How to Slow Down Joint Degeneration from Aging

How to Slow Down Joint Degeneration from Aging

Do you notice that it takes more effort than before to do simple things like run, squat, or get out of your car?  You can still do them, but not as fast and springy as when you were younger.  If you’re over age 40, it’s likely you can identify with this.

The inevitable reality of being mortal is that our body starts to deteriorate after maturity, which is around age 21.  For those who “age well” the deterioration rate progresses slowly and is hardly perceptible until the later years; for those who do not age well, the changes can occur relatively fast and are obvious.

The main musculoskeletal changes associated with aging are:

  • Muscle atrophy, especially in the upper leg and glutes
  • Decreased muscular strength and endurance
  • Decreased cardiovascular endurance
  • Decreased ligament and tendon elasticity
  • Decreased joint cartilage thickness and suppleness
  • Increased body fat percentage

The focus of this article and following ones will be on slowing down the gradual breakdown of the musculoskeletal system via exercises, stretches, diet, new habits and routines and other lifestyle modifications.  Yes, slowing down the aging process and extending your “full functional” years is very possible if you have a good plan, and diligently stick to it.  In other words, start developing good wellness/ life extension habits if you haven’t done so already.

In this article, the topic is joints.  I previously wrote about the importance of keeping your joints strong by doing  specific joint exercises during your workouts.  This discussion is on doing daily joint stretches to counter the degenerative forces that come with aging.

One of things most people first notice as a sign of getting older is decreased ability to absorb and rebound from external forces and mechanical stress.  You start to notice that it takes a bit longer to jump up from a seated position and get up after falling.  You find it more difficult to bend, squat and maintain other awkward body positions.  If you trip and fall to the ground, it takes more effort to get back up.  And, when running you notice that you can feel the shock in your knees more, and therefore do not run as long, or give it up entirely.   The reasons for this are decreased muscle strength, decreased ligament and tendon elasticity, and most of all, thinning cartilage in the weight-bearing joints.  It takes more energy and effort to do these things because your body “hardware” has lost some of its youthful, structural integrity.  Your mindset /motivation to move may be unchanged but your body isn’t responding as quickly and strongly.

As you get older, the cartilage lining your synovial joints (the joints encapsulated by ligaments) loses fluid content.  To compound matters, when you are past the age of 40, human growth hormone (HGH) secretion by your pituitary gland practically ceases.  HGH is the “fountain of youth” hormone that is largely responsible for the features associated with youth:  energy, high metabolism, supple skin, thicker muscles and thicker, bouncier cartilage.  It’s why younger people can bounce right back up after falling down, making it look effortless.

If you are over the age of 50 and your occupation or recreational interests involved placing pressure on your feet, knees, hips, spine, shoulders, elbows or hands chances are you are experiencing aches and stiffness.  Your age, plus your history are not doing your weight bearing joints any favors.  So what can you do?

If you are over the age of 40 and feel the slightest stiffness in your joints, I highly advise you start a daily routine to keep your cartilage healthy.  Your goal is to effectively counter the natural progression of osteoarthritis—the disease that involves advanced thinning of cartilage, bone-on-bone contact, and resultant chronic inflammation and joint dysfunction (stiffness, pain, reduced range of motion).  It plagues millions of people over the age of 50.  Practically all former football players have osteoarthritis.

By investing just a couple of minutes a day every day, you can literally save yourself years of pain down the road, and perhaps preclude the need to take harmful anti-inflammatory medications and even the need to get knee and/or hip replacement surgery.  Instead of pain, you will be able to squeeze out a decade or more of pain-free movement.  That is a huge, quality of life issue because most of the enjoyable things in life require some degree of physical fitness—walking, bending, lifting etc. and joint pain can severely restrict your ability to engage in these activities.

In my view, in order for a preventive measure to be feasible, it must meet the following criteria:

  1. It must be practical, with minimal preparation required
  2. It must be realistic – no super-human feats required
  3. It must address the problem and have close to immediate results

Here is the basic routine that I personally do every day to guard against cartilage deterioration.  I will update this post with a video that illustrates these exercises, but for now, here is the description so that you can get started right away:

Arm propellers – slowly and with focused intent, make large circles with your arms, with the left arm moving counter-clockwise and the right arm clockwise, crossing in front.  Keep the angle of your upper arm about 30 degrees relative to the coronal plane of your shoulder to avoid jamming your shoulder joints.  Do about 20 rotations, and then reverse directions of both arms.

This exercise moves the glenohumeral (GH) joint, where your upper arm (humerus) articulates with your scapula.  Many people don’t realize that in a typical day, they rarely raise their arms above shoulder level.  This prevents areas of the GH joint to get proper lubrication, causing the cartilage to “dry out.”  This exercise exposes all parts of the cartilaginous-lined humeral head to synovial fluid, the “motor oil” of joints and even stimulates production of it.  The rigorous movement also stimulates lubricin production, a compound that further reduces friction inside the joint.

Elbow propellers – similar to the arm propellers, rotate your lower arm (forearms) in opposite circles by keeping your upper arm relatively stationary so that most of the movement is at the elbow joint.  There is some movement in the GH joint, but also some in the radio-ulnar and humero-ulnar joint.  Do 20; reverse directions.

Wrist stretches – interlace fingers as if to pray, then alternately pronate and supinate the hands while making a circular motion, stretching the wrist joints in all directions.

Finger flexion and extension – make loose fists with both hands, and then unfold the fists segmentally (extend the fingers) first at the metacarpal-phalangeal joints (knuckles), then proximal interphalangeal joints, and then the distal interphalangeal joints until your hands are flat, fingers fully extended.  Then, reverse the process (flex the fingers segmentally) back into a fist. Repeat about ten times.

Collarbone stretches – this mobilizes the sternoclavicular (SC) joint, where the proximal clavicle articulates with the sternum (breast bone).  The joints are identified by the two, large bony protuberances at the base of the neck.  For this exercise, make a shortened swimming stroke with your arm:  bring it backwards, raise it up for the stroke and with elbow bent about 90 degrees, make a big scooping motion downwards, reaching all the way back (palm of hand should be facing upwards), and then supinate your forearm and repeat the motion.  You will probably hear some grinding noises in your SC joint as it moves.  Do about 10 repetitions; switch sides.

Torso circles – This nicely moves the joints of the lumbar spine in a stirring motion—the facet joints and the intervertebral discs, forcing their hydration.  Place feet about two feet apart and place your hands on the sides of your pelvis.  Hinge at the hip joints (bend torso forward and down, being careful to contract your back muscles for support) and then move your torso in a large, counter-clockwise circle reaching the maximum lumbar active range of motion in all directions of the circle.  Do ten circles; reverse directions.

Lumbar extensions –  I recommend doing these especially if your job involves prolonged hours of sitting, such as a desk worker, airline pilot, or truck driver.  Sitting flexes your lumbar spine, which encourages posterior disc migration, a risk for herniated discs.  Simply place the palms of your hands behind you, just below your waistline.  Then, lean backwards and bend over your hands (try to keep them stationary in space), arching your back and hold for two seconds.  You should feel tightness in your low back.  If not, bend back some more. Return to neutral.  Do 10 repetitions.

Hula hoops – this targets your hip joints by moving your pelvic bowl around the femur heads.  With feet shoulder length apart and hands on your sides, make big circles with your pelvis like a hula hoop motion.  You should feel your hip joints moving even though your legs are stationary.  By doing this, you bathe all areas of the femur heads and stimulate synovial fluid production.

Knee circles – the knees move mainly as a hinge joint (flexion and extension) but there is some ability to rotate and translate (move in a circular motion and side to side motion).  With feet together touching, bend your knees bout 30 degrees and place your hands around them.  Move your knees together in a clockwise direction 20 times; reverse direction.

Ankle circles – point your toes to the ground, and flex them against the ground by placing light, downward pressure.  Then, move your ankle in a clockwise direction keeping your toes in place.  This moves the many articulation points of the ankle, as well as the joints of the forefoot:  metatarsal-phalangeal joints and interphalangeal joints.

BOTTOM LINE:  As you age, your joint cartilage loses its fluid content and starts to get stiffer.  If the joint doesn’t get much movement, it compounds the problem. You can arrest this process by diligently doing these exercises to ensure all your joints are tasked to move, which signals the body to produce more joint fluids.

Handling Foot Fatigue and Plantar Fascitis

As you age, the tendons and ligaments in your body get weaker/looser, which changes the dynamics of your joints.   It’s probably related to the decrease in human growth hormone levels as we age.

Tendons attach muscles to bones, while ligaments attach the ends of bones forming a joint.  The area that you will notice first when your ligaments weaken are your feet, as they bear all the body’s weight when standing.

I’ve noticed that my feet have flattened over the last ten years (I didn’t have big arches to start with).  When your feet flatten, a couple of things can occur:

1.  You will walk slower.  The foot arch is like a mechanical spring device that is integral to bipedal locomotion:   in mid-step, it loads up potential energy (using the plantar fascia– a broad ligament in the sole of the foot), and in toe-off helps push off the foot from the ground and initiates forward leg swing (think of a steam catapult on an aircraft carrier, assisting jets to take off and fly).  When your feet flatten, you lose a lot of this ability and have to rely more on your leg muscles to walk.

2.  You can develop calluses under your metatarsal joints (ball of the foot).  The flattening effect places more pressure on these joints when you stand.

3.  You can develop foot pain and fatigue.

4.  You can develop ankle, knee, hip, and lower back pain.

#s 2, 3 and 4 are more likely if you are overweight.

If you have any of the above symptoms, and have flat feet, here are the things you can do to lessen the effects:

1.  Take joint supplements that support healthy connective tissue.

2.  Eat bone broth soup to give your body a ready supply of the building blocks of collagen, which is the main component of connective tissue.

3.  Get foot reflexology treatment.  I go to this local Chinese massage center that does Asian foot massage.  It is one of those painful pleasures– after soaking your feet in a hot water tub for 15 minutes, the therapist kneads out all the sore spots under your feet, including the small muscles of the toes.  My feet feel great afterwards.

4.  Roll a golf ball under the sole of your feet:  back and forth, and in circles.  Do this while you’re sitting, and control the deepness of the massage by varying the amount of pressure you place on the golf ball.  Great exercise to do while sitting at your desk; your co-workers won’t even know you’re doing it as they pass by.

5.  Walk barefoot outside, as much as you can.  This exercises the intrinsic muscles of the foot, and all the small joints.  You do not get this benefit if your feet are constrained in a shoe.

6.  Consider wearing a foot shoe, like the popular Vibram Five Fingers brand.  This lets your toes move independently when walking, which exercises the foot muscles, and is the next best thing after going barefoot.

Foot Pain Can Be Caused By This

Image via Wikipedia

If you have pain in your feet, it could be that your feet’s intrinsic muscles are weak and are not supporting and moving your foot bones properly during gait (walking).   As a result, certain bones can bear more weight pressure than others and develop pain; for example the first metatarsal-phalangeal joint (big toe joint).

Muscles can become weak when they are underused, or immobilized in some way over a long period of time.  For example, if you fracture your lower leg and had to wear a cast for three months, that leg would be smaller than the non-injured leg after taking off the cast.  This is because the calf muscle in the injured leg would experience some atrophy due to three months of decreased muscle activity.  You would most likely feel the difference in leg strength as well, after removing the cast.

But what would cause the foot muscles to weaken?  It’s a very simple action just about everyone does in the morning  before going to work, and that is putting on shoes.  Shoes, especially snug fitting ones like lace-up formal leather shoes with hard heels constrict the feet and don’t allow proper engagement of the foot joints when walking.  Basically, shoes act like a cast or splint on your feet.  Imagine wearing a shoe-equivalent on your hands, lacing them up tightly for nine hours a day.  Your hands would weaken eventually, and probably experience pain.

So what’s the solution?  Realize that the feet are designed to grip the ground with the toes/ forefoot, and elongate slightly at the arch to build up energy for toe-off during gait.  The toes splay out when bearing weight to increase stability to the body above.  Wearing shoes inhibits all these actions and can have an adverse effect on foot biomechanics.

Therefore, it is a good idea to exercise your feet by walking barefoot; preferably on a non-flat surface.  Find a grassy park and try running barefoot.  These activities will offer badly needed exercise (strengthening and stretching) for your feet.  If you’re like most people who have been wearing shoes most of their lives, your feet will be highly sensitive to the pebbles and small objects on the  ground; this is normal.  Keep walking and running barefoot as much as you can, breaking them in but obviously avoiding sharp objects on the ground.  This will strengthen your feet and make it more resistant to developing foot problems.

If you arent’ into going barefoot, the next best thing is to wear the Vibram Five Fingers KSO – Men’s walking “shoe.”  It offers the protection of a shoe, while offering the most freedom of movement of your feet.

What is Causing My Heel Pain?

Lateral X-ray of a Calcaneum demonstrating a spur.

Image via Wikipedia

Heel pain can be caused by a number of factors.  One of the most common is a heel spur, medically referred to as a calcaneal spur.

A heel spur is an outgrowth of bone in the shape of a small spire.  If it’s at the bottom or side of the heel bone (calcaneous), it can be painful to walk.  It is thought that heel spurs form as a result of stress on a tendinous insertion into to the heel, but some heel spurs aren’t associated with the area where a tendon inserts into the heel.

Whenever offshoots of bone form (bone spurs), it is due to a history of stress to the bone, either gradual formation following a single impact trauma such as a car accident; or cumulative impact forces over time, such as from sports.  For the foot bones, an example of the latter would be years of playing basketball or ballet dancing.  The repetitive pounding on the joints of the foot can cause bone cells at the impact area to secrete more bone matrix as a compensatory response.  In the spine and large weight bearing joints (knee, hip) they are called osteophytes.

In some cases, the heel spur stops producing pain; perhaps due to resorbption or even callous formation neutralizing its ability to press against tissue. For those that don’t, surgery can be done by a podiatrist or orthopedic surgeon to smooth down the heel spur.

TREATMENT:

In the meantime, avoiding impact trauma to the heel is important (running, jumping).  You can buy special shoe inserts that help reduce pressure on the heel spur.  Comfortable shoes are a must as well; make sure they are wide and have a thick rubber, shock absorbing sole.  The Z-Coil shoe brand incorporates a large spring at the heel to minimize shock/ impact forces to the foot when walking.

Sitting in a chair and rolling a cold beer or soda can (unopened) under your foot can help stretch the foot and ease some of the pain.  A golf ball can provide more focused massage to the bottom of the foot.  Press downward with enough pressure to get a good stretch and massage, but not so much to increase the heel pain.

Dorsal and plantar aspects of foot

Image via Wikipedia

Lastly, consider exercising your feet by walking barefoot around the house and outside (walking barefoot indoors is not as effective due to the flatness of the floor; bumpy and uneven is better).  Walking in shoes actually weaken the foot over time by preventing the intrinsic foot muscles and joints from exercising and experiencing their full range of motion.  You can also consider getting the Vibram foot glove.  This interesting shoe fits on your foot like a glove, allowing some independent movement of the toes.

Plantar fascitis is a condition where the plantar fascia (a wide, band-like ligament connecting the heel to the forefoot) pulls off a thin layer of periosteum (membrane lining the bone) from the heel and results in inflammation and pain at the front, bottom part of the heel.  It can make walking very uncomfortable.

The best approach to treating plantar fascitis is to rest your foot for a few days:  no running, no walking up hill; walk only on flat surfaces.  Use Red Light Therapy and Pulsed EMF for 15 minutes, twice a day for 2-3 weeks to accelerate healing of tissues, and for reducing any inflammation that is causing pain.  Red light therapy uses photobiomodulation to accelerate cell metabolism; thus accelerating healing of tissues.

Compression fractures and hairline (stress) fractures can also cause heel pain.  If you think you’ve fracture your heelbone, have it X-rayed.   You’ll likely get a foot cast, avoid impact to the heel for several months, and wait until the fracture heals (no pun intended).

If your heel bone fractures easily, it could be due to a bone cysts.  See your doctor on solutions for dealing with bone cysts.

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