Exercise…

The next

best

thing to a

Time

Machine

TODAY

• What our muscles do for us

• What are the benefits of RT

• What are the risks

• Recommendations and Guidelines

• Samples

Meet Olga Kotelko…

AGE IS A NUMBER

NOT AN IDENTITY!

RESISTANCE TRAINING

What our muscles do

for us

Help us move (Produce ALL voluntary movement)

What do our muscles do for us?

Maintain posture

Stabilize our joints

Generate Body Heat

WHAT DO OUR MUSCLES DO FOR

US?

Why are muscles so important?

Critical to Joint health, less stress

Posture and Symmetry. Less Stress on Connective tissue

Ability to perform ADL and keep independence

Diabetes and insulin sensitivity every 72hrs. Mod-Vig more

effective Helps with fat loss and metabolism. Upgrade your engine

Makes movement less fatiguing and more enjoyable

Fall Prevention and Fall Resilience

More Confidence to move safely

WHAT RESISTANCE

TRAINING DOES

Interested in how to be like Olga?

First Key is Strength

Leads us to Resistance

Training

Can you reverse the clock?

Muscle

Mass

Strength (from 25% to more than 100%)

Power

Efficiency

Muscle Metabolism (blood sugar

regulation)

RT can increase even in advanced

ages

[18]

A two- to threefold increase in

strength can be accomplished in

three to four months

[13

]

With ongoing strength training

increase in muscle size is also

possible

[13

]

Can you reverse the clock?

Benefits of Resistance Training

Increases insulin sensitivity for the next 16-24 hours

Prevent and/or delay

osteoporosis

Reduce depression, anxiety, stress and improve

mood

[3,4,14]

Lower blood pressure and improve lipid

profile

[11,12,14]

BENEFITS TO BONE

Changes in direction even better

ex. Tennis, line dancing,

gardening and digging as well

Pull of muscles on bone strengthens them

Compressive forces of weights

No more ankle wts --Vests

RISKS OF RESISTANCE TRAINING

For those with severe untreated high BP 180/110 get

treatment before

Even treated high BP, avoid very heavy weights and

holding breath

RISKS OF PHYSICAL ACTIVITY

ACSM Position on Medical Exam and Stress Test before

physical activity over 50

Apparently healthy

individuals No Chronic Disease and

no more than 1 CHD risk

factor

Higher risk individuals

Two or more CHD risk

factors.

With or without symptoms

breakdown Individuals with chronic disease

CV, lung or metabolic disease

RECOMMENDED FOR A MEDICAL EXAM

AND STRESS TEST FOR THOSE OVER 50

Type of Activity Apparently

Health

Higher Risk

No Symptoms

Higher Risk

W/Symptoms

With Chronic

Disease

Moderate Exercise No No Yes Yes

Vigorous Exercise Yes Yes Yes Yes

Reproduced from ACSM Guidelines for Exercise Testing and Prescription, 5th ed.,

by the American College of Sports Medicine, 1995, Baltimore: Williams & Wilkins.

RISKS OF PHYSICAL ACTIVITY

Study of 51,303 cardiac patients over 5yr period.

Of 2.3 million hours of exercise only 3

sudden cardiac deaths

Good judgement and common sense

Improper Technique, Excessive Load, Overuse without

adequate rest, high impact

We were meant to be active, sedentary

lifestyle greater risk

HOW

TO

START

First things first. To the women out

there… If you pick up a weight heavier than 3 lbs.

Lets Start!

This will not happen to you!

DIFFERENCE BETWEEN

STRENGTH AND POWER

Power is ability to produce as much force with as much

speed

Don’t think you need that?

One of the major factors in maintaining independence

[1]

Prevention of falls [2]

Muscular Power is lost before strength

Getting out of chair, going up steps, swinging golf club

Examples of Power

Training

Examples of Power

Training

Strength is the amount of force applied to a given load

Going down stairs, picking up objects

[15

] Muscle strength peaks in mid 20’s and is relatively

maintained into 60’s.

By 80’s strength is half of young adult [16]

DIFFERENCE BETWEEN

STRENGTH AND POWER

JUST STARTING

Develop Basic Foundation up to 8 weeks, 12-15 reps, 1-3

sets, low load

Intermediate Phase 8-24 weeks 10-12 reps, 1-3 sets, low to

moderate load

Progress Further 6 months on 8-12 reps, 1-3 sets,

moderate to vigorous load

KEEP IT SIMPLE

Don’t overcomplicate it, start moving, go slow and gradually

progress Train backside more than front

2:1, 3:1 ratio

Years of working just the mirror muscles

and/or bad posture

More pulling movements for most population

Imbalances set up for pain and reduced

performance

WORK THE MUSCLES YOU CAN’T SEE

ARE MACHINES GOOD OR BAD

There is a place in the beginning

Doesn’t translate fixed linear path, supported

Greater risk to develop asymmetries

STARTING OUT

Warm up and Movement Prep

Increased blood flow to muscles,

oxygenation and body

temperature. (rubber band)

Warm up 4-5min. 30s of ~8-10 moves

Just starting out include as part of

workout

At end should feel warm with elevated heart

rate and breathing

Static vs Dynamic Movement Prep

Tissue Quality Work Foam Roll

To Stretch or Not to

Stretch

STARTING OUT

Warm up and Movement Prep Example

ASSESSMENT & SCREEN

Value of: Baseline Norm and Proper Comparison

Lower Body Test 30s Chair sit

Upper Body Test 30s Arm Curl

Shoulder mobility

screen

ASSESSM

ENT

NORMS

HOW TO BUILD WORKOUT

HIP DOMINANT

KNEE DOMINANT

CORE (ANTI-EXTENSION, ANTI-ROTATION,

ROTATIONAL)

BALANCE

PUS

H

PUL

L

WHAT IS YOUR CORE?

Critically important, prehab or rehab

What is it?

Stop doing sit ups. 730lbs compression (Axler and McGill,

1997)

Core Work

How to train effectively- Anti-extension, Anti-rotation in

neutral position

CORE EXERCISE EXAMPLES

Anti Extension

Anti-Rotation

Rotation in Neutral position

Anti-Flexion

EXAMPLE 1 BEGINNING

Workout example 1

Tubing Rows

Side step outs

Forward and Back

Steps

Single arm cable

row

Sit to stand (can elevate, and load)

Standing leg curl or ball

curl Standing Hip ext

Heel Raises then Toe

raises

Strength Rx

2-3 days per week

Moderate Intensity

8-10 Exercises

Major Muscle

Groups 1-3 sets of 8-12

repetitions

EXAMPLE 2 GREATER CHALLENGE

Workout example 2

DB Row

Shuttle Press

Step Ups

Diagonal Back Hand

Sled Push

Cable Bracing Push-Out

Split Stance Single Chest

Press Tubing Diagonal Lift

Strength Rx

2-3 days per week

Moderate Intensity

8-10 Exercises

Major Muscle

Groups 1-3 sets of 8-12

repetitions

VARIETY AND GRADUAL PROGRESSIVE

OVERLOAD

Should progressive gradually over time as body

adapts

Stuck doing the same routine and weights

Fourth grade math book

Stress and adaptation

STRENGTH VS FUNCTION

Need Strength to help function

However Stronger doesn’t equal direct

function improvement

Specificity to the task

FUNCTIONAL AGING MODEL

Train all Components of Function

Be purposeful

Train in all 3 planes of motion (Sagittal, Frontal,

Transverse) Movements before Muscles

Stand up and Stay up as much as possible

Complicated first moving to simple as you fatigue

Stay Safe. Nothing should hurt. Work vs Pain

RESISTANCE TRAINING AND

OSTEOARTHRITIS

The chicken or the

egg? Strength decline in OA due to drop in activity

Evidence Muscle weakness directly contributes to

development and progression of OA

[5]

Strength training has significant benefit in

improving function and reducing OA pain

[6,7,8]

Investigation of Resistance Training on OA

Group 2 Lower Intensity: 10 sets of 15reps at 10% of 1 RM

After 8 weeks both exercise groups “significantly”

reduced pain & improved function over control. No

adverse effects reported

Better in High Resistance but not statistically significant

between low and high

Study of 102 adults with mild to moderate Knee OA [9]

Group 1 Higher Intensity: 3 sets of 8 at 80% of 1 RM

7/10 reported pain. Moved to 60% of 1 RM

RESISTANCE TRAINING AND

OSTEOARTHRITIS

[18] Very large effect on strength in non OA group but minimal

effect on Function

In OA groups moderate effect on Strength, Function and

Pain almost identical across all three

“When older people with OA participate in strength

training the training directly targets one of the main

barriers to their functional performance.”

“The positive message from this review that should be clearly

communicated to older people with OA is

That no matter how old they are, they will probably benefit in

clinically important ways from participating in a strength

training program, as long as it provides some consistent

overload to their muscles as they exercise. ”

“The biggest challenge with any exercise program

is to maintain long-term adherence, because the

benefits of exercise will diminish if people stop

exercising.”

Boston University School of Public Health

Nancy Latham, PhD, PT

TIPS FOR EXERCISING WITH

OSTEOARTHRITIS

Identify when is the best time of day for you

Change methods, angles, frequency,

resistance level, body position

High and Low Intensity study both effective 8wks [9]

Dynamic and Isometric both effective 16

wks

[10]

• Move all Joints Daily

• Move inflamed joints gently through range of

motion

• Begin with warm up of slow exercises

• Take warm shower just prior

• Slow Controlled movements no bouncing

• Attempt full range of motion to point of mild

discomfort but not pain

• Listen to your body Adapted from Arthritis Foundation (2009)

TIPS FOR EXERCISING WITH

OSTEOARTHRITIS

ACCOMMODATIONS

Arthritis in hands- Claw

Joint replacements

Load patterns i.e. vertical vs angled and

horizontal

Severe deconditioning

THE STRENGTH, ENERGY AND

POWER TO DO WHATEVER THE

HECK YOU WANT

WHEREVER YOU START…

…YOU CAN

MAKE IT

LOOK

RIDICULOUSL

Y EASY LATER

REMEMBER OLGA?

Foldvari, M., et al. 2000. Association of muscle power

with functional status in community-dwelling elderly

women. Journal of Gerontology, 55A (4), M192–99.

Whipple, R.K., Wolfson, L.I., & Amerman, P.M. 1987. The

relationship of knee and ankle weakness to falls in

nursing home residents: An isokinetic study. Journal of

the American Geriatrics Society, 35 (1), 13–20.

[1]

[2]

Blumenthal JA, Babyak MA, Moore KA, et al. Effects of

exercise training on older patients with major

depression. Arch Intern Med. 1999;159(19):2349–56.

[3]

Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen

RD. Physical activity and depression: evidence from the

Alameda County Study. Am J Epidemiol. 1991;134(2):220–

31.

[4]

Slemenda C, Brandt KD, Heilman DK, Mazzuca S,

Braunstein EM, Katz BP, Wolinsky FD

Ann Intern Med. 1997 Jul 15; 127(2):97-104.

[5]

Fransen M, McConnell S. Exercise for osteoarthritis of

the knee. Cochrane Database of Systematic

Reviews. 2008;(4)

Fransen M, McConnell S, Bell M.

Exercise for osteoarthritis of the hip or

knee. Cochrane Database of Systematic

Reviews. 2003;(3):CD004286.

Lange AK, Vanwanseele B, Fiatarone

singh MA. Strength training for

treatment of osteoarthritis of the knee:

A systematic review. Arthritis Care &

Research. 2008;59(10):1488–1494.

[6]

[8]

[7]

Jan MH, Lin JJ, Liau JJ, Lin YF, Lin DH.

Investigation of the clinical effects of

high- and low-resistance training for

patients with knee osteoarthritis: A

randomized controlled trial. Phys

Ther. 2008;88:427–436.

[9]

Topp R, Woolley S, Hornyak J, Khuder S,

Kahaleh B. The effect of dynamic

versus isometric resistance training on

pain and functioning among adults with

osteoarthritis of the knee. Arch Phys

Med Rehabil. 2002;83(9):1187–1195.

[10

]

Kelley, G.A. & Kelley, K.S. (2000). Progressive resistance

exercise and resting blood pressure: a meta-analysis of

randomized controlled trials. Hypertension, 35, 838-843.

Melo, C.M., Alencar, F., Tinucci, T., et al.

[11

]

[12]

[13

]

[14

]

[15

]

O’Donovan G, Owen A, Bird S, et al. Changes in

cardiorespiratory fitness and coronary heart disease

risk factors following 24 wk of moderate- or high-

intensity exercise of equal energy cost. J Appl

Physiol. 2005;98(5):1619–1625. doi:

10.1152/japplphysiol.01310.2004.

Medicine & Science in Sports & Exercise:

July 2009 –Volume 41 – Issue 7 – pp1510-1530

doi: 10.1249/MSS.0b013e3181a0c95c

SPECIAL COMMUNICATIONS: Position Stand

DHHS. 2008 Physical Activity Guidelines for Americans.

Rockville (MD): U.S. Department of Health and Human

Services; 2008.

Lindle RS, Metter EJ, Lynch NA, et al. Age and gender

comparisons of muscle strength in 654 women and men

aged 20–93 yr. Journal of Applied

Physiology. 1997;83(5):1581–1587.

[16] Doherty T, Vandervoort A, Brown W.

Effects of ageing on the motor unit: a

brief review. Canadian Journal of

Applied Physiology. 1993;18(4):331–

358.

[17] Nancy Latham, PhD, PT and Chiung-ju Liu,

PhD, OTR, Strength training in older

adults: The benefits for osteoarthritis,

Clin Geriatr Med. Aug; 26(3): 445–459.

doi: 10.1016/j.cger.2010.03.0201006

[18] Bengston, V.L.S., Merrill; Putney,

Norella M; Gans, D, Handbook of

Theories of Aging. 2 ed. 2009, New York:

Springer Publishing Company.