ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, October 24, 1996 TAG: 9610240005
SECTION: EXTRA PAGE: 3 EDITION: METRO
COLUMN: PERSONAL HEALTH
SOURCE: JANE BRODY
Jennifer Monaghan of Brooklyn had been plagued with an arthritic hip that got progressively more painful for 20 years. By her late 50s, walking a few blocks with heavy groceries or walking empty-handed for a half mile meant crippling pain the next day.
Finally, at age 59, she underwent a total hip replacement that ultimately made her look and feel 20 years younger. Not only were the aging lines of pain gone from her face, many pounds were gone from her once-size-16 hips, because now Jennifer could exercise.
She began walking and doing calisthenics, as recommended by her orthopedic surgeon, to rebuild long-lost muscle strength and flexibility in her hips and legs. A year after her surgery, she was walking three miles nearly every day; this summer, four years and a low-fat diet later, she slipped easily into a size 8 dress for her son's wedding.
The American Academy of Orthopaedic Surgeons began a program this month to get more older people to become physically active and ``moving for life'' regardless of the current state of their muscles, bones and joints. In fact, as the academy notes in a new brochure, lack of exercise makes conditions such as arthritis, osteoporosis and back pain worse or at least more difficult to live with. And failing to exercise after undergoing joint replacement not only deprives a person of the full advantage of surgery, but also increases the risk of falls, the main reason for having to undergo repeated surgery.
The brochure, ``Keep Moving for Life,'' sums it up succinctly: ``Regular exercise slows the loss of muscle mass, strengthens bones, and reduces joint and muscle pain. In addition, mobility and balance are improved, which reduces the risk of falling and suffering a serious injury such as a hip fracture.''
About 65 percent of older Americans do little or nothing to stay in shape and therefore invite health problems such as obesity, diabetes, high blood pressure, heart disease, immobility and loss of the ability to live independently.
Contrary to the concerns of many older people with chronic orthopedic problems who fear that exercise will make their conditions worse, it is lack of exercise that can lead to further deterioration, invalidism and pain. Let us say, for example, that you, like Jennifer, have painful osteoarthritis, the leading cause of disability in people over 55. Rather than further damaging your arthritic joints, a regular program of moderate activity and stretching and strengthening exercises can reduce pain, improve mobility and increase the stability of arthritic joints by strengthening the muscles that support them.
Dr. Nicholas DiNubile, an orthopedic surgeon affiliated with the Hospital of the University of Pennsylvania, suggests swimming or walking in a pool as ideal for arthritis sufferers, since water exercise is a ``nonimpact and nonweight-bearing activity that does not place a lot of pressure on arthritic joints.'' Also recommended are walking (once muscles are strong enough), cycling and stretching exercises.
If repeated or chronic back pain is your problem, exercise is your solution. While strenuous exercise is not recommended during an attack of acute back pain, prolonged rest and inactivity will actually delay, not enhance, recovery. Surgeons, who once put people with back pain to bed for weeks, now want them up and moving after a day or two, doing exercises that increase flexibility and strengthen muscles that support the back. Research has shown that exercise lubricates spinal disks, which helps relieve back pain and reduces the risk of a recurrence.
During recovery, the most helpful exercises include wall slides to strengthen the back, hip and leg muscles; leg raises to strengthen hip and stomach muscles; back leg swings to strengthen hip and back muscles; and partial sit-ups to strengthen stomach muscles.
While these exercises are best continued indefinitely, once back pain subsides you can also begin activities that will keep you in good physical condition overall, such as walking, running, swimming, cycling and lifting light weights.
For those concerned about osteoporosis, weight-bearing activities such as walking, jogging, cycling, climbing stairs, dancing and racquet sports, as well as strength training (lifting weights or working out on resistance equipment), can help stave off the loss of bone with age and can actually make bones thicker and stronger at any age.
As with any new exercise program at any time of life, the best laid plans are those that start off modestly and build gradually. No marathons within the first few months, please.
You can expect some mild muscle soreness and stiffness at first, but this should go away as you continuing exercising and gradually build up your strength and flexibility.
Do not stop exercising because of start-up muscle soreness. However, if the exercise you choose causes severe pain or swelling, it would be wise to stop and consider another activity
To increase your chances of sticking with exercise, choose an activity that you enjoy. Better yet, choose two or three enjoyable activities, since variety keeps exercise interesting and a balanced program that uses different parts of the body is better for you. For example, you might combine walking with cycling, swimming or gardening.
Be sure to warm up and stretch before starting your activities and cool down and stretch again after them. Choose appropriate attire - for example, comfortable walking shoes that ``breathe'' (leather or nylon mesh, not artificial leatherlike materials) and have good arch supports and wear layered clothing in cool or cold weather to permit partial stripping as your body heats up during activity.
Try to build up to at least 30 minutes a day of moderately vigorous activity. If you cannot do the full half-hour at once, split it up into two or three segments during the day, perhaps walking for 15 minutes in the morning and riding an exercise bike for 15 minutes in the evening.
To get the academy's new free brochure, call toll-free (800) 824-BONE (824-2663) or send a stamped self-addressed business-size envelope to ``Keep Moving for Life,'' American Academy of Orthopaedic Surgeons, P.O. Box 1998, Des Plaines, Ill. 60017
FITNESS RESOURCES
Organizations that can help you start a fitness program include these:
The Arthritis Foundation: A variety of recreational programs for people with arthritis are offered, including aquatic classes and exercise videotapes. Contact your nearest chapter - call (800) 283-7800 to locate it - for information on fitness programs for people with arthritis.
The American Association of Retired Persons: The association offers a brochure, ``Pep Up Your Life,'' that includes exercises that can be performed at home. It is offered free to members who call (800) 424-3410.
Local senior or community centers: Most communities sponsor exercise classes for older adults, usually at senior or community centers. Ask at your local town hall or check the yellow pages for a nearby center.
YMCA and YWCA: These organizations offer exercise programs for older adults, ranging from swimming classes and water aerobics to general health and fitness courses. Check your phone book for a center near you.
Health clubs Many clubs offer exercise classes designed for older adults. Check the yellow pages. When you find a club that has programs that seem suitable, be sure to observe them in action before joining.
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