In a previous post, we discussed several negative consequences of having poor exercise and eating habits. Sometimes, staying motivated and setting goals for yourself is difficult if you are “just doing it because you know it’s good for you.” It’s more motivating for most people to move toward a goal than it is to avoid something. What follows is one of the most powerful methods I’ve come across to do just that regarding fitness.  

Dr. Peter Attia, in his book “Outlive: The Science & Art of Longevity”, outlines a powerful thought exercise called “The Marginal Decade.” This exercise helps you create tangible long-term goals and then develop appropriate short-term goals to keep you motivated for the rest of your life.  

First of all, what the heck is the Marginal Decade?

The Marginal Decade is the last ten years of your life. Nobody knows precisely when this is, but you will probably know when you’re in it! The exercise then is to think about what kinds of things you want to be able to do in this last decade of your life. 

Here are a few practical considerations. Which would you choose?

• Do you want to be able to walk at a brisk pace?
• Do you want to be able to go on a hike in the hills?
• Do you want to be able to carry the groceries up the stairs in both hands without using the handrail? 
• Do you want to be able to lift your great-grandchildren? 
• Do you want to be able to squat/kneel to work in the garden? 

You get the idea. Focusing on these things can make improving fitness a permanent priority for you! 

Get a grip!

A second concept that Dr Attia shares is “The Centurian Decathalon,” which looks at your life as an athletic event—one you want to finish well in your own Marginal Decade. Several metrics that measure functional ability have been discovered over the years. 

These include:

Grip strength – surprisingly, this is one of the most important

•  VO2 max-the maximum amount of oxygen your body can use during exercise
•  Number of push-ups-40 for men are associated with a 98% reduction in cardiovascular events than those who can do 10 or fewer.
•  Carries (carrying dumbbells in your hands for time), 
•  Hanging from a pullup bar, 
•  Wall sits-2 minutes

These are strategic qualitative measures of overall function. These metrics naturally decline as we age–the idea is to slow the RATE of decline. These are typically not measured until people are in their 70’s, meaning they have missed 30-40 years of working on them!

All of these tests have been tied to enhanced function as we age; in other words, the ability to do the physical stuff that makes life worthwhile. 

Some are not obvious, like grip strength

For example, taken in isolation, grip may not mean much besides maybe the ability to open jars. But, if you think about it, grip is a strategic metric when it comes to your overall condition. 

Unless you have been sitting around in a recliner doing grip exercises and nothing else, a strong grip indicates that you do a lot of moving around, picking up stuff, and etc. In other words, you’re actively engaged. 

Activity improves overall strength, especially the right kind. If you have good upper body strength, you’ll also have a strong grip. 

Quick story: I developed a performance testing protocol for athletes years ago. In my research, I came across a fascinating bit of information: the most universal measure indicative of success in the NFL for all positions was… grip strength!

I initially had the same thought you probably had about healthspan: “How is that the most critical measure, particularly across all positions?” I was thinking squat, deadlift, vertical jump, 40 times, or something like that. But, in analyzing all those things, grip strength ties back to them directly or indirectly.  

So, “getting a grip” on these measurements means more than awareness. It means determining where you are and taking specific actions to maintain or improve them as you age.

These thought exercises or frameworks will motivate you to focus on things that will help you increase your healthspan. 

So, what exactly is healthspan?

Healthspan simply means the span of your lifetime spent in good health. That is, the amount of time you feel good and move well.

When you think about it, a better question is, how much of your life do you want to spend feeling bad?

For the vast majority of people, physical decline is inevitable and surprisingly predictable: 

They enjoy good health from the time they’re born and through their mid-twenties. They then experience a decline that continues for the rest of their lives. Ultimately, some form of chronic disease severely limits healthspan in their seventies.

This process accelerates in the 50s, typically resulting in some form of chronic disease and decreased mobility beginning in the seventies and sometimes sooner.  

It doesn’t have to be this way

It is possible not only to survive but THRIVE throughout your lifetime and even the majority of the marginal decade. 

So, let’s talk about what you want.

By now, I hope you genuinely believe you have a choice. Now might be a good time to think about what you want in your marginal decade, find out what you need to work on to allow you to do those things, and set goals to move you in that direction. After all, working on these things can delay the decline and make it much sharper, meaning the last decade can be primarily good rather than a struggle! You can continue to DO–take the steps to make it so today!.

My two-pronged experience

I’ve spent the past 40 years as a Physical Therapist (PT) dealing with the effects of poor health.. Over time, friends I worked out with suggested I do fitness coaching. I learned that my passion is helping busy professionals in their forties and beyond, and watch them enjoy the benefits of increased strength, joint pain relief, boosted energy, sharper focus, and weight loss. 

As a PT, I’ve seen people change for  better and for worse. I’ve watched thousands of people have to deal with the results of bad health decisions. As a fitness coach, I’ve also seen people improve and reverse negative issues by changing their behaviors. I’ve watched people come to realize the ability to enjoy life more by increasing strength and mobility.

I’ve watched others go through a downward physical trajectory

Most everyone has seen close friends or loved ones  go through an illness or progress through the aging process to a point that their ability to move and live the way they are used to is diminished.  I’ve seen several examples of this in my lifetime.

The one that hits closest to home is my parents. My dad retired when he was 62 and his activity level dropped off. My mom still did housework and my dad did yard work for a bit, but neither had been overly active up to that point. Although, both lived into their 90s–the last 20 years or so were not good from a physical standpoint. They experienced a long series of arthritis, cardiovascular disease and other issues that are very much related to a lack of exercise and a poor diet. 

Another experience was having the opportunity to work with hospital inpatients for about a year.  While I was seeing them primarily for orthopedic issues, I couldn’t help but notice that the majority of them also had significant progression of systemic diseases (diabetes, cardiovascular). Such problems are the result of lifestyle choices–either not doing things that are beneficial, like exercising, or doing things that are unhealthy, such as smoking, excessive drinking or making poor food choices. 

When I worked with orthopedic patients, who were hospitalized, I found the majority of them suffered from progressive systemic diseases, like diabetes and arthritis. These problems are most often determined by lifestyle choices, especially activity levels, diet, etc.

Even when treating people in an outpatient setting it’s not uncommon  to see people on two or three prescriptions for diabetes, arthritis, cholesterol, etc. in their 30s! 

This is so disheartening. It DOES NOT have to be this way!

And it’s not just about prevention-the point of exercise is to have a more enjoyable life.  To be able to enjoy grandchildren or a walk in the park. It’s life-changing,and it doesn’t have to disrupt your entire life.

The problem is that starting something new is hard!

I get it. It’s not easy to start something new. My beginnings with exercise were not very positive.  As a child, I didn’t do any real organized physical activity until Little League. As an 8 year old, trying out for the 8-10 age-range team was not the best plan.  Lack of experience and playing with older kids (2 years is a lot when you’re 8!) proved to be quite humiliating–that was the end of my baseball career.

My next attempt was freshman football.  Since this was only my second attempt at organized sports, I still was very inexperienced.  The results were similar–I was bad and got knocked around quite a bit.  

There was a difference this time, though, I loved,and still love football! I saw that this was something I could get better at with work, and work I did.  

By my senior year I’d gained 60 pounds and decreased my 40-yard dash time from 5.4 to 4.7 (I went from very slow to pretty fast!).    

These experiences taught me two things. First, just because you don’t like something at first (like exercise) doesn’t mean you’ll never like it. Sometimes it just takes time or a change in focus. 

Second,  it showed me dramatic changes are possible with the right plan. In my case, I read a book by a guy named Bill Starr called “The Strongest Shall Survive”.  Back then, there were few strength coaches or fitness coaches. So, Bill Starr became my coach and I was able to design my own plan with his guidance.  That plan allowed me to make the changes I mentioned above.

These things have stuck with me throughout my life– college, practicing as a physical therapist and fitness coach. Now, even better, I not only live a healthy active life, I get to teach it  for a living!

Here’s how I can help

If you’ve never exercised consistently or tried and failed, I’ve been there and can help get to a healthier place.  I’ve also learned how to deal with the effects of poor physical condition and nutrition and helped thousands of people reverse such effects.  

Whatever your current state, the first step is to assess where you are and where you want to be in order to live the kind of life you’d enjoy.

When you’re ready, I’m here to do that assessment and map out a plan that will work for you.  

Why choose deep squatting?

Many people think squatting, particularly deep squatting, is bad for your knees. On the contrary, deep squatting is not only not bad but is great for your knees.  Deep squatting addresses decreased flexibility and range of motion in several areas. Tightness in the ankles affects the knees, hip tightness affects the knees and lower back, and knee tightness can affect the joints above AND below.  One way these effects happen is that the adjacent joints are forced to become more mobile to make up for reduced mobility, which leads to instability in those joints. 

Another way these other joints are impacted is that the muscles surrounding them are forced to work in ranges they’re not designed to work in. One more potential problem is the fact that joint compression may increase with increased tension in the surrounding soft tissue structures.  

Understanding deep squatting

What exactly is deep squatting? Deep squatting is basically squatting down as far as you can and maintaining that position for a period of time.  In the beginning, this will probably be uncomfortable, but should get more comfortable as your tissues stretch and strengthen in the areas that are stressed.

I recommend starting out with a static squat for 20-30 seconds (sometimes even this is difficult at first, so start where your tolerance is) and increasing the time as you feel comfortable. 

How to perform deep squats safely

You want to get your feet approximately shoulder width apart and squat down by pushing your hips back as you descend.  Go as far as you can comfortably go–no further!  You may hold on to a bed post or door frame to steady yourself and help control the motion in the beginning.  Always keep in mind that it is a good idea to get help from an experienced fitness coach or physical therapist when starting to do any movement that is unfamiliar.

After you get to the point that you can tolerate holding the position well, you may try doing pulses, where you are basically initiating lifting yourself out of the squat, but only go up to the point that your thighs are parallel to the floor. The lower quads and connective tissue surrounding the knee really benefit from exercise in this range. 

It is best to incrementally increase reps, rather than increase the load. You can add load in this range, but you don’t really need to, in my opinion.

Deep squats should be pain free

One thing to keep in mind is that holding the deep squat position and doing the pulses should both be pain-free.  

Caution! You may have discomfort in the soft tissue around the knee, but you shouldn’t have pain in the joint. There is greater compression in the posterior or back part of the joint when you do this activity. No problem if there are no issues but, if there is any meniscus or other pathology in the posterior part of the joint, it CAN be exacerbated when you squat deeply.  

The biggest mistake people often make is pushing for too much time or depth too soon. Go as far down as is comfortable (well maybe a LITTLE uncomfortable) and maintain the position for a short time: 10 or 15 seconds is fine in the beginning. Then focus on gradually sinking further and staying down longer as your tissues gradually lengthen and your tolerance to the position increases.  

One thing you do not have to worry about is maintaining a flat back at the bottom. While this is necessary for safety if you are weight training, you do not need to be concerned about it while doing this exercise because you are probably not loading it; if you do, the load should be very, very light. 

Benefits of deep squats for joint health

As we discussed earlier, deep squatting puts stresses on the joint surfaces and connective tissue that they don’t receive if you never go into those ranges.  These stresses, if applied gradually and safely, can result in improved health of the joint surfaces and connective tissues surrounding the joints involved.

This exercise can be done at any age—actually, the younger the better. Due to our lifestyles (most of us anyway), we tend to start losing mobility in the ankles, knees, hips, and lower back very early-mid 20s-30s and sooner in some individuals. So, the sooner you start, the sooner those changes can be reversed or prevented. 

Deep squatting caution, convenience and cultural factors 

So, you can start at any age. You just need to keep the basic rule of any exercise in mind–it should not hurt. If there is any pain or more than minor discomfort, try to modify it by not going as deep or for too long. If you don’t have the strength to get into position, you can use a bedpost or put your hands on either side of a door frame and use your arms to help.

Another great thing about doing deep squats is that you can do them just about anywhere. At home, at the gym as a warm-up, in a hotel room, in the backyard—there is really no place you can’t do them.

Deep squats, if done properly, will improve the health of you lower back, hips, knees and ankles.  If all you ever do is squat to 90 degrees or even parallel, the joint surfaces do not get the compression they need, and the soft tissues around the joints do not benefit from being stressed in that range. So the muscles and connective tissue are strengthened, and the joint surface health and longevity are improved by deep squats.

Many cultures spend much more time in a deep squat position than most of us typically do. In fact, the time that we spend sitting in chairs they spend in a deep squat position.  Research has shown that these groups have a lower incidence of knee pathology than most of us who live in more Western cultures.

So, to wrap things up, there are no exercises that cover everything. There are a handful that cover several areas, and deep squats are one of those. Add deep squats to your routine and reap the benefits of this impactful exercise!