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Posts for tag: Healthy Aging

By Dr. Doug Williams
February 15, 2017
Category: Frailty
Tags: Healthy Aging   frailty   body systems  
Over the last few months, we have been working our way through the topic of Frailty, which is really a study of how the body unwinds over a life time. Most of the material we have been drawing from has come from an article published in "The American Geriatrics Society."

While some choose to look at topics like Frailty and the unwinding of our bodies over time as a bad thing, this article and our blog series took the approach that we are "Fearfully and Wonderfully Made" and understanding how we function in youth and as we age can help us live as full and complete a life as possible!

The lens that we used to look at this topic consisted of four, separate yet interrelated, segments:
  1. Inflammatory System
  2. Endocrine  System
  3. Musculoskeletal System
  4. Nervous System

The first thing we looked at was Inflammation. We saw that researchers looked at these main markers in inflammation:

  • Cytokine IL-6
  • C-Reactive Protein
  • Total number of monocytes

These were blood markers that increased with age and disease, and were related to the following disease states and functional issues:

  • Death (that is a big one)
  • Bone mineral loss
  • Muscle loss
  • Anemia
  • Insulin resistance (Adult Diabetes)

We also looked at how we could influence these various states of decline and dysfunction, primarily by how and what we ate. There are two links that can help with addressing this issue:

  1. Andrew Wiel Article
  2. Blog Summary from our Healthy Eating Series

Next, we looked at the Endocrine System.  The main markers researchers look at in the Endocrine System are

  • IGF-1
  • DHEA-S

These two markers primarily give insight into the sex hormones: Testosterone and Estrogen. These markers ebb and flow over a life time, but tend to trend down as we age, causing the following functional loss:

  • Decreased strength
  • Decreased endurance
  • Weight loss (due to loss of muscle tone)
  • Decreased walking speed
  • Decreased physical activity
  • Increased inflammation
  • Cognitive issues (dementia)

When looking for ways to positively influence these factors, we found several factors to pursue:

  1. Resistance training
  2. Weight loss/management
  3. Decreasing high glycemic index foods
  4. Increasing sleep
  5. Eating a high protein low carbohydrate snack before bed

Two links that were helpful were:

  1. Article in the Journal of Gerontology (Technical)
  2. Article in Life Extension Magazine (Reader Friendly)

After the Endocrine System, we looked at one of my favorite: the Musculoskeletal System! The main marker for this system is muscle mass or muscle to non-muscle tissue ratio.

We primarily focused on the glute muscle because it is such a big player in much of human locomotion. Decline in the musculoskeletal system results in the following disease and functional states:

  • Diabetes
  • Fall risk
  • Declining bone health
  • Independence

We referenced two helpful links:

  1. The Sit to Rise Test (explained the relationship between core strength and life expectancy)
  2. Getting Your Butt Off the Ground (blog series on how to improve the Sit to Rise Test!)

Finally, we looked at the Nervous System. We saw that the nervous system really brought everything together, which is why it is often called the Master System. The markers that were used in the original article are:

  • Gait (how stable and smoothly you walk)
  • Balance
  • Strength

We added a bonus one that has been making it's way into the literature lately:

  • Cognition (how well your brain works)

When the nervous system starts to fail, you see the following issues:

  • Falls
  • Loss of independence
  • Problems with coordination
  • Cognitive issues (mental slowness, dementia and, possibly, Alzheimer's's disease)

We linked to several articles:

  1. The Nurses Study on Walking (showed a dose-based relationship to exercise brain function)
  2. An Article in JAMA (relative to exercise and brain health - dementia and Alzhiemer's)
  3. Our previous blog series on Getting Out Of A Chair (practical place to start for glute strength)


What's Left?

As I write this article, I am 52 years old. I am sure that some of you reading are much younger than me and some older. One thing we all have in common is we are all headed to one last door in life to open.. death! We all are going to have to step through it, at some point. I have a lot to say about what I believe to be on the other side for me (the waiting arms of Jesus, who made the supreme sacrifice for me!), but that is not what this blog series has been about! This series has been about how things are going to unfold as you get to that last door. Personally, I would like to be able to walk right up to it at the end under my own power. While that may not be possible, I am going to do all that I can to operate as fully and completely as I can in the framework I have been given. I hope some of the material we have covered helps you to do the same.

In Health,

Doug Williams, D.C.
Care Chiropractic 
Lafayette, Indiana

By Dr. Doug Williams
October 18, 2016
Category: Healthy Aging
Tags: Healthy Aging   Mobility   Stability  
Today, we are going from the floor to the ceiling!


Over the last month or so, we have been working on going from the floor to standing up with as little assistance as possible. Far from a circus trick to impress your friends (this trick gets more impressive the older we get - five-year olds won't be impressed at all, 55-year olds would likely quite impressed), this little gem may also predict how long you are likely to live.  Researchers have found that the less assistance you need to get up off the ground, in terms of touches, the less likely you are to die. We have discussed several strategies including stiffening the torso, slowing down exercise to build strength and stability, and, most recently, kneeling on one knee and practicing driving up from the ground.

The original study is based on a participant sitting flat on the ground (say, cross legged) and getting up without touching the floor other than the feet. While this is a really good way to test for total pelvic-hip core strength, it is unlikely to be the way most people would get up from the ground by choice and, quite frankly, it puts a fair amount of stress on the knee joints. Given the patient population that reads this blog, we are going to reserve teaching/training methods to get up from the full sitting position for the clinical setting to avoid creating any unnecessary injuries!

Honestly, anyone who can stand up off the floor from a full kneeling position without using their hands is well on their way to good core strength, balance, stability - and I believe they will be able to maintain their health and independent living for a long time!


Put It Together!
  1. Start out on all fours (face all the way to the ground as if looking for a bug optional).
  2. Raise your torso up without using your hands to the full kneeling position.
  3. Raise one leg up so the foot is flat on the floor. If possible, do so without the use of support of either hand, but feel free to use one until you are stable. Drive up through the heel of the raised leg, ideally without any assist, but feel free to use the palm on the same side leg or touching a wall or chair as necessary.
  4. Actively bring the down leg up into the upright posture.
  5. Stand up tall!  You did it!
If you have worked through this whole series, congratulations!  If you are just starting with today's post, go back and read the previous ones from the beginning - it is worth it. The ability to go from "floor to ceiling" under your own power is really an incredible gift, just ask someone who can't do it. Believe me, that will not be the only physical limitation they have in their life. A solid frame to get up off the floor with translates into so many daily activities and minimizes the aches and pains of daily life. Remember to master all of the steps: getting out of a chair, creating a stiff torso with the wall exercise and half kneeling. Use modifications as long as you need to until you get it right. Slow down movements to bring out weak spots and don't be discouraged! The time you put in will return to you many fold!

Yours in Health, 

Doug Williams, D.C. 

Care Chiropractic
Lafayette, Indiana

By Dr. Doug Williams
October 03, 2016
Category: Healthy Aging
Tags: Healthy Aging   Mobility   Stability  
Let's Take It Down to The Ground! (Almost)

Finally, we are going to start heading down! This last month, we have been on a journey building up the framework to make it possible to get up and down off the ground with the least amount of assistance. Studies have shown that the more help you need getting up off the floor, the shorter the time you have to live! I know that sounds crazy, but I think most of us realize that is empirically true. The less mobile and strong we are, the less healthy and capable we are of taking care of life's daily needs. We have talked about the following:
  1. Proper form in getting up and down out of a chair
  2. How slowing down a movement can bring out the weak spots and help to isolate your training
  3. Exercises that stiffen and firm up the torso, and why that is important in being able to move your body mass up and down
Today, we are going to start going from the chair or "neutral" to the floor. In true Dr. Doug Fashion, let's break it down into teachable and trainable parts!
 

 
Time to Take a Knee
 
Kneeling is a very interesting posture. I associate kneeling with several different things, like prayer and fatigue. Today's blog post isn't about prayer, but I think anytime is a good time to take a moment and talk to God! In addition, most of us haven't been so exhausted that we need to "take a knee" since being a kid and maybe we need to work on that! We are focusing on kneeling as a transition from sitting to the floor and possibly from the floor back up, depending on where you are at physically when you start this program. Some of you reading this might consider yourself in pretty good physical condition, but I challenge you to work on today's exercise. You might find it more challenging than you think, primarily because most exercise happens from chair height up and never fully engages some of the deep hip and core muscles.

Even an individual who is very frail usually reverts to the kneeling position when attempting to get up off the floor in the unfortunate event they take a fall. Usually, they will crawl over to some solid piece of furniture, pull themselves up to a kneeling position, and, if possible, from kneeling to standing.

The "up" leg is usually the position of strength or power. For this reason, as we work on this as an exercise, remember to alternate both legs to the up position. In fact, if you find it much easier to get up from one leg versus the other, do more repetitions from the weak leg in order to strengthen the body's core!
 
Let's Do This Thing!
 
  1. Sit upright on the edge of a solid chair, ie a kitchen or dining room chair - no wheels!
  2. Rotate your torso and pelvis as a unit, 45 degrees to the left.
  3. Slowly lower your right knee to the floor until it touches. Keep your torso and pelvis stiff.
  4. Once your knee touches the floor, drive through your left heel to bring your torso and pelvis (still stiff) back up to the chair.
  5. Repeat on the opposite side.
  6. Start out with five to each side and work your way up to ten to each side once per day.
Tips and Pointers
  • It may be helpful to use a chair with arms and/or position yourself next to a wall or solid piece of furniture, like a table, for extra points of contact, if necessary.
  • Placing your palm (on the same side of your "up leg") on your thigh and applying a downward pressure can help stabilize you when pushing back up (if turned to the left, the left palm goes on the left thigh).
  • A little stiffness, awkwardness and even slight pain is normal. Sharp, stabbing pain or almost falling is not acceptable!
     

​Take It Up a Notch

 
If you find the "slide off the chair" version of this exercise to be really easy, let's step it up a bit to give you more of a challenge!
  1. Kneel with your right shoulder parallel to a wall, right knee down.
  2. Lightly touch the wall with your right hand and place your left palm on your left thigh.
  3. Drive through your left heel until you are standing (use your right hand for balance and your left hand for extra push if needed).
  4. Lower yourself back to the starting position the same way you came - slow and deliberate, with a stiff torso, and using the wall and thigh for balance and support as needed.
  5. Repeat five times, then turn around and use the opposite leg.
Your ultimate goal would be to use no additional support (wall and thigh) and move through the full range of motion with a stiff and solid upright torso and in a slow, deliberate fashion.
 

 
Remember... If you want the stick, you have to get off the couch!


Combine the chair exercise, wall exercise and kneeling exercise to really begin dialing in the framework of a solid foundation for getting off the ground!

Next post, we will go a little farther down to the basement!

Yours in Health,

Doug Williams D.C
Care Chiropractic 
Lafayette, Indiana
By Dr. Doug Williams
September 20, 2016
Category: Healthy Aging
Tags: Healthy Aging   Mobility   Stability  

Going Up to Get Down

As you probably already know, this month, we are working on how to improve your ability to get up and down off the floor without using any help, or at least as little help as possible.

The first article in this series discussed a cool study that showed that your ability to get up and down off the floor with as little help as possible was directly related to how long you were going to live! The second week, we learned how to start training some of the muscles that will help propel you up off the ground by looking at the mechanics of a "chair squat." Last week, we slowed the whole process down in order to isolate and work on weak spots.

However, before you can really go down to the ground  we need to work on how to go upstairs first!

Have you ever tried to move a dog that was crashed out on a bed or the floor? How about trying to lift up a toddler who fell asleep on the couch? Do you ever wonder why it is so hard to move someone who is totally relaxed? In a word: TONE.

Consider this example: Let's say, one of your friends sat down in a bean bag chair and asks you for a hand pulling them up and out of the chair. How hard is it to help them if all they do is grasp your hand and you both pull? Pretty hard, huh? Now, try it again with your friend not only grasping your hand, but stiffening their whole body, especially their mid section. How hard is it now? Much easier right?

A firm structure is one with tone and it allows for an efficient transfer of energy, whether or not the force acting on the structure is from the outside (you helping your friend up) or the inside (you helping yourself up off the floor).

It is the difference between trying to nail a box of jello to the wall and nailing actual jello to the wall!

One of the unique things about muscles that are responsible for maintaining tone in your body is that they do not necessarily require a large load for them to get stronger and more efficient. They actually, more often, require a lighter load! That makes muscle training less like straining and more like activating.

Think of it like this: sitting and inactivity tend to shut off the muscles that maintain tone in your body - taking them offline, if you will. Turning them back on with a low load, but frequently throughout the day, can help to increase the firmness of your torso and make it easier for you to get off the floor and move about!
 

Try not to be distracted by the famous person in the picture to the right. Instead, let's focus on breaking down the simple exercise he is doing that can activate the tone muscles of the body.

  1. Start with your butt and head against the wall, and feet shoulder-width apart and 10 inches from the base of the wall.

  2. Keep your feet flat, stiffen your body like a board (tighten your glutes) and push your pelvis forward. This will cause your body to rise off the wall until only your head is touching (shoulders should also be off the wall).

  3. Hold for a slow count of 30-60 seconds.

  4. Repeat 10 times per day!

Start to combine last week's exercises with this week's exercise and you will really be on your way! Next post, we will finally start moving our way down to the ground. Stay tuned and remember: consistency over time is the way to go!

Doug Williams, D.C.
Care Chiropractic
Lafayette, Indiana

By Dr. Doug Williams
September 13, 2016
Category: Healthy Aging

I Feel the Need for Speed

If you are just joining us, we are in the middle of a blog series about living longer through having a stronger butt. Though that may sound kind of weird, there really is science to back it up! In week one, we referenced a study that showed your ability to go from standing to sitting down on the floor and back up again with the least amount of touches or support could predict your likelihood of death. More importantly, it showed that improving your ability by just a small amount could pay big dividends on reducing your mortality risk. Last week, we started breaking down the process of strengthening your butt, back and hips by changing how you get out of a chair. You can read that post here.

If you have been getting out of the chair by:

  1. Sliding to the edge of the chair and pressing your heels into the floor,
  2. Standing straight up from the hips, keeping your back straight and pushing your behind forward and up,
  3. Tightening your glutes and squeezing your shoulder blades together when you get to the top,
  4. And sitting down the same way, weight through the heels, back straight...
Good Job!


If you have been doing this intentionally and consistently, you may be getting bored and feel like Maverick: "Doc! I feel the need for speed!"

There is an adage in sports training and rehabilitation: "Speed Hides Need." If you really want to see where someone is having trouble with movement, you slow them down! Our brains are very interesting things: once you have a target in mind - mental, emotional or physical - it will pretty much do anything it has to in order to achieve that goal. Sometimes that is good, like in cases of emergency or danger. However, if you are constantly "cheating" to achieve a movement multiple times in a day, not only are you reinforcing abnormal movement, but you are accumulating damage along the way! Slowly but surely, your brain figures out that you can't be trusted with the movement so it starts to take it away from you. Over time, you can no longer get up and down without moaning and groaning, let alone get off the floor!

So let's try the chair exercise again, only a little different:

  1. Slide to the edge of the chair and press your heels into the floor.
  2. Stand straight up from the hips, keeping your back straight, pushing your behind forward and up, while slowly counting to four, reaching the top at the four count.
  3. At the very end, tighten your glutes and squeeze your shoulder blades together, while slowly counting to four.
  4. Sit down the same way you came up, weight through the heels, back straight, while slowly counting to four hitting the bottom of the chair at the end of the count.

How did that feel? Was it harder? Did you find some places that were more difficult to control? Most of us never realize that we are not fully engaging our muscles through a given range of motion, we just get things done through momentum and work around! Slowing a movement down will bring out shortcomings quickly!

Now What?

Let's use this information to add another layer of mobility and stability to your butt.

If you have been working this exercise from an average size kitchen chair and found it harder when you slowed down to initiate movement and travel the first six inches up, and at about six inches away from the seat on the return trip, you just sort of fell onto the chair, that is very common!

Review and pick one of the two options below:

1. If you could complete the whole motion, but found it difficult (you didn't have to swing yourself out of the chair or just plop down at the end), do the following:

  • Get out of the chair and travel up until you feel it get easier, then, rather than continue to the top, start to lower yourself down. Time this out taking four seconds to get up and four seconds to get down. Remember, you are not going to the top of the movement!
  • Repeat five times and, on the last one, go all the way to the top and back down like normal. You don't need to do this every time you get up and down out of a chair, but try to do it at least two to three times per day.

2. If you could not complete the whole motion without modification (you had to swing yourself of the chair, use arm supports or plop down at the end), try one of the following exercise modifications:

  • Follow the instructions listed above, but use a chair that has arm rests. Gradually over time, rely less and less on the use of your arms until you can execute the movement without using your arms at all.
  • Move to a higher surface: A bed is often times higher than most chairs, as is the arm of a couch (be careful not to fall backwards!). Do the four-second count portion, but start a little higher than a kitchen chair. Once you have mastered the higher surface, start over again on the lower surface and go through the steps listed under option one.

Start working on this and, before you know it, you are going to see a noticeable difference in both your flexibility and stability (strength).

Don't worry, I haven't forgotten about our ultimate goal of being able to get up off the floor with the least amount of touches, but sometimes you have to go backwards before you can progress!

Until next time,

Dr. Doug Williams
Care Chiropractic
Lafayette, Indiana