by Karen Hailson Bouvier | Photo by Mary Carpenter
Issue: August 2022
According to the World Health Organization (WHO), a longer life brings with it opportunities, not only for older people and their families, but also for society. Additional years provide the chance to pursue new activities such as further education, a new business or career, or a long-neglected passion. Older people also contribute their time, energy, experience, and other resources to their families and communities. Yet the extent of these opportunities and contributions a person can experience as they age depends heavily on one Elizabeth Pearl factor: health.
How to maintain health as one ages and make the best of life, was the focus of a recent conversation I had with Elizabeth Pearl, MPT, owner of Pearl Physical Therapy in Plattsburgh.
“If you come into the aging process with good healthy habits,” said Pearl, “You come in with a healthy state of mind and body. When we are of sound mind and body — no matter how old we are — we can do amazing things, and the world needs more people doing amazing things.”
Describing physical therapy as “biomechanical analysis”, Pearl said she focuses on her clients’ alignment, that is, their posture, gait and other factors that influence the positions of their bodies. Physical therapy teaches a person how to recognize dysfunctional patterns and “level out” their body. In the case of aging, as with serious athletes, it is important to prepare the body for certain activities. Using her own athletic background, Pearl observed, “I model the care I do on what the pros do. I show clients how to prep the body and mind.”
Following are excerpts from my Q&A with Elizabeth Pearl.
SB: What are the most common physical issues as we age?
EP: Low back, hip, knee, and shoulder pain are common things we see clinically as people age. Overall general weakness and debility are also common.
SB: What are the best types of exercise for adults?
EP: The kind they like! If they choose something they like to do, it will increase compliance with routine exercise. If someone loves dancing, that is the best exercise for them. If it’s swimming, then that’s the best exercise. A combination of movements and activities that elevate the heart rate, put a healthy resistive strain on the muscles and elongates them is the best exercise. I like to see folks join in exercise classes as it’s a great social outlet. This is important for people as they age because they don’t always have the social opportunities and outlets that they need for optimal health.
SB: What kinds of equipment should someone have on hand?
EP: A good pair of sneakers and hand weights (2# -8# dumbbells).
SB: Are heating pads and ice packs helpful? Should one have them on hand?
EP: Always – heat increases superficial tissue temperature which can help a sore or tight muscle feel better. Ice constricts the vessels and can help with pain and acute swelling from straining muscles and ligaments. I’m a big fan of over-the-counter plant-based natural topical analgesics (pain relievers) that people can use at home for aches and pains. They help alleviate excessive tension in tissue which can cause pain and negatively affect one’s comfort and function.
SB: What kinds of clothing is optimal, especially footwear?
EP: Wearing sneakers that fit well for the activity you’re doing is key. Most people over 65 are not runners, yet most sneakers worn are built for runners. Court sneakers are good for people who play pickleball and other court sports, but are not great for a walk in the woods on variable surfaces. All sneakers are not great for every person. Knowing what your foot needs (more stability, more cushion) is important to the biomechanics of our foot and ankle. Loose clothing that is comfortable with movement is a good idea.
SB: Any tips for bone health?
EP: Weight bearing and resistive weight training, postural exercises to open up the front of the chest and shoulders. When the body ages into a flexed and rounded posture, it tightens the muscles we use to breathe, making that more difficult – more prone to respiratory challenges.
SB: What issues are preventable/treatable? How?
EP: Most conditions and diseases are preventable – it really depends on how we care for our minds and bodies. The food we eat can be medicine or toxic to the body. A build-up of a high fat, high cholesterol unbalanced diet can affect the body in ways most of us don’t realize. The saying “junk in, junk out” is
true with how our body processes food as potential nutrient/fuel for optimal bodily function. Those that live a sedentary lifestyle will develop more stiffness, weakness, cardiovascular, and endurance deficits versus the individual who engages in daily purposeful activity as well as exercise.
SB: How important is stretching? How often, what kind, how long, and what areas of the body?
EP: The flexibility/length of a muscle is as important as the strength of the muscle. If a muscle is strong, but does not have the extensibility to move through normal range of motion – it’s only strong in a shortened movement pattern. Muscles that get tight as we get older are in the hips, hip and thigh muscles (flexors and hip rotators, hamstrings, quadriceps) as well as the pectoralis or upper chest muscles. For best results, hold the position for at least 30 seconds and repeat the stretch three times.
SB: How do other forms of exercise (weight bearing and cardio) fit into a person’s regimen of care?
EP: Just like a balanced diet, having a balanced exercise routine is key to giving the body what it needs. Engaging in cardiovascular exercise (brisk walking, jogging, hills, biking, swimming, hiking, cross country skiing), strength and mobility/flexibility training as well as routine meditation lays the foundation for a strong and healthy body. Variety in exercise routine is great for the body as it utilizes different muscle groups.
SB: How often should someone stretch/exercise? Should they rotate activities?
EP: The American Academy of Sports Medicine and the CDC recommends moderate intensity aerobic physical activity for a minimum of 30 minutes five days/week or more vigorous activity 20 minutes 3 days/week. Having a variety of exercises such as brisk walking three days a week and participating in
an exercise class two to three days per week that incorporates resistive and/or body weight training would be a good place to start.
SB: What is one thing you would suggest that someone would find surprising?
EP: Our bodies are more resilient than most people give them credit for. If the brain and nerves are intact and the joint is not fused – the body can learn to do new things – be stronger, move better, feel better. If people don’t like the way they feel and move, they need to do things differently to have a different experience. Often times, that’s where working with a physical therapist is helpful as PTs can evaluate a person’s whole body and make recommendations for modifications to routines that can help turn the needle in the direction of better health.
Elizabeth Pearl, MPT
Pearl Physical Therapy
135 S. Peru Street
Plattsburgh, NY 12901
SITTING IS THE NEW SMOKING:
Making Improved Wellness Your Job
In New York state, individuals with health insurance have direct access to physical therapy treatment without a referral from their physician – except for those injured in a work-related or motor vehicle accident as well as clients with Medicare (where a physician’s referral is required).
Studies have shown that direct access to physical therapists gives patients a faster, affordable, and effective entry point into the health care system. Delays in care result in higher costs, decreased functional outcomes, and frustration to patients seeking physical therapy treatment. Eliminating the referral mandate results in timely, and thus more effective, physical therapists’ services.
As of January 2002, all physical therapy programs are required to be accredited at the master’s level receive extensive education and clinical training in the examination, evaluation, diagnosis, prognosis, and intervention of patient/clients with functional limitations, impairments and disabilities. This means that physical therapists are qualified to recognize when a patient presents with signs and symptoms inconsistent or outside their scope and expertise and when the patient should be referred to a primary care provider.
In addition to annual visits to a physical therapist, Elizabeth Pearl made the following suggestions for aging gracefully:
• Look in a full-length mirror. Notice your posture, body shape, and how you hold yourself.
• Go to a class that enhances movement.
• Find something you like to do and do it every day. Choose patterns and habits that are different from what you’re used to.
• Use a fitness tracker, such as Apple Watch, to count your steps, monitor your heart, and keep accounts of sleep patterns.
• Investigate the programs at your local recreation departments.
• Find something to be grateful for; give service to others.
• An exercise bike, such as Peloton, comes with a membership to an online fitness community.
The internet is well stocked with fitness videos, blogs, and information.
Check it out.
See the PBS fitness show, Classical Stretch, by Miranda Esmonde-White, a Canadian fitness trainer, former ballerina with the National Ballet of Canada, and The New York Times bestselling author of books on aging, health and fitness. She created the dynamic stretching and strengthening workout, Essentrics on which Classical Stretch is based. Her study of the benefits of stretch training has also been the basis of the pledge documentaries Aging Backwards and Forever Painless on PBS.