1. Maintaining Joint Flexibility: The Importance of Stretching For Healthy Transitions March 9, 2015 Jill Stein, Northwestern Medicine Osher Center for Integrative Medicine

2. Range of motion in the joints becomes more limited The material that cushions the joints can begin to thin/break down (cartilage) Connective tissue and muscle fascia change Sedentary Behavior – the “use it or lose it” principle Maintaining Joint Flexibility Why does joint flexibility change as we age? The Importance of Stretching 2 Less range of motion means loss of mobility and possibly slower movements Loss of cushion can create stiffness, inflammation and pain Sedentary behavior results in loss of strength, stability, balance and mobility All factors above can increase fall risk What are the risks?

3. Medical conditions (Arthritis, Frozen Joint, Joint & Connective Tissue Disorders) Synovial fluids may decrease Minerals may deposit in or around the joint Hydration Infection Maintaining Joint Flexibility What other factors effect joint flexibility? The Importance of Stretching 3 Talk to your doctor; have a physical Start moving more Get guidance on appropriate and effective exercise routines Drink plenty of water Be active everyday What can you do if concerned?

4. Joint Mobility – how much range of motion do you have in each joint Condition of Muscles/Muscle Fascia – tight or fluid Connective Tissue – how much can you move tendons and ligaments Maintaining Joint Flexibility Components of Flexibility The Importance of Stretching 4 Exercises – what kind of exercise; sample exercises; creating a regular routine How active are you in your everyday life; Exercise Recommendations Stay well hydrated How To Improve Flexibility

5. Joint Mobility – work around anything that hampers you. Listen to your body. Moving helps if appropriate. Muscles/Muscle Fascia – regular movement, exercise, stretching and massage help. Connective Tissue – range of motion exercises and staying well hydrated help. Maintaining Joint Flexibility Components of Flexibility: The Importance of Stretching 5

6. What Kind of Exercise – Range of Motion, Static and Dynamic Stretching. Some research also shows flexibility benefits with cardiovascular exercise Sample Exercises – all wrist actions, hand/finger exercises; held stretches on chest, thighs, back of thighs, calves; dog/cat, overhead reach, torso rotation Create a Routine – set a schedule; use a calendar; short terms and long term goals Maintaining Joint Flexibility How To Improve Flexibility: Exercises The Importance of Stretching 6

7. Which Joints to Move – neck, hands/fingers, wrists, elbows, shoulders, back, hips, knees, ankles, feet and toes What Kind of Exercise – gentle, moving through full range of motions in all major joints. Not to pain. Sample Exercises – wrist, ankle, shoulder and hip rolls Create a Routine – daily Maintaining Joint Flexibility How To Improve Flexibility: Range of Motion Exercises The Importance of Stretching 7

8. Warm up to a light sweat prior to stretching Static stretching instead of bouncing Hold stretch for 60 seconds per muscle. Can break into 20-30 second stretches. Stretch all major muscles of the body Breathe freely Stretch to mild or moderate discomfort, not pain Maintaining Joint Flexibility How To Improve Flexibility: Static Stretching Exercises The Importance of Stretching 8

9. Gentle, flowing motions Consistent and rhythmic Comfortable and free movements Upper and lower body Breathe freely Gain more joint mobility as you flow through the movements Maintaining Joint Flexibility How To Improve Flexibility: Dynamic Stretching Exercises The Importance of Stretching 9

10. Cardio – 5 or more days of moderate intensity for 30 minutes - OR 3 or more days of vigorous intensity for 20 minutes - OR 2-3 days of combination Strength training for all major muscles – 2-3 days Balance – 2-3 days Stretching all muscle/tendon groups – 2 or more days for 1 minute per group * ACSM Position Stand: Guidance for Prescribing Exercise, Adults all Ages (2011) Maintaining Joint Flexibility How To Improve Flexibility: Exercise Recommendations The Importance of Stretching 10

11. Stretch everyday – warm muscles + range of motion in the joints + a couple static stretches a day. Move injured or tight areas everyday. Cardio 3-5 days per week Strength training 2-3 days per week Balance 2-3 days per week Can do in 10 minute increments. Also, you can benefit from less. Just keep moving! Maintaining Joint Flexibility How To Improve Flexibility: Exercise Recommendations for You The Importance of Stretching 11

12. Key Facts Maintaining Joint Flexibility - Be active, Stretching, Range of Motion, Exercise, Hydration

13. Questions? Maintaining Joint Flexibility

14. Resources Maintaining Joint Flexibility - Group Classes at Northwestern Hospital - Trial Classes: Monday, March 30th. - Spring Classes Start Monday, April 6 th - To Register Call: 312-926-8400; classes.nmh.org/listing/all

15. Thank You Maintaining Joint Flexibility