Whilst reading Stephen Lunn’s article in the Weekend Australia this past weekend, ‘How to live well in your final decade’ I couldn’t help but think of many of iNform’s wonderful clients aged 70+.
If you didn’t get a chance to read this article here is a synopsis:
- Australian’s are living longer than we ever have, but the length of our ‘quality years’ is not increasing proportionally.
- This means on average we are spending more years in a state of ill-health, dealing with disease and/or disability.
- To narrow the gap between years lived and quality years the following is recommended: Get fitter and stronger; eat well; keep you mind occupied; be part of a community; remain useful.
Many of the people aged over 70 that I have worked with over the past fifteen years tick all, if not most of those boxes.
I guess that is to be expected. As an Exercise Physiologist I do see a biased sample of Australia’s population.
The only people that access my services are people who are wanting to take control and action over their health and to be brutally honest, have the means to do so.
I never see people who are passive in their health- that are allowing the deterioration of their health to just happen to them. Why would they seek out someone like me?
Unfortunately I also don’t get to see many of those who have the will to take control, but just lack the means (location/transport; finances; awareness etc etc). That is a massive topic for another day- for now I would like to focus only on those I do see.
When I think of the men and women of 70+ years that I have trained, the following things come to mind:
- An unwillingness to write things off as ‘it’s probably just old-age. No, if your knee is sore, there is a reason for it that may well be changeable.
- A desire to travel. And I don’t mean on a Greyhound Bus with an occasional stop at a local ‘famous bakery’. I mean hiking holidays in Peru, Nepal or Switzerland; expeditions to Antarctica by ice-breaker boat; solo driving around Australia in a Camper-van; Ski holidays in Japan; water-skiing on the Murray River. I have helped people of 70+ years achieve all of these things and many more.
- A drive to get stronger. Not just to help bone density or cardiovascular health. But to feel empowered, independent, capable. One of my clients, a woman aged 71 takes great pleasure helping younger women put their bags into overhead lockers on her many flights to far-flung destinations around the world.
- Improving strength and fitness to help them complete their first marathon, or long-distance cycling event.
- A conviction to live independently. Not just exist, or survive. I am talking about hosting parties and other social events; or fixing things or even renovate by themselves.
It is a great privilege to help people achieve these types of things after their 70th birthday. You are never too old to get started, unless you believe you are.
About The Author
Operation Flinders Mountain Bike Challenge 2019
Throughout the 4 days of the Operation Flinders Mountain Bike Challenge a recurring theme in my thoughts was the relativity of time. From the moment we left the terminal at Adelaide Airport on the Friday morning until we arrived back there on Monday night, we were all completely off the grid. We had no phone or internet connection. Our only form of connection to the rest of the world was a CB Radio, used for location updates to the command centre (and in case of emergency).
It was amazing how slow time passed over those four days. Our days in Yankaninna Station were spent like this: Wake up in our swag; ensure the fire was started and maintained; eat breakfast; tidy up; get dressed to ride; ride from camp A to camp B; arrive at camp B; get changed; eat, drink and chat around the fire; go to sleep under stars; repeat. It was a beautifully simple existence.
Through the days as we rode through stunning terrain we could either quietly enjoy the natural beauty of our surrounds, or chat with our fellow riders. There was plenty of time for each. Most of the participants were strangers to one-another prior to the event. There were a few small groups, but most people only really knew 3 to 4 of the 15+ people that were there for the event. By the end of the fourth day we had united into a real team. We had gotten to know each other well through sharing intimate thoughts and feelings- when you have nothing to do but travel from point to point, then eat, drink and stay warm you have a lot of time to build relationships. And some of the conversations that I had with people who were strangers only a few days ago, I haven’t ever had with long-time friends or even family. When we first met at Adelaide Airport on the Friday there were polite handshakes to introduce ourselves. As we said goodbye on Monday night, there were hugs all round. It was a deeply satisfying trip. I felt relaxed, replenished, rejuvenated.
So what did I learn from this?
I think it is fair to say that most people in our society can relate to this feeling that time is accelerating. That days, weeks, months, even years are careering out of control. Where did the first half of 2019 go? Why is this? Why can 6 months disappear almost in the blink of an eye, yet four days seem like an eternity? Feeling like the to-do list is always longer than manageable and lengthening by two tasks for every one one that we tick-off feels futile and it makes sense that we would feel constantly under pressure. This kind of life is exhausting. At Yankaninna Station we had no choice than to completely disconnect from the rest of the world- but it seems like the pervasive feeling in our society is that we have no choice than to stay permanently connected at all other times. Do we though?
What can you do?
What would happen if you switched your phone off before dinner and didn’t switch it on again until the next morning after breakfast. What if you switched off wi-fi and data-roaming on Friday when you leave the office and used your phone just to make and receive calls and texts from your family and ‘real’ friends. If you were able to do this, what might this do to your perception of time, and pressure? If you couldn’t burn up time mindlessly scrolling through social media pages what might you notice about the world immediately around you? What conversations would you have with your people if your mind wasn’t frequently distracted by alerts from your phone?
No matter how busy you are, you have the ability to find a bit of sanctuary even just for 10 minutes a day by switching off the phone and quietly taking in your surrounds. You can choose to disconnect from the web and completely be with the people you are with. The world will keep turning, it might just seem like it turns a little slower.
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Load management principles are used daily in high-end strength and conditioning/sports settings and are critically important in measuring relative injury risk and determining optimal load.
However, the concept of load management may not be limited to high-performance sports or training settings. There are principals of this concept that are applicable in non-sporting settings (eg. day to day activities, work, and leisure). Exploring the wider contexts to which load management principals can be used may assist in reducing overuse/chronic injury risk for the general population.
Let’s Talk Science
A concept developed based on the idea of an ideal training stimulus having the capability to maximise performance through the use of appropriate training loads while limiting negative training consequences (injury and fatigue). The ACWR describes two workload zones, the ‘sweet spot’ and the ‘danger zone’ which represent the likelihood of subsequent injury.
The ‘sweet spot’ is represented in the graph below as a ratio range between 0.8 and 1.3. The ‘danger zone’ is represented as a ratio greater than 1.5.
Calculating ACWR & Load: Acute vs Chronic
In a training setting, this is typically calculated over a 7-day block (average of daily acute workloads). Measures of the sessional rating of perceived exertion (sRPE) times by the duration of the training session would represent the acute load for a day. Example: If sRPE (perceived difficulty) of a 100-minute session is 5 this would equal 500 arbitrary units (AU) (5*100 = 500 AU).
The chronic load can be calculated as an average of the acute workloads.
Week 1: 500 AU
Week 2: 700 AU
Week 3: 600 AU
Week 4: 300 AU
Chronic Load: (500 + 700 + 600 + 300)/4) = 525 AU
ACWR: Acute Load (Week 5: 700AU)/Chronic Load – (700 / 525) = 1.3
To give some commentary to the above equation: If the acute workload for week 5 was to be 700 AU then the ACWR for that period would be 1.3. A value of 1.3 would represent the top end of the “sweet spot” bracket, meaning that the subsequent injury risk for that week is relatively low. If that acute load was to change to say 900 AU then the ratio would be 1.7 and the injury risk would be relatively greater.
Application to YOU
Both internal and external load is inevitable in the workplace, there is no hiding from the fact. The table above displays the application of the ACWR as a load management tool for individuals across a wide range of occupations. As you can see all scenarios have the capacity to create positive or negative outcomes. The outcome is primarily dependent on the preparedness of the individual to that specific task.
Looking specifically at the receptionist, the increase in acute load may come from working longer days during a busy period or working more days in the week to cover for a colleague who is sick for example. These factors can drive up the acute load, inherently increasing injury risk (eg. overuse injuries, such as a repetitive strain injury), leaving the individual unable to work.
However, this doesn’t only apply to occupational tasks…
Simple scenarios such as going for a 10km bike ride after just dusting your bike off from a 10-year absence of use or going on an overseas holiday where you may be walking over 10km per day while being lucky to clock up 2km at home during a normal day; both are examples of a spike in acute load far beyond that of the chronic load.
Take Home Points
- Ensure that you are prepared for any task you will be completing; whether it be walking, running, cycling, gardening, working, playing sport.
- Be mindful of what your body is used to and try to avoid the spikes in acute load for any given task; should you want to reduce the risk of developing any injuries.
About the Author
In my previous blog I discussed incidental physical activity and all the interrogatives that one needed to know. This blog is going to further discuss physical activity. In particular, it will look at a consensus on physical activity and aging (Copenhagen Consensus Statement) that leading researchers from around the world have recently developed.
Some empirical data for you
Higher social-economic country’s are more prone to inactivity. This is partly due to the high demands commercialism places on individuals as well as advances in technology. Furthermore, there is poor access to physical activity. Whether this be bike paths/lanes, parkland’s on-route to work, outdoor equipment and so forth, this can lead to more sedentary behaviors.
Easy access to high-processed foods at the touch of a button have an impact on the current obesity epidemic.
You get the point!
Collectively, the aforementioned points increase the risk for any one of the nine known co-morbidities that ‘we’ are currently facing (hypertension, type II diabetes mellitus, chronic pain just to name a few). It is of the utmost importance that the human population ages and flourishes well. With advances in medicine & technology ‘we’ are living longer lives, there is no doubt about it. However, some are aging with co-morbidities which decreases quality of life, whilst burdening our medical system. There is also more evidence that being physically active between the ages of 15-45 decreases the chances of a bony fracture later in life. Also, having a robust plastic cardio-respiratory system decreases the risk of dementia and cardiovascular disease in later life.
I could go on!
The Copenhagen Consensus Statement
The Copenhagen Consensus statement discussed earlier. Has four themes. Which provide evidence for the benefits of physical activity and ageing (1). I will briefly discuss the four, whilst also providing the reference for further reading if you wish.
Theme 1: Functional Capacity and Health.
Adults that are physically active over inactive adults: are less dependent, have fewer musculoskeletal issues, have improved immunity, increased cognitive function and are less likely to have cardiovascular diseases.
Theme 2: Brain Health and Cognitive Function.
Neurodegeneration (such as Alzheimer’s) can be slowed or delayed in physically active adults; according to longitudinal studies.
Theme 3: Behavior Change, Intention and Habits.
“Physical activity is an individual behavior that is influenced by interpersonal, environmental and policy factors”. (1)
Theme 4: Sociological Perspectives.
Lifelong physical activity habits and experiences, influence participation in later life. “When physical activity is meaningful to them, older adults are more likely to continue participation”. (1)
As you can gauge from the aforementioned. Physical activity is not just about going to the gym. Having access to open environmentally friendly spaces such as parks with safe equipment, bike paths that lead into the CBD, scenic views that increase awe and enjoyment and lastly, promotion and investment from the government are all going to increase adherence to move more, and more frequently.
So whether if you are in your 20’s or 50’s. find ways that resonate with you to move more. The Exercise Physiology team here at iNform Health can safely guide you through your movement. Enabling you to feel safe, adept and confident to tackle any bike path, or hike.
About The Author
Bangsbo J, Blackwell J, Boraxbekk C, et al
Copenhagen Consensus statement 2019: physical activity and ageing
Br J Sports MedPublished Online First: 21 February 2019. doi: 10.1136/bjsports-2018-100451
Do you sometimes feel tight or stuck in particular parts of your body? Perhaps from being in a certain posture for too long? I have five gentle yoga postures for you (and they’re even based on scientific research).
What a pain in the… back!
In a world where we spend so much of our time seated at a desk. or in the car. or on the couch… it’s no wonder most of us experience some kind of non-specific musculoskeletal pain at some point. As an exercise physiologist, I hear a lot of complaints about back pain, and more specifically, lower back pain… and I’m going to talk about this in a blog all of its own next month; keep your eyes peeled for ‘Low back pain is a tug-of-war between your abs and hamstrings’!
Why do I get back pain?
The short of it is this: when we’re sitting down, the muscles at the front of our body are in a shortened position, whilst the muscles on the back of our body are typically in a lengthened position. Our bodies are really, really smart organisms that want to adapt to make our life easier. So if we sit for 8-9 hours a day, then our body is going to adapt to this shape by adding adhesion to the muscles around our hips and chest, and it’s going to ‘tune-out’ from the muscles on our back body, since we don’t really activate these much *cough, glutes*.
Solution 1 – Increasing neuromuscular connection
By waking up some of these ‘sleeping’ muscles, we increase our brains ability to communicate with that muscle and it’s surrounding muscles so that we can utilize them for movement. A great example of this is our glutes. As I hinted at above, many of us sit on our bum all day long and as a result of this we actually really struggle to consciously activate and squeeze our glutes on our own command. Try it now, lay down on your back and see if you can squeeze your glutes one at a time! (and you’re not allowed to let your hamstrings switch on!). It’s really hard for the majority of people! Our glutes should be the biggest and strongest muscles on our body, these guys are really important and their main job is to stabilise our pelvis, which gives rise to our spine – and that’s a pretty important structure! If we can’t recruit our glutes then other muscles have to do the work that they should be doing, and this is how and why we often get tightness in our back.
If glutes don’t work, then these muscles here (see below) do the brunt of the work when we’re walking, stabilising, leaning, running, reaching, bending over, standing up, climbing the stairs etc.
Solution 2 – lengthening the myofascia
Just as importantly, we need to lengthen the muscles, and more importantly the fascia that are have adapted to be short, tight, and a bit sticky from our lifestyle of habitual sitting. This is where these yoga postures will come in handy! I recently read a research article about a yoga study that showed 96% of people in the yoga group experienced significant reductions in musculoskeletal pain (compared to 36% in the control group) with just a single session of five yoga poses! This builds on existing evidence that regularly attending yoga may improve pain and reduce pain medication usage. So below is a short, evidence-based yoga program that absolutely anyone can do at home to help ease back pain or discomfort!
Aim to hold each posture for about 4-5 minutes. When you’re setting yourself up, you don’t want to go past 60% stretch; this is important as if we go past this point we typically start to see the central nervous systems automatic response to protect our muscles and joints kick in and the muscle will actually be holding on to protect you! So a gentle, light sensation is okay – but nothing strenuous. And lastly, try to pay attention to your breath – particularly noticing the length of your inhale and the length of your exhale and trying to make them smooth, steady and even – this helps put our nervous system at ease and will allow the tissue (muscle and fascia) to ‘soften’ a bit more.
Forward fold, foot to thigh
Great for the hamstrings, the glutes, the fascia that all our back muscles insert into across our sacrum and our adductors (inner thigh muscles). You can use a pillow, a rolled up blanket, or anything really to support your forehead so the stretch isn’t too intense.
Half pigeon pose
This accesses the hip flexors of the leg behind you, if you can, play with gentley engaging the glute and seeing how that changes the sensations at the front of the hip. Chest can stay up, or you can fold forwards onto a pillow. Note: the knee should be out wider than your hips, and if this doesn’t feel great in your knees – don’t do it.
Bound angle pose
This is a favourite. Feet together, knees out wide. Hands can be out like cactus arms, on your belly, or above your head – whatever feels good for you! If it’s too intense, pop a rolled up towel under each knee.
Make sure your knees are relatively even (the top knee will try to crawl back), and then twist from above your navel. It doesn’t matter if both shoulders aren’t on the ground, as you relax into the pose they may head in that direction. Your arm can be outstretched or you can pop the hand behind the head.
Legs up wall
This can be done with or without props. Definitely recommend elevating the hips either on a yoga block or on a rolled up blanket. Arms out (as pictured) is a nice way to open up the fascia in the chest area. If it feels like a struggle to keep your legs up, you can pop a belt/strap around them… and then relax into this juicy pose.
Now let’s be honest, there’s definitely more than 2 solutions. There’s probably hundreds! But increasing your bodies neuromuscular connections, and lengthening out the myofascia that surrounds our muscles can only be a great place to start! Your body is unique, and your discomfort and pain is unique to you, so if you experience back pain and it doesn’t want to go away, or if you’ve nailed the first two steps in this blog and now you’re ready to start loading up the musculoskeletal system to get nice and strong (the ultimate pain preventative); it might be time to see one our Exercise Physiologists.
What should you do now?
- Check in with your glutes daily. Once that’s easy, it’s time to challenge them with some load.
- Do these five yoga poses at the start and/or end of each day, and see what differences you notice
- Set little reminders throughout the day to get up, sit up straight, elongate your spine, pull your shoulders back, squeeze your glutes, stretch, or whatever works for you!
If you would like to join our Clinical Yoga classes, you can click the link below and we’ll contact you with more information shortly!
About The Author
Yoga is an ancient and complex practice, rooted in Indian philosophy, that originated several thousand years ago. Yoga began as a spiritual practice, as a way of reaching enlightenment, but in Western culture it has become popular as a way of promoting physical and mental well-being.
Although classical yoga also includes other elements, yoga as practiced in the West typically emphasizes physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). Popular yoga styles such as hatha, iyengar, bikram, and vinyasa yoga focus on these elements. Several traditional yoga styles encourage daily practice with periodic days of rest, whereas others encourage individuals to develop schedules that fit their needs.
What do we know about the effectiveness of yoga?
- National survey results from 2012 show that many people who practice yoga believe that it improves their general well-being, and there is beginning to be evidence that it actually may help with certain aspects of wellness including stress management, positive aspects of mental health, promoting healthy eating and physical activity habits
- Yoga may help relieve low-back pain and neck pain
- There’s promising evidence that yoga may help people with some chronic diseases such as cancer, multiple sclerosis, and chronic obstructive pulmonary disease manage their symptoms and improve their quality of life
- Yoga may help people with diabetes control their blood sugar
- Growing evidence indicates that yoga may help women manage both physical and psychological symptoms of menopause
- Yoga may be helpful for anxiety or depressive symptoms associated with difficult life situations
- Yoga may help people to manage sleep problems
- Yoga may be helpful for people who are trying to quit smoking
- Yoga-based interventions may help overweight/obese people lose weight
What do we know about the safety of yoga?
Yoga is generally considered a safe form of physical activity when performed properly, under the guidance of a qualified instructor. Serious injuries are rare, however, as with other types of physical activity, injuries can occur. (One of our honours students, Zoe Toland, is currently working with one of our EPs, to investigate the most common forms of yoga injuries as reported by physiotherapists, yoga teachers and yoga practitioners – we’ll keep you updated with the results!).
The most important thing to remember, as with any exercise, is to listen to the feedback your body gives you and modify and adjust what you’re doing accordingly. We want to push ourselves, and whilst feeling some level of discomfort is okay (think muscle burn and high level of challenge), but pain is our bodies way of saying ‘probably best to not do this’.
People with certain health conditions, older adults, and pregnant women may need to avoid or modify some yoga poses and practices. These individuals should discuss their specific needs with their health care professional/yoga instructor and may be better suited to more clinical yoga classes.
What happens in a yoga class?
Sometimes the biggest thing that stops us from trying something new is not knowing what to expect and fearing we’ll be the awkward newbie! So let’s go through what you can expect from a yoga class (or at least ours!)
- Yoga mats and all the props you will need (a block, a strap, a bolster, a towel) are provided, but you can always bring your own if you would prefer!
- The teacher will introduce themselves and talk about what the focus of the class will be; this could be a range of things from a certain postural focus, or an attention focus, or it could be a focus on the pace of movement
- Classes start with slow, controlled, warm-up type movements and typically move into some more challenging series of movements; you can expect challenges that target strength, balance, range of motion, focus, stability, control and your attitude toward the practice
What you won’t get…
- Spiritual-talk. We’re not dissing the spiritual talk, but we prefer to focus on your physical and mental alignment in class
- Chanting. We get it, it feels a bit weird.
- Basically, anything that’s not evidence-based within the scientific literature, won’t be included in our classes (e.g., chakras, lifestyle choices)
How often should I practice yoga?
The recommended frequency and duration of yoga sessions varies depending on the condition being treated. In general, studies examining yoga have included weekly or twice weekly 60- to 90-minute classes. For some studies, classes are shorter, but there are more classes per week. So whilst the research evidence is inconclusive, we think that any form of exercise that is challenging strength through range of motion, and providing you with a form of mindfulness is a great addition to your weekly activities!
Our recommendation: as much or as little as suits your body’s needs and fits in with your weekly schedule.
iNform’s NEW Clinical Yoga Classes!
We are super excited to be launching clinical yoga classes at the end of May, at our new Malvern clinic! Classes will run on Thursday mornings and evenings, for a duration of 45 minutes and will be run by our Exercise Physiologist and Yoga Teacher: Jacinta Brinsley. Jacinta is also completing a PhD in the area of yoga and mental health/mental illness.
If you have any questions, want further information, or want to book in for a yoga class – fill out this form
About the Author