Firstly well done to the Chartered Physiotherapy Society (CSP) for getting their exercise for falls prevention message out on BBC breakfast.
The CSP are absolutely right that falls are not an inevitable part of ageing, but mainly a consequence of the 3-5% loss of muscle mass that occurs per decade past the age of 30. Something we can effect with exercise therefore.
Then comes the recommended exercise intervention.
Cue lots of older people sitting in chairs struggling with therabands, and this animation that, to it’s credit, at least involves some lower limb activity. This is usually neglected in most falls prevention programmes as I have discussed previously.
If loss of muscle (sarcopenia) is the problem however, how much will the activity recommended by the CSP reduce it’s impact?
Sadly standing on one leg or walking with one foot in front of the other will do little for the muscular system. Think of it as practising to use the muscles you have, rather than actually strengthening them. If they’re weak, they’ll stay weak.
I don’t criticise the CSP for this. At least they are raising awareness of the issue and putting something out there that will provoke a conversation.
What are the exercise industry saying?
Given that the solution to this issue has to be exercise based, where is the voice of the exercise industry?
Where are the trainers who can safely work with older adults that may have multiple health issues? Or put another way, do you know a personal trainer you would trust with your Mum or Grandmother?
I don’t doubt that most in the exercise industry are well meaning individuals but there is a complete void in terms of meaningful education pathways.
Sure there are courses available that enable you to work with people who are suffering from heart disease or cancer for example. Thankfully these groups of people don’t make up the majority of the older adult population however. Far more common are general musculoskeletal issues such as osteoarthritis and tendinitis.
To work with these people you must understand force and how to manipulate it in order to achieve positive results.
There is only one course in the UK at present that teaches exercise professionals how to apply this knowledge. That’s unacceptable.
I can’t count the number of older adults who find their way to me having embarked on an exercise programme to combat the effects of ageing, only to be injured by well meaning trainers or poor advice from exercise professionals simply not educated in how to work with these people.
That’s a missed opportunity and it’s the physiotherapy profession who have, to their credit, stepped in to fill this void. The unfortunate thing is they’re not trained to deliver this either.
Resistance training is the answer.
People often ask me what my exercise programme looks like given my job. I can tell you it’s mainly aimed at combating the muscle loss that occurs with ageing. As a result it’s almost exclusively resistance training based.
Compared to my 20s, when I was what many would term an athlete, I have better function and no pain, even though I’m approaching my mid 40s.
The CSP are absolutely right to say that ageing and falls don’t have to go hand in hand. I would go further and say that many of the changes we associate with the ageing process can be minimised, if not avoided altogether with appropriate resistance training.
This is what I want for my clients and what I aim to deliver in conjunction with their performance related goals.
We need educated exercise professionals who are able to serve the population. By the time most people get past 40 they require assistance to either help improve, or work around whatever issues they may be suffering from.
This isn’t easy work but it’s immensely rewarding for those willing to take up the challenge.