Pickleball: Yay or Nay for Older Adults?

Have you caught Pickleball fever yet? It seems like it is spreading faster than COVID. Pickleball is an indoor or outdoor racket/paddle sport where two players (singles), or four players (doubles), hit a perforated hollow polymer ball over a 36-inch-high net using solid faced paddles. The two sides hit the ball back and forth over the net until one side commits a rule infraction. Although the sport has been around since the mid-1960s its rates of participation have grown significantly over the last few years–aided in no small part by the pandemic, which made outdoor activities more popular.

I have been interested in picking up the game myself even though I am not real good at sports that involve a ball; I am more of a runner, cyclist, fitness kind of guy. There are concerns, though, about how safe the game is for older adults like myself. According to a recent article in The New York Times, there were 19,000 pickleball injuries in 2017 (before the sport boomed), with 90% of those being over the age of 50.

The most common injuries are those related to the rotator cuff tendon in the shoulder according to the Baylor College of Medicine. Other injuries include miniscus tears, tendon ruptures, and exacerbation of arthritic knees. The best way to prevent injuries is to warm up before a game; such a warm-up should include some light cardio like jogging, cycling, or walking briskly to the point of a light sweat, as well as stretching. A cool down should include additional stretching. Of course, if there is soreness after playing, cold can be applied and over-the-counter anti-inflammatories can be taken. If a condition persists, it is best to consult a medical professional.

All that being said, should older adults avoid pickleball? While 19,000 seems like a lot of injuries, it is well below other sports such as basketball or riding a bike (which is where most injuries are for those over 65), there are many advantages to pickleball. It is relatively easy to learn and more and more venues are available to play. It also has benefits for the cardiovascular system; it provides a good aerobic workout which can help lower reduce the risk of high blood pressure, stroke, and heart attacks. Pickleball is great for boosting hand/eye coordination and can help with balance. Perhaps most important, Pickleball is fun and social; this means that participants enjoy the experience and are therefore more likely to stick with it, making the game part of a good strategy for senior fitness.

Will I give it a try? If the opportunity presents itself I will. I am aware of the risks and will take the appropriate steps to keep myself away from injuries. It sounds like fun and a great workout!

Protecting those Knees

As we age, we hear more and more about people requiring knee surgery or even knee replacement. While the knee is not the most complicated joint, it is one that gets a lot of use and bears a lot of weight. It is important to be cognizant of the proper form while exercising to avoid injury; in particular, doing lunges or squats the wrong way can put a great deal of pressure and stress on the knee.

When we talk about the knee, we cannot just talk about the bones (the femur, tibia, patella, etc.) but also about the tendons, ligaments, and cartilage. All of these are susceptible to strain and injury. Working with a fitness professional is one way to help ensure that knees stay healthier–or at least avoid serious damage.

A new study referenced in the most recent issue of IDEA Fitness Journal reaches some enlightening conclusions about the connection between exercise and the risk of physical harm to the knees. As a runner (although I run less now than I used to), I always worried about the risk to this all-important joint; I assumed that our knees were like tires: they last for certain amount of miles and then they need to be replaced! Researchers at the University of Southampton and University of Oxford (both in England) found that the benefits of exercise–even for the frail and elderly–outweights the risks with regard to our knees. The study focused on the likelihood of developing knee osteoarthritis from physical activity. 5000 participants were followed for 5-12 years and the data suggests that neither the amount of energy spent in physical activity or the length of time were associated with a risk of developing arthritis.

This is good news; my last blog post focused on a related idea. Many people are afraid to work out for a variety of reasons–including injury. Studies show that the more information that can be shared with those beginning an exercise regimen, the greater the chances of success; that information should include debunking myths and stressing the benefits of exercise (versus the risk of not) as well as setting proper expectations of what the process will be like.

My knees have not worn out (yet), but it is good to know that it does not appear that years of running and physical activity might lead to knee arthritis in the future. One more reason to go boldly ahead keeping myself fit for whatever the future brings.

What Could Possibly Go Wrong (Part II)

Two Vintage Red Cross Bandage Boxes

In my last blog post, I wrote about ways to keep yourself safe while working out at home–focusing on having a safe and secure workout space.

Preventing injury requires more than just cleaning up a large enough space and getting possible obstacles out of the way. There are factors to take into account both at home, and at they gym to consider. An article in at http://www.aarp.org points out 5 issues to bear in mind when embarking on a fitness journey; these factors are especially relevant for older adults.

  1. Start slowly. With New Year’s Resolutions on the horizon many of us may resolve to start working out more often. Going from 0 to 60 in 3 seconds may be great for a sports car, but our bodies require us to move forward gently–especially if we have been sedentary for a while. Working out for too long, too often, or with weights that are too heavy is a recipe for injury. Muscles need to get used to the new routine; they need to grow and strengthen before we get more intense. Ease into it.
  2. Speaking of going from 0 to 60, every workout should begin with a warm-up. Typically, a before-workout warm-up should involve dynamic stretches or motions; in other words, they should be comprised of actions similar to those you will do as part of the workout, just at a slower, more gentle pace. The goal is to warm up the muscles and get the blood flowing throughout the body. Static stretches can be done after the warm-up, or (as I prefer) after the workout; static stretches are the ones where you hold a certain position for a given amount of time.
  3. Get the right athletic footwear. Shoes are like tires; some work better in different situations, and some only work on certain models. As we age, many of us develop issues with our posture and the rest of our kinetic chain (think of the hip bone connected to the thigh bone…); proper athletic footwear can help us excel, avoid pain, and stave off injuries. Like tires, they also have a mileage limit; if the treads on your shoes are gone, time to get new ones. I recommend going to a shoe store that only sells athletic footwear; their employees are trained and can get you the right fit for whatever quirks your feet might present. Do not let me catch you barefoot or in socks!
  4. Switch it up. Do not do the same exercise day in and day out. First, you will get bored. Second, you may cause injuries due to overuse. It is also important to work all the various muscle groups; varying the workout can help make that happen.
  5. My favorite one: if you are not sure about how to begin, reach out to a fitness professional. Most gyms have personal trainers or other fitness experts who are happy to help; often, an initial session is offered for free so that you can get acquainted with the gym and its equipment. If you prefer to work out online or one-on-one with a trainer at home, there are personal trainers who specialize in these kinds of settings–and you will probably save money not having to pay for a gym membership. A trainer will make sure that you cover most of the points above and will help keep you on track. There’s nothing like a good personal trainer to keep you accountable to your goals.

Of course, injuries do happen. Sometimes there are accidents, and other times we have physical weaknesses of which we are not aware. While there are no guarantees, the points above are certainly excellent guidelines to keeping your workout–at home or at the gym–less likely to cause an injury.

Watch Your Form while You Watch that Screen

Exercise Videos

One of the worries that people have when going to work out at the gym is that they may do an exercise “wrong;” in other words, the form may be off. To the casual exerciser, this may not seem like such a big deal…”so what if my foot is in the wrong place or my back isn’t straight?” Not having the correct form is not only a problem in terms of possibly not getting the full benefit of an exercise, but also it can lead to injury.

This is one of the reasons why people like to work out with a personal trainer–especially if they have injuries or are older. A trainer will ensure that exercises are done properly and help prevent injury. Of course, there are dozens of other reasons to hire a personal trainer, but this is really at the heart of it for many; no one wants to end up worse off than when they started.

It is hard enough to figure out the way to do an exercise correctly at the gym (where you might be able to ask a fitness staff member for assistance, or watch someone else’s form, or even have someone “nicely” correct you). With so many of us avoiding gyms and working out at home, the risk of performing a move incorrectly and possibly injuring ourselves increases. Here is a recent article at http://www.cnn.com that addresses this very issue: https://www.cnn.com/2021/01/22/health/proper-form-common-mistakes-online-workouts-wellness/index.html.

When we are at home, we are often less motivated to work out in the first place. Add to this that we may be watching a video or tuned into a fitness class with a bunch of other people, and it may not be the best recipe for success. The instructor–whether the workout is live or recorded–will often give instructions to help keep form the way it should be, but it is not the same as one-on-one on-line or in-person. S/he cannot see everyone all the time. Unless you are an experienced exerciser, it is important to be cautious.

I teach group fitness on-line. It is a challenge to instruct and keep an eye on participants in a gym setting–how much more so on a small screen. How to address this?

–Meet with the instructor one-on-one outside of class time. Many will do this for a fee, or if you are a regular participant in the class perhaps for free. Use that opportunity to ask questions and have your form checked.

–If you are unsure about an exercise, there are many videos available on-line by certified fitness professionals; if they are done well, they will show the move from different angles and give detailed explanations that may not be possible in a group setting.

–Watch your own screen or have a mirror nearby to check yourself. As you do an exercise, does your form match that of the instructor? I am a personal trainer and even I look at the screen to make sure my form is correct so that I am modeling properly for my participants.

–Engage the services of a personal trainer to help master the correct way to do exercises. This can be done in-person or virtually. I can do a much better job of ensuring proper form working with a client one-on-one than in the group setting. Do not think that working with a trainer in this way means that you have to be a client forever; it is not uncommon (and it is OK) to work with a trainer for a limited time.

Despite these warnings, virtual training can be an excellent option–especially for those who are more concerned about the spread of infection, as well as for older adults for whom getting in the car and going to a class might be more challenging. It is important, however, not to be lulled into thinking that form does not matter because “no one can really see me.” No one wants to be involved in an exercise regimen that will ultimately do more harm than good.

The Mental Work of Working through Physical Recovery

It has been one week since my foot surgery and hopefully only another three until I can walk again.
The physical recovery has not been as difficult as dealing with emotional issues that come along with an injury/illness. The first few days after surgery were not that tough; the block on my lower leg meant that I did not feel anything below the knee–especially pain. Once that wore off, I began to feel the discomfort. I really wanted to avoid taking pain meds since I don’t like the side effects, so I’ve been icing and trying to take it easy with several doses of acetaminophen daily. Today I wanted to go to morning minyan (prayer services); I got up, showered, got dressed, but was in too much discomfort to go. Big bummer.

The past several days have been difficult since I am so accustomed to doing a lot of the work to prepare for Passover. For those unfamiliar, imagine two Thanksgiving Dinners two nights in a row, but having to start with all new ingredients. In the past, I did a huge amount of the work and my wife pitched in with some sides and desserts. We were so excited to be doing all the preparation for the Seders together this year, but it ended up being all her. I tried to help where I could, but I felt kind of useless.

That feeling was made worse when I started receiving all the emails from the gym that all my clients were being cancelled for the entire month. That is a tough situation for anyone, but when you are just starting out in the industry and trying to build your client base, it feels devastating (even if the real effect may be much less). Since I don’t know what my recovery will be like and whether I will ever be back to where I was nine months ago before the pain began, there is an added level of anxiety. Will I be able to get back to training as quickly as I want? Will I have restrictions? Can I be successful at this new endeavor in my life? All questions swirling in my head.

It is always nice to have an objective party to discuss these issues with, and I did that today. I have in my mind that these four weeks are just a total write-off, but I can use this time productively. I will spend the week studying and hopefully obtaining my Functional Aging Specialization. Getting ready for that basically requires me to sit on my butt and read…I think I can do that this week. I also have to take things one at a time; I think we can all sometimes get into a downward spiral and follow a rabbit hole into the worst-case scenarios. I have to stop myself and let things unfold as they do without getting ahead of myself.

What has surprised me is just how much this recovery from surgery is emotional as well as physical. I have to deal with not working out, which is my usual stress reliever. I have to consider the possibility that my body may not fully recover. I have to face the fact that I am aging; this doesn’t mean that I’m all washed up, but rather that I have to change my approach. Hopefully, that awareness will make me a better Personal Trainer in the long run–especially as I train those in my peer group.

Wishing everyone a Happy Passover, belated Happy Easter, and all the best in whatever you celebrate. I also celebrate the process of healing–physically and emotionally. But it is hard work!

Learning from our Challenges, and Applying it to the Work We Do

The dog trying taking care of me

I am used to being very active–at the gym every day except for Shabbat training and working out. For the last 8 years or so I’ve been a runner: 3 half-marathons, more 5k races than I can count, several obstacle course races. So the thought of having to not WALK for four weeks is killing me!

I started having heel pain (most likely Plantar Fasciitis) back in late September when I was training for the Columbus 1/2 Marathon; it was a few weeks before the race so I couldn’t quit. Besides, it didn’t hurt when I ran…only afterwards. I finished the race (with my personal best time) but within a few days I knew I had a problem. I went to my podiatrist and we went through the usual conservative steps: new orthotics, stretching exercises, cutting down on the running. I even had a boot to wear at night that was supposed to flex my foot, but that was more annoying than the foot pain. Finally, I spent the last 5 weeks in a boot that went up to my knee. Unfortunately, while it improved at first, when I tried to walk for one hour without the boot, the pain was back.

Yesterday was surgery: stretching the Achilles Tendon was part 1, thinning out the plantar fascia was the part 2. Today I got my knee scooter so I can begin to get around again. Still, it is unclear how much or whether I’ll be able to train for the next month. I’ll need clearance from my doctor before I can go back to being on the Fitness Center Floor.

I am being forced to take a break–for a while at least. It makes me nervous. I rely on my workouts to ease stress, keep in shape, and for the social element as well. Training also helps to pay the mortgage. If I am unable to train, perhaps I will see if I can work at the Welcome Desk so I still feel a part of things.

Here is my real concern. All along I’ve told my doctor that I just want to be able to run again. We all have met people who tell us “I used to be a runner until….” I’ve also met folks who have said, “I was told I would never _____ again, but I did not give up.” I’d like to think I will be in the second category, but I hope I don’t have to make the choice.

When I am “fully recovered,” I hope I’ll understand what this all means. In the meantime, I now have a greater understanding and empathy for my clients who have had injuries or surgeries that have limited their ability to do the things they are accustomed to doing. When we talk about “Activities of Daily Living,” I now have a better sense of what that means.

When I am met with challenges, I always try to learn from them and then apply them to the work that I do–as a rabbi and as a personal trainer. This time will be no different. I will keep you posted on my progress.