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Saturday, February 16, 2019

Racket sports serve up health benefits

It’s the end of the school year, the time of graduation speeches, of looking back at accomplishments and making plans for new ones. It’s a time when many parents think about their hopes and dreams for their children, whether they are graduating or just learning to walk.

As parents, we tend to think about getting good grades, excelling at athletics, being popular, getting into good schools, and getting good jobs. All of this is great, of course. But there is something that children need if they are going to truly succeed in life, and that’s resilience.

Resilience is the ability to overcome hardship and be okay. It’s the ability to navigate life’s inevitable bumps and still be happy and healthy and stay on track. What worries me sometimes is that our current parenting culture of achievement and obsessing over safety — and the way that electronic devices have become so ubiquitous — may get in the way of learning resilience.

According to Harvard University’s Center on the Developing Child, there are four factors that help children develop resilience. They are:

    Supportive adult-child relationships. This is crucial. All it really takes is one supportive, nurturing relationship to make all the difference. This gives children a buffer, and helps them know that they aren’t alone and that they matter to someone. While all parents want to have a good relationship with their child, the demands of daily life can get in the way. Try to spend regular time with your child when they have your undivided attention. Ask about their day, get involved in activities they enjoy, spend time doing things together. Make sure your child knows that no matter what, you have their back — and you will love them.
    A sense of self-efficacy and perceived control. Basically, you want to help a child learn that they can manage, and that even if things go wrong, they can figure a way through. You can’t do this just by telling your child that he is smart and capable; he needs to learn it himself. Bit by bit, giving independence, letting children make decisions and take risks helps them learn to weather life’s storms. It’s not always easy to let children take risks —we never want them to be hurt, emotionally or physically — but with you at their back, and in a gradual way, most children can and do manage just fine. Learning this also involves shutting off the screens and being active. Learning to be physically capable is important. In being active, in running and climbing and other such activities, children learn not just their strengths and limitations but how to plan and troubleshoot.
    Strong adaptive skills and self-regulatory capacities. This is what we call “executive function.” It’s like the air traffic controller functions of life: the ability to prioritize, not get distracted, make a plan, negotiate, get along with others, and manage emotions. These are not easy tasks, and there is no way to learn them without practice. One of the best ways for children to practice is through unstructured playtime, either alone (so they can find ways to entertain themselves) or with others (so they can learn how to work with others). Consistent discipline, not giving in to tantrums, and helping children manage sadness or frustration rather than just fixing things for them, can also help. The Center on the Developing child also has suggestions on activities to support executive function at different ages.
    Being able to mobilize sources of faith, hope, and cultural traditions. It helps to be part of something bigger, to have community, to have traditions that help you through difficult times. This doesn’t mean that you need to join a faith if you don’t belong to one. But if you do, maybe you could go to services a bit more often. If you don’t, spending time with extended family, joining a community group, taking part in service opportunities together… these activities can help give your child a perspective on life, as well as strategies for handling challenges. Because ultimately, the ability to keep perspective and handle challenges is what gets us through and helps us succeed.

In April, scientists reported encouraging results from a pilot study of men with metastatic prostate cancer, or cancer that has spread beyond the prostate gland. Long considered incurable, these advanced cancers are usually treated by giving men systemic drugs that target new tumors forming in the body. The scientists who led this new study took a more aggressive approach. In addition to giving systemic therapy, they surgically removed the prostate gland and affected lymph nodes, and also treated visible cancer in the bones with radiation. By throwing everything but the kitchen sink at these cancers, they achieved a stunning result: some of the treated men are still cancer-free after four years, and one has lived without evidence of cancer for five years. “If these remissions persist long enough, then we have to ask whether some of these men have been cured of their disease,” said the study’s lead author, Dr. Matthew O’Shaughnessy, a urologic oncologist at the Memorial Sloan Kettering Cancer Center, in New York.
How the study was conducted

The small pilot study enrolled 20 men, and O’Shaughnessy emphasized that follow-up with a larger group is needed to confirm the results. Five of the men had cancer that had spread to lymph nodes in the pelvis, and 15 of them had cancerous lesions in their bones. All the men were treated for between six and eight months with hormonal therapy, which blocks testosterone (the male sex hormone that makes prostate cancer cells grow faster). As noted previously, they also had their prostates and lymph nodes removed, and bone lesions were treated with radiation as needed. What the researchers were aiming for is a complete absence of prostate-specific antigen (PSA) in blood for a minimum of 20 months after the start of hormonal therapy. Prostate cancer cells will shed PSA into blood, but if the gland has been removed and all traces of cancer removed from the body, the levels should drop to zero and stay there, even after testosterone levels return to normal.

Overall, five men had undetectable PSA at 20 months and counting, although that number is too small to draw any conclusions about who might benefit most from the approach. According to O’Shaughnessy, when used together hormonal therapy, surgery, and radiation all contributed to prolonged remissions that would not have been possible if only one treatment was used. A study employing the same methods is planned for later this year.
What this means for treating advanced prostate cancer

Until recently, taking out the prostate and lymph nodes in men with advanced prostate cancer would have been unthinkable. Doctors worried that surgery could release cancer cells into the bloodstream, but newer studies show it can safely lengthen survival. Researchers have also been combining hormonal therapy and radiation with encouraging results, and now giving all three treatments is “consistent with a trend of doing more for advanced prostate cancer than doing less,” said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org. Still, Garnick cautions that cures for advanced prostate cancer can take decades to confirm. “Hopefully follow-up research will support this transformative approach,” he said.
When I was a kid, my summer sport of choice was baseball. Every day I played in marathon neighborhood games until it was too dark to see the ball. It was about fun and not fitness. But now that I’m older, and my Louisville Slugger has been officially retired, I need a summertime sport that recaptures the playfulness of my youth, but also works to keep my physical and mental skills sharp.

So, I picked up a racket.

It turns out that racket sports are not only fun, but they may help me live longer. A study published online by the British Journal of Sports Medicine examined the link between six different types of exercise and the risk of early death. Researched looked at racket sports, swimming, aerobics, cycling, running, and soccer. Study volunteers included 80,306 people, who ranged in age from 30 to 98. Over the course of the study’s nine years, those who regularly played racket sports were 47% less likely to die of any cause and 56% less likely to die of cardiovascular disease.

“In many ways, racket sports like tennis, squash, badminton, racquetball, Ping-Pong, and other variations are the ideal exercise for many older adults,” says Vijay A. Daryanani, a physical therapist and personal trainer with Harvard-affiliated Spaulding Outpatient Center. “Besides offering a good cardiovascular workout, they can help with both upper- and lower-body strength at one time. They can be played at any age, can be modified to fit most fitness levels, and do not involve a lot of equipment.”
Body and mind games

Racket sports offer something other fitness sports do not — lateral movement. “Most of our lives are spent moving forward, and that includes our exercise,” says Daryanani. “Racket sports force you to move both back and forth and side to side. This helps improve balance and weight shifting, which can lower your risk of falls.”

This kind of activity also exercises your mind. From a cognitive standpoint, it sharpens your planning and decision-making skills, as you must constantly anticipate and execute your next shot.

Racket sports also serve up a strong social component. You play against other people — either as a single or part of a doubles team — while other exercises like running, swimming, and cycling are more isolated activities. Frequent social contact is essential for a long and healthy life. In fact, a 2012 study in the Archives of Internal Medicine found that loneliness was associated with functional decline and an increased risk of death among adults older than age 60.
Pick up pickleball

While there are many types of racket sports to try, one of the fastest-growing among older adults is “pickleball.” It’s a hybrid sport that blends tennis, table tennis, and the backyard childhood game of Wiffle ball. The paddle is between a table tennis paddle and a tennis racket in size and made of lightweight composite material, such as aluminum or graphite, which cuts down on fatigue. The plastic pickleball resembles a larger Wiffle ball and travels about one-third the speed of a tennis ball, so it is easier to see and hit. Pickleball is played both indoors and outdoors. The court is 20 by 44 feet, or about the size of a double badminton court. The net is shorter than a tennis net, which makes it easier to hit over. Here are the basic rules:

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