Strength Training Seniors by Gillian Mounsey Ward | January 02, 2012 Understanding the Value of Strength- The Epiphany My grandmother, Shirley Mounsey, was the single biggest influence on how I view physical culture and the importance of physical strength. My earliest memories include those of her laboring in her vegetable garden or trimming hedges in her hot pants, a tank top, and platform wedges. The summers were always hot, and she was working hard enough to have an un-ladylike sweat going. I watched with admiration the muscles of her thighs and calves as she worked. I wondered if some day I would look like that; at that age my knee was the thickest part of my leg. My grandmother was always working, she raised my father and his siblings as a single mother – she worked hard to support her family. She taught me that if I wanted something in life, it would not be given to me, and I had better learn to do things for myself. My grandma around the age of 20 (1940) posing on the fire escape of her Brooklyn apartment. A natural brunette, she later decided that blonds have more fun and never went back. The daughter of a Russian immigrant, my grandmother grew up in Brooklyn, New York during the Great Depression. She was streetsavvy and never took anything for granted. At a young age my grandmother realized that she had an aptitude and a love for physical activity. She played all the street sports she could because there were few, if any, organized sports for girls in school. She loved to jump rope (she was fairly good at double-dutch, if memory serves), she played tag and stickball, and she danced. Later she discovered handball and realized that she could hustle the boys out of money. She took great pleasure in beating the boys – a quality I seemed to have inherited. But my grandmother was anything but a tomboy. Shirley loved sexy dresses, high heels, sparkly diamonds, and fur coats, though it was much later before she could afford these things. I do admit that grandma Shirley was a bit of an anomaly. When my friends came to visit (she lived with us throughout my childhood) my friends never knew what to make of her. She was tough on my sister and me, and I think it scared our friends. She was definitely not your stereotypical “sweet old lady.” Grandma would bark orders at us and had the highest of expectations. Most of the time it would sound like, “Stand up straight, pull your belly in, shoulders back, stick out your chest, speak loudly and clearly, enunciate your words, don’t drag your feet, and look at me when I am talking to you.” She embodied the above description to a perfect T. Grandma believed that “skinny” meant weak, and that “fat” meant lazy. My sister and I (both skinny little twerps) were forced to eat rare cuts of meat in natural juices, liver, and vegetables from the garden. For some reason rare roast beef, spinach, and tomatoes stand out in my memory. She was very supportive of my gymnastics career and my sister’s ballet career, and she truly understood the carryover of relentless dedication and hard physical activity to all aspects of life. As a small child I knew that my grandmother’s presence commanded attention. When she walked into a room, heads would turn. Some may have mistaken her exceptional posture for arrogance. Somewhere along the way I recognized that what made her different was her strength – both physically and mentally – and that the two were inseparable. Grandma in the early 1960s, dressed up as usual. My grandmother led an exceptional life and spent many hours telling stories of her youth and Grandma in the early 1960s, dressed up as usual. teaching my sister and me valuable lessons. She enjoyed getting dressed to the nines and dancing with her boyfriend. She enjoyed collecting antiques, cars, jewels, furs, and various types of artwork. Her diet was healthy with an aversion to spices, and she loved chocolate. My grandmother passed at the age of 73 (when I was 15) of a quick and aggressive form of bone cancer. Her quality of life up until the last year was extraordinary – late into her 60s she could dance a 20-year-old under the table. In addition to shaping my value of physical strength, my grandmother taught me that my elders have much to offer. This influenced my career focus and eventually led me to teaching seniors about physical exercise and strength training. Seniors want to be strong – A decade of observation, learning, and experimentation At Hofstra University there was a unique program in the Exercise Science department. Students were given the option to combine various specialties within the major. I chose cardiac rehabilitation because it would make me competitive against my peers when seeking employment. The most important class of the Exercise Science program came in the final year. The class required students to train two volunteers (most of which were considered to be high risk or special populations) for the semester. Students were required to report progress and discuss challenges in regularly scheduled meetings. It seemed odd that I was paying the school, a pricey private institution, for the opportunity to personally train clients for free, while paying my own travel expenses on my leisure time. I recall complaining to anyone that would listen – after all, I had already been working as a paid personal trainer for nearly four years. As it turned out, I learned more from this experience than from the totality of my school coursework to date. From this I was able to decide with certainty that I wanted to dedicate my life to helping people through exercise and education. One of my clients was a 79-year-old woman named Lillian. She lived far from Hofstra University and did not drive in the rain or snow. We did most of our training in the university gym, and at times I went to the gym in her condominium complex. Lillian was relatively healthy but had been diagnosed with osteoporosis, a hip had been replaced 5 years prior, and she had poor balance. She showed up on the first day in regular street clothes and shoes, not tennis shoes. I was at a loss as to how to proceed – I knew that the gym required sneakers, or at least I thought it did. As it turned out, any rubber soled shoe would suffice. I made a quick assessment about the nature of the material in her clothing and the range of motion she would have, and decided to proceed with her dressed as she was. Lillian did not own “exercise” clothes, and I refused to allow her choice of clothing to limit her session. I figured that over time she would want to invest in sneakers, but that never happened. Lillian and I developed a close relationship working together twice a week over the semester and we learned from one another. Lillian taught me that the desires of the elderly are significantly different than those of my college peers. For Lillian, it was important to remain independent, to ensure that her children would not be burdened with her care, and that she be able to play with her great-grandchildren. Lillian was a widow, her husband having passed 15 years earlier. I made many mistakes while training Lillian. Once, I took her on a walk that was too far and we needed to get a ride back. I put her on a rower the first week and she fell off and landed on her bottom – an embarrassing incident for both of us. I am sure there were more, but these two particular injustices are still vivid 13 years later. I also remember Lillian’s love of working with dumbbells and the joy she felt from the sensation in her legs while training on the leg press. My biggest challenge working with Lillian was her balance. I often held her arm or held her hand on our walks. Her posture was poor due to severe kyphosis of her spine. It took several months, but I learned that the balance difficulty was a combination of her posture and her glasses. Because her posture was poor, Lillian looked through the bottom portion of her bifocals when walking, severely affecting her balance. My instincts told me that strength training and possibly new glasses would be the solution. At the time I was a competitive bodybuilder, so I pulled most of Lillian’s exercises from my usual repertoire. What I was doing may not have been ideal, but it worked. Lillian made tremendous progress during that semester and when we parted ways she had a new confidence. She was able to find a friend with whom she continued to train, and she enjoyed an increase in her quality of life due to her personal will and her exercise regimen. From Lillian I learned to focus on the important part of training and not to sweat the small stuff (like her clothing). I learned not to be paralyzed by my own fear of her getting injured. If I taught her to move properly in the gym, she would be less likely to suffer injury outside the gym. I also learned not to coddle her, and to treat her in the same manner I treated a younger client. During my final semester in school I interned at a Phase IV cardiac rehabilitation center in Valley Stream, Long Island. After graduation, I continued to work there, hungry to apply my new education. The rehabilitation center allowed patients to stay long term at their own expense after insurance benefits had been exhausted. Many felt safe and had developed friendships in the clinic, and were thus reluctant to leave. After the nurse hooked patients up to monitors, I instructed warm-ups and supervised their exercise on the treadmills and stationary bikes. Mostly, I helped patients get on and off the bikes and took blood pressure. If not for the conversation and banter I would have lost my mind due to boredom. I was very popular with the older men – a pleasant demeanor and a friendly smile coaxed them into setting up their own bicycle seat heights. What struck me most about this population was how weak they were, and how they were treated – like sick people. I was reminded of the theory of “self-fulfilling prophecy” from a psychology class I had taken in school, and determined that I would treat these patients differently. I started by ceasing to refer to them as “patients.” Because I had spent a fair amount of time with the nurses and cardiologists discussing training routines and diet, I had the trust and confidence of the staff. As a result, I was given the latitude to make some changes. The rehabilitation center had a very old Universal weight machine and a few dumbbells that had collected dust from a lack of use. On a volunteer basis, clients (formerly known as “patients”) would sign up to work with me and learn resistance training. The program was wildly successful. I searched for existing protocols, but little had been written on the topic. Many that participated had previously undergone open-heart surgery. I knew that resistance work would help restore thoracic strength as well as the integrity of the blood vessels and chest wall. The program was fairly simple: 6 to 8 full body exercises, 2-3 sets of each exercise, and somewhere between 8 and 12 reps for most sets. I was fortunate the senior staff trusted me – my theory was not supported in the literature. I was cautious and made changes slowly. I explained to my superiors that the “patients” were required to pick things up as part of their daily tasks. Bicycle and treadmill work were not adequate preparation for the stress of taking out the garbage, carrying groceries, or shoveling snow. Drawing upon my primary example for the best way to age, I felt that all seniors should look and perform like my grandmother. Over the next ten years that I worked as a personal trainer I became regarded as a specialist with senior and special populations. The tough cases were often shoved on my plate with the comment, “Gillian can handle it.” As a result, I learned about cancer, autoimmune disease, diabetes, limb amputations, Parkinson’s, ALS, dementia, severe burns, spinal injuries, and a host of other conditions that would require specialized training protocols. My education came from trial and error as well as personal research on these specific conditions. I spent hundreds of hours developing programs and training clients. To an onlooker, my methods may have appeared radical; after all, I had seniors lifting heavy weights, climbing ropes, jumping rope (if their joints allowed), performing pull-ups, and dancing (a combination of all of the styles I was trained in – ballet, ballroom, Latin, modern, folk, and African). I accomplished this by earning their trust, developing a mutual respect, and believing they could do everything my grandmother could do. This is not to say that every client I trained was capable of or willing to do these things. My philosophy was and remains focused on what a client can do versus focusing on what he or she cannot do. There is nothing worse than beginning with a list of contraindications that left both me and the client unclear as to how to proceed. I chose to begin with a list of “can dos.” My programs are guided by three principles: 1) Is it safe? 2) Is it fun (fun being relative)? 3) Are they making measurable progress? “Forever Young” – a progressive approach. A year and a half ago, I was given the opportunity to develop and run my own program for seniors. Having recently moved from New York City to northern Virginia, I was starting over. A small family-owned gym in Fredericksburg had faith in me and gave me carte blanche to start new programs. One of the programs I created was “Forever Young,” and at the time of this writing it continues to attract new participants. I have worked with this group for 15 months, twice a week. It is a free program for members of the gym that is open to anyone of any age, but geared to the 50+ demographic. For reasons unknown to me, the program attracts exclusively women. I want men to participate, but I have not had one male participant to date. It is my hope that sharing this information will lead others to develop and implement similar programs geared towards seniors. The backbone of this program is strength training and education. The ages of the participants have ranged from 44 through 81. The women that attend with the most frequency are mid-sixties to early seventies. I started the Forever Young program in October of 2010. The class meets Monday and Wednesday mornings at 8am. The class is scheduled to be conducted in the group exercise/aerobics room however most sessions are spent on the main gym floor. In the marketing literature the program is touted as a hybrid strength and conditioning program for seniors, designed to improve muscular strength and endurance, cardiovascular endurance, balance, coordination, and posture. I found the description to be accurate enough and allowed it to be published. I designed the program to combine barbell strength training, dumbbell work, circuits of bodyweight exercises and agility work, intervals on cardio equipment, outdoor adventures, dance, basic yoga, and team competitions. The strength work is highly emphasized, and is the focus roughly two-thirds of the time. Participants are taught to squat, press, deadlift, bench, power clean, and do pullups in addition to many other skills. If their form is poor, they do not progress in weight until form is corrected. There is a briefing at the beginning of each class regarding the content and expectations for the day – timeliness is required (and rarely an issue with this demographic). Three women attended the inaugural class. Of those, two still participate today – Janice, age 71, and Natalie age 67. Both women attend every session. In the last 14 months, there have been other committed regulars that came to most every class. There are another half dozen members of Forever Young that attended regularly but stopped for various reasons. Janice bench pressing with a close grip to avoid bothering her shoulders. Natalie is an attentive spotter. Additionally, there are a few women that pop in for a session or two – these itinerant clients consume an inordinate amount of my time. They are often intimidated by the strength and fitness the regulars routinely display, and they quickly drop out. Attendees are expected to work hard, there is no sneaking beneath the radar as some do in the back of a crowded group exercise class. My eyes are on them, and I see everything. The regular women that quit did so due to illness or a need to care for another family member, or an inability to get to the gym due to other demands in life. This is the harsh reality of this demographic that must be considered. One particular client (a personal favorite of mine) had to drop Forever Young earlier this fall due to the diagnosis and subsequent treatment of rectal cancer. The women have become friends with one another, and share their hardships and support each other. I am proud of each of them and admire their strength and courage. Class begins with a routine warm-up in the aerobics room. There is no music – this ensures they hear my instructions. I lead the group in passes across the floor: high knees, heels to butt, side shuffles, carioca, walking on toes on a line, walking on heels on a line, and various other movements designed to generate joint and muscle warmth, increase circulation, and improve balance. After the instructions are given, we move out onto the loud, busy gym floor on most days. On days that do not require the equipment in the main gym area, I hold Forever Young in the aerobics room and perform circuits with lighter versions of the same exercises they learned on the gym floor. Squat or deadlift form is instructed during every class. When performing the deadlift, we use standard Olympic barbells; when training in the aerobics room, kettlebells are used – each have their utility. The ladies are working toward push-ups from their feet and know how much assistance to use on the assisted pull-up machine. Full range of motion is required unless there is a specific medical/ orthopedic condition that prevents it. New participants are often terrified when they witness my group of ladies deadlifting as much as 95 pounds (I am fortunate enough to have bumper plates so that height off the floor is not an issue). There are days that I teach athletic skills such as running a speed ladder and throwing a ball. The ladies love everything and are at a point where they embrace the new challenges. Natalie (67 Years old) performs her last warm-up set of deadlifts.She does not let Parkinson’s disease stop her. The gym has been very generous to me and provided all of the equipment and space I need. I have light bars starting at 9 pounds that incrementally increase – a must for this program. Most of the women were able to start with 35 pounds on the bench, 65 on the deadlift, and a 15 pound bar on the press. Squats have the biggest variability in initial load – if they are able to be loaded at all. Getting the members of Forever Young to squat at full range with consistency was one of the biggest challenges I had. I spent a significant amount of time debunking the myth that squats are bad for the knees, and I have included unloaded “air” squats in every warmup. Now the ladies tell each other if depth is missed, if their knees are crashing together, or their heels are coming up off the floor. My time is often devoted to new attendees during warm ups while the veterans move through the now familiar routine. An impartial observer can quickly determine the three regulars by their squat technique alone. Other members of the gym not participating in Forever Young generally observe good gym etiquette by moving out of the way when class is in session. Regular gym members have been known to give up benches and squat racks and then watch as Forever Young members perform exercises uncharacteristically done by seniors. Members comment that they wish their own mothers would join the program. The Forever Young ladies know that they run the gym at the 8am hour – and it’s a great feeling. (I should add that 8am is a relatively slow time in the gym, so there is little interference from either side.) I have been attempting to spur growth in the program for over a year, but the turn-out remains relatively low with 8-10 participants on the busiest days. It is hard work, and most people shy away from hard work. The ladies actively recruit new participants to little or no avail. Most of their peers prefer the Yoga class which follows the next hour, and because it generally requires participants to lie on the floor it is far more appealing to the faint of heart. The unfortunate outcome of the low turn-out is that the class is only scheduled two days per week, with more popular classes such as Yoga, Zumba®, and Spin® occupying the rest of the schedule. I pushed to add a third day but unfortunately I do not have the numbers to justify it. The gym has allowed me to continue the program because they believe in it; however the gym must cater to the desires of the clientele. The normal gym policy is that if a class’s attendance falls below 6 participants (as a daily average over any given month), the class is cancelled. My biggest fear is the “Forever Young” ladies’ dependence on me. The ultimate goal is to make them independent and self-sufficient in the gym and at home. This is why I spend so much time educating them instead of telling them what to do with no explanation. They are not very receptive to substitute teachers when I travel – and this needs to change. At some point I will be moving out of the area, and I’ll be training other fitness professionals to implement the program. That is the underlying reason for this article. Alone, I am not capable of eliciting the widespread change that needs to occur. The Program Forever Young evolved dramatically over the past 15 months. This is due to support of the gym and the neighboring community as well as the dedication of the participants. The performance capabilities of the women have far exceeded my initial expectations. There are aspects of the program that are constant each class. These include the personal introductions, warm-ups, and the post class cool-down/review. My office hours begin at 7:40am and class begins promptly at 8am. I am available for 20 minutes pre-class and 15 minutes post class to answer any questions that a participant wants to address privately. These questions usually regard specific medical conditions or personal family matters that affect participation or require program modifications. Class starts at 8am in the aerobics studio. The door is closed, the temperature is set to 67 degrees, and the music is off. Introductions are made if a new member is present and regulars greet the new member. There is a brief opportunity for discussion at this time. Warm-ups follow immediately after introductions and take approximately five minutes to complete. The women line up on one end of the room and do passes across the room (approx. 40 ft) of the following movements: High knee march – 1 length. Walking alternating knee to chest pulls – 1 length. Walking “butt kick” (using hamstrings to bring heels to butt) – 1 length. Walking heel to butt quad stretch – 1 length. Arabesque holds (balance exercise) – 1 length. Side shuffle – 2 lengths. Carioca – 2 lengths. Walk on toes on line – 1 length. Walk on heels on line – 1 length. Shuttle run – 2 lengths. Warm-ups conclude with 10-15 reps of unloaded squats and a briefing of the daily program. Teams and pairings are determined at this time (if necessary). The next ten minutes of class are devoted to balance and agility on most days, and this varies each session. It ranges from standing in place and performing basic single leg raises in all planes to complex movement patterns that call upon memory. This segment includes the dance instruction – sometimes we will spend several sessions choreographing a short routine. This is most easily accomplished when the same women show up regularly. Ballet is used more frequently than any other dance form, but we have at times incorporated an African tribal rain dance, swing dancing, and a classic waltz. Music is permitted during this portion (tough to dance without it). When I am unable to teach, I leave a list of balance exercises and agility drills for my substitute instructor. The actual workout follows, and is typically one of two varieties – endurance/skill based or strength based. Normally, we do one of each variety weekly unless we are in a pure strength cycle. The workouts normally last 35 to 45 minutes, perhaps a bit longer. Below are two examples of each variation that I currently utilize. When weather permits we go outside for portions of the workout. Endurance/Skill #1 3 rounds of a 10-exercise circuit are performed with 5-minute bursts of aerobic work (treadmill, bike, elliptical, row, walk/run outdoors) between each round. Circuits are 30 seconds of work followed by 30 seconds of rest. During the rest interval the participants rotate to the next station (often marked by a note-card). The 10 stations are as follows: Unloaded squat Push-up Lateral step-over (6 inch hurdle) Barbell row or bilateral dumbbell row Sit-up Jump-rope Step-up (alternating onto 8 inch step) Ball toss (rebounding) off wall Speed ladder run Plank hold or back extension The women increase intensity by accomplishing more reps in the work period without compromising range of motion. If the exercise requires external resistance, I provide an assortment of weight choices and the women have their pick. As the women adapt to the stimulus they push harder on the aerobic portion – they may opt to jog. The newer ladies use the aerobic portions to recover and typically walk slower than the more seasoned veterans. I use this time to bring the new participants up to speed, get to know them and give them detailed instruction. New participants are instructed to complete 2 rounds of the circuit instead of 3 until they are sufficiently adapted to the stress. They are encouraged to observe the rest of the class complete the final round and then join us for the cool-down Endurance/Skill #2 Group completes a 0.5 to 1 mile hike/walk together (outside). Implements such as soccer balls, basketballs, medicine balls, and kettle bells are collected and brought outside for team relay races. Relay events include basketball dribbling, soccer dribbling, med ball chest passes, medicine ball throws overhead for distance, farmer’s carries, and tire flips. The segment generally lasts 15-20 minutes. In most instances the women work as teams to move the implement or ball. Teams/individuals work in one direction (approximately 50 yards) with a recovery walk back to the start. Class concludes in the gym with 10-minutes of practice on skills I will eventually include in future classes after mastery/safety has been demonstrated. When Forever Young was a new program, I used this time to provide initial instruction on the barbell slow lifts, teaching one movement a day. Over time, the women have become proficient at the slow lifts, and I recently introduced power cleans, power jerks, and split jerks as well as elementary gymnastics skills. Strength 1 The following exercises are completed with partners. Rep schemes vary, but 5s are the standard for squats, deadlifts, presses, and bench presses. Squat or Leg press (depends on the participant and unfortunately, the level of personal attention that I am able to provide that day based on the difficulty of the skills and size of the class) Squat – 2-3 warm up sets then 3 work sets of 5 reps across Leg press – 1 warm up set followed 3 work sets of 10-12 reps (ascending or across)Press or Bench (alternates each session) 2 warm-up sets with light bar followed by 3 sets of 5 reps across. Working weights are light enough that additional warm-up sets have not yet been required.Deadlift 2-5 warm-up sets, working up to a single heavy set of 5Pull-up (assisted) or Push-up (from feet, negatives are taught if a push-up is not possible) 2 sets of 6-8 reps The women normally perform this workout 1x per week. They are generally capable of making a 5lb jump on the deadlift and a 2lb jump on the press and bench each week. The squat has been far less linear. More than anything else, we drill form and range of motion on the squat. It is my belief that more frequency is required for measurable numeric gains on the squat. Factors such as balance limit weight on the bar, and safety is always first. One exercise is reviewed in detail each session. Over the course of a month all of the lifts are taught and instruction is repeated the following month. The ladies look forward to the instruction and appreciate the dedication to precision and form. During the workout they act as each other’s training partners. I supervise by giving verbal and tactile cues in addition to teaching the spotter/coach and how to make corrections. Strength 2 The ladies of Forever Young and I prefer the Strength 1 (above), but I use this program when a substitute instructor who lacks experience with barbell training covers the class in my absence. Ladies working on their own may do this program as well. And this is an easy third day of training that can be done without my supervision should they come in when class is not in session. Leg press 3x10 reps Unweighted walking lunge 3x12 steps Incline Dumbbell Press 3x10 reps Lat-pulldown 3x10 reps 45 degree body rows 2x10 reps Back-supported hanging knee raise 3x10 reps I have used other movements such as seated dumbbell presses, one-arm dumbbell rows, lying tricep extensions, and Romanian deadlifts with a fixed weight bar as substitutions. When the gym is very crowded, I have been forced to change the workout on the fly. These may appear to be typical bodybuilding assistance exercises, but the dumbbell work offers a high degree of neurological stimulus. I also like these exercises because it requires the women to learn how to properly get into position while bearing a load, and they do not require a spotter. Every class concludes with a brief cool-down stretch and review period back in the quiet aerobics studio. At this time we discuss any challenges faced, call out notable accomplishments of the day and talk about the content of the next class. Due to the nature of the program I am often challenged as a result of raw beginners working along side my seasoned veterans. The women are exceptionally accommodating and learn by teaching each other. Unfortunately, the fact that this is an open, free class that anyone can pop in and out of makes it hard to run a true strength progression for any duration of time. During the cold winter months and hot summer months there is a bias towards the strength work. I take the women outside only when it is between 45 and 80 degrees, depending on the humidity. Currently I have one woman with Parkinson’s disease in the program, one with rheumatoid arthritis, one with Crohn’s disease, two that have recently survived cancer, and one with spinal stenosis and a diagnosis of fibromyalgia. All of the ladies follow the same program. They are mindful of their limitations but work to build a repertoire of movements that they are capable of doing. Everyone progresses at different rates and they celebrate each other’s accomplishments. The Future I look forward to seeing my Forever Young ladies on Monday and Wednesday mornings. They are as much a part of my life as I am part of theirs. To some of them I am like a daughter, to others a granddaughter, and to all of them, a friend. I want what is best for them and the time is coming for me to move on. My husband is a Marine, and I will be moving in the near future. I will introduce this program again wherever we wind up. Getting this message out to the public seems critical as my departure is looming. I do not consider myself to be an expert, just a caring and patient individual with the ability to learn and adapt. Most important, I am not afraid to make mistakes or go against traditional practice when supported with logic and experience, but I always operate with the safety of my clients in mind. There is an overall lack of interest by the fitness community in working with this ever-growing demographic. Additionally, there is a lack of qualified professionals that have experience outside of aquatics, aerobic work, or “gentle” exercise with the senior population. Conducting a program like Forever Young takes immense dedication and time, and there is little monetary reward. A trainer should choose this direction only if he or she has a passion that cannot be extinguished by the many setbacks he or she will face. I’d like to be able to express thanks to my grandma Shirley. It is due to her teachings and her example that I understand the importance of strength and have set forth on a lifelong mission to teach it to others. Discuss in Forums