EP026: Movement Mindset & Balance After 60

Two days of doing nothing can matter more than you think, especially as we get older. We kick things off by reflecting on community, grief, and why “showing up is winning” after a weekend birthday challenge built around walking and push-ups, with everyone modifying to their own ability instead of falling into comparison.

Then we sit down with Hans Karlsson, director of rehabilitation and co-owner of The Six Wellness Clinic in Santa Rosa, California. Hans treats first responders as “working athletes,” and he explains what that mindset changes in rehab, recovery, and long-term performance. We talk about the most common physical therapy realities in the fourth quarter of life, from post-hospital weakness to chronic conditions, and why consistent movement helps protect independence. Hans also shares the practical framework he uses with older adults, including his memorable “48-hour rule” to avoid rapid deconditioning.

We go deeper on balance and fall prevention through vestibular training, what simple tests can reveal about your balance system, and how strength training fits into nearly every plan. We also cover Parkinson’s disease and why exercise helps keep the brain-to-muscle signal active, plus a clear explanation of why knee pain can improve when you rebuild strength, restore tracking, and keep joints moving. If you care about healthy aging, physical therapy insights, strength training over 50, and staying capable for life, this conversation delivers.

Subscribe, share this with a friend who needs a nudge to move, and leave us a review so more people can find the show.

Transcript

Welcome, Grief, And The Challenge

SPEAKER_02 0:08

Wake up, wake up, and listen up. Welcome to the Fourth Quarter Podcast with your hosts, Doug Talmage and Ted Ania. Tune in as we dive into living your best life in the fourth quarter of your life. Hear from health and lifestyle experts, inspirational stories, learn simple steps to keep you motivated or to help get you started. Finally, join us as we coach others live on air who want to begin a healthy lifestyle or just might be stuck and need a breakthrough. Remember, it's never too late to decide to be great. Momentum keeps you motivated, so take a deep breath, lean in, and let's go. Hey, welcome back to the Fourth Quarter Podcast. It's your host, Doug Talmage, along with Ted Ania. We've got an awesome guest this week lined up, and we are excited for you to hear him, to hear him. I'll let Ted introduce him in a few minutes. But Ted, before we do that, I want to just re recap uh or just remind people that about the David Linnell Embracing the Grief episode, episode 25. Wow, what an impactful episode. It brought a lot of uh just connection relevance for people who are in their fourth quarter having to deal with grief. You know, as we age, unfortunately, one of the things we have to deal with is the loss of people. David Linnell's story is not so much about losing someone who's elderly. It's actually, I'll just give it away here. It's about losing his son and through a tragic story. It's a it's a very moving uh and touching story. It's worth the listen. Go back and listen to it. Episode 25. Speaking of David Linnell, we had David, your birthday challenge was this weekend, Ted. Man, I'm still trying to walk upright, man. I'm slumped over. My hamstrings are tight, my triceps are the tenderness is starting to wear off because we did walk 20 miles and did a thousand push-ups. Well, Ted actually walked more than 20 miles and he did a little more than a thousand push-ups. Congratulations, brother. You you stuck to your guns about doing more, as Betty had mentioned. You know, as we get older, we don't want to do less, we want to do more. So but David Linnell was out there. It was great to see him, and it was cool because we had other podcast guests out there. We had Mitch, Karen, Bones, Liz, Ryan, and some future guests were out there walking with us. Zig, you know, Zig or Ziggy, whatever people call them different things, but Nick, cool dude. I got to walk and talk with him a lot. Ted, this is a guest we got to get on. Your wife, Beth. She has an amazing story. And I talked to her a little bit on one of the laps, and we worked out a few things that she might be concerned about, you know, being on the episode. But uh, after talking about it, I think she sees the you know the relevance and the importance of getting her story out here, you know, being in the fourth quarter and just being a badass that she is. But uh, so that that's all I have. But you know, I want to talk a little bit about the birthday challenge, Ted. But I want to, I will, I want to let's go straight to you. Let's get your it was your birthday challenge. What did you take away from it this year?

SPEAKER_01 3:14

Well, I think I think more than anything that I get out of it is just this the stories out there and the seeing what other people are doing. I mean, you just you just look around and you know, I'm I've been blessed with with my health, and the challenge was good. It was something I was pretty confident I could do. But I look at at the other stories, you know, I look at Nick. Nick was here two years ago, and he walked, I think, 17 miles or something with us. He walked 20 miles this year, but he would try to do push-ups two years ago. He couldn't do two push-ups. That's right. And this year, you know, he he made it a point that he was gonna train and get ready for it. I don't know what he did this year, but I'm sure it was two or three hundred.

SPEAKER_02 4:06

Uh oh, yeah. He was doing it. Every time we got down to do him, he got he got down and did some yeah, yeah.

SPEAKER_01 4:12

So, I mean, there's inspiration in that. You saw Mitch out there who last year just absolutely struggled to get around the park, and I think he did five or six laps, you know, it's things like that. Rex was out there, you know, did a couple laps, but he had ridden 60 miles on his bike in the morning, right? Yeah, before showing up. Yeah, you know, you just see things like that. But I think the most inspirational one was my brother-in-law, Don, who he actually is dealing with, you know, he's almost he's in his late 70s, and he's dealing with some pretty substantial health issues. And he went out there and just walked for a couple of hours. I think he walked close to five miles, and you know, it's not easy for him just to see that. Those those are the things that that struck me, and even you. I mean, you're not you're not a walker necessarily, and by hand of it, you were hobbling a little bit and you you tough that out. I was hobbling a lot of it. Yeah, and you know, it was fun this year. We actually had some remote entries. We had Irene and her husband up in Tahoe did, I think they did 16 miles and they were doing push-ups along the way. Wow. And Greg and Terry Stamfield with Betty walked around, I think Donner Lake. So, I mean, everybody, everybody got involved. So those stories, more than anything, are what strike me. You know, it's it's just fun to to connect with people, but just seeing people out there that have had issues, had health issues, and are still out there doing it, that's I think more the story to me. You know, I'm just out there kind of knocking it out and being able to talk to people, but being inspired by others is is the most important thing.

SPEAKER_02 6:18

Right. You know, I'll just leave a little tidbit for anybody who's listening that there was a few moments where you could hear people comparing, you know, uh like, oh, I can't walk as fast as you guys, or many, or you, yeah, I'm not gonna do that many push-ups. And and I remember Telvin having a conversation with David Linnell on one of the laps and just saying, you know, we gotta help people not get into that lane of comparison because some comparison is the thief of joy. And so if you're listening, if you were out there, whether you did a half a lap, 20 laps, or whatever, you know, God bless you and congratulations for showing up, man. That showing up is winning. In my book, if you show up, you win. And so you do you stay in your lane, you got to do what you what you can do, and uh it's a process. And like you said, Mitch came out, and last year he was a train wreck, and this year he's doing laps and he's killing it. And Zig, you know, no push-ups two years ago, and the dude was doing push-ups next to me for a huge chunk of the time.

SPEAKER_01 7:15

So I mean, yeah, and there were people out there, there were people out there that just said, I can't do push-ups. So one of them did jumping jacks and yes, did air squish-ups, reverse push-ups on the on a bench and air squats, and you know, that's the fun part of it is there's no real structure to this. We just walk and everybody does what what they want to do, and like you said, they're not comparing themselves to others, right? Uh, you know, and it's funny that one of our pretty loyal listeners, Tammy, messaged me afterwards or made a comment on Facebook, said something like, you know, it looks like it was successful. My birthday's in September, and I'm still working on what my birthday challenge is gonna be. And she shouldn't have said that because we're coming up with something for her. So don't get me. We're not gonna let her off the hook.

SPEAKER_02 8:11

Yeah, you know, it's you know I'm gonna elevate it.

SPEAKER_01 8:14

Yeah, and you know, we we spoke with David Linnell, and she's still sort of in the planning stages, but next year's challenge is going to be a little bit a little bit bigger with the help of meals on wheels. Oh, yeah. We'll hold that off until we got a little more details, but really looking forward to expanding this a little bit.

SPEAKER_02 8:38

Yeah, that that'll be fun. That'll be fun putting that together. So, Ted, tell us about who's the guest, man, and then what what what's the topic today?

SPEAKER_01 8:47

And the guest is a busy man. We have been trying to track him down for a month. We've been pestering him, sending him texts, but we finally got him here. He's he's a director of rehabilitation and the owner of the sixth physical therapy clinic and friend of mine for years. But Hans Carlson, welcome to the podcast. It's great to have you here.

SPEAKER_00 9:11

Yeah, thanks, guys. Uh uh glad we finally were able to hook up.

SPEAKER_01 9:15

Yeah, yeah. Hey, tell us a little bit about your uh your background.

SPEAKER_00 9:20

Uh okay, so professionally, let's see. Uh, same as Ted, I'm an Aztec. I I went to San Diego State for back in 1900 and blah, blah, blah. And that was an athletic training, sports medicine, bachelor's degree. Came out a couple of years later, went back to grad school for physical therapy. I've spent about half my time in outpatient orthopedics and the other half of my time and concurrently, so so I've always kept doing both in home health care with the geriatric population. Done it for a

Meet Hans Carlson In Physical Therapy

SPEAKER_00 10:00

long time. So this new venture here in Santa Rosa, California has been, like you said, keep keeping me busy, but it's been a good venture. Yeah, tell us a little bit about that. Okay, so so there's a there's a long story and a short story. The the the short story is that I came out here to Santa Rosa to help launch a physical therapy clinic. As it ends up, it I became owner of it. There's where the short story becomes long if you really wanted to hear it. Uh, but it's been a great transition. I partnered up with some amazing people and we're, I think, building something special. And I think you guys saw the video. So this treats all first responders, work-related injuries. It's basically the working athlete. These guys don't get treated like your traditional clinics because they they have an extremely high demand of job. They all tend to get injured and a lot of them get retired out. So we're trying to improve the lifespan of say a fireman in his work life so that when he does eventually retire, he's essentially not a beaten warrior. So it's it's been a fun challenge, and uh there's a lot to to come of that in the future. That's awesome.

SPEAKER_01 11:23

That's gotta be pretty rewarding working with with those people.

SPEAKER_00 11:27

Yeah, I I I will say the part of the allure for me in the call at the fourth quarter of my career is that I wanted to do something that kind of felt like I was giving back, you know, even though as a caregiver, you're you're always kind of given this this feels a little different to me because of the the population I'm dealing with. And you know, those are people that risk their lives for us, and it feels pretty good to to try to keep them healthy.

SPEAKER_02 11:58

Hey, Hans, you were saying earlier off-air that you're also you also treat vets.

SPEAKER_00 12:02

Yes, yes. So, so we have a few vets that have been coming even before I got here through the wellness, they they just kind of are part of the population that we had, and we just keep them going. They they come in and we treat them. If we won't we won't turn them back, we don't take their insurance. So it's a matter of if they want to come in, and we typically will will at least give them something that uh keeps them healthy. I got an 80 near 80. Mark is his name, near 80. Every week he shows up at his appointment time, and you wouldn't believe what this guy can do. It's it's amazing. He is on he is he is balancing on a Bosa ball while doing all kinds of stuff. It's it's uh pretty impressive. That's so cool.

SPEAKER_02 12:49

When and what are some of the some of the modalities or or things you have to offer? I mean, you showed us the video, and it was a very impressive and a cool vibe for that place you got there.

SPEAKER_00 12:58

Yeah, so the six itself is if if we go back to I think it's either military or police, I got your six, which is I got your back.

SPEAKER_04 13:08

Okay.

SPEAKER_00 13:09

That is the the the namesake for that. And we we provide yeah, yeah. So we provide massage therapy, acupuncture, ART, which is active release therapy, uh, physical therapy, which is my branch of the whole thing. We have a chiropractor that's coming on. It's it's kind of uh all-inclusive. We have a gentleman that has this unique PEMF machine, which is pulse electrical magnetic frequency. So that deals with pain and recovery. We're we're likely to bring on some other stuff like red light therapy and things of that nature. We have, if you saw the video and went back to it, you'll see a room that's green but fairly empty. Well, that's kind of the recovery room. So it's eventually we're gonna move our traction table there, and then we're gonna have some other modalities there for recovery, hyper ice and certain things. We get post-surgical patients here, so that'll be where they would go and kind of recover after their session. Outstanding.

SPEAKER_02 14:15

I love it. I like next time I'm in the area, my brother has a gym in Hildsburg, World Gym down there. And so I get down there once in a while, but next time I'm headed down in that direction, I'm gonna swing by and check out your facility.

SPEAKER_00 14:25

Yeah, that would be awesome. Yeah.

SPEAKER_01 14:27

Very good. So over over your career, you have uh, you know, we we spoke and you said you've worked with a number of people who I guess say are in their fourth quarter, which is what we're focused on. What conditions did you treat most often with people in their fourth quarter? What what were you dealing with?

SPEAKER_00 14:47

So there's there's there's a there's it's a wide variety to begin with, right? What you might immediately think physical therapy, oh yeah, that's a hip replacement or a knee replacement, but but it is actually way beyond that. It's it's congestive heart failure, it's you know, diabetic issues where they don't control their diabetes, it's man, urinary tract infection. You know, Medicaid, Medicare will require a physical therapist after hospitalization for a pretty bad urinary tract infection to come out. And there the concept behind that is because they're not moving enough. And if they're not moving enough, they're going to fester an infection that that so the object is to make sure you try to change that. And it's a tough, tough job sometimes trying to convince somebody that was maybe from a different era that didn't adapt to exercise. And and we're talking, you know, 80-year-olds in the upper part of that fourth quarter that that weren't ever exercisers that ever. And then you're coming in and trying to convince them that, hey, I could keep you out of the hospital, and your doctor wants this, and this is how we do that. And but the ones that buy into it notice that there's definitely a difference. And I always tell them that there's no age where you can't improve your strength. And it takes a couple of weeks to start to show that because the nervous system will allow a larger amplitude of contraction after the couple of weeks, and then they start seeing the difference. And then, of course, at six weeks, the tissue adaptation happens, and they're like, Oh, I am stronger. So there's a there's a they got I'm kind of a salesman when it comes to that stuff, and trying to convince a certain population, hey, we can we can help you here, don't give up on yourself.

SPEAKER_02 16:47

Love that. One of our tag lines is movement is medicine, and so it fits right in with what you're talking about.

SPEAKER_00 16:52

Yeah, yeah. Motion is lotion.

SPEAKER_02 16:54

Oh, oh, I like that one too. Okay. Sounds a little more sexy that way. No, I'm just kidding. Yeah, yeah.

SPEAKER_01 17:02

Yeah, I mean, you had you had mentioned when we we spoke once that you could definitely you could almost look at a person and tell, get a good idea of their age and their fitness levels and activity levels based on what you see in them.

SPEAKER_00 17:19

Almost immediately. You you just kind of can tell what what they've spent their last 10, 12, 20 years doing. The ones that have been kind of idle, you you're gonna just see that there's not there's not the potential, you know, that you you start losing potential. And that's that's the sad part because if you don't keep trying, then your potential to recovery, it just starts going down. So if someone's been sitting on that recliner for the past 10, 15 years, you know, they're they're not their trajectory to to suddenly, oh, the doctor says I need to start moving. It's it's a little harder than that. It's easier, it's easier to maintain it than it is to gain it. It it's just it's tough unless you you but you'll see some pay some of the patients are uber fit and and something weird happens, they have a cardiac event or or whatever, and it it's shocking to them, but they're they're typically because of their background, they they will get after it. Almost to a point where you have to slow them down, which is I'd rather have that fight than to try to convince them to move, friend.

SPEAKER_01 18:33

Right.

unknown 18:34

Yeah.

SPEAKER_01 18:34

That's funny because that's one of the things that Doug has had issues with. We we coach some people here on the podcast, and you know, he's had to tell them, all right, you uh you you have to start, you have to set a goal, but don't exceed it. I mean, you

Aging, Recovery, And Real Motivation

SPEAKER_01 18:50

you just need to control what you're doing so you don't overdo it and and have an overuse injury or just kind of burn out.

SPEAKER_00 18:59

Yeah, and I I think that I think that's uh sometimes a part of a personality thing, right? Describing myself to a T, my personality is very close to all or nothing. I and and I run into the same thing that that you guys are probably talking about, which is for six months I'm gonna be an American badass. And then all of a sudden I'm like, oh my god, I pushed myself so hard that that I just can't sustain that. Right. And that's that's that's the negative. You just can't do that. You've got to be smarter about uh um spacing and and longevity is about consistency, you know.

SPEAKER_02 19:41

So consistency, that's it, right there.

SPEAKER_01 19:43

That's a message that runs through this podcast.

SPEAKER_02 19:47

Yes, it's like he's listened to all our episodes.

SPEAKER_01 19:52

Well, yeah, I mean it comes from everybody that we have on, whether they're trainers or nutritionists or whatever it may be, it's just that consistency, it doesn't have to be a major deal, it just has to be just getting out there and doing it.

SPEAKER_00 20:06

Yeah, yeah. And there's evidence showing that it it's not as much as you think. It but you have to do something, you know, you have to get out there and get your heart pumping and the muscles doing something. It's but it's not like you gotta be in the gym for two straight hours every every other day.

SPEAKER_01 20:23

Right. Well, speaking of that, how much exercise should an adult aim for per week, would you say?

SPEAKER_00 20:31

So so I have a it's an old, old study that I bring up almost every time I'm with 80 plus year old or that that what to call the home care population. It's basically pretty simple. There, they're there in uh again, I I the details of it are gonna be kind of uh left out, but let's just let's just go with uh what I tell them, which is 80 plus years old, it takes 48 hours to start to atrophy. So what that means is when you're laying in bed for 48 hours because I'm stuck in the hospital and I can't move, I'm actually gonna start atrophy. Now it's a small percentage, but it's 48 hours. So essentially there was a study, this was from an old continuing ed class where they did a biopsy on some volunteers at 80 and said, don't move for a couple of days, we'll do it again and see what happens. And they physically started seeing the muscles change in 48 hours. So when I am trying to plead with them, I tell them you can take a day off, but don't take two. Yeah. It's just that simple. So so the consistency that I recommend is no more than two days straight off at that age group because you it's just happens too fast. Now 16. year old can have mono and lay in bed for six weeks and the doctor can say you're good to go and play basketball the next day that would devastate an 80 year old it's just they they they would be bedbound after that so so that's why i i typically preach that that 48 hour rule love that and what type of exercises do you recommend for like strength and balance so it it that all that then becomes another what's the presentation of the patient right so if uh if i've got a patient that's uh falling and it's from vestibular input issues so what that basically means is we have three main balance uh sensory sensory input for balance our feet our eyeballs and our inner deep in the ear equilibrium vestibular system right inside there's a particular cochlear cruise that has fluid in it and they sense that oh my god I'm I'm tilting this way that way well we don't ride roller coasters into our 80s we don't ride horses play sports so we start losing that that balance sense because it just gets dormant essentially well what else happens is their feet get a little numbers some of them get a lot numb with neuropathy our eyes start to diminish as you can see we're all wearing the same glasses today so so so so our eyes start to diminish so now all of a sudden those sensory inputs for balance that are supposed to go concurrently to our brain brain's balance center will essentially not get either the full the full input or it'll be skewed from one to the other my feet feel one thing but my inner ear is sending a different signal and then you get a patient that that gets up in the middle of the night their feet are numb it's dark and whammo they fall. So that patient is getting treated a little different you that person could be five out of five on a strength scale and still falling so so when I preach to to that particular age group what we need to do it's not always just strengthening so I have to we'll put them on a balance pad with a narrow base and close your eyes and turn your head or have your eyes gaze left and right up and down trying to stimulate that inner ear it's not really ear nose and throat guys it's not the ear I know it's not the ear but the the mechanism within there that is the the stibular system that's how you help these people not fall which is probably the number one reason physical therapy and home health exist coexist is because of falls. So that person is different than the was pretty healthy but now they're very weak because they've been in the hospital for two weeks and whatever that person yeah how's your balance it looks good well then let's just press strengthening I push resistance I'm not light on them I I have to preach to some of the therapists that I've had under me it's okay they'll handle it give them some resistance because they they're not gonna get strong by just doing a leg lift they need some resistance because that's gonna increase the the the strength throughout their body so that's a pretty simple formula.

SPEAKER_01 25:40

Love it what what do you hear now I've just just heard recently about uh the shoes with the thicker soles that that's affecting balance because you're not getting that connection to oh so so there there's probably a little bit of truth to that I could probably justify a pathway that that could prove that but I also could probably do the same the other way and and and what that would be is adaptation.

SPEAKER_00 26:13

Adaptation is is is human that's what we do we adapt to so so the more my population starts to wear these types of shoes it's a non factor as we get older because we've adapted to that and who knows if that actually might even you know I put people on balance pads. If you're on a little balance pads all day long maybe the it could have a positive effect. We don't know that yet but I have heard that Ted and I don't know and and I'm more of a guy that would want to see some colleges do some studies on

The 48-Hour Rule For Staying Strong

SPEAKER_00 26:50

that to prove it versus somebody coming up with it.

SPEAKER_01 26:53

I don't know if there's any science behind that they're affecting the balance with that said would I put my 84 year old pre-Alzheimer's mother-in-law in a pair of shoes like that absolutely not she's never been in them that would that just doesn't make sense right that it would be like putting little balance pads under her feet she would she wouldn't do well so so yeah I think there's some logical truth to that for sure like like putting high heels on Ted oh wait he's done that no I'm just yeah yeah yeah yeah for sure that's that's interesting what kind of because I can tell you my my balance is is not good right now for someone like me I mean I I walk a lot I'm active but I can tell that my balance isn't right especially you know to sit on the golf course what would be like a basic type of exercise that you would start me on so so I would first have to identify if this is balance is related to it's definitely not related to strength.

SPEAKER_00 28:04

We could probably eliminate that immediately it's probably not related to flexibility because you're probably relatively flexible in in you know for your age group probably even above normal in flexibility. So so so I would first thing I would do is I'd bring this little blue pad that's probably back over my shoulder over here somewhere I would put it on the floor I'd put your feet together on this balance pad. So I'd have them touching each other and I would have you cross your arms like this so that you are are unable to use them as as leverage. And then I'd have you close your eyes and you should be able to on the balance pad close your eyes and keep your feet together and at least do 30 seconds. And if you can't do 30 seconds then we know oh your your vestibular system is contributing to some of these balance issues. If that's the case then I'm gonna the training and the testing are very similar we we try to compromise your feet we try to take away your eyes and we make you move your head or we have you walking while looking left and looking right so that you have to initiate the vestibular system. Your eyes work yes as visual input right so we can see things and we identify things but they also have a horizonal what's going on behind that. And that's the part that sometimes we lose because we're so focused on on a particular object and now we need that inner ear to kick in to to supplement that balance and if that thing has not been strengthened or kept up because we don't ride roller coasters we don't bend over and then you know I always say it's that that you know when we were kids how many times were you running full speed while tracking a ball with our eyes moving while we're moving and there was no balance issue whatsoever. Now if I take you know 65 70 year old person and say go as fast as you can and turn your head left and right and track this ball they're just gonna they're just because that system has been weakened. So so I really make it a point that we we look at the vestibular system on almost every patient. And sometimes I'll go in to see somebody for something totally different and I'm still looking at oh here's a balance section let me check your balance out and they're gonna say oh my God I had no idea and then I'll go have you ever fallen oh I've tripped every once in a while but but nothing pure fallen I said well it's gonna happen if we don't start doing this type of exercise so it's still exercise it's just now we're starting to try to strengthen your sensory system a little bit interesting interesting that's very cool. Wow so we did have one question uh that's more specific is actually one of the people out walking this this weekend anything any exercises or somebody dealing with Parkinson's disease so Parkinson's is a tough one i i actually just saw Parkinson's guy last week Parkinson's and exercise go together so you you you have to keep exercising with Parkinson's you you don't there's no choice you you you in this is of course my opinion someone might refute that but but there's no choice muscles are they just sit there they they don't have a mind of their own but they they they wait for a command and the command comes from our brain it's not the muscles will do nothing unless they're told to do something they they they are literally gonna wait for a a signal so Parkinson's is a signal problem. So it it it's it's a pretty simple concept keep the signal going as much as possible. Now there's some stuff out there in the rehab world called big and loud uh that that combines exercise with with sound like like count out loud when you're doing the exercises so you're having the patients count loudly so there's some neurofeedback happening and and and stuff like that. But the general thought process on it is you you have to keep exercising there's no specifics to it it's whatever you think you can get I tend to think flexibility also gets lost in that because of the rigidity that can happen.

Balance Training And Fall Prevention

SPEAKER_00 32:50

So so definitely you know a strength and flexibility based program is the minimum for sure. So what kind of exercise would you recommend uh walking or you know just something very basic or so so walking is good but you remember if they have a fascinating gait which is the shuffly thing right um you you want to make sure that you reinforce the heel strike to try to normalize as much motion as possible. The problem is walking is an automated response. We don't think about walking it just happens right well that automated response for them is getting blocked in some parts and that's what that's why you'll see this weird kind of shuffling gate you have to try to unautomate that and and and get them back to heel strike step through gate pattern is just one of the things that so walking's good but if you're reinforcing the shuffle that's probably you know now on their feet on their feet is better than not because of the balance aspect they need to keep up as well. So so there it's a it's a complicated and and and difficult thing to to deal with depending on how advanced the Parkinson's is you know but otherwise we're uh strength training just again and then all all the evidence in the world is showing how important strength training is globally on everything. Well Parkinson's is no different it's no different you have to you have to keep up the strength flexibility is is impaired so you got to do that you got to work on motor control. So that would be sometimes I'll have Parkinson's patients go very fast with exercise and then I'll tell them to slow way down and let's start let you so I'm changing the amplitude and I'm changing the speed and I'm changing the you know the velocity of contraction and then I'm slowing it down so they're working on control not just can I take this weight and curl from here to here. Brilliant brilliant I love that yeah yeah so we talk about the exercise that you recommend for adults in their fourth quarter is there any exercises that should be avoided that you can think of well that would that the I mean the common sense there is if I've got a bad back bad knees bad hip I'm gonna have to work around that and that's happens with this population a lot right but but I start with what can we try to do and then if I get the feedback from them that I can't do that my knee's too bad then I go to plan B. All right let me give you a knee exercise that will strengthen the quad with less knee involvement or less weight bearing but but you know a lot of the patients that also it's very difficult to get them to follow through on their exercises when you're not there and that would be that population that weren't exercisers all their lives right so there in that particular case I start with can you walk? And if you can that's one of them and can you do a sit to stand? Can you get up from that chair that has armrests and if you can do 10 sit to stands and take a walk two or three times a day we're we're gonna crush it we're gonna we're gonna do something. So so you sometimes have to minimize depending on the person and then depending on what body part they're having issues with it you know then you you adapt. That's it's just kind of the difference between you know I'm I I think personal trainers are fantastic. My my physical therapy assistant is a personal trainer and physical therapy assistant and he is is awesome. But but when I separate PT from a say a personal trainer we work with the sick people and the and the the people that have you know some pretty serious ailments andor big time surgery. So the adapting to that particular person's problem is probably the the biggest difference between the challenge of those two professions.

SPEAKER_02 37:18

Teddy Teddy mind if I ask him a question about a personal thing that I have experienced is I noticed about gosh for the longest time I had quote unquote bad knees and I couldn't do I couldn't even do an air squat they were in so much pain. And and then and I heard something about it's because I wasn't working them enough or whatever. And so I decided to go on this journey of experimenting and I used my kitchen counter and did assisted air squats for gosh maybe a month and then then I got out and I have this bocce ball cord here on front of me and had two like ski pole things and I started doing traveling lunges with ski poles assisted and I noticed I was starting I'm like oh my gosh I can actually do these now and now I would say it's been about eight months now and now I've built up to doing unassisted traveling lunges holding a 25 pound weight both forward

Parkinson’s Movement And Smart Strength Work

SPEAKER_02 38:10

and reverse is what's the what's the science behind that? Why is that happening? Because I before I would my mind shut off and said hey you got pain in the knees stay away from them but now I I moved through that and now I feel stronger than before.

SPEAKER_00 38:25

So there's a couple of potential things that that are happening there. One of one of them would be that that the your knee pain what what was the source now if if it the source was the underside of your kneecaps and your your quads be based on their strength the kneecaps were were were tracking incorrectly and you were starting to get pain based on what excessive pressure on one side of the kneecap it's supposed to slide right through the groove of of where the it belongs and if the tug of the kneecap is lateral tighter lateral versus the VMO or the medial aspect it won't track correctly so that underside of the kneecap can get kind of softened conch that type of thing and then what ends up happening is people complain man I'm just sitting here and my knees start aching and this and that and they think all along it's something internal derangement of some sort and really it's their quad especially their VMO which is that when you look at cyclist that big knobby thing on the inner part of their quad right attack kneecap if that is not as strong and firing appropriately the kneecap's not going to track appropriately and then eventually you're gonna have knee pain chronic knee pain and that's going to take building that back up sometimes rolling on the IT band to get it loosened up and and now you're tracking and oh my god my knee pain's calm down. So that would be one concept the other concept would be that you have general cartilage let's say wear and tear inside now where the bones come together and if if if you're not moving and doing certain activities with some weight bearing there the again getting back to motion is lotion the cartilage will will release some of the the viscous fluid into the joint with this extra exercise that's why exercise and light arthritis typically actually do very well because it essentially is self-lubricating the joints through exercise so so that would be the other concept that that possibly could have happened there.

SPEAKER_02 40:52

Interesting thank you yeah man uh you were worth the wait Hans absolutely absolutely I love man I eat this kind of stuff up all the time this is great Hans hey wait before we go to the song Ted before we go to the song Hans is wearing a really cool shirt and Hans you you got to let me know how I get one of those because I love it's got the American flag on it and it says the six and again as you heard earlier in the podcast you know it's that the name the six is because I got your six yeah working with a lot of first responders and vets and all that stuff.

SPEAKER_00 41:22

So cool shirt man I got to get me one of those Hans yeah well we have them so you just tell me your size and I'll get one out to you for sure. Good deal.

SPEAKER_02 41:30

Good good all right so we're at a a segment or a portion in the podcast where Ted is going to pick a song he chose a song already I don't know what it is. Hans doesn't know what it is and after we listen to the song Hans and I will give some feedback on how it touched us emotionally mentally inspirationally whatever and we'll see what's going on. Go ahead Ted it's all yours.

SPEAKER_00 41:50

Hey this one's just a little lighter today basically based on the birthday challenge kind of wrapping that up here you go this is just uh for the MTV group and uh they actually play music on the MTV and wrap up the birthday challenge entire straight or something to the walk home by that's definitely uh represents the weekend yeah I was gonna say that might be uh Ted's uh weekend theme song right there yeah it was I actually made a a a video uh social

Song Pick, Final Takeaways, And How To Reach Us

SPEAKER_00 43:50

media reel and to use that song okay because love it yeah very good and it did it recall any memories or thoughts for you Hans well initially when you were talking about the song I'm thinking oh gosh I know exactly what song Ted's gonna break out which which was an old memory with Ted and and Mitch was under my thumb back in the back in the day there was a there was a a little uh theme and and a song uh that they would play that while we what we messed around but that was fun yeah but uh these are some fun times that uh yeah that song is you know I mean that brings you back to of course the age you were when that song was popular so every time I hear a song that and I think that's what music does right it it if you you hear songs back from whatever it was it it it immediately takes you back to that era then you can start going oh my god all the great memories and and whatnot but I think the theme there is is walk right yeah but the ultimate theme there is walk it all combined right yeah exactly movement man movement right motion is lotion I like that one movement is medicine so uh Hans thank you so much for saying yes and and working it out like Ted said earlier if to you know it was an act of God to get you on here but it was worth the wait it was worth the wait you are I can't wait for our listeners to hear some of the wisdom and things you dropped so that they can live uh a healthy healthy fourth quarter man so yes yeah no I appreciate I appreciate you guys too and any time sorry it took so long to get me here but a lot of stuff going on around here so yeah that's a good thing yeah nothing but the best for what you're doing there with the the vet with the veterans and and the first responders and just that wellness center and and your part of it is just absolutely amazing.

SPEAKER_02 45:47

I'm really excited to come down and check out your facility and uh yeah we'd love to have you both up both up display and get our shirts and get your shirts yeah yeah I I got your shirts you just got to come get them all right we'll do it we got to make a road trip I think they got a golf course up that way too Ted they do they do that sounds good I'll meet you there all right sounds sounds good all right you guys hey thanks again for tuning in everybody I'm gonna sign out like I always do and say God bless and peace out if you like what you heard be sure to subscribe follow share an episode if you want to leave a comment go to the show notes there's a text link there we will receive an anonymous text from you with any comments or suggestions thanks again for tuning in and most importantly keep on coming back