Exercises for Older Adults

 

 

Lifter-for-life-1

SEPT 22

Weight Lifting for Middle-Age and Beyond

Many middle-aged and older people have started to lift weights, since extensive data show that lack of muscles increases risk for diabetes, heart attacks and premature death (British Medical Journal, September 2009; Journal of Physiology, September 2009). However, within the first few weeks of their new weight-lifting programs, most get injured and quit.

Often they get injured because they try to train like younger me, by picking the heaviest weight that they can lift ten times in a row, resting and repeating that set two more times. Then they feel sore for the next few days and when the soreness lessens, they lift heavy weights again, usually two or three times a week. This type of training almost always injures older novice weight lifters and ends their training program.

The safest way for most older men and women to start a program to gain strength and increase muscle size is to join a gym and try to use 15 to 20 Nautilus-type machines every day or every other day. On each machine they should pick the weight that they can lift and lower 10 times in a row comfortably, without straining or damaging their muscles (which would make their muscles feel sore on the next day). If they feel the least bit sore, they should take a day or days off until the soreness is gone. As they become stronger and the weights feel very easy for them, they should try to lift 15 times in a row, then perhaps 20 times.  Only when they can lift that weight at least 20 times in a row and not feel sore the next morning, should they try to increase the resistance by going to the next heavier weight.

The key to this program is to avoid injuring their muscles by lifting weights in a single set and increasing the number of repetitions gradually so they do not cause next-day muscle soreness. They should not increase the weight (resistance) until they can lift a set of at least 20 daily and not feel sore the next day.

Before any older or out-of-shape person starts an exercise program, he or she should check with a physician to rule out serious problems that might be aggravated by weight lifting.

This program is for beginners and is intended to prevent injuries that plague older people when they first try to lift weights. It will not build very large muscles. It will, however, increase strength and provide the other benefits of a weight training program. After many months (injury-free) on this program, if a person wishes to build larger muscles, he or she can transition to a more traditional weight training program. 

SEPT 20

Exercise for Arthritis

When you have arthritis, your joints hurt every time you move. When you wake up, your muscles and tendons are so stiff that you can barely get out of bed, but you force yourself to get up and as you keep on moving, the pain lessens and you can move a little faster.

Is your body trying to tell you something when you muscles and joints feel better after you start to move? Dr. Ronenn Roubenoff of Tufts University Medical School published a paper in the Journal of Rheumatology showing that rest worsens arthritis, and strength training helps to control the pain of arthritis.

Most people think that when they have arthritis, they are supposed to rest their muscles and joints, but resting is the worst thing that a person with arthritis can do. Arthritis means that the gears that are formed by cartilage in your joints are damaged, causing your joints to hurt. Resting weakens your muscles and makes your joints wobble even more when you walk. Your car works in a similar fashion. When your car goes over a bumpy road, the shock absorbers dampen the shock of each bump. When you walk or run, the cartilage in your joints act like rubber to absorb the shock. Resting weakens cartilage and increases its likelihood to break. Resting weakens muscles so they can’t control the joint, allowing more wobble of the joints with each movement and therefore increasing cartilaginous damage.

People with arthritis should exercise, but they should not walk fast or run. When you walk or run, your foot stops moving suddenly when it hits the ground with a force that is transmitted up your leg to your knees and hips. This force can break cartilage. So people with arthritis should not run, walk fast, jump, or play tennis or basketball because the jarring breaks joints. On the other hand, these people can pedal a bicycle because pedaling is done in a smooth rotary motion that does not stop suddenly to jar and break the cartilage in joints.

People with arthritis should also lift weights because this strengthens muscles to stabilize joints, and strengthens cartilage to protect it from breaking. Ideally, everyone with arthritis should gain access to weight machines and be taught how to lift weights with proper form, in sets of ten, two or three times week. They should also pedal a bicycle several times a week. The combination of smooth continuous exercise on a bicycle and supervised weight lifting on a machine can help protect people with arthritis from further joint damage and reduce pain. Swimming, rowing or any other activities that use smooth motions can be substituted for cycling.

SEPT 5

More Reasons to Exercise as You Grow Older

Muscles are made up of thousands of muscle fibers just as a rope is made up of many strands. Each muscle fiber has a nerve that innervates it. With aging you can lose nerve fibers that, in turn, cause you to lose the corresponding muscle fibers, but exercising against resistance will make the remaining muscle fibers larger so they can generate more force.

A recent experiment measured the force that a rat’s muscle fiber generates when it is electrically stimulated at the nerve or at the muscle. Electrically stimulating the muscle directly showed that the muscles of young rats generated 40 percent more force than those of old rats. On the other hand, when the nerve endings were stimulated electrically for five minutes, the muscles of the old and young rats generated the same amount of force. The authors suggest that loss of strength with aging is primarily due to loss of nerve function rather than just muscle function (Experimental Gerontology, March 2018). The repetition of a regular and consistent training program teaches your brain how to contract your muscles more efficiently.

Researchers at the University of Guelph have another explanation why people, even those who exercise regularly, lose muscle size and strength as they age. They showed that aging causes loss of mitochondria, the tiny furnaces in cells that turn food into energy (Cell Reports, March 13, 2018). This causes the accumulation of breakdown products called Reactive Oxygen Species (ROS) that delay healing and weaken muscles (Cell Metabolism, March 2017;25(3):581–592).

More New Studies on Muscle Growth for Older People

Osteoporosis: Lifting weights helps to strengthen bones of postmenopausal women who suffered from osteoporosis (J of Bone and Min Research, February 2018;33(2):211-220).

Protein Intake: Several studies show that older people do not gain any additional muscle size or strength from increasing their intake of protein above the current RDA (recommended dietary allowance) of 0.8 gm/kg of body weight/day. Even older men who are taking extra testosterone do not gain any extra strength or muscle growth from increasing their intake of protein to 1.3 g/kg/day (JAMA Internal Medicine, April 2018).

High-Plant Diet after Menopause: Older women who follow a Mediterranean-type diet (based on plants, with fish but restricting red meat and added sugars) have larger muscles and bones after the menopause than women who eat the typical Western diet (ENDO 2018, the Endocrine Society annual meeting in Chicago, March 19, 2018).

Recovery Time: Older people who do strength training need to realize that their muscles will not heal as fast from workouts as muscles of younger people because aging causes their mitochondria to become smaller in number and size (Cell Metabolism, March 2017;25(3):581–592).

Starting a Resistance Program

The most effective way to slow down the loss of muscle strength with aging is to start a resistance exercise program that includes using strength training machines or lifting weights. A review of 25 well-designed and performed scientific studies shows that resistance training can grow larger and stronger muscles in older men and women (Sports Med, Dec 2015;45(12):1693-720). Older people who use strength training machines two or three times a week can make themselves stronger to decrease their risk for falling, breaking bones, and suffering osteoporosis, arthritis, heart attacks, diabetes, and premature death (Am J Prev Med, Oct 2003;25(3 Suppl 2):141-9). See Slowing Loss of Bone 

Before you start a new weight training program, check with your doctor and get expert advice from a trainer so you can learn proper lifting techniques for the equipment you will be using. Most beginners will be far more successful on weight lifting machines, rather than using free weights. The machines are safer because they can guide the way you move the weights with the specific muscles for each machine.

How to Make Muscles Stronger

Just exercising does not make a muscle stronger. The stimulus to make a muscle larger and stronger is to exercise that muscle against resistance to the point where you feel a burning in that muscle. However, if you continue to exercise after you start to feel that burn, you run the risk of injuring the muscle, so most older people can prevent injuries by stopping each set of lifting as soon they feel a burn in their muscles. You can exercise to the burn by using heavy weights with few repetitions or by using lighter weights with more repetitions. Older people gain the most strength by doing more sets of lower repetitions per set than using fewer sets with higher numbers of repetitions per set (Experimental Gerontology, March 29, 2018;108:18-27). The lighter the weight you use, the more repetitions you have to do to feel the burn. For example, several sets of three repetitions each is safer than performing fewer sets of the same weight with sets of 10 repetitions. For more detailed suggestions see Strength Training Guidelines from Dr. Richard Winnett of Virginia Tech.

My Recommendations

Aging can take away much of your quality of life unless you keep your muscles strong enough to perform all of your daily activities. A regular strength training program will help you to move faster, walk with more security, be less likely to fall and hurt yourself, and have more confidence in every movement of your body.

CAUTION:People with blocked arteries leading to their hearts can suffer heart attacks with exercise. Check with your doctor before starting a new exercise program or increasing the intensity of your current program.

AUG 31

Even a 100-Year-Old Can Improve with Training

A new research report shows that you can improve athletic performance with proper training, even if you are over 100 years old. Traditional feeling among scientists is that aging is progressive and inevitable, and that your genetic programming causes you to age no matter what you do. This paper shows that physical training can reverse established markers of aging (J Appl Physiol, February 15, 2017).

A few weeks ago I reported on Robert Marchand, the 105-year-old cyclist who had improved his world record for how far he could ride a bicycle in one-hour from 15.07 miles (24.25 kilometers) at age 101 to 16.73 miles (26.92 kilometers) at age 103. That is an 11 percent improvement in a world record after just two years of serious training, an impressive accomplishment at any age.

Marchand’s Training Program

For two years, from age 101 to 103, Marchand trained by riding 3000 miles (5,000 km) per year, with 20 percent of his workouts doing hard, intense riding and 80 percent doing slow recovery riding. He spun his pedals at a cadence between 50 and 70 rotations per minute.

This new study documents his training program and the improvements in his markers of aging. Athletes can run, ride, swim or ski faster if they improve their maximum ability to take in and use oxygen (VO2max) and their peak power output (strength). These same measurements are used by scientists to track aging in non-athletes. Marchand’s VO2max (maximal ability to take in and use oxygen) increased 13 percent, from 31 to 35 ml.kg-1.min-1, and his peak power output increased by 39 percent, from 90 to 125 watts.

These factors improved in Marchand because he was able to increase his maximal pedaling frequency by 30 percent, from 69 to 90 rotations per minute, and his ability to take in air through his lungs by 23 percent, from 57 to 70 liters per minute. His maximum heart rate and body weight did not change.

Training That Reduces Measures of Aging

Here is a program of training that is typical of the way competitive athletes in endurance sports work to become faster.

Muscle-sugar-depleting workout (one per week): You must exercise long enough to use up most of the sugar stored in your most-used muscles. Muscles use primarily fat and sugar for energy. You have an almost infinite amount of fat stored in your body, but only a very limited amount of sugar stored in the liver and muscles. Sugar requires less oxygen than fat to fuel your muscles, so when you run out of sugar stored in your muscles, you have to slow down. Exercising long enough to deplete muscles of their stored sugar supply increases the amount of sugar they can store and also increases your ability to move faster longer. The faster you move, the quicker you use up your muscles’ stored supply of sugar. The average runner can use up most of his stored muscle sugar supply while running fairly fast for two hours, and the average bicycle rider can use up his stored muscle sugar in three hours.

Intense oxygen deficit workout (two per week): The limiting factor to how fast you can move is the time it takes to move oxygen into muscles. You can increase your ability to take in and use oxygen by using interval workouts in which you run up severe oxygen debts and gasp for breath. You also have to damage muscles so that when they heal, they become stronger. To do this you must put great pressure on your muscles by moving very fast.

Type of Intervals: A short interval lasts less than 30 seconds. You can do lots of them in a single workout because in less than 30 seconds, you do not build up much lactic acid and do less muscle damage. A long interval lasts longer than two minutes and you should do only a limited number of these intervals because they cause considerable muscle damage and can take a long time for muscles to heal and recover.

Recovery workouts (at least four per week): Intense interval workouts cause considerable muscle damage, and it usually takes at least 48 hours for muscles to heal, so each intense workout requires easier workouts on the following day. If you are training twice a day, each intense workout is usually followed by three recovery workouts.

Example of a Weekly Training Program

Sunday: race or depletion workout

Monday: recovery workout

Tuesday: short intervals

Wednesday: recovery workout

Thursday: long intervals

Friday: recovery workout

Saturday: recovery workout

How to Apply These Concepts to an Ordinary Exercise Program

While exercisers who are not competing are likely to spend far less time in their sport, they can still benefit from following the same training principles. Increasing evidence shows that intense exercise is more effective than casual exercise, so plan to introduce at least some intense intervals into your program. You can gain the health benefits and help to prevent injuries if you:

• Plan to exercise every day

• Realize that if you are training properly, your legs are likely to feel sore every morning. If your legs do not feel fresh after a 5-to-10-minute warm up, take the day off.

• Stop your workout immediately if you feel a tightness, discomfort or pain in one area.

• As soon as your legs start to feel heavy during a workout, stop for the day.

Caution: People with blocked arteries leading to their hearts can be harmed by intense exercise, so check with your doctor if you have any questions.

AUG 11

Exercise Keeps You Younger

The decline in brain and body function with aging is caused more by inactivity than it is just by aging. A new study of 85 male and 41 female fit amateur cyclists, aged 55 to 79, found that most of them were physically much younger than most people of the same age (The Journal of Physiology, published online January 6, 2015;593(1)). All rode their bikes for recreation and none were serious competitive athletes. The men had to be able to ride a metric century (62 miles)averaging only 10 miles per hour, and the women 60 kilometers (37 miles), averaging a slow 6.7 miles per hour.

The older bicyclists’ test results were close to those for younger people for:

• endurance,

• pedaling power,

• metabolic health (control of blood sugar levels),

• balance,

• memory function,

• bone density and

• reflexes.

The single best test that correlates with aging is called V02max, the maximal amount of oxygen that a person can take in and use during a given time period. Many population studies show that VO2max drops significantly with aging. In this group of older bicyclists, VO2max was just a little lower than the results in the younger ones.

Incredibly, the older cyclists had test results similar to younger cyclists for lung power and exercise capacity; and even more incredibly, the memory of the older cyclists was just as good as the memory of the younger cyclists. This confirms many other studies that show that a high level of regular exercise prevents your brain from deteriorating. Several thousand years ago, the Romans knew that when they greeted each other with “Mens sana in corpore sano” (a healthy mind in a healthy body).

Older Bicyclists Did Lose Strength

By studying only older men and women who are very active and ride bicycles most days, the authors were able to select a group of older people who are not like the general population in England. Thus this study shows that older people who exercise regularly have bodies and minds that are similar to those of much younger people. The conclusion is that the rapid decline in mind and body with aging is caused far more by inactivity than by aging.

The oldest cyclists were stronger than non-exercisers, but they had much smaller and weaker muscles than cyclists in their 50s and early 60s. This shows that aging makes you weaker, no matter how much you exercise. However, other studies show that while you lose strength rapidly with aging, you lose endurance and recovery time from intense exercise far more slowly.

What You Should Learn from This Study and Others Like It

If you want to be able to run, cycle or walk long distances fast as you grow older, you should try to exercise every day and try to go a little faster on some days. The majority of older people have chosen to be frail, weak and uncoordinated because of their lifestyles, not their ages.

• If you have never exercised, start now.

• If you exercise regularly, continue to do so.

• Find an exercise in which you can keep moving almost every day: dancing, walking, various exercise machines, cycling, skiing, and so forth.

• Those who choose to ride a bicycle should worry more about being hit by a car than about the disabilities associated with aging.

• In our modern societies, people are living longer and often spend many years suffering terrible disabilities of both mind and body. Most North Americans over 70 cannot walk fast. One in eight people over 70, and one in two over 85, suffer from dementia. Exercise helps to slow damage to your mind and body associated with aging.

• Lack of exercise is associated with increased risk for overweight, diabetes, heart attacks, strokes, many different cancers, and premature death.

Caution: People with blocked arteries leading to their hearts are at increased risk for heart attacks when they start to exercise or increase the speed or amount of exercise. Check with your doctor.

AUG 4

Weight Lifting for Middle-Age and Beyond

Many middle-aged and older people have started to lift weights, since extensive data show that lack of muscles increases risk for diabetes, heart attacks and premature death (British Medical Journal, September 2009; Journal of Physiology, September 2009). However, within the first few weeks of their new weight-lifting programs, most get injured and quit.

Often they get injured because they try to train like younger me, by picking the heaviest weight that they can lift ten times in a row, resting and repeating that set two more times. Then they feel sore for the next few days and when the soreness lessens, they lift heavy weights again, usually two or three times a week. This type of training almost always injures older novice weight lifters and ends their training program.

The safest way for most older men and women to start a program to gain strength and increase muscle size is to join a gym and try to use 15 to 20 Nautilus-type machines every day or every other day. On each machine they should pick the weight that they can lift and lower 10 times in a row comfortably, without straining or damaging their muscles (which would make their muscles feel sore on the next day). If they feel the least bit sore, they should take a day or days off until the soreness is gone. As they become stronger and the weights feel very easy for them, they should try to lift 15 times in a row, then perhaps 20 times.  Only when they can lift that weight at least 20 times in a row and not feel sore the next morning, should they try to increase the resistance by going to the next heavier weight.

The key to this program is to avoid injuring their muscles by lifting weights in a single set and increasing the number of repetitions gradually so they do not cause next-day muscle soreness. They should not increase the weight (resistance) until they can lift a set of at least 20 daily and not feel sore the next day.

Before any older or out-of-shape person starts an exercise program, he or she should check with a physician to rule out serious problems that might be aggravated by weight lifting.

This program is for beginners and is intended to prevent injuries that plague older people when they first try to lift weights. It will not build very large muscles. It will, however, increase strength and provide the other benefits of a weight training program. After many months (injury-free) on this program, if a person wishes to build larger muscles, he or she can transition to a more traditional weight training program.  

AUG 2

Weak Muscles Increase Risk for Dementia

Many studies show that having excess fat in your belly is associated with increased risk for dementia, but a new study shows that as a person ages, lack of muscle size and strength appears to be an even stronger predictor of dementia than having excess belly fat (Clinical Interventions in Aging, July 5, 2018;13).

The authors followed 353 men and women, average age 69, and found that those who had both excess body fat and small, weak muscles had the worst memory, speed in answering questions and executive function such as making intelligent decisions. Those who had the weakest and smallest muscles had even worse mental function than those who were just obese and did not have excessive muscle weakness. Another well-performed study of more than 5000 people, with an average age over 70, also found that low muscle size is associated with increased risk for dementia (Age and Ageing, March 2017;469(2):250–257).

Significance of “Skinny Fat”

This new study found that many people who do not have conventional measures of obesity such as excess weight or a high BMI (Body Mass Index) can still be at high risk for obesity-related diseases such as dementia, heart attacks, strokes, diabetes, certain cancers and premature death. The authors call this “skinny fat,” a combination of low muscle size and strength and high fat mass that significantly increases risk for dementia. Sarcopenia (loss of muscle size and strength) and obesity are part of the aging process for many people, and can both be used to predict potential mental decline, dementia, and diseases associated with aging. These conditions can be caused by sedentary behavior, weight gain and an unhealthful diet.

Testing and Treating People with “Skinny Fat”

Strength testing can be as simple as measuring a person’s grip strength with a simple inexpensive hand-held dynamometer. Excess fat can be measured with belly circumference or thickness of the fat layer underneath the skin near the belly button. An MRI of the body will be more accurate but is far more expensive and time consuming. People with weak grip strength or high belly fat are at increased risk for dementia with aging, even if they appear otherwise to be thin and healthy. An earlier study showed that a program of strength training and aerobic exercise and a healthful diet can help slow the frightening loss of muscle size and strength and increase in body fat in people as they age (Clinical Interventions in Aging, August 6, 2015;1267—1282). A recent review of many studies showed that the typical Western diet (high in sugar, red meat, processed meat and fried foods) is associated with a marked increase in the incidence of mental decline and dementia throughout the world (presented at the 2018 Alzheimer’s Association International Conference, July 22, 2018 in Chicago, Illinois). Another study of 2200 people, presented at this same conference, shows that people who consume the equivalent of two-and-a-half teaspoons or more of added sugar a day have a 54 per cent increased risk for developing Alzheimer’s disease. A high rise in blood sugar can damage every cell in your body, particularly your brain.

To prevent blood sugar levels from rising too high, your pancreas releases insulin which lowers blood sugar by driving sugar from the bloodstream into the liver. However, if you have a lot of belly fat, you are also likely to have a liver full of fat, and a fat-filled liver cannot accept sugar from the bloodstream. Contracting muscles can lower blood sugar just by pulling sugar from the bloodstream without even needing insulin. A single bout of exercise will allow your muscles to pull sugar out of your bloodstream without needing insulin for up to 17 hours after you finish exercising. Lack of exercise and low muscle size are associated with high blood sugar levels and increased risk for both diabetes and dementia.

My Recommendations

A high rise in blood sugar after meals is a major risk factor for dementia. You will help to prevent dementia by preventing high rises in blood sugar if you:

• grow larger and stronger muscles

• avoid foods that cause high rises in blood sugar

• avoid having excess belly fat that specifically causes high rises in blood sugar

july 30

More Reasons to Exercise as You Grow Older

Muscles are made up of thousands of muscle fibers just as a rope is made up of many strands. Each muscle fiber has a nerve that innervates it. With aging you can lose nerve fibers that, in turn, cause you to lose the corresponding muscle fibers, but exercising against resistance will make the remaining muscle fibers larger so they can generate more force.

A recent experiment measured the force that a rat’s muscle fiber generates when it is electrically stimulated at the nerve or at the muscle. Electrically stimulating the muscle directly showed that the muscles of young rats generated 40 percent more force than those of old rats. On the other hand, when the nerve endings were stimulated electrically for five minutes, the muscles of the old and young rats generated the same amount of force. The authors suggest that loss of strength with aging is primarily due to loss of nerve function rather than just muscle function (Experimental Gerontology, March 2018). The repetition of a regular and consistent training program teaches your brain how to contract your muscles more efficiently.

Researchers at the University of Guelph have another explanation why people, even those who exercise regularly, lose muscle size and strength as they age. They showed that aging causes loss of mitochondria, the tiny furnaces in cells that turn food into energy (Cell Reports, March 13, 2018). This causes the accumulation of breakdown products called Reactive Oxygen Species (ROS) that delay healing and weaken muscles (Cell Metabolism, March 2017;25(3):581–592).

More New Studies on Muscle Growth for Older People

Osteoporosis: Lifting weights helps to strengthen bones of postmenopausal women who suffered from osteoporosis (J of Bone and Min Research, February 2018;33(2):211-220).

Protein Intake: Several studies show that older people do not gain any additional muscle size or strength from increasing their intake of protein above the current RDA (recommended dietary allowance) of 0.8 gm/kg of body weight/day. Even older men who are taking extra testosterone do not gain any extra strength or muscle growth from increasing their intake of protein to 1.3 g/kg/day (JAMA Internal Medicine, April 2018).

High-Plant Diet after Menopause: Older women who follow a Mediterranean-type diet (based on plants, with fish but restricting red meat and added sugars) have larger muscles and bones after the menopause than women who eat the typical Western diet (ENDO 2018, the Endocrine Society annual meeting in Chicago, March 19, 2018).

Recovery Time: Older people who do strength training need to realize that their muscles will not heal as fast from workouts as muscles of younger people because aging causes their mitochondria to become smaller in number and size (Cell Metabolism, March 2017;25(3):581–592).

Starting a Resistance Program

The most effective way to slow down the loss of muscle strength with aging is to start a resistance exercise program that includes using strength training machines or lifting weights. A review of 25 well-designed and performed scientific studies shows that resistance training can grow larger and stronger muscles in older men and women (Sports Med, Dec 2015;45(12):1693-720). Older people who use strength training machines two or three times a week can make themselves stronger to decrease their risk for falling, breaking bones, and suffering osteoporosis, arthritis, heart attacks, diabetes, and premature death (Am J Prev Med, Oct 2003;25(3 Suppl 2):141-9). 

Before you start a new weight training program, check with your doctor and get expert advice from a trainer so you can learn proper lifting techniques for the equipment you will be using. Most beginners will be far more successful on weight lifting machines, rather than using free weights. The machines are safer because they can guide the way you move the weights with the specific muscles for each machine.

How to Make Muscles Stronger

Just exercising does not make a muscle stronger. The stimulus to make a muscle larger and stronger is to exercise that muscle against resistance to the point where you feel a burning in that muscle. However, if you continue to exercise after you start to feel that burn, you run the risk of injuring the muscle, so most older people can prevent injuries by stopping each set of lifting as soon they feel a burn in their muscles. You can exercise to the burn by using heavy weights with few repetitions or by using lighter weights with more repetitions. Older people gain the most strength by doing more sets of lower repetitions per set than using fewer sets with higher numbers of repetitions per set (Experimental Gerontology, March 29, 2018;108:18-27). The lighter the weight you use, the more repetitions you have to do to feel the burn. For example, several sets of three repetitions each is safer than performing fewer sets of the same weight with sets of 10 repetitions. For more detailed suggestions see Strength Training Guidelines from Dr. Richard Winnett of Virginia Tech.

My Recommendations

Aging can take away much of your quality of life unless you keep your muscles strong enough to perform all of your daily activities. A regular strength training program will help you to move faster, walk with more security, be less likely to fall and hurt yourself, and have more confidence in every movement of your body.

CAUTION:People with blocked arteries leading to their hearts can suffer heart attacks with exercise. Check with your doctor before starting a new exercise program or increasing the intensity of your current program.

JULY 18

Update on Aging

By Dr. Phil Maffetone

It’s more than immunity and hormones, posture and gait play key roles too.

The ageless Hall of Fame baseball pitcher Satchel Paige said it best: “How old would you be if you didn’t know how old you were?” Too many people would say they feel or look older than they are. If that is the case, change it!

We can all update our age, and always strive to be younger. While we know that most debilitating chronic illnesses are preventable, including heart disease, cancer and Alzheimer’s, so is poor aging. Large numbers of today’s elderly are living longer through heroic measures such as heart, lung and liver transplants, around the clock care and other medical means. For most, those ‘extra years’ come at the end of the lifespan, unfortunately, when life is less vigorous and productive. But we can significantly control what may be the most important factor of aging—quality of life. And the sooner we start the better.

All humans do it. The months and years pass and we get less efficient with our bodies and brains. We slow down, and it happens whether we are couch potatoes or Olympians. There is no stopping it—anti-aging is a myth. We can, however, significantly control the pace at which aging occurs by being healthier and more fit. The difference is physiological versus chronological aging.

A normal, healthy life includes aging. And while some illness and death may come from factors beyond our control, most unhealthy conditions that slow people down, or kill them at too early an age, are avoidable. This means we control aging to a great degree by choosing a lifestyle that allows us to be more like an average 40-year old even if we were born 50 years earlier, or a 45-year old even though our driver’s license says 1953.

Chronological age refers to the years that have passed. But when we are healthier and more fit, we function like someone younger. That is our physiological age. It’s related to better blood sugar regulation, brainpower, endurance and strength, and other lifestyle features we influence. This also includes our posture, gait and how we physically move.

While the whole body plays a role in graceful aging, three areas in particular do much of the work: the brain and neuromuscular mechanism, hormones, and the immune system. These areas of the body are continuously repairing and replacing themselves, relying on raw materials from the foods we eat. Adelle Davis’ 1950s mantra, “you are what you eat” still holds true today.

These and other aging factors are so integrated into our whole body that it is difficult to discuss each one in isolation. For example, hormones are an essential part of immunity, and muscle function reflects physical, chemical and mental health. In particular, one of the most common images of aging—posture and gait—is also a sign of how well we are doing it.

The Bent Spine Syndrome

Among the most common images of poor aging are people who do not stand erect. On closer examination, they don’t sit or move that way either, especially when walking. Their lower (lumbar) spine is flexed, and they are “bent” forward having lost their natural spinal curve, which usually helps maintain a healthy-looking upright posture. With a “bent” spine, individuals become shorter. While this typically occurs in the elderly, younger people can begin developing it too. This condition is well recognized by clinicians and researchers, and is called the bent spine syndrome, BSS, originally referred to as camptocormia, derived from the Greek camptos (bent) and kormos (trunk). (See “Camptocormia: the bent spine syndrome, an update.” European Spine Journal. 2010 Aug;19(8):1229-37.)

The BSS is a spectrum disorder, going from mild and moderate to a more severe condition depending on a person’s level of health. Two common causes of BSS include muscle imbalances, often a reflection of various neurological and biochemical problems, and psychological disorders.

The BSS affects the whole body, not just the spine. An example is how proper spinal function can help balance a key component of the body, the autonomic nervous system, which regulates many aspects of health from blood pressure, heart beat and breathing, to gut function, sexual arousal and controlling all stress.

As a functional problem for most individuals, BSS is rarely due to permanent changes in the bones or discs of the spinal column. This is evident when lying down—in this relaxed position people with BSS have relatively straight spines.

In addition, BSS may or may not be associated with pain, but the posture and gait are typically irregular, with related body-wide function that can be significantly reduced. The result is poor aging.

Physical and Chemical Causes

There are a number of physical causes of BSS, perhaps the most common one being muscle imbalance (muscles directly control the skeleton, especially the spine). In most cases, these imbalances are due to some type of neurological dysfunction between the brain and muscle. These weaknesses are not only in muscles directly controlling the spine, but throughout the body too, including those in the feet, pelvis, abdomen, and neck—areas that can significantly affect spinal posture and movement.

Another aspect of muscle dysfunction is reduced energy due to chemical imbalance. Muscle fatigue develops quickly in those with BSS during standing, walking, and even easy physical activities. This is typically due to poor aerobic metabolism.

Other biochemical factors include abnormally high levels of fat found in the muscles of those with BSS. The cause of this may be of hormonal, primarily high insulin due to the ingestion of too much refined carbohydrate. Higher levels of the stress hormone cortisol also can influence the brain, often significantly. This is typically due to the combination of physical, chemical and mental stressors, which, in turn, can affect muscle balance.

At any age, BSS is associated with, often caused by, other chemical disorders that include chronic inflammation. This is usually directly associated with the balance of fat in the diet. The ongoing inflammatory disorder is the first stage of many chronic diseases.

Other hormonal imbalance can play a role too. Especially important are conditions of low testosterone and low thyroid function—both can occur in men and women. In addition, low levels of vitamin D, typically from inadequate sun exposure, and sarcopenia, the loss of muscle during aging, are both very common problems of epidemic proportion that can speed up the aging process.

More severe cases of BSS are often seen in patients with Parkinson’s disease, multiple sclerosis, or other neurological diseases.

Psychology

It has long been know that posture and gait, in addition to being a manifestation of physical and chemical dysfunction affecting muscle contraction, can also reflect ones psychological state. Bent spine syndrome was first observed and researched in young soldiers psychologically affected by war. Whether old or young, images of an aging spine can reflect mental and emotional states.

Growing Younger

Just being aware of ones posture is the first step to improved function. By avoiding the common age- or fatigue-related slumping and making sure the lower spine is not slowly losing its natural curve, one can keep the body healthier and not only more youthful looking, but physiologically younger. By simply sitting up straight, standing, walking and running more erect, we can maintain better balance, and our bodies will function better.

In addition, yoga, tai chi, respiratory biofeedback and other self-therapies can be very effective in maintaining good posture when practiced properly.

Regardless of how much or little you run, bike or lift weights, walking can also do wonders to help train the brain to better maintain proper postures. Walking erect is part of an optimal walking gait. In order to do this effectively, the knees must be gently locked as you land more on the front of your heels. This is different from the running (or jogging) gait, where knees should never lock and landing on the foot is farther forward. (By striking on the back of the heels, often encouraged by wearing thicker shoes, many runners do lock their knees, which can directly cause knee and other physical impairments, poor gait, and wasted energy.)

While most of us are too familiar with the images of aging, we sometimes don’t see it in ourselves. We can control the process significantly. With increased health and fitness we can age more gracefully and have additional active years at the end of our natural lifespan.

july 13

Knee Cap Pain

The most common long-term running injury is called runner’s knee. It is caused by the back of the knee cap rubbing against the femur, the long bone behind it.

When you suffer from runner’s knee, the back of the kneecap hurts when you walk or run, particularly when you walk down stairs. It usually does not hurt to pedal a bicycle. If it hurts to push the kneecap against the bone behind it, you have runner’s knee.

The back of the kneecap is shaped like a triangle with the point fitting in a grove in the lower part of the bone behind it. During running, the knee cap is supposed to move up and down. If it moves from side to side, the back of the kneecap will rub against the front of the bone behind it and hurt. Treatment is to stop the kneecap from touching the bone behind it which is usually caused by the knee cap being pulled toward the outside (laterally), while the lower leg twists the bone behind it inward (medially). When you run, you land on the lateral bottom of your foot and roll inward, causing the lower leg to twist inward. At the same time, three of the four quad muscles attached to the kneecap pull the kneecap outward and cause the knee cap to rub against the bone behind it.

People with runner’s knee usually can pedal a bicycle with their seats set lower than normal to prevent their knees from straightening completely. Orthotics, custom- fitted inserts in the shoes that restrict pronation, may help. They can also use special exercises that strengthen the vastus medialis muscle above the kneecap that pulls the knee cap inward when they run or pedal. Running backward may also help (1).

july 11

Repairing Damaged Knee Cartilage

The ends of bones are soft, so they must be covered with a thick white gristle called cartilage. Once damaged, cartilage can never heal. When knee cartilage is damaged, the person spends the rest of his life losing more cartilage until it is completely gone and the knee hurts 24 hours a day.

If only a small area of the cartilage is damaged, it may be treated with cartilage extracted from your own body. (If cartilage is taken from someone else, your immunity will try to kill it, but it does not try to kill your own cartilage.) Your extracted cartilage is grown in special culture dishes and then injected into a hole in your own cartilage and secured in place. This procedure works very well if you have only a small piece of cartilage missing. The doctors just fill the hole. However, unless they can enclose the entire area for the donor site, the cartilage will not stay where it was put and will not be beneficial. That is why this procedure cannot be used to treat a cracked cartilage in the knee. Remember they have to cover the articular surface that meets the cartilage from the other side of a joint.

When all the cartilage in your knee is gone, the only effective treatment is to replace the whole knee. Knee replacements are now lasting for twelve to twenty years or more, and most remain pain-free.

If you have damaged cartilage in your knee, you should protect that knee for the rest of your life. Running, fast walking and jumping cause further damage, while pedaling and swimming usually do not. When the knee hurts all the time, your doctor will check to see how much cartilage is left. If it’s gone, you will probably be told that you need a knee replacement.

JULY 11

Strengthen Quad Muscles to Help Your Knees

Doctors have known for many years that having weak quad muscles (in the front of your upper legs) increases risk for damage to the cartilage in your knees. A study from Purdue University showed that strengthening these muscles slows down knee cartilage damage and may even improve knee function (Arthritis & Rheumatism, October 2006). The researchers placed 221 adults in their sixties and seventies either on a program of strengthening their muscles in their upper legs or just moving their knees in a series of range-of- motion exercises. The subjects exercised three times per week (twice at a fitness facility and once at home) for 12 weeks. This program was followed by a transition to home-based exercise for 12 months. Older people weaken naturally with aging, but the range of motion exercisers lost more strength than those who exercised against progressive resistance. The strength training helped retain joint space, signifying that this group had less loss of cartilage.

The knee is like two sticks held together by four bands called ligaments. Strength training stabilizes the muscles that support the knee and helps to prevent loss of cartilage with aging. People with knee pain should get a diagnosis from their doctors. Most will be advised to do exercises that strengthen the knee, such as pedaling a bicycle or performing knee strengthening exercises that involve bending and straightening the knees against resistance. People with knee pain should avoid exercises that jar the joints, such as jumping or running.

july 1

Kettlebells Build Hard Bodies

Kettlebells (or girva, as they are called in Russian) are traditional Russian cast-iron weights that look like a cannonball with a handle. They have become a popular exercise tool in the United States largely because of the enthusiasm and effective marketing by strength and flexibility coach Pavel Tsatsouline and kettlebell lifting record holder Valery Fedorenko.

Though kettlebell lifting competitions are relatively new in the United States, they have historical significance in other parts of the world. Recently, kettlebell training has been “discovered” by U.S. athletes and particularly mixed martial arts fighters.

Kettlebell workouts are designed to increase strength, endurance, agility, and balance. Both the muscle and cardiovascular systems are challenged through dynamic total-body movements. They are used by both men and women.

Commonly asked questions are . . .

What makes kettlebells different than dumbbells or barbells?

Why has kettlebell training become so popular with women?

Are they safe?

Are kettlebells appropriate for seniors?

What sizes do they come in?

What weight should a beginner buy?

What is good kettlebell design?

What makes kettlebells different than dumbbells or barbells?

All are free-weights used for strength training, muscle building, and all-around fitness. However, since practically any KB exercise can also be executed with a dumbbell, it is reasonable to ask why you should use a kettlebell instead?

The kettlebell shape (remember the “cannonball with a handle” description) makes the weight displacement different from a dumbbell’s. The off-center weight of a kettlebell makes it more unwieldy, requiring the use of more stabilizing muscles to control it. By the nature of their design, nearly all kettlebell lifts are compound movements that work the body as a whole, rather than isolating muscles. Common kettlebell lifts also tend to work muscles through a longer range of motion, which improves flexibility.

So while barbells and dumbbells are certainly good free-weights, keep in mind that the unique unwieldiness of kettlebell training is precisely the reason many athletes use them today. When comparing dumbbells to kettlebells, it really comes down to being a matter of personal preference.

Why has kettlebell training become so popular with women?

Many of the most common kettlebell exercises, such as swings, cleans, windmills, and snatches, really work the hips, hamstrings, glutes, and waistline. And when done in higher repetitions they are great cardiovascular exercise. Combined with proper nutrition, KB workouts will burn off fat better than almost anything you can think of. And they are fun to use.

Are they safe?

Get some instruction from a good DVD video or coach/teacher. Kettlebell lifting is somewhat different than lifting other free-weights. I am not aware of any reported serious injuries, but you sure wouldn’t want to bonk yourself on the head or drop one on your foot. Ideally, some sessions with a competent instructor is a good way to go, although I’ve seen some excellent video instruction, too. Either way, once you know and practice proper form, kettlebells are certainly no riskier than lifting other free weights such as barbells and dumbbells.

Are they appropriate for seniors?

 

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Used properly, all free weights are senior friendly. Good judgment is the key to safe, successful kettlebell training, just as it is with barbells and dumbbells. But always consult with your doctor before starting any exercise/fitness program. Then begin with modest efforts, perfect your form, and gradually work up. If a particular lift or exercise irritates an existing problem area – don’t do that exercise. It is really a common sense issue.

What sizes do they come in?

The common kettlebell weights follow:

8 lbs

12 lbs

18 lbs

26 lbs

35 lbs

44 lbs

53 lbs

70 lbs

80 lbs

88 lbs

97 lbs

105 lbs

What weight should a beginner buy?

Most kettlebell exercises can be done with a single bell. Or they can be done with a pair of bells of the same weight. Most people start with a single KB and many continue lifting singles.

Next, you must consider your present strength and fitness level when deciding what weight to start with. A rule of thumb is that handling a kettlebell will be more challenging than a dumbbell of the same weight. Most of the companies selling KBs offer beginner guidelines for what weight(s) to buy. I would rely on their advice.

As your strength grows you can buy a heavier bell and sell the lighter one or keep it for higher repetition work.

Best of all, if you can attend a KB training workshop before you buy, or find a trainer nearby, you can try out different weights at the same time you are receiving some coaching.

JUNE25

Senior Exercises for Slenderizing the Waistline

The best approach for you to slenderize their waistline is a healthy diet, 150 minutes of cardio and two strength training sessions each week. Including abdominal exercises in strength training sessions will tone the stomach muscles, which will become visible after overall weight loss occurs. A strong core contributes to good posture and eases the challenge of standing for extended periods of time. In addition, becoming physically fit can make daily tasks, such as showering or carrying objects, easier for older adults. You should consult with your physician before starting an exercise program.

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Burn Calories

Burning calories and expending more than you consume is the only way to lose weight. Mowing the lawn, climbing stairs or going on a walk with friends are all examples of cardio exercises that contribute to weight loss, including the stomach area. The treadmill, elliptical and recumbent bike are all cardio machines available at most gyms. The rowing machine is a good option if you want to challenge your midsection while doing your cardio. Water aerobics and swimming are non-weight bearing cardio workouts that don’t strain the joints, making them a good option if you have joint problems or arthritis. Complete at least 10 minutes of cardio exercise during a session to ensure benefits and contribute to your weekly goal of 150 minutes.

Make a Bridge

The bridge is an abdominal exercise that strengthens the glutes, lower back and stomach muscles. Lie on your back, bend your legs and place your feet on the floor, directly under your knees. Tighten your abdominal muscles and rest your arms on the floor, next to your hips. Push through your heels and lift your hips and lower back off the floor. Align your knees, hips and shoulders. Squeeze your glutes and hold this position for 20 to 60 seconds.

Twist and Turn

Trunk rotations tone the abs while strengthening the arms. Hold a light weight with both hands. Stand up straight, bend your knees and position your feet shoulder-width apart. Lift the weight in front of your waist, straighten your arms, then slightly bend your elbows. Tighten your stomach muscles. Twist your torso and rotate your trunk and arms to your right. Do this without moving your hips or lowering your arms. Twist back to the center, pause, then rotate to your left to complete your first repetition. Complete eight to 10 reps, stopping when your stomach and arms fatigue.

Tighten Your Abs

Pelvic tilts tighten and tone the abdominal muscles. Lie on your back, bend your legs and place your feet on the floor, under your knees. Squeeze your stomach muscles. Throughout the exercise, imagine that you are trying to balance a grape in your belly button. This will help you maintain the contraction. Simultaneously, push your lower back against the floor and slightly lift your hips off the floor. Hold for six to 10 seconds, then release. Complete eight to 10 repetitions.

JUNE 23

The Best Kettlebell Workout for Women Over 50

Women in their 50s often gain weight, experience changes in posture, and lose muscle mass because of menopause. Doing two to three kettlebell sessions a week can help combat some of those physiological changes. Kettlebells increase muscular strength and endurance, and improve balance, core strength, coordination and posture. The workout has cardiovascular benefits as well. Most of the exercises are functional and incorporate the entire body, which makes the workout more efficient and less time consuming than traditional strength training with free weights.

Program Design

Pay careful attention to form and technique when learning how to use kettlebells. It is better to begin with a light weight to master form to prevent injury to the back, shoulders and knees. If you work out regularly, begin with a 10- to 15-pound kettlebell. Try a routine two to three days a week that consists of two to three sets of eight to 10 exercises. Cross train on alternate days with Pilates, yoga or a moderate-intensity cardiovascular activity.

Short Circuit

A circuit kettlebell routine can help banish the excess adipose tissue that accumulates around the midsection during menopause. Include two to three sets of 10 to 15 squats, deadlifts, snatches and swings. Rest 30 to 60 seconds between each exercise before continuing. Finish with two to three bodyweight planks before you stretch. The moves can help you burn calories, aiding in fat loss and increased lean muscle mass.

Muscle Up

You may be dismayed as you progress through your 50s to realize that you are losing tone in your lower body, particularly in the derrière. A kettlebell routine that targets the lower body can prevent things from going further south. Warm up with joint mobility exercises. Perform two to three sets of walking lunges, single-leg squats, figure eights between the legs, single-leg deadlifts and single-arm swings for 15 to 60 seconds. Rest 30 to 60 seconds between exercises.

Upper Body Training

Banish batwing arms with upper-body exercises involving 5- to 8-pound kettlebells, such as snatches, high pulls, bentover rows, alternating shoulder presses, farmer’s walks and overhead triceps extensions. Consult a certified fitness professional to watch your form when you are learning how to use kettlebells.

june 19

Kettlebell Exercises for Seniors

Kettlebells are traditional Russian weights that look like a cast-iron cannonball with a handle. Used properly, they are senior friendly and can be used for maintaining and increasing muscle strength and bone density, and for a cardiovascular workout. They are available in weights from 2 lbs to over 100 lbs. Women should start with about 8 lbs, while men can begin at 16 lbs. Use common sense: If a particular exercise aggravates an existing problem or injury, don’t do that exercise.

Two-Arm Swing

The two-arm swing is the most basic kettlebell exercise and should be mastered before moving to other exercises. Use an overhand grip with both hands on the handle and allow it to hang between your legs. Stand with feet slightly wider than hip-width apart. Start swinging by rocking your hips rather than using your shoulders and use momentum to raise the bell so that it swings to about shoulder height, then back between your legs. Perform for at least one minute, or for a desired number of repetitions.

Single-Arm Swing

The single-arm swing uses the same basic movement as the two-arm swing, but only one hand is used. Remember to swing upward by thrusting the pelvis forward rather than lifting from your shoulders, and allow gravity to bring the kettlebell down in a smooth, controlled movement. Keep the free arm at the side of the body. Perform for one minute or a desired number of repetitions, then change arms and repeat.

Body Pass

Begin in the same body position as for the two-arm swing. Release one hand from the bell, and swing the bell behind your back with the other hand. Grasp it with the free hand at the back and bring it back around the other side to the front again. Make sure you grasp it firmly and breathe throughout the movement. As the weight moves from hand to hand, your arms will loosen and tighten. After the required number of repetitions, repeat in the opposite direction.

Figure Eight

The figure eight is an advanced version of the body pass and should not be done until you have mastered that move. Instead of passing the kettlebell around your body, you pass it from one hand to the other between your legs from the front of the body to the back and from side to side, so that it creates a figure-eight pattern. This gives you an excellent workout. After the required number of repetitions, repeat in the opposite direction.

june 15

Kettlebells for the Aging Population

Swinging and lifting kettlebells may sound like a form of training best left to weightlifters, hardcore athletes, and members of the younger generations. But the reality is that everyone, especially seniors, can benefit from properly training with kettlebells. In 2010 the American Council of Exercise (ACE) at the University of Wisconsin conducted a survey about kettlebell training and its effects on individuals. Researchers found evidence supporting the positive implications of kettlebell training’s potential to strengthen the core muscles by 70 percent, especially for elderly people. One of the research leaders, John Porcari, Ph.D. says, “I think that’s huge because the stronger people are through the core, the less low-back pain they are going to have.” He also pointed out the importance of how working out with the unique weights can affect and improve balance for older kettlebell users. “Older people who are doing some sort of kettlebell-like training are going to be more likely to avoid dangerous falls,” he says.

Kettlebells training can also improve bone density (preventing osteoporosis), combat against age-related muscle atrophy, and help control blood pressure, blood sugar, and cholesterol levels among the older generations.

Due to the many health benefits and quality of life improvements associated with kettlebell training, kettlebell classes and workout videos for older age groups are cropping up all over America. Of course, as with any other type of workout program for the elderly involving weights, the key to getting a safe workout is using wise judgment. It is also advised to consult with a physician before starting any kettlebell training, to begin slowly and gradually increase intensity and weight, and to pay close attention to proper form to avoid injuries. 

Here are just a few typical activities you regularly engage in that require some form of pulling, pushing, lifting, and/or balancing objects that have a displaced center of gravity (meaning they’re not centered and balanced in your hand):

picking up a child or pet

mowing the lawn

operating the vacuum cleaner

toting bags of groceries

catching your balance when you start to slip or fall

walking your dog

playing a sport

carrying a full laundry basket

lifting a suitcase or gym bag

Beginner Kettlebell Exercises for Older Adult

Kettlebells are a centuries-old exercise tool originally used by Russians to develop strength, stamina and endurance with a single piece of equipment. Seniors can use these weights to perform exercises that build muscular strength, improve heart health and increase bone density. Limit your use of a kettlebell to simple exercises using a light weight as you begin to learn how to use this increasingly popular piece of fitness equipment.

Step 1

Perform biceps curls, a simple exercise you can do standing or sitting, to work the muscle on the front of your upper arm. Start with the kettlebell hanging at your side with your palm facing forward. Bend your arm at the elbow, bringing your palm and the kettlebell toward your shoulder. Hold for one or two seconds, then lower the kettlebell. Perform this exercise one arm at a time or using two kettlebells at once. If you can stand while you perform the exercise, curl the kettlebell across your stomach instead of up to your shoulder. Balance yourself with one hand against a chair or wall if you exercise standing up.

Step 2

Perform triceps extensions using a kettlebell to work the upper backs of your arms. Without using the weight, practice putting your hand behind your head with your palm facing your back. Extend your arm at the elbow, turning your hand outward so your palm faces forward when you’re finished. Decide if you can perform this exercise with the weight of kettlebell you have chosen without losing your balance or straining your back. If you can safely perform the exercise, add the weight of the kettlebell.

Step 3

Perform rows, a simple exercise you can do while kneeling on a bench. Place one knee on the bench and one hand on the seat in front of you for support and hold the weight straight down with your palm facing your body. Raise and lower the weight to your chest, bending your arm at the elbow. Keep your elbow tucked into your side and squeeze your shoulder blades together as you raise the weight. This exercise will work your biceps and the fronts of your shoulders as well. Change positions to work your other arm.

Step 4

Add kickbacks to your workouts, which start from the same position as rows, using a slightly different movement to emphasize your triceps and rear shoulder muscles. Raise the kettlebell to your chest, bringing your elbow back behind you with your palm facing your body for your starting position. Extend your arm at the elbow, bringing the weight backward without changing the position of your elbow and upper arm. Return to the starting position by bending your elbow. Switch positions to work the other arm.

Step 5

Work your forearms, chest and the fronts of your shoulders with arm raises. Hold the kettlebell at your side with your palm facing behind you while you are in a standing or sitting position. Raise your arm straight ahead, up to shoulder level. Hold the weight still for two seconds, then slowly lower it. Switch sides.