Don't Lose That Muscle – Your Life Depends On It!
GREG SPINDLER, LMT, CSBE
Sarcopenia! It's the dreaded word for those losing muscle mass faster than desired. This age-related muscle loss can start as young as 30, especially if the person is inactive. From there, it can rapidly increase by 3-5% per decade, up to 30% in a lifetime, depending on an individual's lifestyle. Yikes! Let's talk about how to get around this.
Less muscle can equate to more significant weakness, promote instability, and cause less mobility, increasing your risk of falls and fractures. The American Society for Bone and Mineral Research found that people with sarcopenia had 2.3 times the chance of having trauma fractures from falls such as broken hips, collarbones, ribs, and extremity injuries. If we expect this to happen for most, then why do so many of us allow it to happen? We must be armed with knowledge and prevention strategies.
Based on my clinical practice since 1997, as we age past 50, we should make a point to measure muscle loss, maybe even more so than body fat! The daily walk is helpful for our health, although it doesn't curb muscle loss. Walking muscles are type 1 fibers (slow twitch, for endurance). Type 2 fibers (fast twitch) are needed for explosive movements like lifting, pushing, pulling, squatting, and catching ourselves from falling. Type 2 fibers are larger than Type 1 fibers. This makes it easy to visibly see or measure the decrease in size. For multiple reasons, we can lose these type 2 fibers within muscles at an undesirable rate. And yes, senior citizens still need fast twitch fibers, even though they are out of their competitively active years. An 8-week program is not the answer. A sustainable lifetime program is the answer.
Case Study: A woman in her 70s who, in previous decades, had an active lifestyle of distance running competitions as a fun endeavor. She continues to do this single-approach fitness program of cardio activity but no longer competes. She comes to my office once per month or so. At that frequency, muscle is changing. It's a relatively slow rate of change, so she doesn't realize it is happening. In her own home gym, she has multiple pieces of cardio equipment. Like many endurance athletes, her focus is to be as light as possible to carry the least amount of weight possible. She admits that she doesn't like resistance training, finding it boring. She also wants to avoid carrying the extra muscle weight.
Along with her cardio machine madness, she walks her dog. During one of her typical morning walks, she tumbled, falling, and creating bumps and bruises that kept her from doing her desired cardio routine for days. Was her fall due to lack of strength, lack of mobility, or reaction time? Could she have prevented the bruising on her upper body and face with more strength to react and catch the fall? Fortunately, she wasn't seriously injured, but she might not be so lucky next time. Her constant complaint at each therapy session was upper-body discomfort in the head, neck, and shoulders. In my practice, we focus on resetting this area's proper fascia bias pattern. And then, as homework, the client is to strengthen the areas to maintain it. However, she chooses not to due to fear of adding muscle weight. Her pain is a direct result of muscle underuse, deterioration, and sarcopenia.
What are some early warning signs?
When the pace of walking changes, not because of illness or cardio capabilities, but rather a shorter gait, lack of strength to push off the ground, lack of ability of hip flexion, and hip extension because of decreased strength and instability
Loss of muscle mass in the quadriceps (front of thigh) is one of the first noticeable places. Hello, knee replacements!
Grip strength changes. Dead hangs from a bar are a great way to access where you are with grip strength. Women should be able to hang from a bar for 30-60 seconds and 60-90 seconds for men.
Difficulties in daily tasks. Getting out of bed, laundry duties, gardening, house chores, etc.
Having to hold railings and assistance with arms to get up and down from a seated position.
Inability to squat down. This can be a reflection of something going on in multiple areas. The ankle, knee, hip, and/or low back. Moving the body into underuse direction.
Quality of life could depend on finding the time for strength training. Yes, we can build and maintain muscle as we age. Start with baby steps and gradually amp up the workout volume with weight, reps, and sets, and the body will adapt to strength and endurance. But it has to be done consistently as we age, especially after crossing that 50-year-old timeline. The standard recommendation is 2-3 times per week, but five times per week is preferable, mixing up the routine. Let us stay away from those weight machines in the gym, too. Free weights, barbells, and bodyweight exercises are best. The core shuts down when sitting in a machine, and muscles work closer in isolation. Ideally, you want to keep the core and the nervous and vestibular systems engaged while doing resistance exercises to add a whole-body strengthening effect. It slows the aging process while decreasing the risk of falling traumas.
Think of pushing and pulling as it relates to everyday activities. Keep it structured, challenging, and purposeful without overwhelming the body. Examples are pushing and pulling a sled, Sumo deadlifts, and split squats. Other options include dumbbell shoulder presses, shoulder abductions, adductions, flexions and extensions, walking lunges, etc.
I recommend finding a trainer to help with strength while gaining mobility (or maintaining it). The trainer needs to understand the benefit of working muscles and joint health to design a routine to improve the range of motion and stability of ligaments within the joints. Too much thought goes into muscles only and neglects to strengthen at length with natural movements. That's where improvements or shifts need to happen in the fitness world. One of my favorite quotes comes from a trainer who has trained more Olympic medalists than any other trainer:
"Strength is gained in the range it is trained." -- Charles Poliquin
Don't forget the protein. It must be consumed for the strength training demands. If not, the process of building muscle mass will be dramatically slow. Older men often experience a phenomenon called anabolic resistance, which lowers their bodies ability to break down and synthesize protein. But when a consistent resistance program is implemented, the body will crave protein and anabolic resistance can be turned around.
Protein intake needs to be much more than the typical standard diet. A rule of thumb for daily intake is 1 to 1.3 grams of protein per kilogram of body weight for older adults who do resistance training. For example, a 175-pound man would need about 79 grams to 103 grams per day. Yes, that's a wide range. Everyone is different, so find the amount that is appropriate for you. Divide your protein throughout your daily meals to maximize muscle protein synthesis. Consider consulting with a dietician or nutritionist to discuss your food tolerances. This saves time through trial and error. Once you have established your new habit, making dietary choices is easy.
Now that you are implementing a resistance program and eating more protein to combat sarcopenia, we should address sleep. This is where gains are made for muscle. The body repairs and prepares for the next day during quality sleep, about 8 hours each night. However, many people suffer from insufficient sleep, which compromises muscle regeneration. Sleep disorders, therefore, can contribute to sarcopenia too. While sleeping, there is a significant effect not only on metabolism but also on hormones. Short sleep duration or sleep deprivation reduces the secretion of growth hormones (insulin-like growth factor-1) and testosterone and can also increase cortisol levels. Reducing growth hormones and testosterone may decrease muscle protein synthesis and enhance muscle protein breakdown. In addition, short sleep durations can induce low-grade inflammation. This has been proven to be related to sarcopenia through oxidative stress. Oxidative stress, the imbalance between free radicals and antioxidants in your body, has been proven to contribute to age-related reduction in skeletal muscle function, leading to a greater risk of sarcopenia. In short, poor sleep patterns ruin all the hard work of training and proper diet.
I hope this ignites your desire to take the necessary steps to maintain muscle mass as you age. Prescriptions for resistance training should be the new normal. After you gain muscle and maintain it, you might be surprised by how other parts of your life become easier. It's never too late to start, and your body will thank you for it.