Intro
My name is Clint Russell, owner of CrossFit Coronado, and One Life Physical Therapy. In January 2019 I started training WWII Veteran, Tom Rice, to get him ready to parachute into Normandy, France for the 75th anniversary of D-day in June. Several people have asked me what I did to train Tom for the Jump in Normandy. For those that don’t know, Tom Rice was a paratrooper in the 101st airborne and jumped into Normandy the night before the invasion on June 6, 1944. Their mission was to seize the town of Carentan, which would allow the beach heads to link up, as well as stop a German counter-attack. What I hope people gain from reading this article is that you aren’t too old and its never too late to set goals and achieve them. What follows is our story.
How this came about
I was approached by the Dugas family last December, long time friends and members of CrossFit Coronado, about training Tom. Being a trainer, physical therapist, and having experience with both static and freefall parachuting, I felt I could really help him. His goal was to jump into Normandy this year, June 5th, at 97 years young! He had mentioned to them that he had some orthopedic issues and needed a trainer to help him get stronger. We all had dinner together to discuss the plan.
Tom
Tom suffered 3 gunshot wounds during WW2. One blew out 4 inches of his right radius, which was surgically repaired. (I asked for the surgical report and he said it was in 1944 and the Germans blew up the hospital!) This gave him severe limitations with elbow pronation and supination. The other 2 were in his knees. His left knee had been replaced, his right knee needed to be replaced, but no doctor would agree to it at his age. He had been an elite level runner his whole life. At 65 years old, he ran a 10k in 36 min!
The assessment
CrossFit states that the needs of Olympic athletes and the elderly, differ only by degree, and not by kind. This is exactly the approach used with Tom. I began with a strength and balance assessment. The first movement I look at is a person’s air squat. I began by having Tom sit down to a 20’’ box. He had a very difficult time controlling the eccentric portion of the movement. The squat is the most basic movement, and fixing its inadequacies has tremendous carryover to quality of life. He heavily favored his left knee. He right would dive in, forcing him onto his left side, indicating weakness in the posterior chain. When he walks, he tends to lock out his R knee, as a compensation for quad weakness. He had significantly decreased ROM on overhead reaching. He compensated with his upper trap as a result of scap weakness. His external rotation was limited as determined by his inability to perform a pass thru. (Without adequate external rotation, full flexion overhead cannot be achieved) As for his balance, he could squat down and pick up his car keys with no loss of balance, stand with his eyes close without unsteadiness, walk with head turns, walk backwards. He couldn’t stand on one leg.
2 Goals
The assessment gave us a lot of things to work on. In order for him to skydive, he needed more range in his shoulder so that he could achieve the arch position. We need to address both mobility, and scapular strength. He needed core and hip flexor strength, as well as hamstring flexibility so he could hold his legs up upon landing. As I had mentioned earlier, Doc’s told him he was out of luck regarding his R knee. As people age, they get more and more sedentary. It was my job to keep this guy moving. At his age, if he stops moving, its gonna go south fast. The only alternative with his knee was to strengthen the surrounding musculature as much as possible. So, we needed a regimen that would prepare him for the demands of skydiving, and equally important, if not more so, improve his general fitness and well being so that he remained healthy enough for the trip in the first place.
Time to Go to Work
We began in mid January. Our first few sessions, I told Tom, I didn’t want to push him and would use them to figure out where he was at. Each session would consist of a warmup that started with aerobic work, addressed balance, and flexibility issues. The workout that followed would center around either a bike, row, or ski, a lower body/core strength exercise, and an upper body exercise. We would end each session with specific exercises to improve shoulder function. The goal with Tom was not to stress intensity, and I would rarely push him to go faster, but to keep him moving consistently with good mechanics. The reasoning behind the assault bike, row, and ski erg is that they don’t have an eccentric load. This means that they have very little impact on the joints, and don’t cause the same level of muscle fiber damage as other movements. These types of movements are perfect for the elderly, injured, or deconditioned as they don’t create very much in the way of DOMS. They were the backbone of our training, and on days were his knees were sore, or wasn’t feeling his best, we would use them to keep his aerobic conditioning up, as well as keeping the joints moving to combat stiffness. Tom’s right leg was much weaker than his left. This was addressed early on in several ways. First, I would have him squat with a slight A/P stance, with his right leg being slightly behind his left. This forces more weight on to the weak side and puts him in a position where he can’t shift left. I would stand in front of him and use my knee to block his right knee from caving in. This keeps him in the right position and allows him to move as safely as possible. My favorite lower body exercise for him was lunges. This is because they address a lot of his issues at the same time. Single leg exercises improve balance, strengthen both the quads and glutes, as well as stretch out the opposite him flexor. When we started, I would put an airex pad on the ground, he would have a hand hold on each side, and would lunge down to the pad. Within several months, he got to only needed one hand hold. As I mentioned earlier, he needed his right knee replaced. It would be completely unrealistic to expect someone at his age and with his knee to do any of this without pain. This is where we had to work together and figure out what was acceptable. The standard I like to use is if the pain goes away after we stop, then that’s ok. If it’s still there for several hours, that’s too much. Modern medicine would chastise me for this approach (I’d likely be fired for being this aggressive at a PT clinic), but we must realize that his right knee collapsing when he squats translate to all other aspects of his life. If we can fix it, or even improve the mechanics of his squat, it will improve his knee, his balance, and many other aspects of his life. Some pain will be necessary for this to occur. Communication and properly loading and volume are key to insure we always move the needle forward. Sometimes, instead of squatting and lunging, we would do sumo KB deadlifts. I would stack plates up so he could keep his back his better position. Another movement we used were suitcase deadlifts with a KB. This challenge the obliques more than sumo and are very functional when it comes to moving objects in real life. When we got to our house in Carentan, Tom carried his suitcase up about 7 stairs…
For Upper body, used a lot of single arm dumbbell/kettlebell presses. I was much more a fan of working active range of motion with Tom as opposed to passive stretching. The reasoning behind this is that active also builds coordination, and thus has greater carryover to real life. Some days, I’d have tom do overhead carries with a DB above his head back and forth across the gym. This improves his shoulder range of motion, his balance, his aerobic capacity, and his core strength. He would do pushups on a stack of plates. Ring rows were used to balance out all the pressing movements. I was also very fond of having him do weighted carries. This was done with a 30# slam ball back and forth across the gym.
At the end of each session, we would use a supernova and roll out the adductors, and then work on improving shoulder function. In order to improve shoulder function, we used combos of crossover symmetry, pass throughs, banded pull aparts, and once he got where he could do it, behind the neck presses with PVC pipe.
Here are a few examples of sessions I’ve done with Tom:
Session 1:
Warm Up: Bike 3 min
Balance training-walk 25 ft, pick up cone every 5 feet, then do it backwards
12 min AMRAP (as many rounds as possible)
Bike 2 min
7 squats to 20’’ box, A/P stance
7 Pushups
Roll adductors
3x 10 pull parts+10 pass thru
Session 2:
Warm Up: 3 min row
Seated 3 way active hamstring stretch
4-5 Rounds
2 min row
6 right/6 left lunges
2 Rope climbs-(lower down and come back up with me supporting him for safety)
Crossover symmetry
3 sets of 20 sec holding knees to chest while sitting on a bench
Session 3:
Warm up: 1 min ski erg
5 right/5 left single leg deadlift – he could use a post for support if needed
Balance training-walking with head turns
Ski erg 2 min
5 left/5 right Step ups onto plates
6 left/ right Single arm dumbbell press
3x 10 pass thru+10 behind the neck press PVC
On Balance
The scope of balance is beyond this article, so what I will say here is very simplified. The body has 3 systems for balance. Vision, proprioception, and vestibular. The very young and very old rely heavily on vision. In order to improve the others, we need to put Tom in a position where he is forced to use them. For example, walking with head turns throws off vision and forces the vestibular system and proprioception to make the necessary adjustments to prevent falling. Carrying an object challenges proprioception. Eyes closed removes vision forcing the other 2 to take over, you get the idea. Last but certainly not least, if the person isn’t strong enough to hold themselves up, then it doesn’t matter how well the other systems work.
Wrap up
In CrossFit, we are taught to progress from safe mechanics, consistency, and then intensity. Someone Tom’s age, may not get to intensity. And that’s ok, because intensity is relative. Most of us make our gains at 80%. We have a saying here and that’s that we want you to work hard, but you have to be able to come back tomorrow. If not, you did not get better.
Working with Tom has been the highlight of my career. In physical therapy school we are taught about how inactivity and aging affect the body. From what I have seen here, I don’t think aging affects the body to the level we think it does. I think what affects the body is the mind believing we are too old resulting in inactivity.
Filed under: one life physical therapy, physical therapy, WWII veteran
