Differing Therapies, Overlapping Outcomes
The human body has been called an incredible machine and with 206 bones, over 600 muscles, and more than 4,000 tendons, it surely is that. But to function effectively, these attributes of the body must operate against a strong central core. And the relative importance of a strong core only increases with age; core strength promotes balance, prevents falls, prolongs lives, and even helps with incontinence. Fortunately for older adults living in our community, AgeWell Cincinnati—a coalition of local Jewish service agencies—is helping connect people to therapies that can dramatically improve their core strength.
The fear of falling leads to falls
“One of the big reasons we need to help older clients with their core and their balance is that falls are the leading cause of trauma-based ho
spitalizations among older adults,” said Adrienne Mowery, a physical therapist with Choice Physical Therapy (CPT). “And sadly, there’s a high mortality rate after someone falls. If they break a hip, for example.”
Because these falls are often first-time incidents, Mowery—who spends two days a week working out of her clinic in the Mayerson JCC, where CPT rents space—stresses the importance of strengthening the core before, not after, a fall. “Once an older person has had a fall, they get very nervous about falling again, to the point where they really limit their activity,” Mowery said. “They might get up from a chair and be so afraid of falling forward that they’ll lean way back until all their weight is over their heels. Over time, that kind of fearful behavior isn’t good; it just weakens their core in other ways.”
To help her clients challenge their bodies with confidence, Mowery works with them, one on one, using special techniques and safety equipment. “I can have a client stand on a thick foam pad while wearing an assistive device called a gait belt,” she said. “With the gait belt, they feel secure. This helps me challenge and push them, and I think they surprise themselves with all they are able to do.”
Mowery emphasizes how modest gains in core strength can equate to major gains for a client’s health and safety. “The research is very clear.” she said. “If you can stand on one foot for just one or two seconds, you’re at a high risk for falling. But if you can increase your time by three to five seconds, that is statistically significant; you’re going from a high risk to a moderate or even low risk.”
After ten sessions, Mowery claims she sees improvement in virtually all of her clients. “This is progress that I can objectively track,” she asserted. “But there’s also anecdotal evidence, and that really helps with confidence building. A patient will tell me, ‘Oh, wow! I really couldn’t do that before! I couldn’t get out of a chair without using my arms!’ which is great to hear.”
Water is thicker than air
In the chest-high depths of the JCC pool, a complementary though very different type of therapy is being offered. Helen Gomez is the aquatic therapy specialist for CPT, and her sessions take place entirely in water. Like Mowery, Gomez is adamant about the importance of core health. “You can have the muscle strength of Arnold Schwarzenegger in your arms and legs,” she said, “but if you have the core strength of Olive Oyl, you’re in big trouble, because that’s what your arms and legs work on.”
Since water density is twelve times that of air, the resistance to underwater movements is far greater than movements done above water. “By simply walking through the water, you’re working the muscles in your body, in your core, so much more than when walking through the air,” Gomez said. And that resistance is proportional. “The faster you move against water, the harder it moves against you.” To Gomez, this means that the progress of her clients is uniquely personal, and theoretically limitless.
But Gomez’s favorite aspect of aquatic therapy is how it reduces the influence of gravity on the body. One advantage of this is better patient stamina. “Since water does such a great job sublimating the effects of gravity,” she said, “you can sustain activities longer, with better posture, better form, and less fatigue.” Another advantage of water’s buoyancy is safety. “It’s almost impossible to hurt yourself in the water,” Gomez asserted. “And even if you do lose your balance, water supports you until you catch your balance.”
“You can have the muscle strength of Arnold Schwarzenegger in your arms and legs, but if you have the core strength of Olive Oyl, you’re in big trouble, because that’s what your arms and legs work on.”
— Helen Gomez, Aquatic Therapy Specialist
Women’s pelvic health
Core health and women’s health have always shared a close connection. As the mother of nine, Elisa Travis is very familiar with why that connection is important. Travis is the women’s health and pelvic floor specialist for CPT, and her therapy sessions at the JCC focus exclusively on postpartum-related conditions, core strength, pelvic floor health, menopause, and orthopedic issues connected to pregnancy.
“The issues my patients are dealing with are very personal—usually things they’ve never talked about to anyone else before,” Travis said. “They have been suffering from different conditions for an extended period of time, and they just didn’t know that help out there.”
With an emphasis on privacy and confidentiality, Travis works one-on-one with her patients for the duration of their care plan. Much of that time is spent educating clients and dispelling myths. “Often women say things like, ‘I’m an old lady. This is what happens when you get old. We wear diapers and that’s the way it is.’ Well I’m here to dispel that myth. It’s not necessarily normal,” Travis insisted.
Travis also helps patients with their sexual health and, in the process, challenges misconceptions about aging and sexuality. “Many women have severe pelvic pain and hold a lot of tension in their pelvic floors,” she said. “Or they might have had cervical or ovarian cancer, which can exacerbate issues in that area and lead to painful sex.” Despite the increased challenges that come with age and biology, Travis says sex is healthy at any age. “It can and should be an important part of an older adult’s life,” she said.
With most issues, Travis says the results are significant. “One thing I stress is that women will see changes quickly,” she said. “In some cases, as quickly as a month—depending on the nature or severity of the issue. My patients notice big differences and see major changes in their quality of life. To me it’s very exciting to be able to combine my own knowledge and personal experience with this ability to help people in a very unique way.”
Cedar Village is also offering therapies similar to those mentioned above, including physical, aquatic, occupational, and short-term rehabilitation services. In ordinary times, these therapies are available to all who are interested. However, due to COVID-19 restrictions, Cedar Village is not currently providing out-patient therapy services. Choice Physical Therapy—in addition to the Mayerson JCC location—operates clinics in Blue Ash and Groesbeck.
If you or a loved one could benefit from any of these core strengthening therapies, please reach out to AgeWell Cincinnati. The experts at AgeWell Cincinnati can connect you to 68 services through one number: 513-766-3333.