Ready for Rehab

80% of US population will experience one or more episodes of low back pain during their lifetime. By 2050, 40 percent of the population will be older than 50. This growing age group will have a substantial impact on healthcare in the coming decades. As older adults have a greater susceptibility to chronic low back pain, the physical and psychological impact of this pain on society will be considerable. Improper body mechanics (such as improperly lifting heavy items) can put increased pressure on your spine. This may lead to the degeneration of discs, back pain, and other spinal problems. These statistics put into perspective the importance of protecting the spine and reducing the incidences of low back pain in older adults. Many back injuries could be prevented by using appropriate body mechanics during daily activities.

As an example, when lifting objects, you should set your trunk muscles to immobilize your spine, and then the arms and legs can do the lifting. It is important to keep a straight back with the pelvis as this will keep your center of gravity over your base of support. When lifting an object, keep your feet apart for a wide base of support. This broadens your base of support making it easier to maintain your balance while lifting. You should also lift with your knees. This lowers your center of gravity and helps you to use your quadriceps (leg muscles), which are much stronger than your back muscles, to do the lifting. While lifting an object, you should avoid holding your breath. Finally, once the object is lifted, hold the load close to your body. By doing this, the load will be lighter than holding it away from the body because of the effects of gravity and the increased lever length of the arms.

By seeking professional advice to analyze your unique situation, the rehabilitation team can offer assistance and guidance to help protect your spine and prevent back injury and pain. In addition, your rehabilitation team can offer assistance in creating a plan for protecting your lumbar spine. For example:

• Your rehab team can suggest product selection, placement and training to help you maintain good body mechanics;
• Your rehab team can recommend home modifications which identify the fit between the person and the environment;
• Your rehab team can look at what tasks the individual needs and wants to perform each day to ensure comfort, safety and enjoyment in their living environment;
• Your rehab team will be able to evaluate your body posture, mechanics, and strength.

The Rehabilitation Team assists each person in staying safe in their living environment. The Rehabilitation Team is there to support them through both their challenges and successes. For additional information, please contact your Select Rehabilitation Physical, Occupational and Speech Therapists.

Measures taken to reduce the spread of COVID-19 have changed our everyday schedules and disrupted exercise routines for many individuals. Although it might be tempting to skip your exercise during these challenging times, exercise is essential to your physical health and mental well-being during the COVID-19 pandemic. Regular physical activity can help give our days structure and be a way to stay connected with family and friends. Growing evidence shows that physical exercise does not have to be strenuous or even require a major time commitment. It is most effective when done regularly, and in combination with a healthy diet and mental wellness activity.

There are significant health benefits that can be gained with a moderate amount of daily physical activity. As metabolism naturally slows with age, maintaining a healthy weight is a challenge. Exercise helps increase metabolism and builds muscle mass, helping to burn more calories. Regular physical activity may reduce high blood pressure, help manage weight and reduce the risk of heart disease, stroke, type 2 diabetes, and various cancers – all conditions that can increase susceptibility to COVID-19. It also improves bone and muscle strength and increases balance, flexibility and fitness. Strength training may also alleviate the symptoms of chronic conditions such as arthritis.

There are also cognitive benefits of exercise for older adults. Physical Activity benefits regular brain functions and can help keep the brain active, which can prevent memory loss, cognitive decline, and dementia. Also, exercise improves your sleep. Poor sleep is not an inevitable consequence of aging. Quality sleep is important for your overall health. Physical activity often improves sleep by helping you fall asleep more quickly and sleep more deeply. Furthermore, exercise boosts mood and self-confidence. Endorphins produced by physical activity can actually help you feel better and reduce feelings of sadness or depression. Being active and feeling strong naturally helps you feel more self-confident.

How Can Therapy Help?

The Rehabilitation Team assists each person to progress towards their individualized fitness goals and is there to support them through both their challenges and successes. Your rehab team is specially trained to help adults with a broad range of conditions that affect their ability to participate in physical activity and exercise. Your therapists can identify lifestyle changes that can facilitate improved physical fitness levels. Therapy can offer assistance and guidance by creating a plan of care that includes:

• Resistive weight bearing exercises
• Correcting body mechanics & posture while exercising
• Balance & stability interventions
• Treatment of mechanical pain & dysfunction that limit exercise participation
• Home modifications & functional safety assessments
• Energy conservation with physical activity.

Consult your rehab team today if you are interested in increasing your Physical Activity during the COVID-19 pandemic. For additional information, please contact your Select Rehabilitation Physical, Occupational and Speech therapists.

Research has shown that proper nutrition can extend your lifespan and improve a person’s quality of life. An optimal diet may lead to less heart disease, obesity, high blood pressure, diabetes, and some forms of cancer. Good eating habits throughout life can help to promote physical and mental well-being. For older adults, eating right can help to minimize the symptoms of age-related changes that may cause discomfort. Although the aging process affects some people differently than others, everyone can benefit from eating a well-planned nutritious diet.

Are Nutritional Needs Different for Older Adults?

• Physiological changes occur slowly over time in all body systems and are influenced by life events, illnesses, genetic traits and socioeconomic factors.
• Generally, older adults take in less calories, than younger people. This may be due, in part, to a natural decline in the rate of metabolism as people age. It may also reflect a decrease in physical activity. If calorie intake is too low, then intakes of necessary nutrients may also be low.
• As people age, problems such as high blood pressure or diabetes become more common, necessitating certain dietary modifications.
• As people age, digestive system problems become more common, and some people may have trouble chewing or swallowing.
• For everyone, it is beneficial to eat well and understand some nutrition basics.

What is Malnutrition and how do I avoid it?

• Malnutrition is a critical health issue among older adults caused by eating too little food, too few nutrients, and by digestive problems related to aging.
• Malnutrition causes fatigue, depression, weak immune system, anemia, weakness, digestive, lung, and heart problems.
• To prevent malnutrition as you age: Eat nutrient-packed food, have flavorful food available, snack between meals, eat with other people as much as possible, get help with food preparation.

What are Current Dietary Recommendations for Older Adults?

Fruit: Choose color-rich choices like berries or melons. Aim for 2-3 servings a day.

Veggies: Choose antioxidant-rich dark, leafy greens, such as kale, spinach, and broccoli as well as colorful vegetables such as carrots and squash. Try for 2-3 cups every day.

Calcium: Maintaining bone health as you age depends on adequate calcium intake to prevent osteoporosis and bone fractures. Older adults need 1,200 mg of calcium a day through servings of milk, yogurt, or cheese. Non-dairy sources include broccoli, almonds, and kale.

Grains: Be smart with your carbs and choose whole grains over processed white flour for more nutrients and more fiber. Healthy fats: Because fat is so dense in calories, a little can go a long way in making you feel full and keeping you feeling fuller for longer.

Healthy fats include:

1. Monounsaturated fats are found in foods such as olive oil, avocados, nuts (like almonds, hazelnuts, and pecans), and seeds (such as pumpkin, sesame).
2. Polyunsaturated fats include Omega-3 fatty acids, found in fatty fish such as salmon, herring, mackerel, anchovies, and sardines. Other sources include flaxseed and walnuts.
3. Avoid Trans fats which are found in commercially baked goods, packaged snack foods, fried food, and anything with
   “partially hydrogenated” oil in the ingredients.

Protein: Adults over 50 without kidney disease or diabetes need about 1 to 1.5 grams per kilogram (2.2lbs) of body weight (0.5 g of protein per lb. of body weight is close enough).

Water: Drinking water regularly may help us to avoid urinary tract infections, constipation, etc.

Vitamin B: After the age of 50, your stomach produces less gastric acid making it difficult to absorb vitamin B-12—needed to help keep blood and nerves healthy. Get the recommended daily intake (2.4 mcg) of B12 from fortified foods or a vitamin supplement.

Vitamin D: With age, our skin is less efficient at synthesizing vitamin D, so consult your doctor about supplementing your diet with fortified foods or a multivitamin, especially if you’re obese or have limited sun exposure.

Cut down on sugar and refined carbs: Unlike complex carbs that are rich in fiber, refined or simple carbs (such as white rice, white flour, refined sugar) can lead to a dramatic spike in blood sugar, followed by a rapid crash which leaves you feeling hungry and prone to overeating.

Eat more fiber: Women over 50 should aim to eat at least 21 grams of fiber per day, men over 50 at least 30 grams a day. Good sources of fiber include whole grains, wheat cereals, barley, oatmeal, beans, nuts, vegetables such as carrots, celery, and tomatoes, and fruit.

Mental Health & Mental Illness Defined 

Mental Health: “A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.” 

Mental Illness: “Health conditions that are characterized by alterations in thinking, mood or behavior (or some combination thereof) associated with distress and/or dysfunction.” 

Most Common Mental Health Issues 

• Depression 
• Anxiety 
• Stress 

How Poor Mental Health Affects Your Body 

• Changes in your brain chemistry can also have a big effect on your body. 
• Mental health issues contribute to a wide array of physical  problems that affect everything from your heart to your immune system 
• Changes in the brain have an effect on many of the body’s system; i.e. low levels of neurotransmitters such as serotonin can alter your pain threshold 
• Mental health issues increase your risk of illness because of increasing levels of stress hormones such as cortisol and adrenaline 
• Mental health issues can affect the immune system making it harder for the body to fight infection. 

How Exercise Improves Mental Health

• Help reduce anxiety symptoms and improve mood
• Help keep anxiety from coming back once you’re feeling better
• Release feel-good brain chemicals (neurotransmitters, endorphins)
• Reduces immune system chemicals that can worsen depression
• Increase body temperature which may have calming effects
• Help you gain confidence
• Take your mind off of worries
• Get more social interaction
• Cope with anxiety/depression symptoms in a healthy way

How Much Exercise/What Types Are Best for Mental Health

• 30 minutes or more of exercise a day for 3-5 days a week—Even just 10-15 minutes at a time
• Do what type of exercise you like best: walking, NuStep, gardening, exercise bicycle, aerobics, yoga, etc.—Anything that gets you off the couch and moving is the exercise that can help improve your mood

Getting Started and Staying Motivated

• Identify what you like doing: find out what type of exercise you like doing and you will be more likely to do it
• Set reasonable goals: think realistically and set small goals in the beginning
• Don’t think of exercise as a chore: view your exercise time as your time to yourself
• Address your barriers: find out things that get in your way of exercising and find alternatives and ways around these barriers
• Prepare for setbacks and obstacles: give yourself credit for every step in the right direction. If you miss exercise one day, don’t be hard on yourself. Tomorrow is a new day

How Therapy Can Help

• Therapists can help you find the right exercise for you to manage physical and mental signs and symptoms
• Define an adequate and specialized program to fulfill your needs
• Help you perform exercise safely and correctly
• Help you improve your independence and quality of life

When people hear “wellness”, physical activity and exercise is what usually comes to mind first. Wellness is much more than that. Wellness has four main components- exercise, nutrition, spiritual practice, and rest and relaxation. Wellness is about making lifestyle choices that can minimize the risks for chronic disease and maximize the quality of life. Keeping wellness in your daily routine can get tough. Sometimes there are not enough hours in the day to get what you want done. Wellness should be a top priority for everyone. There are some simple tips to keep wellness in your daily routine and to keep you motivated in doing so.

When introducing wellness into your daily routine you want to start with little bits. You don’t want to start with too much and get overwhelmed. The little bits add up, and that’s what’s most important and most sustainable. You want to actually identify your wellness goals and priorities. It’s hard to work towards something that is undefined, so you want to set a goal. The key is to make your goals become real, rather than theoretical. When making your goals keep “starting with little bits” in mind. Track what you are doing and acknowledge your results. The act of tracking your wellness goals and efforts, and seeing the work pay off, does improve your chances of being successful. With a tracking system you will be able to see what the results are, and affirm the benefit of your efforts. Schedule it- scheduling your wellness time for the week helps reserve the time so you can turn your intention into action. If you know that a block of time is set aside for wellness, you won’t be as inclined to fill it will something else. Having a support system is important to have. Surrounding yourself with people and environments that are health-promoting is important for making wellness an accessible part of your life. You need to be able to understand your inspiration. In order to prioritize wellness you must see the value in it. Have your reasons for wanting to achieve your wellness goals visible to you. This will remind you of why you value wellness, what you want out of it, and what you are willing to do for it.

It is important to keep all four components of wellness in your daily routine. With these helpful motivation tips it should be easier for you to do so. Remember your goals should be something that is achievable. Exercise should not be a huge obstacle for someone, try to find something that you enjoy doing. Nutrition does not mean that you need to be on a diet. The most important thing about nutrition is moderation, so do not try to cut something out completely. You want to slowly work in healthier options as you shift your diet into one that is more nutritious and life giving. Spiritual practice is something that can be different for everyone. You do not have to be a spiritual person to take part in this. Spiritual practice can be anything from prayer, meditation, journaling, singing, drawing, etc. These activities can lead one to have more peace of mind and a greater ability to handle life’s challenges. One’s spiritual practice can be very relaxing which brings us to our last component, rest and relaxation. Sleep deprivation has been linked to many problems, for example, stress and depression. Everyone needs their rest to have a better quality of life.

Our biology changes as we get older, causing seniors to have different reasons for staying in shape than younger generations. Though physical fitness provides benefits at any age, the health perks physically fit seniors enjoy are more notable. Physicians and researchers say seniors should remain as active as possible, without overexerting one’s self. In older adults, exercise helps you live a longer, healthier, and more joyous life.

More exercise means more independence for seniors:

Seniors that exercise regularly are less likely to depend on others. According to Harvard Medical School, regular exercise promotes an older adults ability to walk, bathe, cook, eat, dress, and use the restroom. If self-reliance is a priority, exercise is one of the best ways to maintain independence for older adults.

Exercise improves balance for older adults:

Falling down is a much bigger deal for older adults than younger ones. Every 11 seconds, an older adult is admitted to an emergency room for a fall-related injury, and every 19 minutes, a senior dies from a fall, according to the National Council of Aging. Though no two falls are alike, and preventing falls is very complex, regular exercise reduces the likelihood of falling by 23%.

Regular exercise means more energy:

Though it seems counter-intuitive, being inactive makes you tired and being active gives you more energy. Any amount of exercise promotes the release of endorphins, which are essential neurotransmitters linked to pain mitigation and a sense of well-being. Endorphins combat stress hormones, promote healthy sleep, and make you feel more lively and energetic, overall.

Exercise helps prevent and counteract disease:

Heart disease, osteoporosis, depression and diabetes are common diseases among older adults, and are often deadly. Fortunately, adopting a more active lifestyle can contribute to the prevention of these diseases, or reduce the unpleasant symptoms of these diseases if you already have them. If you are at-risk for disease, exercise may be the key to warding off an unpleasant condition.

Regular exercise improves brain function:

One of the most remarkable developments in health science is the revelation that the mind and the body are much more closely linked. A healthy body likely means a healthy mind, and seniors that exercise on a regular basis have improved cognitive health, according to research from NCBI. More recently, a study from the Alzheimer’s Research & Prevention Foundation, regular exercise has been shown to reduce your risk of developing Alzheimer’s disease or dementia by nearly 50%.

Exercise is crucial for older adults, but it can be hard to know where to begin. If you haven’t worked out for a while, re-entry into the active world can be daunting. There’s also a good chance the exercises you were once accustomed to aren’t ideal for older adults.

Before you launch into an exercise regimen, it’s important to check with a physician to ensure you’re healthy enough for exercise, and to see which exercises are ideal for your current fitness level.

If you need any help, contact the therapy department to help get you started. 

Flexibility: refers to the range of movement in a joint or series of joints. 

• Length in muscles that cross the joints to induce a bending movement or motion. 

How can you Improve Flexibility? 

• To improve flexibility, it is important to stretch
• Stretching- is a form of physical exercise in which a specific muscle or tendon is deliberately flexed or stretched to improve flexibility and range of motion. 

What are the Benefits of Stretching? 

• Improve range of motion 
• Improve performance in physical activities 
• Decrease risk of injury 
• Enable your muscles to work most efficiently 
• Decrease pain and soreness after exercises 
• Improve posture 
• Improve circulation of blood flow throughout the muscles 
• Prevents tightness of muscles 

Types of Stretching 

Dynamic Stretching 

• Low intensity form of stretching that utilizes movement to stretch your muscles 
• Increases circulation and nutrient flow throughout the body Ex: arm swings, shoulder circles, lunges, leg swings, etc. 

Static Stretching 

• Stretching muscles while the body is at rest 
• It is composed of various techniques that gradually lengthen a muscle to an elongated position (to the point of discomfort) and hold that position for at least 30 seconds 

Stretching Essentials 

• Target major muscle groups 
  Calves, thighs, hips, back, neck, shoulders, arms, etc. 
• Warm up first 
• Hold stretch for at least 30 seconds 
• Don’t bounce 
• Focus on pain-free stretches 
• Relax and breathe freely 

Fit Stretching into your Schedule 

• • Do stretches after your morning shower or bath 
• • Stretch before getting out of bed 
• • Stretch after exercise 

Keep up with Stretching 

• It can be time consuming! 
• You can achieve the most benefits by stretching regularly at least 2-3 times a week 
• If stretching helped you increase your range of motion, it may decrease again if you stop stretching 

Approach with Caution 

• If you have a chronic condition or injury, you may need to adjust your techniques 
• Talk to your doctor or physical therapist about the most appropriate way to stretch if you have any health concerns.

If you have a medical problem or you are an older adult, you may be at risk of falling or tripping. This can result in broken bones or even more serious injuries.

Exercising can help prevent falls because it can:

• Make your muscles stronger and more flexible
• Improve your balance
• Increase how long you can be active

You can do the following exercises anytime and almost anywhere. As you get stronger, try to hold each position longer or add light weights to your ankles. This will increase how effective the exercise is.

Try to exercise 150 minutes a week. Perform muscle strengthening exercises 2 or more days a week. Start off slowly and check with your health care provider to make sure you are doing the right type of exercises for you. You may want to exercise on your own or join a group.

When you exercise, always make sure you breathe slowly and easily. DO NOT hold your breath.

Toe Stand

To make your calves and ankle muscles stronger:

• Hold on to a solid support for balance, like the back of a chair
• Stand with your back straight and slightly bend both knees
• Push up onto your tiptoes as high as possible
• Slowly lower your heels to the floor
• Repeat 10 to 15 times

Knee Curl

To make your buttocks and lower back muscles stronger:

• Hold on to a solid support for balance, like the back of a chair
• Stand with your back straight, feet shoulder width apart, and slightly bend both knees
• Lift one leg straight back behind you, then bend your knee and bring your heel toward your buttock
• Slowly lower your leg back to a standing position
• Repeat 10 to 15 times with each leg

Leg Extension

To make your thigh muscles stronger and help decrease knee pain:

• Sit in a straight-back chair with your feet on the floor
• Straighten one leg out in front of you as much as possible
• Slowly lower your leg back down
• Repeat 10 to 15 times with each leg

Stretching the Back of Your Leg

To make it easier for you to move around:

• Sit in a straight-back chair
• Put one foot on a low stool in front of you
• Straighten your leg that is on the stool and reach your hand toward this foot
• Hold for 10 to 20 seconds. Then sit back up
• Repeat 5 times with each leg

Other Activities

• Walking is a great way to improve your strength, balance, and endurance
• Use a walking stick or walker as needed for support
• Tai Chi is a good exercise for healthy adults to help develop balance
• Simple movements and exercises in a swimming pool can help improve balance and build strength

Improvements in Mental Health

Seniors who spend time outdoors may experience less depression and anxiety. Individuals who run, bike or walk in natural settings have a reduced risk of mental health problems compared to people who do their exercise inside.

Participating in nature walks with others is linked to more positive feelings and better mental health, along with lower levels of depression and stress. Seniors who are unable to exercise can benefit from getting outdoors by enjoying the change of scenery, smelling freshly cut grass and seeing beautiful, natural vistas.

Experts advise that seniors should try to spend time in natural areas like parks on a regular basis. The relaxation that nature provides can improve mood and increase overall feelings of happiness.

Abundant Energy

Being outside in nature makes you feel more alive and provides a greater sense of energy and vitality, which can help make you more resilient to illness.

Spending time outdoors may boost your memory. One study found a 20-percent improvement in attention span and memory after spending just one hour in a natural environment. More time spent outdoors resulted in even greater gains in memory, and it may improve creativity as well.

Better Overall Health

Being outside can help increase levels of Vitamin D, which often is low among seniors. Low levels of this important nutrient are 

linked to pain in muscles and bones, inflammation, higher risk of Type 1 diabetes and several types of cancer.

Getting sufficient Vitamin D can help reduce your risk of a number of physical ailments, including rheumatoid arthritis, multiple sclerosis and heart attack. By spending just 15 minutes outside in the sunshine each day, you help your body receive the recommended dose of Vitamin D.

Being outside may also improve your overall immunity by boosting your count of white blood cells, and the improvements may last for a week or more. In addition, time in nature may help you recover more quickly from an injury or illness.

Many Ways to Get Outside

If you enjoy aerobic exercise like walking, heading outdoors for your workout can provide additional benefits. 

Gardening is another great way to interact with nature and get some exercise at the same time. Consider creating a natural area with native species that can become routes for butterfly and bird migration. You might consider joining a group for nature-oriented activities like birdwatching.

No matter the activity, research tells us that simply being outside and enjoying nature can provide a variety of benefits for your energy, creativity, and mental and physical well-being.

“Improving posture can be done with time and focus.”

For most adults, posture is typically an afterthought at both work and home. But as we age, retaining good posture actually becomes even more important to our physical health and wellness. 

What Causes Poor Posture for Seniors? 

Avoiding a wholly sedentary lifestyle is the key to good posture for people of all ages. However, it is unfortunately common for seniors, especially those with pre-existing health complications like arthritis, to take up inactive lifestyles. This can also lead to poor posture. 

Seniors who are recovering from a recent injury or surgical procedure may also encounter similar difficulties staying fit and sitting right. Families and caregivers must encourage their aging loved ones to correct poor posture. Performing a minimum amount of daily exercise to improve balance and muscle strength will help this. 

Good Posture Prevents Falls for Seniors 

Did you know that seniors who are mindful about their postures are more likely avoid injuries and even falls? According to the National Institute for Fitness and Sport, “when you have good posture, your body will work the way it is supposed to, keeping your muscles balanced.” 

When you sit or stand with proper posture, you are doing your body a favor by not overexerting yourself. Overexertion can cause unnecessary strain on weaker muscles. Additionally, being mindful of your posture is great for balance. 

Steps for Improving Posture 

1. Don’t give up; Improving posture can be done with time and focus. 
2. Discuss your current weight with a doctor or caregiver. The conversation should reveal expectations of an acceptable weight for your age, sex, and body type, as well as a plan for how to stay there. 
3. Take up a regular schedule of exercise, if you haven’t already. There is evidence that group nature walks can provide mental benefits for seniors, beyond just delivering a dose of physical activity. 
4. Evaluate the lumbar support of the chairs and other seating options in your home. If necessary, consider purchasing a new chair that encourages better posture. 

It is important to correct poor posture as soon as possible to avoid further health complications, like neck and back pain. Keeping our bodies in motion is essential to avoid the consequences of living an unhealthy, sedentary lifestyle.