We’re Not Doing Good Enough for Our Older Adults in Physical Therapy

Introducing the MMOA Challenge

Where have you seen older adults smashing long held beliefs about their frailty?  Was it at a local masters CrossFit competition or powerlifting meet? Your neighborhood pickleball court? Well it was likely somewhere as we have undoubtedly entered a new empowered era for the seniors among us!

While many of these energetic well-seasoned humans aren’t waiting for research to give them permission, it is doing so at an amazing rate which SHOULD give clinicians and physical therapists serving older adults all the confidence in the world to set higher goals… But ARE we?  Not nearly often enough, which is why we’re bringing you the #MMOAchallenge!

Tips for Physical Therapists and Other Clinicians Working With Older Adults:

  1. Stop under-loading and using the excuse of osteoporosis as justification. We don’t want to turn this blog into a heavy academic piece, but we would be remiss if we didn’t reference here the infamous LIFTMOR trial out of Australia. This trial design included loading older women with a T-score (bone density score) below -1.0 at 80-85% of their 1RM in multi-joint compound lifts: Deadlift, overhead press, and back squat.  Additionally impact training was delivered via jumping chin ups with drop landings
  2. Use the concept of “One Rep Max Living” to better understand, educate, and inspire your older adult patients. For a lengthy description of #1RMLiving check out this entertaining PSA, but here is the TLDR version: Basic activities of daily living require a max or nearly max physical effort for many older adults to accomplish.  The result is a high risk of injury and a guarantee of fatigue from simply trying to get through the day.  Helping patients understand this concept of daily activities requiring max effort can be an incredible reframe as they realize it isn’t that they are “getting old”, it’s simply a matter of capacity which can be changed with properly dosed resistance training and physical therapy.
  3. Communicate with older adults like the strong athletes and people they are or could become. Being told you are “so cute” or “adorable” doesn’t exactly build confidence in one’s strength and resilience, but it is so much more than that.  Take a few minutes and listen to this #PTonICE Daily Show episode from Dr. Jeff Musgraves where he lays out the many types of elderspeak and how they are directly impacting your therapeutic alliance and outcomes.  Simply increasing your awareness of this well intentioned but harmful language pattern will instantly improve the quality of care you’re delivering for older adults in your physical therapy practice.

Ready to take the challenge?  We want to be a part of it! Next time you crush one of these tips in your physical therapy clinic, make a post about it and use hashtag #MMOAChallenge! We’ll repost on our social media accounts to inspire other physical therapists and clinicians to do the same!