Bob Van Pelt walks with a cane. He had to retire at age 37 because rheumatoid arthritis wracked his body since childhood. He also suffers from herniated discs in his lower back and congestive heart failure.
At age 65, it’s a miracle he’s still around.
“I’d be on the couch if it wasn’t for my classes,” said Van Pelt – a fifth-degree black belt in Isshinryu karate – who ambles into the West Seneca Senior Center Monday and Friday mornings and leads a collection of fellow arthritis sufferers through a series of tai chi exercises.
“If you’re exercising with osteoarthritis – that’s what most of these people have – when you bring blood to the joints, it acts as lubrication, so it actually makes the joints feel better,” Van Pelt said. “It works on your balance, it works on your blood pressure.”
Dr. Brian E. McGrath gives Van Pelt and students who regularly take his classes kudos for making a choice that helps keep them fit despite their physical limitations.
“The kinds of things that people should concentrate on are range of motion, flexibility and stabilizing exercises or position exercises like tai chi, which is basically trying to teach you not to tip over,” said McGrath, an orthopedic surgeon with UBMD Orthopaedics and Sports Medicine in Amherst.
How can you stay as healthy as possible despite your physical limitations?
Try these tips:
1. Take movement classes
McGrath, and Dr. Jason Matuszak, a sports medicine specialist with Excelsior Orthopaedics in Amherst, recommend tai chi as the ideal exercise.
“It doesn’t strain the muscles to a great extent,” McGrath said. “It doesn’t strain your skeleton to a great extent. It keeps you more limber. It helps with general strengthening and really works on your balance, which becomes the biggest single issue as people get older. Light weight lifting is good, but tai chi is an incredible exercise. There’d be a lot less spine fractures and a lot fewer hip fractures” if more people practiced it.
“A lot of people equate tai chi with the elderly,” Matuszak added. “The truth is multiple medical studies show that it helps with back pain and chronic pain and anxiety. There’s some really nice studies that say it helps with hypertension. Because it’s relatively easy for seniors to do, we typically just see senior citizens doing it, but we recommend it to a lot of patients for a lot of reasons.”
2. Push yourself, some
People build bone until they are about 35, and their skeleton responds in a positive way to the stress of a heavy workout. “As you get older,” McGrath said, “your skeleton is decreasing in its strength. Bones are significantly easier to break based on their density.” Balance, flexibility and endurance become more important than strength, so it’s important to think progressively when exercising. Start slow and gradually build your routine. Push yourself, but not into a region of pain.
The goal shouldn’t be to conserve energy, however. That makes exercise less meaningful, said Kristen Salvamoser, a physician assistant who works with McGrath at the UBMD Bone Evaluation and Treatment Center. “Work with something slightly heavier that the things you would normally lift,” McGrath said.
3. Think strategically
Balance and coordination is key. That comes with strengthening your core first. “The strength of your core, and especially your quad muscles, is one of the biggest predictors for how long somebody can live independently before they have to move into an assisted living situation or a nursing home,” Matuszak said. “We generally encourage work on larger muscles and toward the core – those are the most important in terms of stability – then moving out toward smaller muscles as you get stronger in your larger muscles. One of the reasons we recommend tai chi is it focuses a lot on those core muscles. Those are the muscles that help you support yourself. That’s what’s going to determine your fall risk.”
Matuszak also recommended doing some light weight training at home by filling laundry detergent bottles or milk jugs with varying levels of water, to build strength gradually. “Programs with strength training are very effective,” he said. “Even 80- and 90-year-old people can triple their quad strength by doing as little as eight weeks of strength training.”
4. Eat right
“Unless you’re exercising appropriately and eating appropriately, you’re bone density will degrade more quickly than it needs to,” McGrath said. Salvamoser said milk, cheese, eggs and yogurt are important for bone strength, as are fortified almond and coconut milk and leafy greens including spinach and kale. She recommended First Lady Michelle Obama’s “My Plate” approach: filling a plate with half fruits and vegetables, and one-quarter each of protein and grains. Also make sure to drink plenty of water and avoid drinking more than two to three alcoholic beverages a day, according to the National Osteoporosis Foundation.
Vitamins are best absorbed from food, but the recommended daily allowance for two bone health boosters – vitamin D3 and calcium – can be daunting. It takes four 8-ounce glasses of milk, 1 pound of cottage cheese, five cups of yogurt or a half-gallon of ice cream to reach the daily recommendation, Matuszak said, and that consumption level becomes impossible to meet for seniors with limited appetites. Vitamin D can be particularly difficult for Western New Yorkers to take in because the sun is the biggest supplier. Not only that, it’s a fat soluble compound, which means skim milk drinkers don’t get much, McGrath said. The federal Food and Drug Administration does not judge the efficiency of vitamin supplements, which can vary widely. The U.S. Pharmacopial Convention “Dietary Supplements” section at usp.org can help. Also, check for a “USP approved” logo on supplement packages before you buy.
Along with proper diet, “you need to load your bones with exercise,” McGrath advised. “Walking, light jogging or any form of low-impact exercise helps the bone regulate itself.” Our skeleton might seem immovable, he said, “but it is an active organ in your body” and needs routine attention and care.
There are no excuses. Some of Van Pelt’s most challenged tai chi students take his classes while sitting, modifying their movements.
“Exercise is good for everybody,” said Pauline Kropovitch, who will turn 85 next month and has taken Van Pelt’s classes for more than two decades. “It keeps you young.”
Inside: See related stories, Pages 7, 10