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Bodywork for Boomers
The Key to Active Aging

By Liz Prato

Originally published in Massage Bodywork magazine, November/December 2008. Copyright 2008. Associated Bodywork and Massage Professionals. All rights reserved.

Pointing to the pile at the back door, Steve Levy smiles and says, "My boots are still drying out from the ski trip." He just returned from two days on Washington's Mount Adams, which involved parking at 4,600 feet, hiking to 7,200 feet carrying a full pack, a tent, camping gear, and skis, and setting up camp for the night. The next morning Levy and his friends hiked to the 12,200-foot summit of Mount Adams, then skied down to their car. "We skied 7,000 feet," Levy reports. "I don't know anywhere you can ski 7,000 feet."

Clearly, Levy's an adrenaline junkie and he's willing to hike in order to get the most mileage out of the slopes. But what's interesting isn't the way Levy ascended or how far he descended Mount Adams, it's the fact that he's 62. "There's only one guy on the mountain older than me," he says.

Maybe that's true on Mount Adams, but America's trails, tracks, and pools are teeming with older adults.


A Generation On The Move
Baby boomers are a generation raised during the running craze of the '70s (remember Jim Fixx in those skimpy running shorts?), and the aerobics craze of the '80s (Jane Fonda in leg warmers!). They're used to hiking, walking, running, biking, kayaking, surfing, and just about every other activity imaginable. The website for the AARP (formerly known as the American Association of Retired Persons) has an extensive forum devoted to fitness (www.aarp.org), and it's not just the Sit and Be Fit brand usually prescribed for older adults. In addition to advice on how to start walking and swimming programs, AARP provides a beginning training program for triathletes. It features a regular column by tennis great Martina Navratilova, who won her last of 59 Grand Slam titles when she was six weeks shy of her 50th birthday. It's clear that this is a generation that won't stop being active simply because their bodies are getting older.

The only problem is, their bodies are getting older. Age is a state of mind, goes the bumper-sticker maxim, but age is also a state of the body. Even if someone feels 30 mentally, his or her body most definitely is not. The joints, ligaments, and muscles that make sports possible have all endured years of wear and tear. It doesn't matter if you're talking about a coffee maker or a quadriceps: if you use something day in and day out for 60 years, it's going to wear down.

A 2000 report released by the U.S. Consumer Product Safety Commission found that in 1998, hospital emergency rooms treated more than 1 million sports injuries sustained by people born between 1946 and 1964 (i.e., the baby boomers). This represented a 33 percent increase from seven years earlier.1 The increase was not so much attributed to more baby boomers engaging in more physical activity; roughly, the same number of people born in that post-World War II era were as active as before. The difference was that, suddenly, those same active adults were aging and therefore more susceptible to injury. Sports-related injuries tend to occur mostly to the muscles and joints in people of all ages, and that likelihood only increases as people's muscles and joints wear down. In 1999, Nicholas A. DiNubile, an orthopedic surgeon at the Hospital of the University of Pennsylvania, referred to this new intersection of age and sports injuries as "boomeritis."2


By The Numbers
As baby boomers continue to age (7,918 people are turning 60 every day),3 massage therapy can be greatly beneficial to this generation, especially since the Western medical system is ill-prepared for the huge influx of aging adults. There are about 7,100 doctors certified in geriatrics in the United States--one per every 2,500 older Americans.

A study by the National Academy of Sciences concluded that as the boomers age, older Americans' healthcare will be compromised due to Medicare's low reimbursement rates and its focus on treating short-term health problems rather than managing chronic conditions or age-related syndromes. Medicare's lack of coverage for preventative services will also negatively impact boomers' managed healthcare.4


The Important Role Of Massage
While massage cannot repair an injury as serious as a tear in the anterior cruciate ligament, for instance, it can go a long way toward warding off some of the more serious injuries. "I really believe massage is the best preventative medicine," says Dr. Gaynl Keefe, a doctor of traditional Oriental medicine in Santa Fe, New Mexico, who recommends massage to many of her clients.

Between 50-60 percent of Keefe's patients are 45 years and older, and almost all are trying to stay active. Part of it is because they want to look thin. Part is because they want to ward off many of the diseases that often accompany age, like cardiovascular disease and diabetes. Part of it is because retired people simply have more time to be active than when they were chained to a desk all day. They're taking exercise classes, traveling, and chasing their grandkids.

As people age, "the body's whole chemical factory slows down," Keefe explained in a July 2008 telephone interview. "In Chinese medicine, it's called a kidney chi deficiency." Whether you call it chi deficiency or aging, the symptoms include: joints and ligaments drying out and becoming less elastic, disc degeneration causing back pain (especially the lower back), recovery time from illness or injury increasing, and the immune system wearing down, making people more susceptible to infection. Enter the healing art of massage.


A Good Routine
Levy received his first massage in 1981 to address the problem of chronic lower back pain. He had been athletic his whole life, but the back pain persisted. For the last 25 years, so has his commitment to massage. "It's a regular part of my routine," he says, along with stretching, running, and weight lifting.

He initially looked at massage as a means to fix his back, he says, but now uses it preventatively. "Massage finds tight spots and releases them before they become injuries." While Levy admits massage doesn't necessarily fix his low back when he's in the middle of a painful episode, he seeks it anyway. He realizes that releasing the muscles around the injury point will help the specific injury heal. But, more importantly, he wants to break the cycle of pain and let his body experience another sensation.

Keefe agrees with Levy's strategy of helping his body reset the pain mechanism. "Massage allows the sympathetic nervous system to relax," she says. "It keeps fluids in and around the tissues moving and helps reduce nervous stress."

According to a 2007 consumer survey, the use of massage among older adults has tripled in the last 10 years. The poll, conducted by Opinion Research Corporation, found that baby boomers had an average of seven massages during the last twelve months (compared with five massages among 18-44 year olds), and 38 percent of those boomers cited medical reasons for seeking out massage.5


Shining Example
Barbara Gasuen isn't what you'd call an athlete, but she's definitely active. The Portland, Oregon, resident walks three miles every morning, travels internationally, and works in her garden. "Working in her garden" doesn't just mean trimming roses or pulling up a few weeds. She pushes a manual lawnmower and hauls wheelbarrows full of compost. At 66, Gasuen considers herself middle-aged.

Gasuen maintains her lifestyle with biweekly massage, which she started receiving eight years ago. She had been in two car accidents that left her with lingering neck and shoulder pain. Additionally, she'd been battling low-back pain for several years, and she figured massage was a good way to keep her body in good working order.

"Since retiring, I've tried to focus on improving my health," Gasuen says. "The only medications I take are a multivitamin and a baby aspirin. When I see others my age--and younger--with their prescription bottles for high blood pressure, etc., I think about how lucky I am." She credits her good fortune to her decision to get regular massage. It helps her stay flexible enough to stay active, which in turn keeps her healthy. And her lower back has barely bothered her in years. "Let me put it this way," she says. "I'll give up my morning latte before I give up my regular massage."


Trends
Low-back pain is one of the most common complaints Erik Mondrow, MD, an internist in Louisville, Colorado, sees in older athletes. With his practice located on the outskirts of the very athletic city of Boulder, Mondrow sees a healthy dose of active adults. Shoulder and neck pain top the lists of complaints, and Mondrow frequently recommends massage for his patients. Even when a patient isn't suffering directly from an injury to the soft muscle tissue, he considers massage beneficial. "Lots of people's maladies are musculoskeletal related," Mondrow says. "Massage intuitively makes sense."

But it's more than intuition telling us that massage is effective in treating low-back pain. An August 2005 issue of Consumer Reports cited deep-tissue massage as one of the remedies voted most effective by readers for back pain, and additional research shows consumers turn to massage as frequently as chiropractic care and physical therapy.6


Payments And Priorities
Then comes the inevitable question of money: who's going to pay for the massages sought by these 78 million aging Americans? Due to insurance laws, Mondrow says he's not allowed to personally investigate whether a patient's insurance provider covers massage before he prescribes it. However, Keefe is well aware that many carriers won't cover it. One of her patients had to stop receiving massage when her insurance stopped paying for it, and her patient's pain and emotional stress increased. Research shows that 90 percent of all massages are paid out of the clients' pocket--even when seeking relief from pain or other medical conditions--and one-third of the 84 percent of Americans who do not receive massage cite cost as their reason.7 With increasing numbers of Americans using massage as healthcare and not just a pampering luxury item, experts say it becomes more essential for massage therapy to be covered by insurance.

Mondrow sees the benefits of bodywork, but in order for massage to be covered under insurance, the medical profession needs to be aware of the numerous studies proving the efficacy of massage. Various industry groups are promoting massage research, for example The Touch Research Institute has conducted and/or compiled research on more than 100 studies about the influence of massage in a vast number of conditions, including those which most often relate to aging: hypertension, chronic pain (especially back pain), arthritis, stroke, and depression. In most instances, legitimate studies found that massage had a positive or preventative effect on many of these diseases of age.8 The Massage Therapy Foundation and the National Center for Complementary and Alternative Medicine are major sponsors of expanded research. Spreading the word about empirical research promoting the medical benefits of massage will help give massage therapists and their booming clients greater access to bodywork.

The upside is baby boomers are more affluent than any generation before or after them. According to AC Neilson, boomers have a median household income of $54,170--55 percent greater than post-boomers and 61 percent more than pre-boomers.9 Their generation alone is responsible for more than half of all consumer spending in the United States. As they age, financial responsibilities, like raising children and/or paying for their college, tend to dissipate. Many older adults downsize into smaller homes and reduce their living expenses. Additionally, a 2006 Merrill Lynch study found that 71 percent of adults plan to work past typical retirement age.10

All this allows boomers to prioritize their finances differently than the 18-44 demographic. When boomers' bodies starts aching and keeping them from participating in the activities they love, massage quickly becomes a priority. And massage therapists will gladly be there to help them get back on the road again.

Liz Prato is an Oregon-based massage therapist and author. Contact her at lizprato@comcast.net.

NOTES
1. Consumer Product Safety Commission, "Baby Boomer Sports Injuries," (April 2006), www.cpsc.gov/LIBRARY/ boomer.pdf (accessed September 2008).
2. Jane E. Brody, "To Avoid 'Boomeritis' Exercise, Exercise, Exercise," The New York Times, December 19, 2006, 1.
3. U.S. Census Bureau, "Population Projections: U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin: 2000-2050," www.census.gov/ipc/www/usinterimproj (accessed September 2008).
4. National Academy of Sciences, "Health Care Work Force Too Small, Unprepared For Aging Baby Boomers," (April 2008), www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12089 (accessed September 2008).
5. American Massage Therapy Association, "2007 Massage Therapy Consumer Survey Fact Sheet: Wellness Drives Americans' Growing Use of Massage Therapy," (2007), www.amtamassage.org/media/ consumersurvey_factsheet.html (accessed September 2008).
6. Nora Brunner, Associated Bodywork Massage Professionals, "Massage Makes Strides in Public Acceptance: Consumer Research Overview," (February 2007), www.massagetherapy.com/media/metricsoverview.php (accessed September 2008).
7. Ibid.
8. Touch Research Institute, "Massage Therapy Research Abstracts: Adult Massage," www6.miami.edu/touchresearch/adult.htm (accessed September 2008).
9. Doug Anderson and Laurel Kennedy, "Baby Boomer Segmentation: Eight Is Enough," (2006), http://us.acnielsen.com/pubs/2006_q3_ci_babyboomer.shtml (accessed September 2008).
10. American Massage Therapy Association.




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