Chiropractor Chandler AZ

Exercise Program for Independent Living

Being independent means staying fit and alert, so that you can comfortably perform your activities of daily living or ADLs. The American College of Sports Medicine recommends that all adults engage in 150 minutes per week of moderate aerobic activity, 2-3 days of strength training and at least 2-3 days of flexibility. For older adults, balance exercise is also very important. All four components are included in this program.

Aerobic Exercise

Aerobic exercise is any activity that raises your heart rate above normal. A normal heart rate for most individuals is about 60-70 beats-per-minute. To calculate your estimated maximum heart rate, subtract your age from 220. Aerobic exercise should get your heart rate somewhere in between your normal resting heart rate and that number. For an older adult, that is usually in the range of 110-120 beats-per-minute.

How do you know if you are in your aerobic zone? A brisk walk, cycling with some effort on a stationary bicycle or a game of pickleball are all good options for aerobic exercise. You can also use the “talk test.” You should be able to carry on a conversation, but it will be easier to speak in short phrases because you are breathing harder. The other simple measure is “ratings of perceived effort.” On a scale of 1-10, you should feel that you are at 6 or 60% of what your maximum effort could be.

To fit in 150 minutes per week, you will need to engage in aerobic exercise for 30 minutes per day, five days per week. That might seem formidable if you haven’t exercised regularly for a while. The good news is that breaking that number down into smaller, multiple bouts per day will give you the same benefit. For example, you might consider going for a ten-minute walk after breakfast, and then again after lunch and dinner.

It can be tough to stay motivated when you are trying to do this alone, so consider finding an exercise buddy for at least some of your weekly walks. Is there somebody in your neighborhood who you see out walking on a regular basis, or do you have a friend who has mentioned that he or she would like to get back into shape? How about a friend from church or a book club?

Many community organizations such as YMCAs have exercise programs for seniors, and some include walking groups. In addition the SilverSneakers (™) programs include a variety of activities that combine aerobic exercise with strength training. Some Medicare gap plans include SilverSneakers (™) as part of the benefits package.

Choose a walking route that is well within your current physical capabilities. If you know of a route where there is a bench somewhere along the way so you can rest if you need to, that’s ideal. The other option is to walk multiple loops closer to home, so that you can cut the walk short if need be. Remember that multiple short bouts will produce the same benefits as a single longer session.

Walking does not require a lot of specialized equipment, but you will need a pair of properly fitted and supportive shoes. We recommend visiting a local specialty walking or running store to find the best options. The people who work in these stores know how to perform gait analysis, so they can suggest the proper amount of support according to your biomechanics.

Both walking and running shoes are designed for the same type of forward movement. Some individuals do well in a neutral cushioned shoe, particularly those with high rigid arches. Many persons need a moderate amount of support, provided by a stability shoe. Those who need a lot of support will choose a motion control shoe.

One of the biggest mistakes many people who are new to walking or running make is to purchase shoes that are too small. You should have about a thumbnail worth of room beyond your longest toe to the end of the shoe. The shoes should be wide enough in the forefoot so that you can ‘play the piano with your toes.’ At the same time, the area around the heel and midfoot (where your arch is) needs to be snug, so that the shoes don’t slip when you are walking and give you blisters.

If possible, consider purchasing a couple of pairs of moisture-wicking socks. They will keep your feet dry in the warmer weather, and prevent blisters.

Clothing simply needs to be loose and comfortable. If you need to use a cane to move around, there is no shame in that. The same applies for walkers. Some people like to use a set of walking sticks to maintain their balance. These are available at most outdoor recreation retailers.

Balance

As we age, we lose acuity in our hearing and vision, and we also lose some of the proprioceptors in our skin. Proprioceptors in the skin sense where the body is in space and send that information to the brain, so we can stay balanced. Because our ability to balance decreases with age (and the risk for falling increases), it is particularly important to perform the following balances at least 3 times per week.

These exercises don’t require any special equipment, although you may want to do them near a counter or sturdy chair to prevent falling. And they don’t take a lot of time: ten-to-fifteen minutes should be plenty to take you through the entire progression. These exercises are a good warm-up for your walking routine, so consider doing them before you head out the door.

Begin with the basic balance progression, as follows:

Stand with your feet shoulder width apart. Think about maintaining a good upright posture. If you can, look at yourself in a full length mirror. Are your shoulders rounded forward? An easy way to tell is if you can see the backs of your hands. If you have proper posture, you should only be able to see your thumbs. Think about keeping the shoulders down, your chest open, and “pack you scapulae” or shoulder blades low and flat across your back.

Pull your head back so that it is in line with the shoulders. This may feel awkward at first, because most people maintain a slight forward neck flexion: the consequence of years of sitting at a desk working on typewriters or computers.

Maintaining your nice posture, move your feet together. This may feel a little wobbly, so use the chair or countertop if you need to in order to maintain your balance.

Now move your feet into a ‘semi-tandem’ stance. Take a step forward and maintain that position, with one foot in front of the other. Try to hold this position for 30 seconds.

The next position is a tandem stance, where the heel of the forward foot touches the forefoot of the training foot. This can be challenging, but with practice, you will find it easier and easier to perform.

Reverse your feet, and perform the semi-tandem and tandem stance using what was the trailing foot as the forward foot.

Finally, the most challenging balance exercise is the unipedal stance, in which you balance on one leg. You may only be able to maintain this stance for a couple of seconds to start. Use the chair or counter to support yourself, and work your way up to a goal of 15 seconds on each foot.

Strength

Many people think that strength training (also called resistance training) is for muscle-bound guys at the gym. But the fact is, everybody needs it. In addition to daily function, strength training is important for maintaining healthy bones. While it may not help you to lose weight, strength training will help you to gain muscle and lose body fat. The lower the percentage of fat mass in your body, the lower your chances are for developing chronic conditions such as hyperlipidemia and cardiovascular disease.

While we recommend balance training as a warm-up for aerobic exercise, strength training is best done with warm muscles, so consider doing these after one of your daily walks.

The strength training exercises we describe here require no special equipment. If you have well-padded carpeting, that will work fine for the floor exercises. If not, you can either perform them on a firm mattress, or consider purchasing an inexpensive yoga mat.

All of these exercises focus on the core, which includes your gluteal, abdominal, lower and middle back muscles. Having a strong core is fundamental to movement, because these are the muscles that support everything that you do with your arms and legs.

Bridging: Lie down on your back with your knees bent and feet on the floor about shoulder width apart. Your arms should be relaxed to your sides. Slowly lift your hips off the floor and raise them to the point at which they form a flat ‘table top’ in line with your upper legs. Be careful not to arch your back. Lower the hips back down to the floor and repeat ten times for a set.

Work your way up to two sets. Once you are comfortable with that, make the exercise more challenging by bringing your feet and knees together, and performing the bridging motion in that position.

Ball squeeze: To perform this exercise, you will need an inexpensive ball that is about 8-10 inches in diameter. The weight of the ball does not matter. Begin lying on your back with knees bent and feet on the ground (see bridging). Place the ball between your legs, just above the knees. Squeeze the ball for a count of three, relax and repeat ten times. Now, keeping the ball between your knees, lift the right foot off the floor and extend the leg straight out in front of you. Slowly lower the foot back down to the starting position, and repeat the same motion with the left foot. Extend each leg ten times for a set.

Leg circles: This is a Pilates mat exercise that is excellent for building strength in the gluteus medius and minimus muscles on the sides of your hips, that keep your pelvis stable when you walk.

Start out by lying on your side. Your legs should be relatively straight with one leg right on top of the other. Use your free arm and hand to steady yourself in this position.

With the free leg, make small circles ten times in a forward direction, followed by another ten circles in the reverse direction. Small circles are more challenging to make than big ones. Another tendency is to make triangles where the leg swings straight forward, then up and back down. Watch your leg as you do this, and think about making small controlled circles. Perform 20 circles on each leg for a set.

Door frame touch: The door frame is a wonderful piece of exercise equipment, and easy to find in any home. Begin by standing about a foot behind the center of the door frame in the semi-tandem stance you practiced in the balance section. Twist to your left and touch the left side of the door frame with the right hand. Then twist in the opposite direction and touch the right side of the door frame with the left hand. When performing this exercise, make sure that you are twisting at the waist, as opposed to simply reaching opposite sides of the door frame with your arms.

TheraBand row: To perform this exercise you will need a length of TheraBand about 36” long. You can also use a set of exercise cables (available at Target, Walmart or through Amazon). Tie the Theraband or cables to a railing or doorknob in the middle, so both ends are equal in length. Grab an end in each hand (you may want to wrap the ends around your hands to make this easier). Start by bending your elbows slightly, and keeping your arms close to your sides, make a rowing motion, straightening your arms as you pull the TheraBand back with each motion. Be careful not to hunch your shoulders. Your elbows should stay close to your waist throughout the entire movement. Row ten times to complete a set. To work a different set of muscles, turn around so that your back is to the doorknob or railing. This time, use the TheraBand to row forward, beginning with elbows bent at your sides and straightening your arms out at the end of the motion.

TheraBand Leg raises: To perform this exercise, tie a length of TheraBand in a loop. It should fit comfortably around both legs with your feet shoulder width apart. Use one hand to grab onto a railing, study chair, counter or doorknob for support. Standing on one foot, swing your other foot forward, keeping the leg straight. The more slowly you move the swing leg forward and back, the more resistance you should feel. Repeat this ten times, then swing the leg straight out to the side, and then to the back. Repeat this exercise on the opposite leg.

Step up and step down: If you have access to at least one step in your house, you can use it to perform the following exercises:

Using the handrail for support, step up onto the step with one foot. Bring the other foot up onto the step, and then step down in the reverse order. Repeat ten times.

Toe touch: Stand sideways on the step. You should hold onto the railing (in front of you) if possible. Lower the leg closest to the edge of the step and lightly touch your foot to the floor. Raise the foot back up to step height and repeat ten times. Perform the same exercise on the opposite leg.

Step and kick: Hold onto the handrail, beginning with both feet on the floor at the base of the step. Step onto the step with your lead foot. Then bring the other foot up, but without touching the step, drive that knee up in an exaggerated marching motion. Bring that foot back down to the ground and follow with the foot that is still on the step. Switch legs and repeat on each side ten times for a set. This is a challenging exercise, so make sure that you are comfortable with the step up and step down and toe touch exercises before attempting it.

Standing half lunge: Use a sturdy chair, railing or counter to steady yourself when performing this exercise. Start standing with your feet in the semi-tandem stance described in the balance progression. Bend your knees and lower yourself halfway down to the floor. Come back up to the starting position and repeat a total of ten times. Reverse foot positions and repeat ten more times for a set.

Frankenstein walk: Tie a length of TheraBand into a loop. Standing with your feet together, it should be snug but not so tight that you won’t be able to walk. Begin by swinging one leg forward and diagonally to the side, plant that foot and move forward. Repeat the same motion on the opposite leg. Try to walk back and forth across your living room 2 times using the “Frankenstein walk.”

Flexibility

Lack of flexibility is one of the primary causes of soft tissue injuries in older adults. To see how flexible you are try the seated toe touch test.

Sit in a chair so that your hips are scooted all the way onto the seat. Straighten out your left leg as far as you can and have the foot still on the floor. Keeping your hips in the same position, lean forward and slide your left hand down the leg as far as you can. Can you touch your toes with your left hand? Repeat on the other leg.

Shoulder stretch 1: Stand inside a door frame with your feet in the semi-tandem stance position. Grab each side of the frame with your hands. Your hands should be at shoulder height. Lean forward, using your body weight to stretch out your chest and shoulder muscles. Hold for 15 seconds, rest and repeat. Then switch leg positions and repeat the stretch two more times.

Shoulder stretch 2: Grab your hands behind your back. Your hands should be right at hip level, with your arms as straight as possible. You should feel a nice stretch through the chest. To get even more out of this stretch, bend forward at the waist and raise your hands up towards the ceiling, keeping the arms straight.

Shoulder stretch 3: You can perform this stretch seated or standing. Begin by straightening your left arm and pointing your arm straight out in front of you. Use the other hand to Grab the top of your left arm, and use it to pull that arm across the chest. You should feel a stretch in the back of the shoulder. Hold for 15 seconds, rest and repeat. Perform the same stretch on the other side.

Triceps stretch: Reach both arms above your head and bend your elbows. Use your right hand to grab the left arm just above the elbow, and do the same with the left hand and right arm. Now slide the right hand down the side of the left arm until it is touching your back right below the shoulder. Hold this position for 30 seconds. Be careful when you are performing this exercise not to round your shoulders or flex your neck forwards. Repeat for 30 seconds reversing hand positions.

Side-to-side stretch: Stand relaxed with your feet shoulder width apart and arms at your sides. Slide your right hand down the outside of your right leg while bending to the right at the waist. Hold 10 seconds. Come back up to center and repeat on the other side. Repeat this stretch on each side 3 times.

Calf stretch: Begin facing a wall with your feet in a semi-tandem position. Lean forward so that your hands are resting on the wall. The forward knee should be bent and the back leg straight. You should feel a stretch in the calf and lower hamstring of the straight leg (leg to the back). To increase the stretch, gradually bend the knee of the back leg. Hold 15 seconds and repeat. Reverse foot positions and repeat the stretch on the other side.

Golf club twist and stretch: If you don’t have a set of golf clubs, you can perform this stretch with a dowel rod of the same length. Rest the golf club on the back of your shoulders behind your neck, grabbing one end of the club in each hand. Slowly twist to the right and left at the waist.