Age is only a number. We’ve seen plenty of patients in their 40s, 50s, even 60s with healthier and fitter physiques than people half their age.
But at the same time, there’s a reason they say Father Time remains undefeated. Sooner or later, we all deal with certain physical changes in the way our bodies move, and they way tissues respond to stress and strain. It’s harder to stay in shape, and certain injuries become more common.
One example we see a lot? Tendinitis and tendon injuries in active adults around their early to late middle ages. There are several reasons that rates of these injuries increase as people get older, but the good news is that they can usually be prevented.
What Are Tendons?
But before we get into that, let’s start with the basics.
Tendons are tough-but-flexible bands of fibrous connective tissue, made from a protein called collagen. You have over a thousand of them in your body.
Tendons bind muscles to bone. This how you move! When a muscle contracts, they drag the attached tendons along, which in turn pull on the attached bone. This allows you to flex your knee, bend your elbow, push off with your foot—even roll your eyes. Behind the scenes, muscles, tendons, and bones work together to enable virtually every kind of motion you make.
Tendons serve other roles as well. Many help protect and stabilize joints during motion. Others can store energy and release it. Your Achilles tendon, or heel chord, does this to generate more force and make walking and running more mechanically efficient.
What Is Tendinitis?
Tendons need to be incredibly strong in order to handle the amount of tension and force placed upon them. And they are! But that doesn’t mean they’re invincible. When tendons are forced to stretch beyond what they can handle or are subjected to repetitive and intense force loads over an extended period of time, the fibers can tear or break down.
The result of that damage is generally referred to as tendinitis, although if you know anything about medical terminology, the name is a little misleading.
“Tendinitis” is often used as a broad label to describe both “true” tendinitis (inflammation of the tendon) and tendinosis. In the (more common) tendinosis, the problem is not inflammation, but cellular degeneration in the tendon fibers caused by tiny, microscopic tears within the tendon.
Either way, though, the common symptoms include stiffness, pain, tenderness, and aching, especially during or after activity.
Sometimes, a large section of the tendon rips all at once (or even tears completely through). This is known as a tendon rupture.
Why Do Tendon Injuries Increase with Age?
So why do tendon injuries disproportionately affect people in their 30s, 40s, and 50s? There’s a complex mix of factors at play.
The Natural Consequences of Aging
As you get older, a number of physical changes occur in and around your tendons.
Most notably, the overall water content within the tendons decreases, which makes them stiffer and less flexible. Tensile strength also decreases. This means that tendons aren’t able to handle as much stress as they used to, and they can’t flex quite as far before they tear or snap.
Circulation also tends to decrease as we age, particularly in the extremities. Tendons of the feet and ankles, including the Achilles, can’t be resupplied with oxygen and nutrients as efficiently as they once were. As a result, tendons aren’t able to “bounce back” and repair themselves as quickly, and full-blown tendon injuries take longer to heal.
These physical changes that make tendons more fragile often collide head-on with active lifestyles. Adults in their middle ages live busy lives, with work, family, and various projects keeping them always on the go. Many of us continue to maintain active hobbies like running, hiking, and sports well into their 40s, 50s, and beyond.
These high-stress activities and repetitive motions continue to place high requirements on the tendons, even as their ability to keep up with that demand declines.
The “Weekend Warrior” Effect
Weekend warriors are especially at risk of tendon injuries, particularly severe tendon ruptures.
Many of us work desk jobs or other relatively sedentary occupations that feature a lot of sitting and not a ton of physical engagement for the majority of the week. Those who fall into this situation but also still love their sports or outdoor hobbies may tend to fill up their weekends with running, basketball, tennis, challenging hikes, or other high-demand physical activities.
Unfortunately, following up longer periods of sedentary living with brief flashes of overexertion (for example, joining an adult sports league on a whim without doing any training first) can lead to a much higher incidence rate of severe injury. More regular exercise and training throughout the week, and training gradually for new sports or activities, is needed to keep your body in good shape for more vigorous athletic activity.
So How Do You Avoid and Manage Tendon Injuries as You Age?
There’s no way to reduce your injury risk to zero. But you can make that risk a lot lower than it probably is today! Here are some of the best strategies to prevent future tendon injuries, and deal with the ones that do occur as quickly and effectively as possible.
- Stay active throughout the week. Regular exercise and stretching will help keep you in better shape—and your tendons more resistant to injury—than long periods of inactivity. Try to shoot for at least 30 minutes of moderate exercise at least three times per week. Take time to stretch and flex each day—you can do this easily during a work break, or even at your desk.
- Adjust your activities. Prolonged activities that stress your tendons with excessive and/or repetitive stress should be minimized. You may need to ease up a bit on high-impact sports or running and give yourself more regular breaks and more rest days. You can cross-train by spending those off-days working on low-impact activities like swimming, cycling, or weight training.
- Start new exercises or sports gradually. Your body isn’t built to go from 0 to 60 in just a few days, especially if you’re well into adulthood. If you’re looking to try a new sport or activity, start slowly at a level you can handle relatively comfortable. Then, increase your intensity, duration, and distance by no more than 15% per week.
- Adjust your equipment. Poor athletic gear, especially shoes, can increase stress loads on your tendons. Make sure you have a good sport-specific pair of athletic shoes that fit properly and are in good repair. Some people might also benefit from custom orthotics, ankle or knee braces, and other wearable devices meant to improve posture and/or increase stability.
- Adjust your environment. At work, this might include things like placing a cushioned mat at your workstation, or improving the ergonomic positioning of your chair, keyboard, desk, etc. At play, you might consider (for example) choosing running or hiking routes with softer and more level terrain.
- RICE therapy. If you do have ongoing tendon pain, the optimal first treatment response is RICE, or rest, ice, compression, and elevation. Avoid painful activities and use a combination of ice, compression wraps, and elevating the sore tendon when you sit or recline to aid in healing.
- Advanced therapies. The foot and ankle sports injury experts at Associates in Podiatry work hard to make the latest research and most cutting-edge treatment technology available to their patients. Our services include both laser and shockwave therapies, both of which have been shown to significantly accelerate the healing process for soft tissue injuries—including tendinitis.
Although you can’t turn back the hands of time, achieving maximum fitness and active lifestyle while minimizing your risk of injury is definitely possible at any age! To schedule an appointment with the Associates in Podiatry, give one of our convenient office locations a call today:
- Princeton: (609) 924-8333
- Roselle Park: (908) 687-5757