United States Masters United States Masters Swimming Swimming

The Future is Now!The Future is Now!

Jim Miller, MD, President, USMSJim Miller, MD, President, USMSFellow AAFP, CAQ Sports MedicineFellow AAFP, CAQ Sports Medicine

ObjectivesObjectives

• Identify the population of masters Identify the population of masters athletes athletes

• Identify those parts of physiology that Identify those parts of physiology that are ‘fixed’ Vs those that are ‘plastic’.are ‘fixed’ Vs those that are ‘plastic’.

• Identify the new research as it applies Identify the new research as it applies to conditioning and agingto conditioning and aging

• Why is USMS a model for success in Why is USMS a model for success in treating aging?treating aging?

Demographics: How bad is Demographics: How bad is it?it?

• Fact: In Western society the number Fact: In Western society the number of people over 65 is growing faster in of people over 65 is growing faster in both size and proportion to all other both size and proportion to all other age groups (excepting the over 85 age groups (excepting the over 85 age group)!age group)!

• Estimate: By 2030 those over 65 will Estimate: By 2030 those over 65 will account for 70 million of the account for 70 million of the population in the US.population in the US.

Masters Swimming – What is Masters Swimming – What is it?it?

• 43,000 members43,000 members

• Registered 18 and overRegistered 18 and over

• Oldest competitive age group is 100-104Oldest competitive age group is 100-104

• Full complement of events and courses Full complement of events and courses SCY, SCM, LCM, Open WaterSCY, SCM, LCM, Open Water

• Coached workouts with stroke clinics Coached workouts with stroke clinics and full utilization of the ‘science of and full utilization of the ‘science of swimming’swimming’

Aging – Fixed? (relatively Aging – Fixed? (relatively inflexible changes) inflexible changes)

CardiacCardiac

• Decrease in maximal heart rate (6-10 bpm Decrease in maximal heart rate (6-10 bpm per decade)per decade)

• Decrease in cardiac outputDecrease in cardiac output• Decrease in LV contractilityDecrease in LV contractility• Decrease in maximal oxygen uptake (VO2 Decrease in maximal oxygen uptake (VO2

max)max)• Increase in both systolic and diastolic Increase in both systolic and diastolic

secondary to the increase in TPRsecondary to the increase in TPR

Aging – Fixed?Aging – Fixed?

PulmonaryPulmonary

• Decrease in vital capacityDecrease in vital capacity• Increase in residual volumeIncrease in residual volume• Increase in respiratory rateIncrease in respiratory rate• Increase in the work of breathing Increase in the work of breathing

against an increasingly rigid rib cage against an increasingly rigid rib cage and lung tissue with less elasticityand lung tissue with less elasticity

Aging – Fixed?Aging – Fixed?

MusculoskeletalMusculoskeletal

• Decrease in muscle mass (sarcopenia - Decrease in muscle mass (sarcopenia - more pronounced in women)more pronounced in women)

• 50% decline in the normal population 50% decline in the normal population between ages 20 to 90between ages 20 to 90

• Decline in type I and type II muscle fibers Decline in type I and type II muscle fibers with a proportionately increased loss of type with a proportionately increased loss of type II to type I fibersII to type I fibers

• After age 30 a decline in the density of After age 30 a decline in the density of muscle fibers and an increase in fat within muscle fibers and an increase in fat within the musclethe muscle

Musculoskeletal (continued)Musculoskeletal (continued)

• Decrease in bone massDecrease in bone mass

• Decrease tensile strength of tendons Decrease tensile strength of tendons and ligamentsand ligaments

• Decrease in mucopolysaccharides Decrease in mucopolysaccharides and increase in water content of and increase in water content of articular cartilage, resulting in articular cartilage, resulting in cartilage weaknesscartilage weakness

Aging – Fixed?Aging – Fixed?

NeurologicalNeurological

• Decrease in spinal motor neurons Decrease in spinal motor neurons (leading to the decrease in strength)(leading to the decrease in strength)

• Decrease in proprioception Decrease in proprioception (contributes to decline in balance, (contributes to decline in balance, righting reflexes, and coordination)righting reflexes, and coordination)

• Decrease in reaction timesDecrease in reaction times

Aging – Fixed?Aging – Fixed?

Hematological and MetabolicHematological and Metabolic

• Decrease in plasma volume, RBC Decrease in plasma volume, RBC mass, and blood volumemass, and blood volume

• Decrease in metabolic rateDecrease in metabolic rate

• Decrease in glucose toleranceDecrease in glucose tolerance

• Increase in triglycerides, total Increase in triglycerides, total cholesterol, and LDL cholesterolcholesterol, and LDL cholesterol

Aging – Exercise BenefitsAging – Exercise Benefits

CardiovascularCardiovascular

• Decrease the decline from 1% per Decrease the decline from 1% per year to 1% per decade!year to 1% per decade!

• Aerobic training has the same benefit Aerobic training has the same benefit with older athletes as their younger with older athletes as their younger counterparts offering the potential for counterparts offering the potential for a 10-30% improvement in the V02 a 10-30% improvement in the V02 max.max.

Cardiovascular (continued)Cardiovascular (continued)

• VO2 max. decline in a trained man at 70 VO2 max. decline in a trained man at 70 is minimized and the rate of decline from is minimized and the rate of decline from that point forward resembles a sedentary that point forward resembles a sedentary younger adultyounger adult

• Improved blood glucose, cholesterol (total Improved blood glucose, cholesterol (total and HDL)and HDL)

• Improved arterial elasticity contributing to Improved arterial elasticity contributing to a lower systolic and diastolic BPa lower systolic and diastolic BP

• Lower heart rate at rest and sub Lower heart rate at rest and sub maximum exercise as in younger athletesmaximum exercise as in younger athletes

Cardiovascular (continued)Cardiovascular (continued)

•Decrease in anginal thresholdDecrease in anginal threshold

•1-4% loss in body fat 1-4% loss in body fat particularly intraabdominal fatparticularly intraabdominal fat

•Improved red cell mass, Improved red cell mass, plasma, and blood volumeplasma, and blood volume

Aging – Exercise BenefitsAging – Exercise Benefits

Musculoskeletal systemMusculoskeletal system

• Maintenance or retrieval of the Type 2 Maintenance or retrieval of the Type 2 muscle fibersmuscle fibers

• Improvement in the mitochondrial Improvement in the mitochondrial densitydensity

• Improvement in the oxygen extraction Improvement in the oxygen extraction capacitycapacity

Musculoskeletal Benefits Musculoskeletal Benefits (continued)(continued)

•Improved strength, Improved strength, endurance, balance (postural endurance, balance (postural stability), coordinationstability), coordination

•Improved flexibility if built Improved flexibility if built into the programinto the program

Musculoskeletal Benefits Musculoskeletal Benefits (continued)(continued)

•Decline in fallsDecline in falls

•Decline in fracturesDecline in fractures

•Stabilization of joints and support Stabilization of joints and support of arthritic joints (4:1 impact of arthritic joints (4:1 impact absorption muscle to bone)absorption muscle to bone)

•Performance benefitsPerformance benefits

Aging – Aging – Exercise BenefitsExercise Benefits

MetabolicMetabolic

• Lessening of losses of muscle results Lessening of losses of muscle results in an increase in fat-free mass, thus in an increase in fat-free mass, thus an enhanced BMRan enhanced BMR

• Improved glucose toleranceImproved glucose tolerance

Aging – Exercise BenefitsAging – Exercise Benefits

Neurological and PsychologicalNeurological and Psychological

• Reinforcement of healthy lifestyleReinforcement of healthy lifestyle

• Enhanced sense of well being and Enhanced sense of well being and self-imageself-image

• Decreased incidence of anxiety and Decreased incidence of anxiety and depressive disordersdepressive disorders

Neurological and Psychological Neurological and Psychological (continued)(continued)

• Delayed functional disabilityDelayed functional disability

• Improved cognitionImproved cognition

• Decline in the incidence of Alzheimer’s Decline in the incidence of Alzheimer’s disease by greater than 50%disease by greater than 50%

Neurological and Psychological Neurological and Psychological (continued)(continued)

• Improved sleep patternsImproved sleep patterns

• Improved appearanceImproved appearance

• Enhanced opportunities for social Enhanced opportunities for social interactionsinteractions

Masters Aquatic Sports Masters Aquatic Sports

• Emphasis upon aerobic and Emphasis upon aerobic and anaerobic traininganaerobic training

• Upper and lower body trainingUpper and lower body training

• Minimal risk of injury during the Minimal risk of injury during the pursuit of trainingpursuit of training

• Heavy emphasis upon social aspectsHeavy emphasis upon social aspects

Masters Aquatic Sports Masters Aquatic Sports (continued)(continued)

• Supervised programming for all ages Supervised programming for all ages and abilitiesand abilities

• Core objectives of service, education, Core objectives of service, education, and growthand growth

• Competitive opportunities in all Competitive opportunities in all courses and open watercourses and open water

USMS Mission StatementUSMS Mission Statement

““To promote fitness and health in To promote fitness and health in adults by offering and supporting adults by offering and supporting Master’s swimming programs.”Master’s swimming programs.”

USMS Goals and ObjectivesUSMS Goals and Objectives

1.1. To encourage and promote improved To encourage and promote improved physical fitness and health in adults.physical fitness and health in adults.

2.2. To offer adults the opportunity to To offer adults the opportunity to participate in a lifelong fitness and/or participate in a lifelong fitness and/or competitive swimming program.competitive swimming program.

3.3. To encourage organizations and To encourage organizations and communities to establish and sponsor communities to establish and sponsor Masters swimming programs.Masters swimming programs.

USMS Goals and Objectives USMS Goals and Objectives (continued)(continued)

4.4. To enhance fellowship and To enhance fellowship and camaraderie among Masters camaraderie among Masters swimmers.swimmers.

5.5. To stimulate research in the To stimulate research in the sociology, psychology, and sociology, psychology, and physiology of Masters athletes.physiology of Masters athletes.

USA Masters Aquatic SportsUSA Masters Aquatic Sports

•USMS - 43,000 membersUSMS - 43,000 members

•Water polo – 800 membersWater polo – 800 members

•Synchronized swimming – Synchronized swimming – 750 members 750 members

•Diving – 250 membersDiving – 250 members

Demographics – USMSDemographics – USMS(by age group)(by age group)

• 18-24 – 5.7% 18-24 – 5.7%

• 25-29 – 9.7%25-29 – 9.7%

• 30-34 – 12.3%30-34 – 12.3%

• 35-39 – 14%35-39 – 14%

• 40-44 – 16%40-44 – 16%

• 45-49 – 15%45-49 – 15%

• 50-54 – 10%50-54 – 10%

• 55-59 – 6.7%55-59 – 6.7%

• 60-64 – 4%60-64 – 4%

• 65-69 – 2.3%65-69 – 2.3%

• 70-74 – 1.7%70-74 – 1.7%

• 75-79 – 1.1%75-79 – 1.1%

• 80-84 – 0.6%80-84 – 0.6%

• 85 plus – 0.3% 85 plus – 0.3%

The Future is Now!The Future is Now!

•The earlier the process of aging The earlier the process of aging is challenged the more positive is challenged the more positive the result and quality of life.the result and quality of life.

•Opportunity exists at the Opportunity exists at the younger age ranges establishing younger age ranges establishing a pattern of behavior that a pattern of behavior that embraces exercise as a routine embraces exercise as a routine part of daily life.part of daily life.

The Future is Now!!The Future is Now!!

•Fitness is at the core of the Fitness is at the core of the message from a personal and message from a personal and societal standpoint.societal standpoint.

•Competition is a means of goal Competition is a means of goal setting for some.setting for some.

The Future is Now!!!!The Future is Now!!!!

““Swimming for Life”Swimming for Life”

The Future is Now!!!The Future is Now!!!

Thank you for your attention!Thank you for your attention!

Questions?Questions?

BibliographyBibliographyAnderson L.B.,Schnohr P, et a;. ‘All-cause mortality associated Anderson L.B.,Schnohr P, et a;. ‘All-cause mortality associated

with physical activity during leisure time, work, sports, and with physical activity during leisure time, work, sports, and cycling to work’cycling to work’

Archives Internal MedArchives Internal Med.. 200;160;1621-1628 200;160;1621-1628Evans WJ.’Exercise training guidelines for the elderly.’Evans WJ.’Exercise training guidelines for the elderly.’ Med. Sci. Sports Exerc.Med. Sci. Sports Exerc.1999:31(1):12-171999:31(1):12-17Manson JE. Greenland P, LaCroix AZ, et al. ‘Walking compared Manson JE. Greenland P, LaCroix AZ, et al. ‘Walking compared

with vigorous exercise for the prevention of cardiovascular with vigorous exercise for the prevention of cardiovascular events in women.’events in women.’

NEJMNEJM..2002; 347:716-7252002; 347:716-725Neil R,Franklin B. ‘Promoting and Prescribing Exercise for the Neil R,Franklin B. ‘Promoting and Prescribing Exercise for the

Elderly.’Elderly.’ Am Fam PhysicianAm Fam Physician 2002;65(3);419-428 2002;65(3);419-428‘‘Exercise and Older Patients: Guidelines for the clinician’Exercise and Older Patients: Guidelines for the clinician’ J Am Geriatric Soc.J Am Geriatric Soc. 2000;48(3):318-324 2000;48(3):318-324

BibliographyBibliography

Team Physician HandbookTeam Physician Handbook 3 3rdrd edition 2002, edition 2002, Hanley and Belfus, Inc.,Mellion, Walsh, Hanley and Belfus, Inc.,Mellion, Walsh, Madden, Putukian, SheltonMadden, Putukian, Shelton

ACSM’s Esentials of Sports Medicine,ACSM’s Esentials of Sports Medicine, Mosby Mosby Press, Sallis and MassiminoPress, Sallis and Massimino

Clinics in Sports Medicine;Clinics in Sports Medicine; ‘Injuries and ‘Injuries and Considerations in Masters Aquatics Considerations in Masters Aquatics Sports’, JW Miller;18:2;1999:413-426Sports’, JW Miller;18:2;1999:413-426

2004 USMS Rule Book2004 USMS Rule Book