Talking to Patients About Healthy Aging
Help patients get their bodies to "grow" with age.
By Jeffrey Tucker, DC, DACRB
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues. These are patients in their 40s, 50s and 60s who make one or two of these exercise choices: walking, Pilates, yoga, boot camps, swimming, "spinning," jogging, weight training, elliptical training, etc. Some of them are always dieting as well, using the latest fad diet to chase away excess weight, high cholesterol, high blood pressure and diabetes.
I am passionate when talking to patients about what getting older means. My idea is to help tack on an additional 10 years – healthy, satisfying years! Through cultivating and recognizing the wisdom of my own aging experience, new research and technology, exercise, and eating nutritious whole food, I hope to make the most of it and am happy to share this information with patients.
Myopic Training: When Training Actually Hinders Healthy Aging
I let patients know that I think it is better to vary their training, rather than focusing on just one or two things. I tell them it is better to do 1) a little flexibility work, 2) a little resistance training, 3) a little cardio, 4) a little nutrition and 5) a little brain exercise, than to immerse themselves in only one, two or even three of these five fitness disciplines. I usually make the list longer, making sure patients also are getting a little more sleep, a little less stress and a little more "spirit."
If degenerative disease is 10-25 percent due to genetics, that means 75-90 percent of degenerative aging is under our control. The fact is we currently have an 80-plus-year life expectancy, meaning we could live at least 30 years as an "older person." But there is one big challenge – we are only given one chance at getting old.
So, if DNA and lifestyle are what determine how well we will functionally age, I am certain that a patient with painful degeneration (spine, knees, hips, shoulders, etc.) in their 40s who is doing what they think is fitness failed because they are missing the balance of the five-plus fitness disciplines.
Something is triggering the degeneration. Chiropractic typically has looked at degeneration from the viewpoint of poor motion (hypomobility, hypermobility), poor posture, repetitive loads, faulty muscle-movement patterns, and fragmented cores and diaphragms. Some of us focus on nutrition, hormones and other concerns as well. All of these factors, plus many more, contribute to the signaling systems within the body; systems that send messages to either grow, or atrophy and decay.
Getting the Body to "Grow" With Age: Tips and Talking to Patients
The question is, how can we send healthy "grow" signals to the body? The big thing is movement – proper movement and a variety of movement. This is the message we (as a profession) need to promote: "Move 20-45 minutes per day! Don't sit more than 20 minutes without moving for at least 2 minutes!"
I tell my patients, "Exercise six days per week pretty hard and you will help delay and even reverse the age-debilitating effects on your muscles, bones, lungs, heart and brain." If you are my patient, "I want you to give me 20-45 minutes a day of movement including flexibility, resistance training and cardio training." If a patient only walks their dog every day, I say, "I like that you walk your dog for 30 minutes. I want you to give yourself that time with movement, including flexibility, resistance training and cardio training. Now let's figure out how you can do that."
If my patient is doing aerobics, like running on the treadmill or riding a bike for 30 minutes, I tell them, "I want you to give yourself 20-45 minutes a day of movement including flexibility, resistance training and cardio training. What you are doing is important, but you have to exert yourself 'all the way out' for a portion of that activity. I'd like to teach you some strength training (weight-lifting), because it may do more than aerobics and should be included in this time as well."
I have to talk about nutrition, too. I start the conversation by asking, "What did you have for breakfast this morning?" I figure if people are into health, they will start the day off with a wholesome breakfast. Unfortunately, more often I get an answer like, "Oh, today I had a glass of orange juice and cereal with milk." I respond, "I'd like to see you water down the OJ, cut down on grains, white foods like white sugar and white flour," and for some patients, eliminate dairy.
This conversation leads me to sharing my food shopping list. If my patient has a chronic degenerative condition, I say, "Not only do I have to get you moving, but we have to decrease inflammation in your body, too." Then I recommend key anti-inflammatory supplements they should take.
I get asked about every new diet, every new exercise craze, and every new fitness method or mode. Honestly, in my experience, it all boils down to movement. If a person does only one type of exercise, I believe they are doomed to suffer type of injury or joint / muscle failure over time. Every singular fitness undertaking cannot and will not, in and of itself, deliver the renovated body patients seek. I hope we can be seen as the profession that helps patients tweak their current fitness programs to remove the cause of degeneration and pain.
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