Article from Laxington Colonial Times March/April 2012

Falls Prevention- a Physical Fitness Essential

Front: (L-R) Fran Coscisa, Inez Zimmerman, and Beverley Ikier. Rear: (L-R) Pam Carle, Carol Goldberg, Lorraine Caron, Liz Sullivan by: Rick Karwan

Have you fallen lately? Have you fallen and fractured a bone? Are you afraid of falling?
If you have answered “yes” to one of the above, please read on and find out how you can turn your life around and be proactive in regaining confidence to do what you like to do.
Acrobats and gymnasts fall off the beam many, many times before they develop the skills to perform cartwheels on it; the artists of Cirque du Soleil think nothing of practicing one maneuver six hours a day until they “get” it. Of course, their life depends on it, but doesn’t yours?
The statistics around falls and fractures are increasing daily and the prognosis for rehabilitating from a hip fracture after the age of 50 is grim; mortality rates are high and a third of patients require long term care after a fracture, according to the International Osteoporosis foundation.
You are probably sitting to read this, but if you sit a lot because you are afraid of falling, then you are putting yourself MORE at risk for fracture because you are losing bone mass. By not placing a force on your bones from muscular activity, they stop new cell production. (Do not even cough!)
In the sixties and seventies, I was nursing in McGill’s busy teaching hospitals, the Royal Victoria Hospital and the Montreal Neurological Institute, daily offsetting the ramifications of the now- considered deadly- BED REST. To keep patients from falling flat on the floor after 2 weeks in bed for appendectomies, childbirth or any procedure that required 30 or more minutes of general anesthesia, we had to “dangle” them. That’s right, all doctors ordered “dangling” before walking as lying about caused gross imbalance; a given in conjunction with de-conditioning
So much has been learned about activity and health promotion we can hardly grasp the 180 degree turns in the treatment of many conditions. For example, arthritis? Then, it was “take it easy” and “save some steps.” Now, we know to strengthen and walk. The same is true for heart surgery. Post-surgery care was “bed rest.” Now, patients are put straight on a treadmill. And today, breaking news is that by exercising the balance system, it can be developed and strengthened just like a muscle.
I’d like you to meet the home team-

And the opposing team, contributing to imbalance:
1. Medical conditions (Parkinson’s, low blood pressure, dehydration, inner ear pathology)
2. Medications (for high blood pressure, diuretics, barbiturates, mood altering and sleep inducing)
3. Dehydration
4. Fear of falling
Apart from inactivity, the above mentioned can seriously affect balance but will respond to balance exercises.

Exercises to Promote balance
These are best learned in a balance class under the supervision of a trained, experienced practitioner. However, the following exercises are safe and simple, offer some benefit, and will get you started. All may be performed seated. Anyone at a higher fitness level will require more challenging exercises.
Eyes

• Move eyeballs left and right, and up and down, following a fingertip.
• Standing, keep your eyes on fingertip and turn around full circle.

Inner Ear

• Turn head left and right, starting slowly and increasing the speed. If you get dizzy, stop and wait until it subsides, and try again.

Muscles – mainly of the lower body

• Stand up from a hard chair. Sit down and repeat; gradually “stop the drop” a few inches above the chair. You may fatigue, but this is strengthening.
• To stretch, straighten out you leg and push heel away from you. Hold this for 30 seconds.

 Feet

• Without shoes, apply foot to a tennis ball and roll, keeping the knee bent and the foot under the knee.
• Take care of calluses and long toe-nails.

Walking safety- “Five for Focus.”

Practice this one starting now, and you will be amazed at the quick results. Take five seconds to view your terrain. What happens is your eyes send messages to the brain detailing the route you have chosen, including heights, widths, depths of obstacles you may have to deal with; lighting, noises, types of terrain and where it may change, for example, cement, grass, mud, puddle. Your brain then selects muscles to advise them of some upcoming performance, for example stepping up, pivoting, ducking down, turning right or left and puts them on “speed dial” for easy recall.

Now, when you start your walk, the calls go through, the muscles do their job, and you are safe. Without this five seconds to focus, you cannot expect your body to respond and perform safely in a new environment; even a familiar one, for that matter. Take “Five for Focus.”

Hydration
64 oz is the recommended daily intake of water. Fill up your containers at the start of the day and begin infusing early. Caffeine and related products take water out of the cell,- so replace the water you lose throughout the day and carry on.
It is predicted that one out of three people over the age of 65 will fall once a year. Each fall causes increasing debilitative results.
You may start now; I just want to encourage you as these exercises and safety precautions can prevent falls, in spite of abovementioned medical conditions and pharmaceuticals. I have been working with 100 seniors a week for 15 years, and to date, we have defied ALL the odds regarding falls and fractures.
Please contact Beverley Ikier at: wellness@theikiercenter.com, or 781-229-1967 for classes in falls prevention, or to have a program in your facility.

Link to article: http://colonialtimesmagazine.com/falls-prevention-a-physical-fitness-essential/

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Ratcheting down a stretch

Stretching is a commonly used term and is advised by many health and fitness professionals. Stretching is pictured in all of the media but very few people know how to stretch to make a difference. Stretching is also controversial. However, I’m leaning towards the research that shows flexibility of soft tissue plays a large role in injury prevention. There are many types of stretching on the market.

My favorite is the “Ratchet”.  As an example I shall use a tight hamstring. The hamstring is actually a group of muscles at the back of the thigh but you can successfully use this method on your tightest muscle.

1)     Sit on the side of the bed.

2)     Extend the right leg out straight, parallel with side of mattress.

3)    Keeping the head up and the back straight, gently bend at the hip to the right thigh. You will come to the first feeling of a stretch- the stretch point. Hold it to a count of 6.

4)     Get in touch with your breathing and during an exhalation bend more at the hip, then stop when you feel the new stretch point; stay there.

5)     Repeat, upon exhalation, bend more, and go further into the stretch. The muscle will relax slowly with this gentle stretching as you ratchet down.

Try to do this to a very tight muscle four times a day and you will be stretching to make a difference.  And remember, the recommended 64 oz of water per day helps to release contracted muscles. 

Body Tapping

Body Tapping is known by other names- tapotement and meridian tapping are some examples. Its origins are thousands of years ago in Eastern medicine and originally was designed to balance energy in meridians, chakras and organs. At the Ikier Wellness Center, we do body tapping for stress management, the loosening of tight muscles and the promotion of circulation, both of blood and lymph.

Body Tapping can be done as a self-care technique to ones's self, or with an agreeable partner. Since lymph and circulatory channels follow those of blood, it is a useful tool in promoting immune function. It is important to experiment with speed and rhythm, to find the one that is most suitable. People on blood thinners would choose a lighter pressure, as would people with osteoporosis.

1) Start by tapping down and up each arm, from the top of the arm, under arm and each side of your arm.

2) Tap under rib cage, then move one hand just below your chest bone, and the other just below your navel.

It is important to keep bouncing through the knees. Proceed to the thighs, front back and each side. Now clap your hands- hooray, you're done!

Another reason to exercise

In case you needed to hear another reason to exercise; data from the Health Partners Research Foundation shows that adults aged 50 and over who started exercising for at least 90 minutes a week saved an average of $2,200 per year in medical costs.  This makes an exercise class seem like a very economical alternative to traditional medicine, and there is the additional benefit of feeling great after a good workout!

But it is important to remember that not all exercise classes are created equal. 83% of fitness facilities serve the older adult populations, but only 43% offer programming geared specifically to this group and even fewer facilities offer programming designed for disease-specific conditions.  A class or program that is dedicated to serving a particular need has a far greater impact on your body and overall health than a general fitness class.

The Ikier Wellness Center’s Osteofitness class is one such program, as it is specifically designed to reverse Osteoporosis and Osteopenia.  Careful  bone strengthening and muscle stretching is combined with balance improvement and falls prevention to create a comprehensive program that tackles Osteoporosis head on, in combination with a healthy diet and the intake of calcium and vitamin D.

Understanding your rotator cuff- there's hope!

Rotator cuff problems can indeed impair function and cause a lot of pain, and progress to the involvement of neck, arm and upper back problems. In many cases, this leads to the constant use of pain meds and is the cause of much absenteeism in the workplace.

In an aligned posture, the middle of the top of the upper arm, the "ball" portion, should be in line with the hip. In our activities and jobs, using the arms in front of our chest more than overhead maneuvers, strain the muscles in the back and crunch the muscles in front. If we could go from our computers or instruments to picking fruit, we would balance the use of our upper bodies.

But no, the forward roll of the upper arm and upper back have become the position of choice as it is function-driven. In a nutshell, upper back muscles strain, overstretch and lose maximum elastic capacity. The upper chest muscles become crunched, shortened and hypoxic (low in oxygen). Neither upper chest nor upper back muscles are in a posture for optimum usage. Unfortunately, this "forward" position progresses and eventually involves neck and arm conditions that become equally problematic.

The Ikier Center sees this problem frequently and has a high success rate for returning the posture and maintaining it. In addition to pain being eliminated, there is a marked increase in hand temperature and reduction of neck dysfunction. Treatment of 1 or all 4 of the muscles of the rotator cuff need individual attention and therapy, ranging from tapping, stretching, soft tissue manipulation and strengthening. Consider being a part of your rotator cuff rehabilitation before undergoing a surgical intervention.

Punctuality is essential for exercise!

As one ages, a decline in activity is often experienced and, sadly, accepted as the “norm”.

Intense research into aging and activity was started at least two decades ago and is still a “hot” topic.

A professionally run resistance training class includes 4 components:

1.       Limbering- to loosen joints and discover tightness

2.       Cardio- moderate elevation of cardio-respiratory system.

3.       Strengthening-application of a force to a targeted muscle group. Resistance in the form of free weights, body weight, bands and pullies all work to strengthen muscular function, and in Osteofitness, increase bone density.

4.       Flexibility- necessary at end of class to allow muscles, which have been contracting, to “let go” and return to resting length, thereby preventing “pooling of blood”-a cardiac risk as well as a “cramper”.

On late arrival:

•          The member missing limbering misses the opportunity to “test” joints for use further on in the class and thereby increases musculoskeletal risk of injury.

•  Members missing 50-75% of cardio are starting in at too high a level of function on an unprepared heart muscle and risk a cardiac event.

On leaving early:

•   Members run the risk of “blood pooling” as well as a risk of cramping and pain.
• Research has proven, as one ages, the activity can increase ONLY IF there is thorough limbering, cardio and stretching. Members who are repeatedly late or leave early not only jeopardize the safety of their work out, but also create a distraction for the working members.

When attending an exercise class, it is generally best to try to:

•        Arrive early enough to collect all the equipment needed for the class, including weights from the equipment room.
•        If it is necessary to leave early, please inform the instructor as otherwise an unannounced, sudden departure could signal a medical emergency.

A great exercise class offers a full service strengthening program encompassing much, much more than building of bone density. Aside from the four standard components (see above) a class should draw on state of the art general health modalities as well as vital stress management techniques. It’s a lot to pack into 1 hour, so try not to miss a minute!