Welcome to the ChapmanPT Newsletter - Edition 1.

Welcome!

Below - I have posted the first edition of our Newsletter for those who are interested in understanding what a typical bi-weekly newsletter contains. If you find this kind of information to be helpful, head on back to the homepage and sign right up!

Thank you for being a part of Chapman Physical Therapy! As you know, we are a small group of doctorally-trained physical therapists who are trying to improve the way our country provides healthcare (easy day, right?). We focus on preventative and rehabilitative strategies to improve our patients’ health without reliance on medication, surgery or injections. There are places and times for these interventions, but we’d rather not rely on them for our health.

As of today, we are initiating a bi-weekly (every other week) recurring newsletter focused on sharing evidence and strategies related to optimal living, with particular focus on those 50 years of age and older.

This is not meant to be a little quick tip here and there. It’s not meant to be read in 30-seconds. I intend to actually give you detailed, relevant information on how best to optimize your health and see 100 years.

If you would not like to receive this newsletter, please just scroll down and click unsubscribe. If you’re interested in receiving evidence-based strategies, literature reviews, and guidance on how to maximize strength, flexibility, quality of life and independence into our fine-wine years, just keep reading - and please share with a friend who may be interested!

Wishing you well,
Dr. Dan Chapman
Physical Therapist & Orthopedic Clinical Specialist

Big Picture: Is frailty a normal part of aging?

No….and I’ll say it louder for the people in the back: NO.

Our society unfortunately associates older age with weakness and frailty, chronic pain, falling, hip replacements and loss of independence. Is this really the expected outcome of revolving around the sun more than 50-60 times? Absolutely not. Many of the negative ideas we hold about the aging process are actually secondary effects of deconditioning and a sedentary lifestyle… not normal aging. Emerging research shows that frailty is preventable through targeted exercise and nutrition. However, we in the medical community have not done a good job of helping people understand how much exercise to perform, and what kinds of exercise helps us the most. I hope this newsletter can help. I read the research so you don’t have to - every other week, I’ll consolidate it, and make it approachable so that you can more easily improve your own quality of life.

So let’s get right into it!

Where Does Nutrition Fit?

I highly recommend you check out this open-access scoping literature review in the Journal Nutrients, Strategies to Prevent Sarcopenia in the Aging Process: Role of Protein Intake and Exercise

But I’m happy to summarize!

First of all - what is sarcopenia? Sarcopenia is what we often associate with old age: a loss of muscle mass and strength to the point where we can no longer perform basic tasks like climbing stairs, gardening, etc. We’re expected to lose some strength and muscle mass as we age, but what we typically see in our society - frailty, falling, inability to stand up out of a chair without using our hands as support - is not an inevitable part of the aging process.

So, how can nutrition help?

In late 2021, there was a BIG update to dietary guidelines for older adults. The recommendation is now 1.6-1.8 grams of protein per kilogram of weight per day. This reflects a 60% increase from 2015 guidance. (I know, we live in the USA and we insist on using miles and pounds, so just divide your bodyweight by 2.2 and then multiply that by 1.6.)

So , if you weigh 150 pounds: 150 pounds/2.2= 68 kilograms
68 kilograms * 1.6 grams of protein = 108 grams of protein/day

Why is this important?

As we age, we naturally lose some (but not much) muscle strength and muscle mass - (estimates put it at about 1.5% of our maximal strength potential/year after the age of 50). Of all the macronutrients we eat (fats /carbohydrates / proteins) protein is the building block of muscle. Our ability to synthesize protein decreases as we age, so since we’re already starting to lose muscle mass and our ability to synthesize protein is decreasing, we need to eat more protein to help the body synthesize what we need. In order to build muscle back, we need to take in protein to help the body build strength. Not eating enough protein is like not putting gas in your tank - you can work out all you want, but you won’t be able to go very far.

Last point for now: ideally, protein intake should be spread throughout the day (don’t go trying to eat 50 grams of protein in one sitting.) If you feel you need to supplement, whey protein supplementation is the best way to do it (think delicious protein shakes with fruits, whey protein and bananas). If you have questions about how to get the right amount of protein into your diet, ChapmanPT can help.

Where Does Exercise Fit?

Mandatory Disclaimer: Undertaking exercise comes with risks. So does living! If you’re unsure what exercises are safe for you, or you have concerns about how exercise fits in with your specific medical history, please contact us or your physician before initiating a new exercise program. That being said, whatever inherent risks there are in exercise are far outweighed by the risks of NOT exercising.

Okay - back to the good stuff:

The nutrition guidelines above are recommended for those who engage in resistance training at least 2x/week. (Note: exercise guidelines for all adults over 50 years of age recommend strength training a minimum of 2x/week. We should all be doing this!) The best exercises to complete? The one(s) you’ll do. The second best ones? Squats, deadlifts, and anything else that uses large groups of muscles and feels challenging (but doable!)

What about walking? Walking is a great source of endurance training and helps improve our cardiovascular system, but it doesn’t help you build muscle. Muscle strength is what keeps us from falling, what helps us squat, sit, stand, pull, push, get up, get down - all the things that we as humans need to do in our daily life. As seen in this research, even a brisk walking program had no effect in reducing falls in older adults. So walking is great - keep it up! - but it’s not a replacement for strength training.

So what works in terms of strength training?

Don’t over complicate it. Pick up things that are relatively heavy for you (but feel doable to perform 8-10 times before taking a break) and then put them back down. If you’re not sure how to perform exercises with good form, call or email us - we’re here to help!

For those of feeling fancy, new research (2021) shows that short bursts of high-intensity-interval-training (HIIT) may be a great option for adults. As seen in this scoping review, HIIT improved functional capacity (your ability to do basic things) for adults over 55, metabolic factors such as insulin resistance, blood pressure, aerobic capacity, and strength.

So what does HIIT look like? Studies use different protocols but commonly include 10 repetitions of “all out” exertion for 1 minute (performing as fast as you can in a safe manner), followed by a 1 minute rest. So, for example:

1 minute standing up from a chair and sitting back down. 1 minute rest.

1 minute shoulder pressing over head. 1 minute rest.

1 minute going down to the floor (safely) and standing back up. 1 minute rest.

1 minute standing marches. 1 minute rest.

1 minute air punches. 1 minute rest

Repeat this once more for a total workout time of 20 minutes. Can’t do 1 minute at a time? That’s fine! Try 30 seconds. Can’t get down to the floor safely (yet)? That’s fine! We can sub out that exercise for something else. No cookie-cutter workout program is perfect for everyone but don’t let perfect be the enemy of the good. Just start moving in a way you feel is challenging but safe. Rome wasn’t built in a day, so start easy and build up!

ChapmanPT Physical Therapists are also personal trainers and yoga instructors. Have questions about the best exercise program for you? We’re here to help!

What If I Have Pain With Exercising?

This is where we often help people the most. Pain should never be a barrier to movement. Movement should never be a barrier to improving health. Whether it’s arthritis, stiffness, an old injury, a new injury, weakness, or some combination that is contributing to your pain, we’ll get you in for an evaluation and get you on the path to moving pain-free.

Questions? Email me at Dan@ChapmanPT.com

About Me

I’m Dan, a Doctor of Physical Therapy, Orthopedic Clinical Specialist and personal trainer. It’s my goal to help people move without pain, and most importantly, help people increase ownership of and independence in their own bodies. One day, I hope to find myself to be what many consider “old”. If I’m lucky enough to see that day, I still plan on playing with my son, traveling with my wife, and opening jars with my hands. To do that, I plan on keeping good care of my body the best I can, with the best evidence we have, in a way that is not burdensome on my lifestyle. This newsletter is a way to share all the knowledge I gather and my experience along the way. If that sounds like something you’d like to be included in, good news! You’re already on the list. If you have friends and family that you think may be interested in being on this list, please share this newsletter with them. They can head to our homepage to be added to it! I’d also love to hear from you about content you’d like to see and questions you’d like answered in future newsletters. Please feel free to reach out to me at any time at Dan@ChapmanPT.com.

Finally, a humble request:
Building a small business that focuses on patient-centered care is not easy in our current healthcare system. I choose to treat patients 1:1 for 45-60 minutes because I strongly believe that’s how care should be provided. I give you my direct email because I think it’s important to be able to contact the people that care for your health. If I’ve helped you in some way, please consider writing a review on Google and Facebook. Patients searching for help have lots of options to choose from, and your words and testimonials make all the difference in helping them find high quality care. Also, I read every one and they mean the world to me!

Thank you so much for your time - I hope you find this helpful!

All my best,
Dan Chapman DPT, OCS