As I reached the ripe age of twenty last month, my annual existential crisis took on a new face as I entered another decade of life. Some day I won’t be young enough to be immune to almost any tumble or tear in my body. I’ll actually break something. I’m young and lucky enough to be able to squat twice my bodyweight without thinking twice about tearing a muscle or causing a lasting ache in my body. But eventually my youth will run out. Eventually, my joints will falter under the weight of one hundred and eighty pounds balanced on my back. I’d like to prevent that day from coming too soon and be prepared for when it finally arrives.
Dr. Marcus Ford, a total joint repair specialist at Campbell Clinic, says that I have a few more years of healthy joints before I should begin developing any aches or pains. Many patients in their teens and twenties that he helps are struggling due to genetic predispositions or some type of trauma, such as a car accident or sports-related injury, that causes them to have joint issues. It’s not until patients reach their thirties and forties that they begin to experience the results of wear-and-tear on their joints.
In our thirties and forties, people begin experiencing ligament tears and overuse injuries. What they were once able to do in their teens and early twenties, they will get injuries from- like tennis elbow. Dr. Lee-Sigler at OrthoSouth Clinic explains that muscle mass begins to decrease if you’re not actively working on maintaining it through exercise, and weight typically begins to increase. Along with less muscle mass, “the ligaments and tendons around the joints are no longer as pliable as they used to be,” said Dr. Lee-Sigler, “there isn’t as much fluid in the joint.” Without as much fluid, the joints aren’t as cushioned and there can be more friction when they move.
Around our fifties, arthritis begins to occur. There’s lots of factors that affect if and how people develop arthritis, such as genetics and how the body. After symptoms of arthritis or other joint problems begin to occur, they will often continue to affect a patient’s life in more ways as they enter their sixties, seventies, and eighties.
The good news is we’re much better off now than we were thirty years ago. Joint replacement has gotten so much better, keeping people active for much longer. They used to wear out very quickly and weren’t very functional. Now we have much more refined techniques. Dr. Ford describes how he enjoys providing hip replacements to teens that he feels will last them until late adulthood, keeping them functional and able to do regular activities for decades, as opposed to a hip replacement that provides less function and will need to be replaced when the patient is in their thirties.
There’s also been significant improvements in biologic medicines for inflammatory diseases. Rheumatoid arthritis patients would be much more limited thirty years ago. Nowadays, the right medication can slow down the degeneration significantly. Now, along with steroid medications, Dr. Lee-Sigler notes that Hyalgan injections have been shown to improve knee pain caused by arthritis. Doctors are beginning to use orthobiologics, which are substances that help patients heal faster after a procedure.
But, to ease my dread of aging, I wanted to know how to keep my body in the best condition as I can for as long as possible. Dr. Lee-Sigler and Dr. Ford both help patients of all ages every year- from teens to those who have been retired for twenty years. And for each stage of their patients’ lives, they have similar advice. When anyone asks them how to avoid joint problems, or avoid exacerbating their existing issues, they recommend a balanced diet and staying active, however that may look for each individual.
“Obesity is a big driver of degenerative joint diseases,” Dr. Ford said. Of course, Dr. Ford also noted the effect of genetics and the development of one’s body in the womb as factors for joint issues, especially in younger patients. Though certainly not the only factor, obesity is one that we have more control over than our genetics. Dr. Lee-Sigler agrees, saying that “keeping your weight within a healthy range is the number one, two, and three things you can do.”
To keep a healthy weight, staying active and eating healthy are the two basic things that we can do. Dr. Ford recommended any exercise that will get you active and social. Some sports, such as cycling and swimming, are low-impact activities that are accessible to people with existing joint problems or are concerned about developing one. Dr. Lee-Sigler suggested tai chi as a great way to gently circulate blood, fluid, and oxygen to the joints. She also said pilates is a great workout that often offers low-impact alternatives for certain moves that may be too difficult for older joints.
Sports that involve lots of running and jumping, such as basketball, can be harder to do as you get older and cause more strain on your joints. Dr. Ford highlighted functional and eccentric exercises to take care of your joints. Functional exercises, which activate multiple muscle groups that are commonly used in daily life, involve push-ups, squats, and jumping jacks. These exercises strengthen your body to do activities such as lifting something heavy off the ground or getting in and out of a chair. Dr. Lee-Sigler also suggests functional training because “there’s things that happen that we’re not aware of when we move,” she said. “We’re not supposed to be aware of them because the muscles and joints and nerves are working in harmony.” She states that functional training helps keep your body in harmony so you can continue doing everyday activities without issue.
But, at the end of the day, Dr. Ford recommends that we find any exercise that motivates us to be active. “It’s all a risk-benefit. If it’s what you love and gets you outside, then go do it,” he said. “As you age it’s easy to get stuck in a chair,” Dr. Ford said. He suggested finding alternatives to our favorite sport to stay active. He noted that pickleball- a sport that combines elements from tennis, table tennis, and badminton- is becoming increasingly popular. It’s a low-impact, social sport that still requires a competitive spirit, making it great for those with deteriorating joints.
Dr. Lee-Sigler recommended that, when deciding what types of exercises to do, we have to ensure that it’s a balanced routine. She explained that some people try to exercise solely to lose weight. As a result, they don’t stretch, warm up before the workout, cool down afterwards, or properly strengthen their muscles. This leads to a higher risk of injury. Stretching prevents muscles from being too tight. “Many muscles cross a joint. When the muscles are short or tight,” she said, “then it doesn’t easily allow the joint to go through its full range of motion. Also, when the muscles are tight, you don’t get maximum strength from them to protect [the joint].” Dr. Lee-Sigler strongly recommended that we choose balanced workouts and practice good form to prevent any injuries.
Alongside a good exercise routine, both Dr. Ford and Dr. Lee-Sigler agreed that eating healthy is crucial to maintaining a healthy weight. “Food is medicine, too,” Dr Lee-Sigler said, adding that “there are certain foods that have natural inflammatory properties.” Green leafy vegetables, dark berries, and other foods that are high in antioxidants are beneficial because they prevent free radicals from affecting your joints. A good diet excludes lots of highly processed sugar and greasy foods. If you’re looking for a specific diet, Dr. Lee-Sigler said the Mediterranean diet is often very healthy. Even healthy foods, however, should be eaten in moderation. Learning the correct portion size prevents overeating.
Her final piece of advice was to never smoke or vape, or quit as soon as possible. “Smoking and vaping increases free radicals, which impact almost every part of your body,” Dr. Lee-Sigler said. “In your joints, they increase the inflammatory potential and decrease the hydration status of your joints.” If we want to make a change to our health and protect our joints, Dr. Lee-Sigler highly recommended that we stop smoking and keep our weight under control. Exercising, stretching, and warming up are important, too, but they can be changes that happen over a greater length of time. Luckily, I never caved into the peer pressure of vaping, so that’s one less problem I have to worry about as I stress over my future.
So, as I complete my yearly existential crisis, I can rest easy knowing that I can celebrate a few more birthdays while I continue picking up big weights. But maybe when I celebrate my fiftieth I’ll start cycling. And when I turn eighty, my fellow eighty-year-olds and I will play pickleball to stay active and social. I’ll happily take Dr. Lee-Sigler’s suggestion of using a Mediterranean diet as a basis for my healthy eating, and I’ll get my daily dose of vegetables and berries that are high in antioxidants. And Dr. Ford’s advice of “stretching, staying strong, staying active,” will ring through my ears as I take care of my body at each stage of my life.