Why Change is Necessary with Age…
For many years, I have repeatedly preached about the value of engaging in an active lifestyle throughout life. It is especially important to be active as one gets older in order to maintain mobility and independence. However, many take this advice to an extreme and refuse to accept the inevitable changes that occur in the body with age. They run, jump, lift and throw like a teenager and often fail to modify their activity or exercise regimen appropriately for their age. Consequently, they suffer from multiple injuries, including muscle tears, tendonitis, bursitis, impingement and advanced osteoarthritis. Keep in mind, everyone ages differently. One person at 60 years of age may be the equivalent of another at 50. However, change with age is inevitable, so be kind to your body…it’s the only one you have! It is always prudent to consult your physician and physical therapist for a program designed specifically for your needs.
The anatomical and physiological changes in the body associated with age must be respected and considered when establishing an exercise program for those over 50. One common change that occurs with age is the loss of the density and quality of bone and cartilage. In addition to loss of bone density, especially in women, osteoarthritis destroys the cartilage in the joints and reduces the space between the bones in a joint. For example, a loss of space in the shoulder joint makes it more likely to impinge the structures that pass through the joint such as the bursa and rotator cuff tendons. Overtime, the impingement will lead to small tears, then bigger tears and possibly a full tear. This can be avoided by modifying the exercises and activities performed at the shoulder. The degenerative knee joint is another example of a how the degenerative and arthritic process creates a narrow space which leads to further damage if modifications in exercise and activities are not modified. When the knee degenerates, it often begins by a dehydration and degeneration of the cartilage at the end of the bones and between the joint of the knees. Certain activities and exercises will accelerate this process. Running and jumping are two of these activities but squatting, especially deep knee bends with heavy weight on the shoulders or in the hands, can be equally damaging. Muscles and tendons are at risk in the aging body as well. As these tissues degenerate and lose their elasticity, they are very susceptible to pulls and tears, especially when not properly warmed-up and stretched. The best examples of an aged and degenerative tendon leading to a more serious problem when not warmed up and stretched properly is an Achilles tendonitis (often caused by overuse or running hills) or Achilles tendon tear (often caused by a sudden burst and stretch such as reaching for a shot in tennis or racquetball).
Always warm up for 5 to 10 minutes before exercise (run in place, slow jog, pedal a bike slowly), then stretch slowly, gently and pain free. Gradually warm into aerobic exercise and begin weight training with light weights, gradually increasing to heavier. Following exercise, perform stretching or yoga. Remember, low weights with high repetitions are safer for those over 50. Also, dumbbells are more comfortable and safer because they allow one to modify the grip and position of the arm easier than a barbell.
Some high impact aerobics are worse than others. Running, for example, has been shown to transmit 3 times the body weight of the runner to the joints of the lower body. Running, jumping, (jumping rope), step aerobics, impact plyometrics (box jumps) and impact calisthenics (jumping jacks) are the best examples of high impact aerobics that can accelerate wear and tear to your joints.
With this in mind, those over 50 would be well-advised to engage in low-impact aerobics on a regular basis. For example, if you want to run two to three days per week, do not run two days in a row and consider performing low impact exercise in between. Some examples of low impact aerobics are: walking, treadmill walking, swimming, elliptical trainer, and an exercise or road bike.
Military press and overhead triceps are two examples of lifting weight overhead that are potentially harmful for several reasons: One, lifting a weight overhead hyperextends and compresses the spine, putting it at risk for advanced osteoarthritis and degenerative disc disease, especially in those over 50. Two, when the shoulder lifts weight overhead, the rotator cuff and bursa can be impinged in the shoulder joint space, especially in those over 50 with a narrower space. Overtime, this may lead to impingement syndrome, bursitis, chronic tendonitis, and rotator cuff tears. (PHOTO 1: Overhead Press – Not Recommended)
Better Alternative: Instead of lifting overhead to strengthen the deltoid and triceps (muscles used in military press), consider a 70 degree lateral raise with low to moderate weight and higher repetitions. (PHOTO 2: Lateral Shoulder Raise 45-75 degrees – Recommended Alternative). To work the triceps, lying on your back with a dumbbell in one hand, extend your elbow to contract the triceps. Use the opposite hand to support the back of the elbow during the exercise. (PHOTO 3: Triceps - while lying on your back - Recommended Alternative).
A bench press through a full range of motion, which fully extends the arms then lowers the weight to the chest, hyperextends the shoulder and puts the internal structures of the shoulder joint at risk. It is a common position to tear the anterior capsule, rotator cuff or labrum of the shoulder, especially in the tight and dehydrated shoulder tissues of those over 50. (Photo 4: Bench Press – through the full range of motion – Not Recommended). As a safer alternative, consider using a 6-8 inch block on the chest to limit the extent to which the shoulder is hyperextended as the bar will be blocked before it touches the shoulder. A second and more practical alternative would be to use dumbbells while lying on the floor. The dumbbells will allow for more comfortable and safer arm position as opposed to a barbell and the floor will block the arms from hyperextending beyond a safe range. (Photo 5: Safe Bench Press – using hand-held dumbbells on the floor with limited range of motion – Recommended).
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Scranton Times-Tribune. Next week: Part 2 “Exercises to Avoid if You’re Over 50!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: email@example.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.