What you need to know about resistance trainingDR. KARL HUEBNER, DC, CSCS

Tell em’ what you’re gonna tell em’

Modern Aging Phenotypes Healthy Aging Phenotype Sick Aging Phenotype

Sarcopenia, Frailty The Metobolic Syndrome Polypharmacy

Exercise Medicine The Iron Prescription

Rational Strength Training Demonstrations Q&A

The Modern Aging Phenotypes What is a phenotype?

The observable traits of an organism as dictated by the genotype (genetics/blueprint), development, environment, and behavior.

The phenotype is to be distinguished from the genotype Identical Twins example

Identical Twins Example Very similar or even identical Genotype Very, very different Aging Phenotypes Twin #1: The Patient, 59 year old female

Morbid obesity, diabetic, hypertensive, end-stage congestive heart failure.

Twin #2: The Caregiver/ identical twin sister Mild hypertension but well controlled, lean, active, athletic, wonderful

example of Healthy Aging Looked 20 years younger than her sister

Two Ladies, same genotype, but tragically different phenotype What happened here???

Take-Away points:

Behavior plays a large and significant role in determining your phenotype (how you turn out).

Generally, Unhealthy Behavior can influence you phenotype more than your genotype.

We have the most control over our behavior than any other factor.

The Aging Phenotype

What We Cannot Control Bad luck Bad genetics Bad environment Unexpected illness or injury

Modifiable Behavioral Factors Healthy Diet Stress Management Emotional Management Physical Activity

The Modern Aging Phenotype Spectrum

The Healthy Aging Phenotype

Advances in: Nutrition Medicine Preventative Medicine Personal and Social Hygiene

Dental care, sanitary bathrooms No plague, small pox, dysentery, or famine So few infectious diseases, so many

comforts

Unlike our ancestors, we have more opportunity to achieve healthy aging than ever.

The Sick Aging Phenotype Made possible by abundance:

So many cheeseburgers and doughnuts at so low cost!

Over-utilization of Passive Care: A pill for this, an injection for that

Advances in transportation: Driving more, walking less Less manual labor

In our modern times, it is becoming clear that the population is skewing more and more toward the SICK end of the spectrum…

Sick Aging Phenotype Characteristics

Sarcopenia Loss of muscle mass (Type II muscle fibers)

Frailty ↓ Bone Mass, Bone Density ↓ Physical Capacity ↓ Independence

Metabolic Syndrome Obesity- Truncal and Vicseral Insulin Resistance Hypertension Systemic Inflammation

Polypharmacy and medical dependence Multiple medications Multiple medical interventions to sustain life

Sick Aging Phenotype: Development.

How does this Happen? Excessive positive energy balance

Too many Big Macs, not enough exercise Sarcopenia, weakness, exercise intolerance Altered Myokine signaling

Promote homeostasis, health, and vigor Obesity (Visceral fat in particular)

Pro-inflammatory Adipokines Promotes inflammation, tissue damage, storage of fat, decrease metabolism

Insulin Resistance Serious, widespread effects on growth, cellular repair, and gene expression Inability to control serum glucose levels Mimics a state of fasting or starvation Suppressed release of nitric oxide → regulation of blood vessel tone → Hypertension

HTN: “The Silent Killer”: Atherosclerosis, heart disease, stroke, etc.

The Downward SpiralDecreased

physical activity + Poor Diet

Obesity, ↑Visceral Fat,

Muscle Atrophy

↑ Inflammation, cellular

dysfunctionInsulin

resistance, sarcopenia

Diabetes, Stroke, Heart

Dz, Frailty

Pain, Degeneration

Positive feedback loop in a pathophysiological process: The process becomes self-reinforced and harder to stop.

How do we stop this?

Pharmaceuticals Very effective… at treating symptoms Cause side effects which are treated by more pills which cause more

side effects Another positive feedback loop

We need to treat the CAUSE… Physical Inactivity and Poor Diet!

Exercise Medicine The most powerful medicine in the world Potent effects against sarcopenia, frailty, and metabolic syndrome Prevents Osteopenia Prevents tendon and ligament atrophy/stiffness Improves myokine and adipokine profiles Improves cardiac function Slows the development of cardiovascular disease Fights Hypertension ↑ insulin sensitivity, ↓ visceral fat Preservation of brain function in aging Accumulating evidence of effects on Depression and Dementia

As close to a “fountain of youth” as we can get

Gets to the root cause of the Sick Aging Phenotype

Exercise Medicine: What It Wont Do

Shrink your bald spot Improve your eye sight Give you ripped abs Give you youthful skin Cure Cancer or other diseases Solve all your problems Make you Happy

“One cannot be MADE to be happy. One can only BE happy.”

Exercise Medicine

Be all that as it may, exercise CAN make us better, stronger, and healthier!

It is the most powerful medicine in the world This is not a novel observation We’ve known it since at least the days of Hippocrates

Which raises an important question… What is the correct prescription of exercise for the aging adult?

How do we Rx Exercise Medicine for the Aging Adult?

It should have the same requirements and rationale as any other prescription: No physician would say “just get some medicine” or write a

prescription for “antibiotics”. Exercise prescription should be no exception. Don’t just “get some exercise”.

Must be Safe Must allow for a broad range of Dosing

Must be Comprehensive Encompass a broad range of General Performance Atributes:

Strength, Power, Endurance, Mobility, Balance, Body Composition

Lower Dose As we get Healthier Higher Dose

The Exercise Rx

A proper prescription, whether exercise or pharmaceutical must specify: Formulation Dose Schedule Route of administration

Specific to exercise medicine: Type of exercise Training variables: Volume, Intensity, Set Design, Duration, Rest

Intervals, Recovery Duration

A Paradigm Shift

Goal: Drive targeted improvements in physical attributes over time to optimize their physical performance and body composition. This is not just “getting some exercise” This is not just “going to the gym” This is not just “a workout” This IS what we will call TRAINING.

Individuals who engage in training are athletes. Modify your identity: You ARE an ATHLETE! An athlete in the most brutal sport of them all:

Getting Older.

The Aging Athlete

The Aging Athlete may indeed be sick, frail, and weak BUT: With the Athlete’s mentality, these are not debilities, but rather

opponents who challenge him or her, against the clock, in the arena of life and time.

As long as you prepare to grapple with these opponents by training for that arena, You Are An ATHLETE!

The Importance of Effective GoalsIneffective Goals Vague Unclear Unrealistic Near-sighted Unsustainable Leads to “falling off the band wagon” Examples:

A sexier you! Lose 20lbs in 20 days! Detox you body in 2 weeks! Six-pack abs, skinny waist, nice butt!

Effective Goals Detailed Clear Realistic Long-term Sustainable Examples:

Become a stronger version of yourself Tracking performance/ adaptation Body composition change (NOT

weight loss) Lifestyle Modification

An Argument In Favor of Resistance Training

Resistance Training is more time-effective than cardio. Basal Metabolic Rate increases by 10% up to 90 minutes after cardio BMR increases by 67% for up to 72 hours after resistance training.

Burns more calories for a longer period of time Studies suggest that strength is a great predictor of longevity

Midlife Hand Grip Strength as a Predictor of Old Age Disability

6089 participants healthy men age 45-68. Maximum grip strength was assessed then reassessed 25 years later. 3218 survivors participated.

“Conclusions Among healthy 45- to 68-year-old men, hand grip strength was highly predictive of functional limitations and disability 25 years later. Good muscle strength in midlife may protect people from old age disability by providing a greater safety margin above the threshold of disability.”

An Argument In Favor of Resistance Training: Insulin Resistance/Sensitivity

Equipment to Avoid at the Gym

Smith Machine Will create dysfunctional muscle No Stabilization work

Equipment to Avoid at the Gym

Oblique Machine Creates a lot of rotation in the lumbar spine

Lumbar spine does not tolerate rotation very well

Remember: Core muscles aren’t strong because they create movement,they are strong because they resist movement!

Equipment to Avoid at the Gym

The Ab Machine Facilitates Hip Flexors Not heathy for your lumbar discs

Remember, YOU CAN’T “TARGET TRAIN”

Equipment to Avoid at the Gym

Hip Adductor/ Abductor Machine Facilitates the already overactive Adductor muscles

NO SUCH THING AS TARGET TRAINING!

Equipment to be CAREFUL of in the Gym

Back Extension (Misnomer) Good if: using glutes to achieve hip extension Bad if: using low back muscles to do back extension

Free Weight/ Body Weight Exercises are the Way To Go

3 Components to a good exercise: 1.) Range of Motion (ROM) 2.) Muscle Activation/ Crosses multiple joints 3.) Capacity for Load (Broad range of dosing)

The Neutral Spine Principle/ Hip Hinging/ Abdominal Bracing

Warm-Ups/ Dynamic Stretches/ Tri-Planar Hip Mobility

Warm-Ups/ Dynamic Stretches

Foam Roll

Demonstration

Core Dead Bug Bird Dog/ Cat Camel Plank/ Side Bridge with Reach-Through Chops/ Lifts with Cables

Demonstration

Lower Body Clam shell Glute Bridge Hamstring Curl Squat

Bodyweight/ Wall Squat Kettle Bell Goblet Squat Kettlebell Swing Barbell

Deadlift Kettlebell Barbell

Demonstration

Upper Body Bench Press (Chest)

Dumbbell/ Barbell Row (Back)

Straight-Arm Pull Down with Cable Seated Row with Cable Lat Pull (wide and narrow grip) Bent-over Row

Good Resources

Dr. Kelly Starrett (stretches, self treatment) Eric Cressey (especially for shoulder issues) Dr. Layne Norton (Form/ Nutrition) Dr. John Berardi (Nutrition)

QUESTIONS???

Cell: 715-451-1929Office: 920-360-5421Email: karlhuebner24@gmail.comWebsite: www.advancedalternativehealthcenter.com1700 Sand Acres DrSuite 5De Pere, WI54115