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Statistics have shown that adults are staying active for longer than those of generations past. Adults aged 35 to 54 now account for 34 percent of the health club population, an increase of 122 percent since 1990, while those over 55 account for 24 percent, an increase of 411 percent in the last 17 years.¹

But while that may be good news for overall health and fitness levels, it can also mean more injuries and conditions. One segment of this population that is particularly prone to the physical limitations of aging is athletes, because these men and women find it hard to train less intensely and allow for more recovery time. Physical therapists spoke with ADVANCE about how to help athletes age gracefully and avoid getting sidelined for good.

More Athletic as They Age
During the 2008 Olympic Games, U.S. swimmer Dara Torres wowed the world by winning three silver medals, including the 50 meter freestyle, at age 41. Then there's cyclist Lance Armstrong, who at 37 is a seven-time Tour de France winner.²

Dr. Kristy Laing, DPT, of Complete PT Pool & Land Physical Therapy, in Los Angeles, CA, is a former competitive gymnast who thinks better training and knowledge of body maintenance is allowing athletes to compete for longer. 

"People can complete physical therapy in order to cross-train, prevent injuries and rehabilitate injuries that will allow them to maintain their competitive level, whereas even 20 years ago, it wasn't as much of an option." 

Gary Calabrese, PT, director of Cleveland Clinic Sports Health and Orthopaedic Rehabilitation in Ohio, also sees an increase in the number of aging individuals who take health and fitness seriously. He cites access to information on the Internet and the explosion of the exercise industry as key reasons for the trend.

"Exercise has certainly become an industry and much more convenient than it ever was for people, especially the elderly or aging. The expectations of people as they age have elevated to the point that they do not expect to slow down. More people absolutely are involved in general exercise and are in the sports for longer than they were 10 or 15 years ago." 

But older athletes can't train the same way they did in their younger days. Dr. Laing, who treats many golfers and tennis players, says athletes should maintain less intense training. 

"All sports can be draining as you age. It just depends on the intensity of the sport," she said. "Golfers and tennis players can continue on well into their 60s and 70s if they are physically fit and able to do so. Tennis players will usually go from singles to doubles to decrease the amount of running and speed that is required."   

Staying Strong
While mental acuity and physical technique can improve with age, speed and agility usually slow, Dr. Laing said. Many athletes think they can just push through the pain of an injury like they did when they were younger, but it's more detrimental when they are older.

"Movement is good-it keeps our joints lubricated and muscles strong," she said. "It is when it is excessive that pain and degeneration will set in. That is where proper training comes into play. Anyone who has proper training and muscle strengthening by a trained professional can continue to maintain their activities as long as they continue to have the mental drive to do so."

With her golf and tennis players, Dr. Laing treats mainly back or shoulder injuries. For the back, therapy includes core strengthening within rotational components, exercises for the hips and lower extremities and form correction. Treatment for the shoulder involves strengthening, range of motion (ROM) exercises and form correction within the swing phases of golf.

To handle the ankle, knee and shoulder injuries of basketball and soccer players, Dr. Laing

uses strengthening, ROM exercises and agility training in all directions, while for baseball and softball ankle, knee and shoulder injuries, she relies on strengthening and stability exercises mainly. Her overall goal with her treatment of athletes is to pursue strength training at a lower intensity.

"You do not have to go and lift heavy weights in order to maintain fitness level, strength, and balance," she said. "There are exercises that I teach most of my patients to do at home in order to maintain their level. The best advice is to seek help when you are feeling pain, and do not push through it. The quicker it is acknowledged and help is sought, the quicker the recovery and the faster they will be back at the court."  

A Tailored Plan
Calabrese also treats many golfers. He says maintaining a level of fitness over the lifespan helps with longevity in fitness abilities, but natural physical occurrences such as losing muscle mass and bone mass are irreversible and can slow activity levels.

"When you deal with any elite athlete, they model themselves after professional athletes in their age category, on the senior tour," he said. "What I tell my patients is that comparing yourself to a professional athlete is OK as long as you're going to train like a professional athlete. For the normal 99.8 percent of the world, that's not a possibility. We have to find a level that's appropriate to achieve individual goals. The more they understand the relationship between strength, flexibility and power, the easier it is to convince them that the program they need to undertake is appropriate for their goals."

Many of Calabrese's clients aim to golf 18 holes three days a week and not have knee or hip pain. Tailoring their training to "a goal, not an image, is really crucial for their program to be successful," he said. Calabrese sets up a split routine for his patients using full weight-bearing, flexibility and power walking and aquatic therapy on recovery days. Good programs will not adversely affect joints and will include cross-training with different levels of impact. Doing any activity every day of the week without rest will produce pain, especially since individuals require more recovery time as they age, Calabrese said.

"If they want to run a 5K, they can't take a prefabricated routine off the Internet. They need to have good medical clearance and talk to someone who understands the aging process in the medical field, then tailor their program to meet their specific needs."

Calabrese also points out that individuals can play more of sports with less impact, such as golf and swimming, as they age. Also, activities such as Pilates that work on flexibility and body control can help athletes stay strong in their sport or activity as they age.

References

1. IHRSA. (2009). U.S. Health Club Membership by Age. Retrieved from the World Wide Web, cms.ihrsa.org/index.cfm
2. CNNHealth.com. (2009). Elite athletes: They're quick, competitive and nearly 40. Retrieved from the World Wide Web, www.cnn.com/2009/HEALTH/07/16/athletes.comeback.endurance/index.html

Lauren Fritsky is a freelance writer and frequent contributor to ADVANCE.