Tag Archives: Fitness

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.

Healthy, holistic success: Be curious, be mindful, be brave

The wheel of life — an exercise designed to help people find true balance among all aspects of their lives — typically has eight areas of focus, from social life to personal growth to career.

Amy Machacek, 46, a high-energy yoga instructor turned entrepreneur, rocked the wheel a bit for her personal and corporate training programs. Her nine categories include “home/environment,” “fun and recreation,” “significant other/romance” and “friends.”Amy Etzell

As the owner of two Northfield, Minnesota–based businesses — HeartWork Yoga and LIFE.REVAMP — Machacek has relied equally on her instincts, her network (including her entrepreneurial father) and her passion for keeping up with industry trends. In addition to her E-RYT 200-hour yoga certification, she has trained in nutrition, meditation and life coaching. She’s also studied with Jack Canfield, co-creator of the Chicken Soup for the Soul series and author of The Success Principles.

Machacek’s liberal arts education at the University of St. Thomas taught her to “be curious” — one of her favorite sayings — and to embrace lifelong learning. “It’s why I have one daughter there now and another starting in the fall,” she says.

On February 6, Machacek will headline UST’s prestigious First Friday Speaker Series in downtown Minneapolis, offering attendees a five-step plan for gaining more energy in all areas of their lives.

On stress reduction: Yoga doesn’t decrease your stress. It doesn’t make your boss nicer or your kids listen to you. But it changes your perception of that stress. I’m helping people process or manage this stuff in a way that is less taxing.”

On the character of an entrepreneur: “I’m not sure whether it takes courage or stupidity! My partner, Dave Shonka, works for a traditional company. He likes the security, but he doesn’t have the freedom. I like the freedom, and I’m OK without having security. Neither is right or wrong, but your choice should match your personality.

“I’m creative, and I really need a creative outlet. Plus, I watched my family do this when I was growing up. It seemed normal to me to put in long hours when you’re building the business and have some flexibility once the business is doing well.”

On growing a business: “If I stay just one step ahead of my growth, I can expand thoughtfully and not have to take on debt. HeartWork initially was yoga classes only, in a small town with 11 other places that offer yoga. We weren’t going to be viable forever if we just did yoga classes.Life Revamp

“Then I created the yoga teacher training school and added personal training to the studio. LIFE.REVAMP was next. I was working on all of my certifications, and I recognized that if I combined nutrition, life coaching and yoga, I could help people gain forward momentum.

“I brought in barre tone classes when I saw them on the coasts. People have short attention spans. If you’re not adding or changing, you’re dying.”

On how fitness fuels success: “Everyone in LIFE.REVAMP is working on their own things, but it all starts with fitness and nutrition. The initial call may come because of career issues, but first people need more energy and clarity about where they are body-wise.

“One of my clients has 750 employees, and his company bought another company this fall. He told me how great he felt standing in front of his expanded team. ‘I knew what I was talking about,’ he told me. ‘I was standing up straight.’ Another middle-aged client who has shed some weight says she’s now ready to focus on being an athlete again.”

On the tyranny of technology: “We have to make some rules for ourselves. At the end of the workday, Ward Cleaver could close his ledger book, turn off the light and go home. And nothing followed him.

“Now, that doesn’t happen — but we don’t have to allow technology into every aspect of our lives. Otherwise, it’s like the spoiled child who demands our attention all the time. We’re losing out on our relationships because of it.”

On positive parenting: “I don’t want to hover over my kids and make every decision for them. I help them slowly make more decisions as they get older, so they’re ready when they go to college. Nowadays, parenting seems to be defined as keeping kids in a sweet, tight grip. My job as a mom is to love my kids and prepare to let them go.”

On beauty and aging: Marcia Wellstone [Markuson] was a classmate of mine at Northfield High. When she died in October 2002, I was 33 years old. I remember it vividly. We’d had a class reunion that summer, and she was this shiny person. She had gotten remarried, she loved her stepkids. I was standing in my bedroom when I heard the news and thought: ‘Who am I to complain about getting older, about being alive?’ Marcia didn’t get this opportunity, and I did.

“I describe it now as my life before that moment and my life after. Honestly, not for one day since then have I complained about aging. I see aging as a gift, and I believe that to the bottom of who I am.”

On the rewards of growing older: “I love the wisdom and experiences that come with age. All the hard stuff and good stuff we’ve been through makes us who we are today.”

On staying curious: “I tell people in my classes every day: ‘Be curious. Don’t act like you know everything.’ Our lives get smaller as we grow older. We don’t get down on the floor. We don’t reach our arms as high. We don’t move as fast, we don’t try new things — but we need to keep reaching in life.”