wellness

A Physical Therapist's Guide to Snow Shoveling Safety

Hello, everyone!

As a physical therapist, I’m here to share some important tips about snow shoveling. It’s a common winter chore, but if not done properly, it can lead to some aches, pains, and or injuries. So, let’s dive in!

Choosing the Right Shovel:

The first step to safe snow shoveling is choosing the right shovel. Look for one with a curved handle. This can help you keep your back straighter while shoveling.

Also, a smaller blade will require you to lift less snow, reducing the strain on your body.

Warm-Up Exercises:

Before you start shoveling, it’s important to warm up your body.

Try marching in place or walking for a few minutes.

Follow this with gentle stretching exercises for your back, arms, and legs to prepare them for the activity ahead. 

Your Physical Therapist can help you identify any specific stretches or areas to stretch that would benefit you most.

Proper Lifting Techniques:

When you’re shoveling, remember to lift with your legs and not your back.

Stand with your feet hip-width apart for balance and keep the shovel close to your body. Bend from the knees, not the back, and tighten your stomach muscles and buttocks as you lift the snow. Avoid twisting movements. If you need to move the snow to one side, reposition your feet to face the direction the snow will be going.

Potential Risks and Injuries:

Improper snow shoveling can lead to various injuries. These include strains and sprains, particularly in the back and shoulders. In severe cases, it can cause heart-related illnesses like heart attacks.

Remember, it’s a strenuous activity that raises your heart rate and blood pressure. Always listen to your body and stop if you feel pain or discomfort.

Watch for Overexertion:

Overexertion is a serious concern when shoveling snow. Be sure to take frequent breaks and drink plenty of water. If you feel any signs of overexertion, such as dizziness, sweating excessively, or shortness of breath, stop shoveling immediately and seek medical attention.

Conclusion:

Snow shoveling is a necessary part of winter for many of us, but it’s important to do it safely. By choosing the right shovel, warming up, using proper lifting techniques, understanding the risks, and watching for overexertion, you can keep yourself safe this winter season.

If you have any questions, please contact your physical therapist for further guidance.

Stay safe and warm out there!

Winter Safety in Industry: Navigating Cold Conditions with Confidence

 
 

As the temperature drops, it’s important to be reminded of best practices to stay safe (and warm). The following tips should always be top of mind:

  1. Good Things Have Layers: Lasagna. Tiramisu. Employees who aren’t cold. Dressing in layers allows you to trap heat easily while providing you the ability to adjust clothing as needed. Start with a moisture-wicking layer (synthetic or polypropylene, not cotton!) to avoid your body cooling down due to sweat. Then add a light insulating layer (light fleece or long-sleeve shirt) to retain heat and, if needed, a heavier fleece to trap the heat and keep you warm. Choose layers that are compliant with your employer and allow the movement needed for work. A wind/waterproof layer can be added to increase protection during outdoor tasks.

  2. Put Your Best Foot Forward: Good traction is key for navigating winter conditions. Invest in non-slip, insulated boots to prevent slips and falls on icy surfaces as well as to keep your feet warm. We chose the word invest deliberately, as well-made footwear will generate benefits. Avoid a tight fit that restricts circulation and movement. What’s inside of your boots is important as well. We recommend a two-layer sock system for cold conditions. Again, lose the cotton and opt for a thin polypropylene sock with a wool sock over top. The first layer allows moisture to be wicked from the feet, and wool stays warm even when wet from snow or sweat.

  3. Have a Nice Trip, and See You Next Fall: This is not breaking news, but we’ll shout it out nonetheless: SNOW & ICE CREATE HAZARDS! Slips trips, and falls—the most common of workplace injuries—increase dramatically during winter months. To prevent such occurrences, along with the pain and embarrassment that often accompany them, snow and ice should be cleared from all walking surfaces. Salt and deicer should be used as quickly as possible for the best results. If walking on snow or ice is unavoidable, take shorter steps and walk slower to improve reaction time to traction changes.

  4. I Don’t Feel Thirsty: Yes, but you still need to hydrate. During the winter season, it is not uncommon to feel like we need to consume less fluids. This can be perceived by less perspiration and decreased feelings of thirst. However, we are still losing fluids through respiration, sweat, and urination even in cold weather. Proper hydration is crucial to ensure our bodies can generate enough heat to maintain a healthy body temperature. Drink water regularly throughout the day even if you don’t feel thirsty. Decrease the intake of beverages with high concentrations of alcohol and caffeine as those can contribute to dehydration.

  5. Communication Matters: Report any safety concerns promptly to ensure a quick and effective response to potential hazards and decrease the risk of injury. Enough said, right?

By following these safety guidelines, we can ensure a safe environment for everyone. Stay vigilant, stay warm, and let's navigate this winter season with caution and care.

All this being said, accidents do happen, and know Advanced Physical Therapy & Sports Medicine is here when you need us!

Providing Experiences for the Next Generation of Professionals

Getting people back to what they love is the job of an athletic trainer. Ensuring there are plenty of high-caliber graduates ready to serve active populations is the job of universities and colleges, whose programs provide interactive learning environments that will prepare students to enter the profession.

Advanced Physical Therapy & Sports Medicine (APTSM) plays a vital role in the process.

“It’s important we offer internships and job shadowing opportunities for those on the path to becoming athletic trainers,” said APTSM’s Traci Tauferner. “The field is projected to grow 25% by the end of the decade.”

While there is a broad range of settings for the athletic trainer—physician practices, professional sports, clinics specializing in sports medicine, occupational health, and performing arts, to name a few—the vast majority of graduates will enter the field’s most traditional setting: schools.

That’s where Tauferner started out after earning her athletic training degree at UW-Oshkosh. With a robust resume developed since her graduation—she’s the Director of Industrial & Tactical Medicine at Advanced—Tauferner now devotes time both to her administrative duties as well as to the onsite therapy services she delivers at multiple locations.

Tauferner is committed to bringing attention to industrial athletic training, especially as the need for athletic trainers to prevent, evaluate, manage, and rehabilitate conditions faced by workforces—directly at companies and municipalities—continues to grow.

“Achieving injury prevention and cost control in this day and age for the industries and tactical groups we serve is not just a desired outcome,” said Tauferner. “In many cases, it’s a matter of survival.”

More than 55 Wisconsin companies and organizations utilize Advanced PT’s hallmark program of onsite wellness solutions. APTSM’s dedication to workplace health and safety has contributed to recognition at local, state, and national levels.

That kind of focus includes providing learning opportunities for those interested in pursuing a career in the field, and Tauferner is passionate about students understanding the paths available to them.

“It’s important for us to provide these experiences for the next generation, especially so in the bourgeoning industrial and tactical realms, as fewer than 5% of graduates are going into those sectors,” she said.

The connection between APTSM and Tauferner’s alma mater remains strong, as evidenced by UW-Oshkosh student Cade Littleton’s recent experience.

Littleton, a senior in the Masters of Athletic Training Program, spent the summer working through four specific rotations: clinical, hospital, professional team, and industrial/tactical.

Littleton said a few football injuries (“some hip and shoulder pain, but nothing huge like a blown ACL”) led him to seek treatment. Though his high school didn’t have a traditional athletic trainer, a nearby orthopedic group supplied the small school with a physical therapist, and Littleton found himself fascinated by the PT’s skills.

“I was just very interested in what he did, so much so that I actually job shadowed him for one of my classes,” said Littleton. “That set me on the PT path, but once I got to school and got a little more experience with athletic training, I became drawn to that, to work with a younger and highly active population.”

To meet the requirements of the program, one of Littleton’s rotations had him paired with Tauferner.

“This was actually the third time I had met Traci,” said Littleton. “I met her following a presentation she did on mental health, then at the WATA (Wisconsin Athletic Trainers’ Association) conference this year.”

For two weeks Littleton followed Tauferner’s schedule (“yeah, she starts early”), which included stints with the tactical groups she services.

“It was cool to see the firefighters and police officers and how they handle things at their own facilities,” said Littleton. “It was a lot different than my traditional experiences.”

With those tactical groups, Tauferner gave Littleton the opportunity to do full evaluations; she provided guidance, talking Littleton through treatment options and giving him the chance to “do his own thing.”

“Traci allowed me to do a lot more hands-on than I expected, so that was really cool,” he said.

He also learned about Tauferner’s use of and advocacy for modern cupping techniques.

“Just how she used cupping and explained it so it made sense to the client was very interesting,” said Littleton. “That helped me a lot because I’m still a student trying to figure this stuff out.”

Asked about key takeaways following the rotation, Littleton doesn’t hesitate.

“The experience pushes me to continue to learn, to ask questions, and to demand respect as Traci does.”

Littleton admitted he’d like to replicate the demeanor Tauferner exhibited throughout their time together.

“Traci’s vibe is straight confidence,” said Littleton. “The setting doesn’t matter.”

Summer rotations are complete, Littleton is now working with UW-O’s athletic trainer for 2023 football season. Set to graduate next May, Littleton is currently leaning towards working in the high school or college setting, but he’s not ruling anything out.

“I’m not 100% sure yet,” said Littleton.

If uncertain about his job setting, Littleton expresses a clearer view in the geographic sense.

“I’m up to moving,” he said. “I’m not a huge fan of winter.”

If you or a student you know is interested in experiencing what Advanced does every day, contact us today!.

The Importance of the Lymphatic System and How We Can Help

Photo caption: OT and Certified Lymphedema Therapist, Allie, teaches our Clinicians about Lymphedema management after surgery.


What is the Lymphatic System?

The lymphatic system is a part of our body that helps keep us healthy.

This system is made up of lymph nodes, lymph vessels, and lymphatic organs, like the spleen and thymus gland. Lymph is a clear fluid that flows through the lymphatic vessels and is filtered by the lymph nodes. It's like a network of tiny tunnels and filters that help remove germs and waste from our bodies.

When germs and other harmful substances enter our bodies, they can get trapped in the lymphatic system. The lymph nodes filter out these harmful substances, like bacteria, viruses, and cancer cells. They also produce special cells called lymphocytes that help fight infection and disease.

Sometimes, the lymphatic system can become blocked. This condition is called lymphedema. Lymphedema can cause swelling in the arms or legs and can be caused by things like surgery, radiation therapy, or infection.

How can We Help?

Connecting with a physical therapist, occupational therapist or Certified Lymphedema Therapist can help manage lymphedema.

These practitioners can design exercise programs that help move lymphatic fluid out of the affected area, reduce swelling, and improve the range of motion.

They may also use techniques like manual lymphatic drainage massage, compression bandaging, and skin care to manage the condition— In these situations, it may be best to connect with a Certified Lymphedema Therapist to discuss this further.

In summary, it's essential to take care of our lymphatic system so it can keep us healthy. We can do this by eating a healthy diet, exercising enough, avoiding injuries that could damage the lymphatic system, and practicing good hygiene. If we do develop lymphedema or other lymphatic system disorders, it’s best to connect with a trained provider that can help manage the condition to reduce pain, improve mobility and keep you doing the things you love to do!

Connect with one of our skilled Certified Lymphedema Specialists to learn more:

Contact us here if you want to schedule a visit with our team.

What is Modern Cupping Therapy?

Cupping Therapy, Modern Cupping Therapy

Modern Cupping Therapy is a form of alternative therapy that has gained popularity in recent years. It involves the use of cups made of glass, silicone, or plastic that are placed on the skin to create suction. This suction is believed to increase blood flow to the area and promote healing.

Cupping therapy has been used for centuries in traditional Chinese medicine, and its modern iteration has evolved to become a non-invasive and safe therapy.

Here's what you need to know about this popular alternative therapy:

How does Modern Cupping Therapy work?

During a cupping session, a therapist places cups on the skin and creates suction. The suction is created using a handheld pump. Once the cups are in place, they are left on the skin for several minutes before being removed. Sometimes, they are moved in a very specific pattern or sequence depending on the desired effect.

The suction created by the cups is believed to stimulate blood flow to the area and promote healing. It can also help to relax the muscles, reduce pain, and improve overall circulation.

What conditions can Modern Cupping Therapy help with?

It can be used to help many different conditions including, but not limited to, those listed below:

  • Back pain

  • Neck pain

  • Shoulder pain

  • Knee pain

  • Migraines

  • Arthritis

  • Fibromyalgia

  • Lymphedema

Is Modern Cupping Therapy safe?

Yes! It is generally safe when performed by a qualified healthcare professional. Minor side effects may include mild discomfort, bruising, or skin irritation. It is important to seek the advice of a qualified healthcare professional before using cupping therapy.

Conclusion

Modern Cupping Therapy is a popular alternative therapy that has gained popularity in recent years. It involves the use of cups placed on the skin to create suction, which is believed to stimulate blood flow and promote healing. The therapy is generally safe when performed by a qualified healthcare professional and can help with a variety of conditions. However, it should not be used as a replacement for conventional medical treatment. If you are interested in trying Modern Cupping Therapy, call today and we can chat further to determine if cupping is right for you and how to work it into your treatment program.


References:

  1. Wang, Sz., Lu, Yh., Wu, M. et al. Cupping Therapy for Diseases: An Overview of Scientific Evidence from 2009 to 2019. Chin. J. Integr. Med. 27, 394–400 (2021). https://doi.org/10.1007/s11655-020-3060-y

  2. Mohamed, Ayman A., Zhang, Xueyan, and Jan, Yih-Kuen. ‘Evidence-based and Adverse-effects Analyses of Cupping Therapy in Musculoskeletal and Sports Rehabilitation: A Systematic and Evidence-based Review’. 1 Jan. 2023 : 3 – 19.

“Police Support Staff Person of the Year.”

Traci Tauferner supplying rehab services at Wausau PD.

On January 7, 2023, the Wausau Police Department recognized Traci Tauferner as “Police Support Staff Person of the Year.” Tauferner, the Director of Industrial & Tactical Medicine at Advanced Physical Therapy & Sports Medicine, provides onsite preventative and reactive care for members of the Department and has been doing so since 2020.

Those who know Traci understand how squirmy this blog will make her, as she is the consummate team player who shuns any form of self-aggrandizement; however, the award is in her name, so we’re going to roll the dice and hope she’s too busy to notice we posted this.

And to put us in an even more precarious situation—because Traci flips really big tractor tires just for the fun of it—we’re going to use her own words to explain what she does and why:

“My passion to do my job to serve and protect others can be directly linked to the events of 9/11. The moment I saw TV news footage of departing soldiers leaving their families at airports across the country, I knew I was also going to help. I joined the Army soon after, and my 17 year old self went from "What have I gotten myself into?" to "I am capable of so much more than I have ever thought.

“I spent nine years in the National Guard, including a six-month deployment in Iraq providing security and surveillance support for tactical units. This training led me to where I am today. Helping others do what their job requires is what fuels and excites me, and a good deal of my energy now goes into developing programs and strategies that ensure essential job requirements can be performed safely.

“The day-to-day work with my tactical teams puts me in the unique position of understanding the physical and mental stressors they face; more importantly, it affords me the opportunity to do something about these circumstances. By providing the most advanced conditioning and rehabilitation resources available to the professionals tasked with keeping their communities safe, we can keep them performing at the highest levels while dramatically reducing the financial burdens placed on their departments.”

Congratulations, Traci!

Advanced Physical Therapy & Sports Medicine provides onsite therapy for Wisconsin companies, organizations and municipalities ranging from 50 to over 5,000 employees. To learn more about how we can customize an injury prevention and management program for your workforce, contact Traci Tauferner at 920-979-5597.

Make a Resolution to Not Make a Resolution

It’s the time of year when many people (well, perhaps not George Costanza) ponder making some improvements in their lives.

But let’s not consider this blog a catalyst for creating a list of New Year’s resolutions, as 25% of us quit those in the first week and nearly half of us are done by February 1.

So, how about trying to be a little more mindful in 2023?

Studies suggest practicing mindfulness leads to a plethora of benefits that include the reduction of anxiety and depression, greater enthusiasm for life, and improved self-esteem.

Best of all, mindfulness is accessible to all!

So this year, instead of joining the Seinfeld 4 (show creator Larry David insisted Jerry, George, Elaine and Kramer were to show absolutely no growth, ever) let’s try a little mindfulness, often described as the ancient art of being present in the moment.

First, Mindfulness Meditation:

Find a place where you can sit quietly and not be disturbed. For a few moments, anyway. Let’s start with 8-10 minutes, but don’t get overly concerned with timing.

Focus attention on your breathing, as it enters and exits the body. Won’t be long before your mind wanders, which means you’re being pulled out of the present. That’s all right. Try to notice your thoughts and feelings as if you’re an outside observer. Return focus to your breathing. Notice where your thoughts are going, accept what’s happening, but always try to return your concentration to your breathing.

Try to do the 8-10 minutes once a day. Before long you will be able to put more focus on your breathing and less on any upcoming plans you may have.

Next, Mindful Eating:

A practice food often used is the raisin. Yes, a single raisin. Move slowly through the following steps.

· Pick up the food. Notice it’s texture, color, size.

· Hold the raisin to your nose and notice the smell.

· Place raisin on your tongue but don’t eat it. Notice texture again. Roll it around your mouth and notice taste as well as paying attention to the feeling.

· Finally, begin to chew the raisin. Pay close attention to the flavor, the texture inside, how it reacts with your body—saliva, temperature of your tongue, any other sensations.

This process just slows everything down and helps you become more aware. Once you do this with a raisin (should take a minute or two), imagine how much more enjoyable your favorite foods become? And you don’t have to wolf things down. Practice often.

We’ll revisit mindfulness throughout 2023. There’s so much to learn, but it’s best to start small and doable. Declaring that the new year will be a veritable “Summer of George” is a bit vague, much too broad, and entirely unrealistic.

Remember, mindfulness is all about paying attention to your thoughts, your actions, and your body. Taking these little steps on a regular basis—grounding yourself in the present—can lead to big benefits and a healthier life.

Dry Needling

dry needling.jpg

Autumn Paul, PT, DPT

You may have heard about dry needling from one of your friends or family members and now you are thinking, “What is dry needling? Could I benefit from it?”

Dry needling is where the practitioner uses a solid filiform needle or hollow-core hypodermic needle (similar to an acupuncture needle) and places it through the skin and enters the muscle. The practitioner’s goal is to place the needle specifically into a myofascial trigger point (hyperactive muscle fibers).

These trigger points can be located in a tense band of muscle. For example, many people have tightness/soreness located in their shoulders/neck from the tension that they carry throughout the day.

These hyperactive muscle fibers (tense bands of muscle) can send signals to other parts of your body which are considered “referred pain”.

The goal of dry needling is to pierce these trigger points in order to allow these muscle fibers to relax, which can help reduce your pain levels.

“So what conditions may dry needling help with?”

● Headaches

● Shoulder/neck pain/tightness

● Lower back pain

● Tennis and golfer’s elbow

● Shin splints

● TMJ/jaw pain

● Plantar fasciitis

● Hip Pain

“Can any physical therapist perform dry needling?”

In order to be able to perform dry needling, the physical therapist is required to go through extensive training. This training includes studying human anatomy and hands-on practice. These training sessions are often a weekend course or even several weekend courses.

“Awesome, I want to see a physical therapist who can assess and see if I could potentially benefit from dry needling. How do I make an appointment?”

First, look online to see what location is closest to you. Then, you can request to schedule an appointment with a physical therapist who is certified to perform dry needling.

—-

References:

Firth C, Meon J, Price M, Taylor J, Grace S. Dry Needling: A literature Review. Journal of the Australian Traditional-Medicine Society . 2020;26(1):22-28. Accessed January 14, 2021.

http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143040461&site=eds-live

http://www.kinfolkwellness.com.au/dry-needling-adelaide

Benefits of Diaphragmatic Breathing

Kelsey Hinkley, DPT

We tend to underestimate the power of breathing! Breathing is an automatic response we typically do without thinking about it. However, breathing and how we breathe has shown to be extremely important.

There are many benefits specifically to diaphragmatic breathing. Some include but are not limited to:

·        Lowering cortisone (the body’s stress hormone) to help your body relax (6)

·        Lowering the body’s heart rate

·        Lowering blood pressure

·        Reducing gastric reflux by applying pressure to the esophagus (4)

·        Increasing sustained attention (6)

·        Reducing swelling and improving efficiency of the lymphatic system (1)

The diaphragm is an upside down U-shaped, skeletal muscle that separates our chest from the abdominal cavity. When we inhale, the diaphragm contracts pulling down and flattening. This helps create a vacuum effect to pull air into our lungs. When we exhale, the diaphragm relaxes back into that U shape, helping to push air out of the lungs. (4,5)  The more air we bring into our body, the better we can oxygenate our blood.

Here is a link to a video tutorial that provides a 3-D view of the diaphragm during diaphragmatic breathing: https://www.youtube.com/watch?v=hp-gCvW8PRY

If we are stressed or have cardiopulmonary issues, we tend to be shallow breathers and use accessory muscles in our necks rather than our diaphragm.  This could lead to muscle imbalance, tension, headaches, decreased oxygen levels, and pain. The more we perform diaphragmatic breathing, the more optimally we function. If we do not breathe like this naturally, it is important to practice this type of breathing. The more we practice, the more efficient and more automatic this type of breathing becomes.

How to Perform Diaphragmatic Breathing (3):

1.      Lie on your back with your knees bent and your back flat

2.      Place your hands on your stomach (A.) or place one hand on your stomach and one on your chest (B.) and concentrate on your breathing

3.      Inhale while expanding your stomach with minimal to no trunk or chest movement

4.      Then exhale without forcing.

5.      There should be a short pause after each exhale before the next inhale.

According to the Cleveland Clinic website, it is recommended to initially practice diaphragmatic breathing exercises 5-10 minutes about 3-4 times per day. (2) If no dizziness or discomfort is noted, gradually increase the length of time as desired.

I hope that after reading the benefits of diaphragmatic breathing, you will take the last 5-10 minutes of your busy day to perform this type of deep, relaxed breathing. You may be amazed how it may benefit your daily life.  Remember, we all get stressed and overwhelmed in life, however, it is how we overcome and deal with these emotions that matter.

 

Citation:

1.      Abu-Hijleh MF, Habbal OA, Moqattash ST. The role of the diaphragm in lymphatic absorption from the peritoneal cavity. J Anat. 1995;186 (Pt 3):453-467.

2.      Diaphragmatic Breathing. Cleveland Clinic website. Updated September 14, 2018. Accessed December 27, 2020. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

3.      Diaphragmatic Breathing. Physiotec Website. Copyright 1996 to 2020. Accessed December 27, 2020. https://hep.physiotec.ca/

4.      Drake R, Vogel A, Mitchell A. Gray’s Anatomy for Students. 2nd ed. Churchill Livingstone, an imprint of Elsevier Inc.; 2010.

5.      Hadjiliadis D, Harron P, Zieve D.  Diaphragm and lungs. National Library of Medicine: Medline Plus. Updated May 16, 2019. Accessed December 5, 2020. https://medlineplus.gov/ency/imagepages/19380.htm

6.      Ma X, Yue ZQ, Gong ZQ, et al. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017;8:874. Published 2017 Jun 6.doi:10.3389/fpsyg.2017.00874

Building Strength

Mitchell Fromm (UW-SP) and Bryan Stuettgen, MPT

Strength is a necessary component of daily living.  Our bodies are designed to respond to stresses placed on them.  The higher the activity level, provided adequate recovery, the more they will adapt to overcome those stressors.  As we age it becomes increasingly important to maintain the recoverable level of stress that will promote growth and maintain strength to reduce injury and prevent muscle loss.

Need for Strength

Within the next 10-15 years, an estimated 30% of the US population will be elderly, putting them at greater risk of health problems and loss of function.  The US National Center for Health Statistics reports the average person spends about 15% of their life in an unhealthy state due to disability, injury or disease occurring in old age (Hunter, 2004).

Age is a major contributing factor to the loss of musculature.  At age 30 muscle breakdown begins to exceed muscle growth.  At age 50 1% of total muscle strength can diminish annually and by age 65 the rate has been found to be around 3% per year (Kennis, 2013).  This age-related loss of muscle contributes greatly to the risk of falling and injury as well as muscle strains and other injuries.  Age-related strength loss is generally characterized by reduced muscle mass and strength and is manifested by preferential type II myofiber atrophy (Hunter, 2004, Van Roie 2013).  It has been considered type II fibers are not able to be activated as well in older populations due to this atrophy and denervation.  Type II muscle fiber type responds better to weight training for strength and power for growth and maintenance over type I which is characterized by its endurance properties.

There are multiple approaches to building strength.  The muscle can advance by recruiting more of the available muscle through training.  Weight lifting or similar activity teaches the muscle to recruit more of the available fibers that exist.  To recruit and utilize muscle a nerve pathway must be available.  Weight training also builds and improves this neuro-muscular connection allowing for more muscle fiber recruitment and better precision of movement.  Another training goal could be hypertrophy or the enlargement of muscle.  Creating more muscle allows for a larger pool of recruitment, which can lead to increased strength through training.  Training cycles targeting both strength and hypertrophy should be included to maximally stimulate muscle fibers and best improve overall growth potential.

Power is lost at an even faster rate than strength.  This loss is directly related to functional ability in daily living.  A study by Pereira (2012) led to findings suggesting that training cessation up to 6 weeks is sufficient to induce significant losses in dynamic strength in 1RM (1 rep maximum weight).  To some extent, functional capacity, and especially explosive force, may be preserved after high-speed power training.  As the older population is more susceptible to detraining from missed activity due to injury or illness, power training should be considered when building an exercise program.

Loss of power generation may also be attributed to the lowered ability to create creatine-kinase during aging, a fuel the body creates and uses to generate power. Calcium release also decreases with age limiting the contraction-relaxation cycle of muscle, and inadequate protein has proven to limit growth potential as it is a staple of building and maintaining muscle.  As they say, the temple cannot be created without the bricks.  Detailing appropriate nutritional adaptations is outside of the scope of this paper, however, proper nutrition must be considered to achieve training adaptations and individual recommendations should be sought by a qualified trainer or nutritionist.

 

Strength in everyday life

Strength is a necessary component in the completion of daily tasks. Walking, maintaining an upright posture, and balance all have strength components where failure in any of the mechanisms may lead to compounding injuries.  Motions beyond them such as bending, lifting, squatting, and transporting items have requisite strength requirements for completion without injury.  The need for strength is apparent and crucial for those seeking to maintain their independence.  Being able to complete tasks unaided reduces or eliminates the need for assisted living while reducing or eliminating those associated costs.  Strength training extends the length of time a person is able to maintain independent motion barring other complicating factors.

Implementing strength training programs can have long-lasting effects.  A long term strength study by Kennis (2013) found that increases in muscle strength and muscle power after a 1-year strength-training intervention theoretically can compensate for age-related losses over 3 to 5 years. Moreover, 7 years after their enrollment in the study, participants of the {strength training intervention} group experienced a significantly lower loss in basic strength compared with the {control} group. 

 

Protocol

Muscle reductions from age are found to be due to multiple factors.  Training both the nervous system as well as targeting the muscle fibers are necessary for a successful strength program.  It is commonly accepted that strength training should be conducted by lifting above 80% of the 1 rep maximum with sets of 6 or fewer repetitions, and hypertrophic training with weights between 67-80% for sets of 6-12 repetitions.  Though these current standards are accurate for those goals, they are not entirely definite and certainly are not exclusive.  Studies conducted and compiled by Van Roie (2013) have examined the growth ability utilizing low weight high rep protocols and found hypertrophy was achievable when the training sessions achieved momentary muscular failure.  Henneman's size principle of motor unit recruitment indicates that, when a submaximal contraction is sustained, initially recruited motor units will fatigue, creating the need to additionally activate larger motor units. When the exercise is repeated to the point of muscle failure, (near) maximal motor unit recruitment will occur, regardless of the external resistance used (Van Roie, 2013).  Expanding on this, one study was conducted in which a highly fatiguing protocol of 60 repetitions at 20–25% of 1RM was immediately followed (no rest) by a set of 10 repetitions at 40% of 1RM. This mixed low-resistance exercise protocol showed interesting benefits on the dynamic strength and speed of movement of the knee extensors (Van Roie, 2013).  Those studies further showed promising results on speed of movement at different resistances, even though training was performed at a moderate speed. 

Studies conducted by Schoenfeld et al (2016, 2017) led to findings indicating that maximal strength benefits are obtained from the use of heavy loads while muscle hypertrophy can be equally achieved across a spectrum of loading ranges.  This is backed by Dr. Mike Israetel when explaining the time under tension can be equal across a range of weights, so long as the muscle fibers are brought close to or achieve fatigue.  As long as all three components (concentric, isometric, eccentric) of the working muscle are achieved through the majority of the range of motion, muscular gains have been found utilizing as little as 30% of the 1RM.  Schoenfeld’s studies contrasted volume with the analysis using binary frequency as a predictor variable revealed a significant impact of training frequency on hypertrophy effect size (P = 0.002), with the higher frequency being associated with a greater effect size than lower frequency (0.49 ± 0.08 vs. 0.30 ± 0.07, respectively).

 Methods such as these or bodyweight protocols are effective for those who are adverse to weight training or unable to due to contraindications, however, volume was the decisive factor in how much could be achieved wherein multiple sessions per week were superior to a single intense session.  Factors that must be considered when using any program or weight is the proper form and control.  Utilizing improper body mechanics can put extreme stress on the joints and swinging weights around with momentum often relates to injury.  It is paramount to only use weights that can be used in a controlled fashion.  This will not only lessen or eliminate an injury risk but subsequently result in better muscular growth as each phase of the muscle contraction and lengthening phases are used appropriately through the entire lift.  Especially in newer lifters, this means that using a lighter weight for more repetitions is the most appropriate choice.  For experienced lifters, incorporating light-weight can allow for an increase in total volume, leading to additional strength gains and improving muscular endurance.  This approach also trains the nervous system to achieve precise motion to achieve a better neuro-muscular improvement.

It can be overwhelming to begin a strength program with a vast amount of information that seems to be ever-changing.  Experts exist in these areas to assist in setting and reaching goals.  Personal trainers specialize in strength and conditioning while ensuring proper form to prevent injury.  When choosing a personal trainer be alert to their credentialing as the field is largely unregulated and there are “internet experts” who claim experience they may or may not have.  Physical therapists are experts in the non-surgical treatment of injuries or conditions.  As such they are great assets in program creation while considering prevention and treatment of injuries, especially for those with a prior history of injury.  Both the physical therapist and personal trainer should have a great working knowledge of anatomy and physiology which is critical for accurate and individualized program creation.  They often work together for the best possible patient outcome.

 

Overall

The need to maintain strength training is clear.  It is highly transferable to everyday life, the amount of which will be directly affected by the effort put into training and the program design.  Multiple programs can be implemented to retain strength, but the secondary and tertiary effects of training must be considered for the best individual approach.  The coach-client relationship should not be overlooked as it is often the largest contributing factor determining compliance and exertion in training, as any properly implemented program will have benefits over the stagnation of not completing any program at all.

Csapo R, Alegre LM. Effects of resistance training with moderate vs heavy loads on muscle mass and strength in the elderly: A meta-analysis. Scandinavian Journal of Medicine & Science in Sports. 2015;26(9):995-1006. doi:10.1111/sms.12536.

Hunter GR, Mccarthy JP, Bamman MM. Effects of Resistance Training on Older Adults. Sports Medicine. 2004;34(5):329-348. doi:10.2165/00007256-200434050-00005.

Kennis E, Verschueren SM, Bogaerts A, Roie EV, Boonen S, Delecluse C. Long-Term Impact of Strength Training on Muscle Strength Characteristics in Older Adults. Archives of Physical Medicine and Rehabilitation. 2013;94(11):2054-2060. doi:10.1016/j.apmr.2013.06.018.

Schoenfeld BJ, Ogborn D, Krieger JW. Effects of Resistance Training Frequency on Measures of Muscle Hypertrophy: A Systematic Review and Meta-Analysis. Sports Medicine. 2016;46(11):1689-1697. doi:10.1007/s40279-016-0543-8.

Schoenfeld BJ, Grgic J, Ogborn D, Krieger JW. Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training. Journal of Strength and Conditioning Research. 2017;31(12):3508-3523. doi:10.1519/jsc.0000000000002200.

Roie EV, Delecluse C, Coudyzer W, Boonen S, Bautmans I. Strength training at high versus low external resistance in older adults: Effects on muscle volume, muscle strength, and force–velocity characteristics. Experimental Gerontology. 2013;48(11):1351-1361. doi:10.1016/j.exger.2013.08.010.