The Practicing Doctor and Aging Athlete


FEATURE STORY

With a remarkable fitness journey, progressing from 5K races to five full marathons in a span of three years—notwithstanding injuries that include shin splint, plantar fasciitis, Achilles tendinitis, shoulder spasms, and delayed-onset muscle soreness—a physician inspires with an important lesson she has learned about a lifelong love for sports; and that is—life is not a sprint, it is a marathon. And like most marathons, it’s never about the finish line, it’s all about the journey

By Maria Lora G. Tansengco, MD


As a young girl, I used to spend lunch breaks in the vast open field of our school in a game called “agawan-base”, the vernacular for the struggle for possession of rival base.I alternately pick my feet up and plunge into the earth to catch myself flying fast, the only motivation to gain speed being the capture of opponents and seize enemy base!

That was how I discovered the love for running. For many years while studying to become a doctor, I tucked away those playful memories, fell out of love from running, until I rediscovered the joy of being active again at a ripe old age of 45. I realized it was either fitness or fatness.

This happened just when my presbyopic eyes have started to scream for reading glasses, tell tale signs of age. What once-upon-a-time came so naturally for my legs proved to be a totally different tale.

So here is a 45 year old re-learning how to run. What I thought would be a breeze owing to a historical love for running became a super slow process, so unlike the toddler in the playground whose running strides were so effortlessly fast.

I slowly gained some sense of fitness and endurance, progressing from 5K races to 5 full marathons in a span of three years. I also had to contend with injuries left and right for which I had to shop for opinions I agree with. I was constantly sidelined by the shin splint, plantar fasciitis, Achilles tendinitis, shoulder spasms, and delayed-onset muscle soreness. This bullheaded doctor will refuse to see doctors who will only tell me to stop. I said, “No to negativity” and “Hello to anti-inflammatories.”

I realized that the sheer distance and the heavy volume of training needed to achieve what I wanted to do kept me constantly put in the back burner. Since training can no longer overcome the loss in functional capacity brought about by the ageing process, I turned to cross-training. Why not train for a triathlon then? Since the distance for each discipline of the swim, bike and run is short, it might be friendlier to my body. I’m just a simple person anyway whose goal was never to be first and fast, but to just reach the finish line in one piece and with a smile on my face.

Inside Track Athletics

I hired Inside Track Athletics, a group of three coaches who were not just athletes themselves but were nerdy geeks who would analyze the numbers that they see in my Training Peaks. It’s a software program that churns out several numbers that my coaches interpret—the Training Stress Score (TSS), Intensity Factor (IF), Functional threshold power (FTP), fitness, fatigue, form and more. You can’t go wrong with numbers, right? Coach Nonoy Basa constantly reminded me that in swimming, consistency is the key. Coach Al Gonzales shared the drills that would help me maintain my balance in the water and on the saddle. Coach Paolo Leano, who turned himself from fatman to Ironman (at the world championship in Kona, no less), scientifically studied my functional threshold power and tied it up with nutrition and rest.

They earnestly conjure up pre-race spreadsheets and strategies based on numbers derived from the previous months training leading up to the race. Gently made aware not just of my obligations as an obstetrician-gynecologist to my patients, but also of my teaching and administrative duties in the hospital, they come up with a well-conceived schedule that makes it difficult for me to be excused from missing it. Plus I hate seeing red in my Training Peaks.

Slow-climbing learning curve

I must admit that compared with their other students below 40, the learning curve for this ageing wanna-be female athlete who is now over 50 is wearily slow-climbing, literally an uphill battle. Since there has been a significant increased interest of ageing individuals who want to be active in sports, here are some of the important pieces of advice I have learned throughout the journey of this ageing doctor-athlete.

The principles in training that apply to the elderly athlete are no different from that of the young athlete. Our body has the remarkable ability to adapt to repetitive stress, making the tissues stronger with improved functional ability as you increasingly challenge the tissues to adapt to greater stress— this is the cornerstone of exercise physiology.

We gain fitness from a continuous cycle of gradually increasing the stress of training followed by rebuilding and restructuring of tissues from days of rest and recovery in order to handle greater stresses in the future.

This allows us to train with a greater workload that includes higher intensity, higher volume, or both, throughout the training season. In the older athlete, however, recovery days may have to be greater than that of the younger athlete. Forcefully progressing through increased volume of training without any periods of rest can only lead to over training, paradoxically resulting in decreased performance, sometimes even in permanent disability. Remember that rest is not a sign of weakness. It can only make you stronger. The most common marker of the decline in age-related performance is aerobic capacity. Also known as VO2 max, this is the volume of oxygen being delivered to the working muscles when exercising at a sustained, maximal workload. The senior’s declining athletic performance may well likely be due to a decline in aerobic capacity.

So how do we maintain this? Joe Friel in his book “Fast after Fifty” maintains that the key to maintaining this is only through high-intensity training, the exercise that unfortunately most of us avoid because it’s just simply hard and painful. It has also been found that resistance and strength training helps a lot in endurance activities.

Abhorrence for love handles

Since the sport of running is dependent on the force of gravity, then gaining weight can be a problem. What actually led me to go back to being active in the middle age is my abhorrence of love handles. I can’t seem to get rid of it despite my active lifestyle. A slight slacking off from training and those nasty flabs around my middle are just too obvious to disregard.

This is where proper nutrition comes in and where I have most difficulty with because I love to eat. I try my best to count calories using MyFitnessPal and eat mostly nutritious foods.

Finally, listen to your body. The elderly is more prone to disease that can affect training. This can be as serious as a heart problem, as debilitating as arthritis, or not even associated with any symptoms like diabetes or hypertension.

Age-related disease does not mean you should never get off the couch to exercise. With a few modifications in training and consultation with the doctor, one can still approach this scientifically and gain the fitness that is necessary to keep one healthy. When I started training for my first marathon, I experienced bilateral knee pain very early in the season.

To make the long story short, a rheumatologist took a look at my x-rays and diagnosed me to have beginning arthritis. Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen helped me to deal with the pain while continuing to train and eventually accomplishing my first marathon. And while diabetes and hypertension run in my family, I have kept my blood pressure and blood sugar controlled as I remain to have an active lifestyle.

In the fifty plus years that this ageing doctor athlete has lived, I already know without a doubt that life is not a sprint; it is a marathon. And like most marathons, it’s never about the finish line; it’s all about the journey.

“I’m just a simple person whose goal was never to be first and fast, but to just reach the finish line in one piece and with a smile on my face”

January 2019 Health and Lifestyle

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