By Michael A. Amaral, MD
Spine & Sacroiliac Specialists
Atlanta, GA

Injuries become more of a concern as we age. For one thing, we heal more slowly. Also, tendons and fascias, which are the anatomical structures that attach muscles together or to bones, start weakening.

These structures strengthen with exercise, but much more slowly than the muscles they're attached to. This means that the tendon might not be able to keep up with the strengthening of the correlating muscle. This is true at all ages, although in our teens and 20s, the tendons and fascias are so strong that there is some leeway. Younger athletes often injure their muscles first while older athletes often injure their ligaments.

Ligaments and tendons also weaken with advancing age because of repetitive stress and simple wear and tear. Muscles can be built and strengthened at any age but we must be careful that the power of the muscle doesn't exceed the ability of the tendon to hold it to the bone. If it does, the tendon will tear. This can be quite painful and disabling as tendon and fascia injuries heal very slowly, often taking weeks or months. Slow movements allow for the stress to distribute along the whole length of the tendon rather than concentrate at its weakest spot.

Pure muscles injuries occur when the muscle contracts while overstretched. This is more frequent in the younger age group where the tendons are strong. Younger athletes are also the ones who tend to stretch to the limit.

Joints and the inter-vertebral discs of the spine are injured by overload. Joint pain is always a sign that you are using too much resistance or doing too many repetitions. You must immediately stop and check with your physician. The resistance and number of repetitions you were doing when you began to experience pain is probably your limit. Be extremely careful in progressing further and do it only under supervision. Taking a period of rest, switching back to lower weight and then increasing them slowly may take care of the problem.

Lumbar disc herniation (tearing) resulting in back pain or sciatica is most often due to trying to lift something while bending and twisting. This is a frequent situation when moving free weights and a good reason to use machines.

Bone injuries are infrequent because they require significant amounts of stress that are usually not seen in the gym setting. However, they can happen if you have weak bone (osteoporosis). This is especially true if you're a woman past menopause. Check with your physician and discuss the appropriateness of a bone mineral density test before starting a heavy exercise routine.

By and large, most of the injuries occurring in a gym setting are due to ligament (tendon and fascia) tears. This is what happens:

• While the muscle is being strengthened, the correlating ligament has actually weakened through wear, tear and repetitive stress. It might strengthen somewhat, but not in proportion to its muscle. In fact, after age 40, it will probably never strengthen in proportion to its muscle.
• At some point, the muscle contracts and the weakened ligament tears. This doesn't always happen during heavy exercise, but may happen a few days later with an apparently trivial movement. This is because the heavy exercise brought the ligament to the breaking point and the subsequent trivial movement is the straw that breaks the camel's back!
• The ligament may tear or its attachment to bone may be disrupted. In any case, it's very painful.
• The body repairs itself by forming scar (assuming that the ligament is only partially injured). This is a slow process and flare-ups of pain by a bad movement are frequent during the healing process. The healing process also lengthens the ligament, making it less prone to injury but also making the muscle less effective.

Several considerations follow:

• Some muscles groups are more resistant to injury than others. This seems to be true for the biceps, triceps, quadriceps and abdominal muscles.
• All other things being equal, some locations are much more disabling than others. A back injury will disable you a lot more than the same injury in the triceps or the quadriceps.

How to minimize the chance of injury?

• Do not move heavy free weights around, especially lifting them or replacing them to lower racks. Use machines where the exercise is done from a comfortable sitting (preferred) or lying down position.
• Use proper form. Get instruction in the safe use of the machines.
• Stop the exercise if any joint pain occurs. Consult with your physician.

Learn How Mature Athletes Can Benefit From Resistance Training
Learn the Basic Principles of Exercise for the Mature Athlete
Learn About The Advanced Principles Of Exercise For The Mature Athlete

Excerpt from "Being 81, Feeling 18: Slow Aging and Regain the Vitality of Youth" by Michael Amaral, MD. To order a copy of the book, send $14.95 to Spine & Sacroiliac Specialists, 550 Peachtree NE, Suite 1770, Atlanta GA 30308, or visit the Spine & Sacroiliac Specialists Web site at www.spineandsacroiliac.com.

Copyright 2006 Michael A. Amaral MD. Reprinted with permission.

The inclusion of this book excerpt on our Web site is for informational purposes only. It does not represent an endorsement by Medtronic Inc., and is not intended as a substitute for professional medical advice, diagnosis or treatment. Before starting any exercise program, always seek the advice of your physician or other qualified health professional.

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