Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

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My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, August 17, 2024

These Are The Exercises Seniors Should Skip and Safer Alternatives

 If you can't do these post stroke your doctor completely failed at their job of getting you 100% recovered!

These Are The Exercises Seniors Should Skip and Safer Alternatives

Whether you’re a master-level athlete who has no plans of ever slowing down or a 65-year-old who’s hitting the gym for the first time in 30 years, the old adage remains true: Age is just a number.

Chronological age, at least. When choosing a workout program, biological age is much more relevant, explains Julie Logue, M.P.H., senior program manager for Silver Sneakers.“The way you have cared for your body over time can better determine appropriate movement and intensity selection,” she says.

Have you stuck to a reasonably healthy diet? Stayed active and maintained muscle mass with resistance training? Worked on mobility and prioritized sleep? Over time, good habits compound while bad habits take a toll, potentially making one person’s experience with aging drastically different from their peers.

As with younger athletes, your training should align with your current fitness level, goals, and any existing injuries or health conditions. There’s no one way for all seniors to stay in shape, and there’s no universal age limit or official cut-off for specific lifts and forms of exercise.

That said, your body will change over time, and your exercise routine should evolve. “Obviously, there are certain physiologic changes that happen to someone who is 70 or 80 versus someone who’s 20,” says Grayson Wickham, D.P.T., physical therapist and founder of Movement Vault, a stretching app and website. He cites a shift in hormone profiles and the inevitable “wear and tear” on a body that’s been active for decades. “But it’s not as much as most people think,” Wickham says, noting that inactivity as you age will only hasten sarcopenia, or age-related muscle loss.

According to the experts (and research), seniors should absolutely continue to prioritize strength training as part of their workout routine. And lifting offers sports-specific benefits to cyclists. Beyond building a strong core and legs for pedaling, resistance training may help seniors minimize falls by improving their balance and spatial awareness. (And if an accident does occur, having some muscle mass on your frame can help you better absorb force and protect your bones and joints.)

However, older cyclists may need to eventually swap some of their routine exercises for more anatomically favorable movements that minimize injury risk and ultimately yield better results.

“The game has changed, and there’s a whole different way of doing this now,” Robert Linkul, C.S.C.S., owner of Training The Older Adult, tells Bicycling. “[In your younger years], your nimble, pliable body could handle the damage you were doing to it by doing the wrong things. Now you’re going to have a very damaging effect if you do that. Your body is not capable of taking that amount of abuse and coming back. So, you have to find the safe and efficient way [to exercise].”

With the help of Linkul, Wickham, and Logue, we compiled the following list of exercises that most seniors should avoid and offered recommendations for what to do instead.


Strength Exercises Seniors Should Skip and What to Do Instead

1. Inversions

“Inversions are movements where the head goes below the heart,” Logue explains. (Think handstands, inverted sit-ups, and pike push-ups.) “They can lead to lightheadedness while increasing pressure in the sinuses. A more moderate approach is keeping your head in line with the heart or higher.”

Instead, try: more traditional core and shoulder exercises

monique doing a dead bug exercise for fitness
To do a dead bug, lie face up, arms extended and knees over hips. This is the starting position. Extend right arm and left leg out. Then return to starting position. Repeat on other side. Continue alternating.Trevor RaabStick to regular push-ups or wall push-ups to build arm and shoulder strength. To target the core, opt for dead bugs, bird dogs, or planks.

2. Plyometrics

When it comes to plyometric movements, like box jumps, bounds, and jumping lunges, there’s plenty of gray area. “It’s all in context,” Wickham says. “[For example,] If you’re just starting to work out and you’re 65, then you’re probably not going to jump right into jump squats.” That kind of impact puts a lot of pressure on the bones and joints, which can be problematic for people with arthritis, osteoporosis, or osteopenia. However, if you’ve been training consistently without pain and have adequate hip and ankle mobility to do a regular squat without your back rounding and knees buckling, you may be able to keep jump squats in your repertoire. Instead, try: med ball power moves
med ball toss
To do a med ball toss, stand near a wall, holding ball at chest. Squat down, and as you stand up, throw the ball up and toward the wall. Catch it and immediately lower into a squat. Repeat.Jodalyn Zambuto.  Even for clients who are still doing plyometric moves successfully, Linkul tends to scale back and offer substitutions that develop power while allowing you to keep both feet on the ground. “You can work just as explosively in something called a release drill,” he explains. “This is basically throwing heavier objects.” Examples include ball slams, medicine ball tosses, chest passes, overhead throws, and sandbag slams.

3. Barbell Back Squat

The problem isn’t with the squat. It’s with the bar and the way it rests across the shoulders.

“I don’t see the need to load the spine with that kind of compressive force,” Wickham says. Linkul shares similar concerns: “People are basically going to counter that weight by over-hinging forward into their squat, and that just exposes your back [to injury] even more,” he says. “I would say the only people that should be doing that are powerlifters because that’s their sport.”

Instead, try: hex bar or goblet squat

monique lebrun performing a kettlebell squat as part of the transverse abdominis set of exercises
To do a goblet squat, stand with feet shoulder-width apart, toes turned slightly out. Hold kettlebell at chest. Send hips down and back to lower into the squat. Drive through feet to stand back up. Keep core tight the entire time. Repeat.Trevor Raab Squats are definitely a good move for seniors to do regularly, as it’s a functional exercise (you sit down and stand up all day!) and targets the lower body, along with the core. Squatting with a hex bar or a kettlebell held goblet-style takes the weight off your spine and allows you distribute the load more evenly, which is why these variations offer a better exercise for seniors than the barbell back squat.

4. Barbell Deadlift

Again, the issues with the barbell deadlift stem from the barbell itself and the position it forces your body into. First of all, a traditional weight plate puts the bar about eight inches off the floor. This means that everyone, regardless of their height or mobility, has to hinge at the same depth. Other types of equipment allow you to customize the height.

To deadlift a barbell, you also have to use a pronated (palms facing you) grip, which internally rotates (and therefore puts more stress on) the shoulder joint. There’s also the forward placement of the bar, which can cause you to hinge too far forward, putting your lower back in a vulnerable position.

Instead, try: hex bar, kettlebell, or dumbbell deadlift

si joint exercises, romanian deadlift
To do a dumbbell deadlift, stand with feet hip-width apart, toes forward. Hold a dumbbell in each hand. Hinge at hips by sending butt straight back and maintaining a flat back and core engaged. Only go until you feel a slight pull in hamstrings. Drive through feet to stand back up. Repeat.Thomas Hengge. A hex bar allows you to step into the middle of the bar for more even weight distribution, rather than lift from behind it. The height on some hex bars is also adjustable, and you can lift it using a neutral grip. “Your shoulders are little more externally rotated. It’s easier for people to pull their shoulders back into a neutral position, and they can pull from little higher. It’s a much more comfortable lift,” Linkul says. You can also use two kettlebells or two dumbbells and elevate them on boxes or padding, if you don’t have access to a hex bar.

5. Barbell Bench Press

Notice a trend? Even though the barbell is technically a free weight, Wickham explains, a barbell puts both shoulders in a relatively fixed range of motion, which can add stress to the shoulder joint. Plus, if one shoulder has better mobility than the other, it could lead to compensations that ultimately result in injuries.

Instead, try: dumbbell chest press

dumbbell push workout, seesaw chest press
To do a dumbbell chest press, like faceup, holding a dumbbell in each hand, arms extended over shoulders. Lower one or both weights to floor. Then press back up. Repeat.Noam Tamir. Pressing with two separate dumbbells allows you to move within each joint’s unique range of motion without compensations that can potentially cause injuries over time. And while you have to grip a barbell with an overhand grip, working with two separate weights allows you to adjust your grip position and, therefore, your degree of shoulder rotation.

6. Bent Over Row

Logue cautions against any kind of lift that puts your body in unsupported spinal flexion, as that position makes it difficult to maintain a braced core and flat back when hinging forward at the waist. Plus, “bending over with a rounded spine [a common form mistake in this exercise] can cause or exacerbate low back pain,” Logue says.

Instead, try: seated or supported row

supported rowTo do a supported row, stand to left of bench or chair, right hand and leg on the bench. Hinge at hips and maintain a flat back and core engaged. Extend left arm down in front of body. This is the starting position. Pull weight to rib cage, keeping shoulders packed and elbow close to side. Extend arm to lower weight. Repeat. Then switch sides.Noam Tamir. A seated row using a band or cable enforces good posture and will fire up the lats. Alternatively, use a bench for a three-point row (placing one hand on the bench for support), or pull from the floor in a quadruped (or all-fours) position.

7. Weighted Russian Twist

This ab exercise requires you to perform a weighted rotation with flexed hips, one of the most dangerous positions for seniors, Linkul says. “You’re just shearing and ripping lumbar [lower spine] and discs back and forth, and they’re just not designed to do that range of motion,” he says. “They’re designed to do 30 to 60 degrees of range, and not with [a heavy] load.”

Instead, try: Pallof press

pallof press
To do a Pallof press, hold resistance band or cable machine handle in front of chest, with it anchored to the side of you. Resist rotation. Keeping core tight, shoulders down and back, press the band straight out in front of chest. Pause, then bring back to chest. Repeat. Then switch sides.Trevor Raab. To safely work the core, including the obliques, Linkul recommends anti-rotation exercises like the Pallof hold and press.

8. Barbell Overhead Press

You probably don’t have to nix this movement pattern altogether. Generally speaking, most seniors can continue to press overhead with some modifications. As with so many other lifts, two weights are better than one barbell, because you can use a neutral, shoulder-friendly grip and work with each shoulder’s unique range of motion.

Instead, try: dumbbell or kettlebell overhead press

tamir practicing the halfkneeling singlearm overhead press exercise
To perform a half-kneeling overhead press, kneel on mat with right foot forward, dumbbell or kettlebell in left hand, racked at shoulder. Press the weight straight up overhead, bicep by ear. Pause, then lower back down. Repeat. Then switch sides.Noam Tamir. You’ll get the same core, back, shoulder, and arm-strengthening benefits with a separate weight in each hand, and you’ll be putting less stress on your shoulder joints.

Logue also recommends using a more moderate range of motion to reduce the risk of injury. “With overhead shoulder movements, I’d opt for arms up and slightly forward, like putting something on a shelf, versus arms directly overhead,” she says.


9. Walking Lunges

Because of their balance component, walking lunges put your knees, hips, ankles, and lower back in a vulnerable position, and a lot can go wrong if your form isn’t impeccable.

Linkul explains that movements with forward flexion and a twisting component—for example, if you fall forward or to one side in a lunge, which can happen as balance gets thrown off—can cause lower back injuries, especially if you do this while carrying weight.

Instead, try: split squat

split squat
To do a split squat, stand with feet staggered, left foot forward. Maintain a tall posture and tight core, with weight over the front foot. Lower down by bending both knees 90 degrees. Drive through feet to stand back up. Repeat. Then switch sides.Trevor Raab. Split squats, or doing a lunge in place, reduces the chances of injuries and falls. And if you’re feeling wobbly in a split squat (or any movement), go ahead and hold onto a stable object. “Balance changes as we age. Using external support, like a weight bench or chair, may increase safety and confidence in those who feel less stable on their feet,” Logue says.

10. Crunches

“When it comes to core work, anything that brings your sternum and pelvis closer to each other should not be performed,” Linkul says. “The reason for that is if you stand up with perfect posture and then you pull your sternum and your belly button closer to each other, that’s putting you in the exact opposite position that you want to be in for good posture positions.”

Crunches, as well as movements like leg lifts, sit-ups, and flutter kicks, fall under this category.

Instead, try: suitcase carry

suitcase carry
To do a suitcase carry, stand tall, holding a challenging weight in one hand. Slowly walk forward, keeping chest up and core engaged and avoiding the pull toward the weight. Walk for time, then switch sides.Trevor Raab. A suitcase carry, during which you carry a heavy weight in one hand, forcing the opposite side of your body to stabilize, is an excellent substitute for traditional ab exercises. Linkul says this move is one of the best exercises for core strength as it helps to improve your gait, reduce the risk of falling, and improve your balance.

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