Expectations for Older Adults

One of the comments I hear often when working with older adults is something like "That young therapist thinks I can do 4 sets of 20 exercises, but I'm XX years old!"

I guess I hear these types of comments more because I am older too, but just today when one of my patients said this to me, I really got thinking about it again. And this is my blog topic tonight.

Yes, being older I can definitely relate to how our body changes with age. Every old injury from my past somehow rises up occasionally to remind me. Muscle aches and pains seem to take a couple of days to go away, unlike when I was 25 and a good night's sleep cured almost everything. And as much as I like to think I'm still as strong as I was at 25, that last jar of pickles was a bit tougher to open.

Now I'm not a health nut or anything. I don't belong to a gym but I do try to stay active. I eat healthy, except for my occasional chocolate cravings. I have been blessed with never requiring a major surgery or having anything worse than the flu, but I did have a severe back sprain some 20 years ago. I find that muscles that have had previous injury do tend to ache more. This unwelcome phenomenon seems to increase in intensity and frequency as I pass each birthday. Knowing how my back can flare up sometimes is what I thought about after the comment of my patient today.

Some of these older patients we work with have had multiple injuries throughout their life. Many have had a joint replacement or other major surgery. Most of them are currently getting over a major surgery, illness or accident. This is often why they are on current caseload.

So my thoughts rambled on to the type of exercises and other activities we are requesting patients to perform as part of their rehabilitation. Do we ask them to do too much at times? Probably. Do we think they feel the same way we do when it comes to muscle fatigue? I really doubt it.

I have always thought of building muscles as a slow process. Start slow with little resistance then increase repetitions and weight as we gain. Even athletes don't go to the gym today, and tomorrow have a bigger muscle mass. Developing a strong muscle is a long term commitment to exercising, eating right, and avoiding injury.

Of course, each patient is different. Some people love to exercise and stay active. Some have never done exercises in their entire life. However many will probably fall somewhere between these two lifestyles. Learning to correctly assess the person is what will tell us how much, and how many.

The other side of my thought here is this; when a patient is requested to do too much, and they get sore muscles from it, are we actually promoting activity and exercise? We all know that if something hurts us, we simply   avoid it. If you slam your finger in the car door, we do our best to never let it happen again. This is a human trait that we can't deny or change.

So, as you start with each new patient try to find out their previous lifestyle. Assess their current body mass and strength, past history of injuries, current diagnoses, and any other information available to come to a sound determination of what their level of exercises and activity should be. Don't stick to one set number of repetitions for every patient; try to set the number with their best interest in mind. Back off if they complain or indicate soreness. If we make exercise something that promotes health instead aches and pains, we all benefit.

Until next time, hope all your thoughts are good,

Tim