How to Strength Train Even Over 90

00:00:00:01 – 00:00:18:26
Dr. Jeffrey Guild
So I no address a common question that people have. And this actually came from a 93 year old client of ours. And it’s so significant that it actually changed her ability to be able to stand up and down from a chair without using her hands. And this minor detail made all the difference in the world. And it’s a common question, a common misconception.

00:00:19:04 – 00:00:38:26
Dr. Jeffrey Guild
And so I wanted to address it here. The difference between strength building and endurance building, and we’re going to relate it back to some very specific contexts that will be specific to your life. So stay tuned. You’re not going to want to miss this important detail. So the common question is, doesn’t walking increase mental strength or, let’s say, for younger people, does doesn’t running increase feel like strength?

00:00:39:07 – 00:01:08:04
Dr. Jeffrey Guild
Doesn’t the endurance work that I’m doing actually increase my leg strength? So if I’m not specifically doing strength training, doesn’t the endurance strengthen me anyway? Oftentimes, the answer is no, and this is not 100% of the time in all cases. But generally speaking, you want to think of strength training and endurance training as two completely separate things. If you’re going out and going for a long walk, so let’s say 30 minutes or save for a 90 year old, ten or 15 minutes, you’re achieving a lot of great things that you’re working on.

00:01:08:04 – 00:01:32:18
Dr. Jeffrey Guild
Endurance. You’re working on balance. You’re working on all of the endorphins and all of the other benefits that come with strength training and just overall physical activity. Now, if the question comes, is that also going to help me stand up better off of a chair? Very likely. Think of the answer as no. You want to focus on very specific strength training tasks that you can do to do things such as stand up, have a chair, climb stairs, or get up off the floor.

00:01:32:28 – 00:01:53:22
Dr. Jeffrey Guild
Those tasks require very specifically more strength and power. The ability to generate force and the ability to generate power through the legs. Now, what’s the difference between strength and power? Well, strength is the ability to lift a certain a mile weight, moving a certain weight from point A to point B. That’s basically the level of strength that someone has.

00:01:54:02 – 00:02:12:16
Dr. Jeffrey Guild
Power is the ability to move that weight or a certain amount of weight, a certain speed or velocity. So how quickly can you move the weight from point A to point B? That’s power. Why this is important is power is more important in daily life tasks than just pure strength. So you can think of a nine year old.

00:02:12:16 – 00:02:26:16
Dr. Jeffrey Guild
I was actually at work with the 91 year old the other day. He’s actually very, very good at being able to stand up out of a chair without his hands. And he can do it and he can do it consistently. Now, the problem is he can’t do it quickly. He can’t do it fast, no matter how much effort he gives.

00:02:26:23 – 00:02:45:26
Dr. Jeffrey Guild
No matter how hard I kill him or ask him to do it, he can’t stand up quickly. So we’re actually working on his ability to stand up quickly. Now for my 93 year old lady. She most of the time is able to stand up without using her hands. And if she cannot able to do it, then she just doesn’t have the pure strength to be able to do it.

00:02:46:01 – 00:03:15:08
Dr. Jeffrey Guild
Now, that’s sustained strength versus power. You can stand up off of a chair. You can complete the task regardless of the speed. In another instance, you can do it, but it’s not very fast and you can’t make it faster. And that’s where the power component comes in. Again, why does this matter? Because the ability to respond to losing your balance, the ability to stand up out of a chair quickly, the ability to also get off the ground often takes a lot more power to be able to do that.

00:03:15:09 – 00:03:38:02
Dr. Jeffrey Guild
So you want more power in your legs, more so than force or more so than strength. And that’s the difference between the two. Now, going back to walking and endurance versus the strength and the power training, walking in general or endurance training in general, think of it as it does not increase leg strength and so don’t view walking or running as ways to increase leg strength.

00:03:38:04 – 00:04:02:23
Dr. Jeffrey Guild
Now, yes, there are exceptions to this, but for the most part, think of them as two different things. So when you’re thinking about your training regimen, think of if I’m going to work on strength or my body stand up, have a chair, work on standing up out of a chair and doing that over and over again. You can add in a power component to it by thinking, I’m going to stand up as fast as I possibly can and then I’ll sit down slow and controlled as I sit down.

00:04:03:02 – 00:04:22:13
Dr. Jeffrey Guild
So that’s very, very important, those little details to add. So standing up fast and then slow and controlled on the way back down. And that way we’re not plopping as a lot of people tend to do. So we want to think of the two as separate and don’t think that going out and walking is going to increase leg strength.

00:04:22:18 – 00:04:41:01
Dr. Jeffrey Guild
Think of them as separate. If you’re working on improving your daily life now, you might be asking, So when should I be incorporating more strength training versus more power related training? Basically, if you’re training for daily life tasks, the ability to stand up from a chair, the ability to go up and down stairs, the ability to respond quickly when you lose your balance.

00:04:41:01 – 00:05:00:24
Dr. Jeffrey Guild
As often, a lot of older people are looking to do, then you certainly want to think to add as much power as you can. So standing up as quickly as possible is very important. Now, let’s say you just want to build strength. You generally want to build up your ability to make your muscles a little bit bigger or to just generally be stronger.

00:05:00:25 – 00:05:19:06
Dr. Jeffrey Guild
Yes. Do more repetitions and stand up and down ten times, 15 times, 20 times and increase that. That’s going to increase your strength. And as you add more repetitions, that’s going to increase your endurance. Now, if you want to train for pure power, you’re going to want to do six repetitions or less. Or for simplicity, just say five.

00:05:19:25 – 00:05:34:12
Dr. Jeffrey Guild
Stand up and down from the chair five times. And then rest for two or 3 minutes. And when you stand up and down from the chair, when you stand up, stand up as quickly as you can and then slow and control it on the way down. Stand up as quickly as you can and then slow and controlled on the way down.

00:05:34:27 – 00:06:03:29
Dr. Jeffrey Guild
And what that’s going to do, it’s going to build more power in your legs. And that’s very, very important for daily life tasks. Now, physiologically, you might ask, what’s the difference between the two? Or Why is power so important? So as we age, we lose strength and power much more quickly than endurance. So quick load physiology, you have basically a certain percentage of what we call fast twitch muscle fibers and slow twitch muscle fibers.

00:06:04:01 – 00:06:22:20
Dr. Jeffrey Guild
It’s actually a fast twitch motor units versus slow twitch motor units. But for all simplicity, let’s keep it just muscle fibers. So the fast twitch muscle fibers are the muscle fibers that allow you to run fast, jump high, stand up off of a chair quickly and to build it’s pop. To explode. To be able to do all those types of things.

00:06:22:25 – 00:06:40:11
Dr. Jeffrey Guild
Now, why does a 90 year old need to build to explode like a football player? It’s when they stand up out of a chair. It makes them look more youthful to their friends, to their family, to themselves. And it will help them live longer and allow them to be more vigorous for longer. Being able to stand up out of a chair quickly is very, very important.

00:06:40:20 – 00:07:10:06
Dr. Jeffrey Guild
As we get older. So why this matters is because those fast twitch muscle fibers are going to decline much faster than the slow twitch muscle fibers as we age. And this is somewhat regardless of training, because if you take elite power athletes, they will basically decline slowly as they age, no matter what they do. However, most of the general public are not power athletes, so they’re not training usually at all.

00:07:10:13 – 00:07:54:07
Dr. Jeffrey Guild
The benefit is we can actually increase strength and power quite a bit, even past the age of 95, simply by training, because we’re not doing it very likely much at all up to that point. So a 95 year old can increase strength and power simply by training, and it can happen actually relatively quickly, and especially because a lot of the strength that comes at the beginning is mostly more coordination, more neurological, the things that happen, the connections in the body that allow one joint to work with another, or for all the muscles to work together simultaneously to achieve a task that actually happens much more quickly than building up the muscle itself.

00:07:54:07 – 00:08:14:19
Dr. Jeffrey Guild
Building up the muscle itself actually takes longer. It’s the coordination. It’s the body’s learning how to work together, to be coordinated. That actually happens more quickly. And so we can see a lot of gains very, very quickly. Even in just one session, we can get someone to build a stand up from a chair much more easily, simply by changing their mechanics the way they move, reducing fear and apprehension.

00:08:14:24 – 00:08:42:20
Dr. Jeffrey Guild
We can make those changes very, very fast. Now, to actually get muscle size, what we call muscle hypertrophy, that tends to take longer, still happens even past 90. We can get muscle size and hypertrophy even into our nineties. That will take longer than the benefits of the coordination can take longer for a 95 year old to get strength gains compared to a young person, not necessarily because they might actually be coming from a lower level of strength and ability.

00:08:42:27 – 00:09:00:05
Dr. Jeffrey Guild
So you might actually see gains in strength and power and all these wonderful physical abilities. Actually, even sooner the older we are, because we might actually be weaker if we haven’t trained before or if we have not been working on these things, then when we start working on them, we can actually see a lot of gains very, very quickly.

00:09:00:12 – 00:09:24:16
Dr. Jeffrey Guild
So there’s a lot of optimism there. Now, of course, there can be the additional challenges, the medical complexity, the arthritis, all the other challenges that can go with being over the age of 90 and that can hinder the progress. However, the other benefit is we can also see gains quite quickly over the age of 90. And so if we can do that over the age of 90, imagine what we can do over the age of just simply 75.

00:09:24:16 – 00:09:44:15
Dr. Jeffrey Guild
I mean, 75, as young as we’re getting older, begin to think about how we’re training. My parents even asked me, what’s the best way to train when we’re in our seventies? And my response was, focus on the strength training. Don’t worry about being able to walk 2 hours instead of one continuously. That’s very good, and I’m glad they’re doing it.

00:09:44:24 – 00:10:08:18
Dr. Jeffrey Guild
But more important, focus on the strength of power. Now, I’d also add flexibility, but that’s a whole other conversation. Focus on power most important, and then strength. And then just understanding the difference between endurance, training, walking versus strength and power. All are important. And for our heart health and for a lot of reasons, we want to we want our endurance to be good and we want to be able to walk long distance.

00:10:08:18 – 00:10:25:29
Dr. Jeffrey Guild
All those things are very important. Also, don’t forget about the strength and the power. That’s even more important, I would argue, than the endurance. That’s what’s going to keep you active, independent and mobile is focusing on the power and the strength and then also make sure that you can continue to walk for a long period of time as well.

00:10:26:03 – 00:10:42:24
Dr. Jeffrey Guild
And oftentimes, if we lack the power and the strength, then what quickly declines is the endurance training, because we just don’t have the ability to then stand up out of a chair or it takes so much energy then to walk a certain distance because we don’t have the strength and power in our legs, even to just accomplish the task.

00:10:42:25 – 00:11:02:25
Dr. Jeffrey Guild
And so the actually the loss of the strength and the power, then much more affects the endurance. Now, you might be wondering for a younger person, is it the same for the most part? And actually, with athletes, the more that we’re doing the endurance training that can actually hinder our gains in strength and power that we’re working on.

00:11:03:07 – 00:11:24:04
Dr. Jeffrey Guild
So if you’re a younger person, it can everything can only go up, up and up and up. So much. So if you start training, let’s say you start running and weightlifting and all that, right? So then all those things will improve together. The endurance, the strength, the power, the physical abilities are going to progress overall and for quite a while.

00:11:24:15 – 00:11:47:22
Dr. Jeffrey Guild
There will come a point, though, where you have to begin to think, okay, do I want to optimize for strength and power or even the difference between power and strength? Or do I want to optimize for endurance? And all those things cannot possibly physically go together. It is physically impossible to optimize for all of them. So elite athletes, they have to think throughout the year, what am I optimizing for?

00:11:47:27 – 00:12:08:29
Dr. Jeffrey Guild
Am I optimizing for power, strength or endurance? Put simply, we can’t be good at everything all at the same time. We can’t optimize everything all at the same time. If we’re at that elite level and if we’re working on a lot of endurance training that can actually hinder our ability to be as powerful as we want to be or as strong as we want to be.

00:12:09:21 – 00:12:37:09
Dr. Jeffrey Guild
Now, as we’re on that journey, everything can improve together and they all help each other out. But as we begin to optimize, we have to begin to start picking and choosing. Same thing with size and and endurance. Similar concepts. Oftentimes we have to choose one versus the other at when we’re optimizing. So to put it simply, think about how you’re training and what you’re training for, why you want to do it.

00:12:37:09 – 00:12:58:04
Dr. Jeffrey Guild
And power and strength are different from endurance. Very likely just walking endurance training is not going to increase the strength in your legs like you think it will. You need to add in the component of power and strength as well in order to do the great thing, such as build, to stand up from a chair, to build a move from the floor to standing up, to be able to climb stairs.

00:12:58:04 – 00:13:14:24
Dr. Jeffrey Guild
You need the power and the strength and just walking by and by itself may not be what get you there. Now, another part to the standing up and down out of a chair is the lowering down part or what commonly will be called the plopping down part. People will say, Well, yeah, I just plop down all the time.

00:13:14:29 – 00:13:36:05
Dr. Jeffrey Guild
Now why do people just plop down all the time? And why is that so common? You’ll just see that they’ll just fall into the chair without any control. That requires a different type of contraction than the standing up. And so to make it simple, think of doing a bicep curl or lifting up a milk jug. You have the lifting up part and then you also have the lowering down part.

00:13:36:05 – 00:13:58:00
Dr. Jeffrey Guild
It’s the lowering down part on a bicep curl or lowering down the milk jug. That’s the same type of contraction as when we’re controlling ourselves on the way down, when we’re going to sit down. It’s a controlled type of contraction. It’s called an eccentric contraction. And this is different than the type of contraction where we stand up. So we have to build to train both.

00:13:58:03 – 00:14:21:28
Dr. Jeffrey Guild
Basically, if you want to work on training, your ability to lower yourself into the chair, nice and slowly and also be able to stand up quickly and powerfully. And it’s possible to train one, but then not the other. And so we want to make sure that we’re training both. So we’ll commonly recommend to stand up, fast out of the chair on the way up and then nice and slow and controlled on the way down.

00:14:21:28 – 00:14:43:18
Dr. Jeffrey Guild
So that way we can strengthen when we’re lowering ourselves down and have lots of control as well as when we’re standing up. And actually that lowering down part also helps with strength gains overall. Now, the lowering down part is also the part that actually increases the muscle soreness afterwards. So think of it as 12 to 72 hours afterwards.

00:14:43:27 – 00:15:10:09
Dr. Jeffrey Guild
Is the muscle soreness that we come and experience with strength training and even something like standing up and saying down of a chair can cause that muscle soreness 12 to 72 hours afterwards. That’s very, very, very common. It’s called delayed onset muscle soreness. Basically know that the day or two after strength training, it’s common to be sore in the muscles that you worked and that most commonly happens with the muscles that you’re doing, that lowering type of contraction.

00:15:10:09 – 00:15:27:16
Dr. Jeffrey Guild
That’s where most of the soreness will come from. So if you’re practicing that lowering type of contraction, then you’re going to be more sore. That’s a good that you do want to be sore. Now, as we’re older, we don’t want to get sore to the point where it completely puts us out of commission, mostly from a motivational perspective.

00:15:27:22 – 00:15:45:24
Dr. Jeffrey Guild
When that happens, as we get older, we tend to just not want to do that quite so much. So as we’re strength training, if you get yourself working to the point where it puts you out of commission the next day, then that’s additional feedback to you to say, Okay, I did just a little bit too much, now I just need it back off.

00:15:45:24 – 00:16:04:04
Dr. Jeffrey Guild
And so that way you can regulate how much you should be strength training. And so then just go a little bit slower and then that’s perfectly fine because doing the strength training is more important than doing too much strength training. Doing the strength training at all is the most important part. And if we go slow or slower, that’s perfectly fine.

00:16:04:10 – 00:16:29:26
Dr. Jeffrey Guild
Just keep doing it, just keep progressing it, just keep making it better. Keep doing more repetitions or keep adding more, more speed or keep adding on more resistance. Either way, keep progressing even if it’s slow and that’s perfectly fine. Now, the other question on power is should I be focused on reducing the amount of resistance and moving fast versus just keep the amount of resistance on, but move it as fast as possible?

00:16:29:27 – 00:16:49:13
Dr. Jeffrey Guild
Both are beneficial and either one will work. And regardless, actually trying to move the weight as fast as possible is going to be beneficial and will not be harmful in any way. Move the weight as fast as possible. Let’s say when you’re on the standing up part, no matter how much the resistance is and again slow and controlled on the way down.

00:16:49:24 – 00:17:07:18
Dr. Jeffrey Guild
And it’s also beneficial to say reduce the resistance and then stand up as quickly as you can and both are beneficial. So always be thinking about moving as fast as possible, no matter how much the resistance is, that’s going to help with the power. Now, you might be wondering, okay, I’m not doing squat, I’m not putting a bar on my back.

00:17:07:18 – 00:17:31:05
Dr. Jeffrey Guild
So how can I gauge resistance if I’m standing up out of a chair? Very simple. So think of the progression of standing up of a chair as I’ll go from standing up, putting my hands on the chair and using my hands to help with myself up. That’s with the least amount weight. Now, the next amount of weight is pressing down on my legs as I stand up the chair.

00:17:31:14 – 00:18:02:07
Dr. Jeffrey Guild
That’s going to increase the resistance because I’m no longer pressing into the chair or pressing into the arms of the chair. I’m pressing into my legs to help myself stand up. Not quite as much help. So more resistance, more load. The most amount of weight is standing above a chair without your hands at all. And I like to have our clients go and what I call the prayer position right here, I have to help them put their hands right here and then I’ll have them stand up from the chair that way and that way they have control over where their hands are.

00:18:02:07 – 00:18:18:19
Dr. Jeffrey Guild
Otherwise they’ll tend to kind of do this middle ground thing where they put their hands on their legs and are they setting up without their hands or are they helping by putting their hands on their legs? So it’s a way of being clear on, okay, are you standing up without your hands? So that increased resistance by removing our hands entirely.

00:18:18:19 – 00:18:38:25
Dr. Jeffrey Guild
So you go from hands on the chair or hands on the armrests of the chair to standing up. That’s with less resistance. Then the next step is putting your hands on your legs and standing up that way. And then the most amount of resistance is standing up. Let’s say if your hands in a prayer position, not using your hands at all and standing up and down without using your hands, don’t.

00:18:38:28 – 00:18:58:15
Dr. Jeffrey Guild
That’s the way to increase resistance and steadily progress your strength over time. And then that way you can be sure that you’re getting better, you’re progressing, you’re increasing your strength and you’re progressing your strength and increasing your strength in a very practical way, such as being able to stand up from a chair. And that’s going to make a big, big difference in your life.