We've all seen the TV ads ─ nice-looking woman in her fifties, sitting on a nice sofa in a nice living room, rubbing her hands, in obvious pain. Of course, she's not Lady Macbeth, trying to rub off the imagined blood of her murdered husband. She's a woman with arthritis.
According to the Center for Disease Control, arthritis is the leading cause of disability in the United States.1 Approximately 47 million people have doctor-diagnosed arthritis and 17 million have arthritis-attributable activity limitations.
Osteoarthritis, the most common form, is a degenerative condition affecting the joints and the soft tissues around the joints ─ the associated cartilage, ligaments, and tendons. The most commonly affected areas are the spine, the hands, and the shoulders, hips, and knees. The pain of arthritis, the reduced mobility, and the lifestyle accommodations needed for pain avoidance are discouraging and may even lead to depression.
Many anti-inflammatory drugs are available for the treatment of arthritis, and in recent years many of these have been found to cause severe side effects. Vioxx is the most notorious of these ─ cardiovascular complications caused a worldwide recall of the drug. Celebrex, another well-known arthritis medication, was also found to increase the risk of heart attack and stroke at high doses.
The very good news is there are several wellness-based treatment alternatives to long-term medication. These include exercise, diet, and in many cases, chiropractic treatment.
Exercise is critical in restoring mobility and, over time, in reducing pain.2,3 Persons with osteoarthritis often experience a vicious cycle of deteriorating symptoms. Pain causes reduced mobility (pain avoidance), which (paradoxically) actually causes more pain, which causes further reductions of mobility . . . . Activities of daily living ─ getting out of a chair, opening a jar, bending and lifting ─ become a real challenge as the person struggles to avoid further pain.
So, restoring mobility is key. Exercise ─ very gently at first ─ is the answer. Range-of-motion activities to get the joints moving again are very beneficial, including
• Arm circles
• Wrist circles
• Shoulder shrugs
• Side-to-side bending for the lower back
• Gentle knee bends
• Ankle circles
• Flexing and pointing the feet
Walking is a perfect exercise for treatment of arthritis. Begin by walking one block, then two, then around the block. Walk five minutes daily for a week, then increase by a minute or two each day. Get up to 15 minutes of gentle walking, then begin to gradually increase your pace. The increased mobility will not only reduce pain, but also provide a cardiovascular benefit and improve one's ability to perform activities of daily living.
Chiropractic treatment, in combination with an exercise program, may assist in restoring joint mobility and reducing pain. Gentle chiropractic manipulative therapy is designed to improve mobility of spinal joints. As spinal joint motion improves, pain lessens, and a positive cycle of return-to-function begins.
1"Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation." CDC Morbidity and Mortality Weekly Report 55(40);1089-1092, 2006.
2Huang MH, et al: A comparison of various therapeutic exercises on the functional status of patients with knee osteoarthritis. Semin Arthritis Rheum 32(6):398-406, 2003.
3Suomi R, Collier, D: Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Arch Phys Med Rehabil 84(11):1589-94, 2003.
Poets throughout the centuries have helped us see that being young is a state of mind. That special state of mind impels us to take actions on our own behalf, actions that have specific consequences for our health and well-being.
But so many people believe in the power of the dollar. They spend vast sums every year on anti-aging, beauty, and cosmetic products in the false hope of being able to purchase remedies that will restore their fading youth.
Others hasten the loss of their youthful glow. Cigarettes, alcohol, and negative mental constructs such as resentment, jealousy, and anger all work to rapidly break down our health and vigor. Negative emotions are especially insidious. Even if a person is healthy in other respects - eating a healthy diet and exercising regularly - stress, fear, anguish, and ill-will relentlessly add invisible workloads to the day, sapping our strength and aging us prematurely.
People who look and feel ten years younger than the age revealed on their birth certificates have learned how to create a positive mental attitude. It's amazing how much bounce you can add to your step when you intentionally set about having a great day. Of course, this is not merely smoke and mirrors. Those who are intending to be young inside and outside take the necessary steps. They don't eat doughnuts (except on their free food days). They rarely consume fast food. They do eat lots of fresh fruits and vegetables. They do exercise regularly, some even doing some form of vigorous physical activity five or six times each week.
These young-at-heart people get sufficient rest. They are willing to give up the attitudes, positions, and annoyances that do not serve their well-being. And many of them have discovered a natural healing method and philosophy that helps them to be well and stay well - chiropractic care.
Chiropractic is a smart, efficient form of health care. Chiropractic care helps remove physiologic obstacles to good health and helps your body learn how to maintain high levels of functioning. After beginning chiropractic care many people comment that they feel as if they've let go of a big weight they didn't know they'd been carrying around. People say they feel lighter and they have more energy. They sleep better. They even feel as if they're taller.
Others comment that they've become more effective at work and in their personal lives. As a result of chiropractic care their bodies are expending much less energy in wasteful and unnecessary physiologic activities. The result is more available resources to do - efficiently and well - what is necessary each day out in the world.
One wonderful outcome is the ongoing recovery of the youthful appearance and outlook we always want to maintain.
1Egger GJ, et al: The emergence of "lifestyle medicine" as a structured approach for management of chronic disease. Med J Aust 190(3):143-145, 2009
2Reinehr T, Roth CL: A new link between skeleton, obesity and insulin resistance: relationships between osteocalcin, leptin and insulin resistance in obese children before and after weight loss. Int J Obes (Lond) Epub Jan 12, 2010
3Cohen DL, et al: Cerebral blood flow effects of yoga training: preliminary evaluation of 4 cases. J Altern Complement Med 15(1):9-14, 2009
"60 is the New 40" is more than a marketing slogan. The phrase is also a metaphor for optimism, as well as a metaphor for good health.
How can 60 really be the new 40? First, there are the demographics. Forty years ago, when today's 40-year-olds were just being born, 40 was a fairly substantial age. In the early 1970s, every 40-year-old had lived through World War II. For the Americans, many of the men fought in the Korean War and some may even have fought in the Vietnam War. In the early 1970s, most women had had their first child by age 25. Today, child-rearing years for adults frequently begin in their 30s and even late into their 40s. Life expectancy in 1970 was approximately to age 71. Today, average life expectancy is to age 79 or 80. Putting everything together, it can reasonably be stated that our "senior years" keep getting pushed further and further back.
"60 is the new 40" means there is plenty of productive life ahead. The phrase implies that, if one is ready, able, and motivated, whole new aspects of living can be explored. Whereas in 1970, 40-year-olds were often beginning to be established in middle-management roles in their white-collar companies, or were becoming shop stewards and supervisors in their factories, today men and women in their 60s are becoming entrepreneurs and launching their own businesses. Backed by a lifetime of experience, people in their 60s are going back to school to get the undergraduate or graduate degree of their dreams, or they're setting up shop for themselves as artists, artisans, or consultants. Regardless of the particular individual choice, the point is that people in their 60s are manifesting the spirit and vision that was previously thought to be the special province of those much younger, specifically, men and women in their 20s and 30s. But it would be a stretch to say that "60 is the new 30", so we'll stick with "60 is the new 40".
But these new activities and endeavors require physical resources and energy.1 If one is not healthy, 60 may in fact not be the new 40. If one is not enjoying good health, then one's focus is usually primarily directed toward getting well. For 60 to really be the new 40, that is, for one to be fully engaged with family, friends, and work, for one to be focusing on the present and maintaining a positive, expectant attitude toward the future, an optimum state of health is required. Such an optimum varies from person to person. What is needed is for us to be functioning at our optimum. Such maximal functioning is based upon numerous factors, including a healthy, nutritious diet,2,3 regular vigorous exercise, and consistent, sufficient rest. Putting these lifestyle choices into place and making these elements of healthy living habitual will go far toward helping all of us make our chronological age irrelevant.
1Caprara M, et al: Active aging promotion: results from the vital aging program. Curr Gerontol Geriatr Res 2013;2013:817813. doi: 10.1155/2013/817813. Epub 2013 Feb 7
2Dickinson JM, et al: Exercise and nutrition to target protein synthesis impairments in aging skeletal muscle. Exerc Sport Sci Rev 2013 Jul 18 [Epub ahead of print]
3Levis S, Lagari VS: The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep 10(4):296-302, 2012
Many people experience increasing musculoskeletal joint stiffness as they get older. Shoulders, knees, and ankles don't seem to be as flexible as they once were. It seems more difficult to bend over and pick up a dropped object. It may be uncomfortable to turn your head around to see the car in the next lane that's right in the center of your driver's blind spot. The bad news is that, left unattended, your joints do get stiffer as you get older. Left on their own, your joints will likely lose full mobility. The good news is there's plenty you can do about it. You can regain and retain much of your youthful flexibility if you are willing to be proactive.
First, some basic physiology. Joints such as the shoulder, knee, and ankle are lubricated by synovial fluid. Synovial fluid keeps joints moist, provides oxygen and nutrition, and washes away toxic end-products of normal metabolic processes. The joints in your spine are also lubricated and maintained in this way. But aging reduces the amount of available synovial fluid. Also, normal aging processes increase the viscosity of the remaining synovial fluid. You have less available lubricant and the lubricant that you do have is thicker. The result is stiffer joints, pretty much from top to bottom.
The specific countermeasure to such physiologic aging is to keep active. This is a pretty challenging prescription in a world in which most of our time is spent seated. Our bodies were designed for hard, physical work. But as we've transformed from an agrarian to an industrial society, and more recently from an industrial to a service-based society, the nature of our work has changed dramatically. The vast majority of our work is now done seated at a desk. When we're not typing on a computer keyboard or reading a spreadsheet, we're at home watching TV, playing games on our computing devices, or very rarely, reading. None of these activities involves active motion. If we want to take care of our bodies, we're going to have to be proactive about creating the time to do so.
We're going to be creating time for exercise. Almost any type of exercise causes synovial fluid to be more available, pumping synovial fluid into joint spaces and helping to lubricate joints.1,2 Exercise increases your internal core temperature, which in turn decreases the viscosity of synovial fluid. The overall result is increased joint flexibility. This benefit is often experienced immediately. The benefit will be long-lasting provided that you continue to exercise regularly.
Thirty minutes of exercise per day, 5 days per week, will assist most of us in maintaining as much joint flexibility as possible. Alternating a cardiovascular exercise day with a strength training day is an optimal program.3 Yoga provides a total body workout which incorporates cardiovascular exercise, strength training, and flexibility. Ultimately, the types of exercise you do are less important than the long-term consistency. Regular, vigorous exercise, done over months and years, will provide great benefit, not only in terms of improved joint flexibility, but also in terms of overall health and well-being.
1Seco J, et al: A long-term physical activity training program increases strength and flexibility, and improves balance in older adults. Rehabil Nurs 38(1):37-47, 2013
2Garber CE, et al: American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334-1359, 2011
3Micheo W, et al: Basic principles regarding strength, flexibility, and stability exercises. PM R 4(11):805-811, 2012
The Macintosh operating system contains a subprogram called "Time Machine" that allows you to reset your status to any previously saved state. Provided that you have designated a location for backups, you can literally go back in time and recover documents, directories, and applications you may have overwritten, deleted, or otherwise lost. "Time Machine" is a marvelous productivity tool that permits us to recover from our mistakes. Wouldn't it be wonderful if we had a similar "Time Machine" that would enable us to recover our lost good health? The very good news is that we do.
In fact, you don't have to be a real-life character in an H.G. Well's fantasy tale to be able to achieve a certain degree of metaphorical time travel. You may recall the slogan, "50 is the new 30," which spread quickly through worldwide media outlets about 10 years ago. The notion that "60 is the new 40" soon followed. Surprisingly, unlike most sound bites that propagate effortlessly along social media pipelines, these hopeful phrases actually contained meaningful content. Age 50 and age 60 could, in numerous respects, really be the new 30 and 40.
But not everyone is willing to do what it takes to either slow down time's relentless ticking or to turn back the clock. Real time, that is, your personal time, and real effort are required to achieve the goal of prolonged good health. People age 50, 60, 70, and more-than-80 can enjoy the physical capabilities (mostly), the mental sharpness, and the appearance (within reason) that we used to think belonged only to persons 20 or more years younger. The price of admission to such a process is continuously engaging in the inner workings of the time machine that is available to each of us. We activate and maintain the operation of this "relativistic" system by eating a healthy diet, doing vigorous exercise for at least 30 minutes five times a week,1,2 and getting sufficient rest on a regular basis, which for most of us means 7 or more hours of sleep per night.
Upon being told of these requirements for good health,3 many people will push back. "I don't have the time" is the primary reply. Of course, one is free not to eat right. One is free not to exercise. But the results of not following-through on these action steps are profound. Heart disease, diabetes, and obesity are the primary outcomes of not engaging in health-promoting behaviors. Interestingly, many people are aware that failing to participate in healthy activities will lead to cardiovascular disease and related disorders. Obviously, mere awareness is not sufficient. What is required is an active choice. If we desire to gain the benefits of our personal time machine we must be willing to pay the price of time.
1Phillips C, et al: Neuroprotective effects of physical activity on the brain: a closer look at trophic factor signaling. Front Cell Neurosci 8:170, 2014
2Lee JS, et al: Effects of 8-week combined training on body composition, isokinetic strength, and cardiovascular disease risk factors in older women. Aging Clin Exp Res 2014 Jul 6. [Epub ahead of print]
3Erickson KI, et al: Physical activity, fitness, and gray matter volume. Neurobiol Aging 35S2:S20-S28, 2014
What if you used to be really fit and now you're not? What if, as the years have gone by, you've added a couple of pounds here and there, and you suddenly notice you're 30 pounds heavier than you were at your 10th high school reunion? Or, what if you've never enjoyed the idea of exercising, exercise was never part of your world-view, but you're not feeling as good as you'd like to feel and think that exercise might help improve your overall health and sense of well-being?
Many people want to get fit or want to regain a former level of fitness for a variety of considerations, including the above scenarios.1,2 But most of us need guidance in the process of getting fit. We need information and even instruction on what to do and how to do it. For example, it would be a serious mistake for someone older than 50, and even older than 40, to simply go out and try to run 4 miles if he had never run before. Muscle strains, shin splints, or even a stress fracture of one of the bones in the foot would be a likely and unwanted result. Similarly, going to the gym and trying to "work heavy" would assuredly create various problems for an out-of-shape person who wanted to "get fit" as quickly as possible. The injured tendons and sprained ligaments resulting from trying to rush would set back your hoped-for progress by at least four to six weeks, further delaying achievement of improved health.
The best way to get fit or return to fitness after a long period of inactivity is to start slowly, progress in small increments, and gain an authentic, long-lasting level of fitness over months and years. Being a smart exerciser means not doing too much too soon, in other words, respecting your body's capabilities. Also, smart exercise involves engaging in a blend of activities, usually on alternating days. Persons who only bike or run and persons who only lift weights will never be as healthy and fit as those who do both aerobic activity and strength training.3 Developing a two-week schedule will provide a thorough, balanced fitness program. In week A you do aerobic exercise (walking, running, biking, swimming laps) on Monday, Wednesday, and Friday. You do strength training on Tuesday and Thursday. In week B you reverse activities, doing strength training Monday, Wednesday, and Friday and aerobic exercise on Tuesday and Thursday. This alternating pattern ensures you are getting the full benefit of your valuable time spent exercising.
It is important to remember that what works for you, works for you. Each of us needs to find his or her best way forward. Some methods of exercise will be experienced as intuitive and enjoyable. Others will be experienced as the opposite. You probably won't want to continue any of the latter. For example, the exercise program suggested by your friend may not be effective for your physical makeup and may even be harmful. Your chiropractor is an expert in healthy exercise and will be able to recommend fitness activities that will be right for you.
1Johanssen NM, et al: Categorical analysis of the impact of aerobic and resistance exercise training, alone and in combination, on cardiorespiratory fitness levels in patients with type 2 diabetes mellitus: results from the HART-D study. Diabetes Care 2013 July 22 [Epub ahead of print]
2Stanton R, el al: Is cardiovascular or resistance exercise better to treat patients with depression? A narrative review. Issues Ment Health Nurs 34(7):531-538, 2013
3Lorenz D, Reiman M: The role and implementation of eccentric training in athletic rehabilitation: tendinopathy, hamstring strains, and acl reconstruction. Int J Sports Phys Ther 6(1):27-44, 2011
Bob Barker, beloved host of The Price Is Right, recently made headlines by announcing his retirement after 35 years. "Barker irreplaceable!" blared the entertainment tabloids. And yet, Mr. Barker celebrated his 82nd birthday a few months ago.
Eighty-two! Who really are the "seniors" among us? And what does "senior" mean in today's world? Certainly, America's population is aging by the minute. Baby boomers are rapidly closing in on their 60th birthdays. But most of those in this huge group (more than 76 million)1 are resisting the concept of "getting older" and searching for ways to stay healthy and fit and well.
Fitness programs provide a major answer to these challenges. Yet, there are many questions. What to do? How to get started? What if I have health issues - can I still get fit?
Before we dive in, some special concerns need attention. Baby boomers and those even older must address decreased flexibility and possibly - temporarily - decreased stamina. Medical issues, including osteoporosis2, high blood pressure3, and diabetes, as well as overweight/obesity, must be considered when beginning a new fitness plan.
The bottom line - have a complete physical exam with your chiropractic physician and/or family physician, and make sure you're good to go. Start slowly and easily, making gradual progress, and adding intensity and duration over the first several months.
Begin a walking-for-fitness program. Walking is fantastic exercise! Do 10 minutes at an easy pace the first day, build up to walking around the block, gradually building up over a 12-week period to a brisk 30-minute walk.
Also, begin lifting weights. Many helpful books are available, or ask a friend who knows what they're doing to show you the ropes. Start slowly, carefully, gradually. Train your upper body and lower body on separate days. Make sure you're focusing, paying attention, and working within yourself!
Nutrition is just as important as exercise in regaining the level of fitness we need to live healthy, long lives. Eating right requires some mental toughness, and it may take a while to build new habits. The payoff comes quickly, though, and is tremendously empowering.
We want to be fit for the rest of our lives. How to keep it all going? Here are a few tips from the fitness front lines -
• Writing down a weekly plan. This keeps your workout and nutritional goals fresh. They're right there, on your desk or refrigerator, where you see them every day.
• Vary your routines. Change your workouts every few weeks. Ride a bike if you've been walking. Use dumbbells instead of machines. Vary your fruits and vegetables, and vary your sources of protein.
• Set up a buddy system or join a fitness club. The support of a group of friends who share your lifestyle goals, can make a big difference.
And, most importantly, have fun!
1MetLife Mature Market Institute Analysis, U.S. Census Bureau, 2000.
2Carter ND, et al: Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. Canadian Medical Association Journal 67(9): 997-1004, 2002.
3Staessen JA et al: Life style as a blood pressure determinant. Journal of the Royal Society of Medicine 89(9): 484-489, 1996.
The average age of Americans is increasing year-by-year. Approximately 77 million babies were born in the United States during the boom years of 1946 to 1964. In 2011, the oldest will turn 65, and on average can expect to live to 83. Many will continue well into their 90s. Most people continue to retain the habits they developed as children and teenagers. For many Americans, these habits included lack of regular exercise, sedentary activities, and poor nutrition.
As adults we no longer possess the free pass we had when we were kids. If we continue to eat high-fat and high-carbohydrate foods, we'll gain more and more weight. If we persist in viewing regular exercise as an unnecessary indulgence, we'll continue to experience high blood pressure, heart disease, and weakened immune systems. Older adults who resist the importance of good nutrition and regular exercise are also missing the thrill and sheer joy of having a vibrantly healthy, high-efficiency body. In contrast, older adults can achieve high levels of fitness, or even satisfactory levels, and feel much more youthful than they have in years.
Young adults who are the children of older adults can set a good example for fitness. Of course, this strategy is the reverse of what we're used to - our parents setting the example for us. But good examples work both ways, and smart parents may be willing to take a tip from their kids.
The first good example is regular exercise. The U.S. Department of Health and Human Services recommends 30 minutes of exercise five times per week. Most Americans do no exercise at all. Get your parents into the routine by inviting them to go for a walk or bringing them to the gym and showing them a few basic exercises. For our parents, the key is to get them started. Keep encouraging them - not as something they "should" do, but rather as something they could bring into their lives as a "choice". No one wants to do what they "should". Make it an invitation - make it fun.
Also, begin to set a good example with nutrition. Take your parents out to dinner at a healthy place - talk to them about eating smaller portions, avoiding fried and processed foods, and food combining. Food combining means eating a portion of protein and a portion of carbohydrate at every small meal. For most people, altering their food habits-of-a-lifetime is pretty radical. Help your parents learn how to take small steps in the direction of healthy nutrition, rather than attempting to change everything at once. Again, help them have fun with it. Good nutrition is a choice.
For all of us, it's important to walk the talk. Our kids - and even our parents sometimes - will mimic what we do. We want our own lifestyle choices to be healthy and life-promoting, so our kids and our parents have a good example to follow. Your chiropractor is an expert in using exercise and nutrition as a means of helping patients restore good health. She will be glad to provide valuable information on both of these topics for you and your whole family.
1MetLife Demographic Profile. MetLife Mature Market Institute, New York, NY, 2006
2Howard RA, et al:Physical activity and breast cancer risk among pre- and postmenopausal women in the U.S. Radiologic Technologists cohort. Cancer Causes Control October 21, 2008
3Leitzmann MF, et al: Physical activity recommendations and decreased risk of mortality. Arch Intern Med 167(22):2435-2460, 2007
