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Strength Training for the Elderly – The Fountain of Youth 

 

Key Points:

  • Strength training is vitally important for quality of life during the aging process
  • Lack of strength training will decrease your quality of life in old age and will increase the speed of the aging process compared to those who strength train
  • Just because you are over a certain age doesn’t mean you can’t train hard and make progress

 

Sarcopenia and why it’s important:  

Sarcopenia is the age related loss of muscle mass and associated muscle strength.

This leads to impaired function of regular daily tasks, decreased quality of life and less independence (1). In addition to this, muscular strength (2) and amount of muscle mass (3) have been correlated with decreased mortality risk. Sarcopenia occurs more rapidly from age 50 onwards at which point we start to lose approximately 1% of muscle mass per year (4). Although this may seem insignificant, it implies that as someone ages from 50-80 there is a potential to lose 30% of their muscle mass (unless we actively do something about it). These physiological changes are going to have a huge effect on a variety of activities including: sports and recreation/hobbies, playing with grandchildren, carrying groceries, cutting the grass etc.

Sarcopenia: What is actually happening

Sarcopenia is an accumulation of key physiological and neural changes occurring in the body. While some level of sarcopenia is eventually inevitable, having a basic understanding of these changes, and what you can do about them is critical in off-setting the ill effects as much as possible.

 1. Reduction in total muscle fibres, and muscle fibre size:

The loss in muscle mass and strength is a combination of a loss in muscle fiber size and total muscle fibre number (5). Although the research is a little conflicting, it seems that it is predominantly a reduction in the type II (fast twitch) muscle fibres size that has the greatest effect on decreased muscle cross sectional area (size) (5).

2. Changes in structure and function of motor units:

A motor unit is made up of a motor neuron (nerve) and all of the muscle fibres it innervates (connects with). In simple terms one nerve connects to a group of muscle fibres, not just a single muscle fibre.

As we age we lose motor neurons. They are maintained quite consistently up until age 60, but between age 60-90 there is a 70% reduction. When a motor neurons dies, the muscle fibres it innervated become orphaned. Surviving motor neurons partially re-innervate with these abandoned muscle fibres, which leads to an increase in the amount of muscle fibres connected to each motor neuron, but a decrease in the number of overall motor units. As we age type II muscle fibres (the big, strong and powerful ones) become denervated (disconnected) and become reinnervated by slow motor units (the smaller weaker ones) (6). This is important because type II muscle fibre CSA is predictive of muscle strength in elderly men (7).

3) Changes in Protein metabolism: 

Muscle mass is governed by muscle protein synthesis (muscle building) and muscle protein breakdown. Muscle protein synthesis which is crucial for maintaining or gaining muscle mass can be stimulated by resistance training and amino acid (protein intake). Elderly muscles are less responsive to such stimuli and therefore may require higher levels of protein in the diet (20-30g per meal suggested) and resistance training to get the greatest effect (8). In regards to nutrition, supplementation with the essential amino acid leucine has been shown to be highly effective in stimulating muscle protein synthesis in the elderly and is something worth considering (9) . Foods that are high in leucine include beef, fish and eggs (11).

Physical Training for the older population:

It is no secret that resistance training can help you maintain or even gain muscle mass and strength as you age. The biggest mistake I see general population/older trainees make is that they are exercising to “maintain strength”, “keep fit” or “stay in shape”. There is no structured plan, and the return on their training time is usually miles from optimal. I believe these populations need to try and train in a manner similar to their younger/ more athletic peers. By all means make sure the exercises are modified and appropriate, but they still need to work hard in a relative sense. Just because someone is past a certain age doesn’t mean they can’t make progress in terms of strength or muscle mass. Results in a study completed in 2012 on subjects in their 70’s support this. Strength training 3 times per week for 6 months increased lean leg mass, quadriceps cross sectional area, and improved strength by up to 46% (11). Interestingly in this study similar results were seen in men and women.

strength training elderly 2

 

Sensible training modifications for the older trainee: 

While it is all well and good preaching that older populations should train like athletes it would not be a good idea to try and get them to blindly follow something outside of their ability. With that being said I think the fundamental aspects of athletic training should be targeted so strength, power, hypertrophy and mobility should all be covered. Attacking these training modalities in a well designed program will also take care of all one’s cardiovascular training needs. The next question is how can traditional training methods be tailored if necessary.

Strength: 

Maximal or near maximal loading (>90% 1RM) on a regular basis is not recommended for de-conditioned, inexperienced or “banged-up” trainees. For this reason it is probably a good idea to lower the intensity of the main lifts but increase the volume or use a variation of the lift where less total load is needed for a similar strength training effect. A simple way of increasing volume while lowering load is to decrease the weight slightly but increase the amount of sets. For example if somebody can bench press 60kg/132lbs  for 4 sets of 5 reps, lower the weight to 5-10% and have them complete 5-6 sets of 5 reps. Another alternative, which from my experience is an excellent way to re-enforce correct positioning and technique during lifts is to prescribe paused reps. Paused reps are harder than regular reps as  a lot of the elastic energy stored during the eccentric (lowering) phase of the exercise due to the stretch reflex has dissipated. Lets use the squat as an example. Have the trainee squat down to their bottom position, and pause in this bottom position for a prescribed amount of time (generally 2-5 seconds) and then squat back up. Make sure that the trainee does not relax in the bottom position, and maintains correct positioning and continues to “support” the weight.

Speciality bars, different grips (neutral, fat grip, etc), and shortened ranges of motion are also useful ways of modifying strength training for older trainees.

Power: 

Power is work divided by time. When talking about power in training terms it is probably more useful to look at is as force x velocity (strength x speed). Basically, it is the ability to display strength quickly. Think of jumping, throwing, sprinting as power exercises, while maximum weight bench presses and squats are more strength exercises.

In my opinion it is essential that everybody train power in some fashion. If you consider this article is essentially about staying “young” for as long as possible why not look at how children play. They play sports where they constantly sprint, jump and throw things. At the playground they play chasing, wrestle, and throw or kick around a ball. All these movements are basically power exercises, the children are trying to produce force as quickly as they possibly can. Children may not realise they are training by sprinting, jumping and throwing but these are all things a Strength and Conditioning coach implements in their athletes programmes. When watching older individuals train what this is something they rarely do…..an absence of power training is very common. Most do some steady state cardio, a lot do some stretching, few lift weights, but very rarely do you see anybody over the age of 40-50, never mind 60-80 throwing a medicine ball, jumping onto a box, or actually moving with any speed. This is the complete opposite of what they did as kids, even though they want to remain young.

Again just as with strength training it is important you pick suitable level exercises for power training depending on ability level and preparedness.

Jumps: As long as correct landing technique is used most people who have some strength training experience should be able to jump onto a low box with some dedicated effort. This method is advantageous as the box reduces the distance needed to land thus reducing the stress to the joints, muscles and connective tissues on impact. Landing on slightly softer material boxes or placing some mats on the box is also an option.

Throws: Medicine ball shot puts, slams, scoop tosses are all relatively low risk. If medicine balls are not an option landmine throws and bench press throws in a smith machine are suitable alternatives.

Sprints: It is unlikely that an older individual will be able to sprint safely without gradually building up a solid base of strength, mobility, and lower speed running first but this doesn’t mean that “sprints” can’t be performed on stationary bikes, cross trainers, and other cardio equipment of this nature.

Hypertrophy and Mobility: These two modalities should not need to be modified much as both are generally safer than strength and power training.

Wrapping up:

Resistance training is crucial for people of all ages. The older you get the more important it is. If you are still quite young you should be thinking about getting into excellent physical shape. Important elements to consider are strength, power and bodyfat %. This will provide you with a big margin for any potential decline with age. (I recommend reading Charles Staley’s articles on this subject). Everybody should train somewhat like an athlete as it will provide the most rounded and beneficial training effects. With sensible modifications it can be tailored for most ability and preparedness levels to make it work.

I propose you treat your strength and power levels as part of your health care. Just like you would visit the doctor a couple of times a year you should be monitoring and testing your performance on strength & power exercises, and having your body composition measured. A medicine ball throw, bench press and deadlift test that you re-check every 3-6 months, along with a DXA scan would be a good start.

Golfers reading this can check out the online training services I provide here: Fit For Golf Online Training Options. There is currently over 80 people using the programs, with ages ranging from people in their 20’s to their 80’s.

Above all else, develop a sensible plan (with the help of a pro if necessary), set some goals, and work hard. Who wants maintenance when progress is available?

Mike Carroll.



References

1)Sarcopenia — Age-Related Muscle Wasting and Weakness: Mechanisms and Treatments

2) http://www.bmj.com/content/337/bmj.a439

3) http://ajcn.nutrition.org/content/86/5/1339.short

4) Advanced Nutrition and Human Metabolism, 6th ed.

By Sareen S. Gropper, Jack L. Smith

5) http://ptjournal.apta.org/content/82/1/62.long

6) http://books.google.com/books?id=tEtc84KTyrwC&pg=PT629&dq=motor+unit+remodelling&hl=en&sa=X&ei=UyzrUeyfBe7i4AOiu4GwAQ&ved=0CDsQ6AEwAQ

7) http://www.ncbi.nlm.nih.gov/pubmed/21054286

8)http://books.google.com/books?id=tEtc84KTyrwC&pg=PT629&dq=motor+unit+remodelling&hl=en&sa=X&ei=UyzrUeyfBe7i4AOiu4GwAQ&ved=0CDsQ6AEwAQ

9) http://ajpendo.physiology.org/content/291/2/E381.full

10) http://books.google.com/books?id=4Drei21kEGEC&pg=PA112&dq=leucine+rich++foods&hl=en&sa=X&ei=EpbsUbCDJpSx4AOj6oDIBg&ved=0CDkQ6AEwAA#v=onepage&q=leucine%20rich%20%20foods&f=false

11) http://biomedgerontology.oxfordjournals.org/content/68/7/769.short

 

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