A Conversation with Doug McKee
Health clubs, gyms and other fitness centers throughout the Bay Area are experiencing a surge in members over the age of 50. In response, fitness trainers are becoming more familiar with the physical abilities and goals of aging clients, which often differ from those of younger people.

To assess the benefits of exercise and fitness for older adults, Bay Area Summit spoke in June 2004 with Doug McKee, one of three personal trainers at the San Francisco Bay Club that specialize in working with midlife and elderly clients. McKee was voted Fitness Professional of the Year in 2000 and 2002 by the club's management and fitness staff, and he received the club's Enhance Award for professional and community service in 2003. He is certified by the American College of Sports Medicine and National Academy of Sports Medicine.

Bay Area Summit (BAS): Have you seen an increase in the number of older people coming to the Bay Club in recent years, and is this age group becoming a larger portion of your clientele? If so, how do you explain this?

Doug McKee (DM): We've definitely seen growth in this area and, yes, the percentage of my clients who are in their 50s, 60s and 70s has been rising steadily. Older people are coming to fitness environments, including many who haven't exercised regularly for decades, for a variety of reasons. What we're finding with these individuals is that while they may initially come in with a goal of losing weight or because of a doctor's orders to exercise a bad joint, they discover that physical exercise is also improving their quality of life. After they get their first taste of what it feels like to exercise and infuse their bodies with oxygen, they get addicted.

BAS: So exercise becomes a quality of life issue that supercedes the original reason they may have come to you?

DM: Right. Many of my older clients are unsure of what to expect when they first come in. But they find that if they maintain the exercise program I design for them, they have more endurance, they can travel more comfortably, they can play with their grandchildren. In other words, they benefit from exercise in ways they didn't anticipate.

I should also add that older people are also coming to fitness clubs like ours because of the increasing awareness about the importance of exercise for older people. The media has helped spread the word that regular exercise improves quality of life.

The Bay Club's Doug McKee specializes in working with midlife and older adults

BAS: Do you find that your older clients have different long-term fitness goals than the younger people you work with?

DM: Yes. My older clients generally have discomfort with some kinds of movements. Part of the aging process is that lean muscle mass is lost, while the size of tendons and other inelastic connective tissues increases, which makes joints stiff and painful. Almost all people over the age of 60 have some pain in their lower back, the ball of their foot, their knee or shoulder. So the goal of my work with older clients is often centered around increasing their ability to perform daily activities such as shopping, gardening and lifting things with greater ease and without pain. My older clients are generally less concerned with appearance than with feeling better and doing their normal daily activities with less pain.

Another of the goals in working with older people is to provide psychological inspiration. One benefit of regular exercise is that it alleviates depression, which sometimes affects older people. The psychological lift to having your body stimulated by exercise carries over to your mood.

BAS: How does the exercise program you design for older clients differ from one you might create for a younger person? Do you use different techniques or stress different activities?

DM: Everyone's abilities are different, so I tailor a person's exercise routines to work within their limitations. When working with new clients in their 60s and 70s, we take things more slowly and start out with lower intensity. I like to start off by teaching a better quality of movement, such as how to properly reach down and pick something off the floor. We work a lot on balance and coordination of movements. For example, my goal is for an older client to be able to stand on one leg for 90 seconds. If they can do this, they have a pretty good gyroscopic capability. Typically older people can't stand on one leg for even 5 seconds when they first see me. Older people often have trouble with balance, and if they have poor balance, they're much more likely to fall.

BAS: What about weight training and other resistance exercises?

DM: Resistance exercises are another important part of any exercise program. Resistance exercises can increase lean muscle mass and slow or reverse muscle and bone density loss, even for people who begin these exercises in their 80s and 90s. Of course, these exercises need to be tailored to the capacity of the individual. The idea, usually, is lower intensity but a higher number of repetitions. We use dumbbells, exercise machines and movements using the body's own weight, such as squats, stationary lunges and push ups against a wall.

BAS: Do you have any success stories you'd like to share?

DM: I have one male client I've been working with for about a year. He's 75 and swims three times a week and works out with me once a week. When he came in he was swimming, but he'd never done any resistance exercises. Since he started working with me, he's increased his upper body muscle mass to the point where he needed to move to a larger shirt and jacket size. His shoulders and chest and arms are bigger. He loves it that he's getting bigger at an age when many people his age are becoming more frail. When he started with me, his coordination was poor and his body was unstable. We started by working on balance and the biomechanics of movement. Once these were adapted, we gradually increased the intensity and repertoire of exercises. He now moves much more smoothly.

BAS: Is there a reason that you have come to specialize in working with older people?

DM: It's partly due to the fact that I'm now in my early 50s and so older people can identify with me. I'm old enough to understand how the body changes with age, and I'm able to connect with older people on a psychological level. I have the patience and there's an element of trust and maturity. Plus, I've just always enjoyed being around and learning from older people.

BAS: Are there some exercises you recommend for older people who can't make it to a health club or gym, or for people to do outside a health club or gym?

DM: I recommend any type of activity that involves moving the body. It could be walking, dancing, gardening, anything that keeps you moving for a sustained period. It's important to do this to increase cardiovascular capacity, which increases the body's ability to take in and distribute oxygen. But it shouldn't be strolling; it needs to be brisk, purposeful walking. If a person hasn't been doing this for awhile, they should start slowly. Start at 10 minutes, then work up in increments to where you're walking briskly for 20 minutes to an hour each day or equivalent activity. It's also important that the activity be one the individual enjoys. If you don't enjoy the activity it won't be sustained and therefore won't be as beneficial. My advice is to find activities that feel good and that a person enjoys doing. and then do it the best way you know how and good things will come of it.

Disclaimer: The views and opinions expressed by the subject of this interview are not necessarily those of Bay Area Summit's staff or its sponsors.

(This article originally appeared in the Summer 2004 issue of Bay Area Summit)

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