Maintaining Mobility as You Age
Listen to Beth Schwendeman, PT, DPT on our podcast Memorial Health Radio in the new episode titled mobility with patients.
Transcription
Melanie Cole (Host): As we age, we may lose mobility. The less mobile we become; the more at risk we may be for illness and injuries. The good news is; there are many exercises you can do to help increase your mobility. If you are able to exercise regularly; you may be able to walk with greater ease, feel more balanced and be more confident. My guest today is Beth Schwendeman. She is a physical therapist and the Director of Outpatient Therapy for Memorial Health System. Welcome to the show Beth. So, what happens as we age to our mobility and explain a little bit about even what mobility is?
Beth Schwendeman, PT, DPT (Guest): Well first off, thank you for having me. A lot of the important things with our patients is as we get older and really even some of our younger athletes have difficulty with mobility and loss of flexibility that makes them more prone to injury or to speeding up that aging process. So, one of the things that we look for with our patients is that we want to make sure that we look for areas that they have deficits and really be proactive in improving and maintaining that flexibility and mobility so that they can stay active.
Melanie: So, what are some of the things that people can do right off the bat from today’s segment that they can start trying whether they are as you say, a young athlete or they are somebody who is aging and wants to really make sure that they can move around and do the things they want to do?
Beth: One of the biggest mistakes that we see in any age population, is that people don’t pace themselves. They try to go from a sedentary lifestyle into an overly active lifestyle and that puts them prone for injury. So, one of the things that we teach our patients is to make sure they pace themselves, that they start slow and then gradually increase as their endurance improves. So, we really like to have our patients work on endurance. We want them to work on really focusing on that core stabilization. Even people that feel that they have a strong core; usually have room for improvement. And we really try to look at those areas of what they are current baseline is and where we can take them to increase their activity levels and their stamina.
Melanie: People hear the word core and they think of sit ups and such. But that’s not really all it is. Speak about what are some core exercises and things that people can do because if your spine is more stable then your hips and shoulders don’t need to hold that stabilizing tension. So, explain some core exercises for the listeners.
Beth: So, there are a never ending amount of core exercises that you can do. A lot of times, we need to start with a smaller foundation of exercises than going into straight sit ups. So, depending on the person’s baseline, is how we would build their program. But a lot of things you can start with. You can do seated. So, you can focus on seated isometric exercises where you pull in those abdominal muscles, tighten up those belly muscles. You can hold those abdominal muscles tight while you march in place. You can do general walking and holding those belly muscles tight and really teaching people how to engage their core with everyday function. So, that can occur with lifting, it can occur with running the sweeper, it can occur with workouts in the gym. All of those things to engage that core and teach your body how to use that as its source of power.
Melanie: What about things like planking?
Beth: Planking can be fantastic if you are ready for them. So, some patients have to start off a little slower before they are ready for a plank. As with any exercise, the most important thing is having the right form. So, before you do planking you want to make sure that you don’t have any symptoms or any issues that are going to be aggravated by the planking and then really making sure that you start slow and focus more on form than the length of the plank. That is much better for you in the long run if you have good form and then gradually build your endurance.
Melanie: So, if they are working on their core and we have got these big hip muscles and big hip joints; what can you do to increase your hip mobility? What are some exercises or stretches that people can do?
Beth: Some of the stretches that we do a lot for a foundation are to have people doing hamstring stretching, hip flexor stretching, piriformis stretching, and really one of the best things that seems to help our patients with overall mobility is just to start a walking program and gradually increasing the amount of time that they walk as their endurance improves. Starting on that nice level ground and then you can gradually increase the difficulty with the terrain. But really working on walking, a stationary bike and then that flexibility with the stretching with the piriformis, the hips, the quads, the hamstrings and getting that overall trunk and lower extremity stretching program.
Melanie: So, you mentioned the piriformis a couple of times and people don’t really understand the importance of this particular muscle that can get tight but that also the sciatic nerve runs right through. So, explain a little bit about it because back problems especially for the aging; are huge and limit their mobility so much. So, explain a little bit about the back and the piriformis and that connection with the nerves and how we can increase that flexibility and mobility.
Beth: We always want to look at a person as a whole. So, if someone comes in with isolated hip pain or back pain; realistically, we are going to treat both. One of the things that is important for patients is that they keep that balance of the healthy muscle tension relationship and that they do focus on that stretching of both their low back and their hips. There are couple of different ways to stretch the piriformis muscle depending on the person’s activity levels and their current flexibility. But one of the big things we work on is really looking at that combination of the relationship between the core, the low back, the hips and the pelvis to make sure that everything is mobile like it should be and then also work on stability because that is where your core starts and that’s where a lot of our functional dynamic movements come from is that core and hip combination.
Melanie: So, what about things like pelvic lifts or tilts; trying to maintain that stability and stretching that piriformis. How do they do that?
Beth: There are a couple of different ways to do it. One of the most common is that we have people lay on their back and then cross one ankle over the other knee and then gently pull that knee across towards the opposite shoulder. If someone is flexible enough to get in that position, that’s a great starting point is to pull that knee over and across just until you feel the stretch in the back of that hip. You don’t want to go to the point that you feel like you are over stretching or you are increasing your symptoms. Another position if people can’t get on their back very well is just to sit and cross one ankle over the other knee in a sitting position and then very gently lean forward until they feel a stretch in their hip. That’s another great way to start if it is difficult to get on their back. The only thing to watch for would be if someone had a hip replacement or had any hip precautions, then that needs to be modified so they don’t break their hip precautions.
Melanie: And what role do the shoulders play, if any, because again, as people age, the mobility of their shoulders and the movement, their range of motion can be so decreased and golfing or whatever it is that they do, they can get a rotator cuff tear so easily. So, what do you want them to know about keeping their shoulders good and strong?
Beth: One of the things that we really preach to our patients; whether they are an active baseball pitcher that has a lot of overuse or whether it is someone that is aging and is losing that mobility and strength in their shoulders; is working on posture. And again, that comes back to what we have been talking about with that core strength and really starting from the core to build that stability there, keeping those shoulders down and back and that way we are being preventative of a future disease process by not letting ourselves slumped forward and get that rounded shoulder, rounded back posture. We really want to keep the back muscles strong and keep those shoulders down and back, looking forward; which also as we age, helps with balance because we are not in that forward head slumped posture. So, as we are keeping those shoulders back and keeping our back strong, we are looking forward and really helping ourselves with balance in the long run as well.
Melanie: So, speak about balance. What can people do at home to work on balance. It’s so important and people are afraid of falling and what can they do to work on those sort of proprioceptive techniques, things that they can do to make it so they are aligned with what their brain is telling them and what their feet are doing?
Beth: One of the things that we definitely want to stress with working on balance at home is safety. So, we don’t ever want anyone to do more than they feel safe with at home. If working on balance is always a good idea to do it with someone else in the house with you, in case you would lose your balance. But simple things to start with at home; a lot of patients do well with a small baseline for Tia Chi. You can do things as simple as standing at your kitchen counter with your feet together, eyes open and trying to maintain your balance with just light fingertips on the countertop. If that gets easy, then you can progress to one foot in front of the other and to hold on with just your fingertips and really work on maintaining that core strength while you narrow your base of support to challenge your balance system. We also have some patients that have difficulty with dizziness that can cause balance dysfunction and that sometimes can be a vestibular issue or people who caught vertigo. That is something that we also take care of in the clinic to really look at that vestibular system and see if there is a limitation that is causing their balance deficits and if that’s the case; then we can treat that as well.
Melanie: So, wrap it up for us Beth, and tell us what you would like the listeners to know about mobility, balance, maintaining all of this as we age and tell us a little bit about your clinic.
Beth: I think one of the important things that we want people to know in the community is that everybody has a chance to increase their activity levels. The National Physical Activity Guidelines recommend 150 minutes of moderate physical activity a week, but that doesn’t mean that that is where everybody is going to start from. So, the main thing that we would want people to know is that everybody has a chance to change their lifestyle, but it happens with time. The main thing is that you make everyday a little better than the day before, that you pace yourself and that you have that confidence in yourself that you are doing what your body needs and giving yourself that fuel to be active and to be healthy and be able to be an active member in the community.
So, our clinic, we have two locations. We have a clinic in Marietta in the Frontier Shopping Center behind Giant Eagle where we have physical therapy, occupational therapy, speech therapy and driver’s rehab and then we also have a clinic in Belpre on the Merritt and Memorial Belpre Medical Campus. We are the last building on the left-hand side and have physical therapy there as well. So, the nice thing about our clinics is that we really offer that multidisciplinary approach that whether people just want to look for injury prevention techniques, they want to look on body mechanics, it’s a young athlete with an injury or looking to do a conditioning program to get ready for their sports season. Really there is nothing we can’t treat and we really pride ourselves on being able to give you the tools you need to be safe and be active and correct any of that dysfunction that you have or that you want to work on barriers that you have.
Melanie: Thank you so much Beth, for being with us today. What great information for the listeners to hear. This is Memorial Health Radio with Memorial Health System. For more information please visit www.mhsystem.org. That’s www.mhsystem.org. I’m Melanie Cole. Thanks so much for listening.
