← Rena Malik, MD Podcast
Rena Malik, MD Podcast
Moment: Why Building Strength Today Protects the Body You’ll Have at 90
00:15:37
In this episode, Dr. Rena Malik, MD speaks with Michael Joseph Gross about overcoming gym intimidation and the importance of strength training for older adults. Together, they share practical strategies for building confidence, seeking support, and highlight how strength training can play a crucial role in healthy aging.
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- [00:01]
A
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- [00:30]
B
A huge barrier for people who are thinking about starting in the gym is that they're super intimidated, right? They're like, I see these people in the corner lifting weights and I don't look like them and I don't know what I'm doing and I might hurt myself. Especially for older people, what have you learned through, you know, all the interviews you've done and the experts you've interviewed and the research you've done? What are good ways to overcome this intimidation?
- [00:54]
C
So first to the issue of safety. We talked about safety in young people earlier. Now you're asking about safety in older people. And the research on that is very similar and equally compelling. In the National Strength and Conditioning association position statement on strength training for older people, they cited a review of the 20 studies involving more than 2500 people aged 60 to 72 taking part in weight training studies for falls reduction. And in all of those studies, those 2,500 people, there was exactly one case of shoulder pain.
- [01:38]
B
Wow, that's, that's 2,500 people.
- [01:42]
C
Just one case with, with no injuries. And as long as people had proper supervision, correct technique, exercise selection and setting appropriate weights.
- [01:55]
B
Well, that's a lot of parameters.
- [01:57]
C
It is a lot of parameters.
- [01:59]
B
Yeah.
- [02:00]
C
But this goes back to the need for help. We just need to insist both for ourselves and for the older people in our lives on finding appropriate help. We talked earlier about how trainers are expensive and trainers are expensive, but injuries are more expensive. And if you can't afford a trainer, you can figure out somebody in your social circle, somebody in your friends or family who knows how to do this and you can get some help. I wish there were a hack for that, you know, but.
- [02:40]
B
Well, we do have social media and I do feel like, you know, you can join local Facebook groups and sort of, you know, there are, I mean, I think older population, very much of it's on Facebook and so you can sort of try to find if you don't have one. I just worry, I think, I think our parents generation is very Good. About having social networks. I think it's becoming smaller and smaller in terms of how big your social networks are as the sequential generations are getting. Yeah. As people are getting younger and younger because of social media, because of Internet, because of video games, whatever. Right. I do think that you can look to your social circles, but I think that like asking for help is something that we just have to get over and you have to be okay being vulnerable because that's what it is. Right? It's feeling vulnerable. And like there's sometimes you gotta put your big boy, big girl pants on and just do it.
- [03:37]
C
Yeah, yeah.
- [03:38]
B
For yourself.
- [03:39]
C
There are also a few gyms that specialize in lifting for older people that are creating resources on social media that can probably not serve as sole guidance, but it would be a good way to start building a set of concepts like, you know, in mind as you approach this. Like there's a little gym in Australia called Groundwork Fitness that does some amazing stuff on Instagram.
- [04:16]
B
Yeah. And there are new things, like at our gym they have something called an egym, which sort of is like, I don't think it's perfect, but I see a lot of older patients on it and it's better than them having nothing. Right. It sort of guides them into like the tempo of exercise and gives them like a goal. It gamifies weightlifting. I think for a new person, something like that could be nice.
- [04:37]
C
Maria Fiataroni Singh. Again, the sort of Bruce Springsteen of weight training research for older people. She has some resources, online resources too that I can give you links to that people can share.
- [04:50]
B
That's awesome. And I know we talked about sarcopenia a little bit and it's defined as age related muscle loss. I hate that because it means that it's inevitable. Right. But it's not inevitable.
- [05:05]
C
It means that it's inevitable if you don't do anything about it.
- [05:08]
B
Right, right. Yeah. And I think that's the key is like, we don't want to get to that point. And I think that is the real key here is like learning about strength training, understanding all these things from your book that tell us, like, look, this is why strength training went through these ebbs and flows of like people promoting it or dissuading it. And I mean, history does tend to repeat itself to some degree. So I think it's always good to sort of see that and then understand the science and then say, look, like sometimes you just have to be the contrarian and you just have to do what, you know, based on the science versus what you might hear from your colleagues or friends or whatever. And so I think it's so important for all people. Listening is like, we don't want to get sarcopenia, and it's not inevitable. It's not going to happen to everybody. If you put in the work with
- [06:02]
C
strength training, that is absolutely right. We right now are at a crossroads in the history of exercise and medicine. We right now have a greater set of resources, a better understanding of what we can do to slow the process of aging, to make it less painful to have a thriving life as we get older. And we right now have to start telling our doctors that they need to pay attention to this. Maria Fiataroni Singh was part of a very recent international consensus statement on exercise as a prescription for all of the chronic diseases of aging. Something like 34 physicians in something like 15 countries. It is a great starting point for people who want. There's never been a single resource that brings together all the research on exercise as treatment for every chronic disease, like actionable guidance for physicians. And I'll give you a link to this too, because if we all printed that out and read the parts of it that are relevant either to the problems we're dealing with or the problems that our parents have had and that we know may be waiting for us around the corner. And we, when our doctors say, oh, I see this coming up for you and I'm going to give you this pill, we can say, okay, let's talk about that. But I also want exercise to be part of my treatment. And even if they say, well, I don't know about that, you can give them this so that they will know a little more about it.
- [07:51]
B
Well, you know, I loved when we used to have prescription pads and we would write out prescriptions, because you could write like, resistance train two times a week and sign it. And then it felt like I was giving you something. Right. I could still do it on a piece of paper, but. But it used to be something. And I'll share an interesting story. So when we were in the, in like, sort of before my time when men would come in with prostatitis, some older urologists would prescribe masturbation. And so they would write like, masturbate three times a week and sign it and give it to the patient and. But tongue in cheek to say, like, look, if we literally said resistance train with a trainer three times a week and signed it and gave it to the patient as a prescription, I think that would even just that movement saying, I don't know anything More. But you gotta do this would be valuable, right? And a lot of us do. We will tell our patients to do it, or we'll send them a written note, or we'll write it on a piece of paper. But there should be a relationship between medicine and, in an ideal world, there should be a doctor who handles, you know, the ailments, right? But then in that same office, there should be a trainer, there should be a psychologist, there should be a nutritionist. Right. And there should be all those things that contribute. And there should be maybe someone who specializes in sleep and someone who specializes in stress reduction. And that would be the ultimate care package, right? To take care of the whole person.
- [09:17]
C
I love that thought. It's not exactly the build out in every specification that you just gave, but one of the greatest things I got to do in the whole eight years I was working on this book was spend a couple weeks at a place called the center for Strong Medicine in suburban Sydney. Maria Fiedaroni Singh's husband, Nalan Singh, created this clinic to implement the academic research they were doing in a clinical setting. So every patient who comes to this doctor's office gets a prescription not just for the medication they need, but also for the exercise that will help them. And this doctor's office has a 2,000 square foot gym in the center of it with 30 Kaiser machines, 30 weight training machines. So you have, you were talking like earlier about how much you'd love to see older people coming in or just people coming in in street clothes, getting a little bit of lifting done and going on with their day. That's what's happening in this doctor's office. Like, there was one woman who was working on the, on the tricep extension, and she was wearing a long scarf that she'd bought at the Picasso Museum in Paris. You know, white hair, 75 years old. And her scarf kept kind of getting stuck in the machine, but she would, she would turn it back and she would just, just keep doing her lifts.
- [10:50]
B
That's so sweet.
- [10:51]
C
Yeah, yeah, yeah.
- [10:52]
B
No, I mean, I think that we need, I think it needs to be education, right? Like there needs to be nutrition education and strength education in early life. Right. And stress reduction is such a huge one too. You've done obviously a lot of work on this and you've been strength training for decades. So what is the most harmful advice you think that you've heard about strength training?
- [11:14]
C
I think the most harmful approach to strength training is to strive after a perfect program. There's no perfect program. The only thing to do is to do the right thing for your body today. And a lot of the time that's going to mean lifting at a high level of intensity relative to your capacity. But since strength is relative and strength is cyclical, you're going to have to back off a lot if you want to go far. And I think it is very difficult to remember that if we considered training to be a form of wisdom, instead of considering it to be a math problem that we could solve, we would all be able to be stronger, longer. The idea that athletic training is a form of wisdom is actually the fundamental principle of the one and only long piece of writing about athletics that survived antiquity. Charles Stocking has translated this text. It's called the Gymnasticus by a man named Philostratus. I was really excited because I was able to write the first description of the gymnasticus in any popular book that's ever been published. Only ever before have academics written about this. But let us consider athletic training a form of wisdom. Inferior to no other is the first sentence of the oldest long book about athletics we have. It's putting athletic training on par with mathematics, philosophy, music, navigation, all the arts and sciences that we consider to be important as core parts of our lives as human beings. It's saying athletic training is up there with all of them, and if you treat it as wisdom, it will yield immense benefits.
- [13:31]
B
Yeah, that's great. How do you think writing this book changed your relationship with strength training?
- [13:36]
C
It made me patient. I think that when we learn about the culture of weight training, one of the best reasons to learn about the culture of weight training, learn about the history of weight training, is to see that in our own lives and in the world as a whole, this is all. You know, this is a long game. I'm going to the gym now to make sure that I have a good house to live in in this body when I'm 90 years old. Maybe a better way of saying all this is that I have a different experience of time now than I used to. You know, I'm not just training for today. I'm training for my future. And I'm also training to connect to the powers that I had when I was younger. You know, I'm trying to live in the past, the present, and the future all at the same time.
- [14:33]
B
If you like that episode with Michael Joseph Gross, make sure to check out the full episode right here.