Fitness Is for Life

Physiotherapist Ceridwen Way delivered this presentation to the  Miami Combined Probus Group at Mowbray Park Surf Life saving club on Tuesday 4th August 2015.

The crowd were enthusiastic and joined into the post-speech exercise/stretching session with gusto. Hopefully, they are now all Moving better, Feeling better and Living better everyday!

Fitness is for fun and fitness is for life.  Let’s get fit!

Exercise is important because :

1. Being inactive has serious consequences

• Increased risk of heart disease, type 2 diabetes, high blood pressure, depression and some cancers (colon, endometrial and postmenopausal breast)
• The increase in risk is large- risk of heart disease from lack of physical activity is similar to that of smoking cigarettes (Harding 2004)
• Commencing physical activity reduced the risk of CHD mortality by 41%. Stopping smoking reduced the risk of CHD mortality by 44%(Paffenbarger, 1993)
• Decreased fitness and function. People who are inactive tend to have decreased strength and flexibility, lower fitness and higher body fat. High body fat has strong links to the incidence of other cancers (including oesophageal, pancreatic, kidney, gall bladder)

2. People with a disability are 50% more likely to be physically inactive

• Therefore are more prone to developing diseases of inactivity
• Find movt more physically stressful, which can –vely impact independence and social interaction.

3. Evidence shows even small increases in activity are beneficial

• Especially for those who are currently very low active.
• Light exercise done for half of the required time improved the aerobic capacity in sedentary women
• 10x3min bouts reduced serum cholesterol
• Light intensity activity is associated with increased insulin sensitivity in type 2 diabetes

Some of the Normal Changes of Aging

1. White tissues are the tissues such as tendon, fascia, disc, cartilage and meniscus and as we hit the balance of cell growth = cell death in our mid 20’s, the slow age related degradation starts in our late 20’s, early 30’s and progresses as we get older eg the cartilage the covers the ends of our bones in our joints degrades leading to OA, cartilage tears in our menisci in our knees or wrists and tendon tears and tendinopathies-partic in SST, GMD and Achilles. Most of us have these processes going on in our bodies but they are not necessarily painful so we still function well despite them being present – that’s the challenge- remaining strong enough so that this degradation doesn’t affect our lives.

An interesting aside is the link between being overweight/having a lot of adipose tissue (ie fat) and tendon health. Having a high BMI increases the release of inflammatory cytokines through the altered glucose metabolism that occurs. This has a negative effect on tendon health and predisposes these people to tendinopathies. Exercise decreases these inflammatory cytokines.

2. Decrease in muscle fibre quantity (in size and number) or sarcopaenia. This decrease in quantity with age also contributes to a loss of strength, balance and co-ordination. This effects all muscle groups including the pelvic floor. New research by Fragela et al (2015), suggests that the quality of the m tissue(it’s composition, relative strength and therefore its ability to function)is more relevant and this has important ramifications in terms of the way people train as they get older- train smarter not harder.

3. I mention the pelvic floor specifically because the longer we’ve been on Earth, the longer we’ve been working against gravity, the higher the incidence of pelvic floor problems eg leakage with laughing, coughing and sneezing, going more often than 6-8 x per day, not feeling fully empty or that eye-watering urge to wee.

4. We secrete a hormone that concentrates our wee overnight so that we don’t have to wake up to go the toilet. This becomes less effective as we age, so then we get up more often at night. If your balance is already poor due to poor leg muscle strength and you’re getting up in the dark, you are more likely to fall.

5. Menopausal changes – mood changes, feeling flat, sleep disturbances, less of the hormones that protect our bone strength. Decreasing oestrogen levels contribute to tendon problems too.

6. Decrease in bone mass.

The symptoms such as joint stiffness, sore backs, sleep disturbances, bowel problems that we tend to blame on age or TMB syndrome as one of my patients called it (too many birthdays!) are also impacted by your genetics, your diet, your cigarette and/or alcohol use and especially the amount of physical activity you do.

The good news is that these changes of aging are not all unavoidable. Resistance exercise can reverse some of the decline in and maintain bone mass, muscle fibre size, quantity and quality. The other benefits of exercise are that it helps you to sleep, improves your strength, improving your balance, releases endorphins which are the feel good hormones, in your brain thus improving your mood and mental health, general increase of muscle tone and fitness has a positive impact on the tone of your pelvic floor which contributes to keeping us dry(not as important as doing specific pelvic floor strengthening though).

Certain types of exercise are better for achieving certain goals.

• Weight bearing exercise is necessary for increasing bone mass eg OP
• Balance exercises
• Racquet sports for eye-hand co-ordination
• Aerobic ex increases the blood volume through the hippocampus in your brain. This is the area that shrinks in those with dementia.
• Endurance exercise stimulates an endocrine process that decreases skin aging
• Low to moderate exercise decreases inflammatory cytokines (improving tendon health) and increases FSH and luteinizing hormones so it may help peri-menopausal symptoms

Physical Activity Guidelines

So in summary

• Do something you enjoy so it’s easier to make it a life habit
• Ideal physical activity level is 2.5-5 hours mod intensity each week
• Make strength training a priority
• 2 sessions of strength training each week
• Weights shouldn’t hurt while you do them
• It’s normal to be sore the next 1 or 2 days after strength training
• Work more on soft tissue and flexibility i.e. stretching, massage and self massage with roller
• Even small increases in physical activity will benefit you.
• Treatment inc ex program development costs can be covered by private health funds, medicare, DVA if you’re eligible.
• Always have at least 1 rest day between strength training sessions
• Remember, any activity is better than none.
• Take that first step towards more activity today – your body will love you for it.

Gold Coast Physiotherapy and Allied Health at Burleigh Heads and Broadbeach  07 5535 5218

References

Paffenbarger,1993
Fragela MS,Kenny AM,Kuchel GA, Sports Medicine (Auckland, N.Z.) [Sports Med] 2015 May; Vol. 45 (5), pp. 641-58.
Kenter, Elise J.; Gebhardt, Winifred A.; Lottman, Irene; van Rossum, Mariët; Bekedam, Margreet; Crone, Mathilde R.; Psychology & Health, 2015 Jun; 30 (6): 627-51.