Over 60 – and overlooked? Assessing and training a growing market
Training older adults needn’t be about what they can’t do, but instead what they can do to not only maintain, but improve their quality of life, says personal trainer Kate DeMayo.
- While older adults vary enormously in their fitness, strength and agility, there are a few areas of fitness that have particular benefits for most of them
- Balance training has been shown to be effective in preventing falls, which affect one in three people over the age of 65 every year
- Balance and stability can be incorporated into a strength training regime by featuring exercises that include weight shifting, unilateral movements and exercises done standing on one leg.
In recent years, study after study has shown decisively how important exercise is for older adults. We now know that exercise lowers the likelihood of developing a range of chronic conditions, including cancer and diabetes; improves memory and cognitive functioning; reduces the incidence of falls; and combats osteoporosis by improving the health of bones. And that’s just the start.We know a lot about why older people should exercise – but do many of us who work as trainers and instructors feel confident in knowing how? Faced with clients aged in their 60s, 70s and 80s, do we understand the kinds of exercise regimes that will maximise their chances of maintaining, even improving, their quality of life?
What not to do?When I studied to be a personal trainer over 15 years ago, much of the conventional wisdom on older adults stressed what not to do with them. No deep squats, because that might aggravate knee arthritis. No twisting, bending or high impact. And no lunging (never mind that half of my clients play lawn bowls, which involves repeated movements that look an awful lot like lunges…).
What to do!The American College of Sports Medicine (ACSM), widely considered the leading authority on exercise research and recommendations, suggests that programs for older people include four components: aerobic fitness; strength; flexibility and balance. That last one in particular is crucial for this age group; balance declines with age, unless it is practiced regularly. In fact, the ACSM now stresses the importance of what is called neuromotor training – balance, agility and coordination – for people of all ages, noting that it is particularly important for older people.
Ask and assessAs well as having new clients fill out a standard health questionnaire, I ask them if they have had a fall in the past five years and whether they have had a bone density test (if so, I ask to see the results).
Exercises for this age group
Sit to standOne of the most practical exercises you can do. There’s a lot of talk about functional training in our industry – well, it doesn’t get more functional than this. This exercise is a beauty, because the ability to get out of a chair is crucial to people’s ability to live independently. For those with poor lower body strength, you can build up a step to the necessary height. Have the seat low enough so that the person needs to make an effort to stand, but high enough so that he or she can stand up from it without using their arms. For those with poor balance, have support available.
Cable horizontal pullThe target muscles are similar to those of a seated row machine, but if your client can stand and use a cable machine with the arm set at around waist height, he or she will be using many other muscles and getting practice in balance and stability. This exercise will work the muscles of the upper back, so it’s great for posture and shoulder health. Pay close attention to technique; watch for raised, hunched shoulders and forward head.
Swiss ball wall squatThis allows clients who struggle with unsupported squats to perform a squat with support, thereby using the large muscle groups in the legs while decreasing pressure on the knees.
Balance test exercisesAll the stages in the balance test can be used as exercises as well as assessment tools. Have the client hold the position for up to 30 seconds. Once they master one level, without needing to hold on, they can move to the next one.
General guidelines for senior training
- Ensure your client can perform an exercise on a stable surface before moving to an unstable one. While Swiss balls, BOSUs and unstable surfaces are fantastic for some clients, ensure your client is ready for an unstable surface – by showing proficiency performing the action on a stable one – before you introduce them.
- Don’t make the common mistake of believing that to do core exercises your client needs to get on the floor. For some older clients, getting up and down off the floor can be awkward, time consuming and embarrassing. If this is the case, use another mode of core exercise.
- Try to incorporate some balance, stability and agility work into each session. Try, for example, exercises that involve weight shifting, such as sideways cable pulls; standing on one leg if your client has adequate balance (many upper body exercises can be performed on one leg); and unilateral movements (one arm bicep curls, for example) to challenge stability. Specific balance exercises, such as heel to toe walking can also be part of a session – just be mindful of trip hazards, and ensure clients have something nearby for support if needed.
- Enlist the support of other health professionals, particularly if clients present with significant health issues such as severe osteoporosis or heart problems, have had major surgeries or have health conditions that may affect their exercise. Asking others for advice will not only keep your clients safe, it will enhance your own credibility as a professional.
- Remember that whether your clients are 19 or 90, they are first and foremost individuals – so keep the personal in personal training!
Our ageing population means there’s a growing market for training older adults. By assessing older clients’ abilities and training them according to their stage, not their age, you can help them reduce their falls risk and maintain their independence, while also growing your business.
Catherine (Kate) DeMayo of Extra Mile PT has been a personal trainer and group fitness instructor since 2004. She is a franchised personal trainer at a major gym, teaches group fitness and has recently launched a new balance-oriented group fitness program ‘Steady, Stable and Able’. catherinedemayo.ptenhance.com