Author: Tanya Thompson, Date: 19th January 2021
Whenever I write about the more mature generation, I choose my words very carefully. Reason being; I never want to offend them and I have tremendous respect for those older than I am. That is just how I grew up.
Besides this, I also know that I have a lot to learn from the older generation and therefore, I treat them with the utmost respect when I train them. I also take the opportunity to learn from their experiences and I love the open and honest conversations. But let’s get to training them. What can we expect? What would our approach be and when would you be considered an active ager?
Just as we cannot put billions of people into 5 standard postures, so too can we not put all of our elderly clients into one, two or even 4 boxes. Everyone ages differently and in differently I mean:
- More mobile
- More prone to injury
- Naturally flexible versus inflexible
- Mindset differences…….
Their life experiences have molded them into who they are today. Those who have been active their whole life, wish to stay this way and others have realized the importance of getting active. But somehow instructors are extremely nervous to train this ‘unique’ population. They have a fear that they will break.
What I have seen over the past 22 years, is that active ageing clients are capable of more than we think. Maybe we are too cautious? In fact, my one client is 80 years old and she prefers to train with me. to the point that if for some reason (usually filming and editing), I am not able to take her, she will rather wait until I can. Her reason, ‘They don’t work me hard enough. They treat me as if I am broken’. She hates feeling inadequate or useless.
With that being said, how far can we push them and what should we be doing to help them achieve their goals? Let’s take a look at the general goals that we have for these clients:
- Maintain or improve strength; this would need some kind of resistance training whether it be weights, body weight or something as effective as Pilates.
- Maintain mobility; incorporating simple stretches into their classes will increase their mobility. But remember, some clients are naturally flexible so this step might not be necessary.
- Keep them moving functionally; here we should be doing exercises where they stand up from chairs and sit back down. Get onto and off of the floor, stand and rotate the spine, squat and rotate the spine and reach behind them while rotating the spine.
- Postural awareness; making them aware of their posture in sitting and standing positions and educating them on how to improve their posture throughout the day.
- Improved proprioceptive balance; balance is affected as we age and therefore, incorporating balance-type exercises can assist with proprioception. Remember to have a support for them nearby.
What do we need to be more aware of:
- Working them on surfaces or equipment that moves too much can give them motion sickness.
- Getting on the floor and off of the floor can be quite challenging for some so I suggest having a low box nearby so that they can use it if needs be.
- Being aware of the change in some of the joints i.e. the shape of their knees due to osteoarthritis and the change in their spine due to osteoporosis.
- Depending on their age and if there is osteoporosis present, keeping them in loaded flexion could be contraindicated for them. By loaded flexion I mean standing and then flexing the spine forward especially when it is loaded.
It is important to be aware of the following:
- The age of your client: 60 – 70, 70 – 80 or 80 – 90 and beyond?
- How active are they in general?
- What exercise have they been doing?
- What conditions do they currently have? Osteoarthritis, osteoporosis, any autoimmune disease, low blood sugar, low or high blood pressure or possible nothing!
- What previous injuries do they have? This will affect the exercise program and enable you to avoid contraindicated movements and exercises.
- Their natural flexibility; they would require more strength training and less stretching and mobility.
- Their inflexibility; they would require a combination of strength and mobility training.
What equipment could we use to help them achieve their goals?
- Exercise bands are amazing for standing arm work (combining posture and arm training), spinal training (exercise band under both feet and holding it with both hands) especially if you have them up against a wall with a slight hinge forward in neutral spine and then doing bicep curls, supine exercise arms work or leg work.
- Appropriate weights where you can bring in strength training into their program. Obviously form is vital, but they need to use weights that will create fatigue in each set. Be aware that you are looking for ‘real’ fatigue and not ‘lazy’ fatigue. We know that they are always going to take a chance!
- Small ball is great for thoracic strengthening, working the adductors and challenging their bodies in a simple hinge. Again, when they are using the ball for any squeezing or pressing, make sure that you encourage them to give it a really good press or squeeze…. no lazy reps! I always say, ‘exercise with purpose, otherwise go and enjoy a cappuccino’.
- Magic circle is great for hip training in supine as well as in sitting to standing type exercises.
- Working the Lats and thoracic extensors simultaneously is a great combination as it encourages an open chest and postural awareness. Try and work these two groups while sitting and standing.
- Bench training is amazing for them. Here you can do various combinations of sitting to standing using the exercise band for arms and spinal work and well as the magic circle. If they don’t like doing this, then this is exactly what they should be doing. hahahaha……
- Pilates equipment is phenomenal for the active agers. It gives them fantastic resistance as well as mobility and not to mention variety. Remember that equipment such as the reformer can create motion sickness for some.
- Gym equipment is great as long as the focus is on good form, appropriate resistance and postural alignment.
If you refer back to the bullet points above where we discuss what we should be aware of, this will give us a great guideline as to what their capabilities are. There are a select few who are intensely focused on toning and getting into great shape, but for the rest of them, want functional movement, they want to feel that they are getting stronger because all of their everyday movements are getting so much easier. They want to age well and Longevity is a High priority for them. But they are capable of working a little bit harder than what they are possibly doing right now. We never want to make them feel like they cannot do something. If you think of all of the exercises that you have in your toolbox, they could probably do a great deal of those with appropriate load and a few modifications and assists here and there. Many of our active agers are stronger than our youth. They are more body aware, they have determination and they are often more motivated because they know how much they need this. If they are coping and not fatiguing too much, then they could probably do more. If it looks too easy and it feels too easy, then it is too easy. Take it up a notch!
The holistic approach
As much as we want to get them stronger, we also need to get them to connect to their body, feel the movement, embrace their gorgeous age and love exercise. This means that we bring in an element of focused breathing, talking them through the feeling of a movement to encourage the connections, embracing quiet movement and working them hard enough to encourage strength training.
But what about spinal flexion?
How much effort is required of your client to lie supine and flex their spine and where is most of the tension placed when they do this movement supine? Well the focus would be in the anterior torso…. Not so bad for them.. but is it necessary? Do they do this everyday? Of course they do! So spinal flexion supine (of the thoracic spine) should be absolutely fine for your client to do. If they are strongly kyphotic then this type of exercise is just reinforcing the position that they find themselves in everyday. So maybe don’t do those. How strong do their ‘abs’ really need to be. It just needs to get them out of bed, get them to hold their pelvis and we can work these effective by lying supine and not lifting the chest. But what about standing thoracic flexion for clients with osteoporosis. Where is the emphasis now? Well when we are standing the effort is definitely on the posterior torso. Obviously if they are in this position for an extended period of time, it is contraindicated for them. But here is the question; Do they do this movement everyday or are we going to encourage them to move like a ‘stick man’? Hopefully not. So gently flexion of the spine without loading it is fine. Just a few of those to encourage a release of the thoracic back extensors is needed because they are going to do this on a daily basis anyway and therefore, showing them how to do it better can be really beneficial. But a clear focus on a good postural position is very important. If you can get the upper back extensors stronger and then gently flexing the thoracic spine, it will be easier because it will have resistance from the stronger, more toned thoracic back extensors. We cannot expect them NEVER to flex their spine again. In fact, this will encourage anxiety of their condition. So your focus will be upper back mobility in extension as well as strength training (that is relative to them) in extension followed by controlled, low load flexion.
What about their shoulders and necks?
When I was working in a retirement home helping the aged to get moving, the one area that I noticed was in really bad condition was their necks, shoulders and upper back. Their mobility was really limited, their necks were extremely stiff and their upper back was stuck in flexion. But what if we could improve this for them? Would this not improve their quality of life? What if this is a focus that we can bring into our program that will help them age with less pain and less restriction. I wished that I had seen them 10 years before (making most of them about 70 or 80 years old), I would have been able to give them the gift of upper body release, strength and stability and therefore, a better quality of life. Make this a definite focus in your sessions and remember that the shoulders, thoracic spine and neck are very closely linked through muscles and joints so do not leave one of the areas out of your program.
The big thing is to not be scared to work them or get them moving. If you know the contraindications of various injuries and conditions then you can design a program that is great for them without instilling fear into their minds. Encouragement, affirmation and positive feedback is really important. Be adaptable and try and be relatable. Know the difference between ‘real fatigue’ and ‘lazy fatigue’ and make it enjoyable…. DON’T DO BORING!
The active agers have so much to offer us and we have so much to offer them. It is a very rewarding process and a symbiotic relationship.
Let’s get them happy, moving and excited to exercise with YOU!
If you want to learn more details of active ageing then you are welcome to look at the 4 online courses that will help you to improve their quality of life.
Check out these online Video Courses
- Training the Elderly
- Safe osteoarthritic training
- Safe cervical training
- Shoulder stability wow factor
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