Exercising with arthritis?


Do you suffer from arthritis?

The first thing to remember is that ‘Exercise is beneficial for people with arthritis’. Arthritis is a very general term which covers a multitude of conditions which affect joints and is frequently (but not always) linked to the body’s aging process.

If you have arthritis follow these simple guidelines to get the most benefit from your exercise:

  • Make sure your warmup is slow and gentle warm up with movement to mobilise your joints encouraging the release of synovial fluid to lubricate the whole joint more effectively.  It’s a bit like warming oil in a pan so it coats the whole pan surface.
  • Choose low impact activities to reduce the stress placed on the joint. Pilates, yoga, walking and swimming are all good.
  • Include strength training as studies have suggested it can decrease pain.  It also works to build bone density which encourages healthy joints. Simple exercises standing up can help build strength so don’t choose classes which are all mat based.
  • Try to maintain the range of movement and flexibility of a joint.  You may not become more flexible but should be able to maintain the movement range that you currently have.  (Without regular exercise you will gradually have less range of movement.)
  • Don’t exercise if you have rheumatoid arthritis and your joints feel warm and swollen. This is an indication of flare up and exercise at this time could worsen your condition.
  • Avoid movements which require extreme flexibility and stretching exercise techniques.
  • Avoid exercises which require kneeling if your knees are affected.
  • Avoid exercises which require repetitive stress or high impact activity such as road running.

By following these simple guidelines you’ll be able to gain all the benefits of regular exercise enabling you to keep ‘fit for life for all of your life’.

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Fitness Trends for 2016

As the New Year approaches we tend to look back and review the past year and also plan ahead to the next one.
2015 saw The Studio develop extra-small classes, enabling clients to enjoy individual tuition within a group format. This makes it affordable, effective and sociable.
I undertook further training to enhance my skills as a fitness professional and soft tissue therapist. My specialist training with an experienced osteopath this year was in the diagnosis, treatment and prevention of knee pain. A really useful area in which to have more knowledge. My soft tissue work training was in recognising and releasing the tightness which causes poor posture and gives back pain along with some new techniques to offer sport massage without pain.

So, what underlying trends can we expect to see in 2016? (ref ACSM)
1. Wearable Technology
Trackers, heart rate monitors etc… all helping increase activity levels by constant monitoring.
2. Body Weight Workouts
Taking fitness back to basics by using body weight instead of machines and free weights.
3. HIIT
High Intensity Interval Training used with many forms of fitness to improve performance and shorten the time spent exercising.
4. Strength Training
Both in the gym and in classes for general fitness as well as improved bone density.
5. Fitness Professionals with better training
Improved training leads to better results and more choice for the public in looking to improve their fitness.
6. Personal Training
Including group PT - extra small group exercise classes, perfect for affordable individual tuition
7. Functional Fitness
Fitness which helps activities of everyday life, essential for keeping active for longer.
8. Fitness for Older Adults
Older adults have specific requirements which are now recognised and will be better catered for.
9. Exercise for weight loss
Dieting alone cannot achieve sustainable weight loss and this trend backs the theory that exercise is an essential part of weight loss.
10. Yoga
Yoga has many forms and often includes ‘wellness’ which features lower down the list of fitness trends. I see these combined to offer an exercise based way to cope with the stress of today’s busy lifestyles.
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Why can't I control my weight?

It’s the magic question to which we all wish we had an answer!

New research from a study conducted at the University of Sheffield has addressed the problem of using a single classification of people who have a weight problem. They are suggesting that this restricts the effectiveness of treatment options. They propose a number of classifications each of which will require a different approach.

Below I have taken their classifications, adapted them to reflect the demographic I see in my work as a physical therapist and then suggest solutions:

  1. Young healthy females displaying the most positive health characteristics.
    These are typically called yo-yo dieters, they are interested in health and fitness and follow the latest trends in exercise and popular diets. They are able to lose weight quite quickly but maintaining the weight loss over a long period is harder. They join the gym or a fitness class at the beginning of the year but find it hard to keep attending once ‘life’ gets in the way. It’s not their main priority in a busy life so is easily dropped.

    For these people, I would recommend a monthly session with a motivational trainer or nutritionist/exercise professional, booked and paid up well ahead. This will keep interest and motivation levels high by suggesting new exercises, new techniques, and help and encouragement in developing healthy eating habits with recipes and nutritional advice.
  2. Males who are unable to control their weight despite having high levels of physical exercise.
    Lifestyle factors are likely to include high levels of food and alcohol consumption. This group can cover a huge age range from mid-30s to retirement. They may be gym members enjoying a weights based training programme on a regular basis, they may get exercise from dog walking or be golfers. The excess weight comes from the excessive intake of food and/or alcohol and the lack of enough cardiovascular exercise.

    I would recommend completing a food diary to capture exactly what is consumed over a month long period. Alongside this find a nutritionist/personal trainer to review the amount and type of exercise. They can then ensure there is enough cardio work to encourage fat burning rather than developing further muscle mass. A tracker to follow activity and monitor heart rate will check actual activity levels. Looking at portion control, meal content and reducing alcohol intake will ensure the best chance of success.
  3. Middle aged females interested in exercise and weight management, although suffering from anxiety, insomnia, depression and fatigue maybe also with low self-esteem.
    This is another big group, many of whom are somewhere along the menopausal curve. Along with the symptoms listed above, weight gain is common as hormones fluctuate. Previously successful weight and exercise regimes no longer work.

    Support during this time is essential, recognizing that many others feel the same way. Exercise classes with a social element offer enjoyable exercise which is more likely to be continued as the people in the class become as important as the exercise content. Community venues or small private centres, rather than big leisure complexes, are more likely to offer this type of class. Look for pilates, yoga and general exercise to music with instructors specializing in this age group.
  4. The affluent healthy elderly, many of whom have high blood pressure.
    Age was not specified so I’ll assume that they mean 65+ although that’s hardly old these days. I think this group is struggling with their weight as a result of changes in life style and in their body as it ages. Food choices have developed enormously during this group’s lifetime and their affluence can lead to indulgent choices with foods high in fat and sugar. This group of people are at risk, if they do not address their weight issues they will soon find themselves in the next category, ie with chronic health conditions.

    This group needs exercise which takes account of their age and high blood pressure as well as a carefully structured eating plan. They also need encouragement and support in keeping to the life style changes required. Exercise combined with a social element is a good solution in this case. Also look for an instructor specializing and qualified in exercise for older adults.
  5. The physically sick but happy elderly with chronic health conditions such as arthritis, diabetes and high blood pressure but low levels of anxiety.
    This group of people are probably in a vicious circle, the chronic health condition has limited their ability to exercise and this has resulted in weight gain, which in turn adds more chronic health issues.

    It is very difficult for these people to keep doing exercise since they have to endure levels of pain to stay active. Unfortunately, without undertaking some exercise, the situation will get worse faster. Basic mobility exercises will get this group into better health, together with dietary advice to cut calories and look at foods which ease the inflammation of arthritis. Small classes designed for people with painful conditions can be helpful, providing support and encouragement from a position of empathy and understanding. Look for an instructor with a GP referral qualification, and ask for a one to one session first.
  6. The elderly deprived who do not have healthy behaviours and have the highest BMI readings.
    These people are likely to have been overweight with unhealthy diets for their whole life. Exercise will not have featured in their lifestyle, and they may have no desire to change. Any cost of treatment is probably an issue, limiting their choices.

    This group are the hardest to help. Approaching GP surgeries to see what they offer is the best way forward. For example they might hold exercise sessions funded by the NHS, they should at least offer dietary advice.
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Pain is not as simple as you might think!

Almost everyone will have felt pain at some time in their life. Here at the studio we see a lot of people suffering from pain, mainly associated with movement or a persistent ache. We can usually help to alleviate this either by reducing it or by offering techniques to manage it. What you may not realise is that there may not be a physical reason for the pain.

To get a better insight into what is going on when you hurt, we need to understand how you feel pain.

The ability to feel pain is very important to our wellbeing. It stops us doing things that are damaging to our bodies, and makes us rest to allow our bodies to recover from injury. So you really should not ignore pain, or simply "work through it".
Firstly you should make sure that there is not physical damage causing the pain.

The expected mechanism of pain starts with some physical damage which causes receptors within the nervous system to fire. This action creates minute electrical currents which are passed from nerve cell to nerve cell up to the pain perception center in the brain. It is here that these signals are actually converted into what we know as pain. All along this pathway it is possible for your body to mistakenly trigger, sometimes from a sort of nerve memory. Hence, for example, the site of an old injury can often be painful even though there is no damage or reason for that pain.

The brain itself is quite capable of "making up" pain. If you injure your ankle your brain will avoid movements that cause pain in the damaged area. This is good. However once the damage is repaired, the brain continues to avoid movements that were painful. The fear of pain can cause actual pain. The brain has to be retrained to understand that the pain is no longer there by specific repeated movement patterns.

Often in avoiding pain the body will stress another area and cause a pain there. It doesn't always make the right decisions as to the best way of helping your body.
We see this type of issue often at the studio. A client may have had a small injury to a back muscle lifting something heavy out of a car (shopping or a child are frequent culprits here). The body's defense mechanism leaps into action and activates a range of alternate muscle actions to protect the damaged area. Unfortunately this will usually cause a misalignment, or imbalance in the body, often resulting in the stressing of and possible damage to a whole set of different muscles ranging from shoulders to knees and ankles.

Clients come to us with a problem in their knee. However, when we have taken a holistic review of their gait and completed a range of movement tests we can see that the problem is not in fact in the knee at all, rather it is a bodily imbalance brought about by a completely different issue.

So, if you have pain, my advice is:
Firstly, check with your GP to rule out a structural or other cause which needs medical treatment.
Then, come to The Studio for a half hour one to one consultation so we can assess the best ongoing solution.
Alternately, or in addition, if you have access to a physio ask them for muscle testing and exercises.

Frequently the solution from me (or a physio) will be regular exercise combined with soft tissue treatment and exercises to include in your existing fitness regime or to do at home.

Don't put up with pain, call us, we may well be able to help.
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Back Pain Solutions - The latest research

As a practitioner in the field of back pain and a member of ‘Backcare’ the UK’s national back pain association I receive regular updates on current research and recommendations.  The most recent publication contained several interesting articles which I will summarise and share with you.

Orthopaedic surgeons speak out about what they see as the alarming trend in dangerous and unjustified back surgeries.

To quote George Ampat a consultant orthopaedic surgeon based at Royal Liverpool University Hospital ‘Unfortunately, there is a false belief that surgery or new technology can fix back pain.  This is far from the truth.’  He says that out of 100 patients who see a health professional for back pain 97/98% will get better without surgery through exercise and over the counter medication.

There are many products on the market for the condition known as sciatica, most of which you will see advertised for a while before they disappear – usually because they don’t work.  Sciatica is usually caused by a collapse of the spinal discs pushing the intervertebral cushion out, a bit like squeezing jam out of a doughnut.  Fortunately, with time and stability work this will usually ease within a few weeks.  One research study in the US looked at the results of surgery and showed a benefit for up to 8 years after surgery.  In the same study, those who did not have surgery also continued to improve over the same period.  Another study looked at the return to work ratio of those having surgery v those not having surgery.  The result?  26% of those having surgery returned to work v 67% of those who didn’t.  In addition, there was a 40% increase in the use of painkillers in those who had surgery.

Exercise myth busted - Don't delay, be active:
Nick Sinfield, a chartered physiotherapist says that a common effect of pain is that you become fearful of movement or believe that a certain movement will damage something.  In fact you should be moving and doing physical activities that move the spine normally.  Moving with a rigidly protected back will prevent your recovery not help it.  By not bending and moving correctly strain is placed on already sensitive soft tissues.

In my opinion if your back is sensitive, painful or stiff you should choose your exercises carefully.  Pick those which will reduce stiffness with gentle controlled movement and minimum spinal load on the spinal structure.  This type of exercise will improve the function of the spine, enabling it to cope better with everyday life. The ligaments and muscles which support your back require strengthening and rest will only weaken these leading to more back pain.

Remember the proven benefits of exercise:

Increases blood flow to all muscles which helps the healing process

Reduced muscle spasm, especially with biomechanic based anti-spasm techniques

Increase in your confidence in your body’s ability to move

Reduction in anxiety which helps with soft tissue relaxation.

Improved body awareness enabling you to listen to your body better in the future therefore reducing the likelihood of a recurrence.


Surgeons Speak out - Surgery can't fix all:
David Hanscom an orthopaedic surgeon specialising in complex spinal surgery says that although there is no connection between disc degeneration and pain there are hundreds of thousands of spinal fusion operations being performed for back pain every year based on MRI scans showing disc degeneration.
He says that in the over 60's, disc degeneration is present in 100% of people - most of whom do not suffer from chronic back pain.  This is normal.  Disc degeneration is not a disease, it is a normal part of aging, like grey hair.  Add to this the research that looks at back surgery patients after 2yrs with only a third showing improvement and you can see that it is easy to end up in what he calls the 'failed back surgery syndrome' with crippling pain for ever.

So, why do so many people see surgery as the best solution?

Well, there seems to be a number of factors having an effect.  Firstly, the health industry is increasingly commercialized with huge sums of money to be made from drug development and spinal devices. So it’s no wonder that these are promoted.

Add to this the fact that exercise in the UK is still almost entirely unregulated so usually excluded from being prescribed on the NHS.

Also, the training required to be effective as a back specialist forms something of a barrier to many exercise professionals.  As a result only a small number of us are fully aware of all the techniques and therefore the best way to help people with back pain.

Finally, people will always tend to select the solution that requires them to do the least work.  Often the choice will look like a life time of exercise against an operation and a period of recovery followed by a pain free existence.  Unfortunately this view is being called into question more and more.

My opinion?

This situation is a great shame because exercise is a cost effective, less invasive and therefore risky, solution.  However the fix for all this is not easy and probably would involve some form of regulation for those exercise professionals who would like to provide the service for the NHS.  Also doctors and surgeons need to be aware of the success rates of the exercise alternative, and also be directing patients down this course.
You can see from this why I feel so strongly that exercise options should be thoroughly tried before progressing to surgery. 

If you have any questions on this just give me a call
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Pelvic Floor Dysfunction - More common than you might think


 HAVE A LOOK AT THE NEW PELVIC FLOOR WORK - IT
AFFECTS MORE PEOPLE THAN YOU MIGHT THINK

Pelvic Floor Dysfunction: What is it, why do you have it and how can you correct it?

To start with, new research in 2014 shows that 80% of women will have Pelvic Floor Dysfunction (PFD) at some point in their life and 30% will have stress incontinence.  Men are also affected by PFD, frequently as a result of prostrate problems, although this is talked about much less.

What is Pelvic Floor Dysfunction?
A dysfunctional muscle is one which will not contract nor release so it tends to be both tight and weak, and consequently, unable to function correctly.
The pelvic floor is the muscle group which forms the 'under carriage' of your trunk.  It supports your internal organs, includes the "bathroom" muscles and adds support to the sacro-iliac joint. So it is essential that it functions correctly.  If it is dysfunctional it will be tight, short and weak instead of being flexible, long and strong.

Symptoms of PFD may include:
Abdominal separation following pregnancy
Stress incontinence
Pelvic discomfort
Back and Sacro-Iliac joint pain

The contributors to PFD include:
Pregnancy
Crunches and sit ups
Poor posture
Wearing high heels
Sitting for too long 

What is the solution?
New research has identified that the pelvic floor will not work effectively in isolation, it will function up to 75% better through a specific mix of muscle group activation rather than with the traditional 'kegels' exercises (controlled lifting of the pelvic floor in isolation).
In addition, all exercises should be performed with the pelvis in a neutral position, not in the pelvic tilt position.
The specific mix of muscle group activation is to work the Glute (butt) muscles in conjunction with inner, and outer, thigh muscles.  This is the key combination for optimum pelvic floor engagement and improved support to the pelvis.

The best exercises are:
Squats with correct alignment to strengthen yet lengthen the pelvic floor
Shoulder bridge with a small ball between your knees
Curtsey or split squats
Clam type exercise using fast and slow twitch pelvic floor activation
Check with an exercise professional to ensure that your technique is correct as this is essential to gain any PF benefit.  The big benefit of this new approach is that by working this specific group of muscles, correctly, the pelvic floor will activate automatically.

Exercises to avoid
Any exercise with a pelvic tilt as this shortens the pelvic floor muscle, encouraging dysfunction.
Crunches or sit ups, which increase the downward pressure on the pelvic floor.
High impact exercise.
Pilates exercises such as 'the 100'

Would you like to know more?
Just contact Anne by phone or email to discuss your needs. The correct exercises and techniques are taught in 'I Move Freely' Pilates Classes at The Studio
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Risk v Benefit - Keeping your exercise programme safe


Risk v Benefit Keeping your exercise programme safe

 

There is much in the popular press about the benefits of exercise for both physical and mental health.  Many people are encouraged to take up exercise by their doctor or physiotherapist.  On the other hand, there are many articles about the risk of injury from exercise.  For example one study showed that over 60% of runners will pick up an injury in any one year, and another stated that 35% of women exercising on a regular basis will have a musculoskeletal injury.  

 

As a fitness professional and physical therapist I use a variety of techniques to ensure that my clients gain the benefit and do not suffer any injury:

 

I encourage clients to work at their own level, not keeping up or competing with each other.

I keep a close eye on the posture of each client as they exercise.  If there is a postural fault when a client walks in, they will probably keep that faulty position as they exercise.  This will be a habit that I am keen to discourage and correct with exercise.

When I spot a common postural imbalance within a group I will add exercises to help them correct it.  This could be drawing back rounded shoulders, lengthening the neck or stretching tight hamstrings to encourage better pelvic alignment.

At the beginning of each session I check how everyone is feeling and how long standing injuries are progressing.  I will include the best exercises to help each persons condition.  This could be reducing range of movement to encourage stabilization of a lax joint, work to strengthen a weak joint or stretches to help muscles tightened up by other sports such as running or cycling.

 
Using these methods I aim to help everyone to exercise and gain a benefit whilst not risking an injury.  Remember that your feedback is essential to ensuring a safe effective exercise programme so don’t keep quiet about any pain or discomfort as there is usually a way to manage it, and it is often a good indicator to the types of exercise you need.
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I have arthritis, should I exercise?

Some Facts about arthritis:
  • About 70% of people over the age of 65 will have some level of arthritis and 1 in 5 of the whole population.  This equates to around 10 million people in the UK.
  • A number of people will have no symptoms and be oblivious to the fact that they have arthritis, but most people with it will suffer some symptoms, such as pain and stiffness, on a daily basis.
  • The most common type of arthritis is Osteoarthritis, followed by Rheumatoid (especially in women) and Gout (especially in men).
  • There are actually over 100 different diseases that can cause the problems characterised as arthritis.
  • There is no cure for arthritis.
 
What is arthritis?
Arthritis affects the joints of the body.  At least two bones meet to form a joint, but some joints have three and wrists and ankles have more. Each joint in the body is constructed in a slightly different way.  Most of the main joints have cartilage covering the bone ends and the whole joint is enclosed in a sort of bag called the joint capsule.  This bag holds synovial fluid which effectively lubricates the joint.
Arthritis develops when the cartilage has become worn, torn, or has been removed, often due to trauma.
The synovial fluid within the joint capsule becomes thicker or ‘stickier’ as we age and as a result doesn’t coat the cartilage as well.  This results in increased wear to the cartilage and the bone ends which become roughened.  The joint can no longer slide smoothly and pain results.  This is typical in osteoarthritis of the knees, shoulders and hips.
With Rheumatoid arthritis joints become swollen as the body attacks its own tissues.  There are many other forms of arthritis, such as spondylitis which is when inflammation around the spine causes pain.

What causes arthritis?
Arthritis has a variety of causes, most of which are not fully understood.  For example:
  • Trauma to a joint earlier in life frequently makes arthritis more likely.  A car accident, sporting injury, trip or fall can all cause damage to a joint, weakening it and making it susceptible to arthritis, sometimes not manifested until later life.
  • Cartilage has a poor blood supply which means that when damaged by twisting or tearing is doesn’t heal very well.  As a result, it was common for cartilage to be removed following trauma, although nowadays this is less frequently performed and exercise is used to manage the situation.
  • Carrying excess weight puts more strain on the joints increasing the amount of wear and tear.
  • There is a clear genetic link which can increase the risk factor for Rheumatoid arthritis which can be activated by trauma.
 
Exercising with arthritis.
Arthritis causes joints to be stiff, painful and to have a reduced range of movement.  Exercise can improve these symptoms but it needs to take account of the arthritis. I work to create an environment and exercises within which the joints can be moved freely and without pain and you feel able to exercise within you own capabilities.  In addition, exercise can encourage good posture, which is essential in keeping the spine straight and reducing the risk of kyphosis – rounding of the neck shoulders as well as potentially slowing the progress of degeneration.
 
Key points to remember:
  • Loosening joints, using movement which is pain free, is essential to encourage and keep the maximum mobility.  For example, in ball and socket joints, simply rotating the limb within the joint capsule can have a beneficial effect, by encouraging the synovial fluid to coat the whole joint and become less ‘sticky’.
  • Specific muscle strengthening work to support the damaged joints will help reduce pain on a daily basis.  This is especially beneficial for the hips, shoulders, knees and spine.
  • Do not push through the pain, look for a different way to loosen or strengthen the painful area.
  • Avoid overstretching and putting joints into positions out of their normal range.  For example, knees are a hinge joint, designed to bend in a forward and backward motion with limited rotational range.  Sitting with legs crossed will stress the joint and in time can cause wear and then damage.
  • Note which activities cause pain and look to find other ways of doing them.  Exercise can be designed to help you strengthen your body enabling you to do regular activities with less pain.

Finally:
Arthritis can be debilitating and has no cure, but exercise is one of the recommended treatments - don’t let arthritis be a reason to stop exercising.

 
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How important is balance to your overall health and well being?


Many clients I see have very poor balance skills when they first attend The Studio.  This usually improves hugely within a few weeks.  I am frequently asked why it is that our balance is so bad, and, why it is important to improve it.

Firstly, why is our balance poor?
Balance is a motor skill which we acquire in childhood.  It requires the use of large muscles groups and although this skill remains with us throughout our lives it deteriorates with age.  At any stage of your life it is possible to improve your balance skills with training.
The ageing process causes muscle weakness which will affect the body's ability to recover from a trip on an uneven surface.  With age often comes inner ear misbalance causing dizziness or blood pressure issues which can cause light-headedness.  Also failing eyesight means you may mis-judge uneven surfaces, or distances from objects.  All of these situations can easily lead to falls.

How big a problem is this?
It is estimated that 30% of the over 65's fall every year, and more than half of the over 75's living in nursing homes or care facilities are unable to live independently because of falling.
Women suffer from bone thinning (osteoporosis) and this increases the risk of hip fractures if they suffer a fall.  Almost 50% of hip fractures are seen in people who had no mobility problems prior to their fall, however only 50% recovered to their previous level of mobility (NICE 2012)

How does this affect you?
  1. Every time you walk you put all of your weight on your front foot as you lift the back foot up to swing it through.  If you step on an uneven surface, ice or simply misjudge the height of a kerb you will need to be able to balance on one leg for that little bit longer than usual to avoid falling. This is particularly true when walking down steps.
  2. When you reach up to a high shelf you probably balance on one leg to gain extra height.
  3. When you get out on the car you will place one foot down and put your weight through that leg as you push up to standing.  The added twist provides more challenge to the balance and it is easy to strain your back if your muscle structure doesn't support you too.

Things to remember
  • Balance can be improved with practise both in a controlled environment such as with an exercise therapist and at home.
  • Improved core strength gives better balance.
  • A fall can signal the end of independent living, changing your life completely.
  • Improve your balance and you'll improve your overall health and wellbeing.

Take action
If you are not currently attending The Studio, call me to arrange an appointment where I can assess your balance and help you to improve it.
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Is there an age when exercise becomes bad for you, risky or inappropriate?

At what age does it become bad, too risky or inappropriate for you to exercise?

In my opinion the answer is there is no age beyond which exercise should not be attempted!
I may be biased having worked in the world of exercise all my life and coming from an active family but my opinion is backed up by recent research and national recommendations.

The current government recommendation for those aged over 65, is
1. To be active daily
2. To accumulate 150mins weekly of ‘moderate intensity activity’ in bouts of at least 10mins at a time
3. To exercise twice weekly for strength, flexibility, balance and co-ordination
4. Minimise the amount of sedentary time. (sitting)
5. Some activity is better than none, and more provides greater health benefits

This might sound onerous, but in reality it can be achieved very easily.

Let’s look into these guidelines a bit deeper to see how easy it is to meet them and what the benefits are.

First we can consider why should we exercise at all?
• All muscle wastes away if it is not used: the motto use it or lose it really is true.
• Skills such as balance and co-ordination deteriorate with age.  However they can be maintained and even improved with regular practise.  This deterioration is the main case of older people falling so easily, so controlled exercise will reduce your risk of falling.
• Bone density also deteriorates with age meaning falls are more likely to result in fractures.  Controlled exercise will improve bone density hence reducing the risk of fractures.
• Posture can deteriorate as we age for all sorts of reasons, most of which are correctable by specific targeted exercise: don’t become a stooping person!
• Your cardio-vascular system ages with you. We get higher blood pressure, less efficient blood flow around the body and much reduced oxygen uptake by the body, leaving us feeling less like exercise, when in fact we need more! See point 1.
• If you are suffering from arthritis, exercise is known to be beneficial, reduce levels of pain and improve mobility.

Second, what is moderate intensity activity (point 2 of the recommendations)?
Activity, here, can be defined as any movement that increases your heart rate from its normal resting rate. The measure of moderate intensity is different for every individual.  It is not advisable to use any generic figures for this, the best approach would be to ask any appropriately qualified instructor.

What activities could count as moderate intensity?
Walking is brilliant provided it is on a regular basis and is appropriately vigorous.  We can check whether you are being vigorous enough by testing your activity level in a SELECT class.  If you walk your dog daily it is quite possible that you already meet the guidelines for cardiovascular exercise.

Interestingly, golf is found to be of limited benefit.  It is not aerobic, it promotes misbalanced strength and flexibility in the body and research shows no bone density improvement.  This would not count.

Gardening is also classed as non-beneficial.  The bending, reaching and kneeling all puts stress on the body rather than strengthening it.

Swimming is similar to walking in that it can be great for cardio if it is done regularly and with appropriate vigour. However it doesn’t improve bone density or balance. And if you suffer any joint issues, breaststroke should be avoided.

Other exercises to consider that can be beneficial are, cycling, rowing or cross-training in the gym.

So what exercise is available to address point 3 of the recommendations?
Generally these exercises are specific routines that are performed in classes, in the gym, in a swimming pool or at home.  The important point here is to ask an appropriately qualified instructor for guidance on what would be the most beneficial forms for you, and also to teach you how to perform the movements without them being detrimental to you.

Pilates is probably the most suitable form of exercise as it is controlled and specific in its aims. It doesn’t encourage excessive movement, and primarily uses the body’s own weight for resistance. This means it is particularly accessible even for people to do at home.

I have developed a specific variant of Pilates designed to be particularly beneficial for people with injuries, aches and pains, bad backs and posture difficulties.  In “I Move Freely” Pilates classes I use biomechanic exercises to gain the maximum benefit in loosening stiff joints, backcare exercises to strengthen yet protect the spine as well as strengthening exercises for the muscles which give support to our skeletal structure.  Posture is addressed with work to open the shoulder girdle, thus preventing the shoulder rounding which can easily lead to ‘hunching’. Also, I avoid some traditional Pilates exercises (e.g. roll downs, the 100 or double leg lifts) which put pressure on the lower back, neck and pelvic muscles.  Provided you exercise correctly and regularly in class and continue to use the correct muscle engagements throughout the week when doing normal everyday activities you will be gaining strength and stability. 

What if you don’t feel able to take part in a class nor want to go to the gym?
SELECT is a small group class (max 4 people) I run specifically to cater for you.  Because the attendees are very limited the exercises can be completely tailored to your individual needs. 
For example, if you cannot get down to the floor, or you cannot stand for any period, we can provide chair based exercise, or we have exercise couches.  If you find it uncomfortable on normal exercise mats we can provide memory foam mats which protect any protruding, or painful parts from the hard floor.
As another example, If you have specific recommendations from your GP or physio, we are experienced at working with your practitioner to make sure the exercises are appropriate to your needs.
SELECT allows me to shape the class to each individual whatever their requirements.
Consequently, SELECT makes getting started easy, it is friendly, focussed to your needs, will address concerns you may have about your body as it ages and work towards keeping you independent and active – fit for life for all of your life.

 If you are unsure in any way about attending a class or what exercise is suitable for you, please arrange to pop in for an informal chat and see how easy it is to incorporate exercise into your life.
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