77-year-old woman sees benefits from weight training

Hyannis cardiologist Lawrence McAuliffe, MD, FACC practices what he preaches to patients, when it comes to the benefits of exercise and strength training. He talks to them about the importance of these activities to lower their risk of heart disease and to help them stay healthy and strong as they age.

Recently, Dr. McAuliffe referred Cape Cod Health News to his personal trainer and strength and conditioning specialist, Norman “Pugga” Routhier, for a look at the kind of routine that can help people of all ages. Routhier designs each personal exercise according to the individual’s needs, goals, exercise history, health history and how much time they can devote to exercise.

“I really believe that strength training is the exercise mode that you get the best bang for your buck, so to speak,” he said. “It is by far the most effective overall conditioning exercise for your whole body: cardiovascular, strength, bones, bone density, joint health, and balance.”

His exercise philosophy is that people should set up a solid strength training foundation for a half hour to an hour, two or three times a week, and then fit in other exercises they like to do, like walking, yoga or biking on the other days of the week. The most important things for an effective exercise routine are consistency and exercise adherence, he said.

Routhier said he is very conservative with how he eases clients into strength training. One example is that if he’s teaching someone how to do a squat, first he makes sure they can sit up and down from a chair with proper posture.

“You don’t want to put a weight load on a faulty movement pattern,” he said. “If you can’t get up from a chair with relatively good posture, you don’t want to add weight to that, because that will exacerbate any postural issue they have or any joint issues they might have.”

The other technique he uses when a client is beginning an exercise routine is “micro-loading.” For example, he starts with two-pound weights for several weeks and then goes up just slightly to three pounds.

“It takes patience and perseverance on the part of the client, but when I explain to them that we’re trying to make it so your body really doesn’t notice the increase, but physiologically it is adapting to the increase, and that’s how you get stronger,” he said. “That’s how you improve your bone density, that’s how you improve your cardiovascular capacity – by those micro-loads. Those micro-loads turn into macro-loads over the course of weeks and months.”

A lot of Routhier’s clients want more cardiovascular benefits, so for them, he sets up a strength training program in a circuit format to make sure they are working all of the major muscle groups consecutively. That way their heart rate stays up for their entire workout.

Kate Nelson Sees the Benefits

Kate Nelson, a 77-year-old Brewster resident, enjoys the circuit format for her workout sessions with Routhier, with whom she has been working for 15 years. She also does circuit training twice a week at a gym and loves to bike ride, do yoga and kayak.

For her routine, Routhier usually starts her off with balance exercises and then gets into mobility and strength. At a recent workout, Kate started with pulleys. For each separate part of the routine, she does three sets of 10 to 15 repetitions, but Routhier doesn’t strictly count the repetitions. Instead, he watches her for signs of fatigue or a loss of form.

“I think that’s the great thing about working with a trainer, because he’s seeing my level of fatigue and connection with my body and my form during the exercise,” Nelson said. “If my form starts to go off, he’ll know I’m getting tired. I tried working out by myself before I came to Pugga, and I’d always hurt myself.”

Routhier next had Nelson do reverse lunge step-ups using a bench. It’s a complex movement pattern that works all the major muscles in the lower body. There’s a lot of balance involved as well as endurance and strength. That completed her warm-up and she moved on to doing squats with a 65-pound weight.

After the squats with weights, Nelson moved on to do a small ankle lift exercise. That allows her big muscles to rest while she works on smaller muscle groups. It’s an efficient way to work, Routhier explained.

Then it was time to work on the upper body. First Nelson did pushups on a half ball called a BOSU. That requires a lot of shoulder stability and upper body strength using the chest, arms, shoulder and abs. Nelson had a complete tear on her rotator cuff a few years back, but it is fully recovered now.

After the BOSU, Nelson did a seated row, lifting 65 pounds to work her upper body and arm muscles. It also helps to prevent her from the tendency we all have to round our back as we get older.

After resting for a few minutes, she moved on to curl and press eight-pound weights while kneeling on a bench to work on balance and mobility. This also works the deltoids in her reconstructed shoulder and her biceps while balancing kneeling on the bench simultaneously works her glutes and her abdomen and back muscles. This exercise uses smaller weights because she is working on smaller muscle groups.

Before You Begin

Not everyone can afford a personal trainer, but Routhier advised that even those who want to do strength training at home would benefit greatly from at least one visit with a professional trainer to make sure they are doing the right exercises and doing them properly.

“Most people don’t have all this equipment – nor do you need it,” he said. “Bands can be very effective and with some light dumb bells you can do a lot. As long as you are providing resistance to the muscles and you can go through a full range of motion, it’s beneficial.”