What can you expect: I'm getting Older. Attitudes to pain.
Update:
In 2020 her family farewelled the much loved woman pictured below.Sadly she was, by that time, in a nursing home, in very difficult times. Vale.
November 2017 update: This is a photo of one of my clients, on stage with the performance artist Taylor Mac, published in the New York Times. The artist had invited the oldest and youngest members of his audience to join him during one of his Australian shows. A year and a bit shy of 90, up she went.
Regular physiotherapy exercise has helped her improve fitness, strength and balance and decrease pain after two lots of hip surgery and knee pain diagnosed as osteoarthritis. Reluctant to undergo further surgery she opted for regular exercise. She is now pain free and can now lift more leg weight than some of my teenage clients.
She was happy for me to use her (now famous) image on this re post .
2016: THE YOUNG AND THE OLD
My patients fall into either of two groups: the first are young athletes and the second are their parents (and the occasional grandparent). The symptoms are usually identical : stiff,swollen or sore hips/knees/ankles or shoulders and/or aching backs. Invariably the younger ones have an 'all clear' on radiology but believe pain is due to an acute injury from which they expect to recover with exercise rehabilitation. While the belief pain is an acute ‘injury’ is unhelpful, the commitment to exercise is good.
In contrast, the over 55s are less optimistic. Their x-rays often show wear and tear leading to either the depressing and unhelpful diagnosis of osteoarthritis /disc bulge. Equally unhelpful is the ‘we can’t see any arthritis yet.’ No wonder many think pain is inevitable with old age . If told joints are damaged or worn or something is ‘out’ many either give up on exercise/ rehabilitation and/or think pain is inevitable or that they need surgery.
‘What can you expect? I ‘m getting old.’ Or even worse: ‘the doctors says its osteo arthritis’
The irony is that pain intensity peaks in the 30s. Yes really: 18-30 years old are more likely to suffer intense pain than the elderly. With age however, the body learns many ‘go to’ pain patterns (aches) which can pop up if the body is neglected or pushed beyond its limits (or sat too long on a long-haul). These are the so called 'weak spots': the back that niggles when tired or the knee that stiffens /swells regularly or the sore big toe. The longer pain has been present, the harder it is to settle these spots. So it might seem as if there is more pain with age but really the same old patterns pop up more frequently, are more achy, linger longer ad are just more annoying overall than the intense short lived adn often forgotten pain of the teens to the early 30s.
Most teenagers who see me (not all) take on board the message that if they cut back on exercise/competition just short of pain, for two, possibly 6 weeks, (and more if pain has been present longer) all the while working hard to build up fitness, strength, agility and balance back to match capacity, (FOR AT LEAST AN HOUR A DAY) then they have a very good chance of playing out the season. And/or the season to come.
In contrast, many older patients, (not all of course) with the same symptoms, soldier on stoically or ‘don’t have time’ to exercise. Many think pain inevitable with age. Some are reluctant to relinquish favorite activity/work demands for a short period or prefer surgery. Surgery is not always the easy ‘out’ some think it will be as pain has a nasty habit of returning in a two years.
There are serious consequence of failing to deal effectively with pain or letting it simmer or undertaking too much surgery. But there is good news: Look after yourself, keep flexible (with gentle stretch programs or modified Yoga) work with weights or Pilates in a sensible graduated program, keep up walking and agility exercises. Importantly know your limits and either increase them fit for task or stay within them and pain will ease, not increase, with age.
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