Seniors and Physicians Form Active Partnerships
THE PHYSICIAN AND SPORTSMEDICINE - VOL 27 - NO. 11 - OCTOBER 15, 1999
Seniors who age actively aren't always the ones who were athletes in their younger years. When people who have been sedentary for years or decades discover the rewards of regular exercise, their lives can change in remarkable ways. And this can happen at just about any age.
As older patients embrace exercise, their physicians take on vital supportive roles: They encourage, treat injuries, and prescribe activities such as resistance training that can help patients stay active.
Shooting Buckets With Grad Students
Ten years ago, Winifred Bedford, now 82, overhauled her lifestyle by adding regular aerobic exercise and swimming and changing her diet. She says she's the fittest she's ever been, and she has no health complaints.
Her physician, Henry C. Barry, MD, MS, associate professor in the Department of Family Practice at Michigan State University in East Lansing, is impressed by his patient's vibrancy. "While I have had no need to suggest modifications to her regimen, I have tried to emphasize fun," reports Barry. "To that end, she played basketball with the graduate students who rented rooms from her!"
The East Lansing resident says she was sedentary for many years. "I've never been the sports type," she says. "When I was in my 50s and 60s, like everybody else I started to get fat."
Her major medical problems have been arthritis in her wrists and fingers, hypertension (her blood pressure was 154/90 mm Hg), and melanoma, which is still being followed. None, however, presented insurmountable barriers when Bedford decided to change her lifestyle. She designed her own dietary program, deemphasizing meat in favor of fruits, grains, and vegetables. "I drink orange juice when I get up, do my exercises, and, as a reward, have raisins with my cereal," she says, adding that broccoli is a lunchtime mainstay.
She starts each day with 17 minutes of stretching and resistance exercise. She has been swimming 3 days a week for years. Now, she's added exercise on nine Nautilus machines to her swim-day regimen. On the other 4 days, Bedford does aerobics to Richard Simmons or Jane Fonda videotapes.
The results of her lifestyle changes: Bedford's weight dropped from 154 to 123 lb, and her blood pressure ebbed to 125/70 to 80 mm Hg. Bedford attributes her blood pressure decline to swimming. And, she adds, "I've had arthritis, but I don't have any now. The exercise seems to get rid of it." She only feels a slight pain in her right wrist when she bends it a "certain way" while working in the yard.
Despite her healthful routine, Bedford is still working on one difficult lifestyle issue. "I smoke like a chimney," she admits. "But Dr Barry gave me the lecture again, so I decided to try to get off them."
Fitness Walk Competitor
Julius "Jules" Curley, 94, was inactive for 41 years. As an advertising manager on the East Coast, his daily schedule afforded little leisure time, and he often worked weekends and holidays.
Five years ago, he began taking a twice-a-week chair exercise class at his retirement community in Ann Arbor, Michigan. Later, he increased his class attendance to four times a week, and last year he participated in a 5-km fitness walk. He used a stroller for balance and was escorted by his son and a reporter from the local paper. He had a boom box in the stroller playing Frank Sinatra's rendition of "My Way."
To stay fit for his walking activities, he does leg strengthening exercises. His physician, Thomas Schwenk, MD, professor and chair in the Department of Family Medicine at the University of Michigan Medical School in Ann Arbor, has prescribed physical therapy and home exercises to complement Curley's strengthening regimen.
"Dr Schwenk says I have the body of a 70-year-old," says Curley, who is on no medications. "I feel like it." Schwenk says Curley is "perhaps the healthiest and fittest 94-year-old I have ever seen."
From age 10 through college, Curley walked and biked up to 6 days a week, managing a crew of boys selling magazines. After graduation, Curley stopped exercising. With age, his health deteriorated. He developed arthritis in his right shoulder and an enlarged prostate gland.
Curley credits exercise and magnetic therapy for relieving his arthritis. "He had some mild joint pain and started using magnets, which he believes helps," Schwenk said. "Far be it from me to deny this, but we have no explanatory model for how magnets help with such pain, although they are used and marketed widely."
In last year's 5-km fitness walk, Curley had to take frequent breaks to catch his breath, but he reached the finish line in an hour and 40 minutes. This year he couldn't participate because of overtraining, he says, but he vows to be ready next year. Says he, "I'm getting better and better as the days go by."
WILLIAM VAN HORN
Despite nursing an injury to his sacroiliac (SI) joint, William Van Horn, a 66-year-old professional massage therapist, is planning to compete in not only the Canadian Ironman Triathlon, but also the Ironman in Hawaii.
Though the injury has affected Van Horn's routine, he is still one of the top-ranked triathletes in his age- group. A former US Marine and construction worker, he took up marathon training at age 42 after becoming concerned about his weight (then 244 lb on his 6 ft 1 in. frame). "The more active I got, the better I felt," Van Horn says.
In 1978 he ran his first marathon, and in the early 1980s he competed in his first Ironman triathlon. "I didn't train for it. I was running at the time, but hadn't been on a bike," he says. Since then, he's competed in more than 300 similar events. "I've been the national champion a couple of years and I've had my slow years too," he says.
To prepare himself for triathlons, Van Horn swims several miles and cycles about 60 miles per week. Because the injury to his SI joint causes sciatic pain, he walks 40 miles each week instead of running—with the blessing and encouragement of his physician, Warren Scott, MD, a family practice and sports medicine physician at Permanente Medical Group in Santa Clara, California.
Van Horn is still near the top of his game, and his ability to train despite injury illustrates a point that Scott says many of his colleagues are a little hesitant to accept: An athlete's age does not affect the healing process. Exercise accelerates healing by stimulating blood flow to the muscles, Scott says. And rehabilitation of a well-conditioned older athlete will mirror that of a patient 20 to 30 years younger, he adds.
Though the degeneration that comes with old age brings its own set of problems, Van Horn says he has yet to face them. He says his only problem is occasional hip pain. Scott says the pain is normal.
Scott is working closely with Van Horn to help him overcome his SI injury. "The problem can really fluctuate from day to day. He can run up a hill and be fine, but downhill it can bother him," he says. Scott has designed short- and long-term treatment programs that include stretching to keep the joint from tightening up.
Mr Louisna is a freelance writer in Miami.