Basic Exercise Guide for Older Seniors and the Infirm

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Falls are the most common cause of hip fractures and traumatic brain injuries among seniors, and injuries like these may spell the end of independent living

Seven basic seated and standing exercises are described that can help improve balance and coordination if you’re frail or elderly, thereby reducing your risk of falling

Nutritional components that can quite literally make or break your bones include vitamins D, K2, and magnesium, and many elderly are deficient in all of these nutrients

Falls are the most common cause of hip fractures and traumatic brain injuries among seniors. They are also the leading cause of fatal injuries.

A broken hip carries a great risk of complications and usually requires prolonged specialized care, and even if you do recover, injuries like these may spell the end of independent living.

Many who have suffered injuries from falling also develop a fear of falling again. Unfortunately, once they start limiting their physical activities to “stay safe,” their risk of falling increases even more…

Preventing falls is one of the primary reasons why exercise remains so important as you get older, as improving your balance, coordination, and strength can significantly reduce your chances of falling.

I believe it’s never too late to start exercising (my mother didn’t start working out until she was 74 years old). She continues to regularly train as you can see in the above video. It is also helpful for seniors to consider more strenuous activities such as high-intensity regimens and strength training.

However, many are simply too old, infirm, or frail to even consider such programs. Therefore, this article will focus on seven simple, basic exercises you can do to help improve your balance and coordination, thereby reducing your risk of falling.


Walking Is a Key Movement

Before we get into those exercises though, I want to mention the value of taking daily walks.

I have been especially sensitized to this over the last year, once I saw the light and started walking about nine miles a day. Movement is essential to good health and walking is one of the most basic movements.

My parents are now both in assisted living facilities with many older individuals, and it is clear to me that once you start relying on walkers to get around you’re on an accelerated downhill path.

So it seems quite rational that committing to a good walking program — provided you’re physically able to walk — would be an excellent investment of time and energy to avoid ever having to use a walker.

As noted by exercise researcher Dr. David Hupin of the department of clinical and exercise physiology at the University Hospital of Saint-Étienne, France:1

“Scientific evidence is now emerging to show that there may be health benefits from light physical activity and from replacing sedentary activities with light intensity activities, when the dose of (moderate-to-vigorous physical activity) is held constant.

They must become less sedentary: cooking or working at a standing desk, rather than sitting. Age is not an excuse to do no exercise.”

This year I officially became a Florida resident and I’m now able to walk on the beach just about every day as you can see in the video I created for our 18th anniversary celebration.


Basic Checklist of Tools and Considerations Before Getting Started

Among the reasons why seniors fall are poor balance and coordination, weakness in your hips and legs, poor posture, and reduced ability to lift your feet, which can lead to stumbling.

These factors — which tend to be primarily due to inactivity — can be counteracted by low intensity exercises such as those demonstrated in the featured video. Here’s a basic checklist of items you will need to perform these exercises:

  • A stable armless chair to sit in, and to use for support during standing exercises (make sure it doesn’t have wheels or slide easily)
  • Alternatively, you can do the standing exercises in your kitchen, using the kitchen counter for support. If you’re frail and are easily unbalanced, be sure to have a personal assistant with you so you don’t tip over and hit your head on a sharp corner
  • A plastic cup, no taller than six inches

Also, here are some general guidelines to consider before you start:

    • Avoid wearing rubber soled shoes, as they may increase your risk of tripping. Leather soled shoes are ideal, but make sure they’re compatible with the surface you’re working on.

You also don’t want your feet to slide unexpectedly, as could happen with a flat-soled shoe on carpet for example

  • Do not close your eyes during the exercise as this will dramatically increase your risk of losing your balance
  • Pay attention to your posture and weight distribution throughout standing exercises. Seek to maintain your bodyweight above your ankles, not your toes or heels
  • If you are frail and/or have poor balance, be sure to perform any and all exercises with supervision and/or assistance. These exercises may look easy, but they can be challenging, so don’t go it alone

Seated Balance and Coordination Exercises for Seniors

Begin seated in a chair that won’t move or slide easily. Start slowly, and only proceed to the next exercise once you’ve mastered or are comfortable with the previous one.

Throughout each exercise, be sure to focus on your breathing — you don’t want to hold your breath, as this may cause dizziness.  Also remain aware of your core throughout each exercise. You want to gently pull your navel back toward your spine to engage your core muscles. Again, start at the beginning with the first exercise, and only proceed to the next one when you can comfortably perform the previous one. All of the following five exercises will be performed seated.

    1. Toe Taps on Cone: Place the plastic cup, opening down, on the floor between your feet. Starting with your right leg, lift your leg up to gently tap the top of the cup with your toes, then place your foot on the opposite (left) side of the cup. Lift your right foot back over the cup, and set it down on the right side.  Repeat 10 times with each leg, alternating sides.
    2. Seated Leg Lifts: Lift your right leg with the knee bent at 90 degrees. Hold your leg up with your foot about 6 to 10 inches off the floor for five seconds. Repeat 10 times, then switch legs and do 10 repetitions on the other side.
    3. Seated March: While seated, march your legs 20 times, lifting your feet at least a few inches off the floor. Be sure to focus on maintaining good posture while marching.
    4. Hand-Eye Coordination and Balance: Place a plastic cup (opening facing down) in your right hand. Stretch your arm out in front of you while balancing the cup in your open hand.

Slowly move your arm out to the side and back to center. Repeat 10 times with each arm. When you’re comfortable with this exercise, you may try doing it with your eyes closed. Be sure to remain seated, and if necessary, have someone help keep you upright, and/or be ready to stabilize you if you get dizzy.

  1. Seated Arm Reach: While seated, simultaneously lift your right arm up high and raise your left leg, knee bent. Hold for a few seconds, then alternate sides. Repeat for a total of 20 times.

Standing Balancing Exercises

When you’re comfortable with all of the seated exercises, you can proceed to the following standing exercises. Use a stable chair or counter for support.

  1. Side Leg Raise: Stand behind a chair, with one or both hands on the back of the chair for support. (Alternatively, keep one or both hands on the counter). Lift your right leg out to the side. Repeat 10 times for each leg. If you’re comfortable, do the exercise without holding on to the chair or counter.
  2. Staggered Stance Balance: Place your right foot forward and your left foot behind, then slowly shift your balance from your front leg to your back leg. Repeat 10 times, then switch leg positions, placing your left foot forward and your right foot behind. If needed, do this exercise standing next to a chair, or between two chairs, with the backs of the chairs toward your body, so you can grab on to them for support.

For even more balance and coordination exercises, check out,2 or the ElderGym’s website. 3 Medline Plus also has a helpful Senior’s Fitness Page.4

While exercises like these may seem exceedingly simple, they can be quite challenging, and can go a long way toward improving your balance and coordination. As researchers have noted, any exercise is better than none at all, and for older seniors, balance-type exercises are particularly valuable.

Important Nutritional Components

In addition to exercising in accordance to your ability, it would also be prudent to address nutritional components that can quite literally make or break your bones. Vitamin D, K2, and magnesium are particularly important for the formation of strong, healthy bones, and many elderly are deficient in all of these nutrients.

One recent study5 found that homebound seniors who received vitamin D supplements with their Meals on Wheels food deliveries had half the number of reported falls compared to those who received a placebo. As reported by the Endocrinology Advisor:6

“Over five months, 68 homebound seniors received either a monthly vitamin D supplement of 100,000 international units (IU) or a placebo… At the start of the study, more than half of the seniors had insufficient vitamin D levels, and fewer than one-quarter had optimal levels.

The supplements increased vitamin D from insufficient to sufficient levels in all but one senior who received the supplements, and to optimal levels in all but five. Also, seniors who received the vitamin D supplements reported about half the falls as those in the placebo group.”

Magnesium can also help protect against weakening bones and hip fractures. In one study,7 postmenopausal women with osteoporosis decreased their bone loss simply by taking 290 mg/day of magnesium for 30 days. It’s important to recognize that magnesium, calcium, and vitamins D and K2 all work in tandem, so it would be ill advised to focus on one above all the others. There needs to be a balance.

In terms of magnesium and calcium, the ideal ratio you’re looking for is 1:1. As for vitamin D, you’ll want to reach and maintain a blood level of 50 to 70 ng/ml. Vitamin K2 is a bit trickier, as it’s unclear exactly how much vitamin K2 is needed to counterbalance these other nutrients. But we do know that if you take a vitamin D supplement, you also increase your need for vitamin K2.

Dr. Kate Rhéaume-Bleue, author of the excellent book, Vitamin K2 and the Calcium Paradox,has previously suggested 180 to 200 micrograms of vitamin K2 per day might be enough to activate your body’s K2-dependent proteins to shuttle calcium to the proper areas, but more research is needed to determine more exact amounts. One way to likely ensure you’re getting enough is to eat fermented vegetables made with a special culture designed to produce high levels of vitamin K2-producing bacteria.


Balance Exercises Can Improve Your Quality of Life

The earlier you start, the better, but remember, you are never too old to start exercising. You may not be able to jump into a rigorous fitness program, but the take-home message here is to do what you can. Engage in physical activities that are within your ability to perform, and just keep at it. Consistency is key, and you may be pleasantly surprised at just how much you can improve your health and fitness by doing even the mildest of exercise.

If you’re in your 70s, 80s, or older, and/or have limited physical abilities, I strongly suggest starting with the exercises described in this article, as improving your balance and coordination can  significantly reduce your risk of falling — which could have life threatening ramifications.

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