Deep-Thinking Physical Therapist Dr. Jes Hill On "Functional Fitness After 50"

By Dana Wood | October 16, 2019
Mega-degreed, Manhattan-based physical therapist Dr. Jes Hill couldn't care less whether we fit into our skinny jeans. Instead, she'd rather see us mid-life women fit, and up for the challenges of our daily lives. Can the grocery delivery addicts among us still lift heavy bags of food if they need to? Are we doing enough to offset all the chained-to-the-computer sitting wreaking havoc on our backs and backsides?
Here are Hill's common sense, refreshing takes on what it *really* means to be fit after 50.
Connect the Dots: Before we dive into our "talking points," please tell us a little bit about your background.
Jes Hill: I'm a physical therapist, predominantly outpatient orthopedics. I've been working clinically for 17 years. I work with everybody, from the most sedentary to the most active. So that means military, high-level athletes, but also people who don't do a whole lot with their bodies at all.
I have a concierge service in New York City, where I go to people. I had three clinics in Vermont that I co-founded and co-owned, and I sold my share in that practice and moved to the city. I also teach for Rocktape USA, which is a movement-education company. I teach courses for clinicians getting their Continuing Education credits.
CtD: Got it. So is it pretty much written in stone that women will go through some sort of metabolic shift at 50?
JH: I don't think it's just women; it's everybody. Yes, there's a shift in metabolism, and lots of other things that occur as we age. But how dramatically someone is affected by that...there's a tremendous amount of variability. It's dependent upon both lifestyle and genetics.
Does every woman put on weight? If you look at pictures of the women's Crossfit Master Athletes, and then you look at people on the street, you can tell there's a wide variety of what happens to people and their bodies, and their capacities, over time.
CtD: What role does genetics play in whether a woman packs on pounds at midlife?
JH: Of course there's a genetic component, but it's estimated at only 14 to 20 percent, with the rest being your lifestyle and environment. People say, 'Oh, this is how my mom was, this is how my grandmother was, so this is how I'm going to be.'
People like to throw their power to the wind, and you have a tremendous amount of capability to kind of etch out what your story is. And I think that's really, really important.
CtD: Is there a particular hormone we can blame for that midlife...puddling...around the midsection?
JH: I don't really like to think of it as 'blaming' a hormone. It's just a redistribution of energy sources. It's not a bad, or a negative, thing. Women tend to hold more fat intra-muscularly, because how we metabolize energy is a little different than how guys do it.
There's been some suggestion in the research that estrogen has a direct effect on the enzyme LPL - lipoprotein lipase. Lipoprotein lipase, when it's more active when we're younger, will distribute our intra-muscular fat around our hips and buttocks. And it seems to change its function over time. As estrogen begins to decline, we start to see an increase in adipose in other areas, such as the abdomen.
And then there's another enzyme, alcohol dehydrogenase, that allows us to break down alcohol in our digestive tracts. Over the age of 25, it stops working as well. When you're drinking three drinks in college, you're fine. But at age 35, you have half a martini on a Friday night and you're lit.
We're complex biological systems. You can't just say it's one hormone; it isn't linear.
CtD: How do you define fitness?
JH: It's about capacity. Do you have the capacity to do what you want to do?
People will say, 'I think I should be skinny.' Or, 'I think I shouldn't have any fat on me.'
At the basic level, you could say that the biological definition of fitness is one's relative ability to contribute to the gene pool.
But what I want to know is whether, with your genes, are you capable of getting things done that you want to do? And can you get them done in a lot of different ways?
Like, can you run down the street if there's a flood? Can you run down the street if there are obstacles? When I view someone's capacity, I'm not looking at how thin they are, or whether they have a little extra adipose around the mid-section. It's more like, can you be a fully functioning human in an unpredictable world? How strong do you think you have to be? For me, personally, I think I need to be strong enough to lift my spouse if she's unresponsive, and get her to safety.
CtD: What do you think about the idea that 'sitting is the new smoking'? A lot of us are chained to our computers all day. Is it really that bad?
JH: There was a study done a few years ago that strongly suggests that people who sit for six or more hours a day are 40 percent more likely to die from 'all-cause mortality' - which is basically anything that can kill you - in 15 years, than people who sit for three or fewer hours a day. And going to the gym for a high-intensity workout a day did not bridge that gap.
So the key isn't in working your body harder. The key is in building a fundamental resilience and health, and in just being less sedentary. Walking around. Doing things. Standing up at your desk. Not just ordering groceries all the time and actually going to the grocery store and carrying heavy things home. Low-grade, gentle movement throughout the day.
You asked for my 'over 50 fitness tips' and here they are:

Dr. Jes Hill's Top 3 Post-50 Fitness Tips

1. Engage in a sport in which your eyes and ears are moving together. These include tennis, running, boxing, handball, ballroom dancing - anything that gets you moving with rhythm and speed, and in a lot of different positions, is very, very important to being functional over time.
2. Make sure you're doing some type of resistance training. So many options here - resistance bands, your bodyweight, kettle bells.
3. Get as much variety in fitness activities as you can. There is no one great workout. I say do them all.



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