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Victoria Musheff: Eric?

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Victoria Musheff: He shows how to use the cell phones.

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Victoria Musheff: It's like… So, no.

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Victoria Musheff: I'm not lying.

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Victoria Musheff: So, it is that spot. Even though there may be some more people that are coming online, or whatever, so, can everybody hear me okay?

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Victoria Musheff: Give me a… if you can hear, just give me a thumbs up.

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Victoria Musheff: I got a nod. Okay.

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Victoria Musheff: Most of you know Dr. Karen Kemper, and this is her second in a series of programs, and she's getting ready to do a pilot study with a group of emeritus faculty as well. But Karen's going to do some things with us today that I think will be very helpful.

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Victoria Musheff: And we're looking forward to the program, and you're still on balance and exercise, right? And so, for those… and I think everybody here knows her, and I think most of y'all are here with us for the last meeting, too. So, Karen, I'm going to turn it over to you. Since you're walking around, I wonder…

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Victoria Musheff: Yeah, just to help everybody, and… Yeah, there's a little…

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Victoria Musheff: I have a little bit of a plug for Stacy to start talking about. It's hard to tell by following you.

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Victoria Musheff: Perfect.

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Victoria Musheff: Yeah, you do have a softer…

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Victoria Musheff: volume, and I figured that was Yverse. Yeah. Okay, now…

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Victoria Musheff: Please help me just move that step aside.

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Victoria Musheff: This is just in the mic. Can you hear us okay on it?

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Victoria Musheff: It'll take me… yeah. All right, thank you, thank you.

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Victoria Musheff: But, I mean, I've given 7 of this.

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Victoria Musheff: Because of Ben's right now.

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Victoria Musheff: So… Okay, let me do one more count.

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Victoria Musheff: Yeah, just…

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Victoria Musheff: There you go. There you go. Perfect. There you go.

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Victoria Musheff: Hmm, okay, can everybody hear me okay with this?

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Victoria Musheff: Okay, thank you. And can you guys hear me okay? I can't…

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Victoria Musheff: I've got a bucket on my head.

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Victoria Musheff: Now, you guys can't see me yet, but pretty soon we will.

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Victoria Musheff: So I'll start over here.

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Victoria Musheff: We… So…

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Victoria Musheff: And can we get a PowerPoint up? Yeah. So, welcome everybody. I'm doing a few things today where I'm going to move around a little bit, so hopefully our cameras will allow our online folks to be able to see what I'm doing.

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Victoria Musheff: As well as the folks here in person will easily be able to see what I'm doing. I'm going to have you do a couple things with me, and…

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Victoria Musheff: knowing that I've got people in Zoom land that I can't ensure your safety.

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Victoria Musheff: Probably most of it will be seated.

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Victoria Musheff: just for now, but it can give you some ideas of some things. So, just to start out with.

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LINDA NILSON: Let's start out with.

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Victoria Musheff: Yay!

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LINDA NILSON: Can't get rid of this.

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Victoria Musheff: Got a little feedback between maybe these two mics.

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Victoria Musheff: Let's turn that off.

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LINDA NILSON: Go ahead, got to send you a mic.

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Victoria Musheff: It's the computer over here at the center of the

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Victoria Musheff: I don't think we're logged in, though.

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Victoria Musheff: I don't think so. I'm gonna move away. Does that…

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Victoria Musheff: That sounds better, if I'm not so close to this other mic. Okay, so, is there a way…

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Victoria Musheff: Can they see me walking around? They cannot see you right now, unless I switch cameras, which I can do. Let's go ahead and switch me to the… not the podium, and that way I'll just… I'll stay put.

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Victoria Musheff: Yeah.

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Victoria Musheff: And let me just see if… I want to make sure I see what they're seeing, and then I can just go from there. All right. So if I'm near the chair, they can kind of see me, right?

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Victoria Musheff: Okay. All right, guys. And so, in Zoom land, just let me know if you can't quite see me, if I'm moving around, or you're not really sure what I'm doing. We won't do a lot of that, but when we do that, I want to make sure it's easy for you to at least see it

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Victoria Musheff: And maybe even do it with me. So, for today, Let's see… I never call.

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Victoria Musheff: Maybe I haven't turned it on. No, you just have me here.

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LINDA NILSON: What's going on? It's starting.

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Victoria Musheff: Now, is… can I move that with this device? Yes, you should be able to forward now. Give it a try. Give it a try.

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Victoria Musheff: And maybe I'm using the wrong thing? No, you're fine, Kim.

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Victoria Musheff: But… But it isn't working. It isn't. -

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Victoria Musheff: Kind of strange, I don't know why that is. I'll have it in the computer. I'm wondering if it's on. It is.

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Victoria Musheff: Because there's no light or anything. Okay, just… I did, I moved it over.

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Victoria Musheff: Now, I just did… did I do that? Yes. Okay, I just need to go back. All right, all right. Look at all of us cognitively being nimble.

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Victoria Musheff: Okay, so today.

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Victoria Musheff: I'm going to do an overview, a little bit of fitness in general, but focus on strength and balance, because it is particularly important for us as older adults. Not that the aerobic part isn't important, but you're probably more familiar with that. I'm going to talk a little bit about

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Victoria Musheff: Changes that we're experiencing to help you understand

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Victoria Musheff: maybe why things are changing, why things seem harder.

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Victoria Musheff: And then, some of the benefits of physical activity, a little bit of how we

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Victoria Musheff: Can mitigate a little bit of the effects of aging through physical activity, and then we'll look at some strategies.

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Victoria Musheff: Very basic strategies, as Debbie pointed out, we're doing a balance class starting in March. We're really excited and scared, because it's new.

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Victoria Musheff: And whenever you've never done a show before, you never know how it's gonna go. But we're very excited, too, to explore this strategy where we're focusing on balance and strength

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Victoria Musheff: In a group setting. So, in past classes, it's been mostly, cognitive, change with a little bit of movement. Now, this class would be mostly movement, with a little bit of cognitive and education. So.

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Victoria Musheff: Oops.

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Victoria Musheff: just to do a review of the guidelines. So we all kind of know these guidelines. I guess kind of know. I know them because I have to do work in this area, but this message has been out there, and, basically telling adults, we need to accumulate about 150 minutes a week.

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Victoria Musheff: Ideally of aerobic activity.

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Victoria Musheff: And engage in at least 2 days a week of strength activity.

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Victoria Musheff: Now… How many of you guys accumulate 150 minutes?

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Victoria Musheff: Good? Good? Good?

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Victoria Musheff: How many are doing strength activity twice a week?

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Victoria Musheff: Not so much. A little bit. So, it's not quite as…

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Victoria Musheff: easy as, like, being aerobic and taking a walk and getting out and doing things. So we have to probably plan for a little bit more.

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Victoria Musheff: We also need to sit less. That's a big problem for us.

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Victoria Musheff: For older adults, we build on those two recommendations of aerobic and strength that say we need to now incorporate balance activities.

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Victoria Musheff: into our routine. And that also acknowledges that as we get older, there are more possible restrictions and conditions that may need to be acknowledged

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Victoria Musheff: to temper these recommendations. So I'll say somebody who lives with a chronic illness

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Victoria Musheff: And some of… and I'm lucky I'm able to do 150 minutes, but some of my peers with this same illness could never do that. So it could be very discouraging when you're dealing with either chronic illness or

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Victoria Musheff: Limitations biomechanically, That you can't accumulate these 150 minutes, so…

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Victoria Musheff: There's an emphasis on adjust to what you can do.

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Victoria Musheff: Anything is better than nothing. So, look for what you can do comfortably and consistently.

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Victoria Musheff: And if you could do 150 minutes, that's great. Now, if you do vigorous exercise, which some folks might, you don't have to accumulate as many minutes, it's 75 minutes.

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Victoria Musheff: But we do see in research that people are less likely to stick to vigorous aerobic programs, more likely to stick to a moderate intensity program. We'll talk a little bit about what that means.

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Victoria Musheff: These would be examples of activities that would be aerobic.

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Victoria Musheff: and strength training. This is not new to you, you're familiar with this, but what's important to think about is what

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Victoria Musheff: is a moderate activity for some people would be vigorous for others, and so you really have to adjust the level of workload to where you are, you start at the starting point, not at the finish line.

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Victoria Musheff: And you need to…

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Victoria Musheff: Also, acknowledge any changes or adjustments you need to make because of chronic conditions. So what do we mean by moderate? So this is our scale, called the Rating of Perceived Exertion Scale, and it is the…

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Victoria Musheff: tool that we use to allow a person to subjectively evaluate how hard they think they're working. Now, you can have scale… you might see in cardiac rehab or physical therapies different types of scales. This one is just a simple, user-friendly 1 to 10 scale.

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Victoria Musheff: So… Does this have a pointer? Is this… or is this the pointer? Okay.

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Victoria Musheff: So…

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Victoria Musheff: When we see recommendations, we usually see this term, moderate activity. This is something that you could do for extended periods of time, and still could talk.

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Victoria Musheff: Maybe not, you know, a lecture, but you could talk comfortably, have a conversation with your neighbor.

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Victoria Musheff: When you move into vigorous.

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Victoria Musheff: This is where the workload becomes a little more difficult, it's a little less comfortable, and while you can speak, you might not easily speak complete sentences continuously. So what that means is you're breathing harder, and it's just harder to speak. We think of that as the talk test.

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Victoria Musheff: Now… The goal is to consistently

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Victoria Musheff: engage in moderate activity. If you could do vigorous, you may… that might be important to you.

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Victoria Musheff: for your recreation and your hobbies, etc, but most folks need to at least get to moderate. So if we're not even doing moderate, don't even worry about vigorous. That's… and maybe not necessary.

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Victoria Musheff: Unfortunately.

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Victoria Musheff: Lots of folks are doing nothing, and so they can't even start at moderate, so they may just start at light activities.

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Victoria Musheff: And that's where they would start to build their ability

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Victoria Musheff: to move to a little bit harder levels, or more challenging levels of work. Now, why do we have to have this kind of subjective

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Victoria Musheff: Way to rate how hard we're working.

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Victoria Musheff: If…

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Victoria Musheff: as we get older, our capacity is smaller, and so I like to use this reference of these boxes. So, you can think of it like a bank account, too, like, $100. Got $100, and in your 40s, you had, like, $100.

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Victoria Musheff: And if you… let's say you run a mile, just for easy reference, you run a mile.

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Victoria Musheff: That takes a certain amount of energy, regardless of how old you are. It's moving your weight over a distance. It takes a certain amount of energy. But when you're younger.

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Victoria Musheff: It's only taking, like, not quite even half of your capacity, doesn't feel so bad.

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Victoria Musheff: So maybe somebody's taken $40 from you, doesn't feel so bad.

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Victoria Musheff: As we get older, our capacity is much smaller, so that same workload Is now taking

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Victoria Musheff: quite a lot of our capacity, maybe, like, 85%, it feels harder. It's the same work.

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Victoria Musheff: But we have less, so it's like if you had $50 now.

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Victoria Musheff: And somebody's taken 40, you're saying, wait a minute, that's…

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Victoria Musheff: We're getting to the… it's too much.

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Victoria Musheff: So, that's just the natural course of aging. Now, how much your capacity changes, how steeply that declines, depends on a lot of things. We'll talk a little bit more about that.

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Victoria Musheff: But part of what I want you to think about is when we're talking about moderate, that can apply also to strength training, how hard you push yourself.

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Victoria Musheff: And what's safe for you?

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Victoria Musheff: So I asked you guys how many are meeting physical activity recommendations. Well, we're kind of a unique group, because we…

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Victoria Musheff: People who have higher education levels tend to be more active, more likely to comply with recommendations, but research has shown that

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Victoria Musheff: Before the pandemic, only about 23% of adults were meeting the recommendations of both aerobic and strength training.

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Victoria Musheff: Now, about 31%, at least in South Carolina, we do a little better, but not… it's not dramatically different. But we've had good improvement

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Victoria Musheff: in the number of folks meeting guidelines, so we've seen a good trend there. It's still only a third. You know, it's not like…

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Victoria Musheff: We can't give ourselves too big of a pat on the back, but it is improving, so that's good news.

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Victoria Musheff: When we ask folks How many people are participating in balance activities.

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Victoria Musheff: It's a little better. 40% say they've done at least one kind of balance challenge in the past year.

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Victoria Musheff: And about a quarter do something about 3 days a week.

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Victoria Musheff: That… I don't really have trend data on that, so that's kind of where we more or less, are.

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Victoria Musheff: And that recommendation to older adults hasn't been out as long as the 150-minute recommendation, so it may not be quite

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Victoria Musheff: is… People may not be as aware, but also not sure what to do with it.

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Victoria Musheff: Versus walk. That's an easy recommendation.

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Victoria Musheff: Now, the bad news is, is when we ask people, you know, how many of you are doing nothing?

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Victoria Musheff: basically sedentary.

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Victoria Musheff: That rate is also,

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Victoria Musheff: about 31% of the population prior to the pandemic, and it does, unfortunately, seem to be trending in the negative direction. There are a lot of things

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Victoria Musheff: That contribute to that, technology, convenience, so there's a lot that contributes to it.

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Victoria Musheff: But this is… this needs to be considered independently of how active you are.

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Victoria Musheff: And that's because of this graph. This is a old… this is kind of old data, but I love this…

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Victoria Musheff: The report of this data, this is looking at, mortality rates, all-cause mortality, When we consider

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Victoria Musheff: How active somebody is, so if they go from 0 minutes a week to 300 plus.

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Victoria Musheff: And with these colored bars, how much are they sitting? From up to about 4 hours, to 4 to 9, and let's see if I see my range… 4 to 8, and 8 to,

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Victoria Musheff: 11 and 11 and more. So, progressively more hours seated, which is kind of disturbing, isn't it? It's like hours seated. There are people who are getting 11 hours of seated time.

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Victoria Musheff: So, what's important to recognize is there are two factors at play here.

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Victoria Musheff: We have the benefit of being more and more active, spending more minutes of activity. So we see these mortality rates go down the more active you are.

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Victoria Musheff: And we see the rates go up the more you sit.

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Victoria Musheff: Regardless of how active you are.

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Victoria Musheff: So, you can't just assume if you go out and accumulate 150 minutes a week of exercise, but then sit 11 hours.

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Victoria Musheff: that they're… that you're in the clear. That…

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Victoria Musheff: one, you know, bout of exercise a day is not going to counteract the 11 hours of seated time. So we have to acknowledge both, and again.

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Victoria Musheff: part of what I think is an important message, if you have a chronic condition where you think you cannot accumulate 150 minutes of aerobic work a week.

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Victoria Musheff: You can get a huge benefit, so if you can do a little bit of something.

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Victoria Musheff: Get a huge benefit by sitting less, or interrupting seated time.

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Victoria Musheff: Get up. Every commercial, get up. Put it on your watch. Don't sit more… certainly don't sit more than an hour without interruption. Get up. Move around 5 minutes, sit back down. But this seems to be very helpful. So if you have a chronic condition, it's… or…

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Victoria Musheff: biomechanical limitations. Just getting up

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Victoria Musheff: And moving around a little bit before you go back to seated time will be helpful.

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Victoria Musheff: Ideally, though, you can see some of that sweet spot, is if you can get about 150 minutes.

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Victoria Musheff: And, lower seated times, the…

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Victoria Musheff: The benefit's pretty strong, but the biggest gain is going from nothing to something.

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Victoria Musheff: Yes, your big… just do something!

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Victoria Musheff: Thank you.

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Victoria Musheff: But you should never be seated for… you should get it every hour. Right, and every 30 minutes would be better, but that might not be realistic.

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Victoria Musheff: 30 minutes, you should… Get up? Yeah, get up, go get some water, let the dog out, something… interrupt it. So the… kind of the way I've heard it phrased is the best posture, the best position is the next position.

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Victoria Musheff: So you don't want to stand still long periods of time either. That's actually not good. It's being stationary. So standing for

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Victoria Musheff: long periods of time. That's why I have some concerns about those standing desks. That's okay, except you're not moving. So it'd be better to get up and down, or at the standing desk, break… take a break from that, too. Move. Don't just be stationary.

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Victoria Musheff: So that's kind of our frame.

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Victoria Musheff: So, benefits, and you're probably very familiar with them.

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Victoria Musheff: But we can think about them as immediate and long-term benefits. So…

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Victoria Musheff: With one bout of exercise, one walk, Your sleep that night.

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Victoria Musheff: is much more likely to be improved. I can't guarantee, because I don't know all the other factors going in your life, but the research shows that one bout of exercise does seem to biologically improve your sleep quality that night.

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Victoria Musheff: also improves mood, and improves blood pressure. We also know that it does improve glucose management as well. One bout of exercise. Now, it's not enough.

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Victoria Musheff: To reverse you out of a diabetes, but it shows that the body is quite responsive.

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Victoria Musheff: In a positive way, to physical activity. So you can imagine, too, it's…

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Victoria Musheff: It also responds, in a negative way, to motionlessness, seated time.

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Victoria Musheff: The long-term benefits, I think you guys are probably familiar with. It's very protective.

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Victoria Musheff: And people who are more physically active tend to have lower risk for chronic illnesses, lower risk for some of the negative effects of aging. What it does is slows it. It doesn't stop it, but it slows it.

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Victoria Musheff: Now, this is one of my favorite slides. Very geeky. Sorry. I want you to love it too, though. And this is why. This is, you know, this is a muscle, and muscles, like all the other tissues in the body, they produce communicators. They're called myokines for muscle. For fat, they're called adipokines.

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Victoria Musheff: Various myokines are produced by the muscle just by the muscle contracting.

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Victoria Musheff: just by… Doing its job.

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Victoria Musheff: And it's producing these chemicals that protect

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Victoria Musheff: Mood and these neurological pathways, decreases inflammation, promotes vascular health, improves the microbiome, improves your ability to use insulin.

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Victoria Musheff: It promotes a healthier, state with the metabolic systems, the mitochondria.

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Victoria Musheff: Bone health, and lipids, just by moving. And that, to me, is fascinating.

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Victoria Musheff: That that's the big payoff, is the muscles are contracting and giving us all this great stuff.

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Victoria Musheff: And when they're not contracting, And the fat cells get a little fluffier, they're producing stuff, too!

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Victoria Musheff: that are counter to this. They are promoting inflammation, they're interfering with healthy vascular health.

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Victoria Musheff: So, this is why doing something, moving your muscles, do something, it's really beautiful, and I hope you will love this slide.

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Victoria Musheff: As much as I do.

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Victoria Musheff: Still to compare.

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Victoria Musheff: Now, talk about…

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Victoria Musheff: some of these changing… changes with aging, we think, what is aging? So we can define age as chronological, or functional, and we're kind of focused on the term biological age. So chronological aging is how many years you have.

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Victoria Musheff: That's certainly an important metric. I mean, the longer you're on Earth.

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Victoria Musheff: Like, things happen, and there's, you know, things get…

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Victoria Musheff: worn out, and also that there are phases in our development, even as into late adulthood, that mark changes that come with certain time periods. But biological age is probably more important in terms of our function, and that's capturing the wear and tear on our bodies.

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Victoria Musheff: This is gonna explain why you have somebody

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Victoria Musheff: Who's the same age as you, that seems a lot healthier, or younger, or not.

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Victoria Musheff: You go to those, you go to those reunions, those high school reunions, you start looking around, right, like.

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Victoria Musheff: Some of you guys are, like, doing great, and some…

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Victoria Musheff: look like they've had some wear and tear. And then you wonder about yourself, like, how do I look? I look at everybody.

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Victoria Musheff: But what's important is that biological aging is influenced by a lot of different things. Some that you can control, some you can't.

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Victoria Musheff: But this is gonna be something that… to keep in mind as far as… how can I slow

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Victoria Musheff: The rate of decline of some of the changes we see biologically with aging.

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Victoria Musheff: So we… We've aged, and we see this varying amount of change over lots of different systems.

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Victoria Musheff: And lots of factors, genes, epigenetics, which to me, epigenetics is so…

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Victoria Musheff: fascinating, and that's the influence and interaction between the genes and the environment may switch on

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Victoria Musheff: Risk factors, switch off risk factors that might

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Victoria Musheff: Create, be protective or counterproductive.

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Victoria Musheff: I have in this box all the things that are affected by aging.

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Victoria Musheff: Like, this is where… Getting older and an accelerated wear and tear will impact these levels of function.

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Victoria Musheff: And a lot of this has to do, you know, with your ability to engage in physical activity, how hard things will feel like they're working, your risk for injury.

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Victoria Musheff: It's also important, you know, we can pat ourselves on the back a lot, like, oh, I'm doing really good, I work out, I'm… you know, if you just work out, you'll have all these benefits. But we do know that the social determinants of health also play a role here, and that means

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Victoria Musheff: Sadly, That some of the things you were exposed to

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Victoria Musheff: Prenatally, as well as in early childhood. Some of these changes will persist into adulthood, no matter how

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Victoria Musheff: healthy you act in later periods, some of the epigenetic changes persist, so you still would have increased risk of heart disease, still have maybe increased risk of some things.

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Victoria Musheff: that are negative that you wouldn't have had if you didn't have those early childhood experiences. So.

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Victoria Musheff: We should have…

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Victoria Musheff: give people grace and be compassionate. We didn't all have the same history, so we have… we're dealing with different decks of cards and different, circumstances.

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Victoria Musheff: So here's some things that change. You know these?

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Victoria Musheff: We're all experiencing it, and we could probably all… we could probably fill out a card, and it would all match this. What we see is an increase in some negative things, like loss of tissue, loss of tissue function, edema, we see changes in our nervous system function.

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Victoria Musheff: Precancerous, mean little cells get started in some places.

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Victoria Musheff: Joint degeneration, and we see more adiposes, who are fat cells.

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Victoria Musheff: Get a little bigger.

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Victoria Musheff: Our muscle cells get a little smaller, and our weight might not actually change a lot.

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Victoria Musheff: And yet… There seems to be more Fluffernutter down here on the way, smiling.

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Victoria Musheff: That's because of those body composition changes. Now, that can happen slower, faster, and actually, you can reverse some of that to some extent. You don't need to change it a lot to get health benefits, so you don't feel like you have to go back to your 40s.

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Victoria Musheff: We see decreases in some of the good things, like how, the… the lack of stiffness of tissues or elasticity.

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Victoria Musheff: With, our ability to communicate to our

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Victoria Musheff: nerves. Now, I was… I was at an OLLI class cheese tasting, and so I was walking out with some of my friends after that, the class at OLLI, and…

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Victoria Musheff: We were talking about… I was talking about the work we're doing with this balance stuff. I said, now, how many of you know how to skip? How many can skip now?

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Victoria Musheff: And… and so you try, like, you're trying to do the skipping, and you think, I don't even know how to tell my body to do this anymore. That's a communication change. You could reverse that. You might not be pretty, you know, it might not be the best, but like you were when you were 5.

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Victoria Musheff: But, this ability to, communicate

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Victoria Musheff: Quickly and effectively to the muscles changes.

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Victoria Musheff: That also makes us more vulnerable to mishaps. If we trip or fall, or we need to hit the brake really quickly, that this might influence

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Victoria Musheff: our ability to do that. So, I also want to mention posture. Mmm…

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Victoria Musheff: Posture. We probably didn't… maybe we never had really good posture ever, right? Because our lifestyles tend to be like this, right? We're like this with everything. Driving the car, we're going to the computer. But, we see a change in posture. As our muscles get weaker, we kind of collapse in.

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Victoria Musheff: We kind of round the back, head goes forward.

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Victoria Musheff: The pelvis changes its alignment, so these things are counterproductive.

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Victoria Musheff: And don't make it… make it harder for us to maintain balance, actually.

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Victoria Musheff: So, for some more bad news, and we're gonna… we're gonna pivot really quickly. So… so…

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Victoria Musheff: To focus just on muscle, what are the things we see is, you know, we see a change in some muscle function.

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Victoria Musheff: Approximately about 10% decreased function per decade.

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Victoria Musheff: That's sneaky.

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Victoria Musheff: It's like, 1%.

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Victoria Musheff: a year. You don't notice that. It's not till the high school reunion 10 years later that you really feel the cumulative effect. I would say the same thing is with weight gain. Average…

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Victoria Musheff: On average, Americans gain about 1 to 2 pounds of fat a year.

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Victoria Musheff: Well, you don't notice one, right? But it…

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Victoria Musheff: At the 20-year reunion, you notice 20. It… but it creep… it sneaks up on you.

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Victoria Musheff: Yeah, vicinity, yeah, because you could be that co-founder, yeah. So,

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Victoria Musheff: So this is a kind of, on average, the rate of decline for endurance and strength.

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Victoria Musheff: And if you're not engaging in Resistance, strength activity, As an adult, older adult.

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Victoria Musheff: You're going to see loss of actual lean tissue, so declines of several pounds.

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Victoria Musheff: I saw that, I work with a physician, she did a body comp recently, or the past couple years.

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Victoria Musheff: I saw how much my muscle mass had declined. It was very disturbing.

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Victoria Musheff: Because this is not something you're checking regularly. But it's happening, unless you're doing weight training. Even if you do weight training, because you're getting older, you'll have a decrease. It'll just be much more gradual.

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Victoria Musheff: Not nearly as dramatic.

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Victoria Musheff: And what I always love to tell the students, all this starts 25 to 30, so…

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Victoria Musheff: Don't be so proud. It's just so slow, you don't notice it. And then women, when they go through menopause, some of this stuff gets accelerated for a period of time.

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Victoria Musheff: Because their hormones are changing, and that's gonna change body composition and bone health.

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Victoria Musheff: We also see changes in coordination and the ability to talk to those muscles. The nice thing is.

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Victoria Musheff: Is that… By practicing talking to the muscles, we can reverse a lot of this. So…

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Victoria Musheff: So lots of things are contributing to this. This is just a huge inventory of things. I want to emphasize nutrition, because

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Victoria Musheff: It's easy to drift into a less optimal diet, and so you may or may not realize you're…

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Victoria Musheff: not quite getting the amount of protein you need, or the variety of vitamins and minerals you need. I'm not talking about, you know.

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Victoria Musheff: out of the norm excessive amounts, but you should at least, for older adults.

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Victoria Musheff: I'm gonna use this frame of reference. In March here, you can correct me, too, if you hear some things differently.

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Victoria Musheff: that, in general, I hear that you should get… sorry, 1.1…

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Victoria Musheff: grams per kilogram of body weight if you're an older adult. Now that, you… it's in kilograms. Divide your weight in half for a rough estimate.

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Victoria Musheff: And then it would be 1 gram per that… those pounds.

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Victoria Musheff: It could be higher, and I'm seeing some things, and there's certainly a lot of messages about being higher, but one of the things I want to stress is I'm seeing some of the benefits of higher, but they don't talk about the risk.

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Victoria Musheff: I see researchers who talk about the risk of higher protein intake, they don't talk about the benefits. So we don't quite have a good communication. We need to be careful. It's not without risk.

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Victoria Musheff: to change that dramatically. You need to understand what your renal function's like, calcium health.

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Victoria Musheff: Things like that before you start making big changes.

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Victoria Musheff: And then, over here, inflammation. So as we get older, we're more likely to have inflammation.

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Victoria Musheff: And this is, you know, very counter…

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Victoria Musheff: This is destructive at all levels.

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Victoria Musheff: You need inflammation, by the way.

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Victoria Musheff: You just don't need chronic inflammation. You need acute inflammation, your body needs to respond to a challenge and to infection. The problem is when it gets stuck in the on position, and it's just all the time. That's when it gets destructive.

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Victoria Musheff: Oh, I thought it was going to be closer to the good news, sorry. Sorry, I want you to get to know this term, sarcopenia. How many people have heard of sarcopenia?

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Victoria Musheff: Good. And anybody in Zoom land, have you heard of sarcopenia? We have. Good. So, sarcopenia is like, to muscles, what osteoporosis is to bones. And we're studying it more, and trying to understand it more in terms of

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Victoria Musheff: kind of like the red flag where intervention is needed. And it describes, degeneration in muscle as it relates to its mass and function, and the composition of the types of fibers.

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Victoria Musheff: It's actually difficult to measure, it's not an easy thing to measure. They haven't quite worked that out, and that's why you're not necessarily seeing mass screenings.

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Victoria Musheff: But… It is something that the, at a clinical level, is being considered.

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Victoria Musheff: It's not necessarily population health screening level yet.

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Victoria Musheff: It is considered a precursor to frailty.

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Victoria Musheff: And there are things you could do to reverse that. I know I've done some talks for scleroderma for the community I work with.

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Victoria Musheff: And I've seen studies where correction of malnutrition

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Victoria Musheff: improve their sarcopenia status. So that's why I think looking at your diet is going to be important, as well as looking at your movement habits.

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Victoria Musheff: And it's estimated about 13% of adults over 60.

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Victoria Musheff: Have sarcopenia, and that's higher if you have a chronic condition.

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Victoria Musheff: And probably higher when you have people who are really inactive.

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Victoria Musheff: So, you know, when we look at these numbers, like a percentage, like, that's a… it gets watered down about different levels of risk.

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Victoria Musheff: And also, remember I told you, it's not easily measured, so you have to take some of those numbers with a grain of salt.

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Victoria Musheff: It will get better.

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Victoria Musheff: Okay, there's the good news.

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Victoria Musheff: I only have one slide for that, but it's… it's powerful. So, it's never too late to benefit.

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Victoria Musheff: Regardless of the age.

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Victoria Musheff: If you start weight training, walking, balance training, you will see improvements. The body doesn't… doesn't forget how to do that. You may… you won't reverse yourself back to 40.

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Victoria Musheff: But you will see improvements, you'll get stronger, your balance will improve, your endurance will improve.

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Victoria Musheff: even… so some of the studies I read was like, even in your 80s, you can see!

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Victoria Musheff: Positive change, it's never too late to start!

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Victoria Musheff: But that's important, because you may feel like, what's the point? Well, There's a big point.

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Victoria Musheff: Even if you just… so you guys see some of these recent, research reports about even 5 minutes, like, we're really trying to… even 5 minutes a day!

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Victoria Musheff: You can see a measurable change, and that's because you're going from the nothing to something, and that's where you get the biggest bang for your buck.

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Victoria Musheff: If you're doing nothing, do something, you're gonna get a big, bigger return.

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Victoria Musheff: And we also know…

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Victoria Musheff: use it or lose it. This… a lot of these changes are hard to tease out from being older.

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Victoria Musheff: To just becoming sedentary.

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Victoria Musheff: Very hard to tease out some of that.

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Victoria Musheff: And I know, I don't know, not my grandparents, but my great-grandparents were, like, farm people.

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Victoria Musheff: And they…

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Victoria Musheff: you know, they would think… when they cleaned the house, it was like, we're washing the walls, like, okay, I was just getting my little duster. I'm tired. So, we know that people probably were a lot more active in our ancestor, like, they were much more fit than we were.

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Victoria Musheff: Yeah, they… yeah, they… they didn't have… I remember the story of my great-grandmother, you know, they had big families, and she'd portion out the food, and everybody would get something on their plate, and she'd say, just enough. Now, it didn't matter what you got, everybody got something. You said, just enough.

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Victoria Musheff: But also, the…

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Victoria Musheff: you… so when you do these activities, I do want to emphasize, you need to find something That's reasonable.

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Victoria Musheff: Because it only works if you do it. You don't store fitness. You gotta… you gotta have a routine that you can regularly participate in.

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Victoria Musheff: And I would also say that it allows you a little variety, because we know people get bored, too.

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Victoria Musheff: And if you're trying to improve things, you'll have a plateau, and you'll need to have a little variety. The brain likes that, if nothing else. But in-store fitness, how quickly do we lose it? Well, I'll give you some proport… you lose…

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Victoria Musheff: You start to lose the… Indicators of fitness gains.

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Victoria Musheff: Three times as fast as it takes to get them.

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Victoria Musheff: So the… the loss is fast. It takes… it takes a while to build a house, easy to tear it down.

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Victoria Musheff: When I'm walking outside.

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Victoria Musheff: Because when I'm walking outside, I'm going up at the small gradients of the things, and if I miss, like, with the snow and ice, I miss 3 days being outside walking. So when I went back out for the same distance I've been doing for 3 years, 3 or 4 years.

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Victoria Musheff: I'm short of breath this time. Yeah. But it's a… it is…

323
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Victoria Musheff: It hadn't been that long. I mean, it's not like I didn't do something in the house, but just that elevation shift outside, there's a difference in the… So, one study I read

324
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Victoria Musheff: They were able to detect a change in some of the aerobic metabolic enzymes.

325
00:39:17.830 --> 00:39:21.570
Victoria Musheff: Decreased within 48 hours of doing nothing.

326
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Victoria Musheff: Now, it wasn't enough that you would feel it, but it was detectable. So it just shows that the body's like, well, we're not using this. We don't need to make more enzymes, we don't need to invest in this.

327
00:39:33.390 --> 00:39:49.259
Victoria Musheff: told me that for every day you spend in the hospital where you're doing nothing except a lot of them, it takes a week to get it back. I would… that… and I'll tell you, that is a huge scary factor. If you're bedridden, the accelerated lean tissue loss.

328
00:39:49.280 --> 00:39:57.059
Victoria Musheff: Or the lean tissue loss is accelerated from just being, you know, doing nothing but moving around, weight-bearing.

329
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Victoria Musheff: So that's a good reference point. One day in the hospital, a week to recover the… what's lost.

330
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Victoria Musheff: Yep.

331
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Victoria Musheff: Now what I love about this… these improvements… whoop, whoop, wrong one.

332
00:40:11.570 --> 00:40:16.620
Victoria Musheff: One bout of exercise was strength training.

333
00:40:17.640 --> 00:40:21.919
Victoria Musheff: The next time you go, one bout of exercise, so one set.

334
00:40:23.030 --> 00:40:26.470
Victoria Musheff: Come back 2 days later, you're stronger.

335
00:40:26.680 --> 00:40:36.789
Victoria Musheff: It's not because you're stronger, it's the communication is improved, the brain got smarter, so it knew how to talk to the fibers better to get the job done.

336
00:40:37.220 --> 00:40:41.149
Victoria Musheff: So, that's some of your initial gains, which is kind of motivating.

337
00:40:41.370 --> 00:40:44.559
Victoria Musheff: But it's not really strength, it's getting smart.

338
00:40:44.930 --> 00:40:54.770
Victoria Musheff: But that also means when you're not doing stuff, the brain's kind of getting stupid. So, my brother started working out. Now, he's a contractor, he's climbing up on the ladder, lifting 400-pound beams, and he's…

339
00:40:55.160 --> 00:40:59.029
Victoria Musheff: He's working with a trainer, he said, I could hardly sit down the next day.

340
00:40:59.610 --> 00:41:02.639
Victoria Musheff: I said, well, you are…

341
00:41:03.060 --> 00:41:09.619
Victoria Musheff: Use the muscles differently, and the brain in the beginning doesn't know how to talk to the muscles, so it says.

342
00:41:09.750 --> 00:41:11.210
Victoria Musheff: Everybody.

343
00:41:11.320 --> 00:41:15.680
Victoria Musheff: Fire. Every… so even little muscles that shouldn't be doing that.

344
00:41:15.950 --> 00:41:31.429
Victoria Musheff: So they are more likely to be overstressed and have that delayed muscle soreness. I said, but also when you're lifting, like you're lifting that cement bag, you're not lifting it over and over until you can't lift anymore. You lift it one time and you move it. So you have that strength.

345
00:41:31.520 --> 00:41:37.740
Victoria Musheff: But this trainer is pushing you to fatigue, and that has different metabolic consequences.

346
00:41:37.890 --> 00:41:44.350
Victoria Musheff: But the communication is where we see the first improvements, which is kind of fun with balance as well.

347
00:41:44.560 --> 00:41:52.750
Victoria Musheff: It's like you're… waking up the muscles. They're remembering how they're supposed to talk and interact with the brain.

348
00:41:53.980 --> 00:41:58.640
Victoria Musheff: Which is why it would be fun in our balance class. We're gonna do a lot of… Waking up.

349
00:42:00.160 --> 00:42:07.139
Victoria Musheff: Also, You will see with a regular exercise program.

350
00:42:07.360 --> 00:42:16.300
Victoria Musheff: you'll see changes, measurable changes, in 6 to 12 weeks. That's kind of why you always see 6 to 12 weeks. That's kind of the sweet spot.

351
00:42:16.430 --> 00:42:23.060
Victoria Musheff: To get enough training and consistency that you start to see, the physiological changes.

352
00:42:29.360 --> 00:42:31.310
Victoria Musheff: Okay, let's move on.

353
00:42:31.470 --> 00:42:42.610
Victoria Musheff: You should assess yourself if you can. Get, if you can work with a physical therapist or a qualified trainer, that's probably great, because you get a lot of one-on-one attention.

354
00:42:43.190 --> 00:42:47.310
Victoria Musheff: If you don't have that access, I would encourage you to go to this website.

355
00:42:47.710 --> 00:42:52.100
Victoria Musheff: Here, now you guys can… Be smart about this.

356
00:42:52.870 --> 00:43:06.720
Victoria Musheff: These three tests that are starred would be a great way for you to assess yourself. Now, this is on the Steady, which is Stop Elderly Deaths and Injuries website. It's a terrible name, isn't it?

357
00:43:07.190 --> 00:43:07.630
Victoria Musheff: What?

358
00:43:08.410 --> 00:43:19.140
Victoria Musheff: I know! But these three tests are… will tap into a little bit of balance and strength, and then the dynamic of… some dynamic balance movements.

359
00:43:19.400 --> 00:43:23.350
Victoria Musheff: So, the four-stage balance test, it's outlined right here.

360
00:43:23.710 --> 00:43:26.699
Victoria Musheff: And… What it's doing…

361
00:43:27.810 --> 00:43:37.269
Victoria Musheff: Is evaluating how well you can balance as you change your base of support, so you've got your feet together.

362
00:43:37.400 --> 00:43:45.379
Victoria Musheff: See? Now, when we… when we train our students to do this assessment, if somebody can't do this, we don't have to do anymore. We know?

363
00:43:46.380 --> 00:43:47.820
Victoria Musheff: We need to know.

364
00:43:48.040 --> 00:43:50.120
Victoria Musheff: No reason to go any further.

365
00:43:50.330 --> 00:43:52.850
Victoria Musheff: You have problems in New York.

366
00:43:53.190 --> 00:43:57.310
Victoria Musheff: Then you make the basis support a little smaller with this semi-tandem position.

367
00:43:57.840 --> 00:44:01.740
Victoria Musheff: And then the tandem. Now, if you could hold these for 10 seconds.

368
00:44:02.020 --> 00:44:06.409
Victoria Musheff: then your risk for falls is lower. Doesn't mean you don't need work on balance.

369
00:44:06.550 --> 00:44:09.140
Victoria Musheff: But it's saying, hey, you've got a pretty good foundation.

370
00:44:09.360 --> 00:44:13.660
Victoria Musheff: You can raise up on one foot, but that's not really needed.

371
00:44:13.950 --> 00:44:20.159
Victoria Musheff: To pass the test for risk, because standing on one foot is a really different kind of challenge.

372
00:44:21.070 --> 00:44:24.809
Victoria Musheff: But practicing balancing on one foot is a great exercise.

373
00:44:25.040 --> 00:44:29.049
Victoria Musheff: So, the next one is the 30 chair stand test.

374
00:44:29.240 --> 00:44:32.669
Victoria Musheff: And in that test, you're just sitting in a chair.

375
00:44:34.060 --> 00:44:37.350
Victoria Musheff: And you're gonna measure how many times you can

376
00:44:37.450 --> 00:44:54.420
Victoria Musheff: sit to stand in 30 seconds. I don't have the chart handy in my mind, but the more you can do that, and given your age level, the better your lower body strength is. I would… so, the nice thing about this is, you assess yourself.

377
00:44:54.560 --> 00:44:57.510
Victoria Musheff: And then this is how you train to improve.

378
00:44:57.930 --> 00:45:04.999
Victoria Musheff: This movement means… I can live home by myself.

379
00:45:05.560 --> 00:45:07.870
Victoria Musheff: I can get off the toilet by myself.

380
00:45:08.060 --> 00:45:10.519
Victoria Musheff: I could get in and out of the car by myself.

381
00:45:11.280 --> 00:45:16.970
Victoria Musheff: I can get out of a chair by myself. This is one of the most important functions.

382
00:45:17.180 --> 00:45:36.899
Victoria Musheff: that you can invest in as far as strength activities. Let me try that? I mean, because I think it'd be safe if we just pulled our… Yes, and I don't have… I don't have… I don't have the, some things worked in, I do.

383
00:45:40.790 --> 00:45:50.239
Victoria Musheff: So the great question is, how many chair stands do you have today? So let's do that, it's just… I actually will have us do a couple. I have us planning to do a couple.

384
00:45:50.400 --> 00:46:01.069
Victoria Musheff: Now, the timed up and go test, and you do need to do these with somebody spotting you, maybe with the four-stage balance, you could have a wall, that's easy.

385
00:46:01.420 --> 00:46:06.069
Victoria Musheff: Chair stand. If you've got… the chair needs to be pushed up against the wall so you don't…

386
00:46:06.340 --> 00:46:08.000
Victoria Musheff: Fly back into the…

387
00:46:08.180 --> 00:46:18.049
Victoria Musheff: chair and tip over. But the time double go is a little more challenging. And in this test, and you'll see in the instructions, you walk out about 10 feet around a cone.

388
00:46:19.000 --> 00:46:20.130
Victoria Musheff: And back…

389
00:46:21.130 --> 00:46:31.210
Victoria Musheff: And sit. This is, everyday movement, and what it does is look at… and I kind of remember this one, is you do this under 12 seconds, that's…

390
00:46:31.360 --> 00:46:33.379
Victoria Musheff: It means you're low risk for falls.

391
00:46:34.620 --> 00:46:40.179
Victoria Musheff: This captures a combination of things that are important. You get up.

392
00:46:40.360 --> 00:46:44.650
Victoria Musheff: You walk, you turn, come back, turn, sit.

393
00:46:45.130 --> 00:46:51.489
Victoria Musheff: So, your ability to do that comfortably. Now, what we see sometimes with people, Is this, right?

394
00:46:51.820 --> 00:46:53.590
Victoria Musheff: They're not that confident.

395
00:46:53.800 --> 00:46:57.969
Victoria Musheff: And then maybe with the turn, not so confident, right?

396
00:46:58.620 --> 00:47:05.900
Victoria Musheff: So you can learn a lot about what you might need to work on based on how easily you're able to walk back and forth.

397
00:47:06.770 --> 00:47:13.150
Victoria Musheff: The grip strength measure, you have to have a dynamometer for that, don't worry about it, but at your doctor's office, that'd be great if they would do that.

398
00:47:14.750 --> 00:47:22.099
Victoria Musheff: You can also subjectively evaluate how you feel like you're doing for everyday tasks, so this

399
00:47:22.250 --> 00:47:27.770
Victoria Musheff: This says, like, I find it easy to walk up and down two or more flights of stairs.

400
00:47:28.160 --> 00:47:31.289
Victoria Musheff: I have no trouble taking out the trash, just carrying things.

401
00:47:31.870 --> 00:47:35.970
Victoria Musheff: I can do housework such as vacuuming and dusting without difficulty.

402
00:47:37.710 --> 00:47:42.060
Victoria Musheff: Okay, everybody who writes that, you say, now I know you can do it.

403
00:47:43.100 --> 00:47:44.850
Victoria Musheff: No more excuses!

404
00:47:46.200 --> 00:47:52.120
Victoria Musheff: You can easily carry a weighted, like, a gallon of milk or something, about 8 pounds.

405
00:47:52.240 --> 00:47:55.059
Victoria Musheff: Reaching up for something.

406
00:47:56.640 --> 00:48:02.000
Victoria Musheff: Don't have trouble, doing outdoor work like gardening.

407
00:48:02.490 --> 00:48:09.470
Victoria Musheff: then also this subjective of, I feel young for my age, I feel independent, energetic, active, strong.

408
00:48:09.700 --> 00:48:16.359
Victoria Musheff: as active as other people my age. So with that, you're really just… it's a subjective thing. How am I doing?

409
00:48:16.500 --> 00:48:19.409
Victoria Musheff: If you kind of rate yourself across those domains.

410
00:48:19.600 --> 00:48:25.049
Victoria Musheff: Then as you engage in the physical training, you might come back to that and say, does this seem easier now?

411
00:48:25.200 --> 00:48:43.080
Victoria Musheff: Now, this might be a low bar. Many of you are already active. You might say, well, this… this is not so hard for me. Well, that means there's other assessments might be… give you more information, but those might be very basic, too. So that's where working with a physical therapist and trainer

412
00:48:43.150 --> 00:48:46.310
Victoria Musheff: Might help you know how to advance.

413
00:48:46.420 --> 00:48:51.579
Victoria Musheff: to move a little farther. This is very good for beginner self-evaluation.

414
00:48:51.970 --> 00:48:56.449
Victoria Musheff: You might have an easy time with some things and not others, for different reasons.

415
00:48:56.860 --> 00:49:00.249
Victoria Musheff: You know, might have joint replacement, shoulder injuries.

416
00:49:00.440 --> 00:49:01.430
Victoria Musheff: What have you.

417
00:49:02.960 --> 00:49:13.169
Victoria Musheff: when you train, you go to train across all these domains, I'm not going to go into these, but these might be things you hear with somebody who works with you or your physical therapist.

418
00:49:13.410 --> 00:49:15.700
Victoria Musheff: I like to focus on function.

419
00:49:16.060 --> 00:49:19.320
Victoria Musheff: So, to me, like, doing a bicep curl.

420
00:49:20.120 --> 00:49:29.760
Victoria Musheff: by itself is not that important to me. Except I do gardening. So I do need to pick up things. So you want to think about

421
00:49:30.170 --> 00:49:39.629
Victoria Musheff: Exercises that allow you to live the way you want, to have the recreation you want, the hobbies you want, good posture.

422
00:49:41.770 --> 00:49:46.199
Victoria Musheff: So, how do you improve function? This kind of mantra of.

423
00:49:46.750 --> 00:49:49.409
Victoria Musheff: Get up, stay up, and move.

424
00:49:49.580 --> 00:49:53.979
Victoria Musheff: Addresses all those domains, That are in the recommendations.

425
00:49:54.290 --> 00:49:59.410
Victoria Musheff: If you're deconditioned, you haven't been doing something for a while, you should start with strength.

426
00:50:00.080 --> 00:50:03.399
Victoria Musheff: Start with strength, to build up strength.

427
00:50:03.550 --> 00:50:15.340
Victoria Musheff: then focus on balance, and then focus on the aerobic activity. Now, if you're already active, you… you want to say, am I doing all three of these things? You should be doing all three. If you're only doing one.

428
00:50:15.500 --> 00:50:25.240
Victoria Musheff: You need to find ways to build those others into your routine. The reason that we emphasize for a beginner not to start just with, like, go walking, I'm not saying don't walk.

429
00:50:25.480 --> 00:50:27.939
Victoria Musheff: But in order to walk safely.

430
00:50:28.070 --> 00:50:32.170
Victoria Musheff: You have to have enough strength, To… walk?

431
00:50:32.430 --> 00:50:39.390
Victoria Musheff: and enough balance to walk without injury. So if you really decondition, you might overestimate your ability to navigate

432
00:50:39.730 --> 00:50:48.550
Victoria Musheff: Now, you might do it in a safe place, like a fitness place on a track, that's okay, but when you go out in the neighborhood, up and down sidewalks.

433
00:50:49.070 --> 00:50:52.930
Victoria Musheff: You want to make sure you have adequate strength and, balance to do that.

434
00:50:54.800 --> 00:50:57.829
Victoria Musheff: Here's some components to think about with strength training.

435
00:50:58.690 --> 00:51:03.470
Victoria Musheff: I won't go into all these components other than We know that…

436
00:51:03.720 --> 00:51:07.030
Victoria Musheff: How much muscle you have, how trained it is.

437
00:51:07.330 --> 00:51:14.729
Victoria Musheff: What kind of fiber composition? This all influences your ability to generate a maximal force, to lift a weight.

438
00:51:15.420 --> 00:51:18.809
Victoria Musheff: Ideally, you're going to train 2 days a week.

439
00:51:19.370 --> 00:51:23.599
Victoria Musheff: That seems to be the dose that allows muscles to improve.

440
00:51:24.160 --> 00:51:25.839
Victoria Musheff: And heal properly.

441
00:51:26.790 --> 00:51:30.200
Victoria Musheff: You need to allow 48 hours in between

442
00:51:31.850 --> 00:51:38.569
Victoria Musheff: the workout that challenged a certain group of muscles. Now, you could… you could do strength training every day if you did different muscle groups.

443
00:51:38.770 --> 00:51:43.139
Victoria Musheff: But those muscles need 48 hours to rest in between training.

444
00:51:44.230 --> 00:51:47.310
Victoria Musheff: To allow them to repair, heal, and improve.

445
00:51:51.200 --> 00:52:00.450
Victoria Musheff: And frankly, 2 days a week is probably a… you know, you're trying to do all these other things, so 2 days a week is probably pretty good, if you're training the same group of muscles both days.

446
00:52:02.000 --> 00:52:11.949
Victoria Musheff: Ideally, with repetitions, let's say you're using machines, you're not really sure how to judge that, you should lift a weight that you can do comfortably

447
00:52:12.250 --> 00:52:15.070
Victoria Musheff: At least 8 to 10 times.

448
00:52:15.790 --> 00:52:17.840
Victoria Musheff: Continue doing that.

449
00:52:18.010 --> 00:52:22.839
Victoria Musheff: Until it's really easy to do it 18, 15, 16, 17, 18 times.

450
00:52:23.700 --> 00:52:25.570
Victoria Musheff: That's how you can gauge

451
00:52:25.850 --> 00:52:32.149
Victoria Musheff: that it's time to increase the challenge a little bit. It's really just a rule of thumb of safety. Now, it's not always easy.

452
00:52:32.370 --> 00:52:35.869
Victoria Musheff: to change that. So let's say you're able to move the weight

453
00:52:36.890 --> 00:52:43.300
Victoria Musheff: 15, 18 times, now you try to increase the weight again to where you could only lift it 8 to 10 times.

454
00:52:43.670 --> 00:52:56.959
Victoria Musheff: Sometimes that's easy, sometimes it's not. If you're using body weight, it may… those rules won't really fit. So what you would use for body weight things, let's say isometric things.

455
00:52:57.670 --> 00:53:00.390
Victoria Musheff: Now you could use that with push-ups.

456
00:53:00.700 --> 00:53:05.459
Victoria Musheff: I'll kind of show you in a minute, but with isometric things, let's say you do, like, a yoga hold.

457
00:53:06.040 --> 00:53:19.659
Victoria Musheff: depending on how hard it is, if it's really hard, try to hold it about 3 to 10 seconds. If it's a little easier, hold it longer. So you're just training the muscles a little differently. How do you make that easier, harder.

458
00:53:20.250 --> 00:53:24.059
Victoria Musheff: It's a little bit of, you know, biomechanics.

459
00:53:24.960 --> 00:53:26.939
Victoria Musheff: It's hard for me to do a push-up

460
00:53:27.200 --> 00:53:29.179
Victoria Musheff: off the ground. I can do a plank.

461
00:53:29.430 --> 00:53:32.729
Victoria Musheff: But to go through the range of motion, and I was never good at that.

462
00:53:33.010 --> 00:53:37.289
Victoria Musheff: That was not how I was built. I could do it, but it's harder.

463
00:53:37.560 --> 00:53:45.459
Victoria Musheff: you can adjust the workload by adjusting your body position. I can go against a wall and do a push-up.

464
00:53:45.550 --> 00:53:59.319
Victoria Musheff: I could go against a table and do a push-up. So, if it's too hard to do one on the floor, start at a level that's easier, because part of what you're doing is learning to talk to the muscles, and wake them up at this lower load.

465
00:53:59.490 --> 00:54:01.820
Victoria Musheff: And then allow them to be able to do more.

466
00:54:02.820 --> 00:54:06.479
Victoria Musheff: You don't have to keep progressing. You could say, this is good.

467
00:54:06.600 --> 00:54:13.659
Victoria Musheff: I don't have to, like, be carrying 100-pound weights, unless that's important to you.

468
00:54:13.810 --> 00:54:20.649
Victoria Musheff: But the idea of… Adjusting slowly, with weight training.

469
00:54:20.860 --> 00:54:26.400
Victoria Musheff: It's gonna be a lot of coming back to that rating of perceived exertion. Try to look for the moderate.

470
00:54:26.560 --> 00:54:29.329
Victoria Musheff: If you do vigorous, you really probably should check

471
00:54:29.780 --> 00:54:34.489
Victoria Musheff: Check with somebody first, because anytime you push into those levels, whether aerobic or strength.

472
00:54:34.810 --> 00:54:36.650
Victoria Musheff: The risk for injury goes up.

473
00:54:36.800 --> 00:54:38.250
Victoria Musheff: Might not be worth it.

474
00:54:39.000 --> 00:54:41.299
Victoria Musheff: You get injured, you're doing nothing.

475
00:54:41.900 --> 00:54:43.999
Victoria Musheff: For months, possibly.

476
00:54:45.250 --> 00:54:48.899
Victoria Musheff: And I like using body weight for a lot of things.

477
00:54:49.450 --> 00:55:00.500
Victoria Musheff: Because that's how I work in the world. I want to go up steps, I want to get up and down off the ground gardening, I want to pick up my kayak, which is hard.

478
00:55:01.030 --> 00:55:06.709
Victoria Musheff: So I like to use my body to do stuff that's, like, functional.

479
00:55:08.420 --> 00:55:15.650
Victoria Musheff: So, what do you want to get up and do? Really, it's up to what, like, what's in fun for you.

480
00:55:15.980 --> 00:55:20.570
Victoria Musheff: Do you want to play with the kids? Do you want to travel? Let's say you want to travel.

481
00:55:21.410 --> 00:55:23.180
Victoria Musheff: You're gonna fly somewhere.

482
00:55:23.720 --> 00:55:41.279
Victoria Musheff: I need to get in and out of that… I need to get in and out of that airport chair, right? Like, you need to be… you gotta have certain strength. Put something in an overhead bin, carry bags, walk on uneven surfaces, maybe wherever you're going to.

483
00:55:41.350 --> 00:55:46.110
Victoria Musheff: So think about what you want to do, and that's how you should train.

484
00:55:47.080 --> 00:55:48.570
Victoria Musheff: And good posture.

485
00:55:48.940 --> 00:55:52.160
Victoria Musheff: What do you need? What strength do you need for good posture?

486
00:55:52.450 --> 00:55:59.470
Victoria Musheff: The muscles in the back and between the shoulder blade need to be stronger, because we're like this. We need to be like this.

487
00:56:00.070 --> 00:56:06.770
Victoria Musheff: The core muscles need to be strong enough to stabilize us as we move, And be able to…

488
00:56:07.620 --> 00:56:14.010
Victoria Musheff: Help us recover if we lose our balance, and our lower leg muscles Half.

489
00:56:14.680 --> 00:56:17.290
Victoria Musheff: Hips, thighs, these need to be strong.

490
00:56:18.800 --> 00:56:20.049
Victoria Musheff: For good posture.

491
00:56:21.930 --> 00:56:27.720
Victoria Musheff: So, let's look at a couple activities. So, these would be the priority activities, as I see them.

492
00:56:28.550 --> 00:56:32.779
Victoria Musheff: Squats, marching, climbing stairs, pushing and pulling.

493
00:56:33.610 --> 00:56:39.680
Victoria Musheff: Raising up on your heels, This coming up, or raising your heels up, getting on your toes.

494
00:56:40.270 --> 00:56:46.510
Victoria Musheff: This is a really important strength exercise, because this is where all the walking comes from, where it starts.

495
00:56:49.680 --> 00:56:53.549
Victoria Musheff: So… I'm gonna shift… let's do a couple movements.

496
00:56:54.990 --> 00:57:00.689
Victoria Musheff: Okay, first of all, think about your sit-to-stand. So push your chair out a little bit.

497
00:57:02.400 --> 00:57:11.369
Victoria Musheff: First, Ideally, When you're in your chair, And you're gonna come up…

498
00:57:11.520 --> 00:57:31.450
Victoria Musheff: some things that make… give you some… a little bit of biomechanical advantages have a little bit of a split stance. So, for you guys on Zoom land, that means my feet aren't just side by side, one's a little bit farther in front, and it usually is the one you feel confidence in, the knee that you feel confidence in. And then when you come up, and you could compare that.

499
00:57:32.070 --> 00:57:39.420
Victoria Musheff: See how it feels with a split stance? See how it feels when you don't have a split stance. You feel a difference, yeah.

500
00:57:40.080 --> 00:57:48.030
Victoria Musheff: So, this movement by itself just practicing that. So when we think about interrupting time, so maybe…

501
00:57:48.440 --> 00:57:52.150
Victoria Musheff: You don't walk around at your desk, you do…

502
00:57:52.260 --> 00:57:57.760
Victoria Musheff: 5 chair stands. That's a way to break up the time and do some strength work.

503
00:57:58.000 --> 00:58:00.660
Victoria Musheff: The other one is marching.

504
00:58:01.160 --> 00:58:06.990
Victoria Musheff: This movement of marching, bringing those knees up, is really important.

505
00:58:07.120 --> 00:58:19.109
Victoria Musheff: This muscle tends to be tight, but it's not strong. So it does need to be stretched. We're not talking about stretching in here today. But this means I can raise my foot up to put my foot on a step.

506
00:58:19.250 --> 00:58:20.889
Victoria Musheff: Or clear a curb.

507
00:58:21.050 --> 00:58:29.509
Victoria Musheff: or step over something. Or even with walking. Walking involves this gait movement, right?

508
00:58:30.010 --> 00:58:32.090
Victoria Musheff: I need to be able to…

509
00:58:32.230 --> 00:58:36.190
Victoria Musheff: Bring that leg up high enough. When you see people change.

510
00:58:36.380 --> 00:58:44.289
Victoria Musheff: Their gait, you see them compensating for weaknesses, and they're using other muscles to kind of propel themselves forward.

511
00:58:44.910 --> 00:58:47.590
Victoria Musheff: So, you guys want to try the marching?

512
00:58:49.170 --> 00:58:56.640
Victoria Musheff: See how comfortable, if you need to balance, touch something. Nice thing about balance, sometimes all you need is this.

513
00:58:56.860 --> 00:59:01.349
Victoria Musheff: Yeah, so, and so Roseanne is also using her arms here. This…

514
00:59:01.640 --> 00:59:04.870
Victoria Musheff: Replicates the arm gate that you need.

515
00:59:05.270 --> 00:59:12.159
Victoria Musheff: to walk optimally. So, whoop, opposite arm and leg? Yeah, it's like just skipping, right?

516
00:59:12.980 --> 00:59:19.920
Victoria Musheff: And you know, when stroke… people have strokes, they have them begin their rehab Crawling.

517
00:59:20.190 --> 00:59:26.910
Victoria Musheff: Which, you know, this replicates some of this movement that little babies do to practice to get ready to be walkers.

518
00:59:27.530 --> 00:59:43.420
Victoria Musheff: So, see how comfortable it is for you to bring that thigh up. Do you feel like you have to lean back to do it? Does it feel comfortable? Does it feel… like, sometimes you can get a little crampy. You know, those muscles aren't used to doing the work, they may get crampy.

519
00:59:44.340 --> 00:59:47.659
Victoria Musheff: Now, I'm not gonna have you do…

520
00:59:48.070 --> 00:59:53.780
Victoria Musheff: Up against the wall. But let's replicate a push. Let's be seated.

521
00:59:54.200 --> 01:00:00.239
Victoria Musheff: If you are seated, You're gonna use your arms to push.

522
01:00:00.960 --> 01:00:04.169
Victoria Musheff: Pushing and pulling, that's how these arms function.

523
01:00:04.360 --> 01:00:10.260
Victoria Musheff: So, see how that feels to just push yourself up without your legs doing so much work?

524
01:00:10.400 --> 01:00:12.459
Victoria Musheff: This is… this is a way.

525
01:00:12.680 --> 01:00:14.449
Victoria Musheff: To work on those muscles.

526
01:00:16.420 --> 01:00:34.670
Victoria Musheff: I'm being very controlled. So this is an important thing. Now, we don't… won't go over today, but if I were to fall and need to get up off the floor, one of the first things I need to do is push myself up into an all-fours position.

527
01:00:34.930 --> 01:00:37.360
Victoria Musheff: So this is a great way to practice.

528
01:00:37.640 --> 01:00:41.259
Victoria Musheff: Working those tricep muscles to do that activity.

529
01:00:42.920 --> 01:00:52.190
Victoria Musheff: Yeah, it was… So this could be a strength, you don't have to actually use weights. That's right, because it's your own body weight, and you can play with that, like, you can hold this.

530
01:00:52.640 --> 01:00:54.679
Victoria Musheff: This is an isometric hold!

531
01:00:55.690 --> 01:00:58.430
Victoria Musheff: Hoo-hoo! Keep breathing, don't hold your breath.

532
01:01:00.160 --> 01:01:02.290
Victoria Musheff: And then see how long you can do that, right?

533
01:01:02.670 --> 01:01:05.269
Victoria Musheff: Great, easy way to do some strength work.

534
01:01:05.670 --> 01:01:09.659
Victoria Musheff: See, I have my little list of the ones I wanted to emphasize.

535
01:01:14.980 --> 01:01:15.900
Victoria Musheff: Oh.

536
01:01:18.860 --> 01:01:24.029
Victoria Musheff: Another added… Here's an added… well, we do this in the Matter Balance class.

537
01:01:26.910 --> 01:01:32.929
Victoria Musheff: You're only going to do a halfway up in a squat, like, well, changed my mind.

538
01:01:34.070 --> 01:01:36.280
Victoria Musheff: Change your mind!

539
01:01:36.520 --> 01:01:41.019
Victoria Musheff: This is part of the hardest part, so this might be your weakest point.

540
01:01:41.850 --> 01:01:42.940
Victoria Musheff: Yeah.

541
01:01:43.260 --> 01:01:46.189
Victoria Musheff: Yep. So, this is a good…

542
01:01:46.390 --> 01:01:49.609
Victoria Musheff: And here's where people get in trouble with falls.

543
01:01:50.390 --> 01:01:52.480
Victoria Musheff: If they're having a hard time

544
01:01:52.830 --> 01:01:55.729
Victoria Musheff: Getting this part, what do they do?

545
01:01:58.070 --> 01:02:03.070
Victoria Musheff: They push their center of gravity forward, and then they go down on the floor.

546
01:02:03.300 --> 01:02:12.879
Victoria Musheff: But they can't control it. So this is a nice practice. Just that little bit, the sticking point, sometimes with weight training.

547
01:02:13.850 --> 01:02:16.369
Victoria Musheff: Now, the last one, let's stand up for this one.

548
01:02:16.990 --> 01:02:34.339
Victoria Musheff: You had your hands on your knees, so you use your hands on that? Your hand, yeah. The other one, you aren't really using, you're… That's right, you really rely more on the legs, and this one is… maybe this is just really my habit of the hand position, I'm not really pushing here.

549
01:02:34.340 --> 01:02:38.059
Victoria Musheff: This is just… my hands are here, so that's good. But you could, you may find you need…

550
01:02:38.110 --> 01:02:43.490
Victoria Musheff: to use that a little bit. If you do, that's where you start, until you don't need it.

551
01:02:43.880 --> 01:02:46.270
Victoria Musheff: Right? This is a little help.

552
01:02:46.500 --> 01:02:50.210
Victoria Musheff: This is where you would ultimately want to go.

553
01:02:50.810 --> 01:02:56.419
Victoria Musheff: Well, while you're seated, I'll do it the other way. I'm gonna have you do something. So, one of the things we want to do with

554
01:02:57.020 --> 01:03:06.039
Victoria Musheff: Movement is combining Some speed. And when you do speed work, you can't use as much resistance.

555
01:03:06.660 --> 01:03:08.030
Victoria Musheff: There's a trade-off.

556
01:03:08.570 --> 01:03:11.810
Victoria Musheff: The heavier the weight, the slower it's gonna be moved.

557
01:03:12.210 --> 01:03:19.959
Victoria Musheff: the more you want to move it, the how faster, you have to have less weight. So, and we'll talk about some stuff with this with balance.

558
01:03:20.830 --> 01:03:24.560
Victoria Musheff: In a seated position, You could do this standing.

559
01:03:24.710 --> 01:03:31.159
Victoria Musheff: I can't go to your safety. I'm not spotting you, so we're gonna do it seated, which is a good place to start.

560
01:03:31.610 --> 01:03:36.040
Victoria Musheff: Part of… Speed is learning how to talk to the muscles.

561
01:03:36.150 --> 01:03:40.969
Victoria Musheff: And move… have them move quickly. So you can start just… Tap one leg.

562
01:03:41.600 --> 01:03:43.460
Victoria Musheff: You're saying, wake up?

563
01:03:43.980 --> 01:03:46.550
Victoria Musheff: I want to talk to you. Do the other one.

564
01:03:48.880 --> 01:03:50.640
Victoria Musheff: Now do the alternating.

565
01:03:52.580 --> 01:03:54.300
Victoria Musheff: Now try to go fast.

566
01:03:57.690 --> 01:04:02.979
Victoria Musheff: So, you practiced doing that without a load, on the body.

567
01:04:03.470 --> 01:04:10.239
Victoria Musheff: I don't want you to do that now, this now. But you could do it at home, touch at a wall. So I had you do this.

568
01:04:10.570 --> 01:04:17.559
Victoria Musheff: psychostemic, and then you could do this, right? But you should have something to stabilize on.

569
01:04:17.860 --> 01:04:21.260
Victoria Musheff: When you're first starting it, because you don't really know

570
01:04:21.390 --> 01:04:26.409
Victoria Musheff: You guys aren't friends yet. You gotta get really confident with each other.

571
01:04:26.650 --> 01:04:29.500
Victoria Musheff: So let's move on to balance.

572
01:04:29.980 --> 01:04:35.859
Victoria Musheff: And what's our time? It is 11.05. We'll, we'll move into wrap-up.

573
01:04:36.120 --> 01:04:40.679
Victoria Musheff: I talked about balance before with the fall prevention, but let me just kind of recap some things.

574
01:04:41.020 --> 01:04:46.910
Victoria Musheff: When we talk about balance, we're talking about Our body's ability to

575
01:04:47.220 --> 01:04:54.950
Victoria Musheff: kind of maintain a state where we keep our center of gravity within a base of support. Center of gravity is in the lower pelvis.

576
01:04:55.070 --> 01:05:04.269
Victoria Musheff: Base of support tends to be the two contact points, but if you're standing on one foot, it's one contact point. That's hard. This is easier.

577
01:05:05.430 --> 01:05:12.130
Victoria Musheff: And we have 3 systems that our body's using to collect data to say, where am I?

578
01:05:12.350 --> 01:05:13.940
Victoria Musheff: To tell the brain.

579
01:05:14.200 --> 01:05:19.340
Victoria Musheff: This is where we are, and the brain says, okay, then do this to keep me up.

580
01:05:20.310 --> 01:05:25.180
Victoria Musheff: Anything that interferes with the data collection, Processing…

581
01:05:25.870 --> 01:05:34.610
Victoria Musheff: Message sending, or muscles responding, will make it harder to balance. So there's lots of places where you could have problems with balance.

582
01:05:36.420 --> 01:05:38.389
Victoria Musheff: when the body… I love the word…

583
01:05:39.200 --> 01:05:42.990
Victoria Musheff: This, and this is not my word, this is the word in the science.

584
01:05:43.760 --> 01:05:49.150
Victoria Musheff: Balance, perturbation, recovery. You've been perturbed.

585
01:05:50.120 --> 01:05:53.230
Victoria Musheff: Let's say you're out and you've been perturbed.

586
01:05:53.890 --> 01:06:02.970
Victoria Musheff: Your body will have some strategies that it'll use to try to recover from that challenge, and it usually prefers

587
01:06:03.100 --> 01:06:07.379
Victoria Musheff: To make these adjustments at the ankle, that's where it's most nimble.

588
01:06:07.990 --> 01:06:10.789
Victoria Musheff: If that's not enough, it'll use the hips.

589
01:06:11.060 --> 01:06:19.610
Victoria Musheff: And if that's not enough, you'll take a step to try to save your balance. But you can see why you need healthy foot and ankle.

590
01:06:20.030 --> 01:06:23.020
Victoria Musheff: You also need healthy, strong hips.

591
01:06:23.170 --> 01:06:27.560
Victoria Musheff: And with the step, you want quick reaction time.

592
01:06:27.890 --> 01:06:33.770
Victoria Musheff: So you're not going like that. You're able to quickly do the recovery step.

593
01:06:34.730 --> 01:06:39.820
Victoria Musheff: With training, you tend to go from a more stable.

594
01:06:40.100 --> 01:06:42.559
Victoria Musheff: Base a support to a less stable one.

595
01:06:43.160 --> 01:06:48.309
Victoria Musheff: you have… Make your bases important.

596
01:06:48.440 --> 01:06:49.909
Victoria Musheff: Bigger or smaller?

597
01:06:50.530 --> 01:07:06.689
Victoria Musheff: And you move from a static change, like, I think it's great that they want you to stand on one foot, but are you doing that all day? Like, you know, this isn't the big challenge. The challenge is I'm walking through the house and picking up things and doing things. You need to…

598
01:07:06.990 --> 01:07:09.570
Victoria Musheff: Train balance dynamically.

599
01:07:09.780 --> 01:07:12.950
Victoria Musheff: And then, sensory limitation.

600
01:07:13.270 --> 01:07:15.729
Victoria Musheff: We're gonna try that in just a second.

601
01:07:17.100 --> 01:07:20.140
Victoria Musheff: I mentioned this before, but if, for those of…

602
01:07:20.460 --> 01:07:32.870
Victoria Musheff: you who weren't in the fall prevention lecture, there are multiple types of balance. You have a static balance, which I was just talking about standing on one leg. It's important, it has its place.

603
01:07:32.950 --> 01:07:42.500
Victoria Musheff: Dynamic balance is where you're stabilizing while you move. Proactive balance is where you see an obstacle.

604
01:07:42.660 --> 01:07:47.630
Victoria Musheff: And your brain makes decisions about how to navigate it. I see this step coming up.

605
01:07:47.870 --> 01:07:51.349
Victoria Musheff: And then I make a change, and I know what to do.

606
01:07:51.840 --> 01:07:55.259
Victoria Musheff: The reactive is, I didn't see the step.

607
01:07:55.590 --> 01:08:03.170
Victoria Musheff: And I hit this… And I have to recover without really thinking, with just my reflexes.

608
01:08:03.550 --> 01:08:07.669
Victoria Musheff: You need to train all those balance systems. That's how fitness works.

609
01:08:08.070 --> 01:08:13.159
Victoria Musheff: You've got to train for what you want to achieve. You've got to train in those areas.

610
01:08:13.920 --> 01:08:17.590
Victoria Musheff: Reactive ballots, You need to do with somebody.

611
01:08:17.779 --> 01:08:19.239
Victoria Musheff: Not on your own.

612
01:08:19.380 --> 01:08:26.260
Victoria Musheff: Because if you mess up, and it's important to be pushed with balance, you need somebody to be your spotter.

613
01:08:26.550 --> 01:08:31.920
Victoria Musheff: The other ones you can try, you could use polls, as a safety…

614
01:08:32.149 --> 01:08:35.840
Victoria Musheff: You know, a little safety thing as you're moving around, playing with some balance.

615
01:08:37.100 --> 01:08:42.410
Victoria Musheff: Or if you have a wall or a countertop, that's a good way to give yourself a little protection.

616
01:08:44.060 --> 01:08:50.860
Victoria Musheff: Now, just to come back to that system that's doing the work, Of collecting data?

617
01:08:51.120 --> 01:08:55.360
Victoria Musheff: We have the… our vision, we have…

618
01:08:55.529 --> 01:09:00.439
Victoria Musheff: The cells, receptors throughout our body, the proprioceptive system.

619
01:09:00.600 --> 01:09:14.539
Victoria Musheff: And we have receptors in our ear, the vestibular system that's monitoring where we are with gravity. When we do assessments, we challenge all of those, including a walking test challenging vestibular balance, so…

620
01:09:14.840 --> 01:09:19.190
Victoria Musheff: with that one, it's always interesting. We…

621
01:09:19.720 --> 01:09:22.250
Victoria Musheff: Have you walk about 10 meters.

622
01:09:22.510 --> 01:09:27.920
Victoria Musheff: Turning your head to the pace of a metronome. Tick, talk, tick, talk.

623
01:09:28.020 --> 01:09:31.229
Victoria Musheff: Because if you have vestibular problems, these turns

624
01:09:31.590 --> 01:09:39.509
Victoria Musheff: can create dizziness, and that might be something that needs rehab. But so we've challenged that to see, like, are you doing this?

625
01:09:40.529 --> 01:09:45.819
Victoria Musheff: Look like you're not able to walk a straight line, which helps us understand what might be going on.

626
01:09:46.529 --> 01:09:50.479
Victoria Musheff: But, as I said before, like, the data collection system, as we get older.

627
01:09:50.819 --> 01:09:52.860
Victoria Musheff: It's like it gets hard of hearing.

628
01:09:53.310 --> 01:10:00.729
Victoria Musheff: Those receptors don't work as well. The receptors in our feet Can get kind of muffled.

629
01:10:01.190 --> 01:10:05.800
Victoria Musheff: That stomping activity is a good way to wake them back up.

630
01:10:06.090 --> 01:10:13.189
Victoria Musheff: to try to take up the volume so those receptors know, where is my foot? What is the surface that I'm on?

631
01:10:13.740 --> 01:10:20.469
Victoria Musheff: But also, there are receptors everywhere. And the more you practice talking to the muscles.

632
01:10:20.690 --> 01:10:25.780
Victoria Musheff: The better they're able to intercommunicate back and forth with the brain.

633
01:10:26.380 --> 01:10:28.140
Victoria Musheff: Vestibular system?

634
01:10:28.370 --> 01:10:36.469
Victoria Musheff: I'm not a physical therapist, I can't fix that. So if somebody had that problem, they'd really need to get rehab, and that works.

635
01:10:36.580 --> 01:10:41.700
Victoria Musheff: There's a lot of, I would say good outcomes, but not permanent.

636
01:10:42.040 --> 01:10:44.260
Victoria Musheff: You haven't proved… have you gone twice?

637
01:10:45.030 --> 01:10:56.340
Victoria Musheff: Yep. Little crystals. Right before I went to vacation, I was experiencing, I said, Called up. Yes.

638
01:10:56.680 --> 01:11:06.440
Victoria Musheff: But they got those crystals out of the way, they fixed that… the problem, the glitch. I sure don't believe it.

639
01:11:07.370 --> 01:11:11.940
Victoria Musheff: I don't believe. There's power in belief.

640
01:11:12.330 --> 01:11:20.729
Victoria Musheff: Okay, so I want to mention this, I know we're getting ready to run out of time, you guys are exhausted, and I've made you sit too long.

641
01:11:21.000 --> 01:11:24.029
Victoria Musheff: I want you to think with balance.

642
01:11:24.240 --> 01:11:29.080
Victoria Musheff: We're really thinking, and we think about this with movement as well, but I want to relate it to balance.

643
01:11:29.630 --> 01:11:37.910
Victoria Musheff: our movements happen along what we call the kinetic chain. There's a… Series and, like, building blocks

644
01:11:38.070 --> 01:11:46.630
Victoria Musheff: of the joints where movement occurs and stabilization occurs. Each joint can stabilize and allow for movement.

645
01:11:46.800 --> 01:11:51.880
Victoria Musheff: But in our… most of our daily movements, it has a preference. So…

646
01:11:53.200 --> 01:12:05.620
Victoria Musheff: The foot tends to be a stabilizer. Ankle allows for movement. Knee wants to stabilize. Hip allows for movement. If you have an injury, if you have an injury.

647
01:12:06.290 --> 01:12:12.079
Victoria Musheff: And I'll bet each of you have experienced this or heard somebody talk about it. Let's say you have a knee injury.

648
01:12:12.980 --> 01:12:16.640
Victoria Musheff: And it wants… it can't stabilize as well.

649
01:12:16.920 --> 01:12:19.760
Victoria Musheff: The joint above and below it has to compensate.

650
01:12:19.950 --> 01:12:25.550
Victoria Musheff: So then, instead of being good movers, they're trying to stabilize as well.

651
01:12:25.850 --> 01:12:30.769
Victoria Musheff: And people will say, my knee hurts, but now my low back hurts.

652
01:12:30.970 --> 01:12:35.740
Victoria Musheff: That's because there's an impact up and down the kinetic chain.

653
01:12:35.870 --> 01:12:42.350
Victoria Musheff: So it's also important… that's why it's important to work with a physical therapist and your doctor. You may have low back pain.

654
01:12:42.910 --> 01:12:44.869
Victoria Musheff: But it might be caused by the knee.

655
01:12:44.970 --> 01:12:49.150
Victoria Musheff: So you have to really know what the source is, and how to rehab.

656
01:12:50.480 --> 01:12:56.310
Victoria Musheff: But just also says why it's important to have these Trainings that enhance

657
01:12:56.670 --> 01:13:04.289
Victoria Musheff: The ability of the body to work the way it wants to at those, joints.

658
01:13:05.500 --> 01:13:10.060
Victoria Musheff: We tend to do 5 primary movements. I had pushing, and pulling.

659
01:13:10.700 --> 01:13:18.519
Victoria Musheff: this… Squat-like movement, single leg movement. Here's what we don't do a lot, though, unfortunately.

660
01:13:21.100 --> 01:13:23.040
Victoria Musheff: I don't fall a lot like this.

661
01:13:23.140 --> 01:13:32.649
Victoria Musheff: Alright, so we do need to practice lateral movements more, talking to the muscles. I would, joke with my students, when I was a runner.

662
01:13:32.750 --> 01:13:36.250
Victoria Musheff: I said, here's Home Runner, I think I'm… I'm so fit!

663
01:13:36.420 --> 01:13:38.399
Victoria Musheff: I've got it all down.

664
01:13:38.580 --> 01:13:40.799
Victoria Musheff: But this is all I do.

665
01:13:41.110 --> 01:13:43.049
Victoria Musheff: I don't run like this.

666
01:13:43.670 --> 01:13:45.519
Victoria Musheff: So, all these muscles.

667
01:13:45.860 --> 01:13:58.080
Victoria Musheff: were suboptimal. They were not particularly strong, and I didn't really know how to talk to them very well. So, you'd go into some aerobic dance class, and you couldn't do it.

668
01:13:58.290 --> 01:14:04.329
Victoria Musheff: I don't move my arms and my legs at the same time. You know, you're a runner.

669
01:14:04.580 --> 01:14:14.199
Victoria Musheff: So, you've got to realize, too, that how you train is kind of limited. You get the benefits for those movements, so that's why it's nice to have a variety of movements.

670
01:14:16.860 --> 01:14:21.869
Victoria Musheff: Brain is the control center for all that data collection, so if things are…

671
01:14:22.530 --> 01:14:27.959
Victoria Musheff: Change there, or negatively impacted there, it's gonna impact your balance.

672
01:14:28.960 --> 01:14:31.359
Victoria Musheff: Bows to do what? Same as strength?

673
01:14:31.850 --> 01:14:35.229
Victoria Musheff: Let's look at a couple things. So, did I?

674
01:14:35.930 --> 01:14:38.580
Victoria Musheff: I did forget to do one of the things I want to do. We'll do it now.

675
01:14:39.370 --> 01:14:41.079
Victoria Musheff: So go ahead and stand up.

676
01:14:42.960 --> 01:14:50.449
Victoria Musheff: And just touching the chair or your table, depending on what's comfortable. Just raise up on your toes.

677
01:14:50.960 --> 01:14:52.710
Victoria Musheff: And see how that feels.

678
01:14:53.300 --> 01:14:54.980
Victoria Musheff: Are you able to balance?

679
01:14:55.430 --> 01:14:56.890
Victoria Musheff: Able to balance.

680
01:14:57.350 --> 01:15:02.950
Victoria Musheff: Now, this is called… So, I don't know everybody's situation.

681
01:15:03.600 --> 01:15:07.889
Victoria Musheff: It would be nice if you could do… A little hop.

682
01:15:08.080 --> 01:15:19.540
Victoria Musheff: See if you can do that hop. If this doesn't feel comfortable, you can get the same benefit just going up on your toes and do a heel drop. You don't come all the way up, but you're still getting that

683
01:15:19.940 --> 01:15:26.130
Victoria Musheff: Challenge of impact through the skeleton without necessarily coming all the way above the floor, right?

684
01:15:30.640 --> 01:15:34.710
Victoria Musheff: It may save your life!

685
01:15:35.450 --> 01:15:43.209
Victoria Musheff: So you can also see that there are other activities, like, you can do this without a step right now, but if you were to step

686
01:15:43.470 --> 01:15:53.560
Victoria Musheff: forward, touching something. What you're doing is that single leg movement. You're balancing on one leg while moving the other. So this is better than just static balance.

687
01:15:53.940 --> 01:15:58.990
Victoria Musheff: Because it's more dynamic. You're moving and stabilizing at the same time.

688
01:16:00.650 --> 01:16:05.399
Victoria Musheff: If you stay… if you will, I'm gonna have you definitely touch a chair for just a moment.

689
01:16:05.530 --> 01:16:11.860
Victoria Musheff: Touch the egg, so… So we had the four-stage balance test. Stand with your feet together.

690
01:16:12.950 --> 01:16:15.829
Victoria Musheff: See how that feels? Feet all the way together.

691
01:16:16.200 --> 01:16:18.939
Victoria Musheff: That's a small base of support, but 2 feet.

692
01:16:19.640 --> 01:16:22.229
Victoria Musheff: Now I want you to touch your chair.

693
01:16:22.760 --> 01:16:24.379
Victoria Musheff: I want you to close your eyes.

694
01:16:25.090 --> 01:16:27.060
Victoria Musheff: See how your body reacts.

695
01:16:27.600 --> 01:16:30.340
Victoria Musheff: If you feel a little quiver.

696
01:16:31.510 --> 01:16:38.519
Victoria Musheff: Okay, open your eyes. Did you feel your brain saying, whoa, whoa, what… it may have contracted muscles differently?

697
01:16:38.960 --> 01:16:40.809
Victoria Musheff: Now, you could try that.

698
01:16:41.140 --> 01:16:42.390
Victoria Musheff: On one leg.

699
01:16:42.790 --> 01:16:43.630
Victoria Musheff: Touch?

700
01:16:44.010 --> 01:16:46.900
Victoria Musheff: The other leg with the foot you've raised.

701
01:16:48.150 --> 01:16:51.879
Victoria Musheff: Now, you have your eyes open, you're touching your chair.

702
01:16:52.210 --> 01:16:58.080
Victoria Musheff: But if you want, close your eyes a minute and see how the body just goes into revolt.

703
01:16:58.650 --> 01:17:02.549
Victoria Musheff: I… what? What's going on?

704
01:17:02.940 --> 01:17:10.280
Victoria Musheff: You just… you just pinched off all this data, and the brain…

705
01:17:10.470 --> 01:17:13.419
Victoria Musheff: was like, what? You just cut me off!

706
01:17:13.610 --> 01:17:20.369
Victoria Musheff: Of all the data. Now, you could train it to get used to that, but when you did that right now, your brain…

707
01:17:20.840 --> 01:17:22.080
Victoria Musheff: wasn't…

708
01:17:22.240 --> 01:17:28.040
Victoria Musheff: didn't have much time to adapt. So if you walk in your house at night, like, the light's off.

709
01:17:28.430 --> 01:17:34.260
Victoria Musheff: You may not have all the data you need if you have a reactive balance challenge, a trip.

710
01:17:34.690 --> 01:17:42.679
Victoria Musheff: Versus walking and seeing something, and your brain says, okay, there's the dog's toy, I need to walk around that. Or if I hit it, it's nothing to worry about.

711
01:17:43.560 --> 01:17:48.410
Victoria Musheff: So that's what we're talking about changing the sensory perception, and changing the base of support.

712
01:17:49.430 --> 01:17:54.099
Victoria Musheff: Alright, I think you guys are probably worn out, and…

713
01:17:54.680 --> 01:18:00.960
Victoria Musheff: This is an example of more advanced balance challenges. Some of the things we'll probably do in the balance class…

714
01:18:01.840 --> 01:18:10.670
Victoria Musheff: So, change the surface stability, change sensory perception, little bit of speed, movements…

715
01:18:10.980 --> 01:18:13.730
Victoria Musheff: Were you gonna work outside the range of motion?

716
01:18:13.950 --> 01:18:20.999
Victoria Musheff: Like, gardening, right? Reactive balance, that'll be interesting. That's the one that scares me the most.

717
01:18:21.200 --> 01:18:24.449
Victoria Musheff: That's because we will make you lose your balance. We make you…

718
01:18:24.640 --> 01:18:27.840
Victoria Musheff: I would say we would probably do minimal that.

719
01:18:28.180 --> 01:18:34.269
Victoria Musheff: Because… Our team would prefer to do that when you have a harness.

720
01:18:34.610 --> 01:18:36.050
Victoria Musheff: You should have a harness.

721
01:18:36.350 --> 01:18:42.260
Victoria Musheff: So that you won't fall. But we can still… we will evaluate that reactive balance.

722
01:18:42.640 --> 01:18:50.570
Victoria Musheff: And then adaptability is that where you would walk on, like, unpredictable or uneven surfaces, and your muscles and brain work together.

723
01:18:51.800 --> 01:18:54.249
Victoria Musheff: Alright, last but not least.

724
01:18:54.450 --> 01:19:06.250
Victoria Musheff: well, not quite last, but close enough. I talked about this along the way, gait. So when… when we're… let's say we're having you do that timed-up-a-go test, we're gonna look at your gait.

725
01:19:06.750 --> 01:19:13.339
Victoria Musheff: Do you swing your arms normally? Are you able to lift the foot up as you walk, pushing off?

726
01:19:13.560 --> 01:19:22.800
Victoria Musheff: As you go, raising the hip through a normal range of motion. And if you're not, and not able to stabilize, like, you see people shift forward.

727
01:19:23.050 --> 01:19:25.289
Victoria Musheff: They're not feeling confident.

728
01:19:25.670 --> 01:19:27.449
Victoria Musheff: Any of you have dogs?

729
01:19:27.820 --> 01:19:30.219
Victoria Musheff: Dog walks on an uncertain surface.

730
01:19:30.370 --> 01:19:41.739
Victoria Musheff: They go down. They go like this, right? We do the same thing. We will widen our stance, and they take little steps. So, you would want to think about how you're walking is…

731
01:19:41.840 --> 01:19:44.359
Victoria Musheff: Kind of that integration of balance and strength.

732
01:19:45.930 --> 01:19:47.130
Victoria Musheff: Precautions.

733
01:19:48.840 --> 01:20:06.889
Victoria Musheff: If you have no chronic conditions, or no symptoms of chronic conditions, you can start doing exercise and adapting and adopting new activities without really consulting your physician. That doesn't apply to most of us. Most of us probably need to at least check

734
01:20:07.600 --> 01:20:16.090
Victoria Musheff: To make sure that anything we do, especially aerobic, won't change medications, How your body's processing them.

735
01:20:16.320 --> 01:20:21.319
Victoria Musheff: Or where they can say, I really want you to not work at a heart rate level above this.

736
01:20:21.980 --> 01:20:27.430
Victoria Musheff: Or with strength, They might say, you have a hip replacement? No.

737
01:20:27.790 --> 01:20:34.400
Victoria Musheff: movements like this. You can do everything else, but not this. So you need to get that counsel so you don't…

738
01:20:34.600 --> 01:20:40.320
Victoria Musheff: do more harm than good. And then with progressions, You can progress…

739
01:20:40.990 --> 01:20:51.430
Victoria Musheff: And keep gradually progressing. If no new symptoms come up, or are made worse, or if you move into the vigorous zone, heavier weights.

740
01:20:51.860 --> 01:20:54.520
Victoria Musheff: Higher heart rate workouts.

741
01:20:54.770 --> 01:21:01.419
Victoria Musheff: Now, the recommendation for progression First, increase the number of minutes per week.

742
01:21:02.270 --> 01:21:07.069
Victoria Musheff: And if you're doing weight training, maybe repetitions. Number repetitions.

743
01:21:07.660 --> 01:21:10.340
Victoria Musheff: Then… days per week.

744
01:21:11.440 --> 01:21:16.420
Victoria Musheff: Then, and maybe not even necessarily, the intensity.

745
01:21:16.820 --> 01:21:23.599
Victoria Musheff: You may get all the benefits you want without going into higher intensities, but if you're at light, you should at least try to get to moderate, if you can.

746
01:21:24.350 --> 01:21:31.699
Victoria Musheff: We need about 2 to 4 weeks to adapt, so when you make the change, you need to stay in that place a couple weeks to a month.

747
01:21:31.820 --> 01:21:40.159
Victoria Musheff: When we were younger, one or two weeks, we would… we would, make all the adaptations and go on, but we can't adapt as fast anymore.

748
01:21:40.560 --> 01:21:45.830
Victoria Musheff: And the most important thing is, if anything changes.

749
01:21:46.730 --> 01:21:49.379
Victoria Musheff: Put a pause on it. Check in.

750
01:21:49.520 --> 01:21:54.130
Victoria Musheff: Because you don't really know… If you're gonna make things worse. Oh.

751
01:21:55.050 --> 01:22:03.490
Victoria Musheff: Get up, stay up, move, I'm gonna let that go. And then see if you have any questions, or you're just so tired, you gotta go get lunch!

752
01:22:03.700 --> 01:22:07.200
Victoria Musheff: You wanna… you want to move? Out.

753
01:22:08.050 --> 01:22:26.059
Victoria Musheff: I would just tell people that, you know, last year, we've been walking for a long time and studying pits, noticing that going up was a little bit more difficult than it had been. Yeah. And so we just… he went to the doctor and ended up 3 stamps. Yes! So listen to your body.

754
01:22:26.360 --> 01:22:28.929
Victoria Musheff: Here, don't hit me.

755
01:22:29.110 --> 01:22:38.929
Victoria Musheff: Yeah, and just pushing the heart to work harder up at that maximal capacity was enough to say, we can't do it.

756
01:22:39.860 --> 01:22:59.180
Victoria Musheff: like, for, you know, and had we not been doing that, I don't know how long it would have been before we would have noticed the change. It may have been. But I think about things like that, too, so if you do have symptoms, don't ignore them. That's right, don't ignore them.

757
01:22:59.390 --> 01:23:05.940
Victoria Musheff: Good. I mean… Yeah, that's, magical thinking isn't gonna help you there.

758
01:23:06.140 --> 01:23:08.040
Victoria Musheff: You know? Alright.

759
01:23:08.150 --> 01:23:17.560
Victoria Musheff: I also like your suggestion of starting slow and using the wall one. Yes. Rolling chairs. Yeah, no rolling chairs.

760
01:23:18.140 --> 01:23:24.979
Victoria Musheff: Yes, use a… use a fixed chair, and it should be against a wall.

761
01:23:25.270 --> 01:23:34.530
Victoria Musheff: So that as you come back in and out of it, if you… if you do have some momentum coming back unexpectedly, it hits the wall, the chair doesn't tip back over.

762
01:23:34.620 --> 01:23:52.439
Victoria Musheff: No, that's a great strategy. What you're doing is getting the visual system to help you out a little bit, so that's a good place to start, but ultimately, once you kind of get comfortable with that.

763
01:23:52.640 --> 01:23:55.150
Victoria Musheff: You should try to do it and look around.

764
01:23:55.270 --> 01:24:09.030
Victoria Musheff: Because that's how life happens, right? And that's where some people might get off balance. They've practiced one way, and if… it's like, as long as everything is like this, I'm okay, but if I look around, my visual system

765
01:24:09.280 --> 01:24:14.540
Victoria Musheff: doesn't know how to work with me anymore. So start with focusing on a spot for balance.

766
01:24:15.020 --> 01:24:21.609
Victoria Musheff: And then try to look around doing that activity. As you get better at doing the spotted balance.

767
01:24:21.750 --> 01:24:24.439
Victoria Musheff: Start challenging yourself a little bit and look around.

768
01:24:24.640 --> 01:24:33.909
Victoria Musheff: Also, when you're doing the… like, when you're walking, you don't necessarily want to look at your feet. You're looking out a little farther ahead for proactive

769
01:24:34.430 --> 01:24:44.770
Victoria Musheff: assessment, like, what's coming up? Oh, we could… well, maybe we'll do this in the balance class, but there's an activity that I would do with my students where you put a block

770
01:24:45.020 --> 01:24:46.329
Victoria Musheff: In front of them.

771
01:24:47.190 --> 01:24:53.710
Victoria Musheff: You have them look at the block, they close their eyes, and have them walk forward. Their brain knows when to step.

772
01:24:53.820 --> 01:24:56.519
Victoria Musheff: Without seeing it. It's truly pretty cool.

773
01:24:58.900 --> 01:25:06.949
Victoria Musheff: that people should use. Yes, that's a great, so, shoes can be your friend, or they can…

774
01:25:07.200 --> 01:25:16.040
Victoria Musheff: you know, make… increase your risk. So you want, in general, like, everyday shoe, it shouldn't be so… cushiony.

775
01:25:16.260 --> 01:25:25.730
Victoria Musheff: That it actually becomes a squishy, unstable surface, and mutes the receptors in your feet from being able to know

776
01:25:25.870 --> 01:25:34.350
Victoria Musheff: know the surface it's walking on. It needs to be cushioned-y enough But these giant mega… platform cushions.

777
01:25:34.660 --> 01:25:38.980
Victoria Musheff: I mean, they're… they sell, but they're… they're not in our best interest.

778
01:25:39.260 --> 01:25:44.360
Victoria Musheff: You also would not want to use a running shoe.

779
01:25:45.050 --> 01:25:50.050
Victoria Musheff: If you're doing activities that involve lateral movement, because

780
01:25:50.570 --> 01:26:00.259
Victoria Musheff: The running shoe is a little flared at the bottom of the outsole, which is designed to dissipate impact stresses with running.

781
01:26:00.500 --> 01:26:07.069
Victoria Musheff: But when you're doing lateral movement, or something on carpet, it grabs the carpet, it will trip you.

782
01:26:07.250 --> 01:26:10.089
Victoria Musheff: So, get a court shoe for indoor work.

783
01:26:10.780 --> 01:26:20.129
Victoria Musheff: Court shoe, so that the platform is kind of… it has some grip, but it's not flared at the bottom.

784
01:26:20.390 --> 01:26:23.409
Victoria Musheff: It's just more straight at the outsole.

785
01:26:25.490 --> 01:26:36.060
Victoria Musheff: And… While you… Be careful, like, a lot of us are in what we call plantar flexion, just slightly

786
01:26:36.200 --> 01:26:47.399
Victoria Musheff: pointed toe, because our shoes have a little elevation, so we're actually… have maybe tighter Achilles tendons, the posterior lower leg muscles.

787
01:26:47.690 --> 01:26:53.280
Victoria Musheff: If you can do exercises in shoes that don't have as much

788
01:26:53.510 --> 01:26:56.610
Victoria Musheff: feel elevation? Like, they're not as cute.

789
01:26:58.180 --> 01:27:03.780
Victoria Musheff: That would be a good way to, you know, to kind of stretch those muscles, let those muscles train.

790
01:27:04.050 --> 01:27:08.040
Victoria Musheff: I know, you can see some of your running shoes, and you know, when you're running.

791
01:27:08.140 --> 01:27:10.709
Victoria Musheff: There's a lot of power in being on your toes.

792
01:27:11.700 --> 01:27:15.050
Victoria Musheff: But…

793
01:27:15.370 --> 01:27:24.410
Victoria Musheff: Well, if you're running, that's the right shoe, if you're not running. And even walking could be okay, but be careful with walking, you may do more lateral movements. You rarely do lateral movements running.

794
01:27:24.740 --> 01:27:35.450
Victoria Musheff: Great question. Other questions from Zoom, or… Not, not yet. No. No. Does anyone online have questions? Do you want to unmute?

795
01:27:36.540 --> 01:27:41.890
Lee Crandall: I don't really have a question, but I wanted to thank Karen for a wonderful presentation. It really.

796
01:27:41.890 --> 01:27:42.510
Victoria Musheff: Welcome.

797
01:27:42.510 --> 01:27:43.810
Lee Crandall: A lot from it, Karen.

798
01:27:44.350 --> 01:27:47.410
Victoria Musheff: Very welcome. It's fun. I love it.

799
01:27:48.950 --> 01:27:51.280
Victoria Musheff: Because it's very relevant.

800
01:27:51.730 --> 01:27:53.849
Lee Crandall: Yeah. It's just relatable, right?

801
01:27:54.200 --> 01:28:14.070
Victoria Musheff: One thing that I've been thinking about, you know, with falling and balance and things like that, I took Aikido when I was in college, and learned how to fall. I know. And it's fantastic, and I think everybody should do that. And, I did fall recently, and the brain did not react near as fast as it was supposed to.

802
01:28:14.070 --> 01:28:18.229
Victoria Musheff: Well, I've, you know, I, I agree with you.

803
01:28:18.230 --> 01:28:27.979
Victoria Musheff: We should learn to fall, but we should learn at 20. Yes, yes. Like CPR, learn it at 20, because I would be nervous about teaching anybody to fall.

804
01:28:28.060 --> 01:28:29.410
Victoria Musheff: Now!

805
01:28:29.530 --> 01:28:33.339
Victoria Musheff: Because the risk and return is not optimal.

806
01:28:33.490 --> 01:28:35.760
Victoria Musheff: There are things we can teach you.

807
01:28:36.030 --> 01:28:37.120
Victoria Musheff: that…

808
01:28:38.160 --> 01:28:47.469
Victoria Musheff: without quite falling, that might help you if it does happen, but it would be… I mean, I wish I learned to fall and took martial arts in my 20s.

809
01:28:48.580 --> 01:29:13.240
Victoria Musheff: It was… it was fantastic, because I fell off of a… I was on a roof getting off of a ladder on a concrete patio, and as I was falling, it was going to get in my way, so I kicked the ladder out of the way and fell down, and I got a little bite of bruises on my arms and things like that. I was lucky! Well, it was braving. Yeah.

810
01:29:13.330 --> 01:29:20.970
Victoria Musheff: That was lucky, though, I mean, so many things could have turned a different way. I was at a workshop a couple years ago.

811
01:29:21.140 --> 01:29:27.859
Victoria Musheff: With a group of folks who were in their 70s and 80s… 60s, 70s, and 80s. I was one of them.

812
01:29:28.160 --> 01:29:34.210
Victoria Musheff: And the… one of the presenters, he and his wife were the leaders, they were in there… they were both 85.

813
01:29:34.330 --> 01:29:39.180
Victoria Musheff: And while we were kind of breaking and doing transition, P…

814
01:29:39.360 --> 01:29:45.319
Victoria Musheff: fell backwards, and I thought, oh my gosh, we're gonna have a fall injury here at the workshop.

815
01:29:45.680 --> 01:29:51.979
Victoria Musheff: D… Collapsed down, rolled his feet back up, came back up, whoop!

816
01:29:52.720 --> 01:30:00.680
Victoria Musheff: And he, was a skydiver. He knew how to fall. Yeah. I was…

817
01:30:00.800 --> 01:30:03.530
Victoria Musheff: I was just amazed at his ability.

818
01:30:03.690 --> 01:30:10.550
Victoria Musheff: to do that, but it's… I think… let me just say, I'm not willing to take the risk to try to teach somebody that at this point.

819
01:30:11.690 --> 01:30:29.230
Victoria Musheff: I've had so many of my friends who've gotten up out of a rocking chair and broke their ankle. Yeah. Or they, you know… I mean, I've had 3 people that I know that have had broken ankles from what I would consider… Routine.

820
01:30:29.250 --> 01:30:43.379
Victoria Musheff: Just nothing. I mean, nothing. So… It's like a twist, they twisted their ankle, but instead of twisting it, it grew. Yeah. And… So when the bones are… Well, when the bones are more fragile.

821
01:30:43.470 --> 01:30:46.410
Victoria Musheff: Their bones are always receiving a load.

822
01:30:46.880 --> 01:30:55.290
Victoria Musheff: And you get loads in different ways, and unfortunately, it's like the straw that breaks the camel's back.

823
01:30:55.600 --> 01:31:01.950
Victoria Musheff: If that was a weak point for them, and they put a lot of load that they may have done all their life, but today was the day.

824
01:31:02.080 --> 01:31:19.629
Victoria Musheff: that that bone at its fragile point couldn't take that load, or there may have just been just enough force on it at that angle, which was one of the reasons we screened out osteoporosis with the balance class, because there's a lot more to think about. Not that we would never work with them. I have osteoporosis.

825
01:31:20.000 --> 01:31:27.999
Victoria Musheff: It's just more complicated. So… The folks with lower bone density, ideally you're working with somebody.

826
01:31:28.310 --> 01:31:29.790
Victoria Musheff: who,

827
01:31:30.500 --> 01:31:41.200
Victoria Musheff: has real tailored expertise to osteoporosis. I don't think that's easily obtained, by the way. I don't think it's easy to find that. I've heard of a couple people in Greenville,

828
01:31:44.430 --> 01:31:47.980
Victoria Musheff: So I'm not sure there would be anything to say that they would have…

829
01:31:48.260 --> 01:31:54.460
Victoria Musheff: how you could counsel them to prevent that. It's just that the earlier the better, if you can do some things

830
01:31:54.840 --> 01:32:19.370
Victoria Musheff: to create stronger muscles around those bones. Muscles and tendons as well. Yeah, so… Everything was just weaker, and it was… Yeah, it was the perfect storm, and that… Here, the other thing is the safety rails, things like that. Yeah. Even if you're not using them, they have that right there. Yes. I was at the… our library in Anderson has all granite steps, two flights, granite steps.

831
01:32:19.470 --> 01:32:26.070
Victoria Musheff: And I was noticing some of the young people almost running down the steps, nowhere near the rail. Yeah.

832
01:32:26.120 --> 01:32:41.760
Victoria Musheff: Did I ever do that? You did, you did! The rail is right here, I'm not always grabbing on it, but it's right there, because thinking about a whole flight of granite steps and how much damage you could do… Yes. And what's great, you raised such a… you raised such a great point, too, because

833
01:32:41.760 --> 01:32:49.300
Victoria Musheff: What happens when you have that railing? It's not necessarily gripping it to help you get down the stairs, but just touching it.

834
01:32:49.300 --> 01:33:02.400
Victoria Musheff: Provide your brain with extra data about what's going on, so that you're better able to navigate the steps. And you can grab it if you… If you need it, yeah. But just that touching is, like, at… it isn't…

835
01:33:02.600 --> 01:33:14.230
Victoria Musheff: It's not to be taken lightly, it's extra data. The brain is saying, okay, I know where I am, okay, I know what we're doing. And then it also says, and if I have a problem, I can recover myself.

836
01:33:15.400 --> 01:33:28.930
Victoria Musheff: The other thing I've noticed is this is, that if steps are uneven… Yeah. For example, if something shifts at all, you know, you expect to… we have standardized… Yes, that's why we have them!

837
01:33:29.120 --> 01:33:36.690
Victoria Musheff: But not everybody has standards. That's right. Because the houses may be older, they've added… DIY.

838
01:33:36.690 --> 01:33:55.820
Victoria Musheff: And just that little… even some fraction of an inch of unexpected height, or… Yeah. The older we can throw you out of the edge. That's right, you can't recover. Then that comes back to proprioception, and we've all been in a situation where we thought there was one more step, and there wasn't, and you kind of had that odd…

839
01:33:56.590 --> 01:33:58.790
Victoria Musheff: You know, step, surprise.

840
01:33:58.900 --> 01:34:07.029
Victoria Musheff: When the stairs are uneven and we're not able to anticipate it, it really can throw you off.

841
01:34:09.190 --> 01:34:17.250
Victoria Musheff: Which, when we… so one of our grad students who did his dissertation looking at falls and hot spots of falls around the state.

842
01:34:17.500 --> 01:34:19.820
Victoria Musheff: Found that people…

843
01:34:20.310 --> 01:34:33.850
Victoria Musheff: were frequent followers at outdoor events, like farmers markets and things where the terrain was less familiar, and there was more unevenness, and they just… Yeah, yeah. Yes.

844
01:34:33.960 --> 01:34:39.410
Victoria Musheff: Yeah, yeah, you're carrying, and you're… and bumping, there's bumping. So…

845
01:34:39.690 --> 01:34:42.460
Victoria Musheff: that's probably a great time, like, I do think…

846
01:34:43.080 --> 01:34:47.789
Victoria Musheff: A ski pole, or a hiking pole, can be a good…

847
01:34:47.900 --> 01:34:56.060
Victoria Musheff: helper, not, like, to bear your weight on it, but to kind of stabilize, touch point, when you're in an unfamiliar place.

848
01:34:56.260 --> 01:35:14.580
Victoria Musheff: To be… I took one out when I was walking the dog in the snow, but I knew there was some ice in there, too. Yeah. Just having that… Yeah, you could test it, and also stabilize. When you go on one leg and you have a touchpoint, things are gonna work out a lot better than nothing, right? Like, especially if that foot goes…

849
01:35:16.650 --> 01:35:36.640
Victoria Musheff: The floor seems more dangerous than in the house, but I guess more falls really happen in the house, because that's where we are. Yeah. We've become sudden, we're not outside as much, but when, you know, I think about wet leaves, you know, hiking, and the group that I go with birdie with, there's a lot of danger in that birdie, because the ground

850
01:35:36.640 --> 01:35:44.190
Victoria Musheff: that you're walking on is… Yeah. One of the ladies who was in one of our Matter of Balance classes,

851
01:35:44.500 --> 01:35:51.199
Victoria Musheff: We had spring break, so the students, you know, were gone, so they had a week off. We come back, and one of our ladies had a broken arm.

852
01:35:51.700 --> 01:35:54.780
Victoria Musheff: Because she loves to hike, and she,

853
01:35:54.900 --> 01:35:59.139
Victoria Musheff: Was hiking and fell backwards and broke her arm.

854
01:35:59.770 --> 01:36:02.549
Victoria Musheff: Fortunately, it was kind of a mixed blessing.

855
01:36:03.040 --> 01:36:08.100
Victoria Musheff: She had a backpack, and so when she lost her balance, there was a lot more force

856
01:36:08.350 --> 01:36:13.040
Victoria Musheff: Pulling her back, she couldn't overcome it, but it also protected her from hitting her head.

857
01:36:13.450 --> 01:36:19.350
Victoria Musheff: Her arm paid the price, so she fell back on the arm, but it just shows you, like, that…

858
01:36:19.660 --> 01:36:22.830
Victoria Musheff: Those places where you may have been able to recover.

859
01:36:24.060 --> 01:36:28.860
Victoria Musheff: become a little more dangerous. So that's why it's important to train for what you want to do.

860
01:36:29.200 --> 01:36:31.060
Victoria Musheff: like, training…

861
01:36:31.420 --> 01:36:39.880
Victoria Musheff: training for stepping back really quickly. That's… that's a thing to practice, so that you can… can do that. But I don't know that she could have…

862
01:36:40.130 --> 01:36:41.960
Victoria Musheff: Done anything on a…

863
01:36:42.440 --> 01:36:48.100
Victoria Musheff: odd incline in a… on a trail, right? I don't know, I didn't… I wasn't there, but…

864
01:36:48.310 --> 01:36:56.809
Victoria Musheff: Yeah. Yeah. Yeah.

865
01:36:57.640 --> 01:37:01.529
Victoria Musheff: Hello, you guys. Thank you! Thank you, it was fun, thank you.

866
01:37:02.640 --> 01:37:07.350
Victoria Musheff: I hope you will, partake in some balance of strength activities.

867
01:37:07.840 --> 01:37:13.499
Victoria Musheff: And… By Zoom, folks! Thank you!

868
01:37:14.460 --> 01:37:23.760
Victoria Musheff: Practice safely. Then that gentleman fell backwards and rolled? He… Well, what he did was…

869
01:37:23.880 --> 01:37:27.790
Victoria Musheff: He collapsed. Like, he knew he was going back, it was so fast.

870
01:37:28.230 --> 01:37:45.539
Victoria Musheff: He knew he was going back, it was like slow motion. He collapsed, which is a thing you're supposed to do, right? Don't become, like, a lever system to fall back. He collapsed, he rolled up, he came back up, whoop, and he's 85.

871
01:37:45.690 --> 01:38:05.060
Victoria Musheff: And I… I was like, are you okay? Yes, I'm fine. Well, the whole idea of that is, if you roll a cube, it chips to corners. You roll a cylinder, it does it. Yeah. And that's the whole idea. And I know it forward, I've never seen it done backwards, but it's the same process. But you took your head.

872
01:38:05.060 --> 01:38:14.350
Victoria Musheff: Right. This is not, you know, this is sensitive, and when you roll, you roll from this shoulder to this hip, so you're only crossing the spline at one point.

873
01:38:14.670 --> 01:38:21.640
Victoria Musheff: But that's a skill that I wish I had learned younger. I've been watching videos to see how

874
01:38:21.790 --> 01:38:24.400
Victoria Musheff: Therapist train falling.

875
01:38:24.590 --> 01:38:28.949
Victoria Musheff: I will never teach it, but I want to try to understand it,

876
01:38:29.170 --> 01:38:31.990
Victoria Musheff: And maybe get a physical therapist to help, but it…

877
01:38:32.640 --> 01:38:49.260
Victoria Musheff: We need to be doing it with the college students, actually. College students need to learn how to fall. You're learning on cushions. Yeah, you're learning on cushions. So even with the training, the guy has you falling on a bed, he's teaching you how to displace impact by slapping the floor.

878
01:38:49.670 --> 01:38:53.360
Victoria Musheff: They… we just need to do that earlier.

879
01:38:53.490 --> 01:39:13.349
Victoria Musheff: to have fun with. We'd have, you know, 5 people, you know, bent over like this, and we'd dive over them and then do a rollout at the other end. But that was… you had been in college, so I was in my 20s. Yeah, you'd only been on Earth 20 years. You had only been on Earth 20 years, you hadn't worn everything out.

880
01:39:16.730 --> 01:39:33.970
Victoria Musheff: watching all this, when I had my hip surgery, they put us into classes before we had surgery. Good. And if every one of these exercises were… we're supposed to do them for, like, 6 weeks, every day, leading up to surgery. So, after surgery.

881
01:39:33.970 --> 01:39:37.210
Victoria Musheff: You continue those same things, but they…

882
01:39:37.210 --> 01:39:41.560
Victoria Musheff: Really, they felt like the muscles were prepared. Yes!

883
01:39:41.610 --> 01:39:47.299
Victoria Musheff: Yeah, and you're… It didn't end up happening.

884
01:39:47.500 --> 01:39:50.030
Victoria Musheff: There's a word for it.

885
01:39:50.390 --> 01:39:54.480
Victoria Musheff: It's the pre-rehab now, right? Do they call it pre-rehab or something?

886
01:39:54.790 --> 01:40:03.010
Victoria Musheff: But then I'll keep you in the postcards a little while. Yeah.

887
01:40:03.600 --> 01:40:10.639
Victoria Musheff: Alright, you've already learned to talk to the muscles. You've gotten that distinct.

888
01:40:10.880 --> 01:40:18.710
Victoria Musheff: Oh, I can do these exercises. Yeah, yeah. It was a $6 billion man in bullshit.

889
01:40:19.590 --> 01:40:27.879
Victoria Musheff: It's pretty nice. Here's a scholarship.