S E4: Ep 4 – Strength and Balance: the benefits of moving more as we get older

Hello and welcome to the Pain Free Living Podcast.

My name's Bob Allen and my aim is to help you to live pain free.

Let's begin.

Hello, and welcome to another episode of the Pain Free Living Podcast.

My name's Bob Allen and this is.

I'm Louise Gordon.

And, Louise, I'm not an osteopath.

I am a change coach and consultant.

So I work with businesses and individuals to navigate change, but I like asking lots of questions, and that's why I'm here.

She does ask lots of questions.

And so today we're going to be talking about exercises for older adults.

If you've watched any of my other podcasts, you'll know that I'm a big fan of exercise, but I'm a big fan of exercise that everyone can do rather than just a few.

So, Bob, you know your mantra we've talked about a number of times is movement is medicine.

And I guess there can be some limitations and when we get older.

So let's just talk through that in terms of how you see exercise for older adults.

Okay, let's do that.

Right.

So when you graduate as a physical therapist, osteopath, chiropractor, whatever it is, you tend to specialize in different areas.

So for me, having two parents that are quite old, working with older adults generally is a bit of a passion of mine because I think they're an underserved, fairly substantial minority of the population.

We're all getting older.

And the message is, and the view generally is that as you get older, pain, lack of movement, a list of medications, as long as you're, et cetera, et cetera are standard and only to be expected, because what do you expect?

You're old and the health service isn't the best for treating older adults.

So, yeah, one of the things that I found that works really, really well is simple exercises, stuff they can do at home.

So that's my view is, again, like you said, my mantra is movement is medicine.

The more you move, the less issues you have.

Joint muscle, etc.

So I'm quite keen on, yeah, coming up with an exercise program that works for older adults.

Right.

Okay, so let's talk about the Otago exercise program, which some subscribers may have heard and some may not have.

So do you want to explain what is Otago?

Okay, so Otago is a strength and balance program that came out of New Zealand, not sure how many years ago, but it's been adopted by a lot of health services around the world.

Because it's really, really effective.

It's a mixture of strength and balance exercises that pretty much anyone can do.

So the joy of that, and one of the big things for me about exercise is that it needs to be progressive.

So you can start really, really simple and you can make it much more challenging.

Right.

Rather than complicated, because never make it complicated.

If you make it complicated, people won't do it, or if you make it too complicated, people may start and they will stop.

So keep it simple.

I, a trained Otago instructor, I ran a class for just over a year and it's really exciting to see the change that you can make, particularly for older adults who have never exercised.

They are in pain and they don't know what to do.

So they've been going to see the GP for a while.

And although the NHS is getting better at recognizing that the more exercise you do, the less issues that you have, it's getting better, but it's nowhere near the level it should be.

So.

So there are quite a few places.

Northampton's a great place for finding Otago classes, because I think it's around 20, 25 Otago instructors around Northampton, so.

Yeah, but like I said, what I like about it is the exercises are simple.

You can do the exercises at home, but it's also a really good group activity.

So the classes that I ran, you had anywhere from 10 to 15, because you can't have the classes too big, because you need to be able to keep an eye on people and make sure they're doing things properly and safety and all those sorts of things.

But as well as doing the exercises, it also became quite a social group.

So we'd have a cup of tea and a biscuit after the sessions, and eventually it got to a point where you just had to kick people out because they just wanted to hang around and talk to each other and have fun, which is part of what it's all about, because, you know, social isolation is also an issue, and the Otago classes helped us to get around that.

And so is there a particular age group that Otago is aimed at?

So Otago came about because one of the things that happens as people get older is that they can get more frail, they can be more prone to falls and injuries.

So realizing that New Zealand being one of the places for leading world physiotherapists, to be honest, yeah, quite leading edge on that.

I came up with this really simple exercise program.

And what they found was that by implementing this program and recruiting older adults onto the program, they felt there were less falls happening.

A fall for an older adult who, who may be relatively frail, particularly can cause broken bones.

Now a broken hip can have a fatality rate of up to 21% because it's a major injury.

Rehabbing an injury in an older adult who can also be quite frail, especially if they've not exercised before, it can be quite traumatic and the fatality rate is quite high.

Now by implementing an exercise program like Otago, it significantly reduces the risk of injury and if an injury occurs they will recover quicker.

So there are a lot of pluses to doing it and one of the things that you have to do if you're an Otago instructor is you're only allowed to charge a certain amount for it.

So the, with the aim being to make it as accessible as possible to the maximum number of people.

So as I was saying, it's a strength and balance program and it really is simple to do.

Is there any recommendation regarding exercise frequency?

Yeah, I mean the thing about, thing I love about exercise, it's dose dependent.

The more you do, the healthier and better and fitter you are.

So from that perspective every day.

But you know, to get through there's, there's roughly around 12 exercises.

To get through the whole 12 exercises probably gonna take about 40 minutes to an hour potentially.

So not everybody has that spare time.

So you, but you can do a couple of the really simple balance exercises, for example, take very little time, really simple to do, require no equipment, but they can make a significant difference.

The better your balance, the less likely you are to fall.

The more strength exercises you can do, the better you are able to move, the less likely you are to fall.

So it's very geared around practical, simple exercises that anyone can do that will make a difference.

Now although it was devised and developed for older adults, actually I've given some of these exercises to younger adults in their 40s and their 50s.

They've never done any exercise.

They don't know where to start.

They have zero level of fitness, but they can still do the Otago exercise.

If you can do the oldest lady in an Otago, my otago class was 99.

So if a 99 year old can do it, then if you're in your 40s, there's no reason why you can't do it as well and it can be just as effective.

And what I found is that by giving people those nice simple exercises to do, they realize that they can exercise.

It's not a major issue to exercise.

And as long as they're consistent and they stick with doing exercises after a while I then progress them Onto more complex, strong.

Yeah, more complex, more resistance based exercise.

Because I can do it.

Because they, they know they can do it.

They've got the confidence that they can do it.

They may not want to go to a gym, but most of the exercises I give are things that I can do at home anyway, requiring minimal equipment.

So, yeah, Otago is basically for anyone at any age.

Right.

And is there, are there alternatives to Otago?

You know, would, would everybody be able to find an Otago exercise program in their area?

It's getting more and more widespread and who knows, perhaps one day the NHS will adopt that as part of their prevention strategy.

Unfortunately, I don't think the NHS has a prevention strategy at the moment.

It tends to be very much, let's fix a problem rather than prevent it in the first place.

Unfortunately, that's what happens when you've got a massive organization.

Even though there's a lot of evidence to say that prevention is going to be a lot cheaper than fixing a problem once it's happened.

It takes a billion committees and however many hundreds of man hours to actually come to that decision.

So in the meantime, there are a lot of exercise classes around.

Otago is a trademarked name.

If you go to an Otago class, you will have a qualified instructor who has been through the whole thing about safety protocols and they will have an understanding of exercise and the benefits of exercise, that sort of thing.

There's around 25 Otago instructors in Northampton.

A lot.

I know quite a few of them and there's quite a few of them that are PT personal trainers as well.

But there will generally be an exercise class for older adults in most towns and cities.

The difference is the downside is that you may have to hunt around a bit to find them.

But yes, they do exist.

There's a, there's a exercise group class for older adults in Northampton that's based around ballet.

Ballet exercises, okay.

You know, so they're out there.

And my recommendation to anyone who's thinking about getting back into exercise is find yourself a class.

There will be something out there that you, that you can, that you want.

Brilliant.

And I guess this links back to your mantra, movement is medicine.

There isn't an upper age limit.

Everybody can find some kind of movement to work for them.

Yeah, absolutely, yeah.

And that's what I say, that you are never too old to exercise.

You just need to find the right exercise for the right level of fitness for you and you find the right instructor.

Whether it's an instructor or whether you go to a class, there is always something you can do.

To get fitter and healthier.

Fab.

Thank you very much, Bob.

Not a problem.

So hope you enjoyed that episode.

You don't have to be old to be fit.

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