The Importance of Physical Therapy for Senior Citizens
Photo Credit: Tumbleston Photography Studios
By Meg Hale Brunton
“Your body is trying to talk to you,” Physical Therapy Practitioner Vanessa Risher explains to people who are beginning to experience chronic pain while doing everyday things. Risher finds that most people think they just have to live with pain, or worse that they should just take a pill to make it go away. She says the pain should not be tolerated, nor ignored, because it is our body’s way of telling us that something is wrong and needs to be corrected. “Our bodies are smart, and they're trying to tell us that something’s not right. Really, we do need to own our autonomy over our bodies so we can take control of our health. Sometimes pain needs to be managed with medication, however there are other options.”
Risher recently completed her first year of practice as a Licensed Physical Therapy Assistant at an outpatient physical therapy clinic in a retirement community in South Carolina. In that role, she has seen the unequaled effect that maintaining a healthy lifestyle can have on a person’s body as they get older, particularly a healthy physical regiment. “We only get one body. Move it every day,” she recommends. For instance, she says that many of her patients play golf, pickleball, or tennis. “Exercise doesn’t have to be this really hard thing. Whatever you like to do, whatever you can find that gets you moving, do it!”
As a Physical Therapist Assistant, Risher encourages her clients not to view pain on a scale of 1-10, but to focus on what life activities they are missing out on due to their pain. “Everyone’s pain scale is different. Everybody is different in how they process those pain signals,” she finds. So, she asks her clients to consider if they are still able to take care of themselves, play sports, travel, and do activities with their grandchildren. “When they start losing functionality, they become motivated to get help.” She goes on to state that she has noticed a pattern of patients waiting too long to seek treatment for their pain, and that most doctors are quicker to prescribe medication than they are to refer their clients to a Doctor of Physical Therapy for an initial evaluation to assess their pain and functional deficits.
Balance and strength training is one of the key elements that Risher utilizes with her patients, focusing on strength-building in two of the three balance centers: the hips and ankle musculature. She has found that a fear of falling due to loss of balance, or weakness can make a person feel very unsafe and isolated. “Making sure people are strong and well-bodied is so important to reducing their fall risk,” she says. “If we can instill some sort of confidence in them, that’s a big win. Keeping the elderly strong, making them feel safe is a big win.” Falls are also detrimental to an elderly person’s health, and could result in hospitalization, or an injury that requires surgery. Risher says that surgery is extremely hard on a person’s body, and recommends physical therapy prior to surgery as well as after it. She goes on to say that, on average, it can take three days or more to recover from every single day a person spends in a hospital bed.
Risher also does lots of work helping clients to rebuild muscle that has been lost due to deconditioning and atrophy, as well as combating bone loss and weakness due to osteoporosis and arthritis. She cites that, around 25-30, muscle mass decreases approximately 3–8% per decade, and that the decline rate increases after age sixty. Risher says that exercising and strength-building is the key to preventing this decline. “Strengthening is so important to maintain that muscle mass that we have because inevitably, we’re gonna lose it. So, we might as well keep what we’ve got strong,” she says as we age. “Arthritis is inevitable, so keeping our muscles strong to have that shock-absorption to counteract the bone-on-bone- that’s really gonna help out in the long run as well.” In her resistance training, Risher regularly utilizes Wolff’s Law and evidence-based Physical Therapy Practice as a method of fighting bone density loss by strengthening the cortical layer of the bone and building muscle around it to reduce the risk of fractures.
“It’s really an empowering thing to see people take control of their own health, and realize that they have a really big factor in it,” Risher says, adding that there is an ebb and flow to the healing process, so some day’s workouts will feel more productive than others. She says she loves getting to work one-on-one with her clients. “You’re the one doing the work; I’m just guiding you through your personalized exercise program safely and ensuring you have proper form to avoid injury.” She also is conscious that physical therapy is not ‘one-size-fits-all’ and works with the clients (based on the Physical Therapist’s evaluation and care plan) to meet them where they are physically. Risher also encourages substantial rest breaks during her training, so that her clients are not painfully sore in the next few days after treatment.
Since Medicare and other insurances often only cover a limited amount of Physical Therapy sessions, Risher prioritizes education above all else in her sessions so that her patients can continue doing their exercises properly at home after they have been discharged from therapy due to positive results. Going by the American Heart Association Guidelines, Risher recommends 150 minutes-2.5 hours of medium-intensity exercise per week, including aerobic and isolated muscle-strengthening activities such as using weights, or resistance bands. Some of her go-to exercises for preventative care are: deep squats, rowing, walking, hip and glute strength training, and core building. Risher hopes people will have fun with their exercise regiment, rather than being afraid of it. “No matter what you have going on, there’s always a way to feel better about yourself,” she says. “Exercise is a great way to do that because you can make your own goals and feel better, stronger and more confident.”
