Muscle & Bone Strengthing EXERCISE PROGRAMME

Muscle & Bone Strengthing EXERCISE PROGRAMME

Introduction This booklet contains exercises aimed at older people who wish to either maintain or increase their independence. Research has shown that there are specific exercises which can help to strengthen muscles and bone. Stronger muscles make every day activities such as washing, dressing, shopping or doing house work easier and less of a strain. Greater strength in both muscles and bones can lead to:- increased confidence and safety doing every day tasks. A reduction in injuries from everyday activities. An improvement in posture, balance and walking. Exercises have also been included that will help to improve your circulation which in turn will help to lessen cramp and help to keep you warmer.

BENEFITS OF EXERCISE PROBLEM I HAVE OR WANT TO AVOID Exercise can help because What you will notice NO ENERGY LAZY SHORT OF BREATH Improves stamina and muscle power Removes waste quicker Stimulates circulation to all organs including the brain Lose weight It is easier to move from place to place Feel less sluggish More energy for day-to-day activities HIGH BLOOD PRESSURE HEART ATTACK HEART DISEASE STROKE Helps lower cholesterol level, stress hormones and muscle tension Helps lower blood pressure Keeps the heart muscle strong Aids circulation and helps blood and body fluids to move Feel better, more energetic Feel less dizzy Prevents ankle swelling, blood clots, leg ulcers and foot pain OVERWEIGHT Burns more calories and replaces inactive fat with muscle. Increases muscle mass Muscles burn calories even when you sleep, so losing weight and keeping it down is easier SWOLLEN FEET The movement of muscles massages veins so blood and fluids return from the feet. Reduces swollen ankles and feet. Walking becomes easier

OSTEOPOROSIS Muscle pulling on bone stimulates bone growth, making bones stronger and less likely to break STANDING OR WEIGHT BEARING FOR 4 HOURS A DAY HELPS Less likely to break a bone if you fall Less pain Better posture helps prevent falls ARTHRITIS Stronger muscles help to hold the joints in correct position so there is less wear and tear on them Moving joints helps to nourish them and keeps a good range of movement. Less wear and tear on joints means less PAIN You will be able to keep doing things for yourself: (wash hair, do up buttons, put own shoes on, walk more easily and safely) CANCER: Breast, colon, prostate Burns fat, which stores carcinogens Gets rid of waste quicker More regular bowel movement Feel more comfortable in the abdomen Burning fat helps to lose weight KIDNEY DISEASE Lowers blood pressure and blood sugars so less risk to kidneys Being upright helps kidneys to drain Stimulates circulation and thirst Removes body waste and drug left overs Kidney infections can cause backache and a general feeling of lethargy. Will feel thirsty, Increased thirst increases fluid intake, = increased urine flow, flushing kidneys and decreasing the chance of stagnation, infections and stones Feel more lively and energetic CAN T SLEEP AT NIGHT NIGHT VISITS TO THE LOO Using the body during the day will help muscles relax and rest at night Helps fluid circulate from legs to kidneys during the day rather than at night Getting a better night s sleep will aid restful sleep, helping you to feel more alert and energetic on waking

CONSTIPATION BLOATING Stimulates circulation and colon activity Decreases need for medicines Feel more energetic Feel more comfortable Less wind to deal with DEPRESSED DON T LIKE THE WAY I LOOK Exercise releases endorphins, feel good chemicals in the brain which help you to feel cheerful and positive Lose weight Tone up muscles Release of endorphins helps you to feel happy and alert May not need medicine or so many Toning the body and losing weight will make you look better, clothes fit better. Have more self esteem. LOW BACK PAIN Improves abdominal muscle tone Improves posture Prevents constipation and bloating which stresses muscles causing pain Better posture and good abdominal muscles will help prevent back pain and make you feel better about yourself Good posture helps in preventing trips and falls URINARY INCONTINENCE Stimulates muscle tone and thirst, which stimulates urine flow Stronger deep abdominal muscles will also mean stronger pelvic floor muscles Fear of drinking goes. Drinking more will stop dehydration which causes headaches and lethargy Moving easier so no delay in toileting, will prevent infection and overfilling The deep abdominal muscles work together with the pelvic floor muscle which will make it easier to control the urge to urinate Less fear of accidents happening Less headaches, feel more energetic INJURY Exercise increases strength, flexibility and balance. Encourages better posture and body alignment Decreases wear and tear Decreases chance of falls and injury More confident to move about Less pain if muscles are stronger Everyday tasks become easier and therefore less tiring, so more energy and verve.

CHANGE BEHAVIOUR FIRST, ATTITUDE WILL FOLLOW THE MORE ONE SITS THE WEAKER AND MORE FRAIL ONE BECOMES USE IT OR LOSE IT!

It is important that before you start an exercise programme you speak to your Doctor especially if you could answer YES to any of the following: Have you at any time been told you have heart trouble or you are being treated for a heart condition? Have you had a heart attack in the last 3 years? Have you had any chest pains while at rest or during exertion? Do you have dizzy spells? Do you have fast, slow or irregular heart beats? Do you have uncontrolled high blood pressure? Have you had diabetes for more than 10 years? Have you had any shortness of breath after mild exertion, at rest or even at night in bed? Have you recently broken any bones? Do you have any joint problems? Do you ever get pain in your buttocks, back of your legs, thighs or calves when walking? Do you have swollen ankles, feet or hands? Do you take diuretics? Have you had more than one fall in the last year? Have you been inactive for more than 3 years and are over 65? If you answer YES or DON T KNOW to any of the following questions you can make an appointment to see your doctor to discuss an appropriate course of action.

Start with a posture Check Stand tall with the feet hip width apart, the toes pointing forwards and the weight evenly distributed over both feet. Knees soft (neither locked nor fully bent) and above the ankles. Lengthen the spine to create a space between the ribs and the hips. Ensure the shoulders are back, down and relaxed. Lengthen the neck. Chin parallel to the floor looking straight ahead. For extra stability and/or comfort, it may be preferable to stand tall with the feet shoulder width apart and the toes pointing slightly outwards.

Exercise Programme The Warm Up Exercises It is important that your muscles and joints are sufficiently warm before starting the strengthening exercises, this will enable you to achieve the best results from the exercise programme. Spend a few minutes walking around the house or marching on the spot until you feel a little warmer,

Circulation Booster 1: Marching. Purpose To promote the circulation and warm the muscles. Place feet hip width apart and begin an arm marching action. The arm march should be from the shoulder with a fixed angle at the elbow. Start with a steady leg march for a few seconds Then stop moving the legs. Now combine the leg and arm march. CONTINUE UNTIL YOU FEEL A LITTLE WARMER

MOBILITY EXERCISES Theses exercises will help to loosen and lubricate your joints and can help to increase the range of movement around a joint.

2. Shoulder circles Purpose To loosen and lubricate the shoulder joints, maintain a good range of movement, release shoulder tension and improve shoulder posture. To help with everyday tasks such as getting dressed, combing hair and reaching actions. Circle the shoulders forwards, up, backwards then down. Ensure the movement is slow, controlled and is as big as comfortably possible. Stand tall with good posture, arms resting loosely by the sides. REPEAT 5 TIMES

3. Head movements (neck mobiliser) Purpose To will mobilise the neck joints and help to maintain range of movement and ease neck and shoulder muscles. Turn the head slowly to the left, back to the centre then slowly to the right. Ensure the movement is slow and controlled and that the shoulders and chest stay facing forwards so that only the head is moving Arms resting loosely by the sides in line with the hip or resting on the chair for stability. Ensure the shoulders are relaxed and down away from the ears REPEAT 5 TIMES

4. Trunk Movements (back mobiliser) Purpose To mobilise the middle and upper parts of the spine and maintain good upper body movement. To help with stability and the performance of everyday actions such as looking over the shoulder. Cross the arms lightly in front of the chest or place one hand on the chair. Lengthen and lift the trunk upwards then slowly turn the head and shoulders to the left. Ensure you are only turning the upper body (not the hips). Return to the start position and repeat to the other side. Pause in the centre before turning to the other side. REPEAT 5 TIMES

5. Ankle mobilisers Purpose This exercise will mobilise the ankles, prevent or reduce stiffness, improve the range of movement and stability of the ankle joint thus improving balance and help with everyday activities such as walking. Place the heel of one foot on the floor under the knee then lift the knee and place the toe. Try to place the toe on the same spot on the floor as the heel. Keep changing from the heel to toe achieving a smooth, controlled action. Avoid banging the heel down. Support the back by holding the chair seat with both hands. REPEAT 5 TIMES THEN REPEAT ON THE OTHER SIDE

Circulation Booster 2: Marching. Same as Circulation Booster 1 but with a little more vigor CONTINUE UNTIL YOU FEEL A LITTLE WARMER

STRETCHING EXERCISES Theses exercises will help to increase the suppleness of your muscles making everyday tasks feel easier and more comfortable. Ease gradually into and out of each of the stretches. HOLD each FOR A COUNT OF 8 and remember to keep the breathing throughout. YOU ONLY NEED TO DO EACH STRETCH ONCE

6. Back Of Thigh Stretch Purpose Helps to maintain good mobility at the hip joint. To help with actions involving reaching down such as putting on socks and shoes and picking items up off the floor. Straighten one leg out in front, resting the heel on the floor with the foot relaxed Place both hands just above the bent knee to support the back Bend fowraeds from the hips. Keeping the chest lifted and the back long The knee of the exercising leg should be soft. Release and repeat on the other side.

7. Chest Stretch Purpose This exercise will stretch the muscles across the front of the chest and improve posture and breathing efficiency. To help with everyday actions such as putting on coats and fastening car seatbelts.. Take the arms backwards and hold onto the back of the chair with both hands. Lift the chest lifted and draw the shoulder blades together until a mild stretch is felt across the chest. Keeping the spine neutral and the tummy muscles pulled in to prevent the lower back from arching. Keep the back of the neck long; jaw parallel with the floor, chest lifted.

8. Calf Stretch Purpose This exercise will stretch the muscles of the calf and improve ankle mobility and stride length. To help with everyday actions such as walking and stair-climbing. Hold onto the sides of the chair for support. Keep one knee bent and directly above the ankle. Straighten the other leg out in front with the heel resting on the floor. Pull the toe back towards the shin and slide the heel a little further. Take care not to arch the back. Make sure the knee of the working leg is extended but not locked out Release and repeat on the other side.

9. Back of Arm Stretch (Triceps) Purpose This exercise will stretch the muscles down the back of the arm and reduce stiffness around the shoulder. To help with everyday activities that involves reaching behind. Place one hand on the same shoulder. Use the opposite hand to gently ease the elbow up towards the ceiling, trying to walk the fingers down the back between the shoulder blades. Keep the shoulders relaxed and the neck long. Release and repeat on the other side.

10. Upwards Side Stretch Purpose This exercise will stretch the muscles at the side of the trunk. To help with everyday activities such as reaching high into cupboards. Place one hand on the same shoulder as with Back of Arm Stretch (No.12) Now reach the arm up to the ceiling. Release the support arm and place it onto the chair. Take the stretching arm slightly over towards the head and lift up into the stretch. Keep the shoulders down and the neck long. Ensure that the bottom remains in contact with the seat and avoid leaning forwards or backwards. To come out of the stretch, support the arm and turn the palm towards the face whilst lowering Release and repeat on the other side.

Getting onto the floor and up safely This is not an exercise but a way of helping you to get down onto the floor. If you know you have difficulty getting up from the floor you should not attempt this or any of the following exercises without seeking advice. You will need: A sturdy chair, preferably with arms placed on a carpet with enough space to lie down. You may need several cushions or pillows placed on the floor until you feel more confident and for comfort. 1. Turn to face the chair, using the arms or seat for support if necessary.

2. Slowly lower yourself onto your knees, one leg at a time. This can be achieved more easily using pillows on the floor across the front of the chair and taking them away one at a tine as you become more confident. 3. Slide your hands off the chair and onto the floor

4. With your hands in front of you, slowly lower your bottom onto the floor, legs to one side 5. Slowly lower yourself onto your side 6. From here you can roll onto your back or front

When getting back up simply reverse the instructions. However it is common to feel a little dizzy when getting back up onto your feet so for comfort and safety 1. Turn side to the chair whilst holding on for support 2. Then turn and move back towards the chair until you feel the chair on the back of both legs Then simply sit back and relax for a few minutes

STRENGTH EXERCISES Progression Begin with one set of five repetitions Build to one set of ten repetitions Once you can achieve this try 2 sets one set of ten repetitions then a short rest then a second set of five repetitions Progress to two sets of ten repetitions At all stages, ensure you maintained good technique for at least two weeks before progressing. Count out loud 1,2,3 as you lift hold for a few seconds and 1,2,3 as you lower to ensure breathing is regular and timing accurate. Ensure movements is slow and controlled on both lifting and lowering and the spine is neutral and the tummy muscles are pulled in throughout as this will help to maintain good posture.

On all fours Use a soft but stable surface to kneel on, an exercise mat is ideal but a rug or carpeted surface is sufficient as long as this is comfortable on your knees Kneeling Posture Check Ensure that your weight is evenly distributed between the hands and knees Knees should be hip width apart and directly below the hips Hands slightly wider but no further forward than your shoulders Ensure your back and neck remains long Eyes focusing on the floor so that there is no strain on your neck

1. Kneeling abdominal strengthening Purpose This exercise will strengthen your abdominal (tummy) muscles which will help to support you back and improve posture. This can to reduce back pain and help to support you spine. Ensure correct kneeling posture Contract tour abdominal muscles by pulling you away from the floor Imagine pulling you naval towards you spine Ensure you back remains long throughout

1a. Lying abdominal strengthening Purpose This exercise will strengthen your abdominal (tummy) muscles which will help to support you back and improve posture. This can to reduce back pain and help to support you spine. This can be used as an alternative to kneeling. Ensure correct kneeling posture Contract tour abdominal muscles by pulling you away from the floor Imagine pulling you naval towards you spine Ensure you back remains long throughout

2. Kneeling balance and wrist strengthening (part 1) Purpose This exercise will strengthen your wrists and back muscles. Ensure correct kneeling posture Contract your abdominal muscles by pulling you away from the floor Slide one arm away along the floor so that you transfer your weight onto the other arm. Slide back in and repeat on other side Ensure you back remains long throughout

3. Kneeling balance and wrist strengthening (part 2) Purpose This exercise will strengthen back and wrist muscles as well as your abdominal muscles. Ensure correct kneeling posture Contract your abdominal muscles by pulling you away from the floor Slide one arm away along the floor so that you transfer your weight onto the other arm. Gradually lift the arm away from the floor as high as is comfortable (this should not be so high that it causes a strain on the arm but challenges your balance) Slide back in and repeat on other side Ensure you back and neck remains long throughout

4. Kneeling back and hip strengthening (part 1) Purpose This exercise will strengthen back and hip muscles as well as your abdominal muscles. It helps to strengthen your spine and wrists. Contract your abdominal muscles by pulling you away from the floor Slide one leg away along the floor so that you transfer your weight onto the other leg. Gradually lift the leg away from the floor as high as is comfortable (this should not be so high that it causes a strain on the leg or hip but challenges your balance) Slide back in and repeat on other side Ensure you back and neck remains long throughout Ensure your hips remain square to the floor and that you do not twist.

5. Kneeling back and hip strengthening (part 2) Purpose This exercise will strengthen back and hip muscles as well as your abdominal muscles. It helps to strengthen your spine and wrists. Contract your abdominal muscles by pulling you away from the floor Slide one leg and the opposite arm away along the floor so that you transfer your weight onto the other leg. Gradually lift the leg and arm away from the floor as high as is comfortable (this should not be so high that it causes a strain on the leg or hip but challenges your balance) Slide back in and repeat on other side Ensure you back and neck remains long throughout Ensure your hips remain square to the floor and that you do not twist.

6. Kneeling wrist and chest strengthener Purpose This exercise will strengthen the muscles in your chest and the wrist. Contract your abdominal muscles by pulling you away from the floor Bending your arms at the elbows lower your chest towards the floor Ensure you back and neck remains long throughout Aim your nose to the floor just in front of your finger tips Hands should be in line with the shoulders and shoulder width apart

6a.. Alternative standing wrist and chest strengthener Facing the wall stand far enough away so that you can just reach the wall with your arms out straight Bending your arms at the elbows lower your chest towards the wall Ensure you back and neck remains long throughout Aim your nose to the wall just in front of your finger tips Hands should be in line with the shoulders and shoulder width apart Then push back by straightening your elbows Ensure you don t lock the elbows Feet should remain flat on the floor at all times

7. Back strengthener Purpose This exercise will strengthen the muscles in your back and strengthen your spine Lying face down contract tour abdominal muscles by pulling you away from the floor Ensure you are looking down at the floor at all times Slowly lift one arm away from the floor as far as is comfortable Repeat on other side Once you can achieve this progress to part2

8. Back strengthener (part2) Lying face down contract your abdominal muscles by pulling you away from the floor Ensure you are looking down at the floor at all times Slowly lift one leg away from the floor as far as is comfortable Slowly lower Repeat on other side Once you can achieve this progress to part 3 With control lift opposite arm and leg Hold for a few seconds then slowly lower Repeat on other side

9 Back Extensions Purpose This exercise will strengthen the muscles in your back and strengthen your spine Lying face down contract your abdominal muscles by pulling you away from the floor Rest your head on your hands Ensure you are looking down at the floor at all times Slowly lift your chest away from the floor as far as is comfortable but without using your arms Once this can be achieved with ease progress to part 2

10 Back Extensions (part 2) Lying face down contract your abdominal muscles by pulling you away from the floor Rest your hands by your sides Ensure you are looking down at the floor at all times Slowly lift your chest away from the floor as far as is comfortable but without using your arms Ensure you feet remain on the floor Ensure you lower slowly and with control Avoid using the muscles in the back of your legs

11 Side hip strengthener Purpose This exercise will strengthen the muscles and bones around your hip. Lying on side with knees bent Contract your abdominal muscles by pulling you away from the floor Lift the leg out to the side and lower with control keeping the toe pointing forwards Ensure the hips are facing forwards at all times. Ensure the leg moves in a straight line and does not bend forwards Hold for a few seconds then lower slowly and with control Rest briefly then repeat When this exercise can be performed with ease and good technique progress tp exercise 12

12 Side hip strengthener Place a pillow between your knees to ensure correct starting position Lying on side with the top leg straight and underneath leg bent backwards at the knee for balance Contract your abdominal muscles by pulling you away from the floor Lift the leg out to the side and lower with control keeping the toe pointing forwards Ensure the hips are facing forwards at all times. Ensure the leg moves in a straight line and does not bend forwards Hold for a few seconds then lower slowly and with control Rest briefly then repeat