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Older Athletes May Need Custom Exercise Programs

How to avoid the most common bone, joint and muscle problems in older athletes

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Updated October 19, 2005

News Release from the American Academy of Orthopaedic Surgeons

Aging Athletes Require Tailored Exercise Regimen to Avoid Overuse Injuries: Orthopaedic surgeons study most common bone, joint and muscle problems in mature athletes.

Research shows that many of the so-called physiologic effects of aging may be related to the increasingly sedentary lifestyle that typically accompanies old age. Regular exercise can slow down or even reverse many of the “physiologic” consequences of aging. Estimates cite that one-quarter of the U.S. population will be over age 55 by the year 2010. With the growing trend of exercise adoption among baby boomers and beyond – coupled with the fact that older athletes are more susceptible to chronic and overuse injuries than their younger counterparts – the number of Americans with musculoskeletal problems is positioned to reach an all-time high. According to a study published in the October 2005 issue of the Journal of the American Academy of Orthopaedic Surgeons, proper diagnosis and treatment of musculoskeletal problems in aging athletes will help active older adults maintain function and safely return to sports via individually-tailored exercise programs.

Age-related declines in muscle function have the greatest impact on older athletes’ functional capacity, as discussed in “Orthopaedic Care of the Aging Athlete,” a study by American Academy of Orthopaedic Surgeons members Andrew L. Chen, MD, MS; Simon C. Mears, MD, PhD; and Richard J. Hawkins, MD. Besides losing muscle and bone mass with age, tendons and ligaments lose elasticity and are more prone to wear and tear injuries. Age-associated declines in hearing, memory, balance, motor skills, sensation, proprioception and cognition further affect athletic participation. Because of these changes, low-impact, endurance sports are often better suited to older athletes, although many choose to pursue high-impact activities, such as skiing. With regular, intensive muscle training, aging athletes – well into their 80s – can minimize or reverse age-related declines in muscle mass.

The most common injuries among aging athletes are chronic, overuse injuries such as muscle strains and tendinitis. These types of injuries result from a decrease in musculoskeletal flexibility and participation in endurance sports – such as long-distance running – which promote muscle fatigue and predisposition to injury. “Chronic and overuse injuries account for approximately 70 percent of injuries in veteran athletes age 60 and older, whereas only 41 percent of younger athletes – ages 21-25 – are affected by these same injuries,” explained Dr. Chen, the study’s lead author and attending orthopaedic surgeon in Littleton, NH. “Because these injuries are related to repetitive activity in the presence of degenerative changes, they often result in prolonged disability.”

Shoulder injuries are also frequent among older athletes. One of the common causes of prolonged shoulder pain, weakness, and disability is a torn rotator cuff. Rotator cuff repair can be very successful in physically active older patients, with up to 94 percent of patients over 65 years old reporting satisfactory results. After repair, up to 80 percent of patients are able to return to athletics at their pre-injury activity level.

Because the majority of older athletes have been physically active since a very young age, they are especially vulnerable to osteoarthritis (OA, or “wear-and-tear" arthritis), which leads to joint pain and stiffness. Despite the popularity of nutritional supplements like creatine, and the use of “anti-aging” agents such as androgens or growth hormones, the researchers concluded that these supplements have not definitively been shown to enhance performance in athletes who train regularly and maintain a well-balanced diet. They emphasized that further investigation is needed from both a safety and efficacy standpoint before these substances can be widely recommended. The supplements glucosamine and chondroitin sulfate have been shown to improve osteoarthritis symptoms in some patients. Exercise and weight control are essential in the prevention and treatment of osteoarthritis, especially of the knee, hip and ankle joints.

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