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YOUNGER NEXT YEAR: THE EXERCISE PROGRAM

YOUNGER NEXT YEAR: THE EXERCISE PROGRAM

Last post I discussed Younger Next Year (YNY), a classic book by Harry S. Lodge, M.D., and Chris Crowley, which lays out the social, biological and evolutionary rationale for seven “Harry’s Rules” to live by. This month I cover the companion volume Younger Next Year: The Exercise Program (YNY: TEP). The YNY books are intended for an over-50 adult and senior audience, which the authors term the “Next Third” of life.

YNY: TEP is a small, 159-page guidebook which focuses on the why and how of Harry’s first three “Rules”: 1) Exercise six days a week for the rest of your life; 2) Do serious aerobic exercise four days a week for the rest of your life; 3) Do serious strength training, with weights, two days a week for the rest of your life.

Early in the book is this statement: “Our goal is to make this the most important how-to book in your life.  A detailed, hands-on guide to the right way to exercise”.  There is no question YNY: TEP is a gem of a little book. But speaking as a fitness trainer who specializes in working with over-50 adults and seniors, YNY: TEP could do a better job with the “how” of strength (resistance) training exercise and, perhaps even more important, the task of preparing aging bodies to safely and effectively withstand the rigors of resistance exercise.

YNY: TEP does an absolutely outstanding job with the “why” of exercise and contains new and updated information not found in YNY, so it’s an important read for that reason alone. Of particular interest is the new information on the cognitive benefits of exercise and chapters 6, 7 & 8, which lay out the “why” for resistance exercise as well as a general strategy for designing a modern strength (resistance) exercise training program for seniors.

 

AEROBIC EXERCISE CHAPTERS

The aerobic exercise chapters (chapters 2, 3, 4, & 5) are of very high quality and contain lots of useful and motivating information.

A concern I do have with the aerobic exercise section of YNY: TEP is referring to bike riding as “the ideal aerobic [activity]” for the senior population. It depends on your tolerance for risk, but I think this is a misguided notion. First, we all spend way too much time sitting (see here), so should seniors really be looking to perform aerobic exercise sitting down if they have other choices? Second, biking encourages poor upper body posture; something most seniors should be looking to correct and improve. Third, I consider biking on city surface streets to be a very high risk activity for everyone, but particularly for seniors: potentially deadly cars dominate and drivers don’t seem to completely notice or take bicycles seriously. Aside from cars, a seniors’ balance and reactions are not what they once were. Finally, on a bike, you’re sitting 5-6 feet up in the air, which is a long way to fall – and most everyone falls sooner or later – if a car doesn’t hit you first. Not convinced? At least pick up Safety Tips for Both Bicyclists and Motorists: Keeping Each Other Safe on the Road, by emailing publicaffairs4@aaa-calif.com.

I also have a small nit to pick with terming everything “aerobic sports”. I prefer the term “aerobic activity”, because that’s what they are, activities; not sports. “Sport” implies competition and being “athletic”, and neither are prerequisites for aerobic activity. “Aerobic sports” stands out as a grating throwback reference in an otherwise modern book.

Lastly, I outlined my thoughts regarding the use of heart rate monitors and, also, measuring aerobic exercise intensity in last month’s post.

 

 STRENGTH TRAINING CHAPTERS

These chapters (6, 7 & 8) contain a wealth of important information and should not be missed. The authors convincingly lay out the “why” of resistance exercise for seniors and develop and explain much of the over-all strategy of a modern resistance training program.

In Chapter 6, called The Astonishing Importance of Strength Training, the authors note that after age forty we lose 10% of our muscle mass per decade – that’s right, 1 percent a year – and the loss is even worse after age seventy. This age associated loss of lean mass (termed sarcopenia) is a big contributor to the loss of strength and functional ability as we age. The only way to mitigate this degeneration is to do regular resistance exercise. The authors also discuss “Four Amazing Things Strength Training Does for You”: 1) Strength training makes you stronger; 2) Strength training grows new bone; 3) Strength training renews and strengthens your internal signaling system and restores balance and coordination; 4) Strength training relieves pain.

Chapter 7, called Train Movements, Not Muscles: Whole Body Movement, discusses the rationale for the modern approach to resistance exercise which emphasizes functional movement patterns; which are multi-joint, multi-plane, whole-body movements rather than single-joint movements. Also discussed is the shrinking physical margin for error in aging bodies – see here for more on this topic.

Chapter 8, called The Three Little Pigs, or Posture and a Strong Core, discusses the importance of proper posture and alignment for life in general, and resistance exercise in particular. One memorable quote: “The original sin of bad self-care is bad posture”. Stability and a strong core are also discussed. The “core” is everything between your pelvis and your shoulder blades. A functional core provides essential spinal stability and the effective transmission of forces from your legs to your upper body – like, for example, when you rise up from a chair – which minimizes wear and tear on your spine and other joints and tissues.

 

PREPARATION FOR MOVEMENT: THE WARM UPS CHAPTER

Here and the next chapter is where, unfortunately, things go a little south. Preparation for movement is a good thing.  The question is whether performing the eighteen movements outlined (downloadable PDF here) will adequately prepare the full spectrum of aging bodies to safely and effectively perform complex, whole-body movements under a resistance load? From my experience, I think that’s not likely for many seniors.

The authors correctly point out that “Eighty percent of people over fifty have lost significant mobility (range of motion) in their hips or ankles. Eighty percent have lost mobility in their back. A vast number have lost mobility in their shoulders. Good range of motion matters for all kinds of things”. The issue and key point is what to do about this loss of range of motion? YNY: TEP offers just the bare minimum answer – what might be appropriate for seniors who are already fairly functional and supple.

Dr. Lodge and Mr. Crowley go on to say “step 1 on the road to preventing or reversing loss of hip mobility – or ankle mobility or shoulder mobility – is this set of ‘preparation for movement’” exercises. But the unfortunate limitation of this book is they offer no step 2! And, from my experience, a lot of seniors are going to need a step 2 or even a step 3.

Also, regarding this topic of seniors’ mobility loss or limitation, there is no discussion of total joint replacements, which a significant number of seniors have had – and I find this an unfortunate oversight.

For more insight into the concerns I raise about this chapter, please see my comments in last month’s post regarding:  a) Corrective Exercise and an Initial Functional Evaluation; b) Joint and Tissue Mobility Techniques; and c) Hiring a Fitness Trainer.

 

STRENGTH TRAINING: THE TWENTY-FIVE SACRED EXERCISES CHAPTER

I am ambivalent about this chapter. On the one hand, there are some excellent resistance exercises presented. On the other hand, the authors do not responsibly address the full spectrum of capabilities of their target senior audience with the performance instructions and tips in this chapter.

Please keep in mind there is nothing inherently “wrong” with the 25 resistance exercises (downloadable PDF here) presented in this chapter, although some are perhaps more problematic than others. The key question, though, is this: Are all of the 25 exercises “right” for your body, right now, if you decide to try them? If you’re already a highly functional senior with no physical issues and adequate range of motion and movement ability, you may be able to get through these exercises with no problems. But if you have poor balance, significant arthritis, moderate/severe loss of joint range of motion, poor lower body strength/stability or have had joint replacements, there are minimal tips, insight or advice that will help you to safely and productively negotiate these exercises to create a positive experience for your body.

With respect to your specific body, the pertinent issue is this: How to appropriately modify or scale each movement to your individual physical capabilities. Each exercise movement has a continuum of progressions or regressions, and the trick is to know where your body needs to fit into this continuum to be safe and have a positive resistance exercise experience.  This scalability issue is handled in a very simple, minimalist and basic manner in this chapter; the on-the-ground situation for seniors is much more nuanced than you might think from reading this book.

To illustrate this concept of modification or scalability, let’s use Exercise Number 4, The (forward) Lunge; page 128. Before you safely attempt a forward lunge, there’s a family of at least five progressively more challenging steps to master and “pass”. The first step is to be able to stand with good stability and balance in a stride stance position, like the start position of Exercise Number 2, the Split Squat. But I’ve had clients who couldn’t initially manage the stride stance position. The authors suggest “ski poles” as an aid for the forward lunge, but is this really an appropriate strategy? From my experience of working with hundreds of seniors, I emphatically think not! You have to develop an appropriate “foundation” for each exercise. So, first do the corrective work necessary to develop some stability and balance in the stride stance position; second, work on a partial range of motion split squat with body weight; third, master the body weight split squat. You get the idea – but there are still a couple of steps to master before safely attempting a forward lunge – or at least there should be.

HIRING A FITNESS TRAINER

The authors say “never overload dysfunction”; which means don’t add resistance, speed or additional range of motion to a dysfunctional movement pattern. But how does a senior reading this book know what’s dysfunctional and what’s not? You really need an expert for that – which means hiring a fitness trainer. The authors do recommend this, but don’t offer any productive advice on how to choose a quality fitness professional, which is why I covered some guidelines in last month’s post.

The key is to learn to move well before you add any weight or resistance to a movement pattern. This is where a skilled and knowledgeable trainer who has experience working with aging bodies can save you from significant headaches or worse. Most seniors will need and should use a fitness trainer to help improve joint and tissue mobility, to scale resistance exercises to your physical capabilities by choosing the appropriate starting point for your specific exercises, and for learning body-respecting technique which minimizes wear& tear on your joints and tissues.

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