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They Were Wrong About Why Walking Gets Harder After 60 (It’s Not Aging) · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: If you're over 60 and you can't walk as far as you used to, that's not something I would automatically write off as aging.
• 0:07
  SPEAKER_00: Especially if you start off feeling pretty good, but after just 10 to 15 minutes, your back starts getting tired, your legs feel heavy, and sitting down is the only thing that gives you relief.
• 0:17
  SPEAKER_00: Hi, I'm Dr.
• 0:18
  SPEAKER_00: Chris Goodwolves and I specialize in scoliosis, hyperkyphosis, and spinal balance.
• 0:23
  SPEAKER_00: And I see this all the time in adults who are still active, but are slowly losing how long they can actually stay on their feet.
• 0:30
  SPEAKER_00: You see, this pattern tells me your legs may not be the main problem.
• 0:34
  SPEAKER_00: And if it keeps progressing, you don't just lose walking distance, you start to lose your independence.
• 0:39
  SPEAKER_00: And that's what we want to prevent.
• 0:41
  SPEAKER_00: You see, the first mistake is assuming your legs are just weak.
• 0:45
  SPEAKER_00: This is where a lot of people get set down the wrong path.
• 0:48
  SPEAKER_00: Their walking gets harder, and somebody tells them their legs are simply weak.
• 0:52
  SPEAKER_00: They start physical therapy, they hire a trainer, they do squats, they do step-ups, they do leg press, maybe even some balance work.
• 0:59
  SPEAKER_00: And look, I want to be clear, strength is important, and I want people over 60 to be strong.
• 1:04
  SPEAKER_00: But I see people who are objectively stronger and still cannot walk any farther.
• 1:09
  SPEAKER_00: So at some point you have to start asking a different question.
• 1:12
  SPEAKER_00: What are those stronger muscles being asked to compensate for?
• 1:15
  SPEAKER_00: See, if your upper body is starting to lean or hunch forward or starting to shift to the side, your back, your hips, your legs, all that have to work a lot harder just to keep you in an upright position.
• 1:25
  SPEAKER_00: That person may feel like their legs are weak because they're fatiguing a lot quicker, but fatigue and weakness are not the same thing.
• 1:32
  SPEAKER_00: You see, you can make those muscles stronger, but still leave the reason they're having to work so hard completely untouched.
• 1:38
  SPEAKER_00: And that is how someone can spend months doing the right exercises, getting stronger on paper, and still look for the chair after just 15 minutes being on their feet.
• 1:48
  SPEAKER_00: So if the legs are not always the main problem, where do we look next?
• 1:52
  SPEAKER_00: You see, sometimes the problem is how your body actually sits over your legs.
• 1:58
  SPEAKER_00: And this is where scoliosis, hyperkyphosis, and spinal imbalances can become really important.
• 2:03
  SPEAKER_00: Some adults had things like scoliosis when they were younger and they knew about it.
• 2:06
  SPEAKER_00: And some never even knew they had it until they were older.
• 2:09
  SPEAKER_00: And then yet other people will develop a degenerative scoliosis later on in life as a result of the disc and the joints breaking down unevenly.
• 2:17
  SPEAKER_00: You see one side of your disc will lose height, and over time your body may start to shift and tilt to the side and eventually start to lean and hunch forward.
• 2:25
  SPEAKER_00: And when that happens, every step can become difficult because your pelvis is moving underneath you.
• 2:30
  SPEAKER_00: Your weight is shifting from one leg to the other.
• 2:33
  SPEAKER_00: The muscles around your spine are trying to keep your body upright and controlled over that base that's moving.
• 2:39
  SPEAKER_00: In comparison, if you're well balanced, that job is much easier.
• 2:44
  SPEAKER_00: There's something called the cone of economy because your body is the strongest and the most energy efficient when your body is in an upright position and your torso is directly lined up over your pelvis and your feet.
• 2:56
  SPEAKER_00: When your body gets out of alignment, those muscles have to work much harder just to keep yourself in an upright position, basically costing your body a lot more energy.
• 3:05
  SPEAKER_00: So if your body's not well balanced, those muscles are spending a lot more energy with every single step that you take.
• 3:11
  SPEAKER_00: At first, you may not notice it, but then 10 or 15 minutes later, your back gets tired, your leg feels heavy, and you need to sit down and relax to recover.
• 3:20
  SPEAKER_00: And that's why two people with the same amount of leg strength can have completely different walking tolerance.
• 3:25
  SPEAKER_00: And it's also why I don't just care about how big the scoliotic curve is.
• 3:30
  SPEAKER_00: See, I can show you two people with the exact same curve measurements, and one can walk for an hour, and the other one has to sit down after just 10 minutes.
• 3:37
  SPEAKER_00: The difference is not just the number on the x-ray or the size of their scoliosis.
• 3:42
  SPEAKER_00: It's what the curve is doing to the way the whole body stands and moves.
• 3:46
  SPEAKER_00: And it has a lot more to do with the size of the curve and a lot more to do with spinal balance.
• 3:50
  SPEAKER_00: But this is where another problem happens.
• 3:52
  SPEAKER_00: You see, you can go see a doctor, they can find something that's a real physical problem, and still miss why you can't walk further than you used to be able to walk.
• 4:00
  SPEAKER_00: And a lot of people like this have already been worked up or seen many providers.
• 4:04
  SPEAKER_00: Maybe they've had an MRI, they've been told that they have arthritis, they have stenosis, maybe they've told that they have a disc problem, a pinched nerve, maybe several of those things all at the same time.
• 4:13
  SPEAKER_00: And those are absolutely real findings, and we find those frequently in people that have degenerative scoliosis.
• 4:19
  SPEAKER_00: But finding something that's abnormal is not the same thing as proving that you actually found the reason cannot walk far anymore.
• 4:26
  SPEAKER_00: You see, I see people that have spent years treating one painful area or a level of their lower back, but their ability to stand and walk doesn't get in better.
• 4:33
  SPEAKER_00: In fact, it generally gets worse over time.
• 4:35
  SPEAKER_00: Maybe they've done injections, maybe they've done physical therapy, maybe they've been to a chiropractor to be adjusted.
• 4:40
  SPEAKER_00: Maybe the pain improves for a little while, but the underlying problem is still there.
• 4:44
  SPEAKER_00: But three years ago, they could walk 45 minutes and now they can't even walk 15.
• 4:49
  SPEAKER_00: And at some point, I care more about measuring how long they could actually be on their feet and walking than I do about what the disc looks like on their MRI.
• 4:58
  SPEAKER_00: Because their walking time and distance is telling you whether the person is actually functioning better or if they're losing function or they're functioning worse than they were before.
• 5:07
  SPEAKER_00: And if function keeps going backward while treatment keeps going forward, somebody needs to rethink the overall plan.
• 5:14
  SPEAKER_00: And there's one clue I hear from patients all the time that can make it even more obvious.
• 5:19
  SPEAKER_00: And that's when patients will say things, I can walk further as long as I have my shopping cart or my walker.
• 5:25
  SPEAKER_00: And this some people will mention almost casually.
• 5:28
  SPEAKER_00: They'll say, you know, when I go to the grocery store, I can still get groceries as long as I have my shopping cart to lean on.
• 5:33
  SPEAKER_00: They'll say things like, yeah, I can't walk around my neighborhood anymore, but if I go to Costco and I have that shopping cart, I'm fine.
• 5:40
  SPEAKER_00: That's useful and critical information.
• 5:42
  SPEAKER_00: Because your age didn't change when you grab the shopping cart.
• 5:45
  SPEAKER_00: Your legs didn't suddenly get stronger, but the position of your body did likely change.
• 5:50
  SPEAKER_00: And the amount of work required to keep yourself in the upright position has likely been decreased because you have something to help hold yourself up.
• 5:58
  SPEAKER_00: So for some people with spinal stenosis, leaning forward can actually reduce your symptoms.
• 6:03
  SPEAKER_00: It can provide relief.
• 6:05
  SPEAKER_00: For other people, simply having something to support themselves makes it easier to stay on their feet.
• 6:10
  SPEAKER_00: Either way, that shopping cart is telling me the problem is not simply I'm 68 and my legs are getting old and weak.
• 6:17
  SPEAKER_00: There's something about how your body is carrying itself while you walk that's actually affecting how long you can stay upright.
• 6:24
  SPEAKER_00: So if leaning or something else buys you another 20 minutes on your feet, I want to know why that is.
• 6:30
  SPEAKER_00: And I definitely don't want to stop with the next piece of advice that people hear all the time.
• 6:34
  SPEAKER_00: Just walk more is not much of a treatment plan.
• 6:38
  SPEAKER_00: This one drives me crazy.
• 6:39
  SPEAKER_00: You see, some people will say they can only walk 10 minutes before their back and legs force them to sit down.
• 6:45
  SPEAKER_00: And the advice they may get is you just need to walk more.
• 6:48
  SPEAKER_00: You need to build up your tolerance.
• 6:49
  SPEAKER_00: But what if walking is the exact thing they can't do?
• 6:52
  SPEAKER_00: Telling someone to get their 10,000 steps in when they can't stand their feet long enough to get them in doesn't explain anything.
• 6:59
  SPEAKER_00: Now look, I absolutely want people up on their feet and walking.
• 7:02
  SPEAKER_00: Walking is definitely good for you and there's a lot of health benefits associated with it.
• 7:06
  SPEAKER_00: But first I want to know what's actually limiting your ability to walk.
• 7:10
  SPEAKER_00: Because if we can improve the one thing that's making minute 15 so much harder than minute one, then walking becomes part of getting stronger again.
• 7:18
  SPEAKER_00: But if we never figure that out, the patients can end up just blaming themselves.
• 7:21
  SPEAKER_00: They can think they're not disciplined enough, they're not strong enough, maybe they're not trying hard enough.
• 7:26
  SPEAKER_00: Meanwhile, their walking tolerance keeps getting smaller and smaller over time.
• 7:30
  SPEAKER_00: That's not a motivation problem.
• 7:31
  SPEAKER_00: That's a problem that has not been fully explained yet.
• 7:34
  SPEAKER_00: Or the right problem is not actually being addressed.
• 7:37
  SPEAKER_00: So if your walking problem has been getting shorter, even though you've been exercising, doing physical therapy, getting injections, or the things that you were told to do, this is the kind of problem we evaluate at Scholar Care Denver.
• 7:49
  SPEAKER_00: We look whether scoliosis, hyperkyphosis, or major spinal imbalances could be contributing to your actual loss of function.
• 7:57
  SPEAKER_00: And more importantly, what can be done to help keep you active without requiring surgery?
• 8:01
  SPEAKER_00: To learn more about what's going on with you, book a free discovery call by clicking on the link in the description.
• 8:06
  SPEAKER_00: And our team will reach out to you and set up a time where you can talk to me one-on-one about your case, what's going on, how severe it is, how it's impacting you, and more importantly, what treatment options may be available to you.
• 8:16
  SPEAKER_00: Now there is one thing I would absolutely pay attention to if you've already been treating this for a while.
• 8:21
  SPEAKER_00: And that is are you getting treatment or are you actually getting better?
• 8:26
  SPEAKER_00: You see, you can spend months doing things like physical therapy, get stronger, have an injection that helps the pain, get some chiropractic adjustments that provide some relief, and still realizing that you're walking less and less every year.
• 8:38
  SPEAKER_00: And that's where I care less about whether each individual treatment helps something or reduced a little pain, and start asking whether the person is actually functioning better.
• 8:46
  SPEAKER_00: Can they actually do more of the things they want to be able to do?
• 8:49
  SPEAKER_00: Because if the pain is a little bit better, but you still can't stand very long or you can't walk very far or do the things you used to be able to do, we really haven't solved anything.
• 8:59
  SPEAKER_00: We haven't actually addressed the underlying problem.
• 9:01
  SPEAKER_00: And if you're doing every single thing that you've been told to do, and your world is still getting smaller and smaller, the treatment plan may not be addressing the main thing that's actually limiting you.
• 9:12
  SPEAKER_00: Providers tend to keep repeating treatments because they tend to help with something.
• 9:16
  SPEAKER_00: They tend to help reduce a symptom.
• 9:18
  SPEAKER_00: But a lot of times people don't actually step back and ask them whether the person is functioning better.
• 9:23
  SPEAKER_00: Can they do the things that are most important to them?
• 9:26
  SPEAKER_00: So what actually happens when things like walking keep getting harder and harder, and none of the treatments you're doing are actually changing the long-term course you're on.
• 9:34
  SPEAKER_00: You see, what happens in those situations is you start building your life around your limitations.
• 9:40
  SPEAKER_00: At first, it's probably not that dramatic.
• 9:42
  SPEAKER_00: You stop taking those long walks because it's just not worth it knowing how your back's gonna feel afterwards.
• 9:47
  SPEAKER_00: You start parking closer to the store.
• 9:49
  SPEAKER_00: You start driving around and around to find that closer parking spot so you don't have to walk as far to the store.
• 9:54
  SPEAKER_00: You're on a vacation or a trip and you skip activities that require walking.
• 9:59
  SPEAKER_00: Even worse, maybe you don't even go on the trip because you have fear you're not gonna be able to do the things that you want to be able to do.
• 10:04
  SPEAKER_00: You start choosing restaurants you go to based on how long you may have to stand and wait.
• 10:08
  SPEAKER_00: And over time, you generally just start moving less because moving has become more and more difficult.
• 10:13
  SPEAKER_00: And once you move less, that's when you really start losing your strength and endurance.
• 10:18
  SPEAKER_00: And then you get the original spinal problem and deconditioning feeding into each other.
• 10:23
  SPEAKER_00: And then five years later, someone just says, Well, I guess this is part of getting older.
• 10:27
  SPEAKER_00: But what if the whole thing started because walking became progressively harder and harder and nobody actually figured out why?
• 10:33
  SPEAKER_00: Then age is not the main explanation.
• 10:36
  SPEAKER_00: It's just the easiest thing to point to or blame.
• 10:39
  SPEAKER_00: I see people that are in their 80s and 90s that are functioning at really high levels, and yet I say people in their 30s that are already struggling to do basic normal activities.
• 10:48
  SPEAKER_00: So when should you actually stop accepting aging as the easiest explanation?
• 10:53
  SPEAKER_00: I mean if your walking distance is basically stable and you just need to get in better shape, great.
• 10:58
  SPEAKER_00: Walk, train, get stronger, exercise, all that's good stuff.
• 11:01
  SPEAKER_00: But if you've gotten stronger than you were in the past, you've been getting treatments, and you still can't stay on your feet as long as you used to, I'd stop accepting that you're just getting older as the explanation.
• 11:11
  SPEAKER_00: Maybe the issue is stenosis, maybe it's degeneration, maybe it's adult scoliosis or hyperkyphosis or lost normal spinal balance.
• 11:19
  SPEAKER_00: Many times it's several of those things happening all at the same time.
• 11:23
  SPEAKER_00: You see, the real outcome isn't whether someone found something on an MRI, whether you complete another round of therapy, it's whether you can actually still go where you want to go and you can still do the things you want to be able to do.
• 11:33
  SPEAKER_00: And if you want to find out whether or not something like scoliosis or some kind of spinal imbalance, maybe the underlying contributing factor while walking is getting more difficult, then book a free discovery call with us at School Like Care Denver.
• 11:44
  SPEAKER_00: Use the link below and my staff will reach out and set up a time where you can talk to me one on one about your case and what can be done to help you.
• 11:51
  SPEAKER_00: And if you're already starting to feel less stable on your feet, watch my video on what that 10 second balance test can actually show you.
• 11:58
  SPEAKER_00: And if you're already starting to feel less steady on your feet, watch my next video on what that 10 second balance test can actually show you.
• 12:05
  SPEAKER_00: I'll see you there.