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The self-Analysis

Details: Written by Alex Zuniga; Created: 25 April 2023; Last Updated: 25 April 2023; Hits: 63

[This is an anecdotal article, based on my personal experience. Nothing here is a diagnostic or therapeutic. This is educational only. For the newbies, consult the MD before attempting any personal exercise program.]

One of the things to consider as I approach maturity is how to adjust my routine exercises age-appropriately. I remember in the old days of Nursing Homes when one of the questions asked by the State JCAHO was - what is the difference between your 50 year old and below and above 50 year old patients' exercise routines

That was a no brainer. You give less intensity, less weights and less reps/sets exercises for those who are above 50 years old.

Do you apply that ‘in general’? the lady asked.

That made me stop. “How generalized is general?”

As I mature, I see there is no such thing as general exercises applicable to my body. There is no universal protocol, no ‘one size fits all’, no master class, no master approach when dealing with MOVEMENT. Each of us is unique and for that reason alone, we need to apply an exercise program tailored to our individual selves. That holds true in everything. One may prefer to be by the sea to relax while another would prefer to be with friends and family to relax. One may prefer to play sports with others (basketball, baseball, football), another may prefer to be doing it alone (swimming, running, cycling - even with a group).

One prefers a demo of the exercise to learn it, while another wants an illustration or a verbal instruction. Medically, one can do a certain exercise routine while the same may be contraindicated for another.

One’s level of fitness can be monitored by BP and heart rate but another would require a different monitoring system on account of current medications (like beta blockers) that prevent natural responses to exercise.

One may want to hurry things up while another wants to take it slow.

Dosages may vary in levels of minimum vs maximum; age; weight; gender etc.

Labs readings may also consider differences along ethnic backgrounds. On top of the ages, genders, weights etc.

The idea of MOVE principle is like that of a boat. Your goal is to keep afloat towards your destination; you may advance differently from the others, sometimes you sink a little or rise a little but the idea is keeping your body afloat. What you don’t want is to sink.

So the MOVE principle would require fundamental baselines. You may need to establish your minimum and maximum parameters based on how your body responds to working out.

A few consider the ‘talk a full sentence parameter’. Meaning if you can still conduct a conversation while working out, you can continue. But once you get out of breath, and you can hardly complete a sentence, stop or rest.
In the old days, people used time as a minimum maximum criterion. Thirty minutes is the minimum time to call their workout a workout; maximum time of one hour is the cutoff.
Yet others use the carotid pulse. You feel the pulse and you set your limits there, usually this involves the maximum heart rate.
Or others use the alternate times for hard intensity exercises vis a vis light intensity: 4 minutes of high intensity workout, 2 minutes of resting.
And finally, we have the ‘feeling minimum-maximum’. And most likely this is how most of us gauge our performances during workouts. If you feel tired, it is over. If you feel you have more energy to spare, keep going.

But here comes technology! That is one of the best adjunct to health management that ever came in modern times.

Just look at my personal readings in my runs last Friday and Sunday.

What I observed is that gearing for a comfortable running (or jogging) pace leads to less stressful and higher number of running miles, with the extra bonus of increased calorie expenditure. My loss of 1 minute in pace was compensated by an increased mileage.

I refused to follow my instincts because I can be impulsive. One of my criteria in assessing the safety of my patients is their impulsivity - which is normal to all of us in ordinary circumstances. Until we get sick and get confined in a hospital. While on bedrest, It is hard to be told you need to slow it down. Or worse, when a medical worker tells you to call for assistance whenever you want to get out of bed (to use the toilet for example) and the assistance doesn't respond immediately.

There was a time I attended a class where we were told to stay still and watch the clock for a minute. I am telling you, that is the longest minute I ever watched. Maybe for another being who is used to waiting that may mean nothing. BUT if your bladder is about to burst, or your colon is ready to empty, 1 minute is 1 year long. And if no one is there to assist you as you were promised, heck, you will try to get out of that bed and BAM! A broken hip.

I thought of this while jogging at a turtle pace covering 5 miles. A young woman passed me by. An older gentleman did the same which I would not tolerate in my impulsive younger years. You wanna race, I will give you a race.

But my maturity has given me the leash of wisdom and restraint. I pay no attention to these young, energized, and maybe elite runners. I am not inclined to beat personal records or prove anything at my age. No one sees me anymore. LOL. And I don’t see them. I would be living in illusion to even imagine these healthy, young and beautiful fast runners would have interest in me. I raise my hand or bow my head towards them in crossing their paths. A little hello and good morning but that is all. They respond in kind. Mindlessly. Just like them, I am focused on my little pace and little goal and my little joy.

The idea is to set your own pace, your own drum beat; to assert your individual uniqueness; to be content with the little improvements you gain while maintaining safety based on your established self-parameters.

Suggested Heart Rate for runners 60 and above is 70-80 percent of max heart rate. 220-60 = 160(maximum heart rate) 70-80 percent of 160 is somewhere between 100=130 beats per minute. Also measure the recovery of heart rate when doing high intensity (those reaching higher than 130 beats for a short period) - it should recover in no more than 2 minutes.

Suggested ordinary pace for 60 and above males: 13 minutes per mile.

These are suggested for ordinary folk like me. They don’t pertain to elite runners or those who had been very athletic and competitive throughout their lives. Believe me, I have seen runners in their seventies who can beat the shit out of me. Well, you know yourselves, just beat your own drum, follow your bliss and joy.

MOVE : My highs

Details: Written by Alex Zuniga; Created: 19 April 2023; Last Updated: 19 April 2023; Hits: 49

[ Note: my personal workout journeys should be considered anecdotal. They should, in no way or form, be considered diagnostic or therapeutic for everyone. They are educational only. Consequently, anyone contemplating a personal exercise program should consult a specialist in general health beforehand. That is a no-brainer. ]

I am getting close to my old routine.

I used to run 5 miles at least 3 -4 times a week. I used to pace between 10-11 minutes finishing my 5 miles between 50 to 55 minutes.

Not anymore. I am turning into my 60s and the last thing I want is to subject myself into extreme workouts like I was in my 20s. There are new parameters for me to adhere to as far as working out is concerned. In my youth, all I thought about was speeding, beating personal records and of those around me. Yeah, youth is the competitive period of life.

Today is different for me. Little improvements in my performance based on what my body can handle give me extreme joy. I don’t care if everybody overtakes me, (in running for example) I am happy as I can be at my own little pace, watching Nature around me, listening to birds and whispers of tree canopies. Exercise for me is simple - MOVE. That is all there is. So long as I get out of bed, or out of chair, or out of the house, that is exercise for me already.

Household and backyard chores are good enough.

But then, there are extra bonuses. Only last December ‘22 to January ‘23 I was agonizing over knee and back pains, made worse by a vacation full of moving around with a backpack checking from one cheap hotel to another. I used public transport to save money and Lord did I suffer. You see, I was initially confident that Manila was easy to navigate with all its public available transportation. In college, I could sprint to catch a bus or jeepney. If there were no more seats, that’d be alright because I could stand the entire length of my trip. Not until my last vacation. I was like an old debilitated man carefully climbing up and down stairs to reach the platforms of public trains. I felt sharp pains in my back whenever I walked a mile or two carrying my bag like a homeless hobo. I could not climb jeepneys and tricycles because of a painful right knee. I swore I would never take another vacation in the city without a personal car.

I had the choice of accepting my fate, ruled by a belief that 60 is the new … 60. I tried so hard to believe that 60 is the new 40 but I couldn’t. Everytime I step down a step and the pain hits, I feel like I'm 101 years old. Already.

But, wait a minute. I am a Physical Therapist and am I not supposed to be the licensed Professional to treat these types of agonies and limitations and turtle slowness? I took stock of what happened: I fell on my face while running in Palm Beach during the pandemic. I landed on my right knee. It healed. This led to years of inactivity as far as running was concerned. I was afraid of gyms and potential crowds. Meanwhile the patients I was treating were getting bigger while my muscles remained the same.

Soon I felt the impact of inactivity. My knee started complaining. Everytime I lifted a patient or bent my knees to attend to my gardening, my back also complained. All these symptoms got worse when I traveled to Manila. I hoped to walk and run as much as I could in the city where I used to live. I did much less than I planned for. I attributed all these issues to old age. I ran many long distances in my heyday, maybe I was paying the consequences now. I have added years to my age and shrinkage to my muscles - my co-workers became fed up hearing my saga of toeing the line of aging.

Meanwhile I encourage my patients to fight off the impact of aging by maintaining a solid active state. MOVE. Cardio 3x a week. Strengthening 2x a week. 10000k of steps per day. Avoid stress. Good sleep. Good nutrition. We all know the game plan having been bombarded constantly by reminders from all social media and commercials and google. Even friends and families and yes, health care workers like me.

Yet I feel like the oncologist suffering from cancer, the cardiologist having a massive heart attack, the neurologist suffering a stroke. Health care professionals are people too. Some are even worse - the smoker telling people not to smoke, the obese telling people how to lose weight, the hyperglycemic telling people how to lower blood sugar. We have been there.

I took a stock of my state and determined a few things. The pandemic in a way, deconditioned me. The fun of exercise and workouts were taken away by the ‘plague’. Upon my return to the US, I vowed to treat myself as if I were my own patient.

It was gradual and very carefully planned. I refrained from the outdoors for a bit and returned to the gym to use all its available machines. Walking on the treadmill was important, leg machines and bikes and ellipticals. It was a crawl.

Little by little, the walking got faster, the time for ellipticals increased as the pain subsided. I fixed my bed to reduce pressures on my back. I visited the parks on occasion to test my abilities in the real world. Soon, I was getting closer and closer to my pre-pandemic levels as I am regaining the old highs of walking -> jogging and hopefully back to running. But I am imposing a few caveats to my exercise fun:

I pay close attention to a few things.

My pattern running. I am a ball of foot strike when hitting the ground. No heel strikes causing knee pain.(this is probably unique with my own legs)
I allot at least the first mile to a combo of slow and fast walks, followed by very short stride jogs (as warm up).
I avoid any changes in terrain or if I encounter one I slow it down. There are road bumps formed by tree roots emerging out the ground, small ups and downs. I am keenly looking out to avoid them.
I pay attention to my heart rate. I am aware that the max heart rate for me is 160. I keep my heart rate within the 80 to 60 percent of that.

I wear comfortable running.jogging clothes.
I listen to my body’s feedback outside of my Apple watch. My breathing, my level of fatigue, pains (any sharp pain is dangerously close to an injury, generalized pain is most likely due to muscle overwork).

When in the gym, I try to move away from others to play my own game, rhythm and pace. Working with many can push one’s competitive edge and that can be dangerous. I limit my strengthening to maybe 2-3 times per week. I mostly focus, for now at least, on my leg muscles since my first and only love in MOVE principle is walking and running, they give me highs and they keep me close to Nature. I tell my patients to exercise in full ROMs and all those eccentric concentric isometric differences. Pushing a little extra effort here and there especially when restoring the muscle after injury or surgery. They don’t apply to me though. I do my happy merry workouts without making faces. I avoid any valsalva maneuver. Or holding one’s breath too long because the effort is too heavy. Valsalva, though effective for other problems, can lead to low BP, which can be dangerous for some. At the same time, I don’t want prolonged persistent high heart rates to prevent tachycardia or worse, palpitations. I often emphasize, at least to myself given my age, that rest is just as important as the stress itself.

Then, I rest.

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