Tall and strong at a young age, I was good at contact sports, particularly rugby and field athletics – running at someone, throwing anything and jumping were all fun for me. It was all about strength, condition and being bullet proof.

Dislocated left shoulder – shrug it off!        Torn right knee cartilage – move on!        Concussion – shake your head and get back up again.

Then, work and career started to get in the way. I married. We started a family. Professional training.  Change of career. More qualifications.  Walking with the kids and dog don’t really count, do they? Sport and exercise got put aside.

Twenty years pass. Sporadic attempts at gym, squash, circuits, and the rest. The kids grow up. Then, “40 years old” arrives and passes. Time to get rid of the growing belly. Back to the gym in earnest.

Boring, boring, boring! Too many ‘beautiful people’ who put me off and seemed so judgemental at my lack of focus and progress. Looking back, the problem was me not knowing what I wanted.

Next? A chance conversation and I was introduced to mountain biking. Now, this presses the right buttons! Wonderful and refreshing in its freedom and variability. Expensive, mind you! Great for aerobic fitness, balance and stamina – but ultimately, you get fit for what you are doing.

The activity doesn’t matter; tennis, running, rugby, and the rest – all wonderful but something was missing – I could bike a steep hill with the best and the rest, but couldn’t run up the street without puffing. The fitness was too specific, too focused.

It took another injury, severe this time, to make, no, force me to think about what I was doing. In my case, I came across kettlebell and body weight training and this works for me, physically and, more importantly, mentally. I enjoyed it and continue to enjoy it. Total body workout, flexible, aerobic and balanced. You can go heavy or light, hard or gentle.

Frankly,what works for me doesn’t matter – at my age so many people are searching for a specific or magical regime or principle that they can work to, a set of rules that they can follow. Well, let me spell it out – THERE IS NO SUCH THING! Human beings are just too variable, we all have the baggage of our particular genetics, history, fears and wants.

This means that even when we exercise in a group, there is a huge range of variability and you have a responsibility to look at what is both good and safe for you to engage in. If this wasn’t true we wouldn’t have specialist participants, (who ‘play to their strength’), in every team sport that I can think of!  Why, then do we imagine that synchronised mass step aerobics, for example, is suiting everyone and yet you don’t see anyone doing their own thing. Peer pressure – think for yourselves!

Most, if not all of this more mature age group, carry injuries. Most will have arthritic changes. The fast, twitch muscle fibres are fast disappearing. Recovery times are longer even just after each training session, let alone injuries!

Then, if that is not enough, even those who manage to get to a class, (of whatever type), are so often greeted by these lovely specimens of male and female beauty and physical perfection!

It’s enough to make you run a mile.

BUT DON’T, please don’t. Don’t blame the trainers for your lack of success in class or even for putting you off from taking up a class.

As an Osteopath, I mostly deal with illness and the effects of injury. Personal Trainers deal with wellness and do their best to avoid injury during training. This is an important distinction, especially as we age and I believe we should keep this in mind when we are choosing our direction.

What I think we should do is to ask,  “WHERE ARE ALL THE MIDDLE AGED TRAINERS?” Why aren’t trainers  staying in the business into their middle years? Why aren’t people of my age taking up training as physical trainers?

Plenty are training as therapists. Why? Perhaps because there are so many people who need treatment and therapy! Why not try and prevent rather than treat?

Let’s face it, these skilled but youthful trainers are wonderful. I have absolutely no criticism other than one that they simply cannot help, and that is their lack of experience in FEELING what I feel.

Most are sympathetic to the middle aged groaning, but aren’t generally empathetic. How can they be?

So, where do trainers go when they get to 35? Why does there seem to be a gap until the emergence of the 65 year old yoga teacher who leads sit-down, ‘aerobics’ in a Care Home?

OK, so I’m going over the top a bit, but I believe that most 40-60 year olds will recognise what I am saying. I try, in my professional life, to encourage exercise, movements, stretching and flexibility to my clients.

Within reason, clinically speaking, I don’t care what they do – If you hate swimming, don’t do it – very good for you but you won’t keep it up. Find your level, use advisors of course, but do what you are going to continue.

Squats or lunges while brushing your teeth. Sumo squats when you stand at the sink. Pull up your pelvic floor and lower abs when weeding the flower bed. Whatever works. Now, this chimes with me with the philosophy that Rannoch Donald is espousing with the 100 Rep Challenge. I strongly recommend you take a little of your valuable time and look at the site and Face Book page and you will see loads of examples of 100 rep sequences. Sure, the macho, the hardened, ‘no pain, no gainers’, the fab abs lot and many more are represented. But you will also find something for you. It’s not how hard you are or even how hard you do it, but that you do it.

Whatever it is!

Find something that fits your life, health state, age and desires. Your motivation doesn’t really matter to anyone other than you, better health, flatter belly, serenity, a better sex life – No one else’s business, but your own – my advice, if anyone cares, is to get your starting premise right and then design your own regime.

Rannoch Donald, Jonathan Lewis, Christian Vila, Steve Cotter, Mark Stroud and many others have great ideas about fitness and can give you a fantastic programme, but, (and I think they would all agree), they will all tell you to be clear about your objectives, don’t just follow the latest trends – think about how their method and advice will fit for you and your lifestyle.

So, what do I want from my exercise regime? None of your business. You have to work out what suits you and do what it takes to achieve it, (with a bit of professional help and guidance, of course).

Good luck.

SHOULDER EXERCISE – MOBILIZATION USING FIT BALL

References;

Wikipedia defines  the general population that use personal/physical trainers “as an age range of 18 to about 50 (45 and younger for males, 55 and younger for females)”. One internet thread I found asked, ‘what is the average age of trainers?’ and was full of well intentioned individuals with great mission statements, but not one of them was over 31!

There are a few certification courses for older trainers and for those training older individuals, but they seem mainly to be in the US.

Interesting article on STRENGTH TRAINING FOR THE OVER FIFTIES

Dear Andrew,

I have indeed been using the Rotater and it has proved to be useful in relieving the aches and strains – particularly those associated with carrying heavy bergens and daysacks for extended periods of time. I find this activity caused a person to slightly hunch and turn their shoulders inwards to compensate for the load across the back. This effect coupled with the need to have a two handed grip on the rife which is carried across the body with one hand on the pistol grip and the other supporting under the barrel area of the weapon really limits the mobility in the upper body.

It’s a useful activity to spend a few minutes in the evening after a loaded march using the Rotater – especially that movement where you have your upper arm parallel to the floor, arm at 90°, fingers pointing forwards and then push your elbow back – opening up the chest and loosening off the muscles at the front of the shoulder that seem to tighten over time and cause you to walk with rounded shoulders – like a boxer.

I have been boxing again this term so the stresses and strains on my shoulders were eased by using the Rotater and keeping them a bit more supple.

I lent the device to my friend who is a great swimmer and was complaining of tightness in the shoulders following a lot of front crawl. He used it for a couple of weeks and was very enthusiastic about its benefits to him so perhaps swimmers are another potential group of people to explore?

I hope this helps, apologies once again for the delay in sending this field report.

Daniel.

Get yourselves a copy on the newstand or check out their online version

Get yourself a Rotater at ShoulderCentric.

“Hi Andy,
Yeah, getting on well with it. definitely got more movement in my shoulders, my arm goes back at more of an angle now when I use it. I’ve been boxing twice a week with Scott (Welch) and my shoulders are
absolutely dead after a session and the next day so been using it to loosen them up and make them feel normal again. Cheers, Mat”

“The problem many golfers face as they get older is a lack of flexibility which makes your great golf shots a part of your memory bank. Having competed in Long Drive competitions winning the Nitro Long Drive for Seniors in 1997 at the age of fifty here I am in 2010 at 62 years old still able to hit it 300 plu…s. # years ago at the Vegas PGA show I met Scott and Chris at the show. My shoulder flexibility had decreased due to calcium buildup from years of injuries. I was shown how to use the Rotator and saw the guys again at the show in Orlando. It was amazing to them and to me how much additional movement and how the regular use of the Rotator had broken down the scar tissue. It is now a part of my daily stretching and my regular golf warm up. My turn and shoulder flexibility is as good now as it was years ago. Now if we could get the guys to invent something as dramatic for the hips Nicklaus, Watson and soon my self would not need so much surgery on our hips. Kudos to you guys. Can’t imagine a more helpful and easy to use aid”.

The Rotater is available in the UK from ShoulderCentric.

First, I am a Registered Osteopath and must state that my interest in this opinion piece is for the relevance of Kettlebell for people who already have back, neck and/or shoulder problems.

More specifically for those who are chronic or long term sufferers. Also, this is quite a long rant, but please bear with me because the general issue of how we tackle chronic back pain in this country is a serious one and often badly tackled and underfunded.

Anyone with an acute back problem should avoid strenuous exercise until they have been properly assessed by a Registered Osteopath, physiotherapist or appropriate medical practitioner.

Second, you may well ask, what on earth is Kettlebell? This dynamic exercise and training form is currently making itself felt throughout the fitness industry and claims the patronage of many celebrities, (Jennifer Lopez, Matthew McConaughey, Gerri Halliwell and Penelope Cruz are often mentioned), Russian Special Forces, boxers, cross-fit trainers, MMA* fighters and football clubs.

Raging through the US for the last decade with crossfit trainers and fitness adherents, the disipline has been in the UK for the last few years and it has now reached a prominence that is hard to ignore.

Its origins are not entirely clear but lifting weights to improve strength and fitness goes back as long as boys have wanted to show off . Kettlebells have been claimed by the Russians, Turks and Scots, (who apparently trained with small church bells!). The kettlebell or Girya resembles a cannonball with a handle. Incidentally, they do not ring. The only sound created is the heavy breathing of the user and the occasional clang as the bell finds the floor early!

Weights vary from 4Kg to 60kg, although typically 8kg, 12kg, 16kg and 20kg are used by normal mortals. The more capable and ambitious ‘kettlebellers’ are called Gireviks, Russian for weightlifter.

Now, it is not my business to promote Kettlebell as a practise, there are plenty of more able people out there who can do that, but must declare that I am an enthusiastic participant who has benefited, and has done so at a number of levels.

What is the technique?

A good whole body mobilisation is essential. Some moderate aerobic exercise such as jogging, star jumps, squats and arm swinging,  shoulder, neck and quads stretches take place over several minutes. Now I know that the evidence for stretching before exercise is now felt not to help in preventing injury, but you will need 6-10 minutes of cardiovascular ‘warm-up’ for the session that follows.

For the chronic back pain sufferer, I think this gives hope. All too often, rehab programmes concentrate on passive stretching and mobilisation, rather than a return to CV health and strength. Personal and professional experience tells me that someone with a 20 year history of back pain is afraid of the consequences of exercise.

The attitude is ‘better the devil we know’ and all that. Maintaining the status quo is better, in the minds of many, than ’stirring things up’, which is often the experience they have starting a new exercise programme. It takes a lot of courage to start a regime knowing that it may well make things feel worse to begin with.

However,the important word there is FEEL. I spend much of my clinical time agreeing with patients when they say, “but won’t that exercise make it hurt more?”. They don’t expect me to agree, because previous advice will often have been about caution and ‘don’t do too much’.

Being frank about what will happen is often more to do with the therapist making their own life easier; management of the patient rather than management of the condition. Both are needed, but it’s the emphasis that may need looking at! Please remember, hurting more does not necessarily equate to damage!

Of course, there are risks, but with proper guidance from your Osteopath, Physiotherapist or health advisor and in conjunction with your trainer, doing damage or causing any permanent worsening of symptoms is unlikely.

The trick is to take the right amount of time for the individual and this is where group classes can be weak – frankly, even the best trainers can’t be expected to tailor programmes for each person in a class of 20+. Don’t blame the class leader though, take personal control and think of how you get around the issue.

So, what is the answer? Well, one answer is to take personal tuition to begin with. Yes it can be expensive, but at say £35 to £40 per session over say 4 weeks, it’s cheaper than an overnight stay in London. Put bluntly, I know plenty of my chronic back pain patients do that fairly regularly ‘as a treat’. So treat yourself to being well and it may improve your mood and mental well-being as well – radical stuff, eh?

Probably sounds smug, but it’s what I did. I took a couple of 1-1 lessons and was joined by a friend for a further 2, (price went down for 2 by the way), then another friend for two last sessions. Then I felt ready to join a group class. Let’s face it, most blokes don’t want to look like they don’t know what they are doing and most women don’t like to be stared at!! No doubt that sounds somehow sexist, but I hope you know what I am getting at.

Photo courtesy Paige Waehner

The basic form is the TWO HANDED KETTLEBELL SWING. I won’t describe each exercise in detail, but the kettlebell swing is where it all starts and the technique must be good to both protect your back and get the most out of the exercise.

The swing mainly targets  the legs and abdominal muscles, the back, (BUT NOT WHILE BENT),the hip rotators and increases cardiovascular endurance. The swing element comes from contact with the inner arm as it meets the inner thigh and the thrust generated by a crisp forward thrust of the hips/pelvis.

The aerobic nature of the exercise is what startled me most when I started.

The next technique to master is the CLEAN.

Clean 1st Pos - Photo Christian Vila

Clean 2nd Pos - Photo Christian Vila

The kettlebell design allows for the weight to roll around the hand and wrist as you lift into the clean, keeping it balanced and ‘close packed’.

Once again, the power is coming from the thighs, abdomen and to some extent the lower back, dynamic, fluid and using the whole body to distribute any stresses. However, you can see that the back is held in a neutral or slightly extended position.

The lifting arm is held close to the body to protect the joints in the arm and shoulder. This is crucial, as injuries to the rotator cuff are common when weights are used with the arms extended or stretched out.  The loose arm is used for balance and seems to help focus the dynamic nature of the move.

PRESS - Photo Christian Vila

The next move is a continuation of the CLEAN; the PRESS can be seen in the image here. Particularly good for shoulder, shoulder blade and upper back muscles, it is once again using the whole body, flowing from one structure to another and while the joints are used throughout their range.  There are few static moments during kettlebell moves, the time when soft and bony structures are most stressed, and so helps in reducing the risk of damage.

While excellent for promoting mobility in the joints at each end of the collar bone, the upper ribs and neck, this exercise needs to be done with good technique. This often means using an approriate weight. I have seen people struggling with too much weight, the technique suffers with the consequent risk of neck strain.

I should also say that the leaders of the class that I attend are very hot on this and encourage swapping weights during a set – the emphasis is on keeping going safely rather than emulating Atlas.

The static presses and exertions of  ‘regular’ gym weights, fixed or free, do, in my view, carry the risk of over-extension of the joints and point pressure on vulnerable structures such as the rotator cuff insertion, acromio-claviclular joint,  knee and shoulder cartilages.

There are plenty of other basic forms, but check those out on the kettlebell sites, (see examples below), as there are variations and styles that should suit most needs.

So, after all that, is it good for your back? Please remember that the back, (or spine), to physical therapists also includes the neck.

Succinctly, if you are well but unfit and want to become so, then yes. If you have back problems, then proceed with some caution!

However, as with all exercise forms, make sure that you seek out well qualified trainers and yet be strong enough in yourself to proceed at your own pace. Their job, in my view, is to provide the knowledge, support and skills, plus the encouragement to keep going and to draw out your motivation.

In conclusion, I like this regime because it is dynamic, relatively low impact and uses the joints through their whole range. It flows, is as much about balance and technique as it is about strength, yet improves power.

Kettlebell is an excellent mix of aerobic exercise and fat-burning, with muscle toning that doesn’t produce too much bulk.

It is egalitarian and friendly. My experience is that the men and women who go are not there just to look wonderful, but to improve themselves generally. Sounds a bit twee, but I mean it. Posers are at an absolute minimum and overt testosterone is low. There is a good mix of abilities, ages and, lets say, weight categories and there is an old-fashioned helpfulness, at least in the class I attend.

Go on, give it a go. As previously stated, check with someone qualified to judge but you may well be surprised by how much you will benefit!

Andrew Bellamy

Training in the Brighton, East & West Sussex area.

http://www.brightonkettlebells.co.uk/

http://thebrightongirevik.blogspot.com/

Influential figures in Kettlebell:

http://en.wikipedia.org/wiki/Pavel_Tsatsouline

http://en.wikipedia.org/wiki/File:Valery_Fedorenko.jpg

*MMA – Mixed Martial Arts

Thanks to John Madden, a professional baseball pitcher. He is recovering from shoulder surgery (torn labrum & rotator cuff) and discovered the Rotater. Here’s the shorter of two videos he’s produced about the Rotater.

I sometimes feel that there is a gap in the way that we as therapists and trainers handle the recovery and rehabilitation phase of shoulder injury; that the categories are sub-divided too starkly into black and white, passive and active, low-stress mobilising and strength building. It seems to me that we should more often look at what the individual needs and build in an intermediate phase, where act as guide but let the injured individual be inventive and therefore participatory in their own recovery. They improve faster as a result. Encourage them to clean windows, polish floors, bounce balls against a wall – all low, (or at least controllable), effort activities that help to distract from the discomfort but also gives a sense of achievement.

This is not revolutionary thinking by any means as business management techniques are always telling us that if the employee ‘buys in’, then productivity and contentment rise! Why should patients and sports people be any different?

Each individual is just that, individual, and has different physical structure, varying levels of physical activity, abilities, age, expectations and needs. It seems intuitive, therefore, that while those who are professionals endeavour to tailor recovery regimes, that they should, in part at least, be led by the recipient.

I am a great fan of The Rotater and, increasingly, of Kettlebell workouts, but they have very different ‘points of entry’ in the timeline of recovery – the Rotater can be used fairly early in the recovery phase – gently at first, ramping up the intensity as pain reduces and range of motion increases and until it becomes an integral part of any workout, prehab or sporting event. Kettlebell is fantastic as a total body workout that is low impact and wonderful as shoulder mobiliser, BUT is only appropriate rather further down the recovery road!

The following video tries to outline a fairly ‘loose’ approach to mobilising the shoulder – be inventive, work within your means to start with, gradually increasing range and intensity, trust your therapist or trainer, but trust yourself as well.

As with all advice on medical conditions, check with your doctor, osteopath, physiotherapist, chiropractor or trainer before embarking on any new regime.

This is an example of a shoulder dislocation. It is of a rare type, inferior, (or downwards into the armpit), and is caused by hyperabduction and makes up only 1% to 2% of all dislocations. This is a Luxatio erecta type.

So, if it is so rare, why does it matter? Well, it is rare overall, but is relatively common in sporting people who fall!  Mountain biking, moto-X, soccer goalkeeping, equestrian sports and skateboarding.

If YOU end up in the emergency room with your arm stuck above your head, the chances are that they will not have seen it. The key to relocating this joint is to dislocate it again first…..FORWARD, creating an ANTERIOR dislocation, then a more normal reduction to its proper position.

As well as the usual problems associated with dislocations, (AC joint, nerve and blood vessel damage), the inferior type causes damage to the floor of the armpit and can lead to  concurrent fractures of the upper arm, AC joint, as well as injury to the nerves, (brachial plexus), or specifically to the axillary artery.

Recovery can be slow, even with conventional physical therapies, medication and exercises. You will probably have to start with PASSIVE movements, such as pendulum swinging which you can see if you run the video. Remember that passive means just that – let someone else make the movements for you, (physio,osteopath), or use the weight of a tin of beans or can of coke and your body movements to generate the impetus.

Repeat these exercises several times a day and at every opportunity. If you don’t use the range of motion, you may well lose it! Repeat each direction on movement about 30 to 40 times. ie, 30-40 clockwise, anticlockwise, front-to-back, etc.

Good luck with your rehab and make use of all the tools available to you; information, professional advice, devices like the Rotater and, most of all, use your imagination.