Staying in the Game

Boulder triathlete Sue Shaedle.

Boulder County is proud of its Olympians and other elite athletes, but even here, professional athletes are a rarity. Most area runners, cyclists and skiers, even those who are sponsored and travel all over, have careers and a family life they work around. As time moves on and genetics kick in, competitive athletes and weekend warriors alike face diminishing returns. That’s usually when they learn to stop chasing dreams of gold and enjoy performing at their personal best.

Exercise scientists usually peg peak endurance at 35 years of age, with slow declines thereafter into the 60s. All athletes lose the race against time, but endurance athletes in general are outperforming the times and distances of the generations before them. These advances are founded upon improvements in nutrition, sport medicine and a refusal of more athletes to accept “too old” as an excuse.

Dave Jones during the Race Across America.

Dave Jones, of Longmont, is a FedEx pilot who’s been active most of his life. Over the years, he’s gone from recreational mountain biking to longer endeavors like cycling across the country. That’s something he’s done twice now, this year finishing the Race Across America as part of a four-man team (all fellow pilots) in less than seven days.

At 53, Jones can easily be called “ripped” when he’s at his cycling weight. He said diet has always been his weakness, and traveling around the world on a nontraditional schedule hasn’t helped either. Yet a lifetime of fitness and the addition of weight training have enabled him to push his limits. Next year he plans to transform himself from an endurance cyclist to a sprint-distance track cyclist.

When his doctor retired, Jones was referred to Dr. David Tusek, whose patients include several elite athletes, even a world champion track cyclist in the masters (over 50) division. For Tusek, modern medicine isn’t just about performance, it’s about optimal living. They two hit it off. “I just like his point of view toward health and modern medicine,” he said. Jones takes his training serious, up to a point. “Life is life, and life is to be enjoyed. I tend to push myself too hard and I’m trying to throttle that back.”

OPTIMIZATION

Besides the annoying reminders from friends, turning 40 marks the age doctors will run an extensive panel of tests. At that age, the body is changing in a way that it hasn’t changed in previous decades. Changes in diet, weight and energy levels often occur, and lethal risks can pop up. More bluntly, that’s when you’ll start to lose friends to disease and poor health.

“As a doctor, I’ve never treated a population. Yet all of our screening recommendations are meted out on massive population data,” Tusek said. “It’s great as a rough guideline – but you need personalized, unique interpretations.”

Tusek brought up the exponential growth of computers over the past 50 years, and how biotech is in a similar boom of rapid growth that the medical community is still deciphering. Yet despite all the recent medical advances, the typical checkup hasn’t changed. Many have argued it’s woefully outdated.

Dr. David Tusek in his Boulder office.

That’s where Diagnocity comes in. Beyond Tusek’s primary care practice, Diagnocity is an attempt to modernize health care and catch up to the available science, using some of the very new tests, to create a “prevention program to assess things that may or may not be early enough before things get bad.” He doesn’t think these test make sense for everyone, but his mission is to alert patients to these emerging tests, like genomics, and let them discuss and evaluate whether it makes sense for them, as individuals.

This isn’t biohacking on steroids, it is proactive medicine. Tusek argues that we as a society should be talking about these new technologies more. Casual sports fans may know that HGH stands for human growth hormone and is a banned substance for pro athletes, but not know why it is prescribed to patients. “I’m passionately convinced we need have to these conversations about things like ‘enhancement’ and ‘optimization.’ And what does that mean even? And is that ethical?”

At one end of the spectrum are people, especially tech industry biohackers, who take nootropics to enhance their brains, and at the other end are those who just want to find out what kinds of vitamins they may be missing from their diet. The side effects of eating better or taking a multivitamin definitely fall on the side of “least harm,” but for some there is always the hope of some new technology or pill that will unlock great potential.

For Tusek’s practice, he sees plenty of casual athletes with ordinary health concerns. But when it comes to options for those patients, he offers a lot more. “We have a lot of weekend warriors here in Colorado and they haven’t even had an EKG,” he said. Tusek said that’s something that competitive athletes, not just elites, should look into.

LATE BLOOMERS

The transition from active to competitive isn’t just for seasoned athletes. For some, it’s not until children are grown that they pick up a new pastime, especially ones with rigorous training plans. Through her daughter’s early childhood, Sue Schaedle stuck with “kid stuff.” When she turned 50, she decided to race a half-triathlon.

After she watched a full triathlon, she was inspired by the middle of the packers. “I know there’s so many pros in Boulder, half of them live in my neighborhood,” Schaedle said. “But it was seeing those other people come in later, you knew they had full-time jobs, and they were still able to do it.” So she made a full triathlon her new goal.

At 53, she’s still beating her recent personal bests at events like Bolder Boulder. “I started training for triathlon in August 2014, I began to experience considerable fatigue after my longer workouts, especially the runs,” she said. Her general practitioner suggested it was likely from working out too much for her age. She was underwhelmed and visited Tusek. He ran a panel of blood tests which revealed her deficiency in B vitamins and chromium. “Once I added these vitamins to my diet I felt less fatigued and much more energized.”

Schaedle said the bloodwork consult helped her feel more energized between workouts. While she takes a multivitamin to help out, she recognizes the importance of a sound diet for better health and performance. “Eating healthy, especially as you get closer to your ‘A’ race is also important.”

PRESCRIPTIVE DIET

It’s easy to get stretched thin while juggling work, home life and peak training. That’s when some athletes look for someone else to do the cooking. Athletes can find healthy, calorie-controlled meals prepared by businesses like Real Athlete Diets Boulder. Its menu emphasizes a balance of carbs and protein with organic and local ingredients. For athletes, the added variety to their diet and time savings is a bargain. “It’s such a big trend, at least in our area,” said RAD founder Kelly Newlon. “People out here are on the bandwagon.”

Newlon grew up working in kitchens and ran in her spare time. She never connected her passions until two years ago, when she started RAD. The idea came when she was teaching in a culinary school and a friend asked to hire her as a personal chef. She turned down that request, but then recognized a business opportunity, and was surprised to find that no one in Boulder was already doing it.

During big races, like the Hardrock 100 ultra-run, Newlon and her team prepare meals for several sponsored athletes and their support crews. Catering now makes up the bulk of RAD’s business, but her athlete clients can still get personalized meal plans. “I wanted to work with elites at first,” she said. “But this is Boulder and that grew to active people.”

When advising runners and cyclists, Newlon emphasizes the importance of diversity on the plate. The pros are up-to-date on new studies on superfoods or protein and carb balance and may ask for tweaks to their dietary plan. For the most part, they listen to their bodies if performance lags. “Our clients are really sort of holistic,” she said. “The first thing they go to change is diet if something’s not right.”

Newlon said casual athletes are more often set in their ways when it comes to diet, often following set, or restrictive, plans. “Just because this is how you started your season, or you eat something on a daily basis, you can still re-evaluate that every quarter or season,” she said. “You can change a few things in diet and see improvements.”

BIGGER REPAIRS

Joanne Halbrecht, MD is an orthopedic surgeon with more than 20 years of experience. She’s established a reputation for being conservative on prescribing surgery, and usually recommends rehabilitation when there is no tear. No surgery, no steroid injections. “A lot of patients feel if they see a surgeon it means they’ll need surgery,” she said. “90 percent of the time, the people I see who don’t have a tear just need physical therapy.”

Working with athletic patients who feel in tune with their body and accustomed to some aches and pains can be different. Halbrecht said she encounters active patients who come to her after they’ve tried some therapy on their own, even activity modification, but stubbornly fought through inflammation which created a longer healing time once the right kinds of therapy were prescribed.

Traditional doctors may treat symptoms with over the counter anti-inflammatory drugs like ibuprofen, but do nothing to resolve the underlying pain. When that nagging pain doesn’t go away and requires surgery, Halbrecht will incorporate stem cells. Stem cell therapy has plenty of baggage associated with it, and some uses are less legitimized by medical studies than others. Platelet Rich Plasma (PRP) injections used to relieve ankle pains have been in use for decades, and while most patients report less pain one year later, the treatment does nothing for other patients.

Halbrecht uses stem cells in conjunction with surgery, since the intrusion has been made. She cited a French study which found that patients with bone marrow stem cells injected during rotator cuff surgery had a 10-year success rate of 87 percent, compared to 44 percent of those without cells.

It’s not always good news. The Boulder running crowd can be stubborn. They do get the knee problems, even meniscus tears and arthritis, and want to continue running long distances. Some even moved here specifically for running and biking. Halbrecht said the realities of genetics still trump medicine; “I used to be a runner, but when you start having knee pain it’s time to switch to a lower impact activity.” That’s when she recommends “wheels and water;” a switch to endurance cycling, swimming or water running.

One of the most common impediments Halbrecht encounters is poor posture. The 9-5 workday hunched over a keyboard causes bursitis, then the weekend comes and body is thrown into new, strenuous motions. That’s a recipe for injury, not because of the weekend pursuit, but the lack of activity the rest of the week. To help resolve this, she routinely puts patients in a posture shirt, which like the kinesiology tape seen on runners and swimmers at the Olympics, primes back muscles to engage.

PERFORMANCE BEYOND SPORT

If the discussion of performance sounds like the sole domain of athletes, it’s not. Health experts continue to expound the association between exercise and health. Cyclists and runners have long used their VO2 max, a measurement of maximal oxygen uptake, as a reference for training in different ‘zones’ below that benchmark.

In December, the American Heart Association released a statement recommending doctors consider a patient’s VO2 max as a vital sign. “A growing body of epidemiological and clinical evidence demonstrates not only that cardiorespiratory fitness (CRF) is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol and type 2 diabetes mellitus.”

Numerous studies show running can prevent those risk factors as well as improve moods and even re-wire brains to reduce symptoms of depression. So for people in their 40s and 50s who want to continue being active into their 60s and 70s, or just continue living past that age, 30 minutes of cardio is the best prevention. We asked our Masters athletes for advice for other aging athletes and they offered similar tips: eat enough protein, lift weights, get plenty of rest and have fun. That’s good advice for everyone, especially those who subscribe to the notion of living one’s best life.