An excerpt from Man Overboard!: A Medical Lifeline for the Aging Male.

OK, you don’t consider yourself an exerciser. It’s just not you. You hate running. You don’t have the social temperament or the body image to show up in a gym. You’re not interested in doing a Turkey Trot, Reindeer Run or, God forbid, the Boston Marathon. You’d almost certainly drown in a triathlon. You just want to walk your one or two miles a day, or ride your stationary bike and leave it at that. Fine. I get it. You’re on board with trying to live an active, NEAT-freak life, but you don’t see yourself becoming an AARPathlete (“ar-PATH-leet”), or any kind of athlete. Let me explain why I think you should at least consider adding a little huffing and puffing to your life.

Golf as a “sport” and the subtleties of aging

 A decline in cardiovascular fitness and muscle power are major factors in the decline of the aging AARPathlete, which is why exercise recommendations—like those from the American College of Sports Medicine (ACSM)—always include aerobic exercise (three to five days per week for 20 to 60 minutes) and resistance (muscle) training (two to three days per week).

But the physical decline we experience with aging plays out in a myriad of other ways, which is why the ACSM also recommends both flexibility and balance training two to three days per week. These more subtle areas of decline are neatly illustrated by the “sport” of golf.

Professional golfers are not immune to injury, but until the PGA makes golf a contact sport, or adds a time component that requires golfers to sprint through the entire course, most of their injuries will remain relatively minor and related to repetitive motion or overuse, or by something that happened far off the course. Tiger Woods seriously injured his back when he got tired of being Tiger Woods and started training with the Navy Seals.

So in a high-finesse, but rigorously non-rigorous “sport” like golf, where mental things like concentration, shot and club selection, and swing adjustment are so key, why does the Senior Tour start at age 50? Because aging diminishes our reflexes, coordination, balance, depth perception, flexibility, and the elastic recoil of tendons and ligaments.

This is why the American College of Sports Medicine includes flexibility and balance in its exercise regimen. Flexibility isn’t just for contortionists or ballet dancers. It helps keep our tendons (binding muscle to bone) and ligaments (binding bone to bone) healthier. It helps keep our bodies in ergonomic balance. If you think about it, every muscle or muscle group has a partner that it must work with, and not against. When you lean over to tie your shoes, your abdominal muscles must contract, but the muscles along the back of the spine must also relax. It’s the reverse when you stand up. When you flex your bicep, the tricep must relax.

If you are still in the active denial phase of your maturing life, here are a host of very logical, very plausible, even believable explanations for why someone with your renowned physical gifts may be starting to suck.

A partial litany of reasons I’m starting to suck athletically

• Job stress
• “The kids/adult children are sucking the life out of me.” (KACSLOOM)
• Sleep deprivation, due to KACSLOOM, and also job
• Have not updated athletic equipment since college
• Genetic factors, including sloth and nihilism
• Subtle fluctuations in the short-term bond market
• Chafing
• Gluten. Damn you, gluten
• Gluten-free foods
• Climate change
• Hops leaching away critical but yet-to-be-discovered micronutrients.

This list is by no means complete, but having a list of poor performance excuses memorized and at the ready can be handy when you’re getting your ass handed to you by the local peloton; or when you’re running a 10K and it seems like the pavement beneath your feet is—no kidding, this has happened to me!—sliding forward, which, as frustrating as that may be, is at least an explanation for why you’re working so hard to run that slow.

Sticking the landing. What’ll it be: the fountain at Caesar’s Palace, or 13 buses at Wembley Stadium?

Alright, so the decline in muscle function and cardiovascular fitness looks like the exit ramp on a stunt jump by your childhood hero Evel Knievel, who, incidentally, died at age 69 of diabetes, liver disease, pulmonary fibrosis, and what pathologists termed “general abuse.”

The good news is that each of us has some say in the matter of this “controlled” crash landing into the everlasting. We hold some sway over whether we land short, like Evel at Caesar’s Palace, where we tumble over the handlebars and break a bunch of bones and spend a month in a publicity-induced coma, or whether we clear 13 buses at London’s Wembley Stadium but still end up crashing and breaking a pelvis—although not badly enough to keep us from walking back up the ramp, with assistance, to the raucous cheers of the crowd. But hey, Knievel landed most of his jumps, and so can you.

There will be a decline, an off-ramp, but there doesn’t have to be a crash. You do get some say over where you land on the infamous “All-Cause Mortality” (i.e., death for any reason) curve, so keep these points in mind:

• For the inert/sedentary individuals, low levels of activity bring the biggest gains (i.e., mortality drops most sharply with small improvements in activity).
• Being active and exercising drops the risk of dying early by 30 percent to 40 percent. (And just to be clear, the risk of dying in this life is 100 percent, a certainty, although scientists are   working on changing that.)
• Yes, the mortality benefits of exercise stall out—i.e., you can’t exercise yourself to Eternal Life—but there’s more to life than how old you are when you die (quantity): there’s how well you lived (quality), and exercise can increase that.

It seems too good to be true, but it is: physical activity improves every health outcome we can name. Note that some of those benefits arrive in the long term, some in the short.

It’s critically important to remember that although the mortality benefits of exercise fade out at a certain level, the health benefits do not. Exercise offers the option of a healthier life, just not eternal life.

Craig Bowron is an internal medicine physician and author of Man Overboard!: A Medical Lifeline for the Aging Male.

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