Better Balance Now!

Ivy Rehab
Fall Prevention
Meryle Richman, PT, DPT, MS, CST, RYT

As we age the ability to maintain balance becomes more difficult. Many factors influence good balance, some of them are biological; and some we are able to influence and are able to improve. Balance and stability are important factors for aging adults to maintain a healthy lifestyle. Loss of balance is the primary factor in falls, which often results in serious injuries.

Good balance is dependent on sensory input form the eyes, the correct functioning of the balance system in the inner ear, posture and center of gravity and our ability to sense the position and movement in our feet, legs and arms. Vision affects the balance system, as the eyes send messages to the brain telling us where objects are in space.

Aging adults are affected by a loss of muscle mass and strength. This is associated with an increased risk of falls and hip fractures. It also has a great affect on maintaining a healthy lifestyle. Weakness in the ankle musculature may cause difficulty in recovering lost balance more quickly. Strong quadriceps muscles are necessary for good balance and walking. Evidence shows the strength and aerobic training can lead to a reduction in falls.

Loss of flexibility occurs with age. This may lead to difficulty climbing stairs, transferring from sit to stand and or getting out of bed without difficulty. Much of the loss of flexibility is due to inactivity. Flexibility exercises, stretches, gentle yoga will help improve flexibility of major muscle groups and therefore improve ones ability to complete everyday activities.

Postural changes develop as people age but not because they age. Rounded shoulders, forward head postures, increased thoracic curves in the spine are common postural changes. These changes affect the center of gravity in the body moving it forward. With changes in the center of gravity, older adults are more prone to loss of balance and an increased risk of falls.

Medications also contribute to the deterioration of the balance system. Research has shown that adding new medications in the previous two weeks increases the risk for falling.

There are many ways we can adapt to the changes in our bodies as we age. Some helpful tips include:

1. Promote safety in the home by using non-skid surfaces, eliminating area rugs & improve lighting in the home

2. Get a yearly eye exam

3. Proper nutrition and hydration

4. Know the side effects of your medication

5. Use caution with pets running around in your home

5. Different forms of exercise, such as strengthening exercises, flexibility and stretches, postural exercise, yoga, tai chi, and aerobic exercise such as walking, will all contribute to decreasing the risk of falls and improve your balance.

Guidelines from The American College of Sports Medicine suggest that:

1) Healthy adults under the age of 65 should aim for:

– Moderate intense cardiovascular exercises 30 minutes a day (aerobic exercise), five days a week or vigorous intense exercises 20 minutes a day, 3 days a week and strengthening-exercises twice a week

– Flexibility or stretching exercises are also recommended a minimum of 2-3 days a week

2) Healthy adults 65 years or older:

– Low-to-Moderate aerobic exercises, 30 minutes a day, 5 times a week and gentle strengthening-exercises (very light weights), 2- 3 times a week

– Flexibility or stretching exercises at a minimum of 2-3 times a week

Types of Aerobic and Low-to-Moderate Exercises:
Screen Shot 2016-08-22 at 10.31.08 AM

If you want to determine your fitness level, refer to the reference guide from The Centers for Disease Control and Prevention.

For beginners, you can simply start out by learning the basics of the talk test, which is a rule of thumb for doing moderate-intensity activity and you can still talk, but not sing during an activity. However, if you are doing a vigorous-activity you would want to learn how to find your target heart rate and determine what intensity range you should be exercising at for optimal cardiac performance.

Check out the Stay Healthy Website to determine a simple way to find your target heart rate at: www.cancer.org/healthy/toolsandcalculators/calculators/app/target-heart-rate-calculator. Once you find your target heart rate, wearing a heart rate monitor will make it easier to monitor your desired rate.

If you would like to improve your current level of fitness, but still have questions about how to begin a safe exercise program if you had an injury or illness, our experienced and dedicated licensed physical therapists can help you get started. With Direct Access a prescription is not required to be evaluated. Contact Ivyrehab Briarcliff (914) 762 – 2222 and Ivyrehab Jefferson Valley (914) 245 – 8807 or visit our Website: www.ivyrehab.com to learn more about Direct Access.

References:
(1) Exercise: Designing a Cardiac exercise Program. New York-Presbyterian Hospital. Retrieved September 2, 2011 from http://nyp.org/health/cardiac_exercis3.html
(2) American College of Sports Medicine Position Stand. Retrieved September 2, 2011 from http://www.mhhe.com/hper/nutrition/williams/student/appendix_i.pdf

Better Balance Now

Better Balance Now!— Fall Prevention
Meryle Richman, PT, DPT, MS, CST, RYT

As we age the ability to maintain balance becomes more difficult. Many factors influence good balance, some of them are biological; and some we are able to influence and are able to improve. Balance and stability are important factors for aging adults to maintain a healthy lifestyle. Loss of balance is the primary factor in falls, which often results in serious injuries.

Good balance is dependent on sensory input form the eyes, the correct functioning of the balance system in the inner ear, posture and center of gravity and our ability to sense the position and movement in our feet, legs and arms. Vision affects the balance system, as the eyes send messages to the brain telling us where objects are in space.

Aging adults are affected by a loss of muscle mass and strength. This is associated with an increased risk of falls and hip fractures. It also has a great affect on maintaining a healthy lifestyle. Weakness in the ankle musculature may cause difficulty in recovering lost balance more quickly. Strong quadriceps muscles are necessary for good balance and walking. Evidence shows the strength and aerobic training can lead to a reduction in falls.

Loss of flexibility occurs with age. This may lead to difficulty climbing stairs, transferring from sit to stand and or getting out of bed without difficulty. Much of the loss of flexibility is due to inactivity. Flexibility exercises, stretches, gentle yoga will help improve flexibility of major muscle groups and therefore improve ones ability to complete everyday activities.

Postural changes develop as people age but not because they age. Rounded shoulders, forward head postures, increased thoracic curves in the spine are common postural changes. These changes affect the center of gravity in the body moving it forward. With changes in the center of gravity, older adults are more prone to loss of balance and an increased risk of falls.

Medications also contribute to the deterioration of the balance system. Research has shown that adding new medications in the previous two weeks increases the risk for falling.

There are many ways we can adapt to the changes in our bodies as we age. Some helpful tips include:

Promote safety in the home by using non-skid surfaces, eliminating area rugs & improve lighting in the home

  1. Get a yearly eye exam
  2. Proper nutrition and hydration
  3. Know the side effects of your medication
  4. Use caution with pets running around in your home
  5. Different forms of exercise, such as strengthening exercises, flexibility and stretches, postural exercise, yoga, tai chi, and aerobic exercise such as walking, will all contribute to decreasing the risk of falls and improve your balance.

Guidelines from The American College of Sports Medicine suggest that:

1) Healthy adults under the age of 65 should aim for:

 – Moderate intense cardiovascular exercises 30 minutes a day (aerobic exercise), five days a week or vigorous intense exercises 20 minutes a day, 3 days a week and strengthening-exercises twice a week

– Flexibility or stretching exercises are also recommended a minimum of 2-3 days a week

 2) Healthy adults 65 years or older:

 – Low-to-Moderate aerobic exercises, 30 minutes a day, 5 times a week and gentle strengthening-exercises (very light weights), 2- 3 times a week

– Flexibility or stretching exercises at a minimum of 2-3 times a week

Types of Aerobic and Low-to-Moderate Exercises:

Moderate Intense Aerobic Exercises Low-to-Moderate Aerobic Exercises
  • brisk walking
  • running
  • swimming
  • cycling; spinning classes
  • water exercises
  • gardening
  • housework
  • dancing, yoga, tai chi

If you want to determine your fitness level, refer to the reference guide from The Centers for Disease Control and Prevention: http://www.cdc.gov/physicalactivity/everyone/measuring/index.html.

For beginners, you can simply start out by learning the basics of the talk test, which is a rule of thumb for doing moderate-intensity activity and you can still talk, but not sing during an activity. However, if you are doing a vigorous-activity you would want to learn how to find your target heart rate and determine what intensity range you should be exercising at for optimal cardiac performance.

Check out the Stay Healthy Website to determine a simple way to find your target heart rate at: www.cancer.org/healthy/toolsandcalculators/calculators/app/target-heart-rate-calculator. Once you find your target heart rate, wearing a heart rate monitor will make it easier to monitor your desired rate.

If you would like to improve your current level of fitness, but still have questions about how to begin a safe exercise program if you had an injury or illness, our experienced and dedicated licensed physical therapists can help you get started. With Direct Access a prescription is not required to be evaluated. Contact Ivyrehab Briarcliff (914) 762 – 2222 and Ivyrehab Jefferson Valley (914) 245 – 8807 or visit our Website: www.ivyrehab.com to learn more about Direct Access.

References:

(1) Exercise: Designing a Cardiac exercise Program. New York-Presbyterian Hospital. Retrieved September 2, 2011 from http://nyp.org/health/cardiac_exercis3.html

(2) American College of Sports Medicine Position Stand. Retrieved September 2, 2011 from http://www.mhhe.com/hper/nutrition/williams/student/appendix_i.pdf

Learn how to prevent changes in balance for a fall-free future

Learn how to prevent changes in balance for a fall-free future.
Practice exercises to improve your balance!

Debbie Lenihan
PT Director
Physical Therapy at Jefferson Valley

As we age the ability to maintain balance becomes more difficult. Balance and stability are important factors for aging adults to maintain a healthy lifestyle. Loss of balance is the primary factor in falls, which often results in serious injuries.

Many factors influence good balance. Some of them are biological and some we are able to influence and improve. Good balance is dependent on sensory input from the eyes, the correct functioning of the balance system in the inner ear, posture and center of gravity, and our ability to sense the position and movement in our feet, legs and arms. Vision affects the balance system, as the eyes send messages to the brain, telling us where objects are in space.

Aging adults are affected by a loss of muscle mass and strength, and have an increased risk of falls and hip fractures. Weakness in the ankle musculature may cause difficulty in recovering lost balance more quickly. Strong quadriceps muscles are necessary for good balance and walking. Evidence shows that strength and aerobic training can lead to a reduction in falls.

Loss of flexibility occurs with age. This may lead to difficulty climbing stairs, transferring from sit to stand and/or getting out of bed without difficulty. Much of the loss of flexibility is due to inactivity.

Postural changes can develop as people age which includes rounded shoulders, forward head postures and an increased thoracic curve in the spine. These changes affect the center of gravity in the body, moving it forward. With changes in the center of gravity, older adults are more prone to loss of balance and an increased risk of falls.

There are many ways we can adapt to the changes in our bodies as we age. Different forms of exercise, such as strengthening exercises, flexibility and stretching exercises, yoga, tai chi, and aerobic exercise, such as walking, will all contribute to decreasing the risk of falls and improving balance.

Screen Shot 2015-02-24 at 10.27.53 AM

Join Physical Therapy at Club Fit Jefferson Valley for a free lecture: “Use it or Lose it” on March 31!

If you would like to attend this free presentation contact Physical Therapy at Jefferson Valley at (914) 245 – 8807 to reserve a seat. Space is limited to 10 participants.

Stabilization & Balance: From Athletes to the Elderly

Master Trainer & NASM Corrective Exercise Specialist Jen Schildwatcher

Master Trainer & NASM Corrective Exercise Specialist Jen Schildwatcher

By Jennifer Schildwachter
Personal Trainer and Fitness Coach Leader

When you hear the terms “corrective exercises”, “prevention of injury”, and “functional strength”, what type of person comes to mind? Although the common answer to this question would be possibly a post-rehab senior with serious injuries, these terms also apply to athletes on their off season maybe dealing with a pre or post season injury or muscle imbalances to correct. When you think “athlete” you often think speed & agility drills or Olympic weight lifting, but the need for core stabilization and balance are needed for all!

Balance is the key to all functional movement and it should also stress a person’s limits of stability, or their “balance threshold”. By training in a multi-sensory environment, the nervous system’s ability to activate the right muscles, at the right time, and in the right plane of motion is vital to the elderly and athletes alike to enhance performance in every day life or an athletic event. All levels of fitness need to infuse this much needed balance and core stabilization exercises to benefit all planes of motion. Both of these needs can be fulfilled in NASM Certified Personal Trainer, Corrective Exercise Specialist, and Performance Enhancement Specialist Jennifer Schildwachter’s paid program; Correct, Select, and Never Neglect. Participants of all adult ages and fitness levels, learn that there is an inherent difference between functional strength and functional stabilization, which both come into play when trying to improve balance.

Core Stabilization and balance go hand in hand. The main goal of an athlete or senior would be to continually increase their limit of stability by creating progressive balance exercises in a controlled but unstable environment.

A good example of an exercise that you could give an athlete or senior, would be: “Single-Leg Dumbbell Shoulder Scaption”

How to do it:
A. Stand with a light dumbbell in each hand; lift one leg directly beside balanced leg.
B. Keep thumbs pointed up while raising arms to shoulder height at a 45-degree angle in front. Slowly lower. Repeat; alternate legs in each set.

This exercise and more can be learned in this class as well as the improvement in balance and stabilization in all physical abilities!

Interested in taking Correct Select and Never Neglect with Jen? You can sign up for the upcoming session beginning on February 17! Feel free to email Jen with any questions at jschildwachter@clubfit.com!

Kickboxing: Don’t Be Afraid!

After crawling out from under a hectic schedule, I was looking for something to change up my cardio routine.  It’s been a while since I’ve tried a kickboxing class, and by that I mean somewhere in the ball park of a decade.  I vaguely remember it being a great workout, but also that it was really, really hard.  (I guess there was a reason I didn’t go back.)  It also brings up 90’s-era visuals of Billy Blanks in a shiny electric blue singlet, which may be either fun or scary, depending on your level of exposure to the “Tae-Bo” fad.

Anyway, I took notice of it on the group exercise schedule when I started here at Club Fit, but since it was labeled as an intermediate class, I stayed far away.  Even now, though I’ve been working out consistently for months, each new activity definitely makes me feel like a beginner again, and I wasn’t sure about jumping right into an intermediate class.  But this week, I considered kickboxing again, because I felt that my cardio endurance had improved (thanks to Spinning), and that my core stability had started to improve as well (thanks to Pilates), and that I had a pretty good chance of getting in a good workout without injury or a traumatically embarrassing fall.

There were definitely a lot of missed steps and a little bit of flailing around, but also a lot of sweating, a lot of using new muscles, and a lot of fun!  The music was definitely inspiring, the moves were fairly easy to follow, and there was a good amount of air-punching involved, so it’s definitely a great way to end a stressful day.  I probably shouldn’t have been so timid to try this earlier, but I won’t worry about it. Now that I’ve started to get the hang of it, I’ll definitely be back.

 

A Balancing Act

Thanks to Nancy in fitness for capturing this glamour shot!

I was inspired by a post on Club Fit Briarcliff’s Facebook page to try the new Balance Class that I’ve seen popping up on the Group Exercise schedule.  I’m always looking for new ways to strengthen and stabilize my core, and I know balance training is a great way to do it – I just wasn’t sure how.  So I signed up for a class and gave it a go.

We started with some really simply balance exercises; balancing on one leg for 30-second intervals, then switching, and the like.  I was surprised at how hard it was just to stand on one leg!  I thought, how is this something I haven’t done recently??  I got nervous for a moment about moving on to the balance equipment I saw spread out in front of us, but I just tucked my abs in more, paid closer attention to our instructor, and worked as hard as I could at staying balanced.  (A tip: find a stable focal point to look at to help keep your balance. Not your own wobbly reflection in the mirror!)

As we moved onto a floor-stabilized balance bar and eventually the very unstable Vew-Do Nub Board, I was really surprised to find that the exercises got much easier very quickly, despite the increasing difficulty.  I learned that once you find your balance, it gets easier to hold it, and easier to find it again.  I certainly wobbled (we all did), but I wobbled less and less as the class progressed.  Balance class also taught me that you don’t need a hard core sweat session to get a “good” workout. I definitely felt an energizing difference in my core strength as I left the gym that night.  It was also really fun!

Have you tried a balance class yet?  What did you think?

Understanding Nutrition

THE GLYCEMIC RESPONSE:

 

 It is important for the body to maintain optimal blood glucose levels. As I have indicated, this is 80- 120 ml/dl of blood. If blood glucose level falls low you may become lethargic, irritable, extremely hungry and unable to think clearly. If glucose level rises to high, you may become very sleepy. Either instance is dangerous, and can cause severe consequences.

The body normally regulates your blood sugar levels by releasing two hormones secreted by the pancreas.  Insulin is secreted when blood sugar concentrations get to high, and Glucagon is secreted when blood sugar levels get too low. (Remember). Diabetes and Hypoglycemia are two conditions where glucose regulation is hindered.

Although our body regulates these responses, it is important for us to eat properly to maintain optimal blood sugar levels, and all body responses. Every cell in our body depends on glucose for fuel, especially the brain and nervous system, which I will discuss later.

So what can you do to maintain optimum levels? First, eat smaller meals more frequently throughout the day. You should be eating approximately every 2½ hours. Second, when you do eat, make sure the meal or snack consists of carbohydrate, fat, and protein. Fats slow down the digestion and absorption of carbohydrates.  Protein triggers the release of many important substances including glucagon, which hinders the effect of insulin. By adhering to these practices, you prevent fluctuations of blood sugar level and help prevent surges of glucose in the blood .You will also feel much better both physically and mentally.

There are times when an athlete may want a surge of blood sugar to get nutrients into the cells quickly. The prime opportunity for this is directly after exercise when the “window of opportunity’ is the best. More glucose and nutrients will replenish deleted

stores used during exercise. The longer you wait after exercise the less amount is restored. How does this translate into something useful? Well, the more glycogen and amino acids that are replenished quickly, the better your recovery and preparation for the next bout of exercise. You will notice increased strength and more energy.

The glycemic effect of food is in relation to our blood sugar and insulin response. It is the effect of how fast and how high blood sugar concentrations rise, and how quickly our body lowers the levels back to normal.

Some carbohydrate foods are rated very high on the Glycemic index. This is another reason why carbohydrate foods often targeted for propaganda and fad diet claims. On the contrary to many fad diets that advocate you should not consume carbohydrates or carbohydrates eliciting a high glycemic index rating, most of these provide an excellent source of nutrients, and are healthy for you.

It is believed that these carbohydrates provoke hunger, food cravings, and cause too much of a release of insulin which claim to promote fat storage. By following special eating patterns, and consuming lower carbohydrates they claim you will lose weight, and fool the body into producing the right amounts of insulin.

Generally, it is wise to choose foods with a low glycemic rating if they are going to be consumed alone, to achieve sustained energy. However, as I have stated earlier, the overall glycemic response of a food is influenced by other foods eaten at the meal.  Keep in mind, people take a little bit of validity, and manipulate others into believing.

 

THE GLYCEMIC INDEX:

 

The glycemic index is a physiological based method used to classify foods according to their response to raising blood glucose.

 

 

  • The index compares how rapidly carbohydrates are converted to blood sugar compared to glucose, which is 100 %.

 

  • The lower the rating, the less of a glycemic response.

 

 

  • The glycemic response of a food is not dependent upon the sugar content or the content of simple versus complex carbohydrate. Carrots eaten alone will increase insulin more than a candy bar with nuts.

 At present, the American Diabetes Association (ADA) has not endorsed the glycemic index for patients with diabetes. The ADA recommends that people with diabetes moderate their carbohydrate intake to keep their blood sugar low, eat less fat, more fiber, and fewer calories to lose weight, rather than attempt to follow a glycemic correct diet. Weight loss alone can bring blood sugar down to healthy levels in type II diabetes.

                                  Glycemic Index Of Common Foods

 

100 %                         80-99%                       70-79%                       60-69%

Glucose                       Maltose                    Bread                         Brown Rice

                                    Parsnips                       Millet                          Bananas

                                    Carrots                        Potato                         Raisins

                                    Potato Chips               White Rice                  Mars Bars

                                    Corn Flakes                                                     White bread

                                    Honey

 

50-59%                       40-49%                       30-39%                       20-29%

Sucrose                     Oranges                       Apples                       Fructose

White spaghetti           Peas                             Ice Cream                 Kidney Beans

All Bran                      Navy Beans                 Most Meats                 Lentils

Yams                           Oats                           Most cheese               

Corn                                                                Yogurt

 

10-19%

Soy Beans

Peanuts

Adapted from Source: Jenkins, D.J.A., Lente carbohydrate: A newer approach to the dietary management of diabetes. Diabetes Care, 5:634, 1982: as adapted by ISSA Performance Nutrition: The complete guide, 1997.