Colin Hoobler: Sitting Disease and How it is Killing Seniors and the Elderly

About Colin Hoobler: Colin is a Doctor of Physical Therapy and he’s been a Doctor of Physical Therapy for 19 years. He is an author and trainer, the creator and host of the action 30 podcast, as well as the fitness show on PBS. He’s a medical expert for his local NBC affiliate. By the way, injured senior community he is out in Oregon. So I’m here in Baltimore. So he is literally on the other coast. He’s a health writer for The Oregonian Newspaper and he’s the Founder and CEO of S3 Balance LLC. He will talk a little bit about that later on in the episode. Well, welcome to the show Collin, it’s so good to have you here.

In this episode, Steve and Colin discuss:

1. How serious of a problem is sitting and remaining sedentary to the aging population?

  • Sitting carries the same or greater risk, an actually greater risk than smoking a pack of cigarettes every day. So if you’re a non-smoker, but you decide to be sedentary and sit, you know, eight to 10 hours a day, which most seniors do, unfortunately, especially if you’re in a community like Memory Care assisted living, then basically if you’re a nonsmoker, you are adding risk to your life. It’s basically like smoking a pack of cigarettes a day. On top of that, you’re talking about an increased risk of suicide, increased risk of chronic pain, osteoporosis, Parkinson’s, diabetes, I mean, the list is so long, you’re definitely going to fall more. Worst of all, that there’s a strong link between sitting that much and becoming disabled. So you will no longer be able to care for yourself.

2. You’ve got a lot of seniors who say, Well, I have to sit a lot because my knees ache, or I’ve got a back problem. So it’s just better to sit. So if I don’t sit and I stand, I’m putting myself at risk for a fall and a broken hip, do you hear that a lot from your patients?

  • Yeah, I hear that a lot, even from non-patients, especially independent living, where they’re supposed to be independent, and staff is not supposed to be able to touch the residents. So they need to be able to get up on their own, they got to be able to walk on their own. Saying that, well, I can’t stand up, because I’m afraid this will happen, is extremely understandable. I understand that the fear is there. But let’s look at why that’s the case. That’s the case because you are sitting too much. So yes, there is a greater risk initially, for a fall, there’s a greater risk for discomfort initially. But what I see 100% of the time, over and over again, is you do it once, even if you have somebody stand up for 20 to 30 seconds, and they sit back down because they just got tired, the next time they get up, even if it’s a minute or two later, they get up faster, and then they don’t want to sit down. So then they’re up to two to 300% more time, the second time, and it’s just this thing that just keeps going downhill. It’s like a snowball. So really, the key is, how do you just initiate that process?

3. How do we get the senior and elderly community to change the behavior?

  • It depends on the person. But there is one term that tends to resonate with seniors more than anything else and that is wheelchair. Yeah, and if you want to make yourself disabled, so you want to make it, so you have to depend on others, which that whole concept is very painful, not just for older adults, but young, middle-aged old kids, there’s something about losing your autonomy that is devastating. From a human standpoint, that is really, it’s not tolerable. 

4. Is there a blood test for inactivity?

  • No, but there are tests for balance, right? There are tests for A1C, which is measured for diabetes, right? But do you want to use A1C’s? Yep, got to keep that low. There are other tests that the more you sit, you will become less and less independent? Do you like using a walker sit more and that will turn into a wheelchair eventually,

5. Do you think that television has anything to do with it? 

  • A lot of times if they if they’re watching a TV program that doesn’t initiate any movement, that there’s literally sitting there watching TV for four or five hours, they’re like, well, I guess I got to get to go to the bathroom, they come back and then they reset another four or five hours. That’s what we’re talking about that deficit they got to get up. 

6. Should the senior and elderly community be doing exercises more like Tai Chi or gentle yoga?

  • Yeah, Thai Chi is great, that kind of thing. But for Free, you can go to, and it’s free, you can look and click on exercises and there are over 40 or 50 videos of exercises, they could do another using the s3 device, you don’t have to have the s3 device, you can do it with a loved one we’re, we’re a loved one just stands in with the arms out and is touching you so that to prevent you from falling, and you know what will happen, you won’t need that person after doing that for too long. It’s extremely powerful, very fulfilling to see that happen. Every time you do it.

7. So 1 to 2 million of our senior and elderly population are in assisted living or nursing homes. Do you think there’s any responsibility on the part of the nursing homes or the assisted living facilites to be a little more proactive in getting their residents or the patients to move around a little bit more?

  • Not a little accountable, a lot of accountability? As it stands right now, if Steve owns his own memory care unit, or assisted living facility, the law states that you only need to provide activities, there’s no rule that you need to educate or get people up. So as long as you provide these types of services, that’s enough for the law. But it’s not enough for me and it’s not enough for the residents and their families, because they still sit all day long. So I think the first step with these communities, whether it’s assisted living, memory care, skilled nursing, they owe it to the residents to number one, they got to educate them. So they make an informed decision. Rather than are you how are you? Are you 100%? comfortable, great stay sitting there? No, you’ve got to find out, Sharon, what do you like to do every day? Well, we’ve got to get you up and doing that every day. Because if you don’t use it, you lose it. And I just started a coalition, by the way, just did that last week, it’s called the Coalition for Active Residents in Engagement and Care and I’m going to start legislating, I’m going to start pushing for legislation to hold these communities more accountable. We need to have stricter standards for education to avoid that ignorance and devastating policies that they have now just well, if they get up, that’s fine. If they don’t, that’s fine too.

8. Do you think the role of medication plays a part of this sedentary lifestyle for people in their 60s 70s and 80s?

  • Yeah, you need to look no further than the research on that. The research says that the vast majority of older adults are grossly over medicated. For example, I think hormone replacement therapy or blood pressure medication, well, a lot of these caught cause fatigue, a lot of them can and they state and these people are on the medications for far too long. The doctors are not proactive enough to not just get them we to wean them off the medication, but to do so in a way that couples it with the most powerful medication we have, which is exercise and standing. So that the medication piece it’s the responsibility to have the doctors the geriatricians there are some fantastic geriatricians that they will only medicate to a point knowing that they’re going to motivate the person to exercise and then that exercise will take the place of medication, but that doesn’t happen very often the research says that less than 25% of the time that physicians even mentioned, exercise, even still the elderly, it’s just not something that’s done. So we have to change this whole, it’s like racism, right? We’ve got to start in order to get away from that you got to face it and acknowledge that it is a problem. Age is a big problem. We stigmatize weak, we pigeonhole people, well, you’re old. So you need to just, you need to just not burden me with your problems, sit there, and then just enjoy your last years of life, your last years of life needs to be spent in vertical, not horizontal, life’s too valuable to skip.

9. Do you see now that the individuals who are in their 50s might be a little more open to more activity? Or are not as sedentary? 

  • Yeah, but it’s a generational thing. The older generation, they were during the age range, right, that occurred before the fitness boom. So it just wasn’t really the thing, especially women. So they don’t really, a lot of them tend not to have that mindset, but they’re smart people, they’re influential, they follow what each other, do what they do and so if you can get them to motivate each other, especially in communities, get one person to lead the classes and please don’t do it in sitting, that’s defeating the whole purpose. I mean, how many times you go into these communities, and there’s five chairs in a circle, and I’m just, I just shake my head and go, what’s the point? I mean, it may increase circulation a little bit but all it really is, therefore is to appease the administration, to be able to say we offer activities, it really doesn’t do much of anything, it doesn’t reduce falls, it doesn’t do anything. 

10.  When somebody has been used to sitting nine hours a day, when they begin to transition to trying to be more active and standing. Is it okay for them to start with a walker? Or is crutches or just something to get them up on their feet?

  • Yeah, it depends on how low level they are. If they can walk with a walker, now they need to walk with a walker more. So rather than just going to and from the bathroom, or just around the house, it’s time to start thinking about leaving the house or doing going around the house more. But it’s just it’s like putting money in the bank only more powerful than money because once you lose your independence, when and you can feel it happening, you know, you start to realize, boy, things are getting harder, it’s already getting harder to tie my shoes. It’s getting harder to go and I’m becoming more nervous going to the airport or leaving my home. It’s starting to happen, and you got to do something.

“Your’re body is a slave to your brain.” —  Colin Hoobler

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Show notes by Podcastologist: Kristen Braun

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