Disclaimer

Information contained within this book is not to be construed as medical guidance. Before beginning any exercise program, please consult your physician.

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INTRODUCTION TO THE

Impowerage Fitness Program

CONGRATULATIONS ON PURCHASING THE IMPOWERAGE Fitness Program specifically designed with the experienced population in mind.

“How old would you be if you didn’t know how old you were?” This is a favorite question of professional trainer and developer of this program, Susan Manning, and is profound and interesting. The essence of the question is “How old do you really feel?” It has been consistently shown that those who exercise on a regular basis feel healthier, happier, more energetic, and physically more youthful. With the help of this program you can combine the wisdom of your experience with a more youthful physical existence. What a formidable combination!

According to a 2000 study by the National Council of Aging (NCOA), nearly half of North Americans age 65 or older describe the present as the best years of their lives. A full 84% of those polled say they would be happy if they lived to be 90 years old. Maybe it takes the wisdom of age to realize there is no scientifically based reason to believe that we “become old” in our mid-sixties. If you stay active and healthy this can be a time in your life when you can stretch yourself and explore life to the fullest.

This fitness program was specially designed to add years to your life, improve your overall health, and give you the energy to truly pursue all of your hopes and dreams during retirement.

Here’s to great health, happiness, and fulfillment.

Dr. Carolyn Anderson M.D. FRCS

Safety First

CONGRATULATIONS ON TAKING THE FIRST step towards a fitter and healthier lifestyle.

Regular physical activity is fun and healthy and being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

In general, men over 40 and women over 50 new to exercise should check with their doctor before becoming more physically active.

Following are seven questions. Please read the questions carefully and answer each one honestly:

| Yes | No
1. | Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? |  |
2. | When you do physical activity do you feel any pain in your chest? |  |
3. | Are you currently taking any prescription drugs (for example, water pills) prescribed by your doctor for your blood pressure or heart condition? |  |
4. | When you were not doing physical activity, have you had chest pain, in the last 30 – 60 days? |  |
5. | Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? |  |
6. | Do you ever lose consciousness or have lost balance due to dizziness? |  |
7. | Do you know of any other reason why you should not do physical activity? |  |

If you answered yes to any of the above questions or if you are new to exercise or becoming more physically active talk with your doctor BEFORE starting your fitness program.

Frequently Asked Questions

If I have a chronic condition, should I consult a doctor before I start exercising?
Yes. If you are at high risk for any chronic disease such as heart disease, arthritis, diabetes, or if you are obese and/or are a smoker, you should check with your doctor before increasing your physical activity.

If I have had a hip replacement or repair is there anything I should not do?
First check with your doctor before doing any lower body exercises. Some things to avoid would be locking your knees and crossing your legs. Listen to your body and do not do anything that causes pain or just “doesn’t feel right”.

Are there any other conditions not mentioned in the list of seven questions that I should see my doctor about prior to starting an exercise program?
Yes, check with your doctor if you have (but not limited to):

Any new symptom that arises which you have not had diagnosed by your doctor.

Severe shortness of breath or any difficulty with breathing.

Acute deep-vein thrombosis, or blood clot.

If you have certain eye conditions, such as bleeding in the retina or detached retina. If you have had any eye surgery: cataract surgery, lens implant or laser treatment or any other eye surgery.

Joint swelling, pain or redness.

Foot or ankle sores that won’t heal.

Effects of Aging & Benefits of Exercise

HAVING AN UNDERSTANDING OF WHAT happens to our bodies as we age gives us the ability to take the steps to counteract the effects of aging making our physiologic age quite younger than our chronological age.

Those who experience the effects of osteoporosis, diabetes, osteoarthritis or other medical problems can also benefit from exercise with the guidance of their physician. There have been many research studies done with Older Adults and exercise that have shown many positive, life changing results.

A healthy diet with regular exercise and a positive attitude can help delay the onset and slow the progression of many of the age-related changes that occur within our bodies this can help you maintain an independent life and feel “young at heart”.

Effects of Aging on the Muscles | Result | Benefits of Exercising
Muscles begin to shrink and lose mass | A decrease in muscular strength | Exercise can increase the strength and size of the muscle
A decrease in the number and size of muscle fibers | A longer muscle response. Not a quick as when we were in our 20’s | Exercise can increase muscle fiber size and reaction time
Tendon (muscle to bone attachment) decreases in water content | Creates a stiffer tissue which is less able to tolerate stresses | Creating a stronger muscle will in turn create a stronger tendon
Grip strength decreases | Turning a door handle or opening a jar becomes more difficult | You can do exercises for your hands to improve grip strength and dexterity
A decrease in the ability of the heart muscle to propel large quantities of blood quickly | We become tired quickly and have a longer recovery time | Cardiovascular exercise can increase our cardiac output and create a stronger more efficient heart muscle
How quickly our bodies convert food to energy (metabolic rate) slows down | This can lead to obesity and increased LDL’s (bad cholesterol) which can lead to other medical problems | Exercise increases our metabolic system and increases our HDL’s (good cholesterol)
Loss of bone mass | Leads to osteoporosis. In the spine can cause fractures of the vertebrae, resulting ha a “dowager’s hump”. Also hip fractures | Resistance exercise has shown to increase the bone density. This can decrease the chance of osteoporosis or slow down those with it
Degeneration of the cartilage, which gives cushioning between bones | Arthritis can develop | Important to keep joints mobile and the muscles surrounding the joint strong for extra support
Connective tissues between bones (ligaments) become less elastic | A decrease in flexibility in the joint | Flexibility and mobility exercises can maintain a good range of motion for the joint
Mineral content of bones decreases | Bones become less dense and more fragile | Exercise has been shown to increase bone density

More Benefits Of Exercise

[picture] | Your 30 minutes of moderate activity can be broken up into shorter segments of time. Example: 15 minutes walking in the morning and 15 minutes raking the lawn in the evening.
[picture] | Increasing your strength and endurance can make it easier for you to climb stairs, carry groceries, get across the street quickly and go for long walks.
[picture] | Improving your balance helps to prevent falls.
[picture] | There is much research showing that people of all ages and physical conditions including those with certain diseases can benefit from exercise and physical activity.
[picture] | Many of the changes in our musculoskeletal system result more from disuse than from simple aging.
[picture] | Your exercise program does not have to be strenuous to receive the benefits. Walking, swimming, bicycling and dancing are all activities that are recommended for maintaining fitness as we age.
[picture] | Scientific research studies show that exercise and physical activity on a regular basis can help prevent or delay many diseases and disabilities.
[picture] | Stretching is a great way to improve and help maintain joint flexibility, which allows the joint to move through a greater range of motion, therefore less restriction in movement.
[picture] | Weight training can increase muscle strength, which will help you to continue your daily activities without maximal exertion, making daily tasks much easier to perform.
[picture] | Research has shown moderate amounts of exercise can reduce your risk of developing high blood pressure, heart disease and some forms of cancer.
[picture] | Exercise is important for both your mental and physical well-being and can improve your quality of life.
[picture] | Just 30 minutes of moderate activity, incorporated into your daily routine, can provide health benefits such as: slowing the loss of muscle mass and prevent age-associated increases in body fat improving your body composition (fat mass to fat free mass ratio).

[picture] | Prior to starting any exercise program see your physician for approval.

Learning Neutral Spine

What Is Neutral Spine?

NEUTRAL SPINE IS THE POSTURAL position where the spine is in the best alignment. The three curves of the spine, cervical (neck) with its slight inward curve, the thoracic (middle) with its slight outward curve and the lumbar (lower) with its slight inward curve are aligned putting even pressure on the disc’s between the vertebrae.

With neutral spine the body is able to function in its strongest, most balanced position, decreasing the risk of injury and increasing the efficiency of movement.

Stresses to the joints, muscles, vertebrae and tissue are minimized.

Research suggests that many spine problems are preventable as many are a result of poor posture and improper body mechanics, which subject the spine to abnormal stresses.

Over time abnormal stresses to the spine can lead to structural changes, including degeneration of disks and joints, wear and tear of cartilage and shortening or lengthening of the supportive muscles and ligaments. Which all can lead to pain.

Good posture, proper body mechanics and regular exercise can minimize current spinal pain and prevent future problems.

Good Posture

The ears, shoulders, hips, knees and ankles are aligned as if a plumb line was running from the ears down through the torso into the legs and the feet.

Think of a thread running right through your body from top to bottom and when you pull on the thread it pulls you up and realigns the body perfectly.

How To Find Neutral

Here is what good posture looks like when you pull on that thread:

The head is centered over the trunk with the chin level and the ear lobes in line with the tips of the shoulder.

The shoulders are aligned over the hips and the shoulder blades are back and down (flat) while being relaxed.

The arms hang relaxed by your sides with the palms facing the body.

The chest is lifted and open.

The back feels lengthened with its natural curves.

The abdomen is pulled up and in (not sucked in).

Your pelvis is level. If it were a bucket of water you would want it level, tipped forward spills the water out front, tipped backward spills the water out back….keep it level.

The knees are straight and relaxed.

The feet are slightly apart and parallel with your weight balanced evenly.

Being aware of your posture is critical in helping changing any misalignments. It will feel awkward at first but eventually it will become your “normal”. When this happens you will feel uncomfortable when your body goes out of good posture.

How To Engage Your Core Muscles

Your core muscles are those muscles that support, stabilize and protect your spine and internal organs.

These muscles are important to everything we do whether just standing or moving around, they keep us upright and stabilize as we pick things up.

When someone has a sore back they are often told to strengthen their abdominal muscles. Most people do not know how to engage these muscles or have been doing improper exercises to strengthen them.

There are two types of abdominal exercises:

Core training where the muscle is contracted isometrically (no movement).

Mover exercises where the abdominal muscles shorten and lengthen under contraction.

When you first start learning how to engage these muscles you may not feel much happening at first. It takes practice so that your mind and muscle can connect.

Eventually as your body learns to “kick in” these muscles you will no longer have to think about it, your muscles will automatically do it on their own.

A strong core is the foundation of our bodies and all movements we do.

Clock Contractions

This is one of the easiest ways to find your core muscles. When lying in this position if you cough or laugh you will feel the muscles that you are trying to contract.

Lay on your back with your knees bent.

Think of your belly button being the center of your clock and all the numbers of the clock are around your torso.

Breathe in and as you exhale think about pulling those numbers in towards the center of your clock (belly button).

You will feel the back pressing into the floor as the muscles contract as two of your four abdominal muscles wrap right around your torso like a corset.

Relax your buttock and shoulders let the contraction happen between the hips and the ribs.

Hold for 10 – 20 seconds then release, repeat 5 times.

[picture] | Additional Core and Abdominal exercises can be found in the Core section of this book

Warm-Ups

WARMING UP IS A VERY important part of any exercise program. Whether you are doing strength-training exercises or cardiovascular endurance exercises you need to do an adequate warm up prior to the start of your program.

Benefits

[picture] | A gradual increase in heart rate bringing the body into “steady state” (oxygen supply is meeting the oxygen demand). This will dilate blood vessels to more readily supply blood, oxygen and nutrients to the working muscles.
[picture] | Increases body temperature warming up the muscle. As muscles warm up, they become more extensible which may reduce the risk of muscle strains.
[picture] | Increases the release of synovial fluid into the joints reducing joint friction and lubricating the joint.
[picture] | Increases the range of motion which may alleviate tension in the muscles and connective tissue which in turn may reduce the risk of strains and sprains.

Should I stretch in a warm up?

While it is not “incorrect” to stretch in a warm up, held stretches may lower body temperature and heart rate, which are an important part of the warm up. These types of deeper stretches are best done at the end of a workout.

Dynamic Range of Motion movements will elevate the heart rate and increase body temperature while lengthening the target muscles.

How To Warm Up

10 -15 minutes of light intensity cardiovascular activity that increases the heart rate to at least 50% or your heart rate maximum. Which would feel like at 2 – 3 on the Rate of Perceived Exertion scale (explained in the cardiovascular section).

Light locomotor movements for 3 – 5 minutes to take the joints through each of their ranges of motion.

Any joint that will be involved in the exercise routine needs to be warmed up. So if you warmed up on the bike then you need to make sure that you warm up the upper body joints that are not involved in cycling by moving your arms.

Example: arms lifted and reaching out front/back x 10, arms reaching overhead x 10, spinal rotations (very slow and controlled), and side to side spinal movements.

You will know when you are warmed up when you have lightly increased facial color, the heart rate is increased to 50% or 2 – 3 RPE, breathing and perspiration are increased and you “feel” warmed up.

Cooldowns

A cool down is another important part of a workout that is often neglected. This is what is done after you have exercised.

During exercise there can be a build-up of metabolic wastes in the body. A cool down will help rid the body of these wastes.

Cool downs have shown to help the body recuperate and recover from exercise more efficiently.

It is a good mental finish to any exercise program.

How To Cool Down

5 – 10 minutes of light cardio, low intensity.

Your stretching program can be done after this.

Strength Training Exercises

Benefits

[picture] | Enhanced physical capacity: stronger muscles enable you to lift heavier weight and lift more times. You can do more with less effort.

Increased metabolic function; muscle is very active tissue with high-energy requirements for maintenance and rebuilding processes. When we increase the muscle tissue through strength training it results in an increase in our metabolic rate. Meaning the body will use more calories daily, and this will help decrease body fat.

[picture] | Strength Training exercises = increased muscle tissue = increased metabolism = decreased body fat.
[picture] | Reduce the risk of injury. Our muscles also serve as shock absorbers and balancing agents. A stronger muscle will help to dissipate the repetitive landing forces in weight bearing activities such as walking or running.
[picture] | Reduced back pain. 80%of low back problems are muscular in nature and are probably preventable with regular, balanced strength training.
[picture] | Strong muscles promote good posture and good spinal alignment to prevent compacted discs and stimulate circulation.

Helps to fight Osteoporosis (weak brittle bones). When a muscle contracts it tugs on the connective tissues that attach themselves to your bones. Your bones then adapt by better absorbing calcium and phosphorus in the blood stream to maintain strength and minimize bone loss. Denser, heavier bones reduce the risk of osteoporosis associated with aging.

[picture] | Reduce stress. Exercise has been shown to be one of the best stress releases.
[picture] | Enhance self-image. When you feel strong and good about yourself your confidence level increases, as does your self-esteem.

Equipment used in this program

The equipment used can be found in most large chain stores or in a fitness store. Level one exercise options are done without weights, you will use your own body weight.

Hand weights: 2lbs – 5lbs (you can use heavier as you get stronger).

Ankle weights: 2lbs – 5lbs.

Thearabands or Tubing with handles.

A mat for exercises on the floor.

Small soft ball (the kind children play with).

Wobble pads, these are optional and are for more advanced balance exercises.

Terms

Repetition: | One complete movement of the exercise is called a repetition (“rep” for short).
Set: | The number of reps completed at one time for an exercise is called a set.
Contraction: | This is when a muscle tightens.
Isometric: | The muscle contracts without moving.
Isotonic: | The muscle contracts while it is shortening (concentric contraction) and lengthening (eccentric contraction.
Rest / sets: | The amount of time you should rest between sets of exercises.

Tips for Performing Strength Exercises

[picture] | Make sure that you do a minimum of 10 minutes warm up prior to starting your exercises (see the warm up section for details).
[picture] | When you finish your exercises you need to cool down and stretch all the muscles that have been worked.
[picture] | Make sure that you have a water bottle and drink throughout the workout to keep hydrated.
[picture] | IMPORTANT to breathe throughout the exercise. DO NOT hold your breath.
[picture] | Use smooth, steady movements when performing the exercises, no jerking or thrusting movements.
[picture] | Avoid locking the joints of your arms and legs into a strained position.
[picture] | Muscle soreness lasting a couple of days and slight fatigue are normal after strength training exercises.
[picture] | Exhaustion, sore joints and painful muscle pulls are not normal. You may have done too much too soon and need to reduce the weight and intensity of your workout.
[picture] | It is better to start with less weight (or no weight at all) and sets and gradually increase the amount that you do as your body adapts and becomes stronger.
[picture] | Starting out with weights that are too heavy can lead to injury.
[picture] | Not using enough weight to challenge your muscles will not allow them to develop and become stronger.
[picture] | Before performing each exercise, get your body set and ready by keeping neutral spine and contracting your core (abdominal) muscles.

How much and How often?

Start with as many repetitions of the exercise as you comfortably can build up to completing between 8 – 12 reps of each exercise.

The speed of movement can be 2 seconds to lift or push, pause, then 2 seconds to lower. The key is to control the movement.

When you finish your repetitions this is called a “set”. Rest for one minute then perform another set of the exercise.

As you progress and feel you can do more, you can either increase the number of repetitions to 15 or add another set of the exercise.

Do strength exercises for all your major muscle groups 2 – 3 times per week.

You have the option to work your full body on those days or work your upper body one day and lower body on the second day and the full body on the third day. Just make sure that the same muscle groups are not worked two days in a row, as your muscles need to recuperate and recover so that they can become stronger.

Lift a minimum of weight the first week, then gradually build up the weight.

If you cannot lift the weight 8 times it is too heavy, if you can lift more than 15 times it is too light.

Which Level should I Choose?

Always start with level one and if it is too easy, try the next level. You may find that in some exercises you are at a level one and may be at a level two or three for other exercises.

Suggested Workout Plans

You may be overwhelmed with the number of exercises included in this book. We’ve put together two different workout plans you can use to make the most of your time while still covering all the muscle areas. The following workout plans list the muscle group you will be exercising, the specific exercise and the page number it can be found on.

Aim to strength train 2-3 times a week. You can alternate between the 2 full body work-outs or between the two split body work-outs to cover all the muscle groups. Another option is to complete the two split body workouts and then complete a full body work-out each week.

Be sure not to strength train the same muscles on consecutive days as your muscles need time to recuperate and recover.

Workout Logs

You can download free printable workout logs based on the following suggested workout plans at http://Impowerage.com/workout.

Use the workout logs to keep track of your workouts. Keeping track of your workouts will help you stay motivated and also help you track your progress. By seeing what you accomplished the previous workout you can try for one more rep, more weight or a different degree of difficulty.

Full Body Workout #1

Muscle | Exercise
Lower Body | Chair Stands
Chest | Wall Push ups
Back | Seated Band Rows
Shoulders | Shoulder Side Raises
Arms (front) | Seated Biceps Curls with dumbbells
Arms (back) | Triceps Wall Push ups
Full Back | All Fours
Abdominals | Crunch
Core | Alternating knee Lifts
Balance | One Leg Balance
Balance | Heel to Toe Walk

Full Body Workout #2

Muscle | Exercise
Legs (front) | Seated Leg Extension
Legs (back) | Standing Hamstring Curls
Chest | Band Chest Press
Back | Standing Bent Over Band Rows
Shoulders | Shoulder Side Raises
Arms (front) | Standing Biceps Curls with Band
Arms (back) | Triceps Extensions
Low Back | Seated Forward Leans
Abdominals | Rotational Crunch
Core | Chair Lean Back
Balance | Tandem Wobble Pad Stand

Lower Body & Low Back Workout

Muscle | Exercise
Legs | Chair Stands
Legs (back) | Standing Hamstring Curls
Calves | Heel Raises
Legs (outer thigh) | Hip Abduction
Legs (inner thigh) | Hip Adduction
Hip Flexor | Knee Lifts
Hip Extensor (Buttocks) | Standing Leg Extension
Full Back | Trunk Extensions
Core/Back/ Buttocks | Bridge
Balance | Two – Legged Balance

Upper Body & Abdominals Workout

Muscle | Exercise
Chest | Wall Push up or Chest Press
Back | Band Rows
Shoulders | Shoulder Side Raises
Upper Arm (front) | Biceps Curl
Upper Arm (back) | Triceps Push up or Extension
Core | Clock Contractions
Core | Alternating Heel Slides
Abs (Oblique’s) | Band Rotations
Balance | Toe Walks

Chair Stands

Strengthens the hips, thighs and buttocks, which are important muscles to help you walk efficiently, rise from a chair quickly and climb stairs with better ease. Level three will include the core abdominal muscles.

Level One:

Standing in front of a sturdy, armless chair with feet slightly more than shoulder-width apart and arms stretched straight out in front of you.

Slowly to a count of four lower yourself to a seated position making sure that your knees DO NOT come forward past your toes and keep your hips, knees and ankles in line (do not let your knees drop in).

Slowly to a count of two rise back up to a standing position. Keeping your knees over your ankles and your back straight.

Do 1 to 2 sets, and 8 – 12 reps.

[picture] | Note: If you find it difficult to go all the way down to the chair, place a pillow on the chair, which will shorten the range of motion.

Level Two:

Same set up as level one but standing securely on a band to add resistance to the exercise.

Level Three:

Same set up as level one and two using the band for added resistance.

With a pillow at the back of the chair, when you sit down keeping your abdominal muscles tight and back straight (neutral spine) lean back into then sit back up before standing back up to starting position.

Seated Leg Extension

This exercise targets the muscles of the front of the thigh. This exercise is one that helps to strengthen the knee joint and makes climbing stairs easier.

Level One:

Sitting tall (neutral spine) on a sturdy chair, sit all the way back so that your feet barely touch the ground. You can put a rolled up towel under your knees if necessary. Hips, knees and ankles in line with kneecaps facing up.

Slowly to a count of two extend your lower leg until it is straight but not locked.

Pause then lower to a count of four, repeat with other leg. Alternating legs.

Do 1 to 2 sets of 8 – 12 repetitions.

Level Two:

Same set up as level one. Add ankle weights to increase the resistance.

Pause at the top and hold for a count of four. Alternating legs.

Level Three:

Same set up as level one and two. Ankle weights to increase the resistance.

Pause at the top and hold for four counts. Repeat same leg for 8 – 12 reps.

Standing Hamstring Curls

This exercise works the muscles in the back of your upper thigh. The hamstrings help you bend your knees and control their motion while you walk. When done in conjunction with leg extensions it will make walking and climbing stairs easier, as well as adding support to the knee joint.

Level One:

Standing behind a sturdy chair, hold on to chair with your back in neutral and core muscles tight.

Bend one knee for a count of two.

Lower to the floor for a count of four, repeat with other leg.

Slight bend in the knee of the supporting leg.

Do 1 to 2 sets of 8 – 12 reps.

Level Two:

Same set up as level one. Add ankle weights to increase the resistance.

Alternating legs.

Level Three:

Same set up as level one and two. Ankle weights to increase the resistance.

Pause at the top and hold for four counts. Repeat same leg for 8 –12 reps.

Heel Raises

This exercise strengthens the calf muscles in the back of your lower leg and creates stability in the ankle joint. These are important muscles for walking efficiently, running, jumping and just standing. They are also important muscles for balance.

Level One:

Seated in a sturdy chair. Back in neutral and core muscles tight.

Lift heels up until you are on the balls of your feet, hold for two counts. Bring them back down to the ground.

Do 1 to 2 sets, and 8 – 12 reps.

Level Two:

Standing behind the chair and hold chair with only one or two fingers. Back in neutral and core muscles tight.

Level Three:

2. Standing, holding hand weights or a band.

Hip Abduction

This exercise targets the muscles on the side of your hip. They are important to keeping your pelvis level while you walk which allows your body to be more stable.

Level One:

Standing behind a sturdy chair. Back in neutral and core muscles tight.

Lift one leg out to the side without tilting your body. Your supporting leg is slightly bent.

Alternating legs.

Do 1 to 2 sets, and 8 – 12 reps.

Level Two:

Same set up as level one. Using ankle weights for added resistance.

Do 8 – 12 reps on same leg before changing.

Level Three:

Lying on your side, your head on a pillow. Back straight and core muscles tight.

Bend bottom leg. Top leg stays straight with ankle weight.

Slowly lift your leg about 6 to 8 inches. Lower back down to starting position.

[picture] | Note: Be careful not to let your hip roll back, keep a straight line from your shoulder, hip and ankle.

Hip Adduction

This exercise works the muscles of the inner thigh. It is important to make sure that all the muscles surrounding the hip joint are strong creating a stable pelvic girdle.

Level One:

Seated in a sturdy chair, back in neutral and core muscles tight.

Place a small soft ball between your knees. Squeeze then release (but don’t let go of the ball).

1 to 2 sets, and 8 – 12 reps.

Level Two:

Same set up as level one. Hold the squeeze for a count of four then release.

Level Three:

Same set up as level one:
a)   Squeeze / release x 8.
b)   Squeeze / hold x 8 count.
c)   Pulse squeeze x 8 count.

Knee Lifts

This exercise strengthens the muscles in the front of the hips. They help you lift your leg when going up stairs, stepping into a car, or stepping over an object.

Level One:

Standing behind a sturdy chair, neutral spine and core muscles tight. Hold on to chair.

Lift knee up towards chest without tilting your pelvis (don’t spill the water!). Lower it back to the floor. Alternate legs.

1 to 2 sets, and 8 – 12 reps.

Level Two:

Same set up as level one. Add Ankle weights for added resistance. Alternating legs.

Level Three:

Standing without holding on to chair, ankle weights for added resistance.

Repeat same leg for 8 – 12 reps. Then repeat on the other leg.

Standing Leg Extension

This exercise focuses on the buttocks (gluteus maximus) and the back of the upper leg (hamstrings). These muscles are important as we use them when we stand up from sitting, walking up stairs, stepping up onto a bus and if they are not doing their job then the hamstrings and lower back have to do it all.

Level One:

Standing behind a sturdy chair, hold onto chair. Back in neutral and core muscles contracted.

Lean slightly forward from the hips only.

Lift one leg back WITHOUT arching your back. Squeeze your buttocks. Return leg to the ground. Alternate legs.

1 to 2 reps, and 8 – 12 reps.

Level Two:

1. Same set up as level one. Add Ankle weights for added resistance. Alternate legs.

Level Three:

2. Same set up as level one and two. Ankle weights for added resistance.

3. Repeat the exercise on one leg for 8 – 12 reps. Then repeat on the other leg.

Wall Pushup & Chest Press

These exercises work your chest muscles, which are important in any pushing movement like pushing open a heavy door.

Level One:

Wall Push Up: Stand in front of a wall with your feet shoulder width apart and about 12 – 24 inches away from the wall. Hands a little wider than shoulder width apart.

Keeping back in neutral and core muscles tight. Bend elbows bringing chest towards wall. Go no closer to the wall than the elbows in line with the shoulders.

Press back up to starting position. Focus on your chest the whole time.

1 to 2 sets, 8 – 12 reps.

Level Two:

Band Chest Press: standing, place the band around your back and under your arms. Elbows bent and lifted out to sides.

Press band until your arms are straight. Then bend back to the starting position.

[picture] | Note: Elbows do not go back any farther than your shoulders.

Level Three:

Same set up as level two with balancing on one foot.

Band Rows

This exercise strengthens your back muscles that are used in any pulling motion like pulling open a heavy door.

Level One:

Seated in a chair, attach the band around something sturdy that will not move, hold band in your hands and arms extended straight out in front of you. Your back is in neutral and your core muscles contracted.

Pull back by bending the elbows, keeping the back in neutral.

Bring back to starting position and repeat with the other arm.

1 to 2 sets, 8 – 12 reps.

Level Two & Three:

Standing in neutral spine with core muscles contracted. Step on the ban with one foot, other footsteps forward and both knees are slightly bent.

Bend forward from the hips (maintaining neutral spine) and place one hand on your knee for support.

Arm starts straight, pull band up while bending the elbow. Return to starting position.

1 to 2 sets, 8 – 12 reps.

Shoulder Side Raises

This is a good exercise for strengthening the shoulders, which we use when lifting our arms out to the sides or carrying objects.

Level One:

Seated in a sturdy chair, back in neutral and core muscles tight.

Raise arms out to the sides, no higher than shoulder height. Lower back down to starting position.

1 to 2 sets, 8 – 12 reps.

Level Two:

Standing with hand weights. Raise one arm out to side, no higher than shoulder height. Lower back down to starting position. Repeat on the other side.

Level Three:

Same set up as level two. Balance on one foot. Alternating feet with each arm raise.

Biceps Curl

This exercise focuses on the muscle in the front of the upper arm. These muscles help us lift objects and hold things while our arm is bent.

Level One:

Seated in a sturdy chair with your back in neutral and your core muscles tight. Use light weights.

Hold your arms down by your sides with the palms of your hands facing forward. Bend your elbows and bringing the weights up towards your shoulders. Do not move your shoulder joint.

Lower weight back down to starting position slowly.

1 to 2 sets, 8 –12 reps.

Level Two & Three:

Standing with back in neutral and core muscles tight. Stand on a band making sure it is secure under your feet.

Curl band up towards shoulders without moving your shoulder joint. Straighten arms back to starting position.

Triceps Pushup & Tricep Extension

These exercises strengthen the muscle in the back of the upper arm. These muscles help us push, such as pushing ourselves up out of a chair.

Level One: Triceps Pushup

This is similar to the push up for the chest but with our hands closer together and placed in line with our shoulders. With the hands closer there is more emphasis on the triceps muscle.

Back in neutral and core muscles tight. Feet 12 – 24 inches away from the wall.

Bend elbows bringing the upper body towards the wall. Then push yourself back to the starting position.

1 to 2 sets, 8 – 12 reps.

Level Two & Three: Triceps Extension

Standing with your back in neutral and core muscles tight. Knees are slightly bent; bend forward from the hips (keeping the back in neutral).

One hand is placed on your bent knee (you can hold onto a chair if balance is an issue). Other arm is lifted and bent.

Without moving the shoulder extend your arm straight. Then bend it back to the starting position.

Core Exercises

THESE EXERCISES ARE PERFORMED WITH no movement in the torso. The abdominal muscles are isometrically contracted.

Make sure that you focus on the muscles being used. The body will usually try and find a way to cheat. Two common ways are by tightening and tucking in your buttocks or by lifting the shoulders.

Part of strengthen your core also includes the group of muscles in the back called the “Erector Spinae”, so exercises will also be shown to strengthen this group of muscles.

Choose one core and one low back exercise to add to your program.

Clock Contractions

This is one of the easiest ways to find your core muscles. When lying in this position if you cough or laugh you will feel the muscles that you are trying to contract.

Lay on your back with your knees bent.

Think of your belly button being the center of your clock and all the numbers of the clock are around your torso.

Breathe in and as you exhale think about pulling those numbers in towards the center of your clock (belly button).

You will feel the back pressing into the floor as the muscles contract as two of your four abdominal muscles wrap right around your torso like a corset.

Relax your buttock and shoulders let the contraction happen between the hips and the ribs.

Hold for 10 – 20 seconds then release, repeat 5 times.

Alternating Heel Slides

This exercise helps to strengthen the core stabilizing muscles in your torso. The key is to make sure that the back stays pressed into the floor by contracting your abdominals, not tilting your pelvis.

Level One:

Lay on your back with your knees bent.

Start with the clock contractions to find your core.

Slowly slide one heel out (you can put a paper towel or file under your heel for easier sliding).

When the foot is fully extended, slowly slide it back in.

Only slide as far as you can keeping the back pressed into the floor with the core contracting.

If your back starts to come up it means that the core muscles are not strong enough yet at that point to counter balance the strength of your hip flexors (muscles in the front of your hip).

1 – 2 sets, 8 – 12 reps.

Level Two & Three:

The same as level one but switching legs, as one leg starts to come back you start sliding the other leg out.

Alternating Knee Lifts

This exercise is a little more advanced than the last one. As the muscles in your hip (hip flexors) have to contract strongly to lift your leg, your core muscles have to counter balance that contraction.

Level One:

Lying on your back with your knees bent.

Start with clock contractions to find your core.

Slowly lift one knee up towards your chest, keeping your back pressed down with the core contraction.

Slowly lower back down to the floor.

Repeat with the other leg.

1 – 2 sets, 8 – 12 reps.

Level Two:

Same as level One but lengthen the legs out a little more so that there is only a slight bend in the knee. This creates a longer lever making the intensity of the exercise increase.

Be conscious of your back staying pressed into the floor.

Level Three:

Same as level One but switching legs.

As one leg starts to lower the other leg starts to lift.

Be conscious of your back staying pressed into the floor.

Chair Lean Back

This exercise requires a strong core. The key is to make sure that you don’t lose neutral spine, do not let your back arch as you learn back. The lean happens from the hip joint not the spine.

Level One:

Seated at the edge of the chair with your back in neutral and a pillow behind you.

Lean back into the pillow keeping the core contracted.

Sit back up.

1 –2 sets, 8 - 12 reps.

Level Two & Three:

Same as level One but with no pillow.

Hold for a couple of seconds and return to start position.

1 – 2 sets, 8 – 12 reps.

Trunk Extensions

This is a good exercise for your lower back as long as you feel comfortable lying on your stomach on the floor. This is also a good exercise if you have a weak lower back.

Laying face down with a large pillow under your stomach. Rest your forehead on a small rolled up towel.

Stretch your arms out over your head, keeping them close to your ears.

Contract your stomach muscles and tuck in your chin.

Slowly lift your right arm and left leg about one inch off the floor, keeping them both straight. Hold for five seconds.

Lower back down to the ground and repeat with the other arm and leg.

1 – 2 sets, 8 – 12 reps.

All Fours (for your Erector Spinae Group and Low Back)

This is the next level to the Trunk Extension, as it requires more balance. This is a great exercise for overall strength in the torso, shoulders and hips. There is a lot of stabilization that has to occur.

Level One:

On all fours with your hands underneath your shoulders and your knees under your hips.

Lift and straighten one leg off the floor behind you. Make sure that your pelvis does not rotate, it should be level to the ground.

Hold for five seconds and place back on the ground.

Repeat five times on each side, alternating sides.

Level Two & Three:

Same as level one but add in lifting the opposite arm and reaching.

Hold for five seconds and place back on the ground.

Bridge

This is another good exercise for your abdominals, back and buttocks muscles that support your trunk and extend your hips. These muscles help you rise more easily from a chair and walk more efficiently.

Level One:

Laying on your back with your knees bent and feet hip width apart.

Lift your hips off the floor and hold five seconds.

Lower back to the ground.

1 – 2 sets, 8 – 12 reps.

Level Two & Three:

Same positioning as level one.

Try straightening one leg while you hold the position with your hips lifted.

Hold for five seconds.
– Bring leg back down and repeat with the other side.
– 1 – 2 sets, 8 – 12 reps each side.

Seated Forward Leans

This is another good low back exercise in an upright position.

Seated on the front half of a sturdy chair.

Keep your back in neutral.

Lean forward from the hips (not rounding the back).

Hold for two seconds.

Slowly return to an upright position.

1 – 2 sets, 8 – 12 reps.

Mover Exercises for your Abdominals

THESE EXERCISES ARE DIFFERENT FROM the “Core” exercises in that there is movement to the muscle. The muscle fibers shorten and lengthen under contraction.

Choose one mover exercise for your program.

Crunch

This exercise strengthens the abdominal muscles through movement. The focus is more on the rectus abdominus muscle. Although it is the upper region that is moving the lower region is also working as it stabilizes the body allowing you to perform the exercise.

Laying on your back with your knees bent.

Hands can be either across your chest or fingertips behind your ears supporting your head.

Contract your abdominals, then slowly lift, looking up to the ceiling.

Hold, then slowly return to the starting position but DO NOT let your abdominals relax until you are all the way down and have held it for a couple of seconds.

1 –2 sets, 8 – 12 reps.

Rotational Crunch

This exercise focuses on the oblique muscles, which are the muscles that help us with rotation.

Laying on your back with your knees bent.

Hands can be either across your chest or fingertips behind your ears supporting your head.

Contract your abdominals, then slowly lift and rotate your body as you reach your hand to your opposite knee.

Hold, then slowly return to the starting position but DO NOT let your adominals relax until you are all the way down and have held it for a couple of seconds.

Repeat to other side.

1 –2 sets, 8 – 12 reps.

Reverse Crunch

This exercise works all the abdominals but created movement through the lower region as the upper region is stabilizing.

Laying on your back with your knees bent at 90 degrees and the feet off the floor.

Bring your knees in towards your chest.

Bring back to starting position.

1 – 2 sets, 8 – 12 reps.

Band Rotations

This exercise focuses on the oblique muscles, which are responsible for rotation of the spine. This is more advanced as it includes the resistance of a band.

Attach the band to a bar or something sturdy that will not move.

Stand sideways to where the band is attached holding the band with both hands.

Feet are apart, knees slightly bent, back in neutral and core contracted.

With your arms straight out in front of you and a slight bend in the elbows, rotate the body away from where the band is attached. Make sure that you lift the back heel as you rotate this will stop any torque in the knee joint.

Bring it back to the starting point.

Repeat 8 – 12 times then face the other direction to do the other side.

1 – 2 sets, 8 – 12 reps.

Cardiovascular Endurance Training

ENDURANCE EXERCISES ARE ANY ACTIVITY such as walking, jogging, swimming, raking etc… that increases your heart rate and breathing for an extended period of time. You can build your endurance up over time. Rather than doing 30 minutes at one time you can do three separate endurance workouts of 10 minutes each, it is the total at the end of the day that counts.

Over time as your endurance increases you will be able to go for longer periods of time before fatigue sets in.

Benefits

[picture] | Aerobic exercise is a good mechanism for weight control
[picture] | Improved metabolism: burns calories and targets fat as an energy source.
[picture] | As you improve in your cardiovascular fitness level, over a period of about one or two months, the metabolism shifts from using primarily carbohydrates to burning a higher percentage of body fat both during exercise and when not exercising.
[picture] | Blood pressure decreases: exercise has been shown to increase the HDL (good cholesterol) levels thereby decreasing build up of cholesterol plaques in the artery walls.
[picture] | Your heart becomes a stronger more efficient pump, pumping more blood per stroke.
[picture] | Resting heart rate lowers: as the heart gets stronger it pumps more blood per beat and therefore does not have to pump as often.
[picture] | Better sleep. Aerobic exercise during the day completed at least three hours before you got to bed can improve the quantity and quality of your sleep.
[picture] | Enhanced mood – exercise releases endorphins into our bodies which makes us feel “good”.
[picture] | Clearer thinking: the sector of the brain responsible for learning and memory, the hippocampus, may also get a boost from aerobic exercise.

Safety Tips

[picture] | Make sure that your drink water before, during and after exercise to keep your body well hydrated.
[picture] | Wear comfortable and breathable clothing especially when it is hot out.
[picture] | Wear layers of clothing when it is cold out.
[picture] | A good pair of running shoes is important as they give your feet support and cushioning. It is a good idea to go to a sports store and talk to someone knowledgeable in athletic shoes to make sure that you have the right fit for your feet.
[picture] | To prevent injuries, use safety equipment such as helmets for biking.
[picture] | Endurance activities should not cause you to feel dizziness or chest pain.

Target Heart Rate Ranges

This chart is based on the age related formula for heart rate ranges. This is just a guideline. If you are taking a medication that affects your heart rate this chart will not work for you. There are other ways to determine exertion levels: Rate of Perceived Exertion, Talk Test and preferred exertion.

Cardiovascular Training Zones

ACSM (American College of Sports Medicine) recommends an intensity of 60 – 90% of one’s heart rate maximum using this age related formula.

Minimum of 20 minutes (work your way to 30 – 60 minutes), 3 – 5 times per week.

At 60 – 70% a higher percentage of the calories burned are from fat.

At 70 – 85%, more calories AND more fat is utilized.

For beginners, a lower intensity will reduce discomfort and encourage longer workouts.

Accumulated time (in one day) and shorter intervals (i.e. 10 min, 3 times in a day) is appropriate for many individuals.

Calculation: 220 – age x 60% or 70% or 85%

AGE | MAX | 60% | 70% | 85%
60 | 160 | 96 | 112 | 136
61 | 159 | 95 | 111 | 135
62 | 158 | 95 | 111 | 134
63 | 157 | 94 | 110 | 133
64 | 156 | 94 | 109 | 133
65 | 155 | 93 | 109 | 132
66 | 154 | 92 | 108 | 131
67 | 153 | 92 | 107 | 130
68 | 152 | 91 | 106 | 129
69 | 151 | 91 | 106 | 128
70 | 150 | 90 | 105 | 128
71 | 149 | 89 | 104 | 127
72 | 148 | 89 | 104 | 126
73 | 147 | 88 | 103 | 125
74 | 146 | 88 | 102 | 124
75 | 145 | 87 | 102 | 123
76 | 144 | 86 | 101 | 122
77 | 143 | 86 | 100 | 121
78 | 142 | 85 | 100 | 120
79 | 141 | 85 | 99 | 120
80 | 140 | 84 | 98 | 119
81 | 139 | 83 | 98 | 118
82 | 138 | 83 | 97 | 117
83 | 137 | 82 | 96 | 116
84 | 136 | 82 | 96 | 115
85 | 135 | 81 | 95 | 114

RPE (Rate of Perceived Exertion):

For many people, heart rate monitoring may not reflect an accurate intensity. Individuals who are taking medication, which affects their heart rate, those with low peripheral vascularity would benefit from this method over the Age Related Heart Rate Chart. For these people the perception of intensity is usually more accurate.

Rate yourself on a scale of 1 – 10:

1   | Very very easy
2 – 3   | Warming up, feeling the heart rate and breathing starting to increase and slight perspiration
4 – 8   | Working somewhat hard (4) to Hard (8)
9   | Not being able to keep up a conversation as you are heavily breathing
10   | Maximum intensity

Talk Test

When exercising between 60 – 85%, your body will require oxygen. Your breathing should be deeper, and faster, but if you are gasping for air, and unable to talk, you are most likely exercising about 85% of your heart rate maximum, which may result in early onset of fatigue and an inability to continue. If this happens you should lower the intensity of your workout, unless your goal is anaerobic training.

Preferred Exertion

Some people, though they are fit, simply enjoy working out at a lesser intensity, while others prefer exercising at higher intensities. Some do not like the feeling of working at high intensities and therefore should choose a lower intensity workout. What will keep you exercising? If you enjoy the workout and it is safe you will more than likely stick to it.

Some days you may not have as much energy and a lower intensity-training workout will be best for you on that day. On other days you may have a lot of energy and find that you are able to increase your intensity for that training session. Listen to your body and train the way you feel.

Some Exercise Options

Endurance exercise can be done in many ways: inside or outside. Exercise equipment or chores around the house. Older adults who have been inactive for a long time will need to work up to the activities gradually.

Walking, swimming, gardening, mowing, raking, cycling.

Activities that is more vigorous (individuals who have been inactive for a long time or who have certain health risks should not start out with these activities). Climbing stairs or hills, shoveling snow, brisk bicycling up hills, digging holes.

Walking, jogging or running

Can be performed outdoors or indoors (on a treadmill). This is a weight bearing exercise, which is good for bone density, but it may irritate your joints, especially those in your knees, hips and ankles. You can start your walking program at a slower pace and work your way up to a “power walk” which is a quicker and more brisk walk.

Tips

[picture] | Neutral spine, stomach and chin tucked in.
[picture] | Your toes should point forward and shoulders should be down and relaxed.
[picture] | Arms should be close to your body.
[picture] | Elbows bent 90 degrees and let them swing comfortably. Not coming any higher than the middle of your chest or swinging back past your hips.
[picture] | Hands relaxed and a loose fist.

Cycling

Can be performed indoors (on an upright or recumbent bike) or outdoors. This is a non-weight bearing exercise, which would be a better choice for anyone with lower body joint problems. Recumbent bicycles and cycle ergometers are the least stressful options.

Tips

To be sure that you have the proper seat height on an upright or recumbent bicycle. Have a seat on the bike; with the heel of the foot on the pedal the leg should be straight and the pelvis level. Then slide the ball of your foot up to the pedal and this will give you the slight bend in the knee that your need.

[picture] | On an upright bike make sure if you lean forward that it comes from the hip joints and not rounding through the back.

Pool Aerobics and Jogging

There are a lot of advantages to exercising in the pool:

[picture] |  The water decreases your body weight taking stress off the joints.
[picture] |  There is resistance in every movement you do in the water.
[picture] |  Water jogging is non-weight bearing.
[picture] |  Can be fun in a group exercise program.

Tips

[picture] | Time, not distance is important.
[picture] | Gradually increase the time to 30 to 60 minutes.
[picture] | If you decide to try water jogging, be sure you obtain a well fitting aqua jogging belt.

Stepping

This can include stairs and machines, such as mechanical steppers, steppers with revolving stairs and climbers. Stepping is a weight bearing activity, which is good for your bone density but may irritate your joints in the lower body. It is good for increasing strength in your lower body muscles.

Tips

[picture] | Do not bounce when you step, the motion should be smooth and controlled.
[picture] | Start slow and when your endurance and strength starts to increase you can gradually increase your pace and intensity.
[picture] | Do not grip the machine tightly but rather hold on lightly or challenge yourself by not holding on at all.

Stretching

Stretching is a very important part of an exercise program and is often left out. Being limber gives you the freedom to move, whether it is bending over to put your socks on or reaching up to get something from a high shelf or even just picking something up off the counter. Stretching is something that needs to be done daily.

Benefits Of Stretching:

[picture] | Increases the range of motion in a joint allowing for greater movement.
[picture] | Opening up a muscle or joint with stretching encourages blood flow to oxygenate the area and flush out metabolic waste from exercise or activities of daily living.
[picture] | Releases that feeling of being “tight”.
[picture] | Maintains spinal health and minimizes back pain. Regular stretching can mobilize the spine through all its ranges of motion, decompress the discs which may take pressure off nerves, and can reduce back pain.
[picture] | Can improve other components of fitness, for example: increasing the range of motion = increased range of strength development.
[picture] | Improve performance in sports. The more flexible the body is, the more mobile, balanced and stable it is.
[picture] | Enhance muscle appearance.
[picture] | Can help prevent injuries. Elongating and bringing blood to the tissue and attachments reduce injuries to muscles, tendons, and ligaments.
[picture] | Many overuse injuries are caused by nerve compressions – muscles tightening around a nerve causing numbing, weakening, loss of motor response, and pain. Stretching can help decompress the joint and assist in alleviating the problem.
[picture] | Brings blood flow to the muscle being stretched which can unlock frozen joints bringing oxygen that nourishes cells thereby promoting healing.
[picture] | Relaxation: when in pain or if you are anxious the muscles tend to tense up to protect you from harm. This protection causes enormous energy expenditure as well as imbalances and more tension. Focused stretching combined with deep breathing can lengthen the muscles and reduce the tension.

How To Stretch:

Make sure you warm up prior to stretching. You can stretch separately from your strength-training workout or do it at the end of your workout when you are really warmed up.

Isolate the individual muscle – the muscle should not be bearing any weight or expending any energy to maintain its position.

Start with no tension – you are in the stretch position but at a point where you do not feel any tension on the muscle you are stretching.

First awareness – slowly bring the muscle into the stretch but only to the point where you initially first start to feel the stretch. (about 40% of a stretch).

Wait until the tension releases – most guidelines tell you 15 – 30 – 60 seconds. But if you hold the stretch until you feel the muscle relax and it releases the tension you will extend the muscle fibers in to a truly lengthened state. This can sometimes happen quickly or take longer for some muscles. If stretching two muscles together (i.e. inner thighs) hold until both sides have released.

Repeat your stretches – once you stretch one side, stretch the other. Then repeat the stretch on each side. You will find that each time you repeat a stretch you can initially stretch farther than before.

Note:

Putting too much tension on the muscle by going too deep into the stretch will not allow the muscle to release and relax.

Less is best as it will result in a faster relaxation of the muscle bringing it back to its pre-stretch resting length which needs to happen before it can elongate further.

Focus on relaxing the muscle and your breathing (your exhale is twice as long as your inhale).

Some muscles may take longer to release due to either: the initial load placed on the muscle, fatigue in the muscle, any inflammation or insufficient warm up prior to the stretch.

Never bounce in a stretch. Always be slow and controlled.

When stretching one muscle (our focus muscle) often there are other muscles that also get stretched at the same time.

There should never be any pain while you are stretching.

Stretches

Quadriceps

This is the muscle in the front of your upper leg.

Stand in front of a chair to hold on.

Bend your knee and hold your ankle (not your foot) with your hand.

If this is too deep of a stretch or you cannot grab your ankle use a towel to support your leg.

[picture] | Keep your back in neutral, do not arch.
[picture] | The knee should be pointing straight down to the ground.
[picture] | Careful not to press your foot into your hand. If you do the muscle will be contracting not relaxing.

Hamstrings

This is the muscle at the back of your upper leg. Here are two ways to stretch this muscle. One on a chair if you are not comfortable with going down to the ground and a second one on the ground, which will allow that muscle to really relax.

Option #1: On a chair

Seated at the front half of the chair. Keep your back in neutral.

Straighten one leg out in front of you with the knee straight.

From the hips lean forward until you feel the stretch.

Option #2: On the floor

Laying on your back on the floor with your knees bent.

Place a band or a towel or a bath robe belt around the middle of your foot.

Extend your leg up and gently bring it in towards your body..

[picture] | Make sure that the back stays in neutral and the pelvis does not tilt.
[picture] | If you are feeling the tension behind your knee joint bend your knee slightly as we are trying to stretch the muscle NOT the tendons.

Hip Flexors

These are the muscles in the front of your hip joint. Your buttocks muscle (gluteus maximus) on the opposite leg is also getting a stretch in this one.

Laying on the floor with your legs straight.

Bring one knee up to your chest.

Let the straight leg relax as this is the one that you are stretching.

[picture] | Option: If this is not a deep enough stretch for you or you are uncomfortable laying on the floor you can do this by laying on your bed and letting the straight leg hang off the bed while pulling the knee into the chest.

[picture] | Head stays on the floor
[picture] | The focus is in the front of the hip
[picture] | If you are laying on the bed make sure the foot can touch the ground so the muscle can relax and not contract to try and hold the leg up.

Hip Rotators

This is the group of muscles that surround the hip joint and cause hip rotation.

Laying on your back on the ground with your knees bent.

Place one ankle over the opposite knee.

Bring the leg that is on the floor up to your chest and hold on behind the upper leg.

[picture] | Option: If these muscles are too tight place your foot on the wall so that you do not have to hold it and the leg can be more extended and relaxed.

[picture] | Use the wall if the muscles are tight.
[picture] | Keep your head on the ground.
[picture] | Keep the knee you are holding pointing to the ceiling and not shifted off to the side.

Adductors

These are your inner thigh muscles.

Sitting upright with your hands placed on the ground behind you supporting your body.

With your feet together slowly slide them up.

Relax.

[picture] | Option: Sit with your back against a wall for support.

Only bring your legs up until you feel the initial stretch, do not “pull” them in.

NO bouncing the knees.

DO NOT press the knees down, let gravity do the stretch.

Calves

These are the muscles at the back of your lower leg. There are two muscles that make up the calf muscle (gastrocnemius and soleus) that converge into the same tendon (Achilles tendon), which crosses the ankle and attaches to your heel.

Stand behind a chair with your hands supporting your body on the chair.

One-leg steps back. Keep your hips bent slightly.

The heel stays on the ground.

Slowly bend your elbows to bring your body closer to the chair.

[picture] | Keep the back in neutral.
[picture] | You want to feel this in the calf muscles NOT in the Achilles tendon.

Chest & Anterior Deltoid

Your chest muscle (Pectoralis Major) and the front part of your shoulder muscle (anterior Deltoid) are both involved in this stretch. The main focus is your chest.

Place your arm on a wall or something your can hold on to.

Rotate your body away by shuffling your feet as you turn. Do not just rotate your torso.

[picture] | The hand holds the arm in position so that it can relax and allow for the stretch to occur. Keep the spine in neutral as you rotate.

Back

The focus is on the large back muscle called your Lattissimus Dorsi.

Place your hand on a railing or something sturdy.

Bend your knees and support your body weight by placing your other hand on your knees.

Let the arm relax as you stretch, do not pull with it but allow it to lengthen.

[picture] | Make sure the arm is relaxed while you are stretching.
[picture] | Do not “hang” from the hand but keep the weight in the legs.

Middle Back & Posterior Deltoids

The middle back muscles are referring to the middle trapezius and rhomboid muscles. The posterior deltoid muscle is the shoulder muscle that sits at the back of the shoulder joint.

This one is easy. Just give yourself a hug. Hands holding onto your shoulders.

The other option is to support one arm with the other hand as you cross it in front of the body (over the chest).

[picture] | Do not push your back out but rather focus on relaxing.

Shoulders (Deltoids)

The shoulder muscle is broken down into anterior (front), medial (middle) and posterior (back) of the shoulder joint. They cause three different actions of the shoulder and therefore need three different stretches. The anterior is involved with the chest stretch and the posterior deltoid is involved in the middle back stretch. This stretch will focus on the medial and anterior.

Standing in neutral.

Place your hand behind your back and hold with your other hand.

If this in uncomfortable you can hold a towel between the hands.

[picture] | Keep upright, do not tilt the body sideway.

Triceps

This is the muscle on the back of the upper arm.

Raise your arm up to the ceiling.

Bend the elbow and touch the back of your shoulder.

You can rest your elbow on the wall to allow it to relax (not shown in the picture).

[picture] | Make sure that you keep your back in neutral.
[picture] | Do not force the stretch.
[picture] | Can be done seated in a chair and resting the bent elbow on a table.

Biceps

This is the muscle on the front of the upper arm.

Standing in neutral.

Arm is straight and hand is on the wall or bar no higher than shoulder height.

Slowly rotate the body.

[picture] | The whole body rotates so you need to shuffle the feet with you as you turn rather than rotating from the torso.

Range Of Motion For Your Neck

NECK MUSCLES OFTEN GET QUITE tense and can lose their range of motion, making it difficult to look over your shoulder or look up to the sky. By keeping your neck mobile you will be able to look around by turning your head verses turning your whole body.

Your starting position: seated in a chair, back in neutral head straight.

1. Chin Tuck: from your starting position tuck your back and then down to your chest. Hold for three seconds then bring back up to neutral.

2. Look Up: from starting position, keeping teeth together look up to the sky, hold for three seconds, return to neutral.

3. Side Look: from starting position turn your head to the right without turning your body. Bring back to center, then turn and look left. Bring back to center.

4. Ear to shoulder: from starting position bring your right ear down towards your right shoulder. Bring back to center, and then bring left ear to left shoulder. Bring back to center.

5. Ear to shoulder & Look: from starting position bring your right ear to the right shoulder. From here slowly turn to take a look at that right shoulder. Turn again to have ear to shoulder then bring it back up to center. Repeat the same on the left side.

Balance And Gait

Fall Prevention

BALANCE IMPAIRMENT, WHICH IS COMMON among the elderly, is one of the most important risk factors for falls and injuries. Falls, instability and immobility are among the most common reasons for medical intervention for the older adult.

In some older adults changes occur with how they walk (gait). Gait velocity slows, stride length shortens and double-support time increases due to the effects of aging.

In a study to test the effectiveness of a home-based exercise program, Campbell et al. (1997) concluded that strength and balance retraining exercises improved physical function and were effective in reducing falls in 116 women aged 80 years and older.

Gait and Balance Changes in Older Adults

•  | The physical changes, which are associated with aging directly, affect an older adult’s ability to maintain postural stability and normal gait mechanics.
•  | Some physical changes:
| – | Stiffening of the connective tissue.
| – | Decreased muscle strength.
| – | Reaction times that are prolonged.
| – | Visual problems: degeneration of the nerves between the brain and eyes, atrophy of eye muscles, cataracts, glaucoma, macular degeneration, and loss of eye lens elasticity.
| – | Hearing problems: degeneration of the nerves between the ears and the brain.
| – | Vibratory and proprioceptive sensation is impaired – your awareness of your postural alignment, movement and body position change.
| – | There is an increase in postural sway.
•  | Gait, balance and muscular tissue have a close relationship. It has been shown that muscle strength is directly associated with gait velocity and that much can be done to decrease and even reverse age-related changes in muscle tissue.
•  | Weak and inflexible muscles can affect the stride. Therefore increasing muscle strength and flexibility will help an individual maintain a successful gait pattern.

Mechanisms of Falling

Mechanical: such as a push or collision or a slip or trip.

Environment:impact from a swinging door, being bumped in a crowd or standing in a moving vehicle.

Self-induced: caused by movement, such as walking or getting up from a chair.

Informational:moving visual fields that create an illusion of the feeling of self-motion or carpets that distort the proprioceptive information from the foot and ankle to the brain.

Informational: dim lighting or glare that can interfere with the visual input.

According to Lipsitz et al. (1991) people who fall tend to be those who take more steps to turn 360 degrees, who cannot rise from a chair without pushing off and who have difficulty determining their body position.

Fear of Falling

Many elderly adults have a very real fear of falling and therefore may bias their posture so that if a fall occurs, they will fall forward and break the fall with their arms. This puts their body into a flexed posture, which ends up placing a higher muscular load at the hips and the knees. This also shifts the base of support to the front of the feet over the toes, which leads to a gait that has increased double – support time (more time on both feet), a reduced stride length and velocity.

When strength and balance are improved which in turn has a positive effect on gait, there is an increase in self-confidence and a decrease in the fear of falling.

Balance Exercises

BALANCE EXERCISES CAN BE INCLUDED as part of your regular exercise routine or you can do them at anytime during your day. These are exercises specific to balance; the strengthening exercises for balance and gait have been included in the strength-training portion of this book.

Progression & Safety Tips

[picture] | Hold onto a chair for balance: initially with two hands, progress to one hand and then progress to only one fingertip
[picture] | Next try the exercise without holding on at all, but have someone or something close by in case you lose your balance.
[picture] | If you are very steady on your feet, move on to doing the non-moving exercise using no hands and with your eyes closed.

Sit and Reach

Sitting on a chair with your feet flat on the floor.

Arms straight out in front.

Reach and lean forward from the hips.

Return to the starting position.

One – Legged Balance

Level One:

Stand behind and hold on to a sturdy chair for support.

Bend one knee and balance on the one foot.

Hold 10 – 15 seconds then switch legs.

Level Two:

Balance without hanging onto a chair.

Level Three:

Balance without hanging on and closing your eyes.

Two – Legged Balance

Level One:

Standing behind a chair holding on for support.

Stand on two wobble pads.

Level Two:

Standing on two wobble pads without holding on to anything.

Move arms out to the sides and back down by your hips.

Level Three:

Standing on two wobble pads without holding on to anything.

Move feet forward, center and back.

Try lifting one foot off of one wobble pad and balance on one foot.

Tandem Wobble Pad Stand

Level One:

DO NOT use wobble pad for this level. Just place your feet in a semi tandem position and hold for 10 seconds.

Switch feet.

Level Two & Three:

Standing on two wobble pads that are placed in a semi-tandem position.

Hold for 10 – 30 seconds.

Switch sides.

Heel to Toe Walk

Walk in a straight line placing one heel in front of the other toe.

Toe Walks

Walk in a straight line up on the balls of your feet.

Exercise And Special Populations

ALTHOUGH EXERCISE IS SAFE FOR the majority of people there are some with certain diseases that need special attention when it comes to performing physical activities. Prior to starting any exercise program or increasing your physical activity you will need to see your doctor for medical clearance.

Following we cover a few special populations and some exercise guidelines and tips.

Hypertension (High Blood Pressure)

Facts:

Blood pressure is the primary driving force-propelling blood to the tissues.

<20/80 is considered optimal, >140/90 is considered the dividing line between normal and high blood pressure.

Someone taking blood pressure medication also may be classified as hypertensive.

High Blood Pressure is related to: heart disease, increased severity of atherosclerosis, stroke, congestive heart failure, left ventricular hypertrophy, aortic aneurysm and peripheral disease.

The cause of 90 – 95% of high blood pressure cases is unknown, but once it is detected, the disease can be controlled.

Exercise and Hypertension

The American College of Sports Medicine recently released a position statement on exercise and high blood pressure that recommends endurance exercise training as a non-pharmacological way to reduce the incidence of high blood pressure in susceptible individuals.

The reduction in blood pressure following and exercise session are not completely understood but it appears that exercise causes a decrease in cardiac output and total peripheral resistance at rest.

Guidelines for Exercising with Hyper Tension:

DO NOT hold your breath or strain during exercise.

Weight training should not be used as the primary form of exercise but more as a supplement to endurance training.

If you are adding some weight training, circuit training is preferred over free weights. Keep the weight low and do higher repetitions (15 – 20).

If you are taking medication which may affect your heart rate, use RPE (rate of perceived exertion) to monitor the intensity.

Be aware of any abnormal signs or symptoms before, during or immediately following exercise and report them to your doctor.

Your doctor may want you to record your blood pressure before and after exercise.

Move slowly when coming from the floor to a standing position as you may get light headed due to a quick drop in your blood pressure.

Mode of exercise:

Endurance exercise: low-impact aerobics, walking and swimming should be the primary exercise mode.

Avoid isometrics.

Avoid heavy strength training.

Weight training can be added although not initially and when it is added it is low weight and high repetition.

Intensity:

Low to moderate dynamic exercises.

40 – 60% of target heart rate.

Use rate of perceived exertion.

Frequency:

Ideally every day.

Duration:

Gradually increase to 30 minutes per day of continuous or accumulated activity.

Diabetes

Diabetes is a disorder that disrupts glucose, protein and fat metabolism. Typically people with diabetes have an elevated blood glucose level (hyperglycemic) that results from deficient insulin secretion, insulin action, or both.

Type I Diabetes: requires insulin administration via injections or a pump to control elevated blood glucose levels.

Type II Diabetes: may require dietary intervention, oral drugs and/or insulin injections to control blood glucose levels.

Benefits of Regular Physical Activity

Cardiovascular -Related | Change
Aerobic capacity, or fitness level | Decreases
Resting heart rate | Increases
Blood pressure in mildmoderate hypertensives | Decreases
Work of the heart at submaximal loads | Decreases
Abnormal thickening of the heart | Favorably Decreases
Lipid/Lipoprotein Alterations | Change
HDL | Decreases
LDL | Decreases or stays the same
VLDL/Triglycerides | Decrease
Total cholesterol | Stays the same
Risk ratio (total cholesterol/HDL) | Decreases

Body Composition | Change
Body fat, especially in obese individuals | Decreases
Fat free mass | Increases
Body fat distribution | Favorably Increases
Metabolic Aspects | Change
Insulin sensitivity | Increases
Glucose metabolism | Increases
Thermic effect of food | Increases
Basal and postprandial insulin needs | Increases
Psychological Aspects | Change
Self concept/self esteem | Increases
Depression | Decreases
Stress response to psychological stimuli | Increases

F.I.T.T Physical Activity Program for Cardiovascular Improvements in Diabetes

Variable | Exercise Non-diabetic | Exercise Type 1 | Exercise Type 2
Frequency | 3 – 5 days / week | 3 – 5 days / week | 5 – 7 days / week
Intensity | 50 – 85% heart rate max 3 – 6 RPE | 50 – 60% heart rate max initially, progressing to 60 – 70% heart rate max 3 – 5 RPE | 50 –55% heart rate max initially, progressing to 55 – 70% heart rate max 2 – 5 RPE
Intensity | 20 – 30 min/session | 20 – 30 min/session | 40 – 60 min/session
Type |  | Dynamic movement | Low impact: bicycling, walking, house work, mall walking, water aerobics

Guidelines for Exercising with Diabetes:

•  | Check with your doctor.
•  | Self-blood glucose monitoring:
| –  | Perform before and after each physical activity session.
| –  | Important to ensure that your blood glucose is in relatively good control prior to increasing the intensity of your physical activity.
| –  | >250 mg/dl, then a higher intensity should be postponed.
| –  | <100 mg/dl, then eat a snack which consists of easily absorbed carbohydrates. About 10 – 20 grams.
| –  | Between 100 – 250 mg/dl, then physical activity can be performed.
•  | Keep a daily log:
| –  | Time of day the self-blood glucose monitoring is performed.
| –  | Any medication taken, amount and time.
| –  | Physical activity time (minutes), intensity (heart rate and RPE), distance. This will help you to understand the type of response to expect from a specific physical activity bout.
•  | Plan for your exercise session:
| –  | Time and intensity.
| –  | Carry extra carbohydrate foods and eat 10 – 15 grams per 30 minutes of activity.
•  | Exercise with a Partner.
•  | Wear a Diabetes I.D:
| –  | Problems can arise and the person assisting you will need an understanding of the condition.
•  | Practice Good Hygiene:
| –  | Take extra care of your feet; inspect them for any irritation spots to prevent possible infection.
| –  | All sores need immediate attendance.
| –  | Report hard to heal sores to your doctor.
•  | Wear Good Shoes.

Arthritis

Arthritis means joint inflammation. It is a general term that includes more than 100 kinds of Rheumatic Diseases. We will focus on two: Osteroarthritis and Rheumatoid Arthritis.

Osteoarthritis

Joint cartilage breaks down. Sometimes eroding entirely to leave a bone on bone joint.

The shape of the joint can become disfigured. The bone ends thicken and bone growths (spurs) develop.

Any joint can be affected but the most common joints affected are the feet, knees, hips and fingers.

Rheumatoid Arthritis

This is an autoimmune disease.

The small joints of the hands and feet are the ones most commonly affected.

The synovial lining of the joint becomes inflamed and can spread to the entire joint. This means damage to both the bone and cartilage.

This creates a decrease in space between the joints which means the joint loses shape and alignment.

This type of arthritis is highly variable with some people bed ridden while others can run a marathon.

Benefits Of Exercise

[picture] | Inactivity leads to: weak muscles, stiff joints a decreased range of motion in the joint, decreased aerobic capacity and decreased energy and vitality.
[picture] | Improved joint function and joint range of motion.
[picture] | Improves your state of mind.
[picture] | Decreases bone mass loss.
[picture] | Increases muscular strength and cardiovascular fitness which will enhance ADL (Activities of Daily Living).

[picture] | Exercise training does not improve arthritis but it also does not worsen the disease process either. It improves many other areas that pertain to the quality of life.

Guidelines for Exercising with Arthritis:

The main goal of exercise is to counter the effects of inactivity.

1.  | Range of motion and stretching exercises:
| –  | When the joint becomes less inflamed, you can gradually work up to several sets of 10 repetitions daily of stretching and range of motion exercises.
2.  | Muscle strengthening:
| –  | Utilize both isometric and isotonic strengthening exercises.
| –  | Isometric exercises (no movement) can build muscle strength without any adverse effects on an acutely inflamed joint.

– 
Isotonic exercises (movement through the joint) will allow the joint to move through a full or limited range of motion while performing the exercise (i.e. weight lifting). This type of exercise is recommended when pain and joint inflammation have been controlled and you have achieved sufficient strength through the isometric training.

| –  | Work your way up to performing two to three sessions per week.
| –  | AVOID: high repetition, high resistance and high impact muscle strengthening exercises.
3.  | Cardiovascular exercises:
| –  | If you are not in an acute flare up, cardiovascular exercise has been shown to be a safe and effective treatment.
| –  | Low impact activities can improve aerobic fitness without negatively affecting the arthritis.
| –  | Swimming, walking, bicycling, water aerobics, low impact fitness classes and rowing are some examples.
| –  | Start with 5 to 15 minutes every other day and work your way toward near daily activity of 30 to 45 minutes duration at a moderate to somewhat hard intensity. 4 – 8 RPE.
| –  | You can do shorter times of cardio and accumulate it throughout the day. For example: performing 10-minute bouts of cardio three times throughout the day.
| –  | Begin and end your cardiovascular workout with a warm up and cool down including range of motion movements for your joints.
| –  | Arthritis in the hips and knees: AVOID high impact activities like stair climbing and running.
| –  | A good pair of running shoes with good support are necessary.
4.  | Recreational exercise:
| –  | Golfing, gardening, easy trail walking are some of the recreational activities that people with arthritis find enjoyable.
| –  | There are community groups that offer exercise for arthritic people or aqua fit classes in pools that have shown to be beneficial both psychologically and physically when exercise is engaged in a group setting.

It is important to rest during a flare up.

Rheumatologists advise a balance of physical activity and rest.

Osteoporosis

Osteoporosis means “porous bones” it is a systemic skeletal disease which is characterized by low bone mass and the deterioration of bone strength. This will lead to bone fragility and an increased risk of fracture. Eighty percent of people with osteoporosis are women (National Osteoporosis Foundation, 2002)

Benefits Of Exercise

[picture] | Gravitational forces that pull the muscle at the bony attachments sites are transmitted by mechanical forces to the skeleton via physical activity.
[picture] | Loading the skeletal system remains the only means to actually increase new bone formation (in the mature skeleton, when the body has stopped growing).
[picture] | Research has shown that physically active people typically have a higher bone mass than those who do not exercise.

Guidelines for Exercising with Osteoporosis:

Exercise is typically monitored by a physical therapist.

Weight bearing activity is essential to maintain a healthy skeleton and the increase in strength may also be beneficial for the non-weight bearing bones.

Focus on strength, flexibility and coordination to effectively decrease the incidence of osteoporosis fractures by lessening the chance of falling (ACSM, 1995).

Exercises should be performed slowly and with control.

Any sudden twisting and/or large compressive loads may cause vertebral fractures.

Cardio:

Low Intensity: 40 – 70 % of heart rate max. RPE: 2 – 4

Minimum three days per week.

20-30 minutes per session. You can work your way up to this by accumulating time throughout the day.

Flexibility:

General overall flexibility of the joints in the body.

Special attention given to the pectoral muscles (chest muscles) as they often experience shortening in clients with Kyphosis (rounding of the upper back).

Strength training:

Strength training for the legs, abdomen and back are the most critical since they not only focus on improving lower body strength and postural control but also may help prevent falls.

If you have good lower body strength it will be easier to recover from a stumble.

Due to the fact that the most common and often debilitating hip fractures occur from falls to the side it is important to improve the side/side balance and increase your balance all together.

Make sure you add the Abductor and Adductor exercises found in the book as well as some of the balance exercises.

AVOID:
– Excessive spinal flexion (sit and reach exercises, and curl ups) due to the fact that this movement may compromise fragile vertebrae bodies.
– Long periods of standing on one leg as this may lead to a fall due to muscular fatigue.

F.I.T.T.

Frequency: 2 – 3 days per week minimum.

Intensity & Time: start with: 1 – 3 sets of 10 – 15 repetitions then progress to 3 – 4 sets of 6 – 10 repetitions (the weight is heavier).

Type: resistance training exercises.

Warm Up & Cool Downs:

An extended warm ups and cool downs of about 10 to 20 minutes as it may take longer to warm the muscles up and adjust the circulatory changes and requirements that are involved in movement

Special Considerations

Make sure the exercise surface is not slick, uneven or have loose or torn carpet as this may increase the likelihood of slipping, tripping and falling.

Some medications may cause dizziness or a loss of balance.

Corrective lenses should be used during exercise.

Refrain from wearing baggy clothing that could catch or snag on equipment.

About The Authors

SUSAN MANNING has worked in the fitness industry for over 31 years. She has managed fitness clubs, developed and directed programs for Personal Training and Group Exercise, written fitness articles, a Step Aerobics manual, taught Fitness Theory, Weight Training, Group Fitness courses.

Susan is registered and holds certifications with, BCRPA (British Columbia Recreation and Parks Association) as Trainer of Fitness leaders – Group Fitness & Weight Training and is also a BCRPA Personal Trainer. ACE (American Council on Exercise): Personal Trainer and Exercise to Music. ACSM (American College of Sports Medicine): Group Fitness. Susan holds a certification as an ACE “Advanced Health & Fitness Specialist” gold level and is a Sport Strength Conditioning Specialist with Twist Conditioning and is currently a Health & Fitness Consultant and Personal Trainer.

Susan focuses her Personal Training on working with Older Adults and has had great success with her clients.

Her Words of Wisdom: Live life to the fullest! If you never knew how old you were… how old would you be?

DR. CAROLYN ANDERSON M.D., FRCS (C) is an Ophthalmic Surgeon with a thriving practice focusing on cataract surgery, glaucoma, and the monitoring of ocular diseases. As a busy cataract surgeon with an office practice of more than 25,000 patients over the age of 55, Dr. Anderson deals mainly with the retired population and those facing retirement within the next decade. This puts her in a unique position to observe the importance of attitude and exercise in aging, health, and wellbeing.

Dr. Anderson’s passion for helping the experienced population led her to begin the Impowerage Magazine. Impowerage is a free online 50+ magazine that publishes articles on fitness, health, wellness, travel, finances and more. Carolyn writes an “On My Mind” column for Impowerage where she shares motivational and medical advice. You can find fitness advice and more workout routines at Impowerage.com.

Impowerage donates 20% of its proceeds to fund research into the prevention and treatment of macular degeneration.

Dr. Anderson is a wellness and productivity expert and the co-author of a best-selling book, Pushing To The Front, with Brian Tracy. Dr. Anderson also writes for the Huffington Post and her own website at CarolynAndersonMD.com.

Her practice is situated in Langley, British Columbia. In 2006, Dr. Anderson opened a state of the art private surgical facility (The Langley Surgical Centre). Dr. Anderson graduated from medical school at the University of British Columbia in 1994 and completed her residency in 1999 with training at The University of British Columbia, Stanford University and The University of Australia.

Glossary of Terms

Lea & Febiger, Philadelphia, 1982 GLOSSARY & COMMON TERMS

Abduction Movement of a body part away from the midline of the body; opposite of adduction.

Activities of Daily living (ADL) Activities normally performed for hygiene, bathing, household chores, walking, shopping and similar activities.

Acute Describes a condition that usually has a rapid onset and a relatively short and severe course. Opposite of chronic.

Adduction Movement of a body part toward the midline of the body; opposite of abduction.

Adherence The degree to which an individual follows a recommended health or illness related recommendation.

Aerobic With or in the presence of oxygen.

Anaerobic Without the presence of oxygen: not requiring oxygen.

Anterior Anatomical term meaning toward the front. Opposite of posterior.

Arteries Vessels that carry oxygenated blood from the heart to the tissues.

Arterioles Smaller divisions of the arteries.

Arthritis Inflammatory condition involving a joint. Asthma A disease of the pulmonary system, characterized by episodes of dyspnea (difficult breathing) due to narrowing of the airways from constriction of bronchial smooth muscle and over production of mucus.

Atherosclerosis A specific form of arteriosclerosis, characterized by the accumulation of fatty material on the inner walls of the arteries, causing them to harden, thicken, and lose elasticity.

Atrophy A decrease in the cross-sectional size of a muscle resulting from inactivity or immobilization following injury.

Basal metabolic rate (BMR) The energy expended by the body at rest to maintain normal body functions.

Base of support That area beneath the body that is encompassed when you connect, via one continuous line, all points of the body that are in contact with the ground.

Blood Pressure The pressure exerted by the blood on the walls of the arteries.

Body composition The body makeup of the relative percentage of lean body mass and body fat.

Body mass index (BMI) The measure of an individual’s body weight to body height used for determining obesity: expressed as kg/m2.

Cardiac output The amount of blood pumped by the heart per minute; usually expressed in liters of blood per minute.

Cardiovascular (cardiopulmonary endurance) The ability to perform large muscle movement over a sustained period; the capacity of the heart-lung system to deliver oxygen for sustained energy production. Also called cardiorespiratory endurance.

Center of gravity The center of a body’s mass. It is the point about which all parts are in balance with one another. Things that affect it are the current body position in space, anatomical structure, gender, habitual standing posture, and if you are holding external weights.

Cervical Regional term referring to the neck.

Cervical vertebrae The seven vertebral bones of the neck.

Cholesterol A fatty substance found in the blood and body tissues and in animal products. It is essential for body production of hormones, steroids but its accumulation in the arteries leads to narrowing of the arteries (atherosclerosis).

Chronic Describes a condition that continues and persists over a long period of time, often of gradual onset, involving very slow changes; does not indicate the severity of the disease. opposite of acute.

Circuit training A series of four to ten exercise stations, with brief rest intervals between stations. It can emphasize muscular endurance , cardiovascular conditioning or both.

Concentric contraction A contraction in which a muscle exerts force, shortens, and overcomes a resistance.

Congestive heart failure (CHF) The inability of the heart to pump blood at a sufficient rate to meet the metabolic demands of the body.

Connective tissue The tissue that binds together and supports various structures of the body such as ligaments (attaches bone to bone) and tendons (attaches muscle to bones).

Continuous training Conditioning exercise such as cycling, walking, aerobic classes where the prescribed intensity is maintained continuously.

Coronary artery disease (CAD) The major form of cardiovascular disease; almost always the result of atherosclerosis. Also known as coronary heart disease (CHD).

Delayed muscle soreness Muscle soreness that occurs 24 to 48 hours after intense exercise.

Diabetes mellitus A disease of the carbohydrate metabolism, in which an absolute or relative deficiency of insulin results in an inability to metabolize carbohydrates normally.

Diastolic blood pressure The pressure exerted by the blood on the blood vessel walls when the heart relaxes between contractions.

Dyspnea Shortness of breath; or distress in breathing.

Eccentric contraction A contraction in which a muscle exerts force as it lengthens.

Energy The potential to do work and activity and is measured by the calories that are derived from carbohydrates, fat or protein. Extension Movement at a joint, increasing the angle of the joint bringing the two body parts farther away from each other. Opposite of flexion.

Flare A worsening or reappearance of arthritis symptoms.

Flexibility The range of motion possible about a joint.

Flexion Movement at a joint, decreasing the angle of the joint bringing the two body parts closer together. Opposite of extension.

Frailty The condition of being frail, fragile, easily damaged; the predisposition toward increased risk of injury, illness, disability and/or death.

Frequency Refers to the number of exercise sessions per week.

Gait phase Specific functional patterns that are represented in the walking cycle.

HDL High density lipoprotein; a lipoprotein that contains more protein than cholesterol. Often called “good” cholesterol because it removes excess cholesterol from the body.

Hyperglycemia An elevated blood glucose level (above 126 mg/dl) caused by deficient insulin production or insulin action.

Hypoglycemia A low blood glucose level (below 80 mg/dl) caused by too much insulin, too little nutrient intake, or both.

Insulin resistance An inability of muscle tissue to effectively use insulin, there is a resistance by insulin sensitive tissues to allow insulin action.

Kyphosis An increased posterior curve of the spine in the thoracic region.

Lordosis An inward curvature of the spine. There is some normal degree of lordosis found in the cervical and lumbar spine.

Low-Impact exercise Exercise where one foot is always in contact with the ground during movement.

Lumbar Regional term referring to the low back. Lumbar vertebrae Refers to the five lumbar vertebrae of the spine.

Metabolism The physical and chemical processes that provide energy for the maintenance of life.

Muscle fiber A muscle cell.

Muscle length The actual length of a muscle between its tendon attachments. Muscle spindles located in muscle fiber which monitor muscle length.

Muscle tone The resistance of muscles to passive elongation or stretch.

Muscular endurance The capacity of a muscle to exert force repeatedly against a resistance or to hold a position or static contraction for a period of time.

Muscular strength The maximum force that a muscle can produce against resistance in a single, maximal effort.

Neuropathy Any disease affecting a peripheral nerve. You may feel is as a loss of nerve function, numbness, tingling and burning pain.

Obesity An excessive amount of body fat. Usually defined as more that 20% above ideal weight or a body fat percentage of over 25% for men and 30% for women.

Orthostatic hypertension Abnormal decrease in arterial blood pressure that occurs when a person assumes an erect posture.

Osteoarthritis A degenerative joint disease, found mainly in older adults, caused by degeneration of the articular cartilage of the joints.

Osteoporosis Bone Density that is well below average, classified as greater than 2.5 standard deviations below peak bone density. This can result in an increased risk of fractures due to the fragility of the skeleton.

Overuse injury An injury caused by activity that places too much stress on one area of the body over an extended period.

Posterior Anatomical Term meaning toward the back. Opposite of Anterior.

Prime-mover muscle The muscle that contracts and is mainly responsible for the movement of the joint.

Progressive resistance As one’s strength increases a gradual adding of more resistance to the exercise.

Proprioception Sensation and awareness of body position and movements.

Range of motion (ROM) The range (number of degrees) that a joint can move.

Ratings of Perceived Exertion (RPE) Developed by Borg, this scale provides a standard means for evaluating your perception of physical exertion. It is based on a scale of 0 – 10.

Rheumatoid arthritis An autoimmune disease that causes inflammation of the connective tissues and joints.

Risk factor Is an inherited trait, characteristic or behavior related to the presence or the development of a condition or disease.

Rotator cuff A group of muscles around the shoulder joint that are responsible for shoulder strength and stability. Made up of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles.

Stabilizer muscles Muscles that stabilize one joint so a desired movement can be performed in another joint.

Static (passive) stretch Low force, long duration stretch that holds the desired muscles at their greatest possible length for 15 to 30 seconds.

Step Length The distance between the points of initial contact by the two feet.

Strength plateau A period of time when no further strength gains occur, which indicates that some aspect of the training should be changed to enable further progress.

Stride The interval in the gait cycle between two sequential points of initial contact by the same foot. For example right foot to right foot.

Stroke volume The amount of blood pumped from the left ventricle during one heartbeat.

Synergist A muscle that assists another muscle in its function.

Synovial fluid Is a transparent, viscous lubricating fluid found in joint cavities, bursa, and tendon sheaths.

Systolic blood pressure The pressure exerted by the blood on the blood vessel walls during the hearts contraction.

Talk test A subjective method for measuring exercise intensity. Based on the fact that if you are able to talk during cardiovascular activity that you are still working in your aerobic training zone.

Tendon Strong, fibrous connective tissue that attaches a muscle to a bone.

Thermic effect of food (TEF) An increase in cellular activity associated with the digestion, absorption and metabolism of food, which increases energy expenditure.

Thoracic Anatomical term referring to the portion of the body between the neck and abdomen; also known as the chest (thorax) region.

Thoracic vertebrae The 12 vertebral bones of the mid-spine.

Triglyceride The storage form of fat consisting of three free fatty acids and glycerol.

Valsalva maneuver Increased pressure in the thoracic cavity caused by forced exhalation with the breath held.

Veins Blood vessels that carry usually deoxygenated blood to the heart.

Venules smaller divisions of the veins.

References

Clinical Exercise Specialist. ACE’s Source for Training Special Populations 2007

Richard T. Cotton, American Council on Exercise. Ross E. Andersen, Johns Hopkins School of Medicine, division of Geriatric Medicine and Gerontology

Hypertension: Dr. Scott O. Roberts

Diabetes: Dr. Larry S Verity

Arthritis: Dr. David C Nieman

Osteoporosis: Dr. Dara A Witzke

San Diego, Calif.: American Council on Exercise

American College of Sports Medicine

Medicine 7 Science in sports & Exercise, Volume 30, Number 6, June 1998, Position Stand, Exercise and Physical Activity for Older Adults

American College of Sports Medicine (2003). Exercise management For Persons with Chronic Diseases and Disabilities (2nd ed.) Champaign, Ill: Human Kinetics

American College of Sports Medicine (2001) ACSM position stand: Physical activity and type 2 diabetes. Medicine and Science in Sports and Exercise

American Diabetes Association (2003). Physical activity/exercise and diabetes mellitus: Position statement. Journal of Diabetes Care, 26 9Suppl.1), 573 – 577

Arthritis Foundation. (2001). Priner on the Rheumatic Diseases (12th ed.) Atlanta, Ga: Arthritis Foundation

American College of Sports Medicine. (2003). In ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities (2nd ed.)

Champaign, Ill.: Human Kinetics

American Council on Exercise. (2005). Exercise for Older Adults: ACE’s Guide for Fitness Professionals (2nd ed.). San Diego, Calif.: American Council on Exercise

Exercise and Cumulative Trauma Disorder 2005 Kimberly Williams D.C.

Kinetic Chain Concepts Involving Common Overuse Injuries

American Council On Exercise, Personal Trainer Manual, The Ultimate Resources for fitness Professionals, Third Edition, 2003, San Diego CA

American Council On Exercise, Personal Trainer Manual, The Resource for Fitness Instructors.1995, San Diego CA

The Stark Reality of Stretching. An Informed approach for all Activities and Every Sport

Revised & Expanded Fourth Edition, Richmond, BC , Canada

Dr. Steven D. Stark

Rapid Review, anatomy Reference Guide, Anatomical Chart Company, 1996 Anatomical chart Company, Skokie, Illinois

Steps to Success Activity Series, Weight Training. 1992

Thomas R. Baechle, Creighton University, Omaha, Nebraska

Barney R. Groves, Virginia Commonwealth University, Richmond, Virginia

Leisure Press Champaign, Illinois

Strength Training Anatomy, Your Illustrated guide to muscles at work, Frederic Delavier
Human Kinetics, 2001

Fundamentals of Physiology, Human Perspective, Lauralee Sherwood, 1991

St. Paul, New York, Los Angeles, San Francisco

Essential Human Anatomy, A Text - Atlas. James E. Crouch

Lea & Febiger, Philadelphia, 1982

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