Jess Bateman has combined a knowledge of Orthopedics and injury prevention to benefit many athletes in the world of functional fitness and weightlifting. She herself has both competed at a national level in Olympic Weightlifting and spent the last five years coaching Senior and Youth athletes, as well as having obtained a USAW-SPC credential.
Coaching Seniors in Functional Fitness
People are continually searching for ways to look and feel younger. The most important of the two is the “feel younger” goal. That’s where you come in. As the population ages, many gyms are starting to realize that there is plenty of work to be done by coaching seniors. Walking is excellent for some maintenance activity, but falls short in maintaining significant muscle power and bulk. Now, I’m talking healthy muscle bulk not Arnold Schwarzen-granny. Continued strength training helps people remain mobile in their Golden Years. Some Medicare plans even include stipends for gym memberships or personal training! An ounce of muscle is worth a pound of fracture treatment!
So Many Options
Form and appropriate workloads are critical to preventing injuries in an older gym population. Globo-gyms use either personal training or classes like the “Silver Sneakers Program” to provide an appropriate exercise protocol for older men and women. However, the cost of individual training can be overwhelming. It depends on where you live, but, in the DC Metro area, for example, PT sessions can range $75-100 per hour. The CDC recommends healthy older individuals get anywhere from 2.5 to 5 hours of moderately intense aerobic exercise as well as 2 or more hours of strength training a week. At these recommendations, personal training can be a luxury few can afford. Not many people on can afford $300 per week on training sessions!
Functional Fitness and HIIT gyms have a reputation for being “insanely intense” programs using heavy weights. We’ve already discussed how this reputation is ill-deserved in a previous post. In fact, these fitness programs are often cost-effective alternatives to personal trainers in that they offer personal attention in small group classes at a lower monthly rate. Many middle-aged adults have discovered that functional fitness gyms provide a great balance of cost, results, and personal attention. And more 65+-year-olds are giving it a shot, too. Are you prepared for these Baby Boomers in your box?
Some Things to Consider
As coaches, we drank the WOD Kool-Aid a long time ago. We know movements are adjustable and programming is scalable. We program for our best athletes and adjust as needed, right? In this article, I’m referring to clients who are seeking general physical preparedness (GPP) and not those with the goal of training for The Games or as a Spartan Masters athlete. That’s a different ball game. I’m talking about your weekend warriors. Your life-long athletes that wouldn’t be caught dead at anything with Silver in the name. The ones who still run a business and aren’t stopping anytime soon. Your senior GPP members have special considerations in regards to overall health and fitness goals. So, how do you provide a welcoming, safe workout environment?
“Healthy” takes on a different meaning when you’re over 65. There are very few people at that age who do not have minor medical conditions such as hypertension, high cholesterol, or even diabetes. Make sure their doctor has cleared them for physical activity., Exercise will improve most medical conditions, but that’s for their physician to recommend. You should be getting medical histories and clearance from ALL clients. Period. Review of medical conditions is a primary reason we recommend one-on-one intake assessments regardless of the client’s age. It’s an especially important point when coaching seniors.
Make sure all of your coaches are aware if a client does have a medical condition. Say that client has mild atrial fibrillation (a-fib). This is incredibly important to communicate. People with a-fib are still encouraged to exercise but will require extensive scaling, and it is important to take their exertion level into account. Some medications may affect the patients’ response to rapid changes in position, like with burpees. Be sure to check in with us for another post on medications your athletes may take and how they affect performance, coming soon.
Medical Safety Measures
This is not limited to senior clients only. It is important to have necessary medical supplies and appropriate training for all coaches and staff. While senior clients may be more at risk, you may also encounter medical emergencies in seemingly healthy 30-some-year-olds. CPR/AED training should be prioritized and please invest in an AED. Some states require this to operate a fitness facility, but even if they don’t this could be the best $1200 you ever spend as a gym owner. You hope you never need to use one, but there’s nothing worse than needing one and not having one on hand.
What is “Moderately” Active?
All right. I know, I know… That section was a bit of a technical downer. I hope you’re still with me because you have a new client who’s eager to learn new skills and improve their fitness. You will have all walks of life come in your door. From the 75-year-old who was a previous track athlete and has never lived a sedentary lifestyle to a 68-year-old who had only been sedentary until their hip replacement and subsequent physical therapy last year. It should be obvious their workouts should not look the same. So what are some standard scaling tools to use coaching seniors athletes?
I mentioned “perceived exertion” before. Especially for those with underlying heart conditions, this is probably the most crucial scaling tool. The Borg Scale of Perceived Exertion is used to rate the intensity of physical activity in the medical community. But why anyone would rank something on a scale of 6-20 is beyond me, so let me break it down a little more.
For the majority of healthy, senior members current recommendations are to keep these athletes between a 4-7 for their perceived exertion. This is not YOUR expectations for their exertion, but how THEY’RE feeling that day. The biggest goal for these athletes is to keep moving. They’re going for functional PRs, like getting through the grocery store without resting. Feeling like they want to quit or pushing past pain to injury is not how you get them more active in their everyday lives.
Functional Fitness WODs are Infinitely Scaleable
Scaling movements may (and definitely should in some cases) look different for senior athletes. 24-year-old Joe may have some mobility issues from life shackled to a desk that can be overcome with stretching and movement progressions. Over time, he can get that beautiful overhead squat. Your older athletes may have bony impingement from long-standing arthritis or joint replacement. These can limit motion due to pain OR have a limited range of motion due to the mechanics of their prosthetic joint. Focusing on muscle activation and getting out of a chair easily could be their end goal. The situation can vary from person to person. I’ll try to touch on some common conditions and considerations for each.
Osteoarthritis Doesn’t Have to Stop People From Exercising
Coaching seniors almost always involves working with arthritis. Osteoarthritis is seen more often than not and can affect several joints. It may not be necessary for these clients to squat below parallel, but it is functional to be able to sit in a chair. They may never need to do more than squat their bodyweight to a box. Just make sure that these are the best box squats you’ve ever seen in your life. You can add a band around the knees for added resistance if they’re never comfortable with a barbell on their back. If they need more assistance at the beginning, consider setting up them up – with or without a box – next to some rings so they can use their upper body for assistance, TRX-style.
Can People WOD after Joint Replacements?
Along with arthritis come considerations for staying active after a joint replacement. Any joint replacement was only designed to handle our natural body forces. There are risks associated with heavy lifting and excessive ROM, especially in the immediate post-operative period. Short term gains become regrets when you’re looking at 2-3 revision surgeries during your lifetime. Surgeons give patients restrictions on the range of motion at a joint post-operatively, too. Please respect these. These limits are in place to prevent dislocations of the joint beyond these ranges.
If a knee prosthesis is flexed past 90 degrees, for example, the client is at increased risk of “jumping the post” and dislocating their new knee. Ouch. These aren’t like native joints that can be mobilized freely. They can and will dislocate far easier than you might expect. Better safe than sorry. When coaching seniors, focus on functional ranges of motion for activities of everyday life. You can learn more about the most recent recommendations for exercising after a total joint here.
Shoulder Health in Weight Lifting
Just as the cartilage and bone can begin to wear in the shoulder joint, it is especially vulnerable to degenerative tendon health, as well. As many as 70% of people over 70 have some amount of rotator cuff tearing, but many don’t notice. These muscles are seemingly not meant to last as long as we live now. Movement technique should always be a priority, but eccentric exercises can be beneficial, too. For the sake of these tendons, it is important to be sure that clients have excellent muscular shoulder control if you are going to have them hang from a bar. You may get the occasional individual who’s driven to try these movements. And that’s fine! Just be sure they are doing it right! Jerking and snapping at the end of their motions will lead to tendon injuries more easily for them.
Back Pain Can Require Creative Coaching
The spine is not immune to the aging process. 75% or more of us experience back pain at some point in our lives. Back pain is very common in older adults. The range of motion can be lost due to pain or previous surgeries. Consider shortening range of motion for these clients, such as sumo deadlifts, or pulling from blocks. Impact (such as jumping rope or running) and rowing are potentially problematic movements, too. The bike may be your best scaling go-to for moderate aerobic exercise with these clients.
Tendon Injuries Are More Common as We Age
We all lose elasticity in our connective tissue as we age. You can see it in the wrinkles of our skin. The same process happens in tendons too. This decreased spring can cause tendons to be more susceptible to injury with sudden movements. Applying a heavy load to a brittle tendon under tension is a great way to pop it. That puts older athletes at increased risk of Achilles and Rotator Cuff injuries. So focus on controlled movements in WODs when coaching seniors.
Ultimately, the goal is to keep your clients moving and pain-free. Sure, we all know exercise should come with the warning label “May cause discomfort.” So maybe I should say “injury-free” instead. Not so different from the goals of your average client of any given age right? There is no “one-size-fits-all” approach to coaching senior clients. Everyone’s previous exercise experience, medical issues, and tolerances for workouts vary. Just keep your coaches and clients communicating to find the best fit for each member. We’ll go into more detail on scaling for specific orthopedic problems affecting an older population, but hopefully, this is a starting point for all of you that find yourself coaching seniors!