The purpose of this article is to discuss health from a musculo-skeletal perspective through the eyes of an osteopath. With the right mind set, keeping active with the right help and a little luck we can keep fit and well into our later years. It’s easy to underestimate how important our muscular-skeletal health is as we get older. Often the focus is on preventing systemic conditions like heart disease or cancer. Your mobile health is just as important if not more important. In fact changes in our ability to keep moving can have a profound knock on effect on the rest of our health. For example to lower the risk of heart disease we should perform a minimum of 30mins exercise a day. If your ability to move is compromised it will make it difficult to achieve your goal of 30mins and therefore have a knock on effect on your cardiovascular health. In my opinion a lack of physical fitness will speed up the ageing process. The good news is that problems with our musculo-skeletal health are on the most part preventable. Mind set is very important. Even at older ages our bodies still have the ability to respond positively to exercise. It really is never too late to start, in saying that the sooner you start the better. We often invest in our financial pension; why not invest in our physical pension too?
We tend to lose strength, flexibility, balance as we get older. Connective tissue contains two substances called collagen and elastin. Elastin is the substance which gives tissue its elasticity i.e. the ability to stretch and return to its original length, it makes tissues good at absorbing forces. Collagen is a substance that gives tissue its strength. As we get older the amount of collagen increases and the amount of elastin decreases, this is why we get wrinkles. Some of the other changes that occur include thinning of cartilage and a decrease in diameter of our neurons (bundles of neurons make up our nerves), the latter can have a negative impact on balance. Okay, so that is the negative stuff out of the way. On a positive note even though the upper threshold of what we can accomplish in terms of fitness diminishes as we get older, we can still retain the ability to respond positively to exercise. At almost any age we still have the capacity to increase strength, flexibility and improve balance.
The two muscular-skeletal pathologies most often associated with ageing are osteoporosis and osteoarthritis. Osteoporosis is a condition where bones become weaker as a result of a loss in bone density. This along with an increased chance of falling puts older people at a greater risk of sustaining fractures. In some severe cases a fracture will occur spontaneously. The best defence against developing osteoporosis in the first place is to increase bone density as much as possible when younger. Exercise along with a good balanced diet including vitamin D and calcium help to increase bone density when you are younger and help to slow down the process of loosing bone density as you get older. The earlier you start exercising the better but there are benefits to starting at any age in the majority of cases. Mal-absorption conditions can also be a cause of osteoporosis. If you notice any sustained changes in your toiletry habits it is advisable to seek a consultation with your doctor.
Osteoarthritis is the type of arthritis associated with ageing. Bones and cartilage are continually remodelling. Stresses cause a certain amount of wear and tear on the joints but the body constantly repairs itself If the process of breaking down the body’s tissues becomes more than the body’s ability to repair it then degeneration occurs. Sometimes the joints become stiff and can become painful. However it is important to note that there is no direct relationship between osteoarthritis and pain. Also it does not have to be progressive, in other words it can be a stable condition that does not continue to degenerate. All too often we put these types of aches and pains down to old age and we do nothing to remedy them. It’s true that osteoarthritis is more prevalent in older people but it is not a natural part of the ageing process. One of the main reasons is we have lived longer so we have had more opportunity to cause wear and tear on our joints. Also the tendency to become less mobile may cause previously painless arthritic joints to become painful.
Spondylosis is a degenerative condition which specifically affects the spine. The spinal discs tend to become thinner with associated thickening of the connective tissues which join the vertebra to one another. As a result the joints become stiffer and eventually painful. Again there is no direct correlation between this condition and pain. With the correct treatment and care it is often possible to keep these joints moving and pain free.
Kyphosis is a term used to describe an exaggerated forward curve of the spine in other words a stoop or hunched back. Often this is preventable with the correct postural exercises. If you are older and the curve has become established it may not be possible to straighten the curve but it is often possible to encourage better movement within the restricted joints.
All too often when speaking to me about their aches and pains patients will say “OH!! Its old age I guess”. My answer to them “We’re not allowed to use that excuse around here”. If we just accept pain as part of the normal ageing process we will never perform the actions needed to bring about change in our body. It’s what psychologists call a self fulfilling prophecy. For example think about two kids both with an equal ability at a given sport. One is lacks confident the other has been given loads of encouragement and is very confident. The under-confident child thinks “I’m rubbish at this”, so they don’t attend practise and don’t try. On the other hand the confident child plays a lot and always attends practise. Before your know it the confident child has improved and is now much better at their chosen sport. The same thing can happen to us at any age when looking after our own aches and pains. Most pain can be dealt with effectively; it’s just a matter of knowing how and sometimes this means seeking the appropriate help.
When we retire or as we get closer to retiring our expectations of what we can and can’t do change greatly in terms of general fitness. People often do less activity because it’s what expected of them. This leads to a slippery slope where one looses fitness which leads to more and more aches and pains. Pain is normally a sign that something is wrong but we don’t have to except it and there is normally a solution to pain. We should look to resolve pain and maintain our body’s health.
Here are some examples of people who have kept active. Hopefully this will serve as an inspiration of what can be achieved at an older age and break some of the stereotypes associated with ageing. I have met an eighty year old patient who swims outdoors in the Serpentine (a lake in Hyde Park, London) three times a week all year round even when it’s snowing. I also met an elderly gentleman just after he completed the Singapore marathon. Ok so maybe these targets are a bit ambitious for the average person, but most of us can find an activity at our own level, for example walking 30mins a day. It’s true what they say “use it or lose it”.
One of the fundamental principles of osteopathy is the body is a unit. This means we never look at one part of the body in isolation. We may focus initially more on the area of pain but we will always look at the bigger picture. Our aim is to not just treat the symptoms but rather treat the cause. For example lower back pain could be the result of tight muscles at the front of the pelvis. Osteopaths will thoroughly examine all joints and muscles. Our aim is optimise the function of your joints. The vast majority of the time we can resolve painful joints.
Having a pathology does not mean that you have to have pain, but pain means there is a dysfunction and that can lead to a pathology or deterioration of a condition . If you have the correct treatment you can resolve pain and possibly prevent pathology occurring or existing pathology getting worse.
The joints in the neck and upper back have a lot of proprioceptive neurons which means these joints provide a lot of information to the brain about where the body is in space. When these joints stiffen it can affect their ability to help you balance. As osteopaths we can assess and treat the spinal joints individually. Stiffness in the lower limb can affect gait and inrease the risk of falls. For example stiff hips may affect one’s ability to lift ones feet correctly increasing the risk of tripping over. Treatment of the relevant joints combined with balancing exercises can decrease the risk of a fall and subsequent fractures.
As osteopaths we believe that prevention is better than cure. We can perform full body examinations and help you to optimize function in all your joints and muscles. Even though there is a tendency to lose strength and flexibility as you get older, osteopathic treatment can minimise these losses which in turn can help an individual’s capacity to keep their independence and maintain a better quality of life.
Looking after your musculo-skeletal health will allow you to remain mobile and active for many more years.
The ability to keep moving can also have a profound effect on your systemic health. Painful joints can lead to less activity which can in turn lead to increased risk of conditions like heart disease. Movement is important for our general physical and mental health. Remaining active is vital for general circulation. The heart pumps blood out to the whole body but the movement in muscles pumps blood back to the heart.
It’s true that as we get older we become stiffer but normally this can be limited. The most important thing is start looking after ourselves sooner rather than later. Prevention is always better than cure. We often invest in our financial futures we need to do the same for our bodies.
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Barry McVeigh, Registered Osteopath (UK)