Case Study: Considerations for the Older Adult Athlete

I would like to share the story of one of my long term clients, Dave, whom I have been training for nineteen years.  In many ways, Dave represents the new face of growing older – at 69 years of age, he is an excellent skier who does extremely difficult black diamond runs, and tries to stay active in the non-winter months swimming, biking, and using his ellipital trainer and Stairmaster.  He speaks of the challenges of learning to achieve high-level ski skills without having skied as a child.  Although all skiers must work on strength, propriception, and skill development, Dave is cognizant that he is at a particular disadvantage for this aforementioned reason. Dave’s specific goals were: 1.    Regular adherence to an exercise program 2.    Skill and strength development for high level skiing (ie, black diamond runs) 3.    Safeguard general health as he ages In recent years, Dave has given more credence to safeguarding his general health.  He has had several health challenges since we have been working together – including two major abdominal surgeries, two hernia surgeries, a foot injury, and tendonitis in his shoulder – that have underscored for him the importance of staying strong and fit as he ages.

Plan of Action I engaged the same process in starting a training program with Dave as I do with all new clients: a comprehensive Fitness and Lifestyle Evaluation which involves a client interview, extensive health history, physician clearance, and fitness assessment (baseline cardiovascular measures, anthropometric measurements, cardiovascular testing, postural and gait analysis, strength and ROM testing). My assessment revealed that while Dave’s cardiovascular fitness level was very high, lower body strength was moderate, upper body strength low, and proprioception an area that required attention.  With this in mind, I recommended that our weekly session incorporate high intensity strength training - the discomfort of high intensity training often makes it challenging for clients to engage in it of their own free will, so to speak! Program Design •    Training with a heart rate monitor, using a HR range I determined based on Rate of Perceived Exertion as opposed to 220-age or the Karvonen Formula (standard heart rate prediction models drastically underestimate heart rate for very fit, older individuals) •    Multiple sets of 3-4 closed chain lower body exercises •    Single set upper body training during ski season, multiple sets during the off-season •    Postural and scapular stabilization exercises, to balance out the forward flexion stance of skiing. •    Constant verbal and tactile feedback regarding proper technique and positioning to facilitate improved proprioception. Outcome It is a marvel to look at Dave’s program sheets over the many years we have been together and see to what extent his strength has increased!  He is stronger at age sixty-nine than he was eight years ago.  He reports that he skies better than ever - doing runs that individuals much younger than him are unable to tackle.  The first ski season after we started training was Dave’s best to date.  Looking through his file, I saw that he said the same thing in 2006 and 2007!  So while his skiing improved quickly after we started training, continued improvements were seen over a period of many years. Furthermore, training Dave has been a good lesson for me in finding the harmony between creative programming, and doing what is best for the client.  I have not felt that using a cornucopia of different exercises would be to Dave’s benefit, despite my love of being inventive with the programs I design.  There is a trend these days in the fitness industry toward variation and creativity, which is not the right approach with every client.  In some cases, this trend can even lead to injuries. Recommended Reading

  • Growing Old is Not For Sissies: Portraits of Older Athletes, by Etta Clark.
  • Second Wind: The Rise of the Ageless Athlete, by Lee Bergquist.
  • “Fit at Fifty”.  The Globe and Mail.  http://www.the globeandmail.com/life/health/fit-at-50/

"I ran the marathon for my 60th birthday; I wanted to do something outrageous and impossible." -Kaye Durland Spilker (first time marathoner) "I started running at age 72 because I was tired of all the boring talk about funerals." -Ruth Rothfarb (who ran her first marathon at age 81)