October 12, 2023

In Terms of Aging, Wellness is Not Enough

In Terms of Aging, Wellness is Not Enough

by Emily Lesser

For those who don’t know me, my name is Emily Lesser. You’ll typically find me in the back corner of class, where I've been lucky enough to throw around heavy barbells and pretend to be a 6’1” gymnast for the last 6 years with Crossfit City of Lakes. My professional title is Emily Lesser, PT, DPT, GCS. The letters after mean I’m a Doctor of Physical Therapy who put in a little extra work after grad school to become a specialist in the care of aging and older adults. I want to do my best to share my secrets here, so please excuse me as I graciously step up to my soap box for this blog post.

Sure, I want you to think of your parents and grandparents, taking a moment to reflect on what successful aging looks like, and advocate accordingly. However, aren’t we all just old people in training? Aren’t we all just looking to be healthy for as long as we possibly can? It starts today.

In my day to day, I see a lot of sick, frail individuals, so let’s start with the harsh reality of adverse aging:

  • One third of community-dwelling older adults over the age of 65 fall each year, 10% of those falls result in fractures, and fall-associated fractures are a direct predictor of morbidity and mortality.
  • Direct medical costs for falls (combined fatal and not fatal) were $646.8 million in 2012, and $668.8 million in 2015. (and these are old, pre-Covid numbers)
  • Research has told us muscle strength declines 1-5% each year after the age of 30. With the rate of decline being entirely dependent on physical activity. After the age of 60, decline in power output occurs at a rate of 3-5% per year.

Enter the CrossFit Methodology. In defining fitness, CrossFit utilizes the sickness-wellness-fitness continuum. It’s a measurable representation of our health. Think blood pressure, resting heart rate (RHR), glycated hemoglobin (HcA1c) levels, body fat percentage. Utilizing these parameters, we see people who have measurable fitness defy the odds, even into their years. When thinking of the continuum, fitness provides a buffer to injury and a resilience to disease. CrossFit Seminar Staff Head Trainer Jenn Hunter Marshall puts it best when she says “we don’t know what’s going to happen in life… but there are certain things we do have control over… we’re creating the best line of defense for ourselves when something goes awry”. As we age, we NEED to emphasize building a base of fitness, an amplified form of wellness, to combat what life throws at us.

In the world of successful aging, we point to masters athletes as guideposts for preventing the steep decline towards frailty. When compared to their sedentary, less active peers, Masters athletes showed favorable health in terms of healthy body composition, more muscle mass, less prevalence of chronic disease and they took less medications. Take a second and google the term “70 year old triathlete vs sedentary individual”. What you’ll find is a cross section of the quads, where the 70 year old triathlete maintained muscle mass, whereas the sedentary individual had a leg infiltrated with fatty tissue and significant atrophy. This is what I’m talking about.

So what does this mean for those of us that haven’t even thought about retirement beyond our mindless contributions to our 401k? Those of us that can still hop into a workout without a 30-60 minute warmup? It means we start now. Osteoporosis is a pediatric disease manifested in adulthood, and more research will come out over our years showing a similar path for frailty and physical decline. We start by establishing a base of strength and fitness. We start by showing up, and pushing our boundaries of strength within the gym1. With more strength and fitness comes resiliency against illness, disease, and the dreaded getting older process.

I’ve been a Geriatric Physical Therapist for 5 years now, enough to dip my toes in the water, and I’m starting to think age-related decline is a choice. A bold statement, I know. There’s always that 1% chance of life taking over in a way we can’t control, leading to sickness and impairment not able to be fixed by fitness. However, if we want to give our bodies a fighting chance, wellness isn’t enough. We need to develop a level of fitness to develop resilient bodies able to combat what life throws at us. It’s time for us to embrace the Masters athlete lifestyle, defying the odds of what people know and think about aging.

*steps off soapbox

Linked is a video of CrossFit explaining the sickness-wellness-fitness continuum:


Peng, Y., Zhong, GC., Zhou, X. et al. Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis. BMC Geriatr 22, 725 (2022). https://doi.org/10.1186/s12877-022-03404-w
Lindel RS, Metter EJ, Lynch NA, et al. Age and gender comparisons of muscle strength in 654 women and men aged 20-93 yr. J Appl Physiol. 1997;83:1581-1587.
Burns ER, Stevens JA, Lee R. The direct costs of fatal and non-fatal falls among older adults - United States. J Safety Res. 2016 Sep;58:99-103. doi: 10.1016/j.jsr.2016.05.001. Epub 2016 May 28. PMID: 27620939; PMCID: PMC6823838.

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