By Emery Styron
Health, Brain & Cognition Lab
Eighty-three-year-old Dolores Lay caught not just one tough break but three when she tripped and fell on her patio in June of last year. Two cracked ribs and a fractured right “funny bone” put her in the University of Iowa hospital for 11 days, followed by two weeks at a rehab center.
Her luck changed when Nurse Practitioner Lori Fitton at the Iowa Bone Health Clinic referred Dolores to board-certified geriatric physical therapist (PT) Jake Raecker. Jake was just starting to offer strength and balance training classes specifically designed for older adults, even frail ones with osteoporosis and fall concerns. His business, Age On Physical Therapy & Fitness: The Gym for 55 + (https://www.ageoniowa.com), operates from 2201 E. Grantview Dr., Coralville.
“Lori told me, ‘You can’t do this and can’t do that,’” says Dolores. “I went back and said ‘this won’t work, I can’t sit around. She recommended Jake.”
Lori and Jake have coordinated care for bone patients from the time he was a staff PT at UI Health Care. She focuses on nutrition for bone health. His expertise is building strength with exercise. “We found out we both have a passion for the same group of people,” she says. “I think we’re a good tag team. I have several patients I have referred to him that have done exceptionally well.”
Stronger than before her fall
“He brought me out of the dark ages,” says Dolores. “I was there for his first class. It’s been an incredible change. I’m much stronger than before the fall. I’m lifting weights, playing with the barbells, doing all sorts of floor exercises. We’re practicing how to fall, learning reactive motions.”
Another client, Steve Ropp, 65, is making progress on back issues related to overcompensating from an Achilles tendon he tore 10 years ago. He praises both Jake’s knack for adapting exercises to fit individual capabilities and the camaraderie he fosters among class members.
“One thing I was surprised about, never thought about, the community that’s built among those of us who are going,” says Steve. “We’ve had socials and happy hours. People are checking in with each other, ‘so and so hasn’t been here for a couple of days,’ that sort of thing. There are a couple of people whose spouses have died. The community side is being built.”
“Clients come for the health benefits of being strong. They stay for the strong community,” says Iowa-born Jake, who grew up in Waterloo and played baseball at Wartburg College en route to a bachelor’s degree in biology. He had originally planned to be a dentist but his grandmother’s experience with osteoporosis changed his career path. “She loved physical activity but was not sure how to be safe. My family said I should consider physical therapy.”
Geriatric residency taught him a lot
Jake earned his Doctor of Physical Therapy at Washington University in St. Louis in 2020 and his specialization in geriatric physical therapy at the Mayo Clinic in 2021. A one-year geriatric residency with Mayo in Arizona taught him “all aspects of how to care for older adults and get the most out of the aging experience,” he says.
He joined University of Iowa Health Care as a PT in 2022, cutting back to part-time last fall to offer classes. Jake went full-time with Age On in April of this year and hasn’t looked back. Classes run each weekday. Personal training is also available, individually or in groups.
Joining classes begins with a free get-acquainted session followed by a one-month trial for $99. Prices beyond the trial month depend on how often classes are attended. “Mondays, Tuesdays, and Fridays focus on strength, Wednesdays on endurance and high intensity, Thursdays on balance and agility. Clients can come to any class they want at any time,” he says. Classes aren’t covered by insurance, but he hopes to have Medicare reimbursement available at some point.
“Everyone has joint replacements. Everyone has a shared goal of continued travel, doing yard work, staying active,” says Jake. “Lots of clients come from health care provider referrals, especially from bone health centers. Many people are told not to move or twist.”
Twisting, moving and more
But move and twist they do in Age On’s sessions, plus a whole lot more. Jake’s geriatric PT training and his encouraging personality inspire confidence in his clients, ranging from their mid 50s into their 90s, who learn to jump, toss medicine balls, hoist barbells, carry kettle bells, walk treadmills, balance balloons on sticks and stretch their skills in PVC pipe workouts.
“Jake loves PVC pipe,” says class member Carolyn Wanat, 78, an osteoporosis patient also referred by Lori Fitton. “He has us batting balloons around to each other in a circle in ways that are unnatural to us.” Class members get used to using their non-dominant hands and are coached in how to not fall, she added.
“Jake has stellar credentials to offer this program. That’s important to me. What he does is spot on for the kind of exercise we need to do to keep bones, muscles and brains healthy as we age.”
Weight-bearing activities like carrying kettle bells have been helpful, says Carolyn. “In February, I started with 5 pounds Now I can do 15 or 20. This is very silly but very practical: the twist-on caps manufacturers put on — I can get those off without grabbing one of those gripper things. I have better arm strength, hand strength, leg strength, all body strength." She also sees improvement in the osteoporosis damage to her left hip.
“His expertise is reassurance,” says Steve Ropp.” The PT that I’ve done over the years, it’s driven by medical insurance. My opinion there’s a tendency not to do it long enough to strengthen what needs to be strengthened. He’s watching your form, saying ‘try this’ or ‘do that.’ You don’t get that in a gym … He’s always real good about saying if this hurts or doesn’t feel stable for you, there’s another variation on the lighter end that you can do.”
Jake, “personally, is the magic,” says Ellie Schlacter, 82. “It’s fun. There’s lots of different stuff going on in each class. You never know what’s going to happen. Sometimes I come out completely blown. Other times just a little sweaty. He’s funny, kind and very personal to each of us. He doesn’t push you, he just encourages.”
Not just strength: ‘It’s confidence’
In four to five months of classes, Ellie has achieved her goal of being able to safely jump off the tailgate of her husband’s small Ford pickup. With no weight-training background, she’s learned to deadlift 120 pounds and even won a silver medal at the National Senior Olympics in Des Moines this summer. “I have developed strength in knees from doing the damn squats,” she says. “I don’t think it’s just strength. It’s confidence.”
Teaching about the importance of movement to help prevent cognitive decline is also part of the class, Jake says. “Up to 40% of dementia cases are attributable to modifiable risk factors. By being active, you are addressing a lot of risk factors for cognitive decline.” (See video)
Research, including that done by the Health, Brain & Cognition Lab, suggests that moderate to vigorous intensity exercise is more effective than milder forms of movement in preserving cognitive health. Jake serves on a task force for the American Physical Therapy Association and is helping write a statement on high intensity training for older adults based on his experiences.
Classes are going well, says Jake. “We’re still new, learning every day.” There are clients of different ages and ability levels in each class. “They inspire me,” he says. “Everybody is amazed at what others are doing. More experienced people are amazed at what new people are willing to do.”
One of the charms of Jake’s system is that “It never gets boring. It’s a different workout routine every day. He always changes things up,” says one client.
Jake says the variety comes from his belief that “what we need in life is to play more. Probably my favorite are the days we play. We adapt on the fly. These days are really fun.”
