adults exercising


Worth repeating: Moderate everything!


I am reminded again of the consequences of extremes in lifestyle management. I had a patient yesterday who thought he was the fittest and healthiest man in the world, workout two hours per day, six days a week, working full time 10 hours per day, spending one day each week with family for fun time and wham! he suffered from multiple bleeds in the brain.


I know my website is becoming gloomier and gloomier with my stories but they are the truth. I deal with these conditions  everyday. Granted that this happened to one in a million of high-intensity exercisers, still at the end of the day it causes me to ponder. For the sake of HIPAA I keep both the patient and myself anonymous. Some of the people I treat are quite known and respected. And the things happening to them are not self-inflicted. They are accidents due to personal mistakes. Usually they recover and the last thing a recovered patient wants is to be reminded of  a bad mistake. Mistakes are better forgotten. So no names shared here. Nobody should know the identity of anyone suffering unless that person is related or involved with the patient.


Enough said, let me expound again on certain hidden rules of exercises.


If you are young up to mid-twenties,  you can work as hard as you can as long as you are healthy. This is the age  for hard-core speed, strength, competition. At this age, regeneration of body tissues and bones is fast. At this age, medical history is usually non-existent. Immune system is excellent. (Parents should still have their kids pass through  medical check-up prior to indulging in heavy sports or athletics). Recovery time after exercise usually lasts 24 hours.


By mid-twenties to mid-thirties, the body begins the decline. It is a soft decline but still close to the prime of life. By this time, the body had already been well accustomed to exercises and training (assuming you were active in earlier years). This is also the age of family life. Priorities are  oftentimes scrambled and there is a possibility that healthy lifestyle is relegated to the back burner. This is the age when you need to get a good grip of your schedule since it will become tighter each day. And this is where ‘overdoing it’ becomes possible. Just like in your earlier years, you can keep the regular routine of improving personal bests, competitions, building muscles strength, endurance. However, recovery may not be as quickly as in your earlier years so allot longer rest periods in between hard workout days. Recovery time between 24-36 hours. The best case scenario:

Aerobics one day, anaerobics the next day, recovery the third day. Repeat.


Example (you can create your own variations to this):

Running one day,  Gym strengthening the next day, rest (or do light cross training) the third day. Repeat.


From mid-thirties to mid-forties, let us admit it, we know we’ve most likely lost our physical primes at this time though  we remain competitive albeit within our age-brackets. Sometimes we make it to the top but most of the time we surrender to others. This is the start of the decline. Our bones have fully matured (by age twenty five)  and we are now entering  a condition of  slow ‘degeneration’. This is the age of prioritizing what we are best at and accepting our increasing limits. What is our strength at this age? Endurance. To those who had been working out throughout their lives, everything may decline but the endurance will remain. To begin with, the years of working out have produced sufficient aerobic and anaerobic endurance and though muscle strength may have already  reached its peak, it is still capable of maintaining that peak. The capillarization of  extremities and heart,  the flexibility of  joints, the stability of  balance should compensate for  diminishing bulk and strength. This is the time we get the kick out of beating a kid ‘half’ our age. Bear in mind  that the  kid has probably not yet  built a strong foundation of his health, whereas, you - you have fortified yours. This is also the age of stability in terms of job,  authority due to experience, sagacity worthy of respect. You are now entering true maturity.


Between ages 45 to 55, health’s trajectory gets into  multiple directions. This is the time of reaping what you sow and sadly, there will be health determinants that may affect you negatively (or not) at this time of life. You health status will depend on how you spent your younger life. For example, sedentary, stressed, obese, uncontrolled smokers, drinkers and drug users develop major health issues. Those who are healthy will remain healthy.


There are other contributors to health beyond one’s control. Genetics, family history, accidents, injuries etcetera can affect people negatively or positively.


Exercise  goal at this age range  is to balance out aerobics and anaerobics forms of exercise. Strengthening workouts are needed because aging decreases strength, flexibility, balance, speed. Cardiovascular build up is needed because aging will start jeopardizing  body systems through wear and tear. The heart and lungs and kidneys and digestive system and endocrine system and everything else will slow down no matter what. That is the Natural Law.


The things to watch for by this age are:

Possibilities of heart disease, diabetes, different forms of cancer, mental issues, strokes, heart rhythm abnormalities, kidney failures, injuries due to overuse or overstressing of the body, poor adjustment to declining abilities, neglect of rest.


Exercise should be moderated and balanced. Recovery is 48 hours or more. Immune system is easily compromised  so put a prime value to rest.


By age 55 upwards, most will know by now their medical problems if they have any. Others will stay in denial. Generally,  more and more are getting well informed and proactive about their health. There are two major reasons for this: the current health care system is becoming exorbitant. A 57 year old person I know has to pay more than 700 bucks a month on top of the 6500 deductible he has to shell out just to keep his health insurance. After being diagnosed with operable herniated disk, his annual expense for his medical is now upwards of 15000. That is a lot of money for an ordinary working American.

The other reason is the quality of life. A lot of people don’t want to live the lives their parents led a generation ago. The baby boomer generation has many things on his plate. He wants to travel, meet more people, enjoy hobbies, interests, be in the thick of active things, be relevant and useful till his last dying breath. This  is the way things are getting nowadays. People are more informed and more serious about the high quality and quantity of their years.


Exercise goals by this time are way past the ‘looking good’ phase and are more into  ‘living good’. I am getting close to this age (53). A few things happen at this time: first you hear about old friends who are now suffering from diseases, worse,  a few who have died or hospitalized due to  different illnesses. There are symptoms you got away ignoring in the past but not anymore - you have lesser endurance ( gone are the days of daily partying and hangover without a single effect on your daily routine); occasional heart palpitation here and there, increased pain, weight gain and shortness of breath with tasks that used to be easy. In my case, after a heavy full day’s work, I just feel like lying briefly on my bed to relax my whole body. ( I used to have sufficient energy to the gym or swimming or running after eight hours of lifting, walking and moving patients). I remember when  I worked a full day’s caseload right after running a 15 miler in the morning. Those days are over. Here is the main issue at this age -- we need to get a medical check up because we’re most likely develop conditions we’re meant to develop.  Heart disease? Check. Hypertension? Check. High Blood Glucose? Check. Prostate/Breast/Colon Cancer? Check. Obesity? Check. Thyroid? Check. Vision/Dental? Check.


Knowing one’s numbers and taking care of them  will spell the difference between saving a lot of money from medical expenses with having a good quality life versus expensive unnecessary expenses with a life full of limitations.


There is no better age when we should be more mindful of our health. This is the time we optimize health. We don’t go to the gym to build those muscles for ladies to swoon over, we don’t run a marathon to win an Olympics gold medal. We do active lifestyle for the wonders it does to our well being. A few things do happen at age 55 upwards. We lose 1% of our muscle mass by each year, metabolism  slows down, oxygen utilization is reduced, muscles and joints suffer the consequences of less flexibility, weakness and degeneration due to wear and tear. Our organs including the heart, lungs, digestive, kidney, liver are slowing down. Our minds become slower.  This is on top of medical problems we may have on account of genetics.

So the focus of exercise by this time is a moderation of everything with special emphasis on cardiovascular. Still, we need to work on strength (mostly to keep muscle tone), flexibility (to facilitate handling of unwanted tasks such as getting up from low seats/beds/cars  or floor), agility (to self-correct loss of balance quickly and avoid falls), relaxation (to free oneself of stress), mental exercise (to reduce risk of dementia or alzheimer’s). Most of all, keep medical conditions in check.