You CAN Reverse Aging Muscle Losses! Part 1

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Push-Up Elderly

James W. Youdas, PT, MS is Associate Professor of Physical Therapy at the Mayo Clinic’s Mayo School of Health Sciences, College of Medicine, teaching gross human anatomy and kinesiology to doctoral students in physical therapy. He is also a researcher and author of 49 journal articles focused on human locomotion, muscle strength, and joint range of motion, including a study comparing conventional push-up and perfect push-up exercises.

HHN: The American College of Sports Medicine says: "Adults should train each major muscle group two or three days each week." Why is muscle group training necessary?

JY: Our muscles need to be used to be effective movers and stabilizers of our limbs and trunk. As we age, we lose muscle fibers and strength. By the sixth decade, people who don’t exercise the major muscle groups regularly will find it difficult to do daily activities they’ve taken for granted, such as walking (torso, leg and foot muscles), moving grocery bags (shoulder, arm, and forearm muscles), rising from a chair or toilet (hip and thigh muscles), or climbing even just a few stairs (back, hip, thigh, and posterior calf muscles).

The good news is, we can halt and even reverse the muscle fiber and strength losses associated with aging. A body of research shows that by training the major muscle groups two or three days a week, we can keep our muscles functioning fairly optimally as we perform activities of daily living in our later years.

HHN: Let’s zero in on the 3 upper body muscle groups. What are they, and what accessible training exercises do you recommend?

JY: 1Torso Muscles: They stabilize our trunks during lifting, throwing, walking, climbing steps, and running. Often they’re called the "core." Back and abdominal.2Shoulder Muscles: They move our shoulders when we start lawn mowers or lift children or push revolving doors as we enter or leave a building. Deltoids, latissimus dorsi, trapezius, pectoralis major, serratus anterior, and rotator cuff.3Arm and Forearm Muscles: They help us lift objects and move our hands when we grasp them. Elbow flexors and extensors, wrist flexors and extensors.

Push-ups (pushing) and pulling/rowing exercises are excellent for keeping the torso (back and core), shoulder, and arm muscles strong. Both are also simple to learn and can be modified to individual fitness levels, as I’ll explain. Note: It’s important not to choose one or the other, but to incorporate both pushing and pulling exercises into your workouts.

HHN: Why is it unwise to do push-up/pushing training without also doing pulling training?

JY: Push-ups strengthen and shorten the pushing muscles, but do not train or correspondingly shorten the pulling muscles on the back of the upper arm and between the shoulder blades, which can lead to muscle imbalances and result in rounded shoulders, shoulder pain, and/or a "forward head" posture, associated with posterior neck pain.

In addition, doing push-up training alone doesn’t stimulate all the muscles necessary for good posture (such as the middle and lower fibers of the trapezius and the rhomboids) or for safe lifting (such as the latissimus dorsi and gluteus maximus).

HHN: What are the benefits from doing push-ups?

JY: You might see these effects after two months of training:

  • The ability to lift heavier loads.
  • Less back pain
  • Less fatigue when standing
  • Improved muscle tone in your chest and arms
  • Straighter posture when sitting or standing.

HHN: Some readers may be unable to do a standard push-up. What’s the easiest and safest push-up alternative?

JY: If you can’t complete a standard push-up from the face down position, modify the starting position.

Begin with a standing push-up. Stand and face a wall with your feet at arm’s length from the wall and your knees apart. Lean forward and place your palms on the wall at shoulder height but slightly wider than the shoulders. The fingers should point vertically.

Bend the elbows slowly and lower your chest while contracting your belly muscles and keeping your back straight (no sagging or arching). Stop when your elbows are bent to about 90°. Return to the starting positon by straightening your elbows.

Perform the standing push-up 5 to 10 times. Alternatively, keep going until you cannot do another push-up. Your fitness level will then guide the number of repetitions best for you.

To make maximum progress, do 3 push-up sessions a week. Rest 48−72 hours between sets. Keep training, and you’ll keep improving.

In time, when you are able to do the number of push-ups the American College of Sports Medicine recommends for your age and gender, per below, you’ll be ready to advance to a more challenging push-up position.

Number of Push-Ups for Your Age and Gender

Men aged:

  • 20 — 29: 35−44 standard push-ups
  • 30 — 39: 24−34 standard push-ups
  • 40 — 49: 20−29 standard push-ups
  • 50 — 59: 15−24 standard push-ups
  • 60+: 10−19 standard push-ups

Women aged:

  • 20 — 29: 17−33 modified prone push-ups (discussed next)
  • 30 — 39: 12−24 modified prone push-ups
  • 40 — 49: 8−19 modified prone push-ups
  • 50 — 59: 6−14 modified prone push-ups
  • 60+: 3−4 modified prone push-ups

HHN: What’s the more challenging push-up position?

JY: The modified prone push-up noted above. Here’s how to do it right:

Get on your hands (fingers forward) and knees, facing the floor. Place your hands about shoulder-width apart. Your knees should be about 6 inches apart. Your feet should not be in contact with the floor.

Slowly lower the upper body while tightening the abdominal muscles and keeping your back straight. Stop when your elbows are bent to 90°. Slowly return to the starting position.

Do one set of modified prone push-ups until you can’t perform another push-up. In other words, train to failure. Your fitness level will guide the number of push-ups best for you.

To make maximum progress, do 3 push-up sessions a week. Rest 48−72 hours between sets. Keep training, and you’ll keep improving.

When you’re able to do the number of push-ups the American College of Sports Medicine recommends for your age and gender, per above, advance to the standard push-up position.

HHN: What’s proper standard push-up form?

JY: Place your hands and feet on the ground. Your hands should be just slightly more than shoulder width apart, and your fingers pointed forward. Your lower back should be in a neutral position, neither sagging nor arching.

If you can’t go down all the way, you can "cheat" by stopping before the elbows bend to 90°. That’s fine as you work up to the 90° angle.

Correct form and function, though, is critical:

  • Keep your back straight when lowering and raising your trunk. If you can’t do this, then the conventional push-up is too demanding. Continue training with the modified push-up until your performance improves.
  • Make sure your hands are slightly more than shoulder-width apart. Positioning the hands too narrowly will cause the triceps and pectoralis major muscles to work excessively and lead to premature fatigue. Positioning the hands too widely, depending on arm length, may overwork the pectoral muscles and increase anterior strain at the glenohumeral/shoulder joint.
  • Check that you’re not doing push-ups too rapidly. People who do push-ups very quickly often fail to complete the full trunk ascent/descent, thereby not realizing maximum muscle activation benefits. I recommend at least 2-seconds per push-up: 1 second descent, 1 second ascent.
  • Be cognizant of shoulder, wrist, or hand pain. If you have wrist pain, [for example, you may be able to diminish it by using push-up bars with padded handles, which eliminate the need for the palms to be placed flat on the floor. If you have shoulder pain, repositioning your hands per above might help. But if the pain is relentless, stop performing the push-up.

Do one set of standard push-ups until you can’t perform another push-up. In other words, train to failure. Your fitness level will guide the number of push-ups best for you.

To make maximum progress, do 3 push-up sessions a week. Rest 48−72 hours between sets. Keep training, and you’ll keep improving.

HHN: The media is awash with various push-up protocols, many with multiple sets. You recommend doing just one set until failure. Why? Is this the protocol best supported by scientific evidence?

JY: I’m not aware of any specific push-up protocol supported by scientific evidence. We do know that too many sets on top of reps can lead to overuse and injuries. And the American College of Sports Medicine estimates that 70% of strength gains can happen in the first training set if performed to failure. In this way, you’ll get stronger safely.

HHN: You spoke earlier of the importance of balancing push-up training with pulling training. What exercise do you recommend?

JY: A rowing exercise is an excellent sequel to and balance for push-ups. Rowing will strengthen your back muscles weakened from poor posture acquired from slump sitting. And it’s easy to do at home using elastic bands, which have varied tensile strengths to accommodate different users' pulling strength.

To properly do the simple rowing workout called a standing back row, see this video.

Another option is to do pull-ups using a pull-up bar you can install (and, if you wish, easily remove) at home.

Most importantly, remember: You are the best judge of what works for you. If you’re overusing your muscles, your body will give you signs. More than to anyone else, always "listen" to your body.

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