Going Deep

He played baseball and football in high school, took up tennis as an adult, and played competitive baseball well into his forties.But at age 47, Dr. Jack Frankeny realized a change was in order.”I looked at my wife and said, ‘I’d rather be hiking at 70 than rebuilding my knees,” said Frankeny, an orthopedic surgeon at the Orthopedic Institute of Pennsylvania.So he decided to give up competitive sports, and segway into a more leisurely set of athletic activities.Dr. Jack Frankeny put away competitive sports at age 47 and now focuses on activities such as lifting and running.”Giving up the rush of competing was hard, but I think when I’m 70, I’ll be glad I did,” Frankeny said. “As a orthopedic surgeon and an aging athlete, I realize you get only so many beats to your heart and definitely only so much pounding on your joints.”Today, Frankeny runs, bikes and lifts weights on a regular basis, but tempers his routine based on how his body feels.At 55, he now cycles more and runs less because he’s hindered by an occasionally sore back, and some nagging arthritis in his hip.”I was lucky enough to get good advice from my dad: When you turn 40, God gives you a pain, and it never really goes away. It just moves around, depending on the latest problem,” Frankeny said, laughing.Still, the good doctor is hoping to set an example for all: “keep exercising till you die, but adapt what you can do.”Yes, it is possible to age gracefully if you listen to your body.”An athlete is basically anyone performing a physical function, whether it is competitive or not,” Frankeny said. “Some compete against each other, others compete against themselves. There’s a tremendous genetic component to [a person’s] ability to be a master’s athlete.”Some people are built in a way that allows them to perform for a long time, and in spite of the greatest willpower, you may not be able to do that. So you have to have a certain flexibility if you want to continue exercising and competing.”With 43 percent of the population in Pennsylvania now aged 45 and older, dozens of aging athletes file in and out of Frankeny’s office regularly with an assortment of different maladies.Welcome to the era of Boomeritis, otherwise defined as the study of injuries to older athletes, often those part of the baby boomer generation, now aged 55-70.”Those of us from the boomer generation, we were raised as athletes, different from previous generations,” Frankeny said. “We’re much more athletic than our parents were, and we try to stay more active than our parents ever did.”There’s a whole bunch of literature out there on boomeritis – aging boomer athletes and what’s happening to us now.”As University of Pittsburgh Medical Center orthopedic surgeon Vonda Wright puts it, the aging body isn’t just “a bad sequel of your 20-year-old self.” Aging changes the body, but aging athletes frequently fail to pay attention to these subtle nuances.”We think we’re still young, and sometimes we try to continue performing as though we were young,” Frankeny said. “Then many of us are astounded when something goes wrong. “Basically we overdo it, over train and over-exercise.”
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Secrets to staying activeThe effects of aging include a decrease in the amount of air the lungs can hold (that’s why it takes more energy to breathe as you get older), a decline in maximum heart rate, a loss of bone density, and rise in body fat composition.The good news is that regular exercise can help to slow the aging process. The trick lies in finding the right combination of frequency, intensity and activity.From a musculoskeletal standpoint, overuse injuries are common in older athletes because muscles and tendons become less flexible as the body ages.”After the age of 30, strength and muscle mass decreases at a rate of 1 percent per year,” Frankeny said. “At 25, you can get away with anything, but at 45, you’ll most certainly get hurt if you overdo it.”Bone strength peaks at about 30, then declines. By the time a person is in his or her late forties, Frankeny says the body’s innate ability to heal itself has also declined. Common ailments at that point include rotator cuff problems and other shoulder issues, especially in athletes from sports such as softball, baseball, tennis and swimming, where the overhead motion is crucial.As people hit their sixties and seventies, arthritis starts to kick in. Still, there are ways for athletes to stave off the effects of aging.Wright, who founded the Performance and Research Initiative for Masters Athletes (PRIMA) out of UPMC, recommends a total body approach to conditioning for all masters athletes. “I call it ‘facing’ your future,” she said.To make an easy-to-remember slogan, Wright has broken her “F.A.C.E” approach into four categories: Flexibility, aerobic exercise, carrying a load, and equilibrium and balance. Muscle fibers shrink and get tighter with age, and tighter muscles limit a person’s range of motion while also making an athlete more susceptible to injury, so flexibility is crucial for the older athlete.To maintain flexibility, Wright recommends that athletes under 65 stretch each muscle group for 30 seconds every day. Athletes 65 and above should hold each stretch for a full minute. In terms of aerobic exercise, Wright stresses that while any kind of activity will benefit your body, you could do much better than a leisurely walk after dinner. The idea is to challenge your body and get your heart rate up.”You need intense exercise every other day,” Wright said. “So if you’re going to walk, you’re going to walk at 90 percent effort for three minutes, then back off and recover for a minute and then rev it back up.”The “C” in the acronym stands for “carry a load” and invokes the benefits of weight bearing exercise. Research has shown that weight training can help seniors slow the rate of muscle atrophy, and to maintain bone density. Wright stresses functional movement exercises and free weights over weight machines.”Weight machines are ridiculous because they move your muscles in one plane of motion and do not involve gravity,” Wright said. “They are totally non-functional.”In the PRIMA program, UPMC director of sports performance Ron DeAngelo stresses body weight exercises, and the use of resistance bands.”You can build strength using your own body weight,” DeAngelo said. “And when you are able to master that, that’s when you add weight to whatever you’re doing. “You want to train the way you’re going to use your body.”Maintaining equilibrium and balance is equally important.As Frankeny puts it, “I’m 55, and I can attest that my coordination and ability to protect myself from falling has clearly declined.”According to Wright, a person’s sense of balance starts to decline age 25, and after the age of 65, one in three people will fall as they go through their day-to-day activities.”Neuromuscular pathways between our brain and muscles degrade so that our ability to tell where we are in space declines,” Wright said. “So we just need to retrain our balance every day.”As I tell my patients, stand on one leg and brush your teeth or wash the dishes. It’s just a matter of getting the body to challenge itself balance-wise.”AdaptingBut as Frankeny has demonstrated, aside from making sure you maintain your overall fitness level, choice of activity also goes a long way toward preserving your body’s physical longevity.”I see folks who retire at 65 and say, ‘We want to do the skiing we didn’t have time to do before,” Frankeny said. “I hear that and I think, ‘Oh God, let me just tattoo my name on your back.’Older skiers are more likely to fall and break something because of the decline in coordinator and neuromuscular control, and the doctor has treated plenty of skiing injuries in his time.”I think there should be a law that says no one should be able to ski after 60. How about sledding or tobogganing? It’s the same thrill, but it’s so much safer. Gear down and switch to what an aging body can do,” Frankeny said. “If you have an aerobic gift and you adapt to another sport, you can probably achieve the same degree of accomplishment and keep the juices going.”Frankeny recommends that older athletes avoid sports that require any sort of impact – like basketball, for instance – and controlled falling.”Sports that involve more than one competitor in the same space, where they can trip each other, should also be avoided,” Frankeny said.Instead, aging athletes should look into taking up sports where they can control as much of their environment as possible – where you ride or run, what shoes you wear, what terrain you do. That’s why running, biking and swimming attract many older competitors, and tennis and golf have long been established as lifelong activities.Of course, switching sports doesn’t guarantee that you’ll avoid injury completely. The road rash all over the right side of Frankeny’s body is the result of an ugly spill he took on his road bike recently as he was trying to make a tight turn.It is testament to the fact that accidents happen, and if you play sports, you have to resign yourself to the fact that you’re going to get hurt.In his humorous, self-deprecating way, Frankeny wonders aloud whether he would have been coordinated enough to complete the turn and avoid the fall 10 years ago.”Probably yes,” he says. “But despite the fact that I’m still purple, I’m OK.”Senior athlete status or not, he’s still moving, and in a pretty functional manner. At the end of the day, that’s really all that matters.