AGEISM! “14 Exercises To Never Do After Age 50” by Reader’s Digest

Alexandra Germano, PT, DPT: You need to be doing 60 percent of the one rep max. It’s a minimal overload necessary for muscle adaptations for training individuals including older adults and including older adults that have osteoarthritis and congestive heart failure. American Academy of Sports Medicine, American Geriatric Society, Section of Geriatrics of the APTA reccomends.

Jimmy McKay, PT, DPT: Welcome to FOXcast Physical Therapy. A podcast for clinicians made by clinicians. It’s brought to you by FOX Rehabilitation. Find out more at foxrehab.org.

Welcome to a special edition of FOXcast Physical Therapy. I’m Dr. Jimmy McKay joining me on the program is Dr. Alex Germano. Alex welcome back to the program.

Alexandra Germano, PT, DPT: Hi Jimmy thanks for having me.

Jimmy McKay, PT, DPT: Special edition today is what we’re doing because an article just came out online from Reader’s Digest and it started to spread. The article was released today and as we record it is Tuesday, September 25th, by Reader’s Digest. That’s a print and electronic magazine company with more than a three point one million followers on their Facebook Twitter page. But today their article by Sharon Fiereisen, the title “14 Exercises You Should Never Do After Age 50”. And as you can imagine with social media and physical therapists, that article did not land well. So we bring in Alex Germano to comment on the 14 exercises that the author and the publication said we should never do after age 50. Alex, when you first saw this title What did you think?

Alexandra Germano, PT, DPT: I thought it was a very broad generalization of what exercise means for an older adult. And I was shocked at how ageist the title came across saying that people over 50 years of age shouldn’t be doing certain exercises that are actually quite functional and wonderful to do. I was just shocked overall about how just general these blanket statements were made and not by people who are necessarily experts in the field of aging and geriatrics.

Jimmy McKay, PT, DPT: Now I will say that there were a few people cited in the in the article One was a DC a doctor Chiropractic and the other was a physical therapist commenting on a couple of the exercises. So I just wanted to go through one by one the 14 exercises and what they said about it and then what your gut reaction is as a physical therapist who works with older adults every single day. As well as you have a dual role. You’re also heavily involved in crossfit and training adults with that type of exercise. Where do we start?

Alexandra Germano, PT, DPT: It strats off up with running the stairs. This is an interesting discussion. They don’t want you running stairs because it’s inherently dangerous to run stairs. So they just recommend going on stair climber which I’ve almost eaten it on a treadmill and I can imagine a stairclimber is not that much safer. If you fell on the stair climber you’d still be in as dangerous of a position as running on the actual stairs. What if you need to climb your stairs quickly in an emergency? I see so many people in apartment buildings. And my first question on eval with them is like how are you going to get out of your house if there’s a fire? Their instinct is going to be want to run down those stairs. So why don’t we train that power and speed?

Jimmy McKay, PT, DPT: Stairs are there something that’s in everybody’s life. So just to make a blanket statement that people over the age of 50 should no longer run on stairs. That’s just ill informed. I’m sorry. Where do we go next?

Alexandra Germano, PT, DPT: Hot Yoga was the next topic which they said that it might be too hot for the older adult. You know older adult being over 50. Still in age that I’m not sure how they chose. But yeah not doing hot yoga due to like maybe extreme dizziness or fainting, but I’ve met many people that the heat bothers and they’re 20. So again a really generalized statement. Again ageist. And I think about the people that have been practicing yoga her 30 years of their life and what if they’re 50 and want to continue doing bikram yoga? They’re totally fine to do that right. They’ve been doing it and it’s important to them. So again I don’t understand why we can’t recommend hot yoga.

Jimmy McKay, PT, DPT: As a practice that focuses their efforts on physical occupational and speech therapy on older adults. Ageism. That’s what this practice is completely founded on eradicating, our founder and CEO physical therapist Tim Fox. So this list of exercises is really flying in the face of everything that the individuals that work with us the clinicians that work with us stands for.

Alexandra Germano, PT, DPT: I was surprised that the general theme of just not doing exercise when with they should be encouraging exercise and finding providers who can support appropriate exercise for patients who are complicated and over 50. So I was just confused at why I was so negative and so fear mongering. It was like the whole article just really makes people afraid to move.

Jimmy McKay, PT, DPT: What was one of the exercises on the list that comes up next?

Alexandra Germano, PT, DPT: High intensity interval training which I have so many opinions on. Because the ACSM themselves recommend moderate to vigorous intensity exercise in a healthy older population. Three or more times a week. You wouldn’t tell the 20 year old they can’t do it so why are we talking to 50 year old? I think it’s really all about ramping up intensity and being smart about the types of vigorous activities you’re doing.

Jimmy McKay, PT, DPT: Dosing appropriately.

Alexandra Germano, PT, DPT: Yes.

Jimmy McKay, PT, DPT: Dosing appropriately as a physical therapists that’s what we’re trying to do here.

Alexandra Germano, PT, DPT: And there’s been studies that come out that say the vigerous intensity can actually be more beneficial than modern intensity in the chronic disease spectrum. So I’m not sure again why are we saying we can’t do it.

Jimmy McKay, PT, DPT: Another ill informed suggestion from Readers Digest. What’s the next suggestion for exercises to avoid over the age of 50?

Alexandra Germano, PT, DPT: That would be spin class. Actually took one the other day for the first time and I thought about how great they are. And I’m I was confused in a few reasons for the spin class a little bit socially a little bit physically. So let’s go social first because we haven’t gone there yet. They recommended that you should not spin in a class because it could be too intense. Again intensity. You should spin at home at your own pace. That is just continuing the problem of social isolation in seniors which I see on a daily basis. If I can get my patient out involved in like a community of people who are exercising their outcomes are better they are happier fighting the ageist fight out in the community. I think it’s so important that we continue to fight the social isolation of getting our folks out there. And like you can talk with an instructor about modifying a pace. I had to do that one time I said Hey I’m not going to be going as far. Like somebody who’s 50 and up has the capacity to do that. But again like physically spinning and biking we know the implications of osteoarthritis can be great pain modulators. Think about desending pain modulation that nice mid-range movement of the knee like getting fluid moving again. I’m not sure why we would not recommend this for something that’s actually a big issue in older adults.

Jimmy McKay, PT, DPT: Great point. Where do we go next after after not doing spin class?

After not doing spin class, please don’t do pushups because it can put a lot of pressure on your shoulders and upper back rather do wall pushups. And I get it. I think there’s definitely scaling options so I think the wall pushup a great option for a lot of people and they even recommend that. But you can move them down like after they get really good at wall pushups. Back to a counter push-up. Which I used the counter with just about everything. Getting people on the floor to do actual pushups because the biggest problem I see is that when I’m getting my patients on and off the floor I get them lying on their stomach they can’t push their body weight up. So if they were to fall and roll onto their stomach how could they get up from the ground? Day one I start introducing the concept of a push up. Full range pushups like you know elbows close to the body a really big tricep and chest moment so that they can get up off the floor. They can do the things that they want to do in a house. So again I believe in the pushup eccentric lowering key to building some strength there.

Jimmy McKay, PT, DPT: It’s an important maneuver. It’s a push. Why wouldn’t you do that? And you lead off by saying progression regression. Yes. OK. They mentioned the wall pushup. But to not progress it, that would be malpractice. I’ll put it out there as a physical therapist.

Alexandra Germano, PT, DPT: I wouldn’t be skilled care right? If you just keep doing wall push-ups that’s not skilled.

Jimmy McKay, PT, DPT: OK we can push-up, can’t get off the floor. What shouldn’t we do next?

Alexandra Germano, PT, DPT: You definitely can’t squat. And they say that it’s just a put too much pressure on your knees. I thought we were done with that discussion about the pressure on the knee is there that’s been pretty much debunked at this point. And they really don’t recommend swatting with weight. They were like you get a great work out if you squat just your body weight in correct form. And again I think that’s amazing. Let’s start with the basics again. Day one, like visit two thing for me is introducing the concept of a squat or hip hinge. We’ll talk about that later. But I don’t understand why they can’t squat with weight. These people have not read the Dale Avers white people on strength training. That you need to be doing 60 percent of the one rep max is the minimal overload necessary for muscle adaptations for training individuals, including older adults, and including older adults with osteoarthritis and congestive heart failure. American Academy of Sports Medicine American Geriatrics Society, Section of Geriatrics of the APTA recommend this. So I’m kind of confused as to why the squatting with weights got thrown out. That’s probably one of the exercises I would totally keep on this list. How do they get off of a toilet get out of the chair? If you’re going to stay functional you have to squat.

Jimmy McKay, PT, DPT: Sounds like you got some evidence to back you up on that whole squatting with weight thing. So, all right so after not squatting with weight even with all the evidence that you just displayed what shouldn’t we do just next?

Alexandra Germano, PT, DPT: Definitely not going to bench press. So was doing some single arm floor presses with somebody earlier today and I was like I read the article and said I shouldn’t have done that. But really again with upper body pushing. Why are we not doing it? And the thing I was most concerned about was that they scaled it with a row. They said you should just row instead. And I love an upper body pull push moment. But like if you’re not telling me to benchpress like give me something off that’s an upper body push. Not like a full body row. You know that section of article also linked to like gym equipment you should fear. So just like it made me like the jump rope was on the list and I was like stop making people afraid to work out. This is the key to living longer. Why are you terrified people in the gym?

Jimmy McKay, PT, DPT: So you’ve got the one two punch of the click bait to get you in and the fear mongering to to keep you around.

Alexandra Germano, PT, DPT: Yes.

Jimmy McKay, PT, DPT: All right where are we going to go next on the list of things not to do once you pass that barrier of 50 years old?

Alexandra Germano, PT, DPT: The Burpee. So as a crossfitter near and dear to my heart is the burpee. And they just like them removing the jump portion. So the part after you’ve laid on the ground you’ve stood up and then jump. So they’re saying don’t jump. Which again we’re aging, losing those type 2 muscle fibers are getting slow. And the problem with getting slow is like when you need that rapid balance reaction and you don’t have it you are not going to be able to move back in that moment. You have to train fast you have to train speed and power. And the burpee is a great way to train speed and power so I’m confused that’s why they said to avoid it. And in their description they said to lower the floor to pop your feet back lower to the floor which is a jump essentially because it’s a powerful movement you’re lifting both feet off the floor. And if you’re if you’re not doing pushups there’s no way your arms are going to support this movement.

Jimmy McKay, PT, DPT: Good point.

Alexandra Germano, PT, DPT: But anyway lower to the floor. Come back up and then just stand up. And I think that’s a great exercise but you shouldn’t be afraid to jump with people who are indicated to jump.

Jimmy McKay, PT, DPT: Right, again if you’re not progressing it’s not skilled care and it’s malpractice.

Alexandra Germano, PT, DPT: Just a variation to that is like the counter-burpee. You can do the same thing you can’t get someone to pop on the floor. Use the counter push up down jump up you know you can make it scalable again.

Jimmy McKay, PT, DPT: All right. So no burpee’s. What should we not do next?

Alexandra Germano, PT, DPT: Pull-ups again. Just really like upper extremity development they’re not into. And that’s actually where I find a lot more the weakness in older adults. Because they’re not handling and like moving as many objects I think above their head so I’m seeing a lot of deficiencies there. They’re mostly walking and getting off the couch so leg strenght is usually OK. But let’s develop the upper extremeties. It’s so hard to do pull ups in the home setting. Pull ups are tough to do. And talking about the implications of grit strength which we all know is a very important clinical indicator. So we should be doing more pulling, more holding we should be developing the upper body I’m not sure why that wouldn’t be functional?

Jimmy McKay, PT, DPT: All sounds good to me. But hey you know Reader’s Digest says No maybe we should listen to him. Not all the evidence, not all of the physical therapists. But there’s a few left where do we go next what’s the next exercise on the list?

Alexandra Germano, PT, DPT: Crunches were a no for them and I agree I’m not the biggest fan of a crunch. I think that society has started to come around to the fact that the crunch isn’t a great core developer we really want to use the core like anti rotationally, anti movement. So planking is a great option. And they suggested the plank which I appreciated and that’s a good part of the article. Again use the counter to planked out there.

Jimmy McKay, PT, DPT: Up next what shouldn’t we do.

Alexandra Germano, PT, DPT: Deadlift which just. Yeah I get that one got me. They never want you to pick up anything heavy from the ground. I guess it can put too much strain on hips and torso. Which I don’t know why. I think that strains probably put strain and good stretch. And if you do it right and you introduce a hip hinge early and you weight them appropriately they’re going to be fine.

Jimmy McKay, PT, DPT: Load it. I guess they don’t want older adults to ever go to the grocery store and bring those groceries from the store to the car from the car to the house. I guess that’s out.

Alexandra Germano, PT, DPT: No no absolutely not you can’t.

Jimmy McKay, PT, DPT: All right. Last exercise on the list. What should we never do once we become 50?

Alexandra Germano, PT, DPT: Never do a jumping lunge, ever. Never again. Back to the problem with jumping. it’s dangerous. They reccomend doing the lunge, I agree lunges are great. Great single length strength developers. Really good for balance in older adults. And even some foot extension, getting that MTP to extend again. A lot of people lose that. And it’s also like how do you get on-off the floor if you’re older? You probably lunge more so than just like slinking down to the floor. So I don’t see why you can’t jump there if they’re are indicated to jump just make them jump. You be amazined taking an older adult who hasn’t jumped in like 20 years making them jump. How hard it is for them to contract the muscles like that and the benefits that you can see from it is just phenomenal. So I recommend it.

Jimmy McKay, PT, DPT: Try to fight the bad information with the good. We know a lot of physical therapists across social media once this article was shared. We’re trying to rage against it. We wanted to come together to to let our physical therapists colleagues know that at least we’re trying to do our part in pointing out the gross inadequacies of this and some other pieces of click bait across the world wide web. Alex Germano a physical therapist in Northern Virginia for FOX Rehabilitation. Appreciate you taking some time out to rage with us against Reader’s Digest and 14 exercises you should never do over it.

Alexandra Germano, PT, DPT: All right thanks Jimmy.

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