The document discusses the benefits of exercise for senior athletes and how to minimize injury risks. It recommends that senior athletes perform moderate-intensity aerobic exercise for at least 150 minutes per week along with muscle strengthening exercises 2 days per week. Strength training should start at a low intensity and gradually increase over time. Proper warmups, cool downs, and rest are important to prevent injuries which are more common in senior athletes due to age-related physiological changes. Sports like running, swimming, and golf carry higher injury risks for seniors so precautions around joint stress and overuse are critical.

1. PREM KUMAR SINGH
[MPT] SPORTS

2. Exercise plays a major role in human life; it
help to remain fit or may be to recover from a
disease or impairment in all age groups.
• Lots of study has been done to prove the
benefit of exercise and its uses in different
condition.
• Study says that there are undeniable
suggestions that regular exercise prevents
primary and secondary complications resulting
from Chronic Illness (Warburton D.E. et al.,
2006).

3. • Elderly people who participate in any
extent of physical activity gain some health
benefits, including maintenance of good
physical and cognitive function.
• Some physical activity is better than none.
• Study also found that the physical activity
is directly proportional to health status i.e.
(Warburton et al., 2006).

4.  The benefits of physical activity for elderly
people are well documented. It improves cardio-
respiratory function, reduces risk factors for
coronary artery disease, and most importantly
improves the ability to perform daily activities
(Lim J.Y , 1999).
 A combination of aerobic activity, strength
training, and flexibility exercises, along with
increased general daily activity can reduce
medication dependence and health care costs
(Mcdermott A.Y and Mernitz H, 2006).

5. India:
• Based on survey overall 392 million
individuals are inactive in India. This is a
surprising amount and indicates a huge
population at risk for developing non-
communicable diseases and age related
complications (Anjana, R.M et al.,2014)

6. Cumulative recommendations from the
American College of Sports Medicine (ACSM),
the American Academy of Orthopedic Surgeons
(AAOS), and the American Heart Association
(AHA) encourage older adults to maintain a
physically active lifestyle with an emphasis on
moderate-intensity aerobic and muscle-
strengthening activities as well as activities
that promote increased flexibility and balance
for older adults who are at a risk of falls

7.  Many athletes who continue to train and
compete into their older years observe a
decline in performance.
• From the mid-30s to approximately 60 years
of age, a slow but progressive decline in
athletic performance is seen in most athletes.

8.  Physiologic change associated with ageing.
 Underlying medical conditions..
 Musculoskeletal injuries.
 Reduced hormonal concentrations.
 Need for longer recovery times from hard
training sessions
 Changes in competitive motivation.
 Lack of available time for training

9. NORMAL
Early
degenerative
changes
Surface fibrillation of
articular cartilage
Sclerosis (thickening)
of Subchondral bone
Hip joint with
normal space and
cartilage covered
Articular surfaces
Narrowing of
upper portion
of joint space
Early degenerative changes in articular
cartilage with aging {PHYSIOLOGIC CHANGES
ASSOCIATED WITH AGING }
Superficial
fissures

10. PHYSIOLOGICAL CHANGES IN AGEING

11. Spondylitic
arthritis
Osteoarthritic
facet joints
Degeneration of lumbar intervertebral
discs and hypertrophic changes at
vertebral margins, with spur formation.
Osteophytic encroachment on
intervertebral foramina compresses
spinal nerves

12. Frequency – how often you train.
Intensity – how hard you train.
Time (or duration) – how long you train for.
Type – the kind of training you do.
FOLLOW FIIT -REGIME

13.  The Overall Recommendations on Physical
Activity for Health published by the World
Health Organization in 2010 state that adults
over 18 years of age must do at least 150
mins/week of moderate-intensity or 75
min/week of vigorous-intensity aerobic
physical activity or an equivalent combination
of both. It also suggests that adult should
perform muscle strengthening training 2 days
per week focusing on all group of muscles. •
Adults over 65 years of age are advised to
follow the adult recommendations if possible

14. RECOMMENDED MINIMUM EXERCISE FOR SENIOR ATHLETES
Adults who are unable to tolerate recommendations should be encouraged to
maintainthe highestpossible activity level andavoid a completely sedentary
lifestyle
*On a scale of 0–10 for level of physical exertion [RPE],
5–6 for moderate intensity, and
7–8 for vigorous intensity
From Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine: American College of Sports
Medicine position stand: exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41:1510-1530

15. Rate of
Borg rating of perceived
exertion [RPE]
Borg rating of
perceivedexertion
[RPE] is an outcome
measure scale used
in knowing exercise
intensityprescription

16.  As elderly individuals beginning a resistance
training program generally have reduced
muscle strength and mass compared with
their younger counterparts, significant
improvements in muscle strength are
consistently observed with a training
frequency of 2 to 3 days/week. While
increasing the training frequency to 4 to 5
days/week may result in further gains in
strength

17.  Elderly individuals beginning a resistance
training program should start at a low
intensity and gradually progress {P.R.T}over
time. • The intensity is generally prescribed
as a percentage of the individual’s 1-RM
repetition maximum (1-RM: the maximum
amount of weight that can be safely lifted 1
time). • If they are looking for an increase in
muscle strength, it is generally recommended
to use a lower intensity weight that can be
lifted for more repetitions.

18.  Currently, there is considerable debate regarding the volume
of resistance training necessary to produce optimal benefits
in muscle strength.
 Typically, multiple sets (2 to 3 sets) of 8- to 15-RM are
prescribed..
 A single set resistance training program can be completed in
a shorter period of time which has been suggested to
increase compliance and reduce the rate of dropouts.
 Regardless, it is clear that a single set is sufficient to produce
significant strength gains. Multiple sets can be employed if
the potential for greater strength gains is desired.

19.  Each repetition should be performed slowly through the full
range of motion, allowing adequate time to lift the weight
(concentric-contraction)as well as to lower the weight
(eccentriccontraction).
 From an equipment viewpoint, variable resistance machines
using weight stacksare desirable for this population, for a
number of reasons:
 (i) they reduce the risk of injuries to hands and feet (ii) they
decrease the risk of injury to the lower back (iii) they are
associatedwith a reduced risk of exercised- induced
hypertension (iv) the weights can be adjusted in small
increments(v) resistance can generally be applied through
the full range of motion.

20. Plasminogen activator inhibiter-1

21.  Cardiac assessment is not required before
initiating moderate - intensity exercise
programs in a majority of senior athletes.
Older adults with >2 risk factors {CORONARY
ARTERY DISEASE } are considered to be at a
moderate risk of adverse responses to
exercise and are advised to undergo medical
examination and exercise testing before
initiating high-intensity/vigorous exercise

22.  The risk of sudden cardiac arrest or
myocardial infarction is very low in healthy
individuals who perform moderate-intensity
activities. The ACSM cautions that vigorous
exercise confers an acute increased risk of
sudden cardiac death and/or myocardial
infarction in individuals with either diagnosed
or occult cardiovascular disease

23. Heart rate accelerated
ST-segment depressionsin leads
overlyingischemic zone
Myocardial Ischemia, Demonstrated by Stress Test
Myocardium
ischemic due
to increased
demand for
coronary flow
with exercise
Normal ECG. No ST segment
depressions.
Myocardium not
ischemic at rest
Coronary artery narrowed by
70% of luminal cross section

24.  Senior athletes are particularly prone to acute muscle
strains and injuries at the myotendinous junction.
 injuries are far more likely to occur due to
degenerative tissue problems that result from wear
and tear due to chronic overuse or trauma experienced
over years of athletic stress. • For example, postural
mal-alignment of the knee, such as genu varus, can
lead to overloading of the medial compartment with
an increased risk of meniscal tears

25.  Tendinosisis common in older athletes and
results from repetitive loading and cumulative
microtrauma to tendons.
 Common tendinopathiesseen in older golfers
include rotator cuff tendinopathy,medial and
lateral epicondylitis,
 • Older joggers are particularly prone to
development of Achilles tendinitis, along with
posteriortibialis tendon insufficiency.

26. Aging athletes are prone
to rotator cuff pathology
Test for partial tear of cuff is
inability to maintain 90°
abduction against mild
resistance
Epicondylitis(tenniselbow) Exquisite
tenderness over lateral or medial
epicondyle of humerus

27. Avulsed long process
head of biceps brachii muscle
Avulsionof insertion of distal bicepsbrachii
tendon.Repairby pulloutwiretechnique;
tendondrawn into “trapdoor” cut in
tuberosityof radius
Rupture of belly
of biceps brachii
Rupture of tendon of long head of right
biceps brachii muscle indicated by active flexion of
elbow

28.  By age 65 lose 40% of glomeruli
 Diminished renal blood flow
 Creatinine is misleading because of
decreased muscle mass (CrCl is better)
creatinine clearance test
 Chronic dehydration
 Hypotension leads to ATN
 Nephrotoxic agents (IV contrast and NSAIDS)

29. ACTIVITY METs
Level walking at
4 km/hr
3.0
Jogging at 8 km/h 8.4
Swimming, 30 metres/
minute
10
Tennis 6-10
Soccer 7-15

30. 1. VO2 max : VO2 max represents the ability of an
athlete to extract oxygen from the environment 85%
VO2max*.
2. Maximum heart rate (HRmax): HRmax can be
calculated using (220 – age). Intensity can then be
expressed as a percentage of HRmax. 50-90%
HRmax*
3. Metabolic Equivalent Units (METs) : METS*
One MET unit implies the consumption of 3.5 mL of o 2
·kg 1 ·min 1
4. Repetition maximum (RM): The maximum number of
repetitions at a given weight
COMMON TERM

31. Techniques of Resistance Training
Used in Rehabilitation

32. Dos Don’t
Set realistic goals High impact activities
Exercise within the limits of the
Exercise tolerance test
Extremely hot, humid conditions causing
dehydration (especially if on diuretic therapy)
Exercise aerobically using large muscle groups
(jogging/cycling/swimming)
Extreme cold (causing frostbite,
Hypothermia, cold-induced angina and
bronchospasm)
Incorporate weight bearing activities
Into their program (for prevention of
osteoporosis)
The valsalva maneuver (especially if
hypertensive/coronary prone)
Wear appropriate clothing and footwear High levels of pollution (athletes with chronic
airways limitation)
Increase activity gradually Abrupt changes in amount/intensity of training
Have rest periods during exercise Prolonged sun exposure (predisposing to skin
cancers
Warm up and cool down sufficiently
Treat injuries quickly and adequately
Exercise with a partner

33. Sport Age effect on injury risk
Soccer ↑ acute arm injury risk
Marathon/long
Distance running
varies from no increased
injury to sport most
affecting injury risk
Golf more overuse shoulder
injuries in older golfers
Orienteering more muscle ruptures in
older athletes
more acute injuries
Ball games increased accident rates

34. • Most common runners' injuries have one
thing in coming; they are caused by too much
running. This becomes truer with age.
Common exercise injuries in older runners
include back pain, bursitis, stress fracture,
hamstring injury, problems with the (patella)
kneecap, shin splints, Achilles tendonitis,
heel pain, Morton's neuroma (a benign nerve
tumor in the foot), calluses, bunions and
many other leg and foot problems

35.  Older runners are also more prone to fall-
related injuries. Often, the reason is loss of
balance; in this situation, it is a good idea to
add balance exercises to the workout regimen.
Another common cause for falls in older people
is dizziness and fainting due to dehydration.
Following a fall, older people are at greater risk
of developing dangerous subdural hematomas,
or collections of blood from an injury that
collect in an area between the brain and the
skull.

36. • Swimmer's may develop a particularly nagging
problem. Dubbed swimmer’s shoulder, this malady
is caused by repeated rubbing of the rotator cuff
muscles against the acromion, a bone in the
shoulder. It occurs in up to 60% of competitive
swimmers. An upper arm strap may relieve some of
the pain caused by this condition. Older swimmers
are more likely to suffer rotator cuff rupture than
younger swimmers. Another injury more common
in the older athlete is rupture of the long portion of
the biceps tendon. Both of these injuries may
require surgical repair.

37.  Older swimmers should avoid using hand
paddles; these increase the risk of impingement
syndromes (where the rotator cuff is pinched
between the head of the humerus [upper arm
bone] and the shoulder blade). Fins can be used
by older swimmers, except those with certain
knee conditions. Older athletes with vision
problems might consider using corrective swim
goggles made by an optometrist.
 Older swimmers should be very careful of
hypothermia when swimming in cold water. The
ability to regulate body temperature gets worse
with age.

38. Older cyclists are more likely to suffer from
compressive nerve syndromes in the arms. An
example would be handle-bar palsy in the hands.
These are mostly caused by over exertion. Other
common in older people include upper limb
fractures ,shoulder dislocations, sprains,
lacerations and abrasions.Neck pain and stiffness
can also occur – generally in patients with pre-
existing neck problems. Urethritis, (inflammation
of the urethra), and saddle pressure sores can be
prevented by using a padded seat and padded
cyling shorts.

39. • Older persons are at increased risk for injuries due
to inclement weather, such as dehydration in the
summer and hypothermia in the winter. Altitude
sickness is another common problem. Acute
altitude sickness can occur at heights as low as
6,000 ft (1830 meters). Symptoms including heart
palpitations, cough, headache, sleeplessness and
difficulty breathing. This condition can be fatal

40. • Common overuse injuries in golfers include
rotator cuff (shoulder) problems, cervical
(neck) disc or osteoarthritis problems, lower
back pain and epicondylitis (golfer's or tennis
elbow). Wrist pain is common in older golfers,
because of continual extension and twisting
of the wrist during the golf swing. Many of
these problems can be avoided simply by
appropriately warming up the body before
starting and by doing stretching exercises.
Muscle strengthening exercises, especially the
back muscles, are key to preventing and
treating many golf injuries.
Golfers Injuries

41. • Osteoarthritis symptoms are common in
older athletes and may actually be due to
another problem. The prevalence of
osteoarthritis in the aged can be misleading.
Misdiagnosis can occur often – injury
conditions (such as meniscal tear of extra-
articular soft tissue damage) are labeled
osteoarthritis, resulting in
appropriate treatment.

42. THANK YOU
P1premkr@gmail.com