SPORTS MEDICINE: FITNESS AT 50+: FIVE BARRIERS YOU CAN BEAT

While exercise is often touted as a fountain of youth, it often gets harder to do as you get older.

Physical medicine and rehabilitation (PM&R) physicians, also called physiatrists, are doctors who restore and maintain function lost due to injury, illness and age-related conditions such as osteoporosis, arthritis, joint replacements or stroke. They often prescribe exercise to prevent and treat many of these conditions, working with their older patients to help them get the right kind of exercise so that they can remain active and independent. PM&R physicians offer these tips to help seniors overcome five common fitness obstacles:

OBSTACLE: Declining Strength

What you can do: Use your endurance. It's true we lose muscle mass as we age, and older people have been told that weight training will help prevent this loss of strength and keep them young. However, many seniors find they can't lift the heavy weight experts say is necessary to actually build muscle. A recent study has shown that while muscle strength diminishes with age, muscle endurance does not. You may benefit from working muscles longer — doing more repetitions — with lighter weights. Exercises that emphasize endurance, such as swimming, walking or biking, may be more enjoyable and beneficial for you than those that require great strength.

OBSTACLE: Arthritis or Other Conditions That Make Moving Difficult

What you can do: You can, and should, still exercise. Ask your doctor or physical therapist about how to use a cane, rollator (rolling walker), or other assistive device. These can be especially helpful if you're recovering from a joint replacement or a serious illness such as stroke or cancer. Another condition that becomes more common as we age is neuropathy, which is nerve damage in the feet and extremities that makes it difficult to maintain balance and walk steadily. For all of these conditions, assistive devices can keep you active while helping you prevent a fall and further injury.

OBSTACLE: Exercise and Activity After Surgery

What you can do: Follow your doctor's orders, but the best general rule is to get moving as soon as possible. The type of surgery you had and the type of exercise you plan to do will influence when you should start exercising after an operation. But a recent study found that people who began physical rehabilitation two days after heart surgery recovered faster than those who delayed. PM&R physicians say keeping active becomes more important as the body ages and loses its ability to recover. The longer you delay returning to activity, the more difficult it will be to regain fitness.

OBSTACLE: A History of Inactivity

What you can do: Get started on the path to fitness by using everyday activities as exercise. Recent studies have shown that "functional exercises," those that mimic actual daily activities such as walking up stairs and getting in and out of chairs, are most effective for you. Climbing a flight of stairs several times or repeatedly rising from and returning to a seated position is an effective way to build leg strength. As you become stronger and more fit, increase the challenge by holding some sort of weight on your shoulders, like soup cans. Physical medicine and rehabilitation (PM&R) physicians say that even mundane household chores such as transferring wet laundry from the washer to the dryer, one piece at a time, can be used to increase strength and flexibility in your abdominal, low back and hip muscles. Once you've established a routine of exercise, functional fitness exercises also can be used to maintain your health.

OBSTACLE: Chronic Pain and Inflammation

What you can do: Choose low-impact activities to keep moving and minimize pain. Experts say that certain types of exercise can reduce joint stiffness, pain and inflammation associated with arthritis conditions, which affect more than 40 million Americans. A PM&R physician can advise you on the exercise best suited for your arthritis, but activities such as walking, swimming and water-based exercise are generally effective and well tolerated. PM&R physicians also advise arthritic patients to take breaks from long periods of sitting so that joints don't become stiff and painful.