Tuesday, May 24, 2011

The Master Athlete - The Weekend Warrior

The Masters athlete is generally defined as the 40+ age group. I am fast approaching becoming a Master athlete myself and it is interesting to compare my own injury history over the last two years with the athletes who attend my clinic. My current ailment is an osteophyte (spur of bone) at both the front and back of my left ankle that is preventing me from doing any weight bearing type exercise. This has been caused by years and years of stair running. The damage has been done on the descent. I always lead with my left foot so it takes all my bodyweight whilst sprinting down stairs. If I had known this 10 years ago…

The common injuries an age group suffers is determined not only by the nature of the tissues that are damaged ,as they change from the age of 20 to 60, but also the types of activity and behaviour that each age group demonstrates.The 20-30 year olds tend to suffer from the ‘trauma’ type injuries. Broken bones, ruptured ligaments, dislocated shoulders, disc prolapse and gross muscle strain. By and large this group are involved in the high risk sports and behave with wanton abandon.

The majority of their ‘overuse’ type injuries are inflammatory in nature – acute bursitis, acute tendinitis, shin splints etc.. These come on reasonably quickly and if well managed tend to disappear quickly also. As most of the injuries in this group are the trauma type, prehab programs for avoiding injury should focus on joint stability. And as we know that tissues start to change later in life, improving flexibility in this decade will help you avoid injury in latter years. Unfortunately, most 20 year olds don’t recognise the value in this.

The 30-40 year olds are at the crossroads. They slowly start to pull out of the dangerous and reckless pursuits and progress more into the cross training, adventure racing, 100km bike rides etc… They are also the group that tend to suffer the most from ‘occupational’ stress. Long hours at the computer, long shifts in the nursing wards or the factory. Unfortunately, this age group is where the significant ‘white tissue’ changes start to occur – from 30-50 years of age. Tendons are slowly starting to degenerate, small bone spurs are starting to form in joints, cartilage is starting to thin and muscles are laying down more fibrous fascia and non contractile tissue. The issues this group suffer from are more the overuse type of conditions, not because of poor tissue structure, but simply because they still think they can do what they did in their 20’s.This group need to spend more time on recovery strategies. Regular massages, more time between high intensity sessions, and a commitment to the ‘preventative’ type activities such as Pilates and Yoga.

The 40-50 year olds start to suffer the true ‘degenerative’ conditions. The white tissue changes have had 10 years to settle in so these tissues are becoming more and more worn out and frayed. What the Masters athlete has trouble comprehending is that a lot of what they are now feeling started on a subclinical level years ago. It has just taken a long time for the degeneration to kick in and lead to a situation where tissue damage is causing the pain.The good thing about the ‘white tissues’ is that they do tend to respond to a constant low load in the form of preventative exercises for the tendons and joint cartilage. If I was to encourage this group to do anything that is preventative, it would be the following regime of ‘tendon’ strengthening exercises;

  • Calf raises – go up on two legs and then come down on one. On the next repetition, swap the leg you come down on. This does not need heavy load. Enough weight so that you can perform 3 sets of 15 reps each leg.
  • 45 degree lunges. Step forward on one leg and allow the knee to bend 45 degrees. Come back to the top and then lunge forward with the other leg. Perform 3 sets of 15 reps each leg.
  • Empty can raises. Hold a light dumbbell with your thumb pointing forward. Lift the dumbbell out to the side up to 45 degrees but turn the thumb down during the upward lift. This directly strengthens the most commonly damaged rotator cuff tendon – the supraspinatus. Perform again 3 sets of 15 reps.
  • Wrist extensions. Hold a light weight over the edge of a table. Hand facing down. Curl the wrist upwards without the forearm moving. Use enough weight to allow 3 sets of 15 reps. This strengthens the muscle most likely involved in tennis elbow

Finally, the 50+ group are the ones to suffer the nasty rotator cuff ruptures, the osteoarthritic knees and hips and the grossly degenerated lumbar spine discs. This group probably represent the more likely group to need some sort of surgery to help their problem. It may sound like a bit of a death sentence but by the time someone gets this stage, then most if the ‘prehab’ interventions won’t help much. The horse has already bolted. The preventative work needs to have started much younger.

Other take home messages for the Masters athlete;

  • Maintain bodyweight. One of the biggest predictive elements to arthritis, patellofemoral pain and back pain is bodyweight. By avoiding the midlife weight blow out, some of the degenerative ailments can be avoided.
  • Cross train. Try and avoid repetitive activities. Mix up in a training week cycling (spin classes), swimming, walking, running, boxing, crossfit classes. This way you can share the stress around your body on a weekly basis. Avoid running stairs 3 times a week like I have done.
  • Do a regular Pilates and/or Yoga class. The core stability benefits and the flexibility benefits are immense.
  • Have no longer than 4 weeks off. If you go on holidays or fall ill, try and be back into a routine by 4 weeks. Any longer and you will start to notice consistent aches and pains.
  • Perform 2 gym sessions a week. The benefits of resistance training for bone density, muscle mass gain, fat loss and joint stability have been well documented. If governments could fund gym memberships for all 40+ citizens, then we would most likely see a reduction in the demands on health care systems down the track. If only I was a policy adviser.