JENN QUINN, A physical therapist at ACHHH, says seniors can do things to stop or reverse muscle loss. She is a fan of sit-to-stand exercises and asks her clients to add weights to their repetitions to maximize the muscle benefits.
Independent photo/John Flowers

MIDDLEBURY — As one gets older, maintaining muscle is tough enough, let alone building more of it.

Slipping into a more sedentary lifestyle seems to come with age, as one’s metabolism slows and the body won’t do as much as one asks it to do.

When it comes to muscle, you’ll lose it if you don’t use it.

But it needn’t be that way, according to two experienced Middlebury-area physical therapists (PTs) whose clients include elders. They routinely guide seniors through basic exercise regimens that can allow them to maintain, and even improve muscle mass to promote mobility and quality of life well into one’s golden years.

Jenn Quinn is a physical therapist and clinical director for Addison County Home Health & Hospice (ACHHH). She’s been helping folks regain strength and physical vitality for the past 23 years — 20 of them spent at ACHHH.

Her upbeat demeanor and expertise in the field inspire confidence in her clients. Some of them are seeking to rebound from debilitating accidents; others just want to be able to do as much as they can for as long as they can.

“Loss of muscle mass is part of aging. We can’t stop that normal process, but we can slow it down. That loss of muscle mass starts in our 30s — with 3-8% per year. The earlier you start with a program, the better,” Quinn said.

She receives most of her patient referrals through primary care physicians and hospitals, once a patient has been discharged. These are folks who want to reclaim strength and quality of life, in some cases to do things some of us take for granted: Walking, playing golf, skiing, entering and exiting a vehicle, and getting on the floor to play with grandkids.

“Often times, it’s evaluate and treat,” Quinn said of her general marching orders. “It’s our job to determine what the (patient’s) needs are and what the focus of care will be.”

Quinn and her ACHHH colleagues have no shortage of work. Each carries a client load of around 20, seeing around five of them each workday.

“We’ve definitely seen an uptick in PT-only referrals,” she said.

So what kind of exercises does Quinn prescribe?

It depends, because everyone’s personal situation, limitations and needs are different.

But Quinn said all PT clients can benefit from resistance training.

“Whether that be therabands, free weights, machines at the gym, body weight exercises, there needs to be some resistance element to see results,” she said.

Quinn is also a fan of sit-to-stand exercises and asks her clients to add weights to their repetitions to maximize the muscle benefits.

“It’s a functional exercise that touches multiple muscle groups in one exercise,” she said.

Quinn acknowledged some clients can’t afford gym memberships and/or workout equipment. And while the gym can be intimidating for some folks, doing PT in a group setting can be helpful and motivational.

On the other hand, sticking to a solo regimen can be tougher.

“There are some people who are starting to socially isolate because of emotional, physical or environmental factors. There are so many things that make (self-directed PT) a hard thing to do,” Quinn said.

But she acknowledged some folks are limited to the home setting for health, transportation or other reasons. In such cases, she visits clients, runs them through their PT regimen, and shows them ways to improvise if they’re on a budget.

Don’t have free weights? Try some hefty soup cans, for example.

“That’s one of the reasons I love home health. It forces us to be creative and think outside of the box,” she said.

She stressed that exercise must be tethered to the client’s strength level. Not everyone can hoist a 5-pound bag of sugar.

That’s why it’s important to at least have that initial meeting with a PT professional, who can gauge the client’s strength and pair them up with the right routine.

People are often surprised by what they can do on their own, without any accoutrements.

“I don’t think people realize how much they can do with their body,” Quinn said. “They can use gravity and their body position. If you’re doing a pushup on a wall, that’s a good place to start, and then slowly move toward pushups from a countertop, a chair, and then eventually, from the floor.”

Quinn has enjoyed the challenge of helping clients overcome workout obstacles.

“One of the reasons I fell in love with home health is because you see the patient in their environment, so you can tailor their home-exercise program to them, and set them up for success,” she said.

Physical therapy programming is only as effective as the patient wants it to be, according to Quinn. And it’s not only about the exercise, it’s also about the person’s diet. Quinn emphasizes lean protein for muscle building, including foods like nuts, peanut butter, cottage cheese and eggs.

“We can set up the best home program in the world, but if you’re not going to do it, it won’t work,” Quinn said. “They have to have buy-in. They’re the ones who have to follow through and do the work. Physical therapists can be cheerleaders and encourage as best we can.”

On average, ACHHH’s PTs work with clients for around 60 days, according to Quinn, and that can stretch to six months in some situations.

HELANA LEATHERWOOD IS experienced local physical therapist who has been leading seniors through exercises aimed at building muscle mass, which she said is vital in preserving quality of life as one gets older.
Photo courtesy of Porter Medical Center

Helana Leatherwood is a physical therapist at Helen Porter Rehabilitation & Nursing, where she helps seniors maximize flexibility and movement.

“You can be in your 100s, working on your muscle strength and muscle power. It has a huge impact on maintaining your function, independence and quality of life,” Leatherwood said. “There’s a misconception of, ‘I’m too old for that.’ But there’s always a way.”

It’s common to see able-bodied seniors out walking, hiking, jogging and skiing. But Leatherwood would like to see more elders doing strength exercises, which she said are just as important as the aerobic side of things.

“There’s a strong correlation between the loss of muscle strength and muscle power, with your fall risk, your risk for hospitalization, your length of hospital stays, and even mortality,” she said.

Like Quinn, Leatherwood is a fan of resistance training and using what a person has available to them if they don’t have free weights at home.

“You can get creative,” she said, while emphasizing the importance of consulting PT specialists — and your physician — before getting started.

Leatherwood encourages her charges to take on as much weight as they can comfortably hoist.

“You have to overload your muscle. You can do a ‘one-rep max,’ where you try to lift as much as you can a single time. Or you can strength train by lifting as much as you can 10 times.”

Doing a bunch of reps at a low weight will build your endurance, but not your muscle mass, Leatherwood explained.

“You should be able to increase the (weight) load as you train,” she said. “The key is, you have to overload what your muscle can do now, to build it up stronger.”

Have a preexisting condition that you think might preclude you from weight training? Think again.

“With PT, we can help modify just about anything,” Leatherwood said. “We can work with any co-morbidity you might have — if you’re afraid of pain, or have an arthritic joint. There’s always a way to work around it and modify it. Strengthening is vital.”

Reporter John Flowers is at [email protected].