The Happily Aging Athlete

Life in Tahoe is often viewed as Utopia but it can also be seen as a monoculture of athletes pushing the limits of every sport imaginable.  Society rewards its' addicts with adrenaline from ever crazier athletic feats.  As a PT I have worked on many of these athletes pushing the boundaries and I am just as guilty of watching in awe and applauding their accomplishments.  However, as I continue to age and hold onto being an athlete but well into my 40's, ouch,  I know my better "athletic" days are in the past.  

I am far more concerned about choosing practically and content not skiing the hardest line or biking and hitting the huge gap jumps that some make look so easy.  I'd rather get up the next day and the following week and be able to do it again.  Slower yes but with a bigger grin acknowledging the prevailing wisdom and contentment that younger generations are being forced to ignore.  I hope this post will generate some discussion, and possibly some scorn, but every year I see kids younger and younger with more traumatic ACL ruptures and dislocated shoulders than ever before and wonder will these kids even be "athletic" when they become 30?

So how can it change?  Longtime Tahoe resident, Squaw Valley skier and author of the infamous Squallywood – A Guide to Squaw Valley’s Most Exposed Lines, Dr. Rob Gaffney gave a presentation at Squaw titled "Go Bigger" about a year ago.  Images of skiers and boarders going bigger enticed the masses I am sure, but I failed to attend only to learn that by "Go Bigger" Dr. Gaffney meant something else entirely.  His presentation was about how Tahoe is missing the mark and driving kids and adults to extreme athletic feats at all costs, physically, intellectually, emotionally and arguably spiritually.  Being enticed to "go bigger" at competitions,  to produce the next great film, win the next medal or simply trying to keep up with friends without acknowledgement of the risks to themselves as well as to the detriment of culture and society seems unbecoming.  One has to question why and when will prudence return? Apparently not this election year, but that is whole other conundrum.  His presentation addressed what many of us acknowledge but fail to embrace and instill in our youth which is that there is more to life than adrenaline sports.  Yet we behave and reward the most audacious sports achievements and encourage bigger jumps, steeper lines and extremely technical tricks.  Of course I appreciate athletic feats and am in amazed at the scope of athletes' abilities but how often have we seen a life altering injury or death of an athlete performing where the margin of error is small and the consequences grave.  

I do not presume to have the answer but just suggesting that there might be more out there for your addiction:)  I love what I do but I believe it or not I would prefer to see you out there than in my office.

 

The Crossfit Conundrum: Part 1. Ultimate fitness vs. Long term durability. Who is responsible?

There is no doubt that Crossfit delivers in its promise to help participants achieve awesome levels of fitness and like any intense physical activity, it comes with risks.

Why are people getting injured in Crossfit?
It is difficult to generalize because philosophies often vary between Crossfit Box’s. The spectrum ranges from intense focus on fundamentals and corrective exercise, to relatively little time spent on readiness with a trust that imperfections will work themselves out.

Three major categories of Crossfit induced, population-based injury are emerging:

  • Extremely fit athletes well versed in the movement patterns who push their limits of durability on a stable and mobile platform.
  • Moderately athletic people with prior history of weight training and/or other regular athletic participation.
  • Individuals who may be athletic to some degree, but with no prior weight lifting experience.

Many injuries can be associated with participants’ lack of readiness.

Readiness is the state of being fully prepared for something. It requires a sound foundation in movement skills, as well as, mobility and stability of the musculoskeletal system (This will be the topic of Part 2). Simply put, mobility = sound and fluid motion through multiple ranges. Stability = good control through these ranges. If either is missing Crossfit will reveal it.

Can we blame Crossfit for injuries? Somewhat yes and mostly NO.

Somewhat Yes: Crossfit’s use of complex movement skills (i.e. olympic lifts, ring work) requires more time teaching and learning than is typically allotted before engaging in the scheduled group classes. It takes time and accurate practice to get the body patterned properly. The learning curve varies greatly within the Crossfit population, from elite level athletes to new mothers. It is extremely challenging to perform “accurate practice” repetitions when being pushed (“encouraged”) to try harder and faster. Yes, people have a choice, but the environment is quite motivating so most choose to go hard.

Within the Crossfit community, there is currently no systematic evaluation strategy to screen for participants’ lacking mobility, stability and/or skill. While there are Elements Classes that teach the movements (often mandatory before full participation), or options for more personalized training, many participants are either unaware of their movement imperfections or are not willing to spend the time working on the fundamentals. A slight paradigm shift in readiness would go a long way for participant durability. Screening and corrective exercise would go a long way.

Mostly NO: The growing number of shoulder, knee and back injuries in Crossfit seems less an issue of programing and philosophy and more a result of participant decision making.  Its a tough workout, and people know its tough, so it is important to come prepared or recognize when to ask for help. While Crossfit coaches will indeed push their minions to try harder and faster, there is the crucial element of personal responsibility to self regulate. Unfortunately, in the socially charged atmosphere of a Crossfit workout, people often ignore these concerns in the interest of keeping up, mirroring others or not disrupting the flow.

Coaches may not catch all form-flaws, so participants must apply good judgement and take control of their bodies’ experience. Many of the Crossfit clients treated in my physical therapy clinic admit to ignoring stiffness, aches and pains prior to their injury. Some feel they should have listened more to intuition. I often get the comment “I was being stupid” when asking them what happened.

Summary:
Readiness Culture: Crossfit Culture could benefit from a slight overhaul in participation readiness via standardized screening tools and more time/focus on the elements prior to and throughout intense groups classes.
Personal Responsibility: Self-regulation and asking for help are ultimately the final steps to achieving fitness goals while preserving long term durability. Own your experience and take the necessary steps to be prepared. We cannot blame a particular fitness modality for injuries when the ultimate decision maker for safety is the participant. Know what you know and when to ask for help.

 

Understanding the "Modern Wellness Model"

Understanding the "Modern Wellness Model"

There are so many types of providers to choose from. Each can be effective or not, depending on the issues they are trying to resolve. Some are considered the Traditional Medical Model like physicians, physical therapists, nurses, dieticians, psychologists, counselors, podiatrists and in some cases chiropractors and midwives. Others are considered to be Holistic Medicine practitioners including integrative medicine physicians, acupuncturists, naturopathic physicians, chiropractors, massage therapists, Rolfers and yes energy workers, shamans and other spiritual healers.

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