From Harvard Medical SchoolStrength and Power Training: A guide for adults of all ages

If you’re like many people, you’ve never lifted weights in your life, and you may wonder, why start now? As you age, muscle tissue and strength dwindles, but weight or strength training can reverse this process. It can also lighten your heart’s workload, boost levels of good cholesterol, lead to weight loss, and improve your mobility. This report answers your strength training questions and helps you develop a program that’s right for you.

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Time to put some muscle into it

Exercise is on every to-do list we can think of for staying healthy, and there’s pretty wide agreement on how much is necessary.The physical activity guidelines issued in 2008 by the federal government echoed other guidelines by recommending that American adults get at least two and a half hours of “moderate intensity” aerobic exercise a week. Aerobic exercise increases your heart and breathing rates so that more oxygen reaches your muscles. Walking at a fast pace of three to four miles per hour (three is brisk; four can feel downright fast) is often held up as the standard for moderate intensity: inexpensive, no special training or equipment needed, and manageable by many, although some people may need to work up to the full weekly amount. And you can get those two and a half hours in 10-minute allotments.Be strongThere are indeed other types of exercise we should be doing that may get overlooked in the enthusiasm for an aerobic workout. Exercises to improve and maintain our balance, for example, and those that help keep us flexible.Many researchers argue that the health benefits of strength training (another name for muscle-building exercise) haven’t been emphasized nearly enough. In fact, for older people, it may be even

more important than aerobic exercise, because research has shown that it could prevent falls and disability. The gradual, age-related decrease in muscle tissue called sarcopenia starts at the depressingly young age of about 30 or so. The average 30-year-old will lose about a quarter of his or her muscle strength by age 70 and half by age 90. Some studies show an even steeper drop-off that accelerates rapidly in our 70s.Vive la resistanceStrength training goes by several names: resistance training, progressive resistance training, weight training, muscle strengthening. The notion of resistance comes from the fact that your muscles are straining against an opposing force — gravity, for example, if you’re lifting a weight. In the typical program, you do the same weight-lifting exercise eight to 12 times, rest for a minute or two, and then do the exercises again. The number of times you repeat a movement (for example, lifting a weight) is often referred to as “reps” (for repetitions) and the groupings as sets. Muscles have to strain to get stronger, so you are supposed to choose the amount of weight that allows you to do only eight to 12 reps — and the last couple of them should be difficult. Two or three sets of each exercise are usually recommended. As you get stronger, you’re supposed to increase the challenge to your muscles by adding more weight. Because muscle needs time to recover, it’s best to limit yourself to two or three workouts a week. Power upMost traditional strength-training programs, and especially those for older people, don’t emphasize the speed at which the exercises should be done. As a result, they increase muscle strength, but not necessarily muscle power, which is a function of both how much force a muscle can produce and the velocity at which it can do it. Muscle power declines even faster than strength as we age. And in several studies, muscle power has been more strongly associated with loss of mobility and falls than strength alone. That makes sense. Muscle power, not just strength, helps with everyday activities like climbing stairs because it allows you to transfer weight from one leg to the other relatively quickly, so you’re less likely to teeter and lose your balance. And think about when you stumble slightly: whether you fall or not depends on how quickly your muscles react and compensate for the loss of balance.A strength program can be adapted to produce more power simply by doing a component of each exercise at a faster speed. It’s been a challenge, though, designing safe modes of power training for older adults. Dr. Jonathan F. Bean, an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School, has conducted a number of studies of a program specifically designed to improve muscle power, especially that of the leg muscles. It involves wearing a weighted vest — adding weight to the torso instead of the arms or legs helps people keep their balance during the exercises — and “task specific” exercises related to day-to-day activities such as getting out of a chair or climbing stairs. The bottom lineStrength training isn’t a vanity project. It’s now recognized as a crucial part of a well-rounded exercise program that will help offset the natural tendency to lose muscle as we get older. Muscle power — strength plus velocity — may be more important than strength alone, and you should

explore safe ways to add some power moves to your muscle-building workout. To learn more about the benefits of strength training, order our Special Health Report, Strength and Power Training: A guide for adults of all ages.

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To learn more about the benefits of strength training, order our Special Health Report, Strength and Power Training: A guide for adults of all ages.

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Notable from Harvard Medical School

** Strength and Power Training: A guide for adults of all ages

If you’re like many people, you’ve never lifted weights in your life, and you may wonder, why start now? As you age, muscle tissue and strength dwindles, but weight or strength training can reverse this process. It can also lighten your heart’s workload, boost levels of good cholesterol, lead to weight loss, and improve your mobility. This report answers your strength training questions and helps you develop a program that’s right for you.

[CLICK TO READ MORE or BUY]

** Hearing Loss: A guide to prevention and treatment

If you think you might need a hearing checkup, you probably do. Hearing Loss: A guide to prevention and treatment describes the causes and cures for hearing loss. You’ll learn about the latest advances in hearing aid technology and find out which kind of hearing device may be best for you. This report also contains in-depth information on the causes, diagnosis, and treatment of hearing loss.

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Plugged-up feeling in an ear

Q: I have a problem with my left ear, which often feels plugged up. It usually starts about 4 p.m. and lasts about three to four hours. I cough, clear my throat, yawn, close my nostrils and blow — nothing seems to help.A. It seems like you have had this problem for a while, so my first suggestion is to see a doctor and start the process that would lead to a diagnosis and proper treatment.The diagnosis of almost any ear problem starts with a few basic questions. One of the most obvious is also one of the most important: have you lost any hearing? Sometimes people experience hearing loss as a plugged-up feeling, so some tests may be necessary to sort that issue out. Doctors also ask patients with ear complaints about dizziness, pain, ringing in the ears, or fluid discharge. The answers help steer testing and other diagnostic detective work. Ear problems with dizziness — the room-spinning kind that’s the main feature of true vertigo — might merit investigation into whether someone has Ménière’s disease, a rare condition caused by an imbalance of fluid in the inner ear. Ear pain is a good clue that the problem is a middle ear infection. Ear pain with a moist discharge is a common symptom of swimmer’s ear.Other important questions: Are both ears affected or just one? Did the symptoms come on suddenly or gradually? Do they persist or come and go?Your ear may feel plugged up simply because it is — with earwax. I can’t explain the regular late-afternoon onset, but earwax blockages can wax and wane (forgive the pun!). They can get worse after a shower, for example, because the wax soaks up water. As tempting as it might be, don’t try to remove earwax yourself. Cotton swabs and pencil erasers can break off in the ear canal, which isn’t the straight passageway that it appears to be from the outside but one that bends and narrows. Let a doctor take a look.Another possibility is that you have eustachian tube dysfunction. You can’t see the eustachian (pronounced you-STAY-shun) tube. It’s entirely inside your head, connecting the middle ear to the nasopharynx, the area at the very back of the nasal cavity near where it joins the throat. In adults, the eustachian tube is a little over an inch long and runs forward and downward from the middle ear to the nasopharynx. It’s made of cartilage and bone and is lined with a moist, mucous membrane.Normally, the eustachian tube helps equalize air pressure on either side of the eardrum by allowing air to flow in and out of the middle ear. If it gets blocked, then there’s less pressure in the middle ear, which creates a little suction, so the eardrum gets pulled inward. This causes a full, plugged feeling in the ear and also makes the eardrum less able to vibrate, so hearing will seem a little off. If the blockage is severe and lasts awhile, the low pressure in the middle ear can pull fluids out of the surrounding tissue and blood vessels, so the middle ear fills up with fluid.A cold or allergies can cause the lining of the eustachian tube to swell shut. And in situations when

the air pressure is changing rapidly, as it does when you’re in an ascending or descending airplane, your eustachian tubes must function well to keep the air pressure on either side of the eardrums the same. When you blow out with your mouth closed and your nostrils squeezed shut to “pop” your ears, you’re forcing air up the eustachian tubes and bringing the air pressure back into equilibrium.Some people have eustachian tubes that don’t function very well, so they get the plugged-up ear sensation rather easily from a cold or during airplane travel or without any apparent precipitating event. This may be your problem.Bad cases of eustachian tube dysfunction can be treated by inserting little plastic tubes into the eardrum to aerate the middle ear from the external ear canal, rather than depending on the eustachian tube to do the job.If the plugged-up feeling is constant and is affecting only one ear, then a doctor needs to check the opening of the tube in the nasopharynx to make sure it isn’t blocked by a cancerous growth of some kind.If the plugged-up feeling comes and goes, then what can you do? While there’s no real proof that antihistamines or decongestants help, I tell patients to feel free to try them if they wish.— Jo Shapiro, M.D.Brigham and Women’s Hospitalhttp://mail.mailig.ig.com.br/mail/?AuthEventSource=SSO#inbox/123bef739029fe2a