Flexibility of the Aging Athlete

Jacy Brown, SPT, Britt Wickett, SPT, and Clay Lovro, SPT

sa-flexibility-student-poster

20 Comments on “Flexibility of the Aging Athlete

  1. It is great to see that SA have greater shoulder flexibility and there are no significant differences with hip and ankle flexibility when compared to a younger population. I would be curious to know if the hip and ankle flexibility is significantly different when compared to age-matched norms and therefore I am curious how you decided on the modified Thomas test to measure hip flexibility? Is their another test for the hip and ankle that would have offered aged matched norms or is there not enough research on this aged population? Thank you!

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    • Thank you for the question, Chelsey,

      Yes, it was difficult for us to find research on community dwelling norms, especially with the methods that we used. There is not much published information on flexibility in the senior population. However, there actually was a couple of articles that we could have used had we tested ankle dorsiflexion and hip extension in the standard ROM positions–with the knee bent and patient seated for ankle dorsiflexion, and side-lying for hip extension. However, this is an ongoing study and the screening process that was used was set up several years ago, and thus we continued using those methods so that we could use all the information previously gathered.

      Jacy Brown, SPT

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  2. Did you look at collect any data in regards to how long the athlete had been involved in the sport to see if the amount of time correlated with the amount of flexibility? If not, do you think this would be a relevant factor in the amount of flexibility that the athlete had?

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    • Thank you for the question Hailey,

      For the purpose of our research we did not not specifically look at the amount of time involved in each sport. The purpose of our study was to establish normative values for flexibility for competitive athletes over the age of 50. Another one of the Senior Games research groups looked at flexibility by sport, however they did not look specifically at the amount of time involved in the athletes sport of choice.

      Britt Wickett, SPT

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  3. I understand that you are unable to unable to draw direct conclusions from this observational study. However, I was wondering if you think that the statistically significant results that you found are also clinically significant? If so, how will you use this information when treating geriatric patients in a clinical setting?

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    • Thank you for the question Jena,

      A difference of 5 degrees is considered to be clinically significant in terms of standard goniometric measurements. None of the significant differences found in our research revealed a difference of 5 degrees or more so although our data was statistically significant it was not clinically significant.

      Britt Wickett, SPT

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  4. Did you guys collect any data regarding which sport/event the athlete was in? If so, were there any noticeable trends in ROM for those subgroups?

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    • Thank you for the question Codi,

      The data collected at the National Senior Games was collected by two research groups. Our research group focused on flexibility changes by gender and age while the other group focused on flexibility by sport. This information can be seen on the poster “Competitive Sport Type on Flexibility, Injury, and Fall Risk in Aging Athletes”.

      Clay Lovro, SPT

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  5. What is the explanation regarding the gradual decline in shoulder and ankle flexibility in the SA compared to hip flexibility? Is this related to the sports they are participating in? Is the decline in shoulder and ankle flexibility similar to non-senior athletes where seniors in general lose hip flexibility at a later time?

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    • Thank you for the question Shaina,

      One trend associated with flexibility is that over the lifespan as age increases there is a general decline in flexibility seen in all joints of the body. One reason for this is because as we age the body tends to adapt a more flexed posture, which in return leads to a decrease in flexibility. The joints most affected by the loss of flexibility are the joints in the lower extremities. The results of our research reveal significant differences between all age groups for shoulder ROM, significant differences between the 7th, 8th, and 9th decades for ankle flexibility, and no significant differences between age groups for hip flexibility. (A p value < 0.0001 indicated a significant difference). Our research did not focus on the specific sport an athlete was participating in. Comparing our research to normative values found in the literature was a difficult process for hip and ankle flexibility due to our research utilizing different methods compared to other studies; identical methods were used for shoulder flexibility. In a study completed by Soucie et al., shoulder flexibility was gathered using the same method as our research. Comparing their community dwelling volunteers aged 45-69 to our senior athletes aged 50-69 results showed that senior athletes had significantly better shoulder ROM, with the difference approaching clinical significance of a 5 degree difference. For hip flexibility we compared our research to identical methods used in a study completed by Clapis et al. Their population of sedentary subjects aged 18-36 were compared to the entire population of senior athletes in our study. Results from this comparison showed increased hip flexibility in senior athletes compared to sedentary 18-36 year olds; however, this difference did not show clinical significance. Finally, for ankle flexibility our research results were compared to a study completed by Gadjdosik et al. In this study identical methods were used to gather ankle flexibility but were only gathered in active women age 60-81. When comparing the results from this study to 60-81 year old female senior athletes from our research there was no significant difference. Additionally, we compared ankle flexibility of senior athletes of both genders to subjects aged 28-54 in a study by Thomas et al. Results from this comparison showed no significant differences between senior athletes and a younger population. In conclusion, senior athletes still show a gradual decline in flexibility with age. However, senior athletes show a more delayed decline when compared to their community dwelling counterparts.

      Clay Lovro, SPT

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  6. You have a very interesting study. I was wondering how you would implement this information into your future practice, especially in older adults that may not be active or see the importance of maintaining their flexibility. Did the SA’s make any interesting comments during data collection for the flexibility measurements?

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    • Thank you for the question Jessi,

      The results from our research will be very beneficial in our future practice. It is important to note that although senior athletes maintain an active lifestyle, a gradual decline in flexibility is seen with age. However, compared to their community counterparts a more delayed decline is seen in senior athletes. Most importantly, the results and comparisons from our research support the promotion of an active lifestyle and regular exercise as useful means for maintaining flexibility throughout the aging process. Which in return, can hopefully lead to a more prolonged and healthier lifestyle. No specific comments come to mind during the data collection. Our time at the National Senior Games was a very enjoyable experience.

      Clay Lovro, SPT

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  7. Did you ask the study participants if they regularly included stretching/flexibility exercises as part of their warm ups or program versus just being active in their sport but not doing any specific stretches? Can and should seniors at least do regular stretching even if they cannot be active in a sport or activity is what I wonder. Thanks!

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    • Thank you for the question Scott,

      During our data collection we did not ask our study participants if they regularly included stretching/flexibility exercises as part of their routine. However, we did ask participants about his/her prior medical/surgical history, how frequently he/she exercised/practiced for his/her sport, and if they had suffered from a recent fall/injury. Although a decrease in flexibility cannot be entirely prevented throughout the aging process, it appears regular exercise and maintaining an active lifestyle can potentially delay its decline. We encourage all seniors to participate in some sort of physical activity. This could include participating in a sport, going to the gym, walking, stretching, completing a home exercise program, etc. Therefore, yes it is beneficial for seniors to regularly stretch; especially, their lower extremities (hip flexors, hamstrings, gastrocs). An exception to this would be if the decreased flexibility is being utilized and important for the individual to overcome a specific impairment.

      Clay Lovro, SPT

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  8. In your results section it shows that females have greater shoulder flexibility and males have greater hip flexibility. Were you able to determine why this occurred? I would have thought females had greater hip flexibility so it was interesting for me to see it was the opposite. In the SAs, were there more female participants in overhead activities than males? Could this have influenced the results?

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    • Thank you for the question Abigail,

      I apologize for the confusion. You are correct that our results show that females have greater shoulder flexibility when compared to men; however, females also have greater hip flexibility. To measure hip flexibility we utilized the modified Thomas test. If the subject’s thigh rested flat on the table, it was recorded as a 0. If the subject was unable to rest the thigh flat on the table the number of degrees of flexion from 0 was recorded. Although it may appear when looking at the hip flexibility by gender chart that men have a greater hip flexibility, women actually have greater hip flexibility because a smaller number that approaches zero indicates that the thigh rests closer to the table, which indicates a greater hip flexibility. For our research we did not look into the specifics on why women on average had greater shoulder flexibility than men. However, research shows that as age increases men show a greater decline in flexibility than women due to the genetic makeup and physiological differences between the genders. For example, hip flexibility in women tends to be greater due to the shape of a woman’s pelvis to allow assistance with the birthing process. Overall, there was more female participants in the National Senior Games compared to male participants. However, we utilized a sample of convenience of approximately 1600 senior athletes that volunteered to participate in our research, so we do not believe this negatively influenced our results.

      Clay Lovro, SPT

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  9. Based on the results of this study do you have any ideas on best types of regular exercise and activity that you would recommend for the geriatric population to improve their flexibility? Was any data collected on favorite types of exercise performed by the athletes at home?

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    • Thank you for the question Ike,

      Based on the results of our study it would not be appropriate to conclude that there is one best type of exercise or activity for improving flexibility. The purpose of our study was to establish normative values for shoulder, hip, and ankle flexibility in competitive athletes over age 50. Our findings do not allow us to make any direct conclusions regarding specific means for improving flexibility in the geriatric population. However, our results appear to support that living an active lifestyle may be beneficial in maintaining flexibility throughout the aging process. Data was collected on what types of exercises the athletes participated in, but for the purposes of our study we did not examine the potential impact exercise type has on flexibility, this would certainly be an interesting area for further investigation in future studies.

      Britt Wickett, SPT

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  10. Hello,
    I have two questions regarding this study that I hope that you can clarify for me. First, while it is apparent that SA maintain a greater flexibility than age matched peers are the normative values within a functional range? and if so what would the benefit of “additional” flexibility that was beyond what was needed for functional movement?
    Secondly, I am curious how this can be implemented into clinical practice? Of course we can use these findings as tool for patient education for preventative measures, but can we apply these findings to our patients who are seeing us with a limited ROM, or are further studies needed before we can recommend sport as a tool to “improve” ROM vs “maintaining” ROM?

    Thank you for your time,

    Jon Gray SPT

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    • Thank you for your question, John.

      Yes, these values would be within a functional range as they allowed each athlete to participate in his/her sport at the National Senior Games. It is difficult to say what “additional” flexibility would do to benefit the senior athletes, but we can only speculate it would improve their performance and prevent injury. To answer your second question, we do not know if the athletes have superior ROM as compared to community dwellers because they perform in these sports, or if they perform in these events because they have superior ROM. It does, however, provide us the information necessary to promote living active lifestyles in order to maintain or decrease the decline in ROM throughout the aging process, but further studies would be needed to state that being active in these sports would “improve” ROM in our patients.

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