Tag Archives: exercise

Can a Mobile App Improve Seniors’ Mobility?

I first went to a physical therapist two decades ago, in my 40s, when I injured my shoulder in yoga. Young, fit and overly sure of myself — a runner and bicyclist, an aerobics instructor — I didn’t do the exercises with any consistency, and I live with that mistake to this day.

After visiting a different PT twice in my early 60s for a pulled hamstring and another shoulder injury, I figured out that physical therapy, like yoga, only pays off with regular practice. If you commit to performing the highly specific, often tedious exercises every day — or nearly so — your body will heal and feel better. Otherwise, you likely will remain in pain.

Given that reality, how practical is the growing trend of providing physical therapy not in a clinical setting but via a mobile app that people can access at home?

Physical therapy traditionally has been hands-on. Photo by Raspopova Marina on Unsplash

My experience as a physically active 68-year-old woman dealing with the normal wear and tear of aging proves that it can, indeed, work. Hinge Health, a San Francisco–based company whose services are free through my Medicare Advantage plan, has been nothing short of a godsend for my stiff neck and perpetually impinged left shoulder.

Initially, I was skeptical whether video visits with a PT and a health coach could possibly be effective. But I was so tired of shoulder pain, which was hindering my spring bike riding, that I decided to try it last May.

“People come to us with a wide range of goals,” says Doctor of Physical Therapy Melanie Cosio, based in Mobile, Alabama, and serving members (the word Hinge Health prefers to “patients”) across the country. “We often see people getting ready for a surgery, whether sports-related or they slipped and fell at their house.”

She sees plenty of older people like me, who’ve been athletic our whole lives and — seemingly out of nowhere — are now more prone to injury or sudden aches and pains. “They want to stay on top of their mobility,” says Dr. Mel, as the program calls her.

Hinge Health also serves older adults who may be housebound, lack access to in-person appointments or want a daily dose of motivation, backed by scientific research. “Hinge Health gets us into people’s homes, no matter how rural they are,” she explains. “The connection I can make via video is really impactful. We’re also making programs that are easy to digest and access from someone’s phone.”

“Our stretching and strengthening exercises help your body get more resilient and train your nervous system to better cope with pain.”

Hinge Health mobile app, education library

Traditional physical therapy states that movement is medicine. Hinge Health translates that time-honored philosophy into a 21st century AI-powered program that potentially reaches more people and keeps them exercising longer.

Rewards, including free exercise gear and performance badges, are woven throughout the program. Key to why Hinge Health works, however, is reliance on the foundations of successful physical therapy — motivation, consistency and education — but with a modern, more accessible twist.

Daily texts provide chipper reminders to “exercise for better sleep and a more vibrant you,” “keep marching forward” and “get up and glow.” Those prove to be more motivational than annoying. In fact, the messages work to plant a seed: I’d better do this today if I want to hit my weekly goal.

The daily playlists are no more than 11 minutes, and each session earns points that eventually push you to the next level, with progressively harder exercises. At the end of each session, you can indicate whether a particular movement was too hard or too easy, and the system will adjust your playlist’s difficulty.

An assigned physical therapist and health coach are within easy reach through the app and typically respond within a day. More immediately, Hinge Health’s TrueMotion® AI technology, or “real-time feedback,” lets you track through your smartphone whether you’re performing the exercises correctly.

“Laser beams of light are being shot so they can monitor where you are,” explains Tony Schmitz, a Hinge Health member from St. Paul, Minnesota. “It’s a little Wizard of Oz-ish: Who’s behind the curtain, really? Maybe it’s all AI and there is no person.”

More enticing for me than the technology was the free equipment. Hinge Health sent a phone stand when I finally enrolled last spring, after my insurance provider, Blue Cross Blue Shield of Minnesota, mailed out two invitation letters (“move better and feel better with online physical therapy”). A set of resistance bands, which I had never used in weight-training workouts before, and a yoga mat soon followed. I even got an electronic muscle- and nerve-stimulating device called Enso 3, once I had demonstrated that I was serious about the Hinge Health program.

“They’ve really dialed this in,” says Schmitz, 72, an author, retired journalist and self-described gym rat who’s endured a series of health challenges and now practices his Hinge Health exercises every day. “They’re giving you this stuff early on to really get the hook in. Mission accomplished.”

“It’s possible to retrain your pain system by considering all the factors that may contribute to your pain: sleep, stress, relationships and worries.”

Hinge Health mobile app, “Pain Is Your Protector”

Founded in 2014 and holding a “moderate buy” consensus rating on the New York Stock Exchange (HNGE), Hinge Health serves 1.5 million people through 2,350 client companies and over 50 health plans. The program focuses on musculoskeletal care, with the low back, knees, shoulders, neck and hips being the most common areas treated.

Given how strongly Blue Cross Blue Shield promoted the program, I found it odd that the company refused to comment for an article I wrote about Hinge Health in Next Avenue, an online magazine produced by Twin Cities PBS for people 50 and older. After being turned down for an interview, I asked the media relations team via email: “Could anyone explain how Blue Cross selects the clients to target for Hinge Health? For example, I got two unsolicited letters, possibly because I had used PT before.”

No response may indicate an answer. On November 21, two weeks before the open-enrollment period ends for 2026 Medicare plans, Blue Cross Blue Shield of Minnesota announced that “high cost pressures across all Medicare programs” were forcing the insurance giant to cut its SilverSneakers benefits at two of the Twin Cities’ most popular workout facilities, Life Time and YMCA of the North. The loss of free memberships will affect 26,000 seniors, according to the Minnesota Star Tribune.

Even if Blue Cross discontinues its sponsorship of Hinge Health, I’ve learned enough to do the exercises on my own and to recognize that a home-based routine of physical therapy augments more rigorous workouts outdoors or at a health club.

Photo by Delaney Van on Unsplash

The program’s wholistic approach includes an emphasis on education. A new article appears at the end of each daily playlist focusing on sleep tips, mindful eating, building goals and habits, breathing and meditation, and mental health. One article features author and podcast star Brené Brown and “Atomic Habits” author James Clear describing how all-or-nothing perfectionism can undermine new habits. Instead, “plan for failure,” the article says. Don’t beat yourself up if you fall short of a particular goal. Reset, reevaluate and try again.

My biggest learning from Hinge Health is that the pain in my body gets fed in my brain. Emotions affect it, especially fear. I’ve learned how to carefully, mindfully move toward my shoulder pain (and my emotional pain, for that matter) rather than freezing up or backing away.

“Pain typically goes a lot deeper than the physical pain that someone’s in,” explains Dr. Mel, the PT with whom I work. “Knowing that pain is multifaceted, we encourage people to move. It’s often the best way to support healing.”

Maintaining health becomes more challenging and time-consuming as we age — whether building muscle mass and strengthening thinning bones or figuring out how to consume enough fiber and protein. Hinge Health asks members to articulate a North Star goal when they enroll. Mine is simple but not always easy: Keep moving well, and well into old age.

Health Habits for Women to Practice as We Age

I was born with good health and have been blessed to have medical insurance and routine dental care throughout my life. Dad modeled daily exercise, Mom pushed us kids outside to play (likely because she craved peace and quiet), and both parents ensured we had bicycles and insisted we use them.

I thank them to this day that I still love to ride my bikes.

The habits I have built and the health I have sustained have served me well into my 60s. But it isn’t the decades-long practices — the balanced diet, the use of movement for both physical and emotional wellbeing — that are consuming me these days.

I am thinking instead about the physical changes that come with age, the need to work on bone density and balance, to guard my skin against the sun, to manage unexplained flareups in my hips, hands and feet. “Aging is not for the faint of heart,” my father used to say. (Actually, he said aging is not for “sissies,” but that word feels wrong today.)

So, at a time of life that requires equal doses of courage and self-confidence — and a commitment to spend more time on daily health habits — here are the practices I am working to develop.

ProTip #1: Hug your muscles to your bones.

I would hear this instruction in yoga classes, but I never quite grasped it till I was diagnosed with osteoporosis in November 2022, a blow that tossed me into old age without warning. Indeed, the bone-thinning disease that tends to strike women after menopause elicits sobering statistics:

  • Half of all women over 50 will break a bone because of osteoporosis, a “silent disease” that often is diagnosed only after a hip, wrist or other bone has broken.
  • Of the 10 million Americans who live with osteoporosis, 80% are women.
  • Caucasian and Asian American women are four times more likely to experience thinning bones than African American women and Latinas.

You can take medication for osteoporosis, and deal with the risks and side effects, but women can fight back in natural ways as well: eating more protein, taking Vitamin D3 supplements, lifting weights. In addition, I recommend a 12-pose yoga series designed by Dr. Loren Fishman and brought to light by New York Times writer Jane Brody in 2015.

Among the “side effects” of this prescription for osteoporosis, said Fishman, a physiatrist, in Brody’s “Personal Health” column, are “better posture, improved balance, enhanced coordination, greater range of motion, higher strength, reduced levels of anxiety and better gait.”

Kendra Fitzgerald’s version of the 12 poses on YouTube.

My sister found varieties of the 12 poses on YouTube, and after experimenting with several, I landed on the 20- and 29-minute versions by Kendra Fitzgerald. I’ve also strengthened my practice by taking “yoga for bone density” classes from certified instructors who have taught me the power of engaging muscles deeply while holding each pose (and who claim that the practice can improve your T-score).

Try it: Plant your feet on the floor. Root down through your heels and send that energy up your legs. Engage your thighs, your glutes, your abdominal muscles. Pull your shoulders down your back and radiate strength up your spine. Stand tall, sending your head toward the ceiling and pressing your fingertips toward the floor. Feel your strength as you hug your muscles to the bones.

ProTip #2: Employ your smartphone’s flashlight.

Twenty-five percent of older people — 65 and up, according to the Centers for Disease Control and Prevention (CDC) — fall at least once every year. And women are at greater risk. A weakened lower body, vision problems, a Vitamin D deficiency, impractical footwear, and home hazards such as throw rugs and lack of railings in bathrooms and on stairways are among the causes.

If you fall once, according to the CDC, you are twice as likely to fall again. Traumatic brain injury, broken bones and an increased fear of falling may result. People who feel uneasy on their feet are less likely to move around outdoors or to exercise at all — and, therefore, are more likely to become weak and isolated.

One solution? I turn on my iPhone flashlight both indoors and out, a tip from a young man who uses his phone’s flashlight when he’s crossing a street at dusk with his wife and children. I tried it walking home after dark when I still worked full time less than a mile from my home, scanning the sidewalk for uneven surfaces and tilting the light toward fast-moving vehicles as I approached a crosswalk. Now I use the flashlight when I get up before sunrise during a long Minnesota winter. It helps me navigate around houseplants, resting dogs and rocking chairs — as well as up and down the stairs — without waking my late-sleeping husband.

ProTip #3: Wear a funny hat.

Two age spots on the left side of my face came from years of commuting, a dermatologist told me, when the sun would shine hard through the driver’s door window. And to think I used to revel in the warmth.

A lover of stylish sunglasses, I also used to wonder why so many men wear baseball or bill caps. Now I get it. A bill cap keeps the sun out of your eyes and off your face. Even better are the hats that have a drawstring at the throat and a circular brim that shields the back of your neck as well.

In addition to applying sunscreen throughout the year — another dictate from the dermatologist and one of five skin-protection recommendations from the CDC — I cut my hair short so it looks halfway decent after a sunhat or bike helmet flattens it throughout the spring and summer. I bought my sunhat at REI. But instead of disparaging them as “old lady” hats, I wish I’d started wearing one when my skin was as dewy and wrinkle-free as the young models on this Sungrubbies site.

ProTip #4: Love your feet.

Time seems to speed up as we age, an aphorism cited so often that psychologists are studying whether it is perception or reality. Growing older is like a time machine that swirls you around in busyness for decades until it dumps you in your 60s, with more wrinkles, less ambition, a craving for sleep — and feet that, overnight, start to cramp and crack.

I was introduced to foot massage in a mat Pilates class after my osteoporosis diagnosis, where the teacher has us spend the first 5 minutes of every session rubbing lotion methodically on and between our toes, down the instep, up the outer edge, around the ball of the foot, over the heel. My feet tingle with pleasure, just as they do after I wince and roll barefoot over a spikey red plastic “peanut massage ball” that the Pilates teacher recommended.

“As you age, the muscle tissue in your feet can thin, and your nerves may not work effectively. This can lead to loss of feeling in your feet, [called] neuropathy,” says an article on footcare for seniors, which also instructs women — hooray! — to “avoid shoes that have high heels or pointy toes.”

The next steps? To stride toward the sunlight and shadows of old age, until the next physical and mental challenges present themselves.

#30DaysofExercise . . . and Live to Tell

Like half of all Americans, I live less than five miles from where I work.

So, no excuses during National Bike to Work Week — except for Thursday, when I have to dress up for a volunteer recognition lunch and attend a fancier work function in the evening.MayisBikeMonth

Exercise-challenge programs such as National Bike to Work Day on May 15 or Run 2,015 in 2015 (whoops, too late now!) are effective motivators — except when they’re inconvenient. I learned that the hard way during the 30 Days of Biking challenge in April.

On the face of it, my mere seven days of biking during the cold, rainy month were a failure compared with the hard-cores who rode their bicycles to bakeries and tweeted throughout the month or posted grinning, thumbs-up photos on Instagram.

What I did instead is what I do every day, every month, every year: I exercised. The particular daily movement that I chose — biking, running, fitness yoga, walking — depended on the weather, on my schedule or on my mood.

The #30daysofbiking challenge did inspire me to log the experience. I kept a daily record of my exercise, and that’s proven to be fruitful now that warm weather is here and I really want to up my cycling miles and train to run another half-marathon.

My daily logs are both instructive and inspiring. I note the excuses, but I see also that I managed to move every day. The journal entries reinforce my midlife exercise mantra: Something is better than nothing. Any exercise counts.

30 Days #2

EXCUSES ARE EASY to come by. It’s harder to sidestep #30DaysofExercise, however, than daily cycling because it allows you to be more a generalist than a specialist.

On April days when it was too windy and cold to bike, I could easily walk the 1.2 miles to work. Likewise, on a day after my running partner had pushed me to run farther than I would have on my own, I could stretch my aching quadriceps and hamstrings in a yoga class.

But the exercise log’s purpose was to record, specifically, whether I had biked. And it revealed more than anything why I failed to get my seat on the saddle for 23 of the month’s 30 days.

  • April 1: Blew it on the first day of the bike challenge! Warm but really windy and then had horrendous rainstorm this evening. Oh, well.
  • April 9: Pouring rain today, 40 degrees. Going to Core Power at noon.
  • April 17: Went for a run with Lou Anne. No energy for more exercise today.
  • April 21: It snowed today. Enough said.

30 Days #4

WITH MY LONG LEGS and short trunk, I seem built to ride a bike. It’s an effortless exercise.

And so it’s easy for me to combine biking with errands, which feels more healthful — and less stressful — than other forms of multitasking.

Movement has more meaning, my cycling log has taught me, when there’s purpose behind it.

  • April 12: Rode to Rainbow Chinese and back to meet friends. As we get more serious about becoming a one-vehicle family, it will become essential to bike.
  • April 16: Still not feeling well so working from home. But I felt well enough to bike to work for meetings. Nobody seemed to mind that I was wearing spandex bike shorts, with bad hair and carrying a helmet.
  • April 26: Rode around the neighborhood and then went to Mom’s. I like combining biking with appointments. It’s a twofer, the equivalent of walking to work.

30 Days #3

CYCLING MAKES ME SMILE in a way that running never has. I love the sweep of scenery, the sense of being one with the natural world.

“You can’t buy happiness, but you can buy a bike,” I read on a cyclist’s T-shirt one sunny Sunday when I was biking home on Midtown Greenway.

Discovering the joy in the simple act of riding was an impetus behind the founding of 30 Days of Biking by Twin Citian Patrick Stephenson, whose idea has gone viral and international. He describes the practice of daily cycling as “transformative.”

  •  April 4: Wore my runner’s mask to bike this morning. Legs and fingers froze. No wind, gliding through the streets. Hills felt good after sculpt class yesterday.
  • April 14: Woke up with sore throat and sniffles. Hunkered down and got tasks done at my desk. Rode the six-mile loop along the River Road after work: 60 degrees, sunny, little wind. I felt better afterward.
  • April 28: Thirty-minute ride at 7 p.m. through the neighborhood. Not enough but it was something. Like any exercise or art or behavior at which I want to get better, biking has to be a practice.