EXERCISE FORW W W . A D V A N C E D P H Y S I O . C O M . A U ( 0 2 ) 4 9 5 4 5 3 3 0  

WOMEN OVER 55

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Julie, one of our regular clients told us.

“A month ago, just after turning 55 I felt a pain in my shoulder whilsthitting a boxing mitt in my personal training class. The same week,mid-cobra in my yoga class I knew if I pushed the pose any furtherthat my back was going to go as well. I realised that in spite of all ofthe fitness work I had done over the years my body was no longercoping with the beating I was giving it. I know fitness is important,but maybe my Physio was right that the benefits of certain highintensity exercise were not worth the risk.”

Julie’s story is typical of many women her age. Changesin body composition, bones, muscles, joints and tendonsmake the body more susceptible to injury as we age.Exercise is critical for the health of women over 55,however they need to adopt an approach suitable forthem.

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What happens to the bodyas we age?

There are many changes after the age of 55. Muscles are stiff and weaker. Thecartilage which protects your bone in the joints (articular cartilage) loses elasticity andstrength and bone density diminishes (more about this in the next section). Tendonsdegenerate.

Musculoskeletal function

Skeletal bone mass and strength in women declines progressively and slowly in the yearsprior to menopause then declines more rapidly with the decline in oestrogen levels. Thisdecline in bone mass accounts for the high rates of bone fractures experienced by olderpeople especially women.

Bone Density

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According to the American College of Sports Medicine, cardiovascular fitness declines 5-15% per decade after age 25. It translates into how well you can cope with exercises whichhave a high cardiovascular demand such as brisk walking, swimming, and cycling. Thedecline is due to the heart being incapable of beating as fast, combined with a reducedblood volume being pumped through the heart.

Cardiovascular fitness

Declines with age as the number of cells in the brain and spinal cord decline, as do thespeed and efficiency which nerves communicate. This causes slower reflexes, co-ordination and strength. Exercise has been shown to improve reaction times, co-ordinationand muscle strength (which is partly neurological). Cognitive or intellectual function lossand mood changes including depression are more common as we age, partly due tochanges in brain nerve function.

Neurological function

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Aging is associated with changes in totaland regional fat distribution that havenegative health consequences. It isgenerally associated with increases inabdominal adiposity and fat deposition inskeletal muscle and cardiac muscle, liverand bone marrow, until extreme old agewhen fat mass may decrease.

Body fat (Adiposity)

Importantly your body weight may not bechanging but due to age related changes inskeletal muscle mass (which declines), youmay be getting fatter while your weight staysthe same.

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In some individuals there is a limited ability for thebody to develop adequate tissue mass to storelipids (fat), particularly in the lower body. In otherwords, some people cannot store excess fat underthe skin. This is seen in small hip circumferenceseen in some people. Think of the person with alarge tummy but skinny legs and bottom. As there is an insufficient reservoir of tissue tostore fat under the skin, the body redirects it to theorgans, such as liver, heart, skeletal muscle,tendons and other areas. There are several serioushealth consequences with this including, pain,insulin resistance, adverse lipid and cholesterolblood concentrations and even reduced lifespan. Body fat and exercise are closely related. In pre-and post-menopausal women, the amount ofabdominal fat correlates with the amount ofexercise undertaken. More exercise = lessabdominal fat. Age and menopause have no effecton this.

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Why Exercise?

Exercise will have a positive effect onall of these systems provided it is ofthe right type and dosage. TheAmerican Family Physician (2010)suggests that you need to average 20-30 minutes of moderate to vigorousaerobic activity per day, plus musclestrengthening exercises at least twiceper week. This can be challenging aswe age due to lowered physicalcapacity and injury risk. A review in 2003 British MedicalJournal concluded that activities likerunning and weightlifting can increasebone density.

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Another study demonstrated that Pilatesadministered for 6 months 3 times perweek was effective for significantimprovement of bone density in the lowback and upper thigh bone (femur) in post-menopausal women. In another publication American familyphysician reported that physically activepeople have a lower risk of depression andcognitive decline in active adults. Low-impact activities like swimming andyoga do not help strengthen bones. Long-term adherence to exercise is crucialto the effectiveness of exercise on bonemineral density and should be adoptedalong with other lifestyle measures such asadequate calcium intake, ceasing smoking,modest alcohol consumption andmaintaining an adequate body weight.

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So, what are thebest choices forexercise for womenover 55 year of age?

It is hard to generalise however we have tried toanswer this with the following tables whichcompares common forms of exercise, their benefitsto different systems such as muscle strength andco-ordination, and an estimate of their injury risk. This guide is an approximation. “Boot camp” couldmean anything, but is widely known to involve highintensity “military style” training. Different yogaclasses will have different emphases and intensity.Pilates classes vary between instructors andstudios.

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ReformerPilates Running Brisk

WalkingBootcamp Weights Yoga Swimming CyclingPilates

Bone density + + ++++++ +++ ++ +

Muscle strength + + +++++ +++ ++ ++

Flexibility ++ + ++++ + ++++ +

Cardiovascularfitness + ++ +++++++ + ++++ +++

Body fat % ++ ++ ++++++++ ++ +++ ++

Posture +++ + +++++ + +++ +

Co-ordination ++ + +++++ + +++ +

Injury risk + + ++++++ ++ +++ +

ReformerPilates Running Brisk

WalkingBootcamp Weights Yoga Swimming CyclingPilates

Table 1 Comparing the benefits of different exercise types on different systems

Table 2 Comparing the injury risk of different exercise types.

POOR INTERMEDIATE BEST

LOW INTERMEDIATE HIGH INJURY RISK

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What is ideal for you? Ideally, we arelooking for low risk/high rewardexercise or mix of exercises, so thisprobably takes out running,bootcamp, heavy weights and someforms of yoga. Walking has a fairly low injury riskbut has a low reward, it does little forbone density and muscle strength,and does not get the heart beatingrapidly enough to improvecardiovascular fitness. Running canbe ok if you have excellentbodyweight and good biomechanicseven into old age. Weight training needs anunderstanding of technique, volume,rest intervals, and recovery andneeds to be customised according toyour goals and exercise experience.

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We feel that Reformer Pilates, some forms of weight training, swimming and cycling are the bestoptions. Pilates with its mix of western type resistance training and eastern mind/body awareness is anexcellent way to get supple, strong and lose weight. Reformer Pilates utilises equipment andprovides a safer and better way to exercise compared with “matt style” Pilates.

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Final Tips

Doing a variety of things challengesour various systems in optimalways, and adds important variety tothe routine. Exercising with a qualifiedinstructor in a group environmentadds safety and can motivate you.  Getting professional advice if youget aches and pains, and havingthe health professional (usually aPhysio or Exercise Physiologist)involved in your exercise planningenhances the safety andeffectiveness of your program.

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Our client Julie followedthis advice. She took upindoor cycling, mixed it inwith some brisk walkingand joined a reformerPilates class twice perweek. Her comments aretypical. “By the end of the thirdPilates class I felt strongand long and felt as thoughI’d used my brain to controlmy body, not just my will tosurvive an hour ofexercise. This holisticapproach very quicklyimproved my posturewithout aggravating oldinjuries.”

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More about Pilates

Pilates was created by Josef Pilates in the 1920s and was originally a method practiced in dancers.Health professionals, especially Physiotherapists and Exercise Physiologists have long recognisedthe benefits of incorporating therapeutic exercise into their prevention and management of pain andmany have adopted Pilates exercise for management of many conditions.

The majority of clinical trials support the use of Pilates as an effective and safe rehabilitationtool. A recent randomized controlled trial compared Pilates to trunk strengthening and foundfavourable results. In the 101 subjects tested, Pilates was superior to a traditional trunkstrengthening program in reducing disability and improving quality of life. Theseimprovements were still seen 3 months after the study ended. There have been numerousstudies looking at Pilates’ effect on low back pain and balance in older adults. These showthat Pilates is either superior to or as good as a traditional exercise program.

THE EVIDENCE BEHIND PILATES

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Our Pilates Classes

At Advanced Physiotherapy, we are very excited tointroduce our Reformer Pilates classes. Under thecareful guidance of our therapists, you will be ableto utilise cutting edge Pilates equipment. For those who have not utilised Pilates equipmentbefore, they are versatile machines which work ona spring system. By changing the amount of loadedsprings, you can make exercises harder and easier.The exercises are performed in various positionssuch as lying, kneeling, sitting and standing. Thething we love most about Pilates equipment is thatit is suitable for everyone, from the elderlypopulation to the elite athlete!

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We have formulated our Pilates classes on current bestpractice guidelines. In the Pilates classes, your programwill be centred on you, with your goals and aspirations atthe forefront. We will teach you to appreciate your bodysystem and build awareness towards specific muscles. Our Pilates program can help you:

Ensure activation of the correct stabilising muscles

Improve your posture

Increase strength, power and endurance of yourmuscles

Improve mobility and flexibility

Prevent injury through increased muscle control

Improve balance and coordination

Relieve pain for some conditions

Lose weight

The Assessment Process

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Undertake a thorough history

Before entering into the Pilates classes, you maywish to have a one-on-one assessment with oneof our health professionals in order to:

This is recommended but not compulsory if youdon’t have any major problems and are currentlyexercising regularly.

Assess your body’s mechanics

Assess past injury

Screen for future injury risk

Are our classes suitable for you? These classes are most suitable if you are:

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Female

Between 50 -70 years of age

Able to attend 2 or more classes per week

Enjoy exercising in a relaxing small groupenvironment

Wanting to strengthen, improve your postureand keep or maintain a healthy weight

Wanting to compliment other forms of exercisesuch as walking, cycling or swimming with a safestrengthening routine

These classes are not designed for:

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Those who want noisy classes with high-intensity instructors People with certain medical conditions (this will be screened at your first session) Those who only want to attend occasionally or for a short time

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See what our clients say

“Nicole is a brilliant teacher. Friendly and comfortable atmosphere”By Sian 22/10/19

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Checkout some of our other reviews.

Excellent once again some new movesintended to challenge us. Great

session, thanks Nicole.

Enjoyed the class by Emma thismorning. Lots of variety. Like the way

the class started on the reformersthen switched to stations

Wendy McDonald

Excellent session Nicole is verypatient and knows her stuff, it's

always challenging and the benefitsbecome obvious with time.

Fantastic, can’t wait to go again.

2nd visit. I'm really enjoying it andNicole is lovely

Loved this class.

Great class last night, thanks

Nicole introduced a new movementnone of us had done before that was

quite a challenge. Always pushing thebars, good one Nicole.

Loving these classes. Nicole is awonderful instructor, she explains andprompts on each exercise to ensure i

get the most out of every session.Always given positive feedback. Im

extremely happy

I always enjoy Jessica’sclasses, always challenging however I

feel supported to keep trying.

Enjoyed the class by Emma thismorning. Lots of variety. Like the way

the class started on the reformersthen switched to stations

Classes with Nicole are always wellconsidered and varied. Loved this

workout tonight

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I F Y O U W A N T T O T E S T O U RC L A S S E S , P L E A S E C H E C K

O U T T H E W E B S I T E F O RS P E C I A L O F F E R S .

www.advancedphysio.com.au

02 4954 5330 

Unit 2 Building 2, 335 Hillsborough Rd,Warners Bay NSW, 2282

https://www.newcastle-physiotherapy.com.au/Pilates/Pilates-1505/

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Simply follow this link to register for these classes:

02 4954 5330