Playing It Safe
Never before have so many baby boomers been so physically active. What's their secret to maintaining lifelong fitness?
By Sherry Ballou Hanson

Barry Copp, 51, of Carlisle, Mass., is a teacher and former Army first lieutenant who served during the Vietnam War. Except for a hand broken during a climbing expedition when he was "young and foolish," he has led an active and injury-free life.

"I was never one to warm up much, but when I jogged I would certainly start off slowly," Copp explains. Though he is not able to get out to run as often with a new baby in the house, he still walks, hikes, and skis. Staying active is his key to a successful physical lifestyle. But not everyone Copp's age is as fortunate.

Dr. Nicholas DiNubile, chief of orthopedic surgery at Delaware County Memorial Hospital in Drexel Hill, Pa., describes "boomeritis" as a phenomenon where people born between 1946 and 1964 are showing up in increasing numbers with sports injuries. The American Academy of Orthopedic Surgeons (aaos), of which DiNubile is a member, reports more than 1 million sports and exercise-related injuries occurred in baby boomers just in 1998 (the latest year for which statistics are available). This dramatic increase over previous years may be attributed to the growing number of people over age 50 in this country who continue to be physically active.

Staying active is great, but "where are you fitness-wise?" is the question anyone contemplating physical activity should ask him- or herself, says Dr. Letha Griffin, an orthopedic surgeon at Peachtree Orthopedic Clinic and Piedmont Hospital in Atlanta. Have you been active all along, or are you living a sedentary lifestyle? Do you have a past injury or injuries to musculoskeletal tissue that might be weak links?

Facing facts

"Body changes happen to all of us, usually around age 40," cautions DiNubile, whose duties include serving as orthopedic consultant to the Philadelphia 76ers basketball team. Tendons, ligaments, and the disks in the lower back and neck become more prone to injury. Muscle loss usually begins shortly after age 40, and people who are not physically active may lose 30 percent of their muscle mass over a 20-year period. As aging muscles lose endurance and strength, they become more susceptible to injury and need more recuperation time.

But DiNubile offers some hope. "Changes are inevitable, but problems are not." If you have not been active, start gradually with a walking program, making sure you allow for past injuries. You may have been a marathoner in your 20s, but if a knee injury sidelined you, sports such as biking, power walking, or swimming might work better now, especially if you want to become active again for the long haul.

Common injuries

According to the aaos, sprains and strains are the most common injuries in sports. A sprain is a stretch or tear of a ligament, a band of connective tissue that joins the end of one bone with another. Feet and ankles commonly are sprained in sports like basketball and volleyball, which require jumping.

A strain results in a twist, pull, or tear of a muscle or tendon, a fibrous cord that attaches muscle to bone. Chronic strains result from overuse or prolonged repetitive movement of muscles and tendons. Hand strains can occur in tennis, rowing, and golf, while elbow strains frequently result from racquet sports and throwing. Quick-start sports like competitive running also put an athlete at risk for strains.

And don't forget your feet. "To prevent foot problems, make sure your shoe is the shape of your foot," urges Dr. Gail Dalton of the aaos. Ninety percent of foot surgery is performed on women, she adds, because women often wear shoes that are too small. Also be aware that as people age, their feet become longer and wider, the arches fall a bit, and padding on the heels and balls of the feet thins out. The shape and size of your shoes need to match your feet as they are today, not as they were 20 years ago.

High-arched feet and flat feet are more prone to injury than feet that fall somewhere in between. "The high-arched foot is hard to fit and may be more prone to stress fractures," says Dalton. Such a foot may need a more cushioned shoe. The low-arched foot, which is more flexible and more apt to get bunions, needs more support (see "Choosing the Right Gear," page 70).

Training tips

But boomeritis is no reason to stop exercising. Fitness is essential to healthy aging, and age 40 is no time to quit. Instead, "accept body changes, and listen to your body," says DiNubile. "Train smarter, not harder."

DiNubile emphasizes a balance in physical conditioning: A safe and well-rounded physical conditioning program includes cardiovascular/aerobic, strength-training, and flexibility activities. For example, David Fothergill, age 38, an exercise physiologist in Groton, Conn., works for the U.S. Navy on its diving bio-effects team and is an avid biker. "I bike year-round. During the summer months I ride to work three or four times a week, a round-trip of 26 miles, and do a longer road ride every Sunday with a cycling club." Fothergill balances his biking primarily with weight training, calisthenics, and swimming.

According to Griffin, the latest aaos guidelines on cardiovascular fitness suggest that even a mild increase in heart rate (30 minutes a day in 10-minute increments) works to increase fitness. Strength training with free weights or weight machines builds muscle strength, endurance, and bone density. And no matter what you do, stretch daily (try yoga or the martial arts) because increased flexibility protects against injury. People definitely tighten up with age, especially the muscles and tendons along the front of the shoulder, lower back, hamstrings, and calf muscles.

High-impact activities such as running and intense aerobics become riskier as we age — as does performing the same workout or sport continuously. "Never work the same muscle group two days in a row," advises DiNubile. And, "break a sweat [by warming up] before a heavy workout," he adds. Finally, round out your active life with a well-balanced diet to nourish muscles, and choose proper gear for your sport.

What's your sport?

Running: Copp's favorite activity has been running, but as the miles add up, so do the risks. Repetitive motion injuries can occur as well as damage to feet, knees, and the back from the jolting movements.

To minimize this risk, follow a progressive program to build distance gradually. Always warm up for at least five minutes and then stretch, especially the Achilles tendons and hamstrings. (These are the muscles on the back of the leg, which tend to tighten and shorten when runners do not stretch adequately.) Stretch again after your run.

Get fitted properly for shoes, looking for good shock absorption and allowing a thumbnail's width between the end of the shoe and the longest toe. Run on a clear, clean surface, preferably not asphalt.

Biking: Properly selected and maintained equipment is important while biking. Wearing a helmet is highly recommended. Also, make sure your seat is level and high enough so your leg is flexed only 10 degrees to 15 degrees when the pedal is all the way down.

Start your ride slowly and build intensity after you are warmed up. Finish with a few minutes of slow pedaling to bring your heart rate down closer to normal. Cross train with weights to keep your upper body strong.

In-line skating: More than 26 million Americans participate in this sport. Safety equipment — this includes a helmet, wrist protectors, and knee and elbow pads — is key, as injuries can occur even when you fall standing still. Beginners should take a lesson to reduce the likelihood of injury and should avoid uneven surfaces and hills. Learn how to move and how to stop before you venture into confined areas with other skaters or into traffic.

The boot of your skate should fit comfortably over all parts of the foot, including the socks you will wear skating. Purchase your skates at the end of the day when your feet are at their biggest.

Basketball: This sport becomes riskier with age, but many injuries can be avoided or at least reduced. Warm up for five to 10 minutes, and stretch your groin, hamstrings, back, and shoulders before you play. Shoe selection is critical: Choose a shoe that absorbs shock and fits well but is not too tight.

If you have any old injuries, wear protective padding. If you need eyeglasses to play, use safety glasses or glass guards.

Tennis: "Tennis elbow" may be the first thing that comes to mind, but proper technique can help you avoid this repetitive motion injury. Start backhand swings from the shoulder, and bend your arm on both forehand shots and during service. Always warm up and stretch.

To prevent foot, ankle, and back injuries, wear good tennis shoes with support; two pairs of socks help, too. Avoid landing on the ball of the foot, and don't make sudden stops and starts, which can sprain an ankle.

Golf: The leading injury to golfers is golfer's elbow, but injuries also can occur at the knee, hip, wrist, and spine. To avoid golfer's elbow, the aaos recommends strengthening the forearm and slowing the swing, so there is less shock when hitting the ball. You can develop the forearm muscles by squeezing a tennis ball for five minutes and doing palm-up and palm-down wrist curls with a light dumbbell.

The rotational stress of a golf swing, combined with poor flexibility and muscle strength, can cause minor strains in the back that escalate over time. Try using a rowing machine, or perform pull-downs or other exercises to strengthen the upper body. Stretching before your game is a good idea.

Skiing: Skiing leads the list of winter sports with the most injuries. The annual cost for injuries is more than $5.57 billion. Knee injuries are the most common; severe twisting or bending of the knee can tear the anterior cruciate ligament.

If you're a beginner or have been off the slopes for a while, start with a ski lesson. Know your limits and stay in control, cautions the National Ski Patrol. Equally important: Stop before you get tired.

Ski with your hips above your knees. If you start to fall, keep your arms forward, feet together, and hands over the skis. Don't fully straighten your legs if you fall, and don't land on your hands. Dress in layers and wear eye protection.

If you get injured

Anyone can be injured during physical activity, but those over age 40 can avoid being sidelined by remembering two simple facts: You become more susceptible to injury as you age, and if you get injured, you require more time to repair the damage.

After an injury, muscle tissues become somewhat less compliant, and stretching is more important than ever. Be sure to finish whatever physical therapy program you are doing, and get your doctor's clearance before resuming your sport. If at all possible, try to do some type of aerobic exercise to maintain cardiovascular fitness while you recuperate, recommends Griffin. For example, if you are recovering from an upper-body injury, get in the swimming pool, walk, or pedal on a stationary bike. Injured runners have fewer options, but weight machines and swimming laps in the pool may work.

Emphasize cross-training as you come back from an injury so you aren't setting yourself up for a repetitive motion injury or strain. And above all, seek expert advice sooner rather than later, recommends DiNubile. Find an orthopedic surgeon or sports medicine specialist who believes in exercise. He or she can help you design a fitness routine to promote wellness and minimize chances of further injury.