the cons. Running without shoes means that your feet aren’t protected, from either the elements, like cold, heat, snow and rain, or the variety of things you can find on the road — glass, pebbles, nails, and more. Barefoot runners will be more prone to blisters, points out Lee, and might be at a higher risk for Achilles tendonitis or plantar fasciitis while transitioning from running in shoes.

Be cautious as you transition from running in shoes to running barefoot.A conscientious uncoupling from your shoes is key to a successful transition, advises AlterG,. If you want to start running barefoot, think about talking to your physical therapist about it. She might be able to do a gait analysis to see whether your gait would need to be improved before you transition. If you run with a heavy heel strike, it may be difficult for you to switch to the forefoot strike essential for barefoot running. Lee suggests following these tips from the Spaulding National Running Center to make a healthy transition:

  • Land gently, with your foot relatively horizontal and under your hips (this will shorten your stride).
  • Transition slowly — see the full running plan from SNRC for guidelines.
  • Stretch your calves and Achilles tendon before and after running.
  • Buy low profile shoes (low heels, minimal arch support, flexible soles) to use when running barefoot is not safe.

And, above all, listen to your body! Don’t do anything that causes pain, and see your physical therapist or doctor if you have pain that lasts for more than a couple of days after running.

 

Lee Couret, PT, MSPT, CSCS Lee Couret, PT, MSPT, CSCS, is a physical therapist and the owner of Southshore Physical Therapy, a Physiquality network physical therapy clinic in New Orleans, Louisiana. A triathlete himself, Lee has served as the physical therapist for the University of New Orleans Privateers, a local triathlon team; the Swamp Dawg Multisport Team; and many local high school athletic programs.
Lee is a Certified Strength and Conditioning Specialist and has completed in many triathlons, including the Ironman Florida and Ironman France triathlons. He sends a special thanks to Irene Davis, Director of the Spaulding National Running Center at Harvard Medical School; much of this information is derived from a course he took with her in 2012.

 

For further reading, look through our selection of articles on running, in addition to the below links:

Bernstein, Lenny. Is barefoot running better for you? The Washington Post, May 9, 2014.

Physiquality.

The benefits of barefoot running. AlterG, June 10, 2011.

Reynolds, Gretchen. New York Times.

Crowell, Harrison Philip. Reducing impact loading during running with the use of real-time visual feedback. Journal of Orthopedic Sports Physical Therapy, April 2010.

Lieberman, Daniel et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, January 28, 2010.

Barefoot running training tips. Spaulding National Running Center.

Milner, Clare E., et al. Biomechanical factors associated with tibial stress fracture in female runners. Medicine and Science in Sports and Exercise, February 2006.

Proprioception. Physio-pedia.com.


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Protecting your shoulder during summer sports

Physiquality – pq blog

Summer is coming, along with plenty of outdoor sports and activities. But athletes need to be aware of their bodies; many summer sports can cause shoulder injuries, particularly if played several times a week.While different “overhand” or “overhead” sports – think any sport that requires arm rotation, like swimming, tennis, volleyball and baseball, especially baseball pitching – use different muscle mechanics, all such sports can lead to shoulder instability. Repetitive rotating motion can cause the shoulder ligaments to loosen, and possibly even dislocate the shoulder.“Pay close attention to how your shoulder feels when playing your sport,” says Cristina Martinez Faucheux, a physical therapist and co-owner of Moreau Physical Therapy, a Physiquality clinic in Louisiana. If the shoulder feels loose, or if a quick pain is felt when raising your arm overhead, like something is slipping or pinching in the shoulder, this could be subluxation of the shoulder, and something that would require treatment with a physical therapist.

Frequent use (or overuse) of the shoulder can cause several problems in the rotator cuff.Frequent use (or overuse) of the shoulder can cause several problems in the rotator cuff, which are the four muscles that surround the shoulder along with the tendons that connect these muscles to the scapula, collarbone and upper arm. Read More

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What is fibromyalgia?

Fibromyalgia is a condition that, for many people, is associated with more questions than answers. However, physical therapists, as experts in musculoskeletal problems, are an important resource for people who have fibromyalgia.

Let’s start with what fibromyalgia is: Due to its varied symptoms, fibromyalgia can be difficult to diagnose. People with fibromyalgia usually have widespread pain throughout the body, often accompanied by tender points, muscles and joints that are particularly susceptible to pain and movement. According to the Mayo Clinic, “Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.”

Other symptoms can include insomnia, fatigue, muscular stiffness (especially in the morning), headaches, forgetfulness and cognitive difficulty (sometimes referred to as “fibro fog”), and tingling in the extremities (the hands and feet). The symptoms sometimes begin after a traumatic event, like a car accident or an invasive surgery, or they can develop over time. It’s most often diagnosed in women, but 10-20% of those suffering from fibromyalgia are men. You may also be at risk if family members have been diagnosed with fibromyalgia, or if you have a rheumatic condition like rheumatoid arthritis or lupus.

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How exercise can help prevent disease

It’s probably no surprise that exercise is good for you. The physical therapists in the Physiquality network recommend physical activity as part of living a healthy lifestyle, and we all know it can help you lose weight and feel better. But how exactly can it improve your health? Here are a few ways exercise can actually prevent health problems.

Heart disease

The oft-cited parameters to work out 30 minutes a day, 5 days a week (or 150 minutes a week) were published by the American Heart Association in 2011. They are part of the AHA’s simple seven rules for maximal heart health:

  • Get active
  • Control cholesterol
  • Eat better
  • Manage blood pressure
  • Lose weight
  • Reduce blood sugar
  • Stop smoking

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10 common fitness mistakes you might be making

Hopefully those New Years’ resolutions have paid off. You’re eating healthier and working out more, and maybe your clothes are a little bit looser. But have you thought about what could be holding you back or putting you at risk of an injury? Here are some common errors you might be making at the gym.

You walked in without a plan.
Many people — especially those that are going for the first time (or the first time in a long time) — walk into the gym and wing it, with no sense of how they are going to structure their workouts. But if you walk in without a plan, how can you expect to make progress, asks Mark Salandra, the founder of StrengthCondition.com (one of Physiquality’s partner programs). Mark advises, “Write down a workout plan: Map out all your workouts to the set. Figure out your goals and set a plan to get there.” (Need a workout journal? Check out Physiquality partner fitbook™ journals for tracking your workouts and diet.)

There are many ways to set such goals. Mark suggests reading books, doing research on the internet, or even taking advantage of the trainers the gym makes available. He points out that they can advise you on proper form, the right machines for you, the frequency of your workouts and — most importantly — creating a workout plan.

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I have arthritis. Can I exercise? Should I?

Arthritis is one of the more common conditions, especially as people age. According to the CDC, as many as 50 million adults in the U.S., or 1 in 5, have been diagnosed with arthritis, and the numbers are expected to grow as our population ages. While there are many types of arthritis, the most prevalent is osteoarthritis, caused by the wearing away of cartilage in joints, especially the knees and hips.

Arthritis can be extremely painful and often debilitating. According to David P. Thompson, a physical therapist at Allegheny Chesapeake Physical Therapy (a Physiquality member in Pennsylvania), “Patients with arthritis frequently report a variety of symptoms, including pain, stiffness, swelling, warmth in the joint, aching, joint deformity, difficulty with bearing weight, trouble with walking, and general loss of function.”  Read more