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Training the elderly

4/13/2017

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Training and Challenging the Elderly
 
     I’ve been exercising for over 45 years. I started with wrestling in high school and college and I then transitioned into power lifting and non-competitive bodybuilding. During that time I’ve never taken more than a week off and even that week off was so my body could recuperate from the intense and grueling workouts I was putting it through and then train harder when I started up again. Needless to say I was highly motivated. I was inspired by muscular athletes like wrestlers, gymnasts, sprinters etc… At the time, Bruce Lee and Arnold Schwarzenegger were huge inspirations for me, Bruce Lee more from a muscular and functional standpoint and Arnold purely from a physique standpoint.
      So I’m now in my 50’s and am writing this as a sort of rough guide into training the geriatric and elderly crowd. I’ve been a certified personal trainer for over 20 years now and when I first started I wasn’t sure how to train an older adult. I couldn’t relate to their physical state. I was somewhat intimidated, seeing them as fragile, brittle, weak and unstable. I would either push them too hard (accidently)  or not push them at all for fear they would break! What I’ve learned, since entering my 50’s and going through my own hormonal change, is that older adults aren’t necessarily nearly as fragile as I once thought.  Each person is different obviously and age-related issues should be recognized on a case by case basis. But what I’ve found is 99% of people (of all ages) want to be challenged and pushed, especially the elderly. They want to feel confident, strong and feel empowered. (And they want to show off to their friends!)  A lot of what goes into training the elderly is reprograming their own idea of themselves. Often times an older adult thinks they can’t do a particular movement because it hurts or there’s stiffness and it’s because they’re ‘old’. It’s a very satisfying experience to get them to do things they didn’t think they could do.
     I would say that the biggest cause of what we call aging is the change in our hormones. We don’t produce as much growth hormone or testosterone and therefore lose muscle mass and bone mass. The combination of losing muscle automatically puts more stress on our skeletal system thereby compounding joint problems and stress on our spines which in turn makes us less stable and more prone to injury from falling. This in turn can make us less confident, depressed and inactive. It’s a chain reaction. Our job as trainers is to design safe, functional and challenging programs for this group and help them to regain a sense of self-worth, confidence and functional strength. 
     So here are a some things I incorporate when training the elderly:
  1. Balance pad. This is a good starting tool to find out how much balance they have. I start by having them just stand on it with both feet and look for any wobbling or instability. I start by holding their hand while they stand on it too just for assurance purposes and physical contact. If they can stand on it with both legs with no wobbling I then have them stand on one leg while I hold their hand. What’s surprising about this exercise is how much confidence plays a role in how they do. Most haven’t done anything like this, at least in a while, and after a few tries they instantly begin to master it and already feel better. I then have them do some exercises on the pad like tossing them a tennis ball and once they feel confident standing on the pad catching the ball I throw it off to the side and tell them to catch it with one hand. I increase the difficulty gradually so that they’re able to accomplish what I’m asking them to do.
  2. < >Myofascia release. I don’t recommend this until you, as a trainer, know how to release the fascia. Often times older adults walk with an irregular gait or seem a little lopsided or have apparent stiffness, it’s often times because of muscle tightness and gunk built up in their fascia. It’s important to have the client let you know how much pressure you can apply.I keep saying ‘say when’ or ‘are you okay?’. It’s important for their sessions with you to feel like a collaboration in which they have the final say. They’ll be more open to your suggestions and also feel empowered and you’ll have more clout when convincing them to try what you want.
  3. Hands-on stretching. Like myofascia release, stretching allows you to physically touch the client. Many of us who are younger don’t realize that older adults aren’t touched as much.Many of their friends or loved may have passed away (if you live long enough you experience the death of a lot of people) and don’t get the needed contact that I think all humans need. Physical contact with the elderly also has a biochemical effect. Most all of my older clients have more color in their faces after our workouts and you can literally see that they have better blood flow. Again, you want to ask ‘tell me when’ or ‘are you okay’ as you’re stretching them. This should be gentle stretching.
  4. Variety. I like to give my clients as many different kinds of challenges and modalities as they can handle, that way they don’t get bored and are stimulating different fuel delivery systems and motor neurons and brain functions. It also prepares them for real life situations.
  5. Be aware of what medications they’re taking and what the side effects are. Also work with their doctors if possible. The client will feel supported and safe working with a team of professionals that care about their well-being.
 
     The elderly are great clients, they’re consistent, usually have money, and very appreciative. As with any client you’ll want them to fill out a health and wellness questionnaire and waiver.

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