I wanted to write a piece on how to reduce injury as we get older as I have made many observations during my 20 years as a physiotherapist. One of which is that it is quite apparent that, as people get older, their injuries tend to reoccur and last for longer periods.
When you were in your 20’s, if you had an injury, you could probably ‘shake it off’ in a couple of days. But as you hit your 30’s and 40’s, these small injuries may come back and haunt you. That hip, back or knee injury, you sustained whilst skiing back in 2006, may become a persistent niggle now.
At the time at which my injuries occurred, I was not overly concerned. However, in time, I have become far more aware of the consequences and permanent effect of these injuries as we get older. I’ve also realised how they continue to affect my activities and lifestyle.
So why do we take longer to recover with age?
The White Elephant in the room- AGEING
Most of us don’t start to think about the ageing process at the age of 30 (well, I certainly didn’t!) but our muscular and skeletal system starts to age at this point.
I feel that ‘The Ageing process’ needs to be re-named. We all hate to talk about it and finding the right words as a physiotherapist can often leave me tongue-tied. Terms such as ‘wear and tear’, ‘arthritis’ and ‘degeneration’ can have a demoralising effect on patients. This can also be counter-productive to achieving a successful outcome.
Ageing is a natural process that leads to changes in your joints, bones and muscles and can be attributed to many factors. These include genetics, activity levels, illness and previous injuries. These will all take their toll on your muscular and skeletal system.
Imagine your body is a rock perched at the edge of the sea. The waves splash and churn against the rock and, over time, start to change the shape and wear down areas of the rock. Sometimes the seas are strong and sometimes not. Every rock has a different tale and set of waves and this is how our bodies adapt to time and the forces going through them.
The Science bit;
At a cellular level, our bodies age, die and re-generate constantly, but as we get older, our cells are not replaced. This causes our organs to function a little slower. The eyes and ears are first to reduce their cellular activity, followed by the musculo-skeletal system.
Our bones gradually become less dense. This is mainly because your body does not absorb Calcium and Vitamin D as effectively as before. In women, the effects are heightened during and after the menopause by the reduction of Oestrogen, which can start as early as our mid-forties.
Our vertebrae will also become less dense and their discs lose their fluidity, becoming stiffer and dehydrated. Often, when looking at MRI images, clinicians need to consider which ailments are caused by the natural effects of time and which are abnormal. Disc disease is a normal ageing occurrence and, therefore, other factors need to be considered when treating back pain.
Other changes include stiffening of our ligaments and tendons, reducing their elasticity, increasing the likelihood of tears and strains and increasing the length of the healing process. The cartilage in our joints becomes thinner and our muscles gradually lose their strength, with time.
We can lose up to 15% of our muscle mass if we do not maintain it through the regular strengthening exercises. If you don’t use it you lose it!
AND THE GOOD NEWS?!
Yes, there is good news. Many of us are defying and effectively delaying the ageing process.
So, what helps?
Muscle mass, cartilage and bone density can all be maintained by our adherence to a continuous programme of resistance or strength training. Resistance training involves working muscles with some resistance and this can be done using small weights, bands or body weight. Resistance training works the muscles and skeletal system in the same way cardio training works for the heart. It reduces muscle loss, helps to improve the tensile (elastic) strength of tendons and offsets osteopenia (reduction of bone density).
Load bearing and range of movement exercises can help cartilage function and keeping flexible can help with ligaments.
Strength training has so many positive effects that it is the true hero of the musculo-skeletal system. Strength work can also be started at any stage in your life and you only need to work to 60% of your maximum effort to witness the benefits.
The key is that we do these exercises at least twice a week and that we KEEP DOING THEM. I encourage you to start some strength work today slowly and gradually and listen to your body with no expectations! It is imperative to get a bespoke programme that is designed for you and to make ensure you are performing the exercises effectively.
Classes such as Pilates are also a terrific way to get all you need for your musculo-skeletal system to remain healthy.
These exercises are also likely to ensure that you remain injury-free! So, start shaping your musculo-skeletal future now!