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St. Joseph's Hospital Health Center

Care That Moves You

Jun 10 2013
Orthopedic Conditions and Injuries That Come with Aging
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Over the last 10-20 years, age related activity levels have changed dramatically. Many 50 -60 year olds, now function and have a mind set comparable to those individuals who are a decade or so younger than themselves. The issue becomes understanding some of the inevitable physiologic changes of aging, many of which cannot be influenced in a positive way.

That being said, there are structural and functional changes that come with aging, which make the body more susceptible to injury, both from acute trauma and from repetitive overuse/overloading. When we think of injuries in the older population we tend to forget the aging heart muscle that typically demonstrates a decrease in cardiac output, thus limiting the amount of blood the heart can distribute to those body parts requiring increased blood and oxygen during exercise. Skeletal muscle, with age, loses the type 2 fast contracting fibers. Although one can enlarge the remaining fibers, new ones will not develop as they do in younger individuals. The loss of muscle activation with aging can also cause loss of coordination and strength. Bone loss, particularly in women, increases the susceptibility to injury related fractures. Changes in connective tissue (i.e., ligaments and tendons) lead to loss of flexibility, which puts increased stress on joints. The joint cartilage itself becomes thinner, less spongy and less resilient to stresses; this condition is known as arthritis. Balance is another very important faculty adversely affected by aging and puts all at risk for a variety of injuries.

A couple of examples will illustrate some of the above concepts. Rotator cuff tears are increasingly more common in an older population, however, these injuries are often asymptomatic in individuals. For people 50 years old, as many as 30% - and for 80 year olds as high as 80% of these are asymptomatic. Partial thickness tears is not included in these numbers. Asymptomatic meniscus tears are also quite common in individuals age 50 or older but are less prevalent than rotator cuff tears.

In order to limit the likelihood of injury, several steps can be taken, however. Many of these steps are obvious and are not limited to the older participant, just more important for the older participant to follow to avoid injury.  Warm up and cool down for a few minutes before and after exercise. To increase flexibility and balance, train with activities such as yoga or Pilates. Additionally, balance exercise programs with cross training in an attempt to avoid overuse conditions.

Remember to “listen to your body” and realize that injury recovery as we all age is sometimes painfully slow and does just the opposite of what we strive for: to feel good and be fit.


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