Aging Is a Real Pain in the Neck. . .

And the Back. And the Knees. But with stretching and exercise to relieve the pain, it doesn’t have to be.

From the WebMD Archives

Mark Liszt, a food broker from Los Angeles, has had operations on both knees and a toe. A doctor has suggested a total replacement of his right knee, but he’s afraid it will affect his ability to play ball. At 59, Liszt can’t stop. On Tuesdays and Fridays, he plays basketball with guys who are sometimes half his age. On Saturday, he hobbles around all day with serious knee pain. Friends and family have referred him to doctors, but he’s stayed away. “I don’t want to be told what a fool I am,” he says.

Like many in his generation, Liszt wants to be more active than his father, whom he says he can’t imagine playing sports at this age. Playing basketball, he says, makes him feel young and keeps him in shape. His inspiration is an 81-year-old teammate, Moe, who survived the Auschwitz concentration camp and is still a force on the court. “I said I’ll just keep playing basketball until I can’t,” Liszt recalls telling the doctor who recommended the knee replacement. “I want to be like Moe.” So for now, he’s decided to live with the aches and pains.

For men approaching midlife, orthopedic surgeon Stephanie Siegrist, MD, has some good news: You can stay active and feel younger. But you’ll have to put some work into it. “I encourage patients not to think, I’m getting older, I’m deteriorating,” she says. Instead, she urges them to think “As I get older, I must invest more time and effort into maintaining my resilience.” Then, rather than diagnosing your own aches and pains, says Siegrist, author of Know Your Bones: Making Sense of Arthritis Medicine, you should seek out doctors who “understand your viewpoint” and will help you maintain a realistic level of physical activity.

Why aging brings aches and pains

As you age, the ligaments and tendons that hold your joints together become “stiff and leathery,” says Siegrist. At the same time, osteoarthritis can cause the cartilage in a joint to wear away. Both processes can lead to aching, soreness, and pain. The best way to feel younger, she says, is to condition your body in ways so that if you need to run to catch a plane or shovel the snow in your driveway, your body “doesn’t feel overwhelmed by the challenge.”

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Alan Hilibrand, MD, is an orthopedic surgeon and spinal specialist based in Philadelphia. He tells WebMD that arthritis can be especially debilitating in the back. While almost everyone over the age of 60 develops arthritis in the lower back, some develop degenerative disks as early as their 20s and 30s.

Men run into problems when they fail to recognize their bodies are not as resilient as they once were, says Michael Schafer, MD, chairman of orthopaedic surgery at Northwestern University’s medical school and a spokesman for the American Academy of Orthopaedic Surgeons (AAOS). This is the “weekend warrior” syndrome: The guy who sits at a desk all week joins a pickup game of volleyball and ends up rupturing his Achilles tendon.

A variation on the weekend warrior syndrome is the man who decides to get back in shape and initially pushes himself too hard, leading to muscle soreness or inflammation. The risk weekend warriors face, Schafer says, is that the soreness or injury will lead them to give up on exercise altogether.

Proper conditioning can be thought of as a three-legged stool, Siegrist says. The first leg is flexibility, the second is cardio endurance, and the third is strength. Weightlifters, runners, and yoga fiends take note: “As you get older,” Siegrist says, “you’ll need to give equal time to all three.”

How flexibility gives you an edge over aches and pains

Stretching is vital to preventing aches and pains because it improves the pliability of the ligaments that support the joint, Siegrist tells WebMD. But keeping limber is the area of conditioning that men are most likely to neglect. To get the attention of her male patients, Siegrist informs them that keeping flexible is important in any sport that requires peak physical performance. “I tell my golfers that the other guys in your foursome probably aren’t stretching. So if you do, it will give you the edge. I joke that it will take 10 strokes off your game.”

Siegrist is a big fan of yoga, but if you can’t bear to do that, then you can stretch at your desk or while making coffee or watching TV. It doesn’t have to be just before or after workouts, she says. “Every little bit counts.”

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Why you need cardio training to help lighten the load

It’s easy to blame age for your aching joints. But the true cause may be that extra 30 pounds you’ve loaded onto them, also known as your “spare tire.” Cardiovascular training — along with a healthy diet — is the best way to take care of that problem. And of course it’s vital for preventing heart disease and stroke. Guidelines vary, but Siegrist suggests “challenging your body” (something more intense than a casual stroll) for 30 to 60 minutes each day.

If you are looking for relief of back pain, then you should choose cardio training that conditions your trunk muscles, Hilibrand says. That means exercises performed in a standing position, such as running or jogging. If you have disk problems that make high-impact exercise painful, you may want to consider lower-impact alternatives such as stair machines, elliptical trainers, or cross-country ski trainers.

Why strength training helps relieve aching joints

Why will strength training help ease joint pain? Because strengthening the muscles that cross your joints helps them act more effectively as stabilizers, Siegrist says.

Strengthening the trunk muscles is especially important for relief of back pain, Hilibrand says. “The spine supports the upper body weight on the pelvis,” he says. “The only thing that shares that load is the trunk muscles, so the stronger they are, the less weight that will be carried on the spine.”

Orthopedic specialists urge strengthening the “core” — the stomach, back, rear, and thighs. Many men ignore these muscle groups in favor of the chest, biceps, and shoulders, says Schafer. But having a strong core should be the foundation of your workout program, he says. Hilibrand suggests meeting with a trainer or physical therapist to set up a program that focuses on core strengthening.

How bad is it, doc?

Some men will run to a specialist at the slightest muscle twitch. Others would rather hobble through their days than go near a doctor. The best course of action is somewhere in between, say orthopedists.

The key is to listen to your body, says Schafer. Ordinary joint soreness can be treated by scaling back on an activity, icing the joint, and taking over-the-counter (OTC) anti-inflammatory medications (such as aspirin or ibuprofen) as needed. (The orthopedic association says that most mild sprains and strains can be treated through rest, ice, compression, and elevation — RICE.) If the pain persists and is accompanied by swelling, or if it interferes with your normal daily activities, you should seek a medical evaluation, Schafer says.

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Siegrist says a daily dose of OTC painkillers is acceptable for most healthy people if it quiets their pain and allows them to be more active. (Some people should not take anti-inflammatories due to existing conditions or medications; consult your health care provider.) But if you find yourself routinely taking more than the maximum daily dose, you should see a doctor, says Siegrist.

Back pain can be particularly intractable. But proper conditioning can help you function with periodic pain, says Schafer. Conditioning may reduce the length or severity of painful episodes, he says, even if it does not permanently banish the pain. Some rehabilitation experts have developed specific exercises for back pain.

A patient like Liszt, Siegrist says, may want to seek out alternatives to knee replacement, such as a brace, different medications, or arthroscopic procedures that can ameliorate the pain. “There are lots of steps between nothing and a joint replacement,” she says. “They’re there to buy him time.”

But ultimately, there is no medical Fountain of Youth that will make you feel 20 again. And unless you mind your weight, exercise, and modify your activity to levels that are appropriate for your level of conditioning, Siegrist says, even “the best operation in the world won’t be successful.”

WebMD Feature Reviewed by Jonathan L Gelfand, MD on July 01, 2007

Sources

SOURCES: Stephanie E. Siegrist, MD, orthopedic surgeon, Rochester, NY; author of Know Your Bones: Making Sense of Arthritis Medicine, Windsor Media Enterprises, 2005. Alan S. Hilibrand, MD, associate professor, orthopaedic surgery, Thomas Jefferson University Hospital. Michael Schafer, MD, chairman, department of orthopedic surgery, Feinberg School of Medicine, Northwestern University. American Academy of Orthopaedic Surgeons.

© 2007 WebMD, Inc. All rights reserved.

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