The Four Pillars of Mobility

Hi again. It's Doctor. Keller Worthing with another home edition of house call. A very special edition, in fact, because Today, we're talking about the latest research in healthy aging known as the four pillars of mobility.

I'm gonna explain why an active lifestyle at any age rests on these four cornerstones.

So stay tuned.

Do you remember what happened to so many of our parents when they got older? And how you see the same thing happening to your friends? They move less. They sit more till pretty soon, they can hardly move at all. They give up on activities like playing golf or tennis due to aches and pains, and and then they start avoiding climbing stairs, and then it just gets worse from there. Soon even playing with their grandchildren becomes a liability.

It's not a happy place to be when you're in what we're supposed to be your golden years. Well, I'm here today to tell you if you do the right things, then this is not something that you need to accept. And yes, it's gonna take a little bit of work because to age gracefully and maintain quality of life you deserve, you can't simply go gently into that good night. You need to fight.

You need to be vigilant about staying mobile and active every day. But you also need to do it safely so you don't get injured along the way. Well, this involves taking care of each of the four systems that support movement. Your joints?

Your bones, your muscles, and the fourth pillar, which I call maintaining strength and power.

Those are the four pillars of mobility. And a little investment in their maintenance now will determine your quality of life for the rest of your years, but it's never too early or too late to improve.

So today I'm gonna briefly introduce each of these four pillars and how to care for them. This video is kind of the introduction to all four. But we'll provide all of the details you need for each in future videos.

Okay. So let's get started with pillar number one.

Joint health.

So too often, when it comes to joint health, you can end up in this cascading downward spiral. Right? A person becomes more and more inactive because of their pain. So they don't move and they become de conditioned.

And that leads to more pain and then less movement and then more deconditioning. And eventually, they're barely moving at all. Obviously, this is not the way. Today, we clearly know that movement itself helps with many of the cellular issues that cause joint pain. As well as the conditioning that helps prevent it. In fact, it's now believed that the primary factor in joint pain is a lack of physical activity, not aging itself.

So think about that for a moment. That is how important activity is for your joints.

So what activities should you do for joint pain? Okay. Well, I'll take you through my whole body plan for your joints in future videos. However, to get you started today, if you're not currently active, or on a program, then I recommend you just start by walking ten minutes.

Go three to five days per week. Go at your own pace at a rate that's comfortable for you and pain free. And then every week, try to add five minutes. So in week two, you'll walk for fifteen minutes.

In week three, twenty minutes and so on. You don't even have to exceed more than thirty five minutes unless you really feel that you're comfortable doing that. And this alone can make a big difference in how you feel.

Studies show that just walking reduces pain and stiffness, especially in people who have knee pain and hip pain, And the reason this works is twofold.

The knees and the hips, like many of our other joints, are synovial joints. This means that they're lubricated and nourished by synovial fluid.

So, therefore, the movement of walking keeps the knees and hips limber and encourages the nutrients in the synovium to enter the joints and to promote their repair. Almost like a car, if you let it sit and don't drive it for a long time, you know, all the fluids get kind of crusty and old, and the engine won't turn over anymore. A lot happens with your joints as well. In fact, orthopedic guys always say, you don't use it, you lose it. This is very, very true with your joints.

At the same time, the muscles above and below the joints learn to fire at the right times, providing more stability.

It's a phenomenon called muscle guarding, and this greatly reduces pain, plus walking itself strengthens those leg muscles. Your muscles are kinda like your shock absorbers for the joints.

Now there are very specific exercises that I recommend for joint pain, by body part that I'll cover in future videos. But here's a few general things to think about until then.

You can get joint movement by both active exercise, which engages the muscles, and by passive range of motion or stretching These have different benefits and both are important.

When you're doing active exercise, start with low impact activities that won't put extra stress on the joints. I like resistance training, which means using weights or machines or bands. Strthening your muscles helps the joints. And I'll get into the specifics of that down the line.

And before I move on to the next pillar, I'd like to mention that I'm also a big fan of starting with quatic exercise. That means exercising in water if that's available to you. It's a great joint saver because floating in water unloads the body and the joints. And this can decrease pain.

And provided it's warm, the water also improves circulation to the joints. And then the weight of the water itself applies a pressure to the body that can reduce inflammation when you're actively moving in it. The mass of water also creates a steady resistance to your movements. So, for example, if your pool has stairs, you can practice walking up and down as part of the workout as well. But to do your aquatic exercise routine, you'll need to be standing in water that's at least deep enough maybe up to the bottom of your breastbone.

That allows the mass and the weight of the water to really create the beneficial effects.

So the benefits of aquatic workout have been confirmed in multiple studies. One study published in the journal of strength and conditioning research compared land based and aquatic exercise programs and their effects on people with knee osteoarthritis over six weeks.

Both therapies were found to be effective for reducing pain, promoting range of motion, and increasing thigh muscle size and endurance, but the aquatic group reported significantly less pain during the exercise.

So if exercise pain is an issue for you, then consider going the aquatic route to start.

Okay. So let's move on to pillar number two. Bone health.

More than any other factor as we age, our bones put us at the greatest risk of losing our mobility.

As we age, our bones lose density and become more brittle, and that puts us at greater risk for serious injury.

According to the National osteoporosis Foundation, over forty million adults have low bone density. Which places them at a greater risk for osteoporosis and for injury in general.

In fact, osteoporosis is responsible for roughly two million broken bones annually.

But sadly, over eighty percent of American seniors who suffer bone breaks are not tested or treated for it. So what activities can you do to help protect your bones?

Well, the key to maintaining bone strength as you age is light impact.

Okay. This means providing enough resistance to the bone tissue that the body gets the message that it needs to hold on to this bone tissue. Okay. So fortunately, this is a lot more fun than it sounds.

Walking, hiking, climbing stairs, playing tennis or pickleball, and dancing are all great bone stimulating activities.

But keep in mind though, some healthy exercises like bicycling or swimming are not ideal for bone maintenance because they don't put enough direct load onto your bones.

Okay. So what specific exercise strength and bones?

Well, our friend resistance training scores here too. It's recommended that postmenopausal women and older men perform strength exercises at least two to three days per week. And I would add that specific attention should be given to the exercises that challenge balance, because that helps prevent falls. Okay? In fact, I would also argue that balance could be like the fifth pillar of mobility, but I'll talk more about that in a future video. So for bone health, I like exercises that target the hips, the lumbar spine, because these are two areas at the greatest risk for fracture and for bone loss. These can include things like lunges performed in different directions and yoga planks, which again I will show you more about in other videos.

So if this type of aerobic activity or resistance training seems daunting, then you can always start off in the water to lessen the impact, and then progress to exercise on land just as you can with your joint training regimen.

But you do need to eventually build up to resistance training with weights, which will do the most to protect and strengthen your bolts.

Okay. Let's move on to pillar number three. This one was for all the stallone and Schwarzenecker fans out there. And that is Muso would be the ding.

Alright? All kidding aside. Avoiding frailty and maintaining muscle as we age is actually much more important to seniors than it is to teenagers in the gym. That's because the loss of muscle mass and strength that comes with age known as sarcopenia can lead to the loss of mobility and independence just like with the other pillars.

So please pay attention to this. You lose your muscle mass and you might end up in a nursing home or require someone else to care for you. Don't let that happen. Due to declining hormone levels, as well as reduced activity, adult shed muscle rapidly after the age of sixty.

And apart from making it more difficult to get around and perform the activities of daily life, muscle loss is associated with a higher risk for falls. For bone loss, and even for insulin resistance, which is what can lead to type two diabetes.

So what can you do to prevent muscle loss?

Well, remaining active in general helps to slow the rate of muscle loss, but to hold on to as much of that precious muscle tissue as you can, and to potentially build more of it, you have to lift weights.

But don't make the mistake of thinking that you're too old. Okay? One famous clinical trial showed that even frail hospitalized people in their nineties were able to improve their strength by a hundred and seventy four percent.

And the same group added nine percent more muscle to their thighs in just eight weeks of resistance training. So in other words, you are never too old or too sick or too weak to be pumping like Arnold. Alright?

I'll provide some specific muscle building routines in future videos. How many days a week, which exercises, how many reps, sets, etcetera.

But keep in mind that this is not about vanity. Alright? We want exercises that provide the most bang for your mobility buck. The national strength and conditioning association recommends that older adults focus on multi joint exercises.

That means those that work more than one joint at a time. And therefore, mimic your activity in your daily life. These can include squats.

Lack pull downs, overhead presses, cable rows, chest presses, and then certain core exercises. Which I will also talk about in future videos. Alright. Now let's move on to the final pillar. Number four, strength and power. Well, the good news to start here is that resistance training for muscle mass will improve your strength levels automatically.

But as you get more accustomed to lifting, you'll want to target strength and power more specifically. And here's why. Okay. First, just to define here. Technically, strength is recognized as your ability to produce force.

And power describes your capacity to produce force quickly Okay? These are separate qualities, and they rely more on neuromuscular efficiency than just the size of your muscles. In other words, to improve them, You have to train your nervous system's ability to recruit the muscle mass that you have. This means lifting heavier and lifting faster. Respectively.

So why should you care about strength and power? Well, they're what get you off a chair, or unable to catch yourself as you stumble, and they can literally be the difference between life and death in many situations as you age. So how do you get stronger?

Alright. Well, you begin with a muscle building program, which usually involves higher number of reps, repetitions of the exercise, maybe in the fifteen repetition range.

And then you'll transition to emphasize strength by simply going a little heavier in the weights and then reducing the reps to maybe the six to ten repetition range. And you just do this by adding weight.

Now let's talk about power for a moment.

How can power help you? Well, imagine getting up from the toilet or out of a car, or darting across the kitchen to take something that's burning off the stove, you may not think of these as power movements, but all of these movements require a speed component, as well as a muscle force. And that means power. Alright?

We'll go through this in the future videos. But basically, after you're comfortable with your strength workouts, we'll spend a few weeks using lighter weights. Later than you did for muscle mass and try to increase the speed that you lift with on the way up. For example, if you're doing a shoulder press, You're gonna press the weight up as fast as you can, and then you're gonna control it on the way back down.

So you think fast up and slow down.

This type of training may be new to you, but it's been shown to be very effective for seniors.

In fact, an article in the European Review of aging and physical activity found that power training may even be more useful than traditional strength training for improving physical functioning. Just a fancy term for your ability to get around and function?

Well, that's it for today. A brief introduction into the four pillars of mobility. But I will see you again very soon where we break down not just the exercises, but also diet guidelines, nutritional support, and requirements and lifestyle tips for each of the pillars. Alright, guys. This has been Doctor. Keller Whortham, for house call, and I will see you guys real soon.