Why Motion Is The New Lotion

Bill Case, PT, is a second generation Physical Therapist in Houston, Texas. He’s passionate about helping people regain their balance, recover from falls and ensure it doesn’t happen again. Zibrio chatted to him about some of his secrets.

Zibrio: Tell us something that most people aren’t aware of when it comes to their balance. What is the fundemental thing, do you think?

Bill: Postural awareness is absolutely key to staying balanced and preventing a fall. I always tell my patients that posture is the fountain of youth. Bad posture equals pain, loss of movement. Eventually, it’s almost inevitable that you will fall.

Think about it, most people spend their lives sitting, hunched over at a desk or keyboard. When that continues for days, then years, it effects the way our muscles work – or don’t work – to keep us balanced when we want to be upright and move around.

Zibrio: If someone has already got bad posture, is there anything they can do about it?

Bill: Sure there is. You can change the way your body works at any age. When we sit hunched over for long periods of time, the head tilting forward puts a strain on neck and back muscles. Did you know that for every 1 inch forward of the head in a slouched position is like the head becoming 10lb heavier in terms of load on the muscles supporting it?

Motion is your body’s lotion. You have to get out and exercise if you want to maintain your independence and keep doing what you enjoy. If you ignore it, then ligaments tighten, muscles weaken, joints wear out and nerves inflame. In a word: PAIN.

Chin Tuck

Zibrio: Could you give us an example of an exercise someone could do?

Bill: A simple one to do either sitting or standing: Pull the shoulders back and look straight ahead. Tuck the chin into the chest. You should feel a good stretch in your neck muscles and along your shoulders. Hold it for 5 seconds, rest, then repeat it 5 times. Do this often during the day.

Zibrio: What about balance itself? Do you give your patients balance-specific exercises, beyond posture?

March in Place

Bill: Yes. Posture is  a major part of the problem, but you also need muscle strength and flexibility. You can improve these at any age too. Most people when they age, and especially if they’ve been sedentary for a while, find their hip, thigh and calf muscles have weakened. I like to give them the marching in place exercise:

Stand upright next to a chair with head and shoulders back. Breathe normally, picking the knee up to waist level. Repeat with each leg, as if you are marching in place. Perform this exercise 10–20 times. When it becomes easy, put less pressure on the supporting chair.

A lot of older adults struggle to get up out of a chair, or to walk up and down stairs. You need to do exercises that strengthen the leg muscles. Squats are great general exercises for overall leg strength. it’s a natural movement. While holding onto a chair, the focus is on the stomach, back, and hips to maintain balance and an upright posture.

Standing upright next to a chair for support, maintain a straight posture, breathe out and slowly lower into a squat. Hold for 5 seconds, slowly stand up and relax. Repeat 10 times.

Bill Case
Chair Squat

Zibrio: Thanks, Bill. Do you have any last words of wisdom?

Bill: You’ve got to keep moving. There are 640 muscles in the human body that control movement and balance while maintaining posture. A sedentary lifestyle – like most people have – accelerates muscle weakness and poor posture, but daily exercise can reverse that no matter your age. My patients are living proof of it.


Note: A leader in physical therapy innovation, Bill Case invented the
diagonal rotary patterning exercise machine. He is also a national
and international lecturer on orthopedic injuries and a published
authority on exercise, injury, and injury prevention. Bill is a
contributing writer to Self, Men’s Health, Fitness and Prevention
magazines and the coauthor of SPORTS PHYSICAL THERAPY. As
founder and co-sponsor of Houston’s Annual Senior Falls Prevention
Day, he scripted and produced Keep Fit and Moving (DVD) for older
adults to help prevent falls. He can be reached at: casephysicaltherapy and keepfitandmoving

3 Real Reasons Why You’re Failing at Fitness

Why don’t we do the things that we know are good for us? Or only occasionally?

Think back over the last month, how many times have you had a conversation with someone (or thought to yourself) about making a healthier choice – doing more exercise, eating more vegetables, less fried or sugary foods? Did your behaviour change? Has your friend’s? If so, how long has the change lasted?

If you’ve made a healthier change that’s lasted for longer than six months, congratulations! you’re in the small minority of people who manage it. If not, perhaps you’re feeling guilty, or annoyed, or trying your best not to think about it.

Why do we keep failing at healthy resolutions?

  1. Changing a habit is hard, especially when it involves giving up something we like or enjoy. Often, we do the unhealthy thing without consciously deciding to (those days when you find yourself staring into the fridge, or heading straight for the couch automatically).
  2. We discount the future risk. Yes, we know it’s supposed to be better for us to exercise / lose a bit of weight / drink more water / stop smoking. We know statistical studies show that we’ll live longer / reduce the risk of dementia / of falling / of developing diabetes or heart disease. But it’s in the future, and it’s only a statistic, not a guarantee. And that piece of cake is sitting in front of us, right now. One more piece won’t hurt. We can begin /go back to that lifestyle change tomorrow, right?
  3. It’s difficult to know if these healthy choices are really making a difference. After all, it takes a decade or more to find out if it’s really made an impact on our longevity. How could you measure it today?

Ultimately, we don’t want to spend days thinking about and measuring our health. We want a quick and easy way to tell so that we get on with our lives and interests, whatever they are. A scale tells us if we’ve lost or gained weight. A blood pressure monitor tells us if we’re still in the healthy zone. Wouldn’t it be great to have one gadget that gave a composite score of overall wellness?

Such things are on the horizon, but what can we do in the meantime, if we want to make a change?

  1. Don’t get overwhelmed. Try changing one thing. Commit to going to bed a little earlier, to improve sleep.
  2. Frame the change in a positive way: learning a new exercise or eating vegetables is easier to stick to than giving something up.
  3. Make it specific. One extra serving of vegetables each day, 30 minutes earlier in bed.
  4. Start today, right now. Then by tomorrow, you’ll have already begun your new behaviour.
  5. Tomorrow, commit to doing it again. One day at a time.
  6. Find an intrinsic benefit to the change: the taste of a new food, the way a walk outside wakes you up and makes joints less stiff the rest of the day. By enjoying the healthy choice for its own sake, we can build habits based on the immediate benefits, and still reap the long term improvements.
  7. Find inspiration from others who have changed, often late in life. There’s always time to change and make a better tomorrow.

5 Ways You’re Hurting Your Balance and How to Fix It

I’m not talking about your bank balance, but your physical, stay-upright-don’t-fall balance.

Think you don’t have a problem? You may be right, yet the vast majority of balance problems go unnoticed until someone actually falls and injures themselves. And whether you’re 35 or 75, recovering from a fall is whole lot harder than not falling over in the first place.

But with a little self knowledge, you can assess some of your possible weaknesses, and take action without needing to become a statistic (every 20 seconds someone over 65 has to visit the ER because they’ve injured themselves in a fall).

  1. You sit down all day. The human body is brilliant at adaptation. The most common reason people in retirement fall over is because they’ve spent the last 40 years sitting down and their muscles have adapted to doing that very well, and lost their earlier ease for movement. Fortunately, this change can be reversed by challenging the body again: exercise that targets strength, flexibility and balance will send different signals to your brain and muscles and they will start to respond. Start slowly, and seek help. A class like Tai Chi, which also incorporates breathing exercises, has been shown to be particularly good for improving  balance.
  2. You’ve started new medication. Or changed the dosage. Many medicines affect your balance, either over the short term while your body adjusts, or longer term because of interractions with other drugs (including over the counter medicines) you may be taking. Always take professional advice from your doctor or pharmacist. Talk to them about how all your medications make you feel and they can help make sure they’re not increasing your risk of falling.
  3. Your eyesight is poor. Our eyes play an enormously important role in keeping us balanced, and not only by warning us of holes we may drop into or obstacles we may trip over. Our brains compare input from other senses with the information coming in through our eyes to tell if we’re leaning, standing upright, moving, or stationary. That moment of confusion many people experience when stepping off a moving treadmill is a good example of this. As eyesight can deteriorate over time, it is worth checking in with an optometrist yearly to ensure your eyes are working at their best.
  4. You suffer from hearing loss. This can be a problem on two levels. One, you may not become aware of a hazard until too late, resulting in sudden movement and possible loss of balance. Secondly, with loss of hearing, many people withdraw from their surroundings, tuning out some of the other senses as well. This can make you additionally vulnerable. Sometimes being aware of this tendency can be enough to make a conscious effort to stay alert. In other cases, it can be worth seeing a doctor about hearing aides.
  5. You’re depressed or anxious about falling. Both depression and anxiety can lead people to disengage from those around them, physically and emotionally. Often people avoid going out and doing things they used to enjoy because they’re worried about falling . But studies have shown that such behaviour actually increases the risk of having a fall. The best protection is to stay active and engaged in your life, in order to maintain an alert brain, and strong, flexible muscles.


September is National Fall Prevention Month, and there are events going on all around the country to help raise awareness and put people back on their feet. Falling is not a natural part of aging. But you might have to do something about it to make sure it doesn’t happen to you.

Brain Boosting Benefits in 60 Seconds?

Would you like your brain to operate as if it were 7 years younger? Would you like an improved memory, clearer thinking, less stress?

Recent scientific studies have found there is a way to invite these benefits into your life. It doesn’t have to cost you a cent, and anyone can do it. You can enjoy improved concentration, better sleep, lower levels of the stress hormone, cortisol, and lower blood pressure, through a daily practice of Mindful Meditation.

But isn’t meditation only for spiritual folk?, I hear some people ask. Do I have to spend hours crossed-legged on the floor, clearing my mind and retreating from reality? The answer to these questions is No.

Firstly , yes meditation can be part of a spiritual belief system, but it doesn’t have to be. Secondly, you may like to sit cross-legged , but it is also possible to practice in a chair, or in some situations, meditate lying down. Meditations can last from 1 minute to as long as you like. I recommend building up to 20 minutes a day when you’re starting out.

And no, this isn’t taking a break from reality. It can feel like a wonderful time-out, but as you use Mindful Meditation regularly, you will find yourself connecting more to reality and the world in a positive and gentle way.

Sound good? Let’s get started! Read through this list of steps and then you can begin.

First, get comfortable. The aim is ‘restful alertness’. You can sit upright in a chair with your back straight. Place the soles of your feet on the floor.

Take a moment to notice your surroundings and then turn your attention to your breathing. Take slow deep breaths, in through your nose and out through your mouth.

Now, breathing gently, slowly close your eyes. Without judgment, notice the rise and fall of your chest and the sensation of air moving at the tip of your nose.

Know that distractions are a normal part of Mindful Meditation, they are part of the meditation practice. If you have thoughts, you can acknowledge them. These are not bad thoughts, nor good thoughts, they are just thoughts.   Let them go and return your attention to your breath.

After at least a minute, and when you are ready to bring your mindfulness practice to a close, take a deeper breath in, and on the outbreath you can gently open your eyes. How do you feel? Calmer? Refreshed?

Mindful Meditation strengthens your awareness of the present moment.  It empowers you to see situations more clearly and enables you to choose how you respond. You can use this technique when you’re waiting in line at the grocery store, or if you feel yourself getting annoyed. Close your eyes, concentrate on your breath, and take a moment to pause.


4 Things You Didn’t Know About Allergy Dangers

The blossoms are beautiful this time of year. Trees, shrubs, the grassy parks alive with wildflowers. Everything comes alive, people start planning summer fun. But, this beauty extracts quite a price from a number of people, in the form of seasonal allergies, like hayfever.

  1. over 17 million adults suffer from hayfever in the US
  2. 4 million work days are lost to hayfever each year
  3. Allergies can increase your risk of falling
  4. Risk of bad side effects to allergy medication increases with patient age


While an allergy doesn’t affect your balance directly, it impacts some of the systems that contribute to good balance. When suffering from symptoms, many people experience poor sleep, and feel tired and unable to focus during the day.

Having a stuffy nose or blocked sinuses also makes some feel removed from the world around them. Both these symptoms make people less alert to trip hazards and slower to respond when they do notice. Perhaps when tired you start to shuffle your feet, rather than walk normally. Itchy, streaming eyes can affect vision quality.

While some medications can help with the symptoms above, they come with their own problems, especially first generation antihistamines, which can cause drowsiness, and even an inability to think clearly. These effects can be magnified in older adults because aging means there are fewer receptors in the brain, and increased blood-brain permeability.

So what can you do? Unfortunately, there is no magic solution to removing allergy symptoms, but there are things you can do to prevent a fall.

  1. Pay attention, consciously, when you move around. Be aware that your body might need more time to react, and plan accordingly
  2. Before taking any medication, check with your doctor to make sure it won’t react with anything else you take, and if a non-drowsy version is right for you
  3. Perhaps schedule in some daytime rest – meditation, reading, or napping, to make up for loss of sleep at night
  4. Drink plenty of fluids
  5. Don’t stop exercising: if the climate outdoors makes you miserable, try changing your routine for a bit. Go swimming, or take a class inside.


What is your favourite way to beat allergies? We’d love to hear from you.

Have You Earned the Right to be Lazy?

True or False: The wonderful part about retirement is that you’re allowed to sit down and eat cake.

Think about it, you’ve worked hard your whole life, you’ve looked after others, looked after yourself, at least in the basic sense. Now that you don’t have to get up early and drive to work, where’s the harm in being glued to the couch for a day if you want to be? The last time you were able to do that was probably as a teenager, and then your parents probably wouldn’t have let you sit still for as long as you wanted to.

Well, here’s the thing, sitting on the couch all day is only fun if you’ve chosen to do it, meaning you are capable of choosing to do something else, should you wish to.

And that’s where it gets tricky. If you spend many days sitting on the couch, pretty soon it’ll be all you’re able to do. And that’s when it stops being fun.

Research shows that the majority of retirees prefer to be able to live in their own homes for as long as possible, rather than moving to a care home. And the only way to maintain that level of independence is to continue to challenge the body and mind so that they don’t atrophy.

Experts give similar advice to anyone who wants to maintain a good level of health and fitness:

  • Find something that you enjoy doing, and do it every day.
  • Find a friend or group who will help motivate you on the days when the couch wants to play kidnapper
  • Take the chance to learn something new. Exercising doesn’t mean you’re signing up for the same thing every day for the rest of your life. Change it up a bit. Gardening, dancing, walking, swimming…. the list is only as short as your imagination.
  • If your activity has started to bore you, exchange it for another, but keep moving.

The benefits of staying active include feeling happier, fewer aches and pains, better sleep, all of which will contribute to better balance and lower fall risk. And, you can still enjoy sitting down and enjoying that cake. After all, you’ve certainly earned it.

A Simple Trick to Boost Your Health at Any Age

No matter how ‘healthy’ you are when it comes to diet or exercise, there is one simple habit that will improve your overall health. And the good news is

  1. It’s free
  2. It feels good
  3. Your family and friends can benefit too

It’s what scientists refer to as ‘non-noxious sensory stimulation’. Or touch, of the pleasurable kind.

Many kinds of touching all have beneficial health effects:

  • hugging
  • stroking
  • massage
  • holding hands
  • consensual sex
  • pat on the back
  • high five / fist bump

Pretty much any kind of touch that is carried out in a loving, friendly way is good for us.

Recently, there have been a number of studies to work out why this is the case. And it boils down to oxytocin, a hormone that has far reaching consequences in our bodies. 

As infants, oxytocin release is triggered during natural birth. Another dose comes with skin to skin contact after birth, and during nursing. Oxytocin is released in both mother and infant, and gives to both a long list of benefits.

Researchers have been delving deeper into what those benefits are and how they work.

Simply put, Oxytocin, sometimes called the ‘love chemical’ because of the feeling of relaxed well-being it generates, gives some surprising benefits:

  • lower blood pressure
  • reduced inflammation
  • reduced cortisol
  • better gastrointestinal function, leading to better growth
  • faster healing
  • better responses to stress
  • improved mood

It turns out that Oxytocin is released into the circulatory system, as well as into the brain. The effects can last up to thirty minutes from a single dose. And after multiple doses, these effects can last for up to three weeks.

Older adults often suffer doubly from lack of Oxytocin – over time, our skin’s sensivity reduces, meaning that we need more stimulation aged 90 to produce the same effect we experienced aged 20. But many older adults live alone, and do not have access to gentle touch, from hand holding to hugging, that would brighten their lives, literally.

Research published in 2014 also discovered that the act of stroking a pet, like a cat or dog, triggered  oxytocin release in both human and pet.

So take a stand today, for your own health, and that of everyone dear to you. Reach out and touch them. Give them a hug and let them know their health is important to you.

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Is Healthy Living Too Risky?

Exercise aerobically, and you could bring on a heart attack. 

But don’t do it at all, and you risk heart disease.

Doing advanced exercises to improve your balance can put you at risk of falling, yet without them, you risk falling because your muscles are weak and respond too slowly.
Then there are all the environmental dangers: exercising outside is good for getting fresh air into lungs and absorbing Vitamin D from the sun. But sometimes that air is polluted, rather than fresh, and excessive exposure to sunlight can lead to skin cancer. And that’s before we get started on the dangers of automobile traffic for cyclists and runners.

And what about the sport specific injuries? Shin Splints for runners, Golfer’s Elbow, Tennis Elbow, Swimmer’s Ear, Plantar Faciitus. 

Wouldn’t it be safer to just stay at home and not stress the system? 

Most of us can point to relatives who drank or smoked and didn’t have gym memberships, and yet they worked out okay, some of them living into their nineties.

But modern life is not kind to the human body. By the time we retire, most of us have spent the better part of forty years seated: at desks, in cars or public transport, on sofas. We’re sitting ducks for age-related diseases.

It doesn’t have to stay that way. 

In order benefit from exercise, your body needs to leave its comfort zone. To improve your balance, you need to challenge the muscles that make you stable. But how can you do that if you’re worried about falling? 

One option might be to have a friend stand close, not touching you, but ready to help you before you fall. Or practise a one-legged stand initially holding onto the back of a sturdy chair. As your muscles get stronger, you can lift your hand off for a few seconds, then build to where you can do the exercise for a full minute without holding on at all.

Take anyone who has succeeded at anything, and ask yourself if it happened overnight. If you aspire to running the New York Marathon, there is some basic preparation and quite a bit of training that takes place if you hope to cross the finish line uninjured. 

And so it is with any level of activity. If you decide to start on something, make a plan. Think of the risks and come up with a safety net to minimise them. 

Don’t give up, there is help available. Exercise is possible at any age, and you can stack the odds in your favor. 

To get started, the National Institute for Health has some useful exercises that can help.

Medals Are Only For The Young

Young athletes get sick of hearing how short is the window for sporting excellence, and how they have to make sure they have a sensible career plan to fall back on.They may take heart then, at the 12,000 athletes over 50 years old who took part in the Senior Games this year in Minnesota. One of them was Houstonian Emma Lou ‘Scottie’ Scott. Now 81, Scottie has competed in most of the Games since 1991 when she became eligible (initially the lower age limit was 55).

It’s not about the medals

Scottie is a lifelong sports enthusiast. She started competing in volleyball at high school, won a scholarship to gain her degree in Physical Education at Sam Houston State college, and has never looked back. 

She has taught girls volleyball, basketball, badminton, tennis, swimming, archery, modern dance (which used to be part of the Physical Education curriculum for girls). She was part of the iconic group who played pick-up games at the famous Fonde Rec in Houston, showing up for practise twice a week, somehow finding the energy to do so after long days teaching up to 300 students, and coaching 30 in volleyball. 

hall of fameHer house is a shrine to sports and her sporting heroines. There is a box of medals from the Senior Games – national and regional competitions that she keeps in the hall (the rest of some 300 awards, including several from a number of Gay Games, hang off furniture or are under the bed). She was inducted into the Texas Senior Games Hall of Fame in 2007. 

The walls of the rooms are covered in signed photographs of famous players, including Kim Perrot of the Houston Comets Women’s Basketball team, and signed baseball cards from the original players in the All American Girls Professional Baseball League (the inspiration for the film A League of their Own), with whom she also met.

The biggest change that she has welcomed in the world of sport is the opening of opportunity for female athletes brought about by Title IX legislation of 1972. At first it was hard to get her school students to participate in sports like basketball, so she switched to the sports that were popular with women at the time: volleyball and swimming.

Retirement means go up a gear

Once she retired, she knew she couldn’t just sit on her porch and watch the world go by. She signed up for the Senior Games immediately, qualifying that first year in Badminton, Discus, Shot-put, and Javelin in a week of competing events around Houston. When she reached the Nationals that year, however, she realised that there was no time to compete in all the sports in which she had qualified, and chose to concentrate instead on singles and doubles badminton. It has remained her passion ever since. When asked what keeps her going, she said she loves the different parts of the game, the mental as well as physical aspects of playing. And she enjoys the company of other athletes.

Find something you enjoy,” she counsels. Then just get out there and do it. “Above all, stay involved.”

Doctors have advised her that she’d benefit from both knee and hip replacement surgery, but she is putting it off as long as possible, knowing that it will compromise her mobility in the short term and admitting that her life is too busy right at the moment.

When not playing or competing, she works with an Angel Flight network who drive cancer patients from airports to their accommodation; has been a vocal advocate for mammograms for lesbians, supports her partner on the board of the Texas Ramblin’ Roses (a group of women RV enthusiasts), and is involved in the community group LOAF (Lesbians over age 50). And then if there is any time left over, there is her beloved dog – a Scottie, appropriately.


‘Senior’ is a Dirty Word

Try this experiment: ask a random group of people the following question:

If you had to identify the kind of person you are, using only 3 words, what would those words be?

I’m willing to predict that the vast majority of the answers concern their job, spare time interest, such as a sport, and perhaps a characteristic, like ‘kind’ or ‘energetic’. Some will mention religious affiliation, perhaps ethnic group or gender, some, that they are a parent. A very tiny minority will mention their age-group.

When I conducted this research myself, the only ones to fall into this latter group were people not yet 25 years old. I found that the older people were, the less they identified themselves by their age, or their relationship to family (many grandparents whom I know adore their grandchildren, did not choose ‘grandparent’ as one of their defining terms – or even ‘parent’). 

And yet, companies and government agencies talk to and about ‘Seniors’ and ‘Baby-Boomers’ as if they are an homogenous group with the same aspirations, fears and experiences. I may be a 40-something mother of 2, but if I came across someone marketing a product to me in those terms, I’d be pretty sure to run a hundred miles in the opposite direction because those are not the things by which I choose to define myself.

So if you want me to choose your product, you’d better pay attention to that. And when companies talk to 30 and 40 year olds, most of them realize this and refine the pitch. Why then, do we expect people to lay down their individuality at the doorstep of a particular decade?

We recently participated in National Falls Prevention and Awareness Week (#FPAD15), lead by the National Council on Aging, and other agencies. Here in Houston, there have been a few well-attended events connecting users of community centers with advice on exercise programs and home safety. But the response from the press and a number of ‘senior’ living establishments has been somewhat underwhelming.

I wonder how much of that is because the help is being broadcast on the wrong channels? Perhaps if we used more positive language we might gain more interest, and therefore be able to help more people. We should be using labels like #ageDisgracefully or #DontLeaveitTotheKids for the adventurous set, #golfersDoitStanding (change the sport as appropriate), #brainsloveoxygen for culture vultures, and so on.

People of all ages hate being told where they are weak. It’s time to celebrate how we are strong, and how to stay that way.