The Pandemic and Sarcopenia:
Fitness professionals are on the front lines of preventive care.
By Julio A. Salado, NSCA-RCPT*D, NREMT-B
Since the pandemic, inactivity has increased for many people, and the negative impacts on their mental and physical wellbeing may have long-lasting effects on their quality of life.
As fitness professionals and leaders, we have the skill set to assist in countering one of the under-recognized growing health care challenges exacerbated by the pandemic, sarcopenia.
My article highlights the need to service the residents of our community that do not have a gym membership or accessibility to fitness equipment for various reasons including socio-economic factors (occupation, education, income, location of residence).
Sarcopenia is the age-related involuntary loss of skeletal muscle, muscle strength, and its function. It can begin as early as age 40. Therefore, it is important to bring awareness to individuals in their 30’s and 40’s about the benefits of physical activity, as this is the optimal time to build and/or maintain muscle mass and function for gross and fine movements. By the age of 80, people who are inactive may lose up to 50 percent of their muscle mass. According to Jeremy Waltson’s 2012 work “Sarcopenia in Older Adults” in Current Opinion Rheumatology: “Other than the loss of strength, the functional declines associated with sarcopenia can contribute to a number of adverse health outcomes, including loss of function, disability, and frailty. Sarcopenia is also associated with acute and chronic disease states, increased insulin resistance, fatigue, falls, and mortality”. (1)
In a recent study published in the Journal of the American Geriatrics Society indicated that there is evidence of the association between sarcopenia with incident Alzheimer’s dementia, mild cognitive impairment, and cognitive decline in older adults.
One key take-away from this study concluded ‘poor muscle function, but not reduced lean muscle mass, drives the association of sarcopenia with late-life cognitive impairment”. (2)
Whether an individual is eighty or thirty-five, reduction of physical activity contributes to sarcopenia. The past year’s “stay at home order” during the peak of the pandemic added another barrier to physical activity. Though we are now thankfully in the vaccination phase, the world has changed. Lingering fears of contracting and spreading COVID-19 through in person activities, as well as general anxiety about beginning or restarting a fitness regimen may overshadow many people’s motivation to get active.
While the timetable for returning to normalcy is not fully determined, this period of transition holds an amazing opportunity for the fitness professional to help return to physical activity.
The good news is that sarcopenia can be addressed at any age through a safe and results-driven strength regimen. Keep in mind, most people do not know the term sarcopenia, however, if they recognized the concept and its consequences, they would likely want to know how to address the issue.
To counter this situation, I suggest the following:
- We collaborate with other health and medical professionals to create public awareness about the adverse effects of sarcopenia and encourage physical activity.
- We provide a holistic fitness regimen that acknowledges stress and the perception of limitation caused by the pandemic may influence a person’s motivation to be active.
There are three reasons that the health and fitness professional’s unique skill sets can be effective with helping our community become active:
- In our roles as coaches and mentors, we are great motivators.
- We can prescribe exercises that promote healthy aging.
- We can encourage individuals to stay up to date with preventive services provided by medical professionals. For example, we can advise clients to keep current with cholesterol testing, flu shots, colon and breast cancer screening and annual checkups.
My approach is designed to challenge an individual’s current fitness level and to promote behavior modification and lifestyle changes.
The question is, how do we reach the population that does not have a gym membership or access to fitness equipment?
One of the best tools to utilize is social media. A second option is a hybrid model. You can do in-person events at the gym, public parks and community center and simultaneously live stream. Occasionally, local media may learn of your public health event and may share it with their viewers.
Through social media, we can help many people who we may never meet in person, but who will nonetheless benefit from our knowledge and expertise. We also can attract new clients by building trust and developing new relationships.
The main objective is to use our sphere of influence to build an online resource for the prevention of sarcopenia.
Below is a sample outline to help fight sarcopenia for the individuals most affected by isolation and inactivity during quarantine, helping them to discover (or rediscover) that the benefits of physical fitness may improve their quality of life for years to come. This strategy can be messaged through articles, videos, and online/in-person workshops on social media platforms.
My fitness regimen involves a synchronicity of Western exercise science and Eastern holistic arts that helps the individual overcome the perception of limitations and movement, promotes acuity, and develops self-confidence, which leads to more empowerment.
Education is an essential part of my method.
I advocate discussing and providing examples for the two widely used methods by health and fitness professionals: 1) the SMART goal-setting method for creating an exercise program; and 2) the SAID principle for exercise selection, which states that the body will adapt to the specific demands placed upon it.
These are two fundamentals for developing any result-driven exercise regimen. Let us briefly review the SMART and SAID principles.
The SMART method is a general approach to goal setting that has several relevant aspects for exercise and physical training. The acronym is Specific, Measurable, Attainable, Realistic, and Timely.
First, the exercise program revolves around a tangible goal. An example of a tangible goal is being able to walk up and down two flights of stairs without being winded. After creating a specific and attainable goal, we proceed to baseline assessments. Those include the individual’s current ability to perform this activity, which is measured by how many steps were taken; and by noting the person’s level of fear (perception of limitation) in performing the activity.
The SAID Principle:
The SAID principle stands for Specific Adaptations to Imposed Demands. It can apply to people of all ages; this principle, as adapted, forms part of the foundation for choosing specific progressive and safe exercises for the public.
The following steps are suggestions to help kickstart motivation, and to promote inclusivity and empowerment through physical activity:
- Provide education about the benefits of physical activity and consequences of inactivity.
- Suggest practical activities such as walking and counting daily steps. Set the goal of increasing the amounts of steps each week.
- Prescribe exercises that are modified, safe, and challenging, to promote physiological adaptation. Examples include walking around the block with a backpack or stair climbing.
- Demonstrate activities with equipment people are likely to have at home, and suggest substitutions for weights, such as common household objects.
- Focus on posterior chain exercises to counter the negative effects of a sedentary lifestyle. Teach how to hip hinge as well as scapular retraction.
- Show exercises that are not familiar to the general population, such as farmer’s walks with a suitcase and bear crawls.
- Show regression and progression of common exercises. For example, change the tempo for squats. Use a bodyweight clam abduction exercise instead of side planks.
- Encourage them to acknowledge their achievements to build self-confidence.
- Remember to promote exercise as a stress reliever.
- Suggest inviting family and friends to participate.
- Include fun in your posts. Humor is part of a healthy lifestyle.
- Provide local resources such as a nutrition workshop and suggest exploration of other modalities of fitness, either online or in person.
- Emphasize the importance of continued physical activity and its relationship to sarcopenia and healthy aging.
The following is a sample four-week beginner’s body weight workout for home. It is designed to counter the negative effects of a sedentary lifestyle and the use of smart devices. Always be sure to include a disclaimer in your posts regarding consultation with a medical provider before attempting the exercises.
Exercise prescription: Duration 4 weeks. Frequency is two to three times per week.
We want to emphasize the importance of quality of exercise technique versus quantity of repetitions. This can be achieved by providing a minimum and maximum range of repetitions to create small achievable goals. Be sure to encourage questions regarding the exercises.
Week one is their baseline for physical ability, and I would suggest that they assess and write down their overall feelings of well-being, including their stress level. At the end of the four weeks, the individual can compare the initial workout log to the final week to see their success and challenges including if the program has helped to alleviate stress.
Ideally upon completion of the four-week program, the individual will be motivated to continue to stay active. They will have built strength, developed healthier habits, and may reach to you for more suggestions.
Week 1: 2 sets, Week 2: 3 sets, Week 3: 3 sets, Week 4: 4 sets
Floor exercise: Giant Set.
1. Bird dog variation with lateral shoulder raises (with neutral wrist) and opposite leg hold: Repetition minimum 10 max 20.
2. Side elbow plank clam hold for time. Hold 5-15 seconds.
3. Floor Bridge ups: Repetition minimum 10 max 20.
4. Bear crawl hold: Hold 5-15 seconds.
5. Seated breathing exercise (chair is optional): Duration 30 seconds to 1 minute, focus on slow inhale and exhalation.
Standing circuit: Giant set.
1. Scapular retraction: Repetition minimum 10 max 20.
2. Downward and downward scapulae drill: Repetition minimum 5 max 10.
3. Hip hinge: Repetition minimum 5 max 15.
4. Side-step and shoulder side raise: Repetition minimum 5 max 10 set in one direction. Repeat on other side.
5. Farmer carry with cans: Walk minimum 10 max 20 paces without dropping the cans.
Tips to help Fitness Professionals build interest and engagement on social media!
I would suggest posting questions on your social media to begin a dialogue:
- Do you know about sarcopenia and how to fight it?
- How have events of the past year changed your relationship to fitness?
- What physical changes have you noticed in yourself in the past 6-12 months?
How to use your posts to build your fitness business:
- Invite followers to join your email list for the latest videos and events.
- Include your contact information in all posts.
- Expand your campaign by asking others to share your post with their social network.
Fitness professionals are on the front lines of preventive care.
Our profession has changed dramatically from pre-COVID-19 to the present.
Pre-COVID-19, we had a great deal of in person contact with young and middle-aged adults and special populations. This came to a complete halt for most of us. As we begin to emerge from this difficult time, it is critical to address the impacts of inactivity that so many people have experienced.
As we enter a new phase in the pandemic, we can leverage our sphere of influence and use platforms such as social media to create a dialog about this underreported condition, sarcopenia. The ability to reach more individuals will be more effective if we work as a collective whole toward increasing public awareness.
Every one of our contributions has a positive impact that may not be measurable in revenue or followers but in knowing we are part of the greater good in our community.
To discuss collaborating, exchange ideas and creating events, contact me at email@example.com
Julio A. Salado, NSCA-RCPT-D*, NREMT-B
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- Walston JD. Sarcopenia in older adults. Curr Opin Rheumatol. 2012;24(6):623–627.
- Beeri, MS, Leugrans, SE, Delbono, O, Bennett, DA, Buchman, AS. Sarcopenia is associated with incident Alzheimer’s dementia, mild cognitive impairment, and cognitive decline. J Am Geriatr Soc. 2021; 1– 10.