Health Matters: 50+

[Secret Chief]

I thought it might be beneficial to have a place where those of us who are 50 or above can talk about health matters that affect the more mature amongst us. Tips, concerns, advice, questions, information, repeating a post you posted earlier, whatever. Tai chi, vitamin B12, crossword puzzles, hiking.....you name it, go for it.

 

[Secret Chief]

Ok I'll start.
I'm 63. In the last 6-12 months I've found that I only have to do something like an hour's garden weeding and I get a stiff back for at least a week. My osteopath is great but at £40 a pop I'm thinking it might be cheaper to employ a gardener! Any thoughts?

 

[ChristineM]

@Secret Chief

Stiff back? Tennis ball. Lie on your bed, place the tennis ball between back and bed at the tender spot. Maybe shift about a bit. Lift a knee up towards your chest for a few seconds. 10 minutes a day, far cheaper than an osteopath.

Also a back brace may help.

I'm not doing my health problems, there isn't enough space ;-)

 

[Secret Chief]

@Secret Chief

Stiff back? Tennis ball. Lie on your bed, place the tennis ball between back and bed at the tender spot. Maybe shift about a bit. Lift a knee up towards your chest for a few seconds. 10 minutes a day, far cheaper than an osteopath.

Also a back brace may help.

I'm not doing my health problems, there isn't enough space ;-)

Thanks, I'll give it a go. I do try holding my knees up against my chest (as per osteo's advice) but not tried a tennis ball. Not considered a back brace, but then the ache hasn't become an issue till recently.

 

[icehorse]

My wife studies and applies pain science in her career, she has several thousand very happy clients. I say this not to brag (although I am proud of her), but to establish some credibility...

So here's a bit of pain science, heavily summarized:

1 - There is a LOW correlation between chronic pain and tissue damage !!!! (Ya really gotta let that idea bounce around in your brain for a while. That seems to go against everything we've ever heard, I know.)

1b - It ain't where you think it is. Our movement system is complex. If you have a sore elbow, it could be because there is some restriction in your shoulder. You never know!!

2 - Our bodies do not really have "pain" sensors. Our tissue can sense things like heat, cold, pushing, and pulling, but not pain.

3 - Our bodies send data to the brain, the brain evaluates the whole context, and decides whether to declare a certain situation "painful".

4 - None of this is to say your pain is not real. Your pain is real !! But often you can minimize or eliminate it.

5 - The brain's top priority is to protect the body. If the brain becomes alarmed or uncertain as to the status of a part of the body, its first defense is to issue pain signals to that body part to make it stop moving. Often this is a great strategy, e.g., it helps damaged tissue heal.

6 - Everyone has a brain-body, proprioceptive "map". This map is based on ongoing communications between the brain and the body. The body is constantly sending data to the brain about what's going on.

7 - To be accurate, the map depends on high quality, ongoing data, much of which comes through movement.

8 - When we get injured, we rightly protect the injured tissue by reducing or stopping movement. This allows the tissue to heal, hooray, but it also causes the map to this tissue to get reduced, and have poor quality data. So back to point 5, if the brain is getting uncertain data, its first strategy is to issue pain signals.

== A scenario

Let's say we sprain an ankle. Real tissue damage. Pain. Immobility. All is as it should be for healing.

But weeks, months, years go by, and the ankle still feels weak and painful. By now the tissue has healed, but the map has been corrupted. Given a bad map, the brain will continue to issue pain signals. So what we have to do is restore the map!!

== A solution for chronic pain

We want the pain associated with that old injury to go away. So in order to restore the map to that tissue, we need to give the brain a TON of data about that tissue. The technique is to do a lot of MOVEMENT EXPLORATION in that area. So if that ankle still hurts, you have to explore all the movements you CAN do with that ankle. An important caveat is DO NOT MOVE THROUGH THE PAIN !! Instead move up to the edge of the pain, and then move around the pain. Try moving from a slightly different direction. Try the same movement with your knee bent, or or hip at a different angle. To reiterate point 1b - we never know the actual source of the pain. If your repaired ankle is sore, it could be that your knee is tight from helping the ankle heal.

So you have to do a lot of movement exploration. Up to and around the pain, not through it!! The more pain free data the brain receives, the more it trusts that the tissue is okay. The more the map is restored.

== Flexibility vs. Mobility

Flexibility is a measure of pain free range of motion, it's not bad. But mobility is better. Mobility is a measure of pain free range of motion UNDER YOUR OWN STEAM. So if your PT can move you in a certain pain free way, but you cannot make that movement on your own, you have flexibility, but not mobility. WE WANT TO MAXIMIZE MOBILITY.

So stretching is an old idea, and an okay one, but stretching is mostly about flexibility.

A new improvement to stretching is called CARs (controlled articular rotations). CARs is basically movement exploration and stretching - but using only your own muscles. So something like downward facing dog relies on a gravity assist, it doesn't count as a CAR. You can find a number of good Youtubes on how to do CARs.

 

[Secret Chief]

My wife studies and applies pain science in her career, she has several thousand very happy clients. I say this not to brag (although I am proud of her), but to establish some credibility...

So here's a bit of pain science, heavily summarized:

1 - There is a LOW correlation between chronic pain and tissue damage !!!! (Ya really gotta let that idea bounce around in your brain for a while. That seems to go against everything we've ever heard, I know.)

1b - It ain't where you think it is. Our movement system is complex. If you have a sore elbow, it could be because there is some restriction in your shoulder. You never know!!

2 - Our bodies do not really have "pain" sensors. Our tissue can sense things like heat, cold, pushing, and pulling, but not pain.

3 - Our bodies send data to the brain, the brain evaluates the whole context, and decides whether to declare a certain situation "painful".

4 - None of this is to say your pain is not real. Your pain is real !! But often you can minimize or eliminate it.

5 - The brain's top priority is to protect the body. If the brain becomes alarmed or uncertain as to the status of a part of the body, its first defense is to issue pain signals to that body part to make it stop moving. Often this is a great strategy, e.g., it helps damaged tissue heal.

6 - Everyone has a brain-body, proprioceptive "map". This map is based on ongoing communications between the brain and the body. The body is constantly sending data to the brain about what's going on.

7 - To be accurate, the map depends on high quality, ongoing data, much of which comes through movement.

8 - When we get injured, we rightly protect the injured tissue by reducing or stopping movement. This allows the tissue to heal, hooray, but it also causes the map to this tissue to get reduced, and have poor quality data. So back to point 5, if the brain is getting uncertain data, its first strategy is to issue pain signals.

== A scenario

Let's say we sprain an ankle. Real tissue damage. Pain. Immobility. All is as it should be for healing.

But weeks, months, years go by, and the ankle still feels weak and painful. By now the tissue has healed, but the map has been corrupted. Given a bad map, the brain will continue to issue pain signals. So what we have to do is restore the map!!

== A solution for chronic pain

We want the pain associated with that old injury to go away. So in order to restore the map to that tissue, we need to give the brain a TON of data about that tissue. The technique is to do a lot of MOVEMENT EXPLORATION in that area. So if that ankle still hurts, you have to explore all the movements you CAN do with that ankle. An important caveat is DO NOT MOVE THROUGH THE PAIN !! Instead move up to the edge of the pain, and then move around the pain. Try moving from a slightly different direction. Try the same movement with your knee bent, or or hip at a different angle. To reiterate point 1b - we never know the actual source of the pain. If your repaired ankle is sore, it could be that your knee is tight from helping the ankle heal.

So you have to do a lot of movement exploration. Up to and around the pain, not through it!! The more pain free data the brain receives, the more it trusts that the tissue is okay. The more the map is restored.

== Flexibility vs. Mobility

Flexibility is a measure of pain free range of motion, it's not bad. But mobility is better. Mobility is a measure of pain free range of motion UNDER YOUR OWN STEAM. So if your PT can move you in a certain pain free way, but you cannot make that movement on your own, you have flexibility, but not mobility. WE WANT TO MAXIMIZE MOBILITY.

So stretching is an old idea, and an okay one, but stretching is mostly about flexibility.

A new improvement to stretching is called CARs (controlled articular rotations). CARs is basically movement exploration and stretching - but using only your own muscles. So something like downward facing dog relies on a gravity assist, it doesn't count as a CAR. You can find a number of good Youtubes on how to do CARs.

Many thanks for posting. And to your wife.

 

[YmirGF]

As I have said elsewhere, I have enjoyed disgustingly good health all my adult life. The only thing that is a constant now is, when I get up in the morning, or get up out of a chair after an extending bout of sitting, it is very difficult to get my legs going. It takes at least 30–60 seconds for things to limber up, and then I can run a hundred-yard dash again.

I told that to a physiotherapist I was incarcerated with, and he said to leave it with him, and he would think on it.
The next day he came by and said that there was nothing that he could think of except to pretend I was a shark and always keep moving. LOL.

Like many, I could shed a few pounds, but I am a fairly active person otherwise.

 

[Secret Chief]

find a number of good Youtubes on how to do CARs.

Such as this?

 

[anna.]

Ok I'll start.
I'm 63. In the last 6-12 months I've found that I only have to do something like an hour's garden weeding and I get a stiff back for at least a week. My osteopath is great but at £40 a pop I'm thinking it might be cheaper to employ a gardener! Any thoughts?

My thoughts: don't hire a gardener. Work with your doctor to find ways to strengthen your back and soothe the aches.

As you get older, when you start pulling back from doing things because they're harder to do, you'll slowly but surely lose your ability to do them. Do as much as you can, and keep doing it for as long as you can. Safely, of course.

Some of my family live in rural areas (I live in the city). They say, and I've seen on visits, that their elderly neighbors are out mowing and weed-whacking and driving tractors, using pitchforks, mending fences, etc. etc. in their 80s and into their 90s.

I see my friends deciding not to drive after dark or see their driving circle get smaller and smaller and I resolve not to do that. As long as I'm safe, and healthy, I'll challenge myself to do things that don't feel quite as comfortable anymore because "use it or lose it" is real.

I learned this lesson watching my dad, and I swore I wouldn't let myself give in until there was no longer an option. I had surgery recently and had lost quite a bit of strength, and battled to regain it, which I have, thankfully. It doesn't take long to lose muscle strength.

Gerontology has a term called "regulation of loss." It's how older people cope with diminishing abilities. Moving from waking unassisted to walking with a cane, to using a walker, and so on. Eventually time catches up with everyone, but don't slow down and make time's job easier. Motion is lotion, keep moving as much as you can - safely.

 

[Shaul]

Ok I'll start.
I'm 63. In the last 6-12 months I've found that I only have to do something like an hour's garden weeding and I get a stiff back for at least a week. My osteopath is great but at £40 a pop I'm thinking it might be cheaper to employ a gardener! Any thoughts?

As we age we need to adjust our activities. Most of us recognize intellectually that our bodies change but don't "listen" to our bodies. If a given activity, such as gardening, are causing issues then we should adjust how we do those. Using a sound plan will allow us to enjoy most activities more. If gardening for an hour causes problems then consider gardening in more by shorter increments. Also do preparation. Stretching and preparatory exercises, say grip strengthening, should be explored. During the activity take note of what your body is telling you. Pause periodically to note what motions you are doing and how your body is responding. Modify the activities in a way that reduces stress. It may be cheaper to hire a gardener but not more enjoyable. Don't let a lack of planning take away a simple pleasure you enjoy such as gardening.

 

[YmirGF]

My thoughts: don't hire a gardener. Work with your doctor to find ways to strengthen your back and soothe the aches.

As you get older, when you start pulling back from doing things because they're harder to do, you'll slowly but surely lose your ability to do them. Do as much as you can, and keep doing it for as long as you can. Safely, of course.

Some of my family live in rural areas (I live in the city). They say, and I've seen on visits, that their elderly neighbors are out mowing and weed-whacking and driving tractors, using pitchforks, mending fences, etc. etc. in their 80s and into their 90s.

I see my friends deciding not to drive after dark or see their driving circle get smaller and smaller and I resolve not to do that. As long as I'm safe, and healthy, I'll challenge myself to do things that don't feel quite as comfortable anymore because "use it or lose it" is real.

I learned this lesson watching my dad, and I swore I wouldn't let myself give in until there was no longer an option. I had surgery recently and had lost quite a bit of strength, and battled to regain it, which I have, thankfully. It doesn't take long to lose muscle strength.

Gerontology has a term called "regulation of loss." It's how older people cope with diminishing abilities. Moving from waking unassisted to walking with a cane, to using a walker, and so on. Eventually time catches up with everyone, but don't slow down and make time's job easier. Motion is lotion, keep moving as much as you can - safely.

What a great response, @anna.

Granted, I am a mere 67, but got a chuckle out of paragraph 3. It is true.

RE: Diminishing capacity. That is a tough nut for males to deal with. My dad and a neighbour did not handle it very well after major surgeries.

 

[exchemist]

Ok I'll start.
I'm 63. In the last 6-12 months I've found that I only have to do something like an hour's garden weeding and I get a stiff back for at least a week. My osteopath is great but at £40 a pop I'm thinking it might be cheaper to employ a gardener! Any thoughts?

I agree with @anna. Gardening is great for the mind and gives you a bit of gentle muscle work. I get back trouble periodically and I got a lot of help from the physio at my local GP practice. He explained a lot of back trouble in older people is because the discs between the vertebrae compress with time and this leads to a bit of free "play" between the segments of your spine, allowing them to move out of position and cause pain. This can be alleviated to some extent by strengthening your core: muscles in the abdomen and down your sides that hold your spine erect. He gave me some exercises which after a few weeks helped a lot. You might try a physio rather than an osteopath and see where you get to.

 

[Secret Chief]

I agree with @anna. Gardening is great for the mind and gives you a bit of gentle muscle work. I get back trouble periodically and I got a lot of help from the physio at my local GP practice. He explained a lot of back trouble in older people is because the discs between the vertebrae compress with time and this leads to a bit of free "play" between the segments of your spine, allowing them to move out of position and cause pain. This can be alleviated to some extent by strengthening your core: muscles in the abdomen and down your sides that hold your spine erect. He gave me some exercises which after a few weeks helped a lot. You might try a physio rather than an osteopath and see where you get to.

Ok cheers. I did used to go to a physio but when I was recommended an osteo, the osteo seemed to "sort me out" with fewer sessions.

 

[F1fan]

I turned 60 last February and this year marks my 40th year as a licensed competitve cyclist. The trick for older athletes is to not get out of shape in the winter. Those who race cyclocross in the fall and winter are vastly more fit in spring and summer. I had fewer hours on the bike this spring and I have been trying to get my fitness back. Last night I had my best group ride all year, as Moseley and me beat up on the others just like old times. It's fun being 60 and seeing guys in the 20's and 30's struggle to hold on. I just have to stay hydrated, rested, and maintain a good diet and stay motivated in training. Yoga has helped the body overall since there is a limited range of motion in cycling.

 

[exchemist]

Ok cheers. I did used to go to a physio but when I was recommended an osteo, the osteo seemed to "sort me out" with fewer sessions.

I only ever saw the physio once. He gave me the exercises to do at home and I just did them.

 

[Secret Chief]

As we age we need to adjust our activities. Most of us recognize intellectually that our bodies change but don't "listen" to our bodies. If a given activity, such as gardening, are causing issues then we should adjust how we do those. Using a sound plan will allow us to enjoy most activities more. If gardening for an hour causes problems then consider gardening in more by shorter increments. Also do preparation. Stretching and preparatory exercises, say grip strengthening, should be explored. During the activity take note of what your body is telling you. Pause periodically to note what motions you are doing and how your body is responding. Modify the activities in a way that reduces stress. It may be cheaper to hire a gardener but not more enjoyable. Don't let a lack of planning take away a simple pleasure you enjoy such as gardening.

My wife's the garden enjoyer, I'm just the unskilled weeder

 

[anna.]

What a great response, @anna.

Granted, I am a mere 67, but got a chuckle out of paragraph 3. It is true.

RE: Diminishing capacity. That is a tough nut for males to deal with. My dad and a neighbour did not handle it very well after major surgeries.

Thanks, and yes it's very true! No wonder some of them don't have much use for city weaklings. When they're finally sitting on their front porch, they've earned that sit.

My dad didn't either. I think it was the first brick wall of his life and he didn't know how to get past it. He went downhill after a surgery that was supposed to make him more mobile, not less.

I take long drives, intentionally drive alternate routes to see something different and force my brain to reorient. (I can almost hear my brain: "recalculate! recalculate!") Also drive after dark, do all my own work at home, cook from scratch, and do activities I haven't done before (recently went to my first music concert at a venue that's been a local landmark for decades, yet I'd never been inside).

I just want people to grab as much as they can before they go.

 

[Secret Chief]

I turned 60 last February and this year marks my 40th year as a licensed competitve cyclist. The trick for older athletes is to not get out of shape in the winter. Those who race cyclocross in the fall and winter are vastly more fit in spring and summer. I had fewer hours on the bike this spring and I have been trying to get my fitness back. Last night I had my best group ride all year, as Moseley and me beat up on the others just like old times. It's fun being 60 and seeing guys in the 20's and 30's struggle to hold on. I just have to stay hydrated, rested, and maintain a good diet and stay motivated in training. Yoga has helped the body overall since there is a limited range of motion in cycling.

If my back is behaving I still go running 3 or 4 times a week, between 3-10 miles each run.

I was wondering about doing yoga again; I did it for about a year but it sort of fell off the radar. How long have you been doing it? Any particular type?

 

[anna.]

I agree with @anna. Gardening is great for the mind and gives you a bit of gentle muscle work. I get back trouble periodically and I got a lot of help from the physio at my local GP practice. He explained a lot of back trouble in older people is because the discs between the vertebrae compress with time and this leads to a bit of free "play" between the segments of your spine, allowing them to move out of position and cause pain. This can be alleviated to some extent by strengthening your core: muscles in the abdomen and down your sides that hold your spine erect. He gave me some exercises which after a few weeks helped a lot. You might try a physio rather than an osteopath and see where you get to.

I've heard the same re: strengthening the core, and also stretching the hip flexors. Sometimes those get forgotten. One of the exercises I do are bridges, but in addition to exercises, don't forget balance! If you can't balance on one foot for 30 seconds, start practicing in front of something you can grab when you need to - a dresser, or counter.

 

[anna.]

If my back is behaving I still go running 3 or 4 times a week, between 3-10 miles each run.

Impressive! I couldn't do that when I was 25...