Mark Borigini M.D.

Overcoming Pain

Using Exercise to Stay Happily 'Nifty After Fifty'

Studies show that seniors prefer to exercise with others their age

Posted Sep 24, 2008

Anyone who lives with chronic pain understands the suffering. But for the senior population, chronic pain becomes a nightmare, particularly for those seniors who find themselves alone in life. With little help from friends, relatives, or even strangers, it becomes all the more difficult to seek help, let alone experience relief.

As the baby boomers morph into senior citizens, chronic pain and the alleviation of it will become a prevalent dilemma. A 2005 Canadian Community Health Survey found that more than one-quarter of seniors living at home and 38 percent of those in institutions suffered from chronic pain. For the household population with severe pain, 53% admitted that it interfered with most activities. It is not surprising that seniors who experienced an increase in pain over a two-year period had a greater chance of being unhappy, regardless of illness or other problems.

Before any of us can ease pain, we all must first understand the why of pain. Common reasons for senior citizen pain include:
1. Falls and other trauma.
2. Arthritis.
3. Poor healing leading to prolonged post-operative pain.
4. Osteoporosis-related backbone fractures resulting in chronic spinal column pain.
5. Postherpetic neuralgia, a chronic nerve pain which occurs after an attack of shingles.
6. Face pain due to ill-fitting dentures or poor dentition in general.
7. Back and neck pain due to poor posture and worse mattresses.
8. Abdominal pain due to chronic constipation, which actually can be due to chronic pain medications.
9. Circulatory problems of the legs.
10. Cancer, an unfortunate diagnosis seen more frequently as the population ages.

Some of the above can be prevented through lifestyle changes, including exercise. Even if a senior has lived the majority of his or her life in a sedentary fashion, senior citizens can improve health and longevity with relatively simple exercise.

More specifically, so-called "strength exercise" is important to maintain muscular strength. Research has shown that strength exercise decreases chronic pain caused by arthritis and other diseases of aging; it also sustains one's ability to live independently. Examples of strength exercise include use of free weights, push ups and pull ups.

Further, "flexibility exercise" is also important for the senior population, as studies have shown that seniors with greater flexibility can recover prior to falling-which in turn can avert potential fractures. Flexibility exercise includes stretching exercise, which can be achieved through motivational practices such as Tai chi and yoga.

All this being said does not mean seniors are going to flock to gyms. Studies show that seniors prefer to exercise alone or with others their age, as opposed to a mirror-laden room with toned and well-tanned young people. A Canadian Fitness and Lifestyle Research Institute study showed that exercise classes are three times as likely to be taken by individuals in their teens or early 20s as by those in their 60s.

Consistent with the data which show that seniors do not like exercising with younger people, there is a theory that people of all ages prefer to exercise with those their own age. Further, research shows that people are much more likely to persevere with exercise in a group setting. Unfortunately, many senior exercise programs are geared to helping seniors work out alone.

The goal should be to advocate and nurture group exercise for senior citizens, whether it be through community centers or private club-like entities.

One approach to this is "Nifty After Fifty", manifested as a growing chain of locations in Southern California dedicated to "well-being and lasting independence" for the senior interested in health and fitness. Among many things, this program offers spa services, brain aerobics, driver training, nutritional programs, and full-body strength training for today's young senior citizen in a non-threatening environment. This health and fitness chain is one answer to some of the concerns researchers have had when the senior patient sets forth on the quest for physical improvement.

When a senior joins Nifty After Fifty, the new member is evaluated by physical therapists and fitness coaches. The result is a customized fitness program, whose foundation is based upon the strengths (and recognized weaknesses) of the individual's medical and social history. Strength training is achieved with modern computerized pneumatic resistance machines, which allow for safer workouts and accurate monitoring. Flexible exercise programs are offered in the form of yoga. Nifty After Fifty members have decreased their risk for falls and fractures by more than 85%.

The arrival of such an enterprise is none too soon, as the population ages, and the medical community struggles with ways to keep the more senior among us healthy, functional, and pain free.

I understand that there are plans to open Nifty After Fifty franchises outside of California. Let us hope that this venture is successful. The research shows that this venture is necessary.