Its common for caregivers and their care recipients to want to feel stronger and get stronger, as soon as possible, especially after an illness, surgical procedure, or hospitalization. But before people launch into a rigorous physical therapy routine or start with the regular routine of household chores in order to “get back to normal”, it may be better to simply recover from what originally set you back in the first place.
After an illness or hospitalization it’s common for most (if not all), to feel a little weak and fatigued. This is something that doctors have termed as “post hospital syndrome“. And, yes, it’s a thing. It’s described like this: “Post-hospital syndrome is caused, in part, by ongoing effects of the original illness. For example, someone who has been hospitalized for pneumonia may experience lingering fatigue, reduced strength, foggy thinking, or constipation after leaving the hospital.”
But in addition to continued recovery from the condition that put a person in bed or in the hospital initially, there is another factor that many don’t appreciate. It’s the inactivity that goes a long way to weaken people. Lying in bed for a weak or two will lead to muscle atrophy and general weakness. According to Business Insider, “Within a week, your problems only get worse. You see, normally, your muscles and bones help support your weight under gravity. But now that you’re lying down, they’re out of a job. And as the saying goes, if you don’t use ’em, you lose ’em. For every week in bed, you lose about 1% of your bone density, making your bones more brittle and easy to fracture. That’s why astronauts, who often go for months without gravity, exercise for at least two hours a day and load up on calcium.”
The National Council of Aging advises “To prevent this, start moving your body as soon as your doctor gives you the green light. If you’re working with a physical therapist, follow their recommendations for restarting activity. Begin slowly. Aim for daily movement, even if it’s just doing gentle exercises in bed or sitting upright in a chair. Spend as much time out of bed as you can. When you are able to, progress to taking short walks with a caregiver or friend.”
While most will respond positively to exercise it’s good to start out slow and progress activity at a measured and gradual pace.
Four Reasons to Start Exercises Slowly After an Illness, Injury, or Hospitalization
Reduce Potential for Injuries
Seniors, or others, who have been sidelined by an illness, hospitalization, or just a sedentary lifestyle may have visions of their glory years, but, their bodies will probably not be used to the typical movements we call “exercise”. Many will think that picking up a couple of dumbbells and immediately start “lifting” is the thing to do. But this may actually lead to muscle strains or ligament sprains.
If your muscles are not used to carrying weight at different angles or if your joint range of motion will not allow a particular movement, then the senior may end up in a worse situation than if they had simply done gentle calisthenics or “reaching” exercise that would prepare their muscles and joints for more strenuous work.
Decrease Risk of Falling
As I am sure you know, some exercises, especially done in standing can actually lead to loss of balance and falls because the senior’s response/reaction timing may be slowed and they are unable to recover from a stumble or loss of balance while performing the exercise.
But another seldom considered contributor to falls is leg muscle fatigue or it’s close cousin, DOMS which stands for Delayed Onset Muscle Soreness. Both of these are the results of strenuous exercise and should be expected. However, an elderly person who has burned out their legs performing a relatively aggressive leg strengthening exercise session may find it difficult to walk afterwards, which will make them more prone to falls.
Provides Time to Learn the Movement
In many cases, it has been a while since seniors or the elderly have formally done any exercise and they may struggle to coordinate the correct movements because they’re just not familiar with them. This is another reason why it would be helpful to start any exercise regimen slowly. It gives the individual time to learn the movement so that they are confident with what they are being asked to do.
Again, once a person is familiar with the movement, understand how to do it, and confident that it’s not going to cause any other aches and pains, then that would be the time to consider adding a little resistance to the movement in the form of a light dumbbell or light resistance band.
Improve Strength Through Longer Load Times
When you finally start the formal resistance program, encourage the elder to use slower paced repetitions. I frequently have to remind my patients, “Hey, slow down. You’re not getting paid to do this (exercise)”. Going slower with the repetitions does a few things. 1. Allows time for the mind and body to connect with the movement. 2, Allows the senior to observe whether or not the movement is potentially injurious. 3, Decreases the “ballistic” strain on the tissues, thereby further avoiding injury. And, 4, it builds strength faster than rushing through the exercise because by going slow, the muscle is working a greater percentage of the time than if the movements were fast.
What’s The Best Exercise For The Elderly
Whether it’s the best exercise or not, I think a progressive walking program is the easiest. Especially for anyone who is weak from being sedentary, recovering from an illness, injury, or hospital stay. I have written about it here. But, the elderly have been walking all their lives and walking is something they know how to do. Plus walking is functional and it’s what will help keep them independent. Walking is not only good for their heart health, but it’s also a strengthening activity, helps lower blood pressure and sugar, improves cognition, will help with respiration and digestion, etc. It’s just good all around. And, it can be enjoyable.
Bryan Williams
Physical Therapist
is a licensed therapist with near 30 years of professional experience treating a diverse patient population in a multitude of settings. With simple strategies, he educates and empowers his clients with simple strategies to help them move better and with less pain.