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Physical Therapy is the Entry to Fitness for Sedentary Older Adults

Lately it seems I have had many patients who come to me for a variety of issues (typically back pain), and during their evaluation it becomes very clear the issue is not sciatica, posture, or whatever else might be on the MD's prescription. The issue is overall deconditioning and weakness. Most older adults I see have stopped working out long ago. Their muscles have atrophied and can no longer support their daily routine. Every time they stand up from a chair, have to stand to make dinner, or walk through the grocery store it feels like a max effort event. They feel weak and dependent, which only adds to their pain and frustration. Now as a PT I have 2 choices:

1) give them clamshells, leg raises, etc to get them moving safely without any discomfort

2) load movements like the hip hinge, squat, and lunge to improve strength in a functional pattern I will choose squats, lunges, and deadlifts every time. Not only are they more functional and translate better to tasks like picking something off the floor or getting out of a chair, but it also transitions better to a gym program. My goal is to set you up with a plan to maintain progress without PT. And that means a gym or personal trainer. Now if you haven't been to a gym or worked out in awhile, that might be a really scary idea. It would be even harder to go from table exercises to the typical exercises you see in a gym if you know you've recently been injured or in pain. You might think- is this good for me? Does this personal trainer really know what's best for me considering my history? Should I be doing this at my age? How do they know they won't reinjure me? But not if you've already been doing them with your physical therapist. If you start building your strength and confidence with movements like squats, deadlifts, and lunges in physical therapy, it's less scary and intimidating in a new gym with a new person. You have the opportunity to ask questions and make sure you are comfortable with the movements before trying more intense exercise with someone different. Fitness is a use it or lose it deal. If you come to physical therapy twice a week for 8 weeks, we can make a big difference in pain and function. If once you're done with physical therapy you stop exercising, you will lose all the strength and functional gains you worked so hard on in PT. The best way to keep yourself accountable is to have someone help you. A personal trainer or a group class like CrossFit is a great way to stick with exercise and not only keep your progress from PT, but blow past it to do so much more. Fitness isn't just for 20 yr olds. It's a lifelong journey designed to keep you independent. Make sure your corner is stacked with people ready to help you.


Dr. Samantha Gach, DPT

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