To a non-athlete, the list of my tennis injuries may signal that, at 62, retirement from the game would be a very good idea: rotator-cuff injury (2001); sprained wrist and back (2002); tennis elbow (2003); re-injured wrist (2004); hip sprain (2005); toe surgery, back sprain (2007); re-injured rotator cuff (2009); back spasms, rotator cuff again (2010); broken right toe, burst cyst behind right knee, right-hip arthritis, sprained back (2011).
But to a senior athlete, pain is such a constant that is often ignored. It takes a rapid-fire sequence of play-stopping injuries to illuminate what seems obvious to others: An aging body demands accommodation.
“How we age is 30 percent genetics and 70 percent under our direct control,” says orthopedic surgeon Vonda Wright, author of “Fitness Over 40” and director of the Performance and Research Initiative for Masters Athletes, a University of Pittsburgh program aimed at helping older sports enthusiasts exercise effectively. “Baby boomers get that, and they want control — they’ve always wanted control. But sports medicine doctors haven’t caught on that these athletes want to hear how to keep playing — not why to stop playing.”
“The fact is,” she adds, “a 75-year-old athlete may still perform many times faster and be in better health than a sedentary 30- or 40-year-old.”
We senior athletes are a stubborn bunch — and there are more of us every day. The fastest-growing demographic for fitness club membership is people over age 55, according to the International Health & Racquet Sportsclub Association. In 2005, the number of 55-and-older members was 8 million; in 2009 it was 10.3 million. Aging athletes are competing at every level, from local 10-Ks and tournaments to elite competitions such as the Summer National Senior Games, where in June some 10,000 athletes from ages 50 to 101 participated in 18 events, including basketball, pole vaulting and triathlon. (The 101-year-old competed in shotput, javelin, discus and hammer throw.)
Some aging athletes come to competition later in life, such as Mary Lathram, a 96-year-old Falls Church woman who began swimming for fitness at 64, started competing at 65 and set a world record in the 200-meter backstroke at 92. Some are athletes who never stopped, such as 48-year-old marathon runner and orthopedic surgeon Ben Kittredge of Alexandria, who has kept running since college — eight miles a day, seven days a week. Many others are like me, former teen athletes who compete intermittently as adults. I led my tennis team at the University of Georgia from 1967 to 1971 and still qualify for teams at the highest local amateur level.
With age, however, comes an increased risk of injury, says orthopedic surgeon Thomas Martinelli, a former collegiate basketball player. “For instance, ankle sprains become less prevalent, while fractures become more likely with the same injury. Rotator-cuff tears increase in incidence over age 40 and are almost unheard of in the under-20 group.”
Yet doctors are seeing more injured senior athletes with high expectations. “When I started practice 24 years ago, if a 60-year-old walked into my office I’d assume they were lost,” says George Branche III, an orthopedic surgeon with a sports medicine specialty in Arlington.
“The changes in medical technology since the 1980s have been huge and made things possible that were impossible before,” notes Branche, who specializes in knee and shoulder surgery. Yet many orthopedic surgeons resist repairing some joints on athletes over age 60, urging them to accept joint replacement or reduced activity.
Many athletes complain that some medical professionals still dispense outdated advice, such as total rest to heal an injury rather than continuing to condition other muscles that can safely be exercised. Sports medicine experts such as Marje Albohm, president of the National Athletic Trainers’ Association, contend that continued exercise of healthy areas is a sound principle of conditioning. Part of the problem, says Vonda Wright, is that most research on what middle-aged and older people can do physically is based on relatively sedentary populations, which calls into question its relevance for actively athletic adults.
Branche understands the disconnect between senior athletes who want to be repaired and the reluctance of some doctors to perform certain surgeries on them. “On one hand, an older competitor must acknowledge that just because a fellow athlete was able to have surgery to repair an injury does not mean that he or she will be able to do so,” Branche says. “On the other hand, surgeons need to recognize that continuous improvements in medical technology and the greater fitness of some of today’s older athletes may mean they should consider surgery they might not have 15, 20 years ago.”
Of course, the best advice is to reduce the risk of injury in the first place. The key is being mindful — and respectful — of the changes that occur as one ages.
A plethora of factors influence the maintenance of conditioning and the rate of decline — factors such as the ability to train intensely, skeleton size, body fat composition, joint mobility, strength, endurance and coordination. For example, age-related decline in strength can be partially offset by resistance training, so a softball player with strong legs and hips can still sprint fast enough to beat the throw to first base. However, if that player has poor joint mobility in the hips or knees, acceleration may diminish despite his or her strength, according to Martinelli.
Vigorous conditioning can mitigate declines in strength and aerobic capacity, according to Wright. Senior athletes can also lessen the chances of injury through such steps as cross-training and taking sufficient rest time between intense workouts.
Still, having expert knowledge and keeping yourself in shape doesn’t insure one against injury. Even Branche, 55, who does fitness training twice a week and plays tennis three times a week (often with men two decades younger) found himself sprawled on the court at the McLean Racquet Club last fall, victim of a burst quadriceps tendon. After surgery and six months of therapy, Branche, once a nationally competitive amateur tennis player, is back on the court. He fully expects to continue at least as long as his father did — well into his 70s.
“Tennis is in my blood,” he says. “Playing the sport gives me an extra good feeling of competition as opposed to having my exercise centered solely on fitness and conditioning. As I have gotten older, the fitness and conditioning aspect becomes more important in continuing to play tennis.”
Leet is an Arlington-based communications and management consultant who recently started the blog More Fit After 40.