Aging Athletes: Maintaining Performance and Health

Baby Boomers, likely the first generation raised with a focus on the significance of exercise, have led to a surge of adults over 60 more active than previous generations. However, as we age, more activity can increase the risk of injury. Most literature focuses on injury risk for athletes under 35, and athletes aged 40, 50, 60, and beyond bring their own unique challenges with exercise. In addition to reviewing the effects of aging on the body, mind, and spirit, let's examine how the body changes with age and how training should be adjusted for athletes.

Living a healthier life as we age is a goal many of us have. Even more so, people who spend most of their lives focused on healthy-living are athletes. Whether they have been training much of their adulthood or taking on a more active role in later life, the focus is on health, fitness, and pushing their bodies to the limit. This includes runners, triathletes, professional athletes, etc. None of us can escape the process of growing older, but due to several age-related changes, aging athletes may be at a greater risk of injury. So, what can they do to protect themselves from injuries and other risks?

The aging body

As our bodies age, we undergo several changes at the cellular level that may ultimately affect our health. The process of cells dividing and replicating becomes slower, resulting in bodily systems wearing down. One such process is cellular senescence, where the cells “retire” after several replications. The DNA in these “retired” cells can contain errors that may lead to chronic disease.

Telomere shortening is another process of cellular aging. Telomeres are the protective caps on the DNA ends that shorten with each cell replication. Again, as the DNA shortens, there is the potential for errors.

While not exclusive to athletes, a person's overall health, genetics, lifestyle choices, and habits influence the rate and intensity of aging bodily systems. Studies have suggested that how we treat our bodies affects the rate of cellular aging, and some studies hint at the possibility of reversing aging.

Flexibility

Years of intense exercise can overload joints and cause cartilage thinning. Our joints and tendons tend to have reduced flexibility and range of motion as we age. This reduction in elasticity may result in an athlete's increased risk of injury. Tears in the Achilles tendon are common since a person loads up to 10 times their body weight during running and jumping.

Muscle mass

A decrease in muscle mass is also called "sarcopenia." Muscle mass decreases as we age by 1–2% per year. This reduction in strength makes it more difficult for athletes to lift heavy weights or run as powerfully as they may have when they were younger. Muscle strains common in the aging athlete tend to be injuries involving the lower legs and the calf muscle. The aging bodybuilder, however, is at risk for bicep muscle tears.

Bone density

Bone density diminishes with age, known as osteopenia (bone loss), causing bone weakness. Menopausal women can lose 3–5% of bone density annually. This bone depletion may progress to osteoporosis and increase the risk of fractures, especially if athletes engage in higher-impact sports such as football or soccer. Stress fractures commonly occur in the lower extremities, tibia, and foot.

Cardiovascular

A person's cardiovascular capacity also changes as they age, which can be responsible for an athlete's decreased endurance. Aging may be responsible for making blood vessels less elastic and reducing cardiac output. As a result, there is a decline in “maximal oxygen consumption” (VO2), and the athlete may be unable to engage in higher endurance sports activities like they once did.

Coordination and balance

Due to changes in sensory perception and muscle response time, maintaining balance becomes more challenging as we age. This disruption in balance increases the risk of injury due to falls, which can be detrimental in any situation, especially in sports requiring precise movements.

Nervous system

Aging affects the nervous system by the possible slowing of nerve conduction. This means a person's reaction time and possibly their cognitive status could be affected. This impacts a person's reflex ability to make split-second decisions, increasing injury risk.

Hormonal changes

As we age, there is a depletion of hormones such as growth hormone, testosterone, and estrogen. The changes in hormone levels can affect a person's bone density and energy level for higher endurance activity. Muscle growth slows, as well as the ability of the body to recover from the muscle strain of an intense workout.

Training for aging athletes

Because several physiological factors are in play, the aging athlete must adapt their training methods accordingly. Most literature associated with sports injuries focuses on the under-35-year-old athlete; however, athletes in their 40s, 50s, 60s, and beyond each have their own unique set of risks and challenges with training. Focusing on strength training, balance, and coordination exercises, along with working on flexibility, can reduce injury incidents while engaging in athletic activity.

In one study of the patients presenting to a hospital's emergency department, 50% were for musculoskeletal injuries. While most of those patients were younger, the older adults with the injury had a much higher severity due to the aging systems.

Practice preventative healthcare

Regular visits to your primary healthcare provider for prophylactic healthcare are vital to achieving and maintaining optimal health as we age. Regular labs and screening for chronic conditions associated with aging can ensure the aging athlete can maintain their level of activity and diagnose conditions in their early stages for prompt treatment.

Strength and functional fitness

It's essential for training to include exercise that improves strength, balance, and flexibility. Strength training will help to reduce muscle loss that leads to sarcopenia. This will not only help the athlete on the field but also aid in safety in everyday activities around the home. According to the Centers for Disease Control and Prevention, falls are the leading cause of fatal and nonfatal injuries in adults over age 65.

It is so important to prepare your body before you start exercise by stretching your muscles and having a cool-down period when you complete your activity.

When engaging in muscular training, it is essential to consider cross-training with flexibility exercises to prevent the overuse of muscles. Consider incorporating yoga or Pilates to improve flexibility.

Nutrition

Proper nutrition is always essential for active people. You should ensure that you consume a diet with adequate protein, vitamins, and minerals to build muscle mass and provide food for energy. You can consult a registered dietician to provide a comprehensive diet plan appropriate for your needs.

Maintaining adequate hydration is crucial to regulating body temperature during exercise, maintaining blood pressure, and supporting good cardiovascular health.

While supplements are very popular, you must consult your healthcare provider to review any supplements for your regimen to ensure safety.

Cardiovascular training

Athletes training for a significant amount of time typically have reduced rates of chronic illnesses such as cardiovascular disease, diabetes, and metabolic syndrome. However, there are sometimes genetic predispositions and unknown underlying conditions that present a risk.

Incidents of higher-than-average cholesterol can result in plaque build-up in the arteries, thereby increasing blood pressure and raising the risk of coronary artery disease. Underlying coronary artery disease can increase the risk of a myocardial infarction (heart attack) or sudden death. Regular visits to your healthcare provider are advisable.

Incorporating some low impact exercise into your routine, such as walking, swimming, or riding a stationary bicycle, may be beneficial.

Mental preparation

Athletes need to exercise and maintain their mental fitness to maximize their physical fitness. Although aging athletes are known to experience lower rates of anxiety and depression, maintaining care for your mental health is still a priority.

Consider practicing techniques like mindfulness, prayer, or meditation to achieve focus and nourish your inner self.

Because aging may present a gradual decline in physical performance or changes in an athlete's routine, maintaining a positive attitude and confidence becomes a driving force for motivation.

An athlete's endurance and performance may change as they age, so setting realistic goals is essential.

Consider consulting a mental health professional to help you with strategies to manage changes due to aging.

Connecting with other active people of your age and stage in life may be helpful so you don't feel alone in your journey.

As we age, there are changes in our bodies that indicate this process is occurring. While it may be more evident in older adults who have been sedentary, people engaging in more vigorous activities may delay, but not escape, age-related changes. Adjusting physically, as well as preparing mentally, is equally important. Maintaining a routine with a healthcare provider can help address concerns promptly so athletes can remain active for as long as possible.