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The Graying of Fitness

WSJ and Projo article

The graying of fitness

11/18/2007 01:00 AM EST

BY SHIRLEY S. WANG

The Wall Street Journal

Longtime junior varsity baseball coach Ralph Caruso, who retired from teaching at Barrington High, is still playing hardball. He plays for the RI Blues, a team in the over-50 age bracket of the Rhode Island Men’s Senior Baseball League.
Sports medicine, long geared to the needs of young athletes, is branching out to help older people remain active and athletically competitive as they age.

While much of the new attention is focused on so-called masters athletes — those over 40 who regularly compete in organized events — doctors and trainers say many of the strategies and services these athletes use can help anyone improve their workouts and other daily routines to stay active and healthy.

“This is the first generation who have lived with physical activity their whole lives,” says Marje Albohm, an athletic trainer and director of Sports Medicine and Orthopedic Research at OrthoIndy, an orthopedic group in Indianapolis. “Their goal, and (trainers’) goal in advising them, is to maintain their desired level of physical activity throughout the life span.”

That’s why many Rhode Island and Massachusetts gyms and health centers, along with their counterparts across the country, now offer programs and services designed specifically for baby boomers, to help them get fit and stay active — and, in some cases, continue to compete.

The University of Pittsburgh recently opened a wellness center called the Performance and Research Initiative for Masters Athletes, offering competitors over 40 years old a package of medical care, nutrition counseling, mental training and physical therapy previously aimed only at younger athletes.

In May, the editor of the American Journal of Sports Medicine called for more research on how older athletes recover from injury and how quickly they can get back to recreation or competition. In August, the American College of Sports Medicine and the American Heart Association issued new recommendations for physical activity that for the first time include guidelines specifically intended for older adults.

It’s a burgeoning market. Those over age 55 make up the fastest-growing segment of health-club members: There were 8.5 million in 2006, up from 1.5 million about 20 years ago, according to the International Health, Racquet and Sportsclub Association.

Rhode Island gyms have taken notice. American Health and Fitness Center in West Warwick and Healthtrax at the Care New England Health and Fitness Center in East Providence, for example, say the vast majority of their members are over age 40. They cater to their needs with everything from private trainers and special training programs to private lounges for older members to hang out in.

Doctors also say they’re seeing greater numbers of patients playing sports into older age, and masters events are increasingly popular.

About 10,000 athletes participated in the Huntsman World Senior Games last month, an event in which anyone over 55 can compete in sports including basketball, triathlon and mountain biking. The games, in St. George, Utah, have grown every year since they started in 1987.

For those who have been exercising all their lives, getting older may mean changing exercise routines. But sports-medicine experts are quick to stress that changing doesn’t mean slowing down or stopping physical activity.

Another target group is people who used to be more physically active, but got away from it for one reason or another, often because of the time pressures of raising children, noted William Parker, general manager of American Health and Fitness. When the kids are grown, they’re ready to get back in the game, but find they can’t do what they could do when they were younger, be it jogging or hiking through the woods. So they come to the gym for help in getting fit again.

Still others, he said, are simply trying to cope with the physical changes that come from age — from the increase in aches and pains to restricted use of knees, shoulders, backs and other parts that simply don’t respond like they used to.

Parker said he recently attended a four-day conference in Boston for fitness professionals that focused on coming up with ways for people in this age group to deal with physical changes, including balance, strength and endurance.

As the body ages, muscles become slower and weaker, most significantly affecting speed, balance and the ability to recover from injuries. Researchers and doctors say to compensate for these changes, older athletes should focus more on balance and flexibility, in addition to pure strength and cardiovascular training. These are important for physical activity at any age, but particularly so in middle age and beyond, when overuse injuries and falls are of greater concern.

“The worst thing is to become injured by choosing inappropriate activities, or to re-aggravate an old injury,” says Albohm of OrthoIndy.

But being physically fit isn’t only about competing, Parker pointed out. It’s also about how you carry yourself as you age. It’s about having the confidence to get around and remain independent, as opposed to people who may start to shuffle along or find their activities restricted because they don’t have confidence in their physical abilities. Everyone benefits from being in shape, he said.

Studies of active, older athletes have yielded encouraging findings related to health and aging. A June study in the International Journal of Sports Medicine found that average marathon times remained essentially the same from the 20s through the 40s and then declined less than 5 percent a decade in the 50s and 60s.

Regular exercise into older age, even at less-intensive levels than marathon running, can slow age-related changes in heart rate, aerobic capacity and muscle mass. Numerous studies show greater physical activity is associated with decreased risk of cardiovascular disease, hypertension, diabetes and obesity.

The new physical-activity guidelines from the American Heart Association and American College of Sports Medicine urge older adults to design workout routines around their own abilities to reach the activity goal for all adults: 30 minutes of moderate exercise five days a week. For some older individuals that may mean a moderately paced walk, for others a three-mile run. The idea is to induce “noticeable” but not large changes in heart rate and breathing, the guidelines say.

Balance, in particular, is emerging as an important element for older people, according to doctors, researchers and the guidelines. Older muscles are smaller and slower and respond less efficiently when we need to brace ourselves, making us more vulnerable to falls, says Marjorie Woollacott, director of the Motor Control Lab at the University of Oregon’s Department of Human Physiology in Eugene.

Practicing tai chi, a form of martial art, helps both healthy and frail individuals improve balance, according to several studies, including a recent randomized controlled trial published in the August issue of the Journal of the American Geriatric Society.

Experts suggest using balance boards and balls, and challenging your body while doing activities, such as by running up and down a curb rather than sticking to flat ground, says Waneen Spirduso, professor of kinesiology and health education at the University of Texas-Austin who researches how the body’s motor system changes with age.

Variety — or cross-training — is also important for everyone, say sports-medicine doctors, but particularly for older individuals, whose bodies may not be able to handle extreme stress on certain body parts, leading to injury. More-active older athletes may need to alternate between high-intensity and lower-intensity activities every other or every third day, doctors say.

“A mixture of activity is optimal,” says Miriam Nelson, director of Hancock Center for Physical Activity and Nutrition at Tufts University, Boston, and lead author of the updated exercise guidelines for older adults. This means, for instance, that golfers should continue to hit the driving range, but they also need to stretch and go to the weight room regularly.

It’s also more fun that way, said Michael Boyes, site director at East Providence’s Healthtrax, who said his staff makes a point of trying to mix things up for the members there. “It’s nice having different variations. With traditional fitness (programs), people get kind of bored after a certain point, where at centers like ours, they have lots more alternatives to give them more variety and more social fun.”

And, he said, they further cater to this age group by providing separate lounges for the baby boomers to hang out in before and after they exercise.

One of the benefits of pairing with Care New England, a network of hospitals and health centers, Boyes noted, is that his facility is also a medically-based fitness center with staff members who are specially trained and programs that are specially designed for dealing with specific health-related issues, from physical therapy after an injury or surgery to cardiac rehab after a heart attack.

So when it comes to the vast range of needs presented by baby boomers, he said, “having a medically-based fitness center is much more conducive to servicing their needs.”

Prima, the program for masters athletes in Pittsburgh, addresses all these elements in designing programs for elite athletes, and for sedentary older individuals who want to become more active, says Vonda Wright, an orthopedist and the program’s director. Prima’s 12-week “Start” program, which opened in June, caters to this latter group with the goal of helping them train slowly to a point of being able to run a 5K race.

Finally, doctors and trainers — and another recommendation for older adults from the ACSM/AHA guidelines — say stretching to warm up before exercise and to cool down afterward is particularly important as people age. The belief is that improved flexibility from stretching helps prevent such injuries as pulled muscles, though little research is available that makes the case.

Older athletes should be especially vigilant about injury because “it takes longer for the body to adapt to stress” in older age, says Bruce Reider, director of sports medicine at the University of Chicago and author of the American Journal of Sports Medicine editorial calling for additional research on aging athletes.

The slowed resilience of the body makes it more likely that an overuse injury could occur. If you notice a “crescendo” or buildup of pain across sessions that worsens or seems to linger on, you may have an injury, says Dr. Reider.

Individuals may consider getting professional help to resume or establish a healthy exercise plan. In looking for a trainer or a health club, ask about credentials. Athletic trainers must be licensed, for instance, but there are many certifications for personal trainers. Make sure the professionals understand their goals for fitness, whether it’s running a marathon at age 75 or going to the park with grandchildren, and have worked before with “people like you,” says Tufts’s Dr. Nelson.

Parker said the bottom line for people of any age is: “Just get moving.”

Providence Journal Staff Writer Laura Meade Kirk contributed to this report.