Transcription:
Keeping Active for the Long Haul

Melanie Cole (Host):  As you grow older, an active lifestyle is more important than ever. Regular exercise can help boost energy, maintain your independence and manage symptoms of illness or pain. My guest today is Jim Bjork. He’s a physical therapist with Aspirus Health System. Welcome to the show, Jim. What do you tell seniors is the most important aspect of exercise, fitness, and health to really work on maintaining?

Jim Bjork (Guest):  I think the main thing is just to keep active. Keep moving. Sometimes they need specific programs. Sometimes I just tell them to get up and walk. Then, we start the program as they walk and prove themselves.

Melanie:  So, if somebody hasn’t been an exerciser before and they’re maybe in their late 60’s or 70’s, getting up and walking is a great way to begin but what if they ask you, “Do I need to join a gym?  What do I need to do?”  How do you get them started?

Jim:  I get them started from a standpoint of “do they want to join a gym”?  No use joining if you’re not going to go. The main thing is just to see what their activity level is, where they want it to be and then how are we going to meet that level.

Melanie:  So, they have lots of limitations as it were, Jim. They have arthritis; they have aches and pains, maybe heart disease or diabetes to go along with that. So, are there certain things you like them to consider before they start an exercise program?

Jim:  Correct. I like to have a physician check them out and make sure that if there is a cardiac condition, can they handle it. I also have them check, if it’s a diabetic patient, check the blood pressure before and after the exercise to see if that’s being affected. I also look at nutrition-wise. Do they get enough fluids? Do they eat properly? If not, I get a dietician on board as well.

Melanie:  Okay. I’d like to sort of bring in the concept of something that many seniors are afraid of which is falling. Can exercise help them?  If so, how?

Jim:  Definitely. Exercise not only gives you strength, which a lot of people think about, but exercise will also help improve their balance overall. Balance is an aspect of life that if you don’t use it, you’re going to lose it. If they’ve been more sedentary, even the aspect of walking a block might scare them. What we do is start them off in the house. Do a little walking where you have things to hold on to.

Melanie:  We hear about functional fitness and balance and things for seniors. What are those?

Jim:  Fitness programs for seniors are, basically, what I look at is can they get up and down from a chair without using the arm so much and we might start with that. Do they use steps at home?  Do they avoid steps because of the balance?  We work on balance using a step up program. We also work on just general strengthening. Can they move their legs?  Can they flex their legs?  From a standpoint of looking at their balance also from a posture standpoint:  are they flexed over which is, obviously, going to affect their balance aspect.

Melanie:  So, that’s a good point that you bring up when you talk about posture. What postural exercises do you like to have seniors do?  That kyphosis, that leaning forward, becomes so prominent if they don’t do something about it.

Jim:  Definitely. Sometimes if they get to a point where they need a walker or cane that may even get them more of a rounded back posture. So, aspects of just sitting upright and squeezing their shoulder blades together. Then, I give them rubber bands or therapeutic bands to increase that strength of the upper back. They might even swing their arms up and overhead to get the upper back muscles fired in. The upper back has to be strengthened to help with the lower back.

Melanie:  What if they try some of the things you and I are discussing today and they have pain?

Jim:  One thing is--I don’t like pain--but in the aspect of how long does it last? Is it just during the exercises?  Does it last an hour or two?  That’s okay pain. That means that things are working. Pain that lasts into the next day, I get it and I’m concerned with. Maybe we overdid it. Maybe we should deal with it. Don’t give up on the program but kind of cut it back a little bit.

Melanie:  Certain pains – do you want them to acknowledge sharp, shooting pain, dull, achy pain?  I mean, as a physical therapist are there certain knee pains or shoulder pains that you tell them “Okay, that’s not cool. We’ll do a different exercise”?

Jim:  Correct. What I do is look at is, it sharp? Does it linger for more than an hour or two after the exercise? Some people in their 50’s, 60’s and 70’s, obviously, get that feeling. Is it a deep pain or is it just “muscle being used” pain?  If it’s more than muscle being used pain, I might stop that exercise and go back and re-look at it and give them a different program.

Melanie:  Let’s talk about functional fitness, Jim, because it’s really something that is just so important if they just even want to be able to go shopping or play with their grandchildren. What are some really great exercises that they can do every day to work on some of that functional strength to improve quality of life?

Jim:  Some of them are very simple. I’ve had several people do what I call “the morning routine”. What they do there is, as they are getting their breakfast made, put something in the toaster, an English muffin or toast, and what they can do is stand upright holding on slightly to the counter and kick their legs backwards, to the side, marching in place. Then, what they can do is, reach up into the cupboard alternate arms. That’s going to get their “fired in” back muscles. And, it’s not a specific time of the day. It’s while they’re actually getting their breakfast ready. Very simple aspects.

Melanie:  As people age, do they lose flexibility?

Jim:  Yes, your muscles and ligaments basically tend to tighten up on you a little bit and if you become sedentary it’s even more difficult to get moving again. As we age, also, we decrease our water supply in your body, so to speak.  In other words, the water supply in your body, the fluidity of the body, gives you that nice stretch ability. As we age, we kind of lose that ability. So, it’s even more important in their 40’s and 50’s to start going on an exercise and stretching program.

Melanie:  What can they do? Because, sometimes, you hear people reach up to the cabinet as you say and say, “Geeze, I think I just tore my rotator” which is such a common senior injury. So many people have torn rotators. What can they do to keep a little bit more flexible?

Jim:  Basically, what I do is have them sitting down so it’s safe. They get a cane or a wand – a stick if you will or a yard stick--and hold it together with the ends in front of them and raise that stick up as far as they can overhead. Then, you bring it back down to your lap. Then, you bring it up to your chest height and you swing it from side to side to increase the flexibility, not only of your trunk, but your shoulders as well.

Melanie:  I love that exercise, Jim, and it’s also a really good golf exercise. So, a lot of seniors like to golf because it’s a sport--something that they can do well into their 80’s and even into their 90’s. Give us some exercises that you tell people to do to help keep them strong and strengthened and flexible for golf.

Jim:  Golf is a great program because not only do you get exercise from your swing and your flexibility but if they don’t use the cart all the time they can actually get a good aerobic workout. Things I tell them to do are:  get out of that cart, get up to that first tee, get a golf club and do a little rotation. Reach down like you’re going to put that golf club on the ground. Most of them, including myself,  can’t touch the ground but that doesn’t mean you’re not flexible. But, get that flexible, get the hamstrings, stand there and hold on to that post of the first tee and do a little marching, a little side swing of the legs and swing backwards. Get that body ready for the golf so you can enjoy it so you don’t have to give up on it at hole number six.

Melanie:  That’s fantastic advice and what about backs?  Once of the things I hear the most is, “My lower back, my lower back”.  Stenosis, they shrink. Osteoporosis. All of these things affect seniors. What do you tell them about maintaining good bone strength as they get older?

Jim:  Bone strength is very important. Nutrition-wise, get some calcium. Hopefully, they absorb some in their diet from a standpoint of milk, dairy products. That’s big in Wisconsin here. But also, weight bearing walking. One or two pound weights. They don’t have to go out and get weights. What I tell them is if you drink a little bottled water, fill it up and there’s your weight. You can swing it in front of you. You can do some squats holding onto the weight. So, it’s not heavy weights. It’s mainly maintaining weight-bearing acceptance to the body that’s going to give you the bone strength.

Melanie:  They hear the term “weight-training” and they recoil. “I’m too old to do weight training.”

Jim:  Studies have shown people even in their 90’s can regain strength and flexibility if they start a program. The easiest program is a simple stretching program. You don’t have to go to the gym and get involved with lifting heavy weights. Most of the people, what they want is a nice tone body. They don’t want a body that’s meant for competition. So, you don’t have to get the heavy weights at all. Don’t be afraid. If you want to go to the gym that’s fine but don’t be afraid to just use the aspect of around the house. I use brown sugar, powdered sugar with my patients. That’s a two pound weight they’ve got at home.

Melanie:  In just the last minute, your best advice for seniors as they’re aging for keeping active for the long haul.

Jim:  Activity. Activity, activity, activity. Walk. Do some light stretching exercises. Not only are you increasing your physical capabilities but studies are showing that your mental state--the delay of Alzheimer’s-- all involves activity of some sort. Not only such activity of such games as crossword puzzles but physical activity increases flexibility, your bone strength but also your mental health.

Melanie:  Jim, why do you recommend people come to Aspirus Healthy System for their care?

Jim:  I think we look over the whole program or the whole person. What we discuss at Aspirus, especially with the therapy aspect is, what do you want out of this?  What goals do you want?  We might have different goals. We might look at a person and say, “Oh, they can’t move. Let’s get them moving.”  They might want to move specifically to pick up that two-year-old granddaughter or grandson. So, what we do is, we actually look and listen to the patient and set goals and a program that’s appropriate to what they want out of it.

Melanie:  Great information. Thank you so much for being with us today, Jim. For more information, you can go to aspirus.org. That’s aspirus.org. You’re listening to Aspirus Health Talk. This is Melanie Cole. Thanks so much for listening.