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Although the above scenario is impossible, we can implement strategies to decelerate this inevitable process. Science demonstrates that the human ageing process involves multisystem degenerative changes. Osteoporosis/Osteopenia is a disorder involving a reduction in bone density and concomitant fractures, affecting 1 in 2 women and 1 in 3 Australian men over the age of 60 years. Osteoarthritis is a degenerative joint disease that affects all of us, some to a greater extent than others. The degree and distribution of joint ‘wear and tear’ depends on individual and environmental factors.
Changes that occur within the musculoskeletal system with ageing involve a gradual denervation and transition from type 2 ‘fast twitch’ muscle fibres to type 1 ‘slow twitch’. This accounts for the decline in strength and power as we age, although muscular endurance stays relatively constant. Damage to muscle fibres occurs more readily with age, which can be associated with low lumbar degenerative changes leading to nerve root impingement and a lack of neural impulses reaching the muscles of the posterior thigh. This also results in a slower functional recovery. A prime example of this, is the ‘old man’s calf’ or recurrent calf tears. Tendon tissue can also be much less tolerant to load, and is more likely to exhibit degenerative changes including poor collagen organisation, presence of micro-tearing and new blood vessels in attempts to heal the damaged tissue.

So is there anything we can do to prevent these miserable changes from occurring to our bodies? Although these changes are a normal part of human evolution we can go a long way in slowing down the degenerative processes. From a skeletal perspective, various medications such as Caltrate can help to improve bone density, while Vitamin D deficiency has been linked to osteoporosis. With a rich source of Vitamin D being the big ball of gas in the sky, getting a daily dose of UV rays might be a pertinent factor in maintaining bone health into our 50’s/60’s. Weight bearing exercise is our other line of defence against brittle bones, as it strengthens the trabecular (internal) bone lines of stress.

Although there is no cure for osteoarthritis, there is some exciting developments in medical management of this condition. Viscosupplement injections are being widely utilised by sports physicians to assist in smoothing roughened articular cartilage and improving joint lubrication. These substances have shown promising results when compared with cortisone injections. Another exciting area is that of Platelet Rich Plasma (PRP) injections. This is basically an injection of your own blood with all the good stuff (growth factors) extracted from the whole blood in order to facilitate cartilage regeneration. There is limited scientific evidence for PRP at present. Even more exiting is the possibility of stem cells, which may lead to a cure for osteoarthritis!

Research investigating muscle strengthening for the elderly has been promising. It has been shown that a 12 week program of strength training can improve innervation and recruitment of fast twitch fibres in 50-60 year olds, thereby maintaining strength and power. Lumbar spine management including nerve sheath injections and epidurals can be used in recurrent episodes of back related leg muscle strains. Maintaining lumbar / neural mobility and core strength can also assist in not only low back health, but avoidance of the ‘old man calf tear’.

Managing age related injuries can be a major deterrent to maintaining an active lifestyle. With a combination of modern medicine and physiotherapy modalities such as strength programs and biomechanical correction, these age related changes cannot be prevented, but can be slowed in their tracks, rendering the individual an active & health lifestyle.
 

Shane O’Sullivan

Sports Physiotherapist
Prahran Sports Medicine Centre