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Episode 83: Inbetweenie - A Tale of Two Seniors
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Welcome to Episode 83 of the Movement Logic podcast! In this Inbetweenie episode, Sarah discusses the importance of ‘banking’ capacities like strength, balance, and endurance, in order to have the best possible last 10 years of your life. Drawing from some real-life encounters, she compares how two very different lifestyle choices have led to two very different final decades for two women.
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Transcript
Introduction to Movement Logic Podcast
00:00:02
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaversdorf and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up to date and cutting edge tools, evidence, and ideas to help you as a mover and a teacher.
Episode Overview: Between Seasons
00:00:37
Speaker
Welcome to episode 83 of the movement logic podcast. I am Dr. Sarah Court. I'm a physical therapist and this is an in between episode. We are in between seasons five and six right now. And so Laurel and I will be in your ear holes with just a few short episodes here and there just to keep your whistle wetted.
Exercise as a Lifelong Habit
00:00:58
Speaker
that that sounds weird anyway i think you know what i mean so today today what i want to talk about is this idea of what we do now and how it's going to impact the last 10 years of our life so i think everyone listening to the podcast is on board generally with the idea that exercise should be a lifelong habit right we don't just sort of Finish one day you don't you don't turn 60 and get a gold watch and you say oh well I guess I'd exercised exercised enough and now I can just Sit down and watch my daytime TV shows and never get up again, right? I think everyone understands that that's not a not a positive way to experience being alive in our later years of our life but I want to talk specifically about this idea of our last decade and I how and what we can do now to impact what that last decade looks like for
Health Shifts in Later Life
00:01:51
Speaker
us. Now, if you have read Dr. Peter Atiyah's book Outlive, this will be a familiar concept to you. I liked a lot of things about the book. There's some things I wasn't crazy about, but this was one of the things that I really liked that he talked about, which is the idea that for a lot of people,
00:02:07
Speaker
something happens in their last 10 years that kind of comes out of nowhere is a sort of a surprise to the person that then really impacts their health and their wellness and then as a result the quality of the life that they're living how it can go from essentially basically fine or seemingly basically fine to absolutely in the toilet very quickly and in a way that surprises people when it does. And so I never want to be like, oh, I'm going to like hack my life and I'm going to go outside and stare at the sun first thing in the morning. And then I'm going to do my, you know, Wim Hof breathing and then I'm going to drink my mushroom coffee. And, you know, that's like that's for somebody else. That's not for me.
Health 'Deposits' through Exercise
00:02:56
Speaker
But what I do believe in and what I do practice is this idea of making deposits in the bank now. And the bank is holding things like strength. It's holding muscle size. It's holding balance capacity. It's called holding cardiovascular, cardio endurance. It's holding plyometric capability.
00:03:19
Speaker
and that if we continue to make these kinds of deposits and investments, not only is it going to improve those last 10 years of our life, but we'll probably still be doing it to some capacity in those last 10 years.
Comparing Exercise Habits in Seniors
00:03:32
Speaker
But that's not something that for a lot of people at the moment, and in particular for I think a lot of women who are now in their 70s and their 80s, they may not have been encouraged to participate in exercise to participate in in a sport to to maintain or to continue exercising or even to just to to start exercising at all and then they find themselves sometimes in a really tough position so this in between the episode is called a tale of two seniors because i have had recently two patients in similar situations but
00:04:08
Speaker
Very different experiences based on their prior habits and their current habits. And so I wanted to talk about ah The two of them as an example of of what I'm talking about. So the first person When I first met her she's late 70s and I don't know for sure that this is this person's last decade But they do also have another condition going on separate from what I saw her for ah But when I met this person she came to me because she had had a hip replacement relatively recently and had then had a fall in a parking lot and it messed up her hip replacement so then she had to have a revision surgery and so you know the deconditioning you know there's this yeah secondary level of deconditioning with it and so she wanted to get back in shape and
00:05:03
Speaker
When I first met her, you know, she was definitely kind of on the on the weaker side, but she was very, I guess, determined is the right way to put it. And, you know, I'm not here to to psychoanalyze anybody, but she definitely was a like, you know, can do, let's do this kind of a person. And so we started doing our therapy. I did some manual therapy. We did exercises. We did a lot of Pilates because she really liked it.
Choosing Care Facilities for Health
00:05:28
Speaker
And then the reason I stopped working with her, really the only reason I stopped working with her was because she decided to preemptively put herself into a full-time care facility because of this other condition that she has. She sort of wanted to, she didn't want to wait until Somebody else was having to you know, wrestle her to get her to go, you know which was an incredibly wise and You know forward-thinking thing for her to do and this place was is all the way across town So that's why this person is not my patient anymore But I used to see her sometimes because she lived not far from where I was working where I work and I would see her out with
00:06:08
Speaker
her you know home health aid walking. I would see her all the time out walking. She you know got over the effects of that second surgery on that hip. She was doing incredibly well. I believe she's probably still doing great. She has made a conscious commitment to exercise, partly also because it's going to have a valuable effect on her other health condition, but also because I think she just,
00:06:37
Speaker
strikes. She just struck me as someone who had probably always done some sort of exercise. Now, would I have preferred her to get into lifting weights so we can really think about dealing with any bone density issues or actually building more muscle mass for her? Yes. And did I try to get her into lifting weights? I sure did. And she sure did not enjoy it and basically told me she didn't want to do it anymore.
00:06:59
Speaker
And that's okay. I mean, you know, not everybody's going to want to do what I want them to do. Lots of people don't want to do what I want them to do. But she was still exercising, right? She was still going on. She would take like a couple of miles walk every day. She would ah she really liked Pilates. She had a whole series of home exercises with ah dumbbells that I had her doing.
00:07:22
Speaker
so You know, it was sad the day that was our last day working together because I really enjoyed her a lot. We had great conversations, very smart person. ah But I wasn't worried about her, you know, as she sort of walked off without looking back. And I have that feeling like, oh.
00:07:40
Speaker
The little baby bird is leaving the nest. But I wasn't concerned. I wasn't like, oh no, this is the beginning of the end. She's going to go to this place. She's going to sit down. She's not going to take advantage of all the classes and activities. We had already looked for Pilates studios near where it was and other places she could exercise. Like we had prepped her. So I wasn't worried about her. I'm not worried about her. I haven't spoken to her, but I'm sure she's somewhere taking a Pilates class.
00:08:05
Speaker
hey out there doing great. So that's one person, right? That's one person who had to have a hip surgery.
Challenges of Sedentary Lifestyle
00:08:13
Speaker
And because she had previously banked the habit of exercise, it was not such a struggle to encourage her to exercise in the rehab sense post her revision, hip revision surgery. And I'm sure like until, on on until time.
00:08:33
Speaker
Now the other person that is currently still a patient of mine, this is someone who I go to their house. And the reason I go to her house is because she's not very mobile. When I first met her, ah she had also recently, I'm not sure, one of the things that was challenging with this person is that their sense of time, the passage of time was not super clear. So I'm not entirely sure how long ago this was, but I met her after she had had a fall and fractured her femur and so had had to have surgery where there's a, you know, metal holding the two pieces of her femur together and pins and the whole thing.
00:09:15
Speaker
This is not someone who had made any sort of lifetime habit of exercise. And my understanding was, and again, it was a bit difficult to get the full story out. I'm not entirely clear about the timeline, but following the surgery, she had been put into a rehab facility and I believe she was only there for a few weeks and then basically discharged herself because it wasn't, you know, she was allowed to leave whenever she wanted and came back home. But didn't really have good home health PT coming to work with her. And some of that is the fault of the medical system and and this one medical system in particular that has a reputation for not really providing good care, unfortunately. And I just don't think they pay their doctors enough, but that's a different story.
00:10:04
Speaker
So she basically, when I first met her, she was mostly sedentary. She wasn't getting up to do much. She was getting up to go to the bathroom and then to go to the kitchen maybe once or twice a day, and that was about it. And when she was getting up, she was using a walker.
00:10:20
Speaker
And it was very difficult for her to get up from her seated or or you know lying down position. she had It was very physically difficult. Just getting up and down was hard. And walking for her was also hard. I don't know exactly what happened in the surgery. but yeah Again, this it's hard to know with the timing. She has essentially been left with one leg.
00:10:41
Speaker
Slightly shorter than the other and I don't know if it was because of a lack of good PT following the surgery I don't know if it was maybe the surgery they messed it up a little bit i I don't know but she she has to have one heel slightly lifted when she's walking and I've been I've been working with her now for in a few months it'll be coming up on a year and you know that has not improved and that seems to be something that that's not changing. The other thing that's difficult is this person's home is very full of stuff. So it's hard to kind of carve out space to do exercises with and you know I spend some of the time that I that I am there just like moving things around or or putting things in the garbage or
00:11:27
Speaker
making space for us to work together. She walks with a walker. Since I've been working with her, we have managed to get her outside, which is new because she wasn't going outside. And in order to do that, she has to go down a couple of steps and down a sort of steep driveway and then turn around and go back up again. And in the beginning, it was very hard for her because she was very deconditioned. but she has improved in her strength and in her capacity so that she can do it now and she can go up and down the stairs with a walker and with me holding the walker for her. She can't do it by herself, but she can do it with someone else there, which is compared to when I met her is is definitely an improvement. But what she says to me all the time, and this is this is what I'm really getting at, what she says to me all the time are things like, I can't believe that this is my life.
00:12:16
Speaker
I can't believe that I just live in this room most of the time and I don't go out, I don't see people. I never expected that I would be this disabled. I can't believe that I still need to use a walker. you know I spent a lot of time breaking it to her that probably she would you know be using a walker walking around outdoors just for safety reasons. And and also this woman is about 10 years older.
00:12:44
Speaker
than the first woman. But it caught her by surprise. It caught her by surprise that her health could go so downhill so quickly. And that the quality of her life could go so downhill so quickly. She also tells me all the time that she's depressed. I i would be too.
00:13:04
Speaker
You know, her world has gotten very, very small. I am probably one of two or three people that she sees on a weekly basis. It's not a good situation. And I don't blame her. And I never would say anything like this to her. But my sense is that You know, she had had falls before the one where she broke her femur and had always kind of just, you know, bounced back, you know, maybe had a few bruises here and there. And then she had this one fall that was really bad. But at no point prior to the bad fall,
00:13:38
Speaker
Did she decide or was she advised to start doing PT to get someone in to help her, to work on her strength, to work on just basic foundational movement skills like going from sitting to standing, going up and down stairs.
00:13:55
Speaker
practicing balancing on one leg and then the other and so because there was nothing banked ahead of time i mean in an ideal situation someone's banking strength and balance and coordination and flexibility their whole life but even if she had started like when the falls started happening for example you know there's a possibility that she never would have had the bad fall to begin with Now, i again, I'm not trying to judge this woman. I think, honestly, it's more got to do with a lack of education around the importance of these things and a lack of emphasis on it for women and especially for women who are in their 70s and 80s. She has fantastic stories from her life.
00:14:40
Speaker
She has lived an incredibly cosmopolitan, international life. She'll tell me stories about when she was in Buenos Aires, and she'll tell me stories about when she was in London and in Paris. And she had an incredible, fun life, for sure.
00:14:56
Speaker
But I don't think she ever prioritized exercise. And, you know, to be fair, neither do most people. Something like 80% of the people in this country do not exercise on a regular basis. So, you know, I don't blame her for that. But it is really clear that it would have gone a long way. And it certainly would have made her current condition nowhere near as dramatically different from what it was before the bad fall.
Envisioning Your Last Decade for Motivation
00:15:22
Speaker
I know I'm kind of preaching to the choir, but if you have clients, patients that you work with, and they are in their, you know, fifties, sixties, as opposed to just this kind of general sense of, oh, I should be exercising. Oh, I should be exercising more. Oh, I should be doing this kind of exercise. Everyone telling you that you should exercise. It starts to sound like, you know, the Charlie Brown teacher, like, weren weren weren
00:15:45
Speaker
But this idea of what do you want the last 10 years of your life to look like? And I think there's something about that as a thought that kind of like puts you on notice a little bit, kind of pulls you up and makes you think, hmm, well, what do I want the last 10 years of my life to look like? Do I want to be someone who can't leave my house?
00:16:05
Speaker
because I'm so deconditioned. I have such poor mobility in my joints that I cannot get out of the house without assistance and I don't have the strength capacity. I don't have the endurance to do more than walk up and down the street outside the house and then come back in. Is that what I want?
00:16:23
Speaker
and you know obviously she doesn't want it either i wish i could do more but i definitely don't want that for myself or do i want to be the person who has continued to emphasize exercising for myself throughout my life and in particular as i get older making sure that i am doing heavy lifting making sure that i'm doing impact training making sure that i am doing Sprint cardio right the kind of cardio work that gets your heart rate up I want to make sure that I'm doing all of those things so that let's say I do fall over and I break my femur I am able to rehab from it and actually come back in a way that is functional where I'm not now living at this lower level quality of life, that would be my goal, right? And so that might be a really interesting thing to say to somebody that you're working with. I think in particular, you know, we all have clients, those of you that are teachers or or clinicians, we all have clients and we all have patients who are just kind of doing it because they know they're supposed to, but they're not really into it, right? They're like, oh, my wife told me I need to start exercising or, you know, I heard it's good for me to da da da.
00:17:29
Speaker
I think this is a really interesting thought experiment and an interesting way to give more relevance to what your clients and patients are doing now and to give more focus to what they're doing now by giving them this idea of, okay, well, visualize your last 10 years. What do you want it to look like? What do you want to be doing?
00:17:52
Speaker
Do you want to be gardening? Great. Let's keep working on getting up and down from the ground and all that kind of stuff. I don't know. That's all I know about gardening is you have to get up and down a lot. Do you want to be playing tennis? Great. My mom is 78. She plays tennis at least once a week.
00:18:10
Speaker
ah She's been playing tennis her whole life. I'm like, please don't ever stop. yeah And you know, because she never did stop, she's still able to do it. So think of you probably right now as you're listening to this, if you have any clients or patients like this, you've probably got them in your mind right now. You're like, Oh, yeah, Kathy really just is doing this because she's heard that she's supposed to. Maybe I'll ask her what she wants her last 10 years to be like. Yeah, just see see what people say and see if that gives them maybe a little more motivation that is internally generated instead of just you having to be the cheerleader that generates all the motivation from the outside. All right, you guys, thanks for listening.
Podcast Subscription and Engagement
00:18:48
Speaker
I'll put a link to Outlive the book in the show notes, because it's worth a listen or a read. Thank you so much for listening to this in between me. Please subscribe, rate and review. Those things all help get us in front of more people. And we will see you in two weeks.