Treat your Skeleton Like the Vehicle That It Is
A Primer on Bones & Muscles i.e. the “Infrastructure” that Drives Us Through Life
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A few months ago a delightful reader prompted me to write a newsletter about aging. I discussed practical ways to age healthfully — and on our own terms.
Today I’m doing a deeper dive into the subject of strength training because it’s that important for health as we age. Our bodies are held up by muscles and bones, and without a strong frame to support us, over time it can become increasingly difficult to engage in basic activities.
Our balance naturally declines as we age and is exacerbated by inadequate muscle tone (in addition to poor eyesight, foot problems, medication side effects, and other issues). Falls are the leading cause of injury and death-related injury in Americans over 65. Deaths related to falls have increased by 30% in the past decade.
Longitudinal studies of aging consistently show that people who engage in activities to maintain their bone and muscle mass have fewer diseases, better mobility, less arthritis, more sex (okay, I made that up, but it’s probably true), sharper minds, and a better quality of life.
Another snazzy feature of weight training is that you can see the results — and quickly. After four-to-six weeks of strength work, you will notice improvements in your balance, back pain, metabolism and urinary frequency (due to a stronger pelvic floor).
How much weight training do you really need?
Amazingly little. Even twenty to thirty minutes twice a week is enough to make a significant difference in strength.
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How to get stronger
Because we carry our own body weight around on our legs every day, it’s a lot easier to strengthen our leg muscles than it is to buttress our upper bodies, core, and pelvic floor. The easiest way to increase arm strength is to use handheld weights. If you have good form, planks and push-ups are great, too. You can also use resistance bands or a weighted ball, basically anything that requires your muscles to push against something else to do their work.
This site has nice demonstrations of how to use a light set of weights for upper body work and includes a “weight lifting for beginners” section at the bottom. For even more ideas, the CDC lays out a comprehensive program for anyone starting weight training here.
You can even turn your daily walk into an upper-body workout by wearing a weighted vest or backpack on the trail. Many of my patients with osteoporosis of the spine and/or the hips find this an easy way to build upper and lower body strength in one swoop.
Kegel exercises are still the “go-to” for pelvic floor stability, but I commonly recommend everything from vaginal weights to pelvic floor physical therapy for patients suffering from urinary incontinence, sexual dysfunction, pelvic pain, and other symptoms stemming from pelvic floor muscle laxity.
Ask for help
Personal experience and years of seeing patients have taught me that we generally under-value — and under-utilize — physical therapists (i.e. the “body mechanics”). People tend to wait to seek help only when their proverbial car breaks down. But prevention is always better. So instead of seeing a physical therapist only when you blow a gasket, I recommend that you take a regular survey of your skeleton — and then take it to the shop, early and often. After all, we only have one “vehicle” to drive us through life; inflating the tires and aligning the axels can help absorb the shocks and prevent a breakdowns (or two) along the way.
If it’s in your budget, a few sessions with a trainer can be helpful to get you started. If you prefer a more DIY approach, the book Strong Women Stay Young by Miriam Nelson has an easy-to-follow program (that is applicable to men, too!) to help build strength in all your important muscle groups:
abdomen or core (to reduce low back strain)
pelvic floor (to help improve continence, sexual function, and hip rotation)
legs and hip stabilizer muscles (to stabilize knee and hip joints and for balance)
shoulders and upper back (for posture and neck mobility)
arms (for everything from swimming and playing tennis to lifting pots, pets, and kids)
Yoga gets all of the above muscle groups. It’s also great for balance, flexibility, and mindfulness. When patients moan that “yoga is too hip and trendy,” I remind them it’s a three-thousand-year-old trend for good reason — and that their future skeleton will thank them.
Get a head start
In case you thought you were off the hook because you’re only forty — hold tight! You may have heard of the term osteopenia, or loss of bone density, which can occur due to age, genetics, post-menopause and/or insufficient calcium or vitamin D intake. Sarcopenia is the medical word for loss of muscle mass, and it starts around thirty-five years of age. After that, we have to work harder just to maintain the muscle mass we already have. Strength work bolsters muscle mass, which, in turn, improves bone density. Working on both is critical as we drive through life. (Stay tuned for a post or podcast episode with more specifics about osteoporosis.)
Grab a snack
Last thing: I love the concept of “exercise snacks.” What the heck is this? The “snack” refers to a short burst of exercise — even for thirty to sixty seconds. The idea is to do something that gets your heart rate up — with jumping jacks or pushups for example — for only one minute and then stop. Dr. Matthew Stork at the University of British Columbia has studied the surprisingly substantial benefits of exercise snacks. He has some specific suggestions here. The benefits? Time and convenience. It’s a total of five minutes of your day. Bon appetite!
As springtime approaches, I invite you to insert strength-building activities into your regular life. Whether it’s by taking regular walks with a friend, downloading a yoga app, or “Kegeling” your way through February, your body and mind will thank you.
P.S. My podcast guest Tiler Peck, principal ballerina for the NYC Ballet, describes how the appropriate therapy for a “pain in the neck” helped change her entire life. Check it out!
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Doctoring is a team sport. As always, I welcome your wisdom and feedback.