Aging, Fitness and Flexibility

van Damme Volvo Splits

Two of the biggest physical issues we face as we age are:

  1. Loss of strength and power (1,2)
  2. Loss of mobility and flexibility (3)

For most people, exercise is a means to improve and maintain their health and well-being (including aesthetic goals).

So it makes absolute sense to focus on preventing or minimising the loss of these physical qualities as much as possible, in order to maximise health and well-being for as long as possible.

One of the best things about the rise in popularity of Crossfit and functional training is the emphasis on explosive movements to develop power.

However, despite this increased popularity, it is still rare to see people in gyms, fitness groups and sports clubs (martial artists and dancers excepted) doing any dedicated and meaningful flexibility work (a couple of quick toe touches before a workout don’t count).

I think this stems from a few different reasons:

  • Flexibility work is hard to monetise (there is no equipment to sell for example, outside of maybe a mat and a strap).
  • Stretching well takes time – people have been sold on 30 minute fitness, which is great, I love short sessions, but not at the expense of what you need.
  • Most people don’t know how to stretch well, so they don’t feel any lasting benefits from doing it and give up.
  • Misinterpretation of the research surround stretching, especially around pre-exercise stretching and force production which has seen a preference for dynamic mobility over more traditional flexibility work.

Use It Or Lose It

Almost everyone will agree that “prevention is better than cure”, and this is especially true with flexibility training.

Like every physical quality, flexibility exists on a “use it or lose it basis”, so if you live a modern life like I do (lots of sitting, very little physically taxing work outside of exercise), then it is very easy to lose.

To combat this, it is essential to work on your flexibility pro-actively.

Optimal Vs Reality

Understanding what is optimal for physical health and fitness, and what can be realistically achieved by someone for whom fitness is a small component of their life is quite important.

For the person who exercises because they have to in order to maintain their health, but they don’t necessarily derive any pleasure from it, the minimal effective dose for flexibility is all that is needed.

This person can regain flexibility by stretching (4), can then maintain it with almost any activity that requires range of motion – for example, a gym based exercise program or tai chi practice.

Additionally, if they make an effort to squat, bend, reach and generally move more in day to day life, then maintenance is that much easier.

Fitness Enthusiasts

For people who spend a lot of time and energy into improving their physical fitness, a specific focus on stretching will be beneficial.

This can take place as part of the warm up, cool down or separate session, as there a pros and cons to each.

For the fitness enthusiast, recreational or even professional athlete, a prime focus on flexibility and it’s associated qualities – motor control and joint stability – is even more important, due to the high loads placed on the body consistently from training and competition.

I believe that stretching is the only physical quality that in relation to it’s training, the saying ‘more is better applies. – physical preparation coach Ian King, whom I have mentioned on this blog previously. (5)

Again, this is a contentious area, as most research doesn’t show a cause-effect relationship when it comes to stretching and injury prevention, but there are many contributing factors, of which flexibility is just one.

Conclusions

You don’t need to turn yourself into Jean Claude van Damme (pictured above at age 53 in a Volvo commercial), but you do need enough flexibility to reach up overhead comfortably, bend down without strain and essentially move without restriction doing the things you do in your day to day life.

If you don’t lead a physically active life, then it is more important to increase your activity – even if you don’t exercise – than worry about specific stretching.

Once you are active, a focus on stretching can really complement whatever it is you are doing.

 

This post is a re-worked version of my May 2016 newsletter. You can sign up below to receive all future editions, plus my upcoming (and FREE) guide to stretching.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 



 

References

(1) Strength and muscle loss with aging process

(2) Age associated loss of upper extremity strength and power

(3) Flexibility of older adults and the influence of physical activity

(4) Purely my opinion, eccentric exercises can also be very helpful.

(5) King, I., Legacy – Ian King’s training innovations, King Sports International

Pain and Personal Responsibility

The Mind Is Key

When it comes to persistent/chronic pain, taking responsibility for your thoughts, emotions and actions is paramount to achieving any semblance of a normal life.

If you’ve ever experienced any intense or lasting pain, there’s a big chance you’ve said to yourself at least once “I don’t deserve this”.

Unfortunately, the world is not a fair place, and bad things happen to good people, but, viewing yourself as a victim of pain helps no one, least of all yourself.

This post isn’t about blaming your (or anyone for your pain), but rather to encourage you to take responsibility for the things you can control, in order to give yourself the best possible chance of living a fulfilling and meaningful life.

Is It Your Fault You Are In Pain?

The most commonly accepted model of pain is Melzack’s “neuromatrix model” (1). This model says that pain is an output of the brain, based on multiple sensory inputs, including:

  • Cognitive: memories, attention, meaning and anxiety
  • Sensory: inputs from skin, musculoskeletal tissues and the viscera (organs)
  • Emotive: inputs from the limb system

With this in mind, it is fair to say that any time you experience pain, you probably aren’t at fault based on anything you were consciously aware you were doing, because so much of the pain experience is generated unconsciously.

It is also fair to say that you can influence your pain based on what you think and do when you experience it.

So, to answer the question, in general, the answer is no, it’s not your fault you’re in pain.

However, as always, there are a few exceptions:

  • Acute pain is your fault if it stems from an injury that occurred because you did something stupid – think alcohol related injuries or playing a game of pick-up football knowing you haven’t been active in years.
  • Gradual onset pain stemming from overuse type injury (work, exercise etc) is very preventable with appropriate workload management.
  • Acute, non-specific pain is often the result of psycho-emotional components, more so than any tissue trauma, thus if you constantly put yourself in stressful situations and don’t know how to manage your thoughts and emotions, then you are probably playing a big role in your pain.

No One Can “Fix” You

One of the biggest examples of not taking personal responsibility for your pain, is the misguided notion that someone, or something, will fix you.

There is a growing body of research demonstrating that people with the highest expectations about making a recovery from pain do so. (2)

Combined with the large (and growing) body of research that suggests passive approaches to managing chronic pain aren’t very effective, it is obvious to see that there is a big role for you to play in your own recovery.

This doesn’t mean more passive therapies are useless. It just means the appropriate context has to be set.

What we can boil this down to is as follows: if you can find a knowledgeable practitioner that your like and connect with on some level, who inspires confidence in your ability to recover and gets you involved in the process, then you probably will.

Now, before you think that you have found and done all of that and you’re still in pain, it’s important to define “recovery”.

Defining Recovery

Most of the data on chronic pain comes from specialist chronic pain clinics. These are often public funded and run in, or in association with hospitals. They are typically “end of the line” treatments for people who have not responded to any other form of pain management.

The results these clinics achieve are “fair” when taken objectively, often decreasing a persons self-rated pain by a couple of points on a 10 point scale.

But, when we take into account that nothing has worked before, this improvement is quite impressive.

Additionally, when people are asked to rate their quality of life, measuring things like anxiety, depression and fear of the future, things are generally even more positive.

This gives us good insight into what is realistic for chronic pain sufferers.

If “end of the line” sufferers can improve this much, then good management earlier in the timeline can theoretically achieve even better results.

One of the biggest differences between those who succeed in managing their pain and those who don’t, is that they take action despite their pain.

Don’t Wait For Your Pain to Get Better to Start Living Well

In personal finance circles, there is a lot of talk about developing the habit of saving money, no matter your income.

That is, if you are on the minimum wage, and can only afford to save a few dollars each week, it is still important to do so, even though the amount across a year might not be very much, the habit developed carries on with you throughout life, as you (hopefully) increase your income.

A similar approach can be taken when you are in pain.

Instead of thinking “when I feel better, I can finally do x”, try shifting your mindset to “how can I find a way to do x, despite my pain”.

Now this is often easier said than done, but a good practitioner will be able to guide you through the process. Many times the limitations are self imposed, and a graded exposure approach can work wonders.

What Can You Do About Your Pain?

  • Accept your circumstances, rather than looking for someone or something to blame.
  • Seek out an excellent health practitioner to work alongside you and help build a team around you.
    • Don’t be afraid of medications. Used appropriately, they can be life changing. It goes without saying that you should talk to your doctor before starting or stopping any medications for your pain.
    • Consider working with a psychologist who specialises in chronic pain, in Australia there is an excellent Medicare rebate for psychology – discuss it with your doctor.
  • Outline functional based goals, rather than pain based goals. For example, saying “I’d like to walk my dog for 45 minutes” as opposed to saying “I’d like to walk completely pain free”.
  • Focus on processes, rather than outcomes. Processes are the things you do, outcomes happen based on what you do, but they are always variable (because of factors beyond your control).
  • Start small and build up slowly. 
  • Don’t “let pain be your guide”. Chronic pain is an unreliable guide of what to do or not do. Some days or weeks are worse than others. The challenge is to persist through the bad weeks as much as you can, and enjoy the good weeks without being fearful.
  • Stay positive. I know this can sound like throaway type advice, but there is evidence to suggest that if you can get through your pain, your brain returns to normal – the changes associated with pain are not permanent! (3)

Conclusions

It can seem like an impossible journey at times, and a completely isolating one, but you are definitely not alone.

People have gone before you and conquered pain. Others going on to live full lives despite their pain. Both, in no small part, due to their determination to make their lives better.

This doesn’t mean that you can will yourself better, but it does mean that there is hope.

There are dedicate professionals out there who study hard and work even harder to help people in pain live better lives.

Sometimes you have to work to find them. Sometimes you have to travel to reach them.

But you must, you owe it to yourself, because, the right advice, the right words at the right time, the right actions in the right amount, can change your life.

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 



References

(1) Melzack and Katz, Pain

(2) Expectation and low back pain recovery

(3) Brain structure during and after pain