Advice on Treating Ageing Athletes
As the saying goes, “getting old ain’t for sissies”. But it’s interesting to note those sports where the athletes actually peak in their 30s. Typically, closed-skill sports that require a high degree of muscle force production (sprinting, weightlifting, power-lifting) have world champions and Olympic record holders that are somewhere in their 30s. However, the majority of sports tend to suit the younger age group (25-26 being the peak) where the favourable hormone ratio is rampant and the lack of white tissue degeneration that leads to soft tissue injuries in the older athlete is not as prevalent.
It’s these “white tissue” injuries that tend to curtail improvements in performance, as they seriously affect the trainability of the athlete. The “white tissues” – tendons, fascia, disc, cartilage and meniscus – start a slow age-related degradation around our late 20s and early 30s and progress as we get older.
Whether we like it or not, this process will happen; and it will manifest in the types of injuries that we see as we get older – for example. Achilles ruptures peak at around 35, cartilage wears thin and leads to osteoarthritis in our 50s and 60s, degenerative meniscal tears occur around the 40s.
We can halt, and even reverse, the hormone degradation (particularly testosterone) associated with getting older that seems to precede this white tissue degeneration. However, this process involves chemical enhancement which, in most countries and international competition, is illegal and ill-advised due to some possible serious side effects. The USA seems quite happy to “allow” an active medical market in hormone replacement therapy. But practically speaking, we can’t change this age-related effect, so we need to work with it. Here are some suggestions:
- Older athletes do need more recovery than their younger counterparts. We need to encourage the “train smarter, not harder” approach with our patients/clients.
- Injury for life. Essentially white tissue injuries are injuries we tend to carry with us for life. Those chronic Achilles tendinopathies swing between being painful and pain-free, but they never really go away. Therefore, whatever active intervention and exercise therapy we prescribe needs to be encouraged to maintain for a very very long time.
- More soft tissue and flexibility. If we could encourage one thing in the older athlete population, then it would be more frequent massage, stretching and self-massage (foam roller) work. This may not necessarily improve muscle flexibility, but it may improve the fascia to muscle extensibility, reduce the muscles’ tendency to “guard” when subject to stretch, and help correct the imbalances between high tone vs low tone muscles that can “pull” joints into suboptimal positions.
- Prioritise strength work. It still amazes me how the older population shirk pushing some tin in the gym. So many studies have shown the benefits that even light to moderate weight training has on bone density; not to mention the benefits of both maintaining “fat burning” muscle mass, and training the joint-supporting muscles that can offset age-related wear and tear. Developing and maintaining a cardiovascular fitness base actually gets easier as we get older. This explains those ageing footballers, rugby players and AFL players who are load-monitored and don’t train as much as the younger players, but can still get out on the weekend and put in a top performance. The older we get, the less we need to train, as we have a residual base that carries us from one year to the next if it is maintained. What we do lose is muscle strength if it is not regularly attended to; therefore, prioritise the strength work in the older athletes.
Adapted from Dr Chris Mallac, Sports Injury Bulletin (Jan 2015).
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