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Becca Jordre, PT, DPTGeriatric Certified Specialist
Certified Exercise Expert for Aging Adults
Health & Sport History
Materials: ✓ Health History Form
Health History
• Follow all of the questions on the form when asking an athlete’s health history.
• In general, a condition is only logged if it has been diagnosed by a health care professional. An athlete that isn’t sure or “thinks they might have” something is not valid for checking ‘yes’.
• Athletes may choose to skip any question that makes them uncomfortable.• When estimating minutes/week of cardiovascular or strength training please
use a ‘typical week’. • Do not count minutes of ‘being active’ such as yardwork or watching
grandkids.• Do count taking a dog for a walk.
Athlete Instructions
• “I’m going to ask a few questions that will be useful when we analyze your SAFE screen results for research purposes.”
VITALSBlood PressureHeart RatePulse Oximetry
Materials: ✓ Electronic blood pressure
unit
✓ Pulse oximeter
Blood Pressure
• Take blood pressure in the left arm, with the electronic BP cuff.• Athlete should be seated with left arm supported on the table.
Heart Rate
• Taken from electronic BP cuff
% O2 Saturation
• Place O2 sat monitor on right hand, 4th digit (ring finger).• This can be done while BP is taken.
Athlete Instructions
• “I’m going to wrap this cuff around your left arm for blood pressure. This (pulse oximeter) goes on your right ring finger.
• Please sit quietly now while I take your blood pressure.”
Vitals – Athlete Feedback
• Athlete blood pressures are often high due to the testing environment, recent eating, travel, dietary changes and recent (or pending) competition.
• Remind athletes that this is just one snapshot of blood pressure for them and cannot (and should not) be used to diagnose hypertension.
• If they are concerned about their reading you may take it again after one minute of rest or encourage them to start watching their blood pressure with more independent measurement.
• If blood pressure is >160 mmHg/>100 mm Hg ask follow up questions regarding their usual blood pressure and if they are taking any prescribed medication. It may be appropriate to suggest they visit their doctor with the recorded pressure.
Blood Pressure
• If O2 sats are <95% remind the athlete to sit tall and take a deep breath. If O2 sats increase with this correction you should remind them of the influence their posture might have on getting good oxygen into their body.
• If O2 sats are below 90% you should advise them that this value is not considered appropriate for exercise.
O2 Saturation
• Heart rates are highly variable in this setting 60-100 beats/minute is considered normal. You may see some lower resting heart rates due to the athletic population being tested.
Heart Rates
StrengthGrip StrengthFive Times Sit to Stand Test
Materials: ✓ Stopwatch ✓ Standard chair
without arms (approximately 43 cm high)
Grip Strength
• Record athlete’s dominant hand.• Keep dynamometer set at position 2 for all athletes.• Athlete position: arm by the side, elbow bent to 90*.• Allow once practical trial and then record the right and left hand in kg.• Keep one hand under the dynamometer to prevent athletes from dropping it. • Show the athlete where they fall on the normative chart using the higher of the
two hands for comparison. • The example dynamometer reading to the right would be recorded as 32 kg.
Athlete Instructions
•“I’m going to test your grip strength. Hold your arm by your side with your elbow bent. You’re going to squeeze this as hard as you can. I’m going to have you try it once and then we will record your next trial.”
Grip Strength – Athlete Feedback
• If the athlete’s grip is below the mean for their age and gender they should consider more resistance training in their week.
• Encourage them to meet with a trainer or a PT for this.
• Weak grip strength is an indicator of OVERALL strength and should not be interpreted as a reason to work on hand strengthening but, rather, overall strength and resistance training.
Grip Strength GRIP STRENGTH (kg)
Age Norms, dominant hand (mean in kg)Men WomenAthlete Comm. Athlete Comm.
50-54 53 44 36 2855-59 52 39 34 2560-64 49 41 32 2465-69 46 37 31 2270-74 44 35 29 2275-79 41 33 28 2080-85 39 28 25 2086+ 33 NA 22 NA
Five Times Sit to Stand Test
• Explain and demonstrate the test.
• athlete position: sitting, arms crossed over chest, feet flat on ground
• Secure their chair by standing behind it and blocking it with your foot.
• Record the time from the word “go” until the athlete sits after the 5th
stand.
• Record exactly what is on the stopwatch.
• The video test (upcoming slide) would be scored at 6.37 seconds.
Athlete Instructions
• “Stand and sit five times as quickly as you can. I will start timing on the word “go” and I’ll stop when you return to sitting after the fifth stand. Please stand up completely each time. You may sit on the edge of your chair but you do have to come to a full stand and sit back down each time.”
Five Times Sit to Stand – Athlete Feedback
• If the athlete’s time is higher than 9 seconds they should consider adding more strength training to their weekly routine. They should also know that their score puts them at a higher risk of falling as compared to other senior athletes. They should consider a fall prevention program as well.
• Encourage them to meet with a trainer or a PT for this.
• The balance and strength handouts have good advice for these athletes.
Five Times Sit to Stand Test
CHAIR STAND .
Age Athlete Goal 60+ Less than 9 seconds Community Goal Less than 12 seconds
Strength- Video
• Grip Video
• Five Times Sit to Stand
AnthropometricsWaist CircumferenceWaist to Hip Ratio
Materials: ✓ Retractable Tape
Measure✓ Calculator
Waist Circumference
• Have the athlete stand with their feet together and abdominals relaxed.• Place the tape around the most narrow aspect of the athlete’s waist. If there is no obvious waist
use the umbilicus for reference.• Move to the side of the athlete with the tape at eye-level to record the waist measurement in
cm, flip the tape to see this in inches.
Hip Circumference
• Inform the athlete that you are going to measure the widest aspect of their hips.• Maintain a position to the side of the athlete at eye level to the tape measure and hips•Measure around the widest aspect of the hips.•Use the measurement in cm to calculate the ratio below.
Waist to Hip Ratio
• Waist/Hip=waist to hip ratio
Athlete Instructions
• Waist "Please stand with your feet together and your stomach relaxed. I’ll be measuring the most narrow part of your waist.” or “Please point to your belly button and I’ll measure you waist from that reference point.”
• Hips "Now I’m going to measure the widest part of your hips. Just continue to stand with your feet together.”
Waist Circumference & Waist to Hip Ratio – Athlete Feedback
• Waist circumference greater than 40” in men or 35” in women is associated with an increased risk of cardiovascular and metabolic disease
Waist Circumference
• Waist to hip ratio is a measure that takes body size into consideration when determining how narrow the waist should be. It has been shown to be a valid indicator of cardiovascular and metabolic disease risk. Ratios equal to or higher than 0.85 in women are indicative of risk while ratios equal to or greater than .90 are indicative or risk in men.
Waist to Hip Ratio
.
Anthropometrics - Videos
• Height and Weight• Waist Circumference and Wait to Hip Ratio
FlexibilityShoulder Flexion
Ankle Dorsiflexion (AROM with knee straight)
Thomas Test
Materials: ✓ Treatment plinth✓ Large and small
goniometers
Posture
• If the athlete is unable to comfortably lie down (neck neutral) without a pillow, place an AirEx pad under their head and record the need for this under “posture” as “yes”. If AirEx is not needed enter “no”. If the athlete appears to need a pillow but refuses a pillow you can still record “yes”.
Shoulder Flexion
• Athletes knees should remain bend with feet flat on the mat.• Instruct the athlete to actively flex their arm overhead as far as they can.• Measure the amount of flexion with the fulcrum over the lateral aspect of the greater tubercle,
the proximal arm parallel to the midaxillary line of the thorax and the distal arm along the lateral midline of the humerus.
• Record both sides.
Athlete Instructions
• SHOES OFF PLEASE, they will stay off until the end of the screen.• Posture: Please lie on the mat with your knees bent and your feet flat. If the athlete is extending
their neck to lie flat suggest, “would you like a pillow?”• Shoulder Flexion: “Raise your arm up overhead as far as you can go.”
Calf Flexibility
• Have the athlete straighten their knees and dorsiflex the right ankle as far as they are able• Center the fulcrum over the lateral aspect of the lateral malleolus. Align proximal arm with
lateral midline of the fibula, using the head of the fibular for reference. Align distal arm parallel to the lateral aspect of the fifth metatarsal.
• Record the number of degrees they can dorsiflex past a 90* (neutral) position. • If they are unable to dorsiflex to the neutral position record the number of degrees they are
lacking with a negative number.• Repeat on the left.
Thomas Test
• Assist the athlete in attaining a position on the end of the plinth with their knees flexed toward their chest.
• Assure that the athlete’s flexed knees allows the lumbar lordosis to just flatten.• Assist the athlete in lowering their right leg to the table.- If the athlete’s thigh rests flat on the table record this test as 0. • If the athlete’s thigh does not rest on the table, measure the degrees of flexion.• Place the goniometer fulcrum at the greater trochanter of the hip with the distal arm along the lateral
midline of the femur and the proximal arm along the lateral midline of the trunk/pelvis.• Assist the athlete in bringing the right knee back up to their chest and bring the left leg down to
measure. Then assist the athlete back to a seated position.
Athlete Instructions
• Calf Flexibility: “Pull your toes up toward your nose as far as you can.” Give a tactile cue.• Thomas Test: “Sit on the end of the table in front of the blue line. Now bring your knees to your
chest.”
Flexibility– Athlete Feedback
• If your shoulders are tight you can try the posture stretch on our bone health handout. Maintaining a more upright posture can assist in keeping your shoulders more flexible. When stretching your shoulder be sure you posture is upright as well.
Shoulder Flexion
• If your calves are tight it actually increases your risk for falling. Try the calf stretch on our flexibility handout.
Calf Flexibility
• Having tightness in your hip can lead to back pain or knee and ankle issues. Try the quad stretch on our flexibility handout.
Thomas Test
• If you require a pillow to lie flat it suggests you are getting tight in your upper back and neck. This is worsened by maintaining a slouched position. Check out the bone health handout for posture tips.
Posture
.
Flexibility - Video
• Shoulder• Calf • Thomas Test
BalanceSingle Leg StanceSingle Leg Stance (eyes closed)Single Leg Stance (on foam)
Materials: ✓ Gait Belt✓ Stopwatch x 3✓ AirEx Pad
Single Leg Stance
• Arms crossed over the chest, one leg raised without contacting the opposite leg.• Allow the athlete to choose the leg they will stand on. Changing their chosen leg is fine. • Stop timing at 30 seconds OR if…
….the athlete shifts their foot, squeezes their legs together or places their foot down to balance.• Record the time exactly as displayed on the stopwatch.• The athletes score is the best of 3 trials (automatically computed in database).• Once the athlete achieves 30 seconds they move to the next condition for balance.
Single Leg Stance Eyes Closed
• Timing will not start until they shut their eyes in this position. They should achieve a balanced position with eyes open first.
Single Leg Stance on Foam
• Allow the athlete to step up on the foam, guard carefully as the foam is often a trip hazard.• Proceed as with single leg stance eyes open.
Athlete Instructions
• “I’m going to have you wear this belt for the next part of the screen as we will be challenging your balance.”• “For the next three trials you’ll be balancing on one foot. You need to keep your arms crossed over your
chest. You may choose which leg you want to balance on and if you want to switch which leg you are using you may. I’ll stop the time if you touch your foot down, shift your foot position, squeeze your legs together or use your arms to balance. I’ll stop you at 30 seconds if you go that long. Your score will be the best of 3 trials.”
Balance– Athlete Feedback
•Research shows that older adults in the community who cannot stand on one leg longer than 30 seconds are at an increased risk of falling. This does not seem to be a rigorous enough task for senior athletes who, we suspect, challenge their balance more in a given day.
Single Leg Stance Eyes Open
•Balance with your eyes closed takes away one key tool in balance…your vision! Imagine that this is how well you’ll balance in the dark or if you’re not looking forward when you lose your balance.
Single Leg Stance Eyes Closed
•Standing on foam impacts the way your feet and legs interpret balance and imbalances. Being better here will improve you ability to balance on grass and uneven ground.
Single Leg Stance on Foam
•Our research on senior athletes so far suggests that athletes who do not meet the 5 and 15 second thresholds for balance with eyes closed and on foam are significantly more likely to experience a fall.
Missing thresholds on Eyes Closed AND Foam
.
Gait SpeedUsual Gait SpeedFast Gait SpeedGait Speed Reserve
Materials: ✓ Stopwatch x 3✓ 20 m walkway
Usual Gait Speed • Time the central 10 meters of the walkway• Follow behind the athlete and slightly to the side • Record the time exactly as it appears on your stopwatch, the database will calculated speed.
Fast Gait Speed• Use the return walk for fast feet and again time the central 10 meters of the walkway.• Use your second stopwatch to record the time for fast gait.
Athlete Instructions
• Usual Gait: “For this first walk I’m going to have you walk at your usual pace, like you’re walking to the mailbox or in a mall. Don’t worry, you’ll get to show me your fast pace after this. “
• Fast Gait: “Now, you’ll walk back to where we started as fast as you can without running.”
Gait Speed – Athlete Feedback
•Walking speed has been considered a vital sign in older adults with links to mortality and chronic diseases. Senior athletes seem to walk a bit faster than the general population.
Usual Walking Speed
•Fast walking speed
Fast Walking Speed
•This is the difference between your fast and usual speeds.•A larger reserve is associated with fewer disease states.
Gait Speed Reserve
.
Becca D. Jordre, PT, DPT
• Board Certified Geriatric Specialist
• Certified Exercise Expert for Aging Adults
• Associate Professor
• University of South Dakota
• 605-677-9282(cell)/605-658-6370(office)
Contact Becca Jordre, [email protected] prior to conducting SAFE screening for detailed norms and instructions.
Senior Athlete Fitness Exam (SAFE) Goal CARDIOVASCULAR Blood Pressure
mmHg <140/<90 mm Hg
Oxygen Saturation %
≥95
Heart Rate beats/min
60-100 bpm
Waist Circumference
“ ♀ ≤ 35” ♂ ≤ 40”
Waist to Hip Ratio
♀ ≤ .85 ♂ ≤ .9
STRENGTH (dominant hand) Grip Strength Kg
See chart
Chair Stand (seconds) sec
<9 seconds
FLEXIBILITY Shoulder (degrees) R L
>168 degrees
Ankle (degrees)
R L 10-20 degrees <5 indicates fall risk
Hip (degrees)
R L
0 degrees
Posture (needs pillow to achieve neutral supine)
Yes No No
BALANCE All trials measures in seconds up to 30 seconds. Single leg eyes open Score is the BEST of 3 trials
30 seconds indicates increased fall risk in community dwelling older adults
Single leg eyes closed Score is the BEST of 3 trials
>5 sec indicates increased fall risk in senior athletes
Single leg on foam eyes open Score is the BEST of 3 trials
>15 sec indicates increased fall risk in senior athletes
Usual Gait Speed Meters/second
1.2m/s
Fast Gait Speed Meters/second
>1.7 m/s
Gait Speed Reserve Meters/second
>.33 m/s
This resource is intended for senior athletes who exercise regularly and may not be appropriate for all older adults. Talk to your physician or physical therapist if you’re interested in starting an exercise program.
Balance Training for Athletes Over 50
Good balance requires the ability to pull together information from your eyes, inner ear, muscles, and joints to keep you upright and in the game. This intricate interaction is what enables you to “catch” yourself when you are suddenly thrown off balance. Paying attention to your balance can up your level of competition by making you steadier on your feet. Senior athletes tend to demand increased levels of balance control on a daily basis as they engage in more challenging activities on and off the field. Improving or maintaining your balance is one of the best things you can do to prevent a fall. How does balance change with aging? As we age, our balance changes. Nerve impulses traveling to and from our brain slow down and our sensory organs (eyes and ears) give us less accurate position information. Stiffness in our muscles and joints decreases the feedback and response times needed for rapid balance adjustments. While we cannot halt normal aging, specific training can assist in overcoming some of these challenges and decrease our risk of falling. What can I do? Improving balance requires strength, flexibility and balance activities. You can establish an individualized balance program with a physical therapist. You can also seek out an evidence-based fall prevention program in your area. Go to https://www.ncoa.org/ and click on Falls Prevention at the bottom of the page to see what is available near you. Regular and consistent balance training can significantly reduce your fall risk. The following exercises are just a few examples of what you can do on your own to start making a difference. As you practice, be safe. Make sure the environment around you is free of clutter or hazards. Stand in the corner of a room where you can touch two walls or at a kitchen counter where you can easily steady yourself. Choose exercises that fit your abilities. Know your limits and if you feel unstable, stop. You want to feel confident when practicing balance. It is fine to start these exercises while holding on. Try holding onto the wall, a railing, or a counter until you can hold your balance without support. Start with 2-hand support, then 1-hand support, then none. As you work your way through the following exercises, you will see that they comprise 4 stages of balance, moving from a wide stance to a narrow stance, to standing on one leg This is designed to increase the level of difficulty. Don’t progress to the next level until you’re steady for at least 10 seconds.
This resource is intended for senior athletes who exercise regularly and may not be appropriate for all older adults. Talk to your physician or physical therapist if you’re interested in starting an exercise program.
Bone Health and Fracture Prevention for Athletes Over 50
Adults who exercise regularly are more likely to have healthy bones. The right exercises and good habits can reduce age-related bone loss and risk of fracture. Both muscle strengthening and weight-bearing exercise have proven to be effective at maintaining a healthy skeleton. How does bone health change with aging? Bone loss is a common concern with aging. Hormone changes during menopause promote less bone growth in women but men can also be at risk. Vitamin D is a key nutrient in keeping bones healthy, though levels can often decrease with age. People deficient in Vitamin D are at a greater risk of fractures and falls. The trend toward decreased activity levels with advancing age has also been shown to contribute to poor bone health. What can I do?
• Lift Weights: Strength training stimulates bone while it improves muscle strength. Resistance exercises should be done 1-2 times per week for a total of 60 minutes each week.
• Make an Impact: Weight bearing activities such as step aerobics, stair climbing, hiking and jumping have all been shown to improve bone density. Variety is best!
• Straighten Up: Exercises that strengthen the back and core have been found to help prevent spine fractures. Upright posture helps protect the spine from compression.
• Stay Balanced: Exercises that improve muscle strength, core stability, balance and coordination all help prevent falls and ultimately fractures.
• Get Screened: The National Osteoporosis Foundation recommends screening for (1) women 65 & older, (2) men 70 & older, (3) those over 50 who have broken a bone without significant trauma or, (4) those who have lost height of more than 1 ½ inches. Talk to your healthcare provider about the risks of low Vitamin D and visit https://www.nof.org/ to learn more.
POSTURE STRETCH: To open your chest and promote more upright posture, lie on your back with your knees bent. Rest your arms out to the side in a ‘T’ position. If this is easy, try resting your arms up in a ‘Y’ position. Use pillows to support your arms as needed. Hold 1 minute. Repeat x 4.
This resource is intended for senior athletes who exercise regularly and may not be appropriate for all older adults. Talk to your physician or physical therapist if you’re interested in starting an exercise program.
Cardiovascular Training for Athletes Over 50
Cardiovascular fitness refers to the ability of the heart and lungs to deliver oxygenated blood to the muscles of the body so that they can perform exercise. Maintaining high levels of cardiovascular fitness increases life expectancy and reduces a person’s risk for many chronic diseases and conditions including heart disease, high blood pressure, Type II diabetes, osteoporosis, obesity, and many forms of cancer. Staying fit will keep you competitive and ‘in the game’ longer.
How does cardiovascular fitness change with aging?
With age our heart’s ability to pump blood gradually decreases because it cannot beat as forcefully or rapidly. Our lung function is challenged as our rib cage stiffens, posture changes, and our respiratory muscles weaken. Blood flow to the heart and muscles decreases as we age due to narrowing and stiffening of the arteries and can further decrease cardiovascular fitness. Performing regular cardiovascular exercise maintains or slows the rate of decline in the function of these critical body systems in order to support competitive sport.
What can I do to improve my cardiovascular fitness?
Improving your cardiovascular fitness comes down to four basic factors summarized by the acronym “F.I.T.T.”.
Frequency• A good goal for cardio frequency is 3 to 5 days per week. Make it a regular part of your
day.Intensity• Make sure you’re exercising at a level that will make a difference! Check your target
heart rate with the formula below or use the ‘talk test’. If you can easily carry on a conversation while exercising you’re probably not working hard enough.
Time • Current guidelines are at least 30 minutes of moderate intensity exercise 5 days per
week or 20 minutes of vigorous activity 3 days per week. Adding time beyond an hour is fine but likely won’t make a big difference in your overall fitness. If cardio is new to you start with short sessions and build up slowly.
Type• Variety is good for you! Try mixing up your cardio choices. Walk, run, swim, cycle – it all
works. If you’re choosing a new cardio exercise look for one that involves large muscle groups and allows for continuous movement.
This resource is intended for senior athletes who exercise regularly and may not be appropriate for all older adults. Talk to your physician or physical therapist if you’re interested in starting an exercise program.
Flexibility Training for Athletes Over 50
Flexibility comes from tissue in our joints, tendons, ligaments and muscles. This tissue can allow impressive amounts of tension, compression and torsion without tearing or injury. Good tissue flexibility can help to prevent injuries. Beyond that, it can allow senior athletes to be better able to ‘wind up’ for a pitch, stoop down for a ball, stride past the competition or outreach the other team. Better ankle flexibility is even associated with a lower risk of falling.
How does flexibility change with aging?
As we age, the tissues that allow flexibility become less hydrated and less pliable. Joints, tendons, ligaments and muscles become more stiff. Senior athletes have been shown to maintain better flexibility than the average older adult, though losses still occur with age.
What can I do to be more flexible?
Flexibility is a great example of ‘use it or lose it’. The more you use a motion or move in a certain way, the easier that movement will become. Your body’s ability to adapt to new movements, reach higher, and stretch further is still there. It just takes a bit more attention and time than it used to. A warm-up with dynamic stretching is a useful means of improving flexibility and decreasing the risk of injury before competition and may enhance your performance. Static stretching after a workout or warm up can help you to gain even more mobility and may make your next workout or competition even better.
WARM UP – Dynamic Stretching
LUNGE WALKING
• Take a walk with exaggerated lunge steps and big arm movements. Walk for at least a minute or 20-30 steps.
• Start small and as you begin to warm up, make your movement bigger.
• Repeat this with high knees. • Be creative! Create a dynamic warm up that mimics the
movements you’ll make during your specific sport.
This resource is intended for senior athletes who exercise regularly and may not be appropriate for all older adults. Talk to your physician or physical therapist if you’re interested in starting an exercise program.
Strength Training for Athletes Over 50
Strength is the ability to move or hold against resistance (your body weight, hand weights or resistance bands). Power is a component of strength and is the ability to use strength at higher speeds. Both are needed in sport competition as they allow athletes to jump higher, hit farther, and move faster.
How does strength change with aging?
Though strength commonly declines with age, the ability to gain strength with the right training is never lost. Applying sound strength training principles to your training routine will help you toward better performance and help protect your body from injury.
What can I do?
One of the most important aspects of strength training is to make it progressive. That means when the weight you are lifting gets easy enough to lift more than 12 times, you should increase it. If you lift the same weight, month after month you will not get stronger. However, if you cannot lift your chosen weight at least 8 times, or if it causes pain, decrease it or switch exercises. Strength training should not cause pain. Keep your exercises challenging. It is OK to experience temporary muscle soreness after a workout but ongoing pain is a sign of overdoing it. Working key muscle groups for just one to two sets twice a week is enough to make gains. This will give you time for other exercises and lessen the stress on your joints. CHAIR SQUATS
Stand and sit without using your hands. Once you can do more than 12 repetitions try this from a lower surface or practice faster reps.
→ Keep your knees and toes pointed straight ahead or slightly outward. Don’t let them go inward or into a “knock knee” position.
→ Don’t stoop, keep your posture tall! → If you have pain with this exercise, try it from a
higher surface.
Place an elastic loop around your thighs, above your knees. Keeping your core engaged and your feet pointed forward side step one way until you are tired, then switch directions. You should feel this in the side of your upper thigh.
If this is too easy or when you can step 15 times in one direction, increase to a band with more resistance.
Keeping you in the game!
For more resistance, add an elastic band under your feet, or weights in your hands. Squat until you almost reach your chair, then return to standing with tension on the band. Stay tall!
CHAIR SQUATS WITH RESISTANCE MONSTER WALKS
To receive an exercise program specifically for you, find a local physical therapist. www.moveforwardpt.com
How much should I lift? Lower intensity → Start with lighter weight that makes you tired at reps. Higher intensity → Work up to heavier weight that causes fatigue at reps.
SHOULDER ROTATION
Sit or stand tall. Hold a band between your hands. Keeping your elbows at your side, pull your hands away from each other and return to the start position.
Say No to Pain! Strength training
exercises should not be painful. If an exercise
causes pain, try something different!
Ready for a dose of power? Try these exercises with a little speed. Perform 3-4 repetitions quickly, then another 3-4 times at regular speed, alternating and continuing more sets, as you are able. Be careful – don’t let speed destroy your form!
Static Stretching
Static stretching will improve your flexibility, but it’s best after exercise or following a good warm up when your tissues have plenty of blood flow and are less likely to be injured. The American College of Sports Medicine (ACSM) recommends at least 10 minutes of stretching, twice weekly for older adults. Consider some of the following exercises as a way to improve your flexibility. Remember stretching should not hurt. You should feel tension, not pain.
STANDING CALF STRETCH
Stand at a wall and place one foot behind you. With your knee straight and your toes pointed at the wall feel the stretch in the back of your calf.
Hold 30-60 seconds at least twice on each side.
To receive an exercise program specifically for you, find a local physical therapist. www.moveforwardpt.com
Keeping you in the game!
STANDING QUAD STRETCH
Stand behind a chair for balance. Place one foot behind you on a sturdy chair or other surface. Stand tall and feel the stretch in the front of your thigh. For a greater stretch
• Bend your opposite knee • Tighten your buttocks
Hold 30-60 seconds at least twice on each side.
FIND YOUR TARGET HEART RATE Age predicted max heart rate: 208 – (0.7 x Age) Example for 60 yo: (208 – (0.7 x 60) = 166 beats/min) Target Heart Rate (HR): Resting HR + ((Max HR–Resting HR) x % intensity) Example for 60 yo: 70 + ((166-70) x.60) = 127.6 beats/min) 70 + ((166-70) x. 80) = 146.8 beats/min A 60 year old person with a resting heart rate of 70 would train at a HR between 128-147 bpm to be at 60-80% intensity.
To receive an exercise program specifically for you, find a local physical therapist. www.moveforwardpt.com
Keeping you in the game!
Warm Up and Cool Down Regardless of how you structure your exercise, it is important to include a 10-15 minute warm-up and cool-down in every workout. Let your heart have time to pump more blood out to your exercising muscles by easing in slowly. Don’t push yourself until you’ve started to break a sweat. When your workout is over, cool down until your heart rate is well out of your target zone.
Boost your performance with interval training High intensity interval training (HIIT) is a fun way to mix up your training sessions. Rather than holding the same pace for your cardio exercise try varying your intensity with intervals. After your warm up, ramp up to a sprint or very intense pace for 30-60 seconds. Then go easy for the same amount of time. Repeat this for approximately 15 minutes and you’ll enjoy similar, or even superior, cardiovascular benefits to a longer workout. As a bonus, you’ll train your body to move faster for sport competition.
On Heart Medication? Some heart medications are designed to keep your heart at a steady rhythm, so your heart rate won’t change as much with exercise. In this
case, try the talk test. When you’re at your target heart rate you should be ‘out of
breath’ but still able to speak.
Keeping you in the game!
BACK STRENGTH TRAINING (I,T,Y)
WEIGHT LIFTING: Lifting weights will help to build muscle AND bone. Lifting a weight over your head can help to strengthen the bones in your arms AND your spine. Be sure to keep your posture upright.
Slowly work up to weights that make you tired after 10-15 repetitions. Once your can do 15, increase the weight.
Do not perform this exercise if you already have bone loss (osteoporosis or osteopenia).
To receive an exercise program specifically for you, find a local physical therapist. www.moveforwardpt.com
For more ideas, visit Stepping Out Strong; https://americanbonehealth.org
Keeping you in the game!
Lie on your stomach with a towel roll under your forehead for support. Place a pillow under your stomach if this position places strain on your low back. For each of the above positions (I,T,Y) raise your arms off the ground while squeezing your shoulder blades together. Hold for 5 seconds and repeat until you’re tired. If you can do more than 15, add small hand weights.
Palms Ups Thumbs Up Palms Down
I T
YIf you have
osteoporosis or osteopenia there
are more guidelines for
strength training safely. Do not
start an exercise program without
first consulting your healthcare
provider and a physical
therapist.
To receive an exercise program specifically for you, find a local physical therapist.
www.moveforwardpt.com
www.cdc.gov/steadi
Need a challenge? Once you are comfortable performing the above exercises, try each one with your eyes closed.
Keeping you in the game!
Always practice balance in a safe environment. Stand at a counter or in a corner so you have an easy way to stabilize yourself. If you don’t feel safe, stop. It may be better for you to practice
with a professional.
Static Balance Exercises
Dynamic Balance Ideas: 1. Try the static balance activities while performing a movement related to your sport
such as head turns, arm swings, or leg kicks. 2. Try heel-toe tightrope walking forward and backwards. 3. Finally, try these exercises while standing on a pillow or another unstable surface
such as grass or sand.
Dynamic Balance Exercises
An athlete practicing head turns in tandem
stance.
Dynamic balance, or balance maintained while moving, is another key component to balance training. Do not start working on dynamic balance until you are no longer challenged by the static balance exercises shown on the left.
www.cdc.gov/steadi
