Tips for the aging athlete

A big goal: Avoid hurting yourself

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Adults 65 and older are more prone to musculoskeletal injuries during exercise and should moderate their activities and expectations as they age, said two orthopedic medicine physicians in Montgomery County. The doctors explain why and how you can still stay fit as you age.

Cells and tissues regenerate less than when we were younger. In other words, the process of renewal and growth to repair or replace tissue that is damaged or suffers from a disease process lessens with age.


Tendons, the cord-like tissues that attach muscle to bone, show signs of weakness as we age, said Dr. Eran Kessous, a physician specializing in sports medicine with offices in Silver Spring, Gaithersburg and Bethesda. He adds: “In the aging process in muscles and tendons, I like to explain to patients that tendons are like rope and a used rope when you’re 65 years old. An older one is not as strong as a new one. If you overload, it’s going to tear down or cause tendonitis or a flare up of mild to moderate arthritis.” Also, the water content of tendons decreases as we age, making tissues stiffer and less able to tolerate stress.

Muscle mass & strength loss

The natural aging process impacts muscle mass and strength loss, thus “rendering bones and joints more susceptible to injury,” Dr. Kessous said. The loss is also known to decrease lifespan and quality of life. You can regain muscle mass and slow this part of the aging process by starting with easier activities a few times a week such as light dumbbells or stretch band exercises, progressing to more weights and repetitions.

Fragile bones

As we age, more bone is broken down than is replaced by new bone. Bone loss creates more fragile bones, “so everything needs to be done in moderation,” Kessous said. “Your doctor might say it’s OK to pick up running because it may strengthen your bones, but if you are too overzealous, you can create stress fractures and complete fractures.”

Cardiovascular health

The safer activities recommended are walking, swimming, doubles tennis and biking. “They all can give you really good cardiovascular maintenance and provide enough impact that you are going to maintain bone health as well,” Dr. Kessous said.

The Centers for Disease Control and Prevention recommend that adults aged 65 and older need at least 150 minutes a week (for example, 30 minutes a day, five days a week of moderate intensity activity such as brisk walking).

“Obviously there are some people who are stronger than others and can do more,” Dr. Kessous said. “So everyone is different.”


“The most common physical changes that can increase the risk of sports injuries is arthritis,” said Dr. Mark Peterson, an orthopedic surgeon in Rockville. “When the cartilage wears out in the joints, flexibility decreases and the time to recover is a little longer.” He recommends golf and the simple racket sport known as pickle ball that is booming in Florida.

The older athlete

“The biggest thing about the older athlete is to avoid hurting yourself. Modify your activity and then modify your expectations while trying to stay in as good shape as possible,” Dr. Peterson said. He recommends against playing soccer or basketball, hard impact sports that involve cutting and pivoting. Overuse injuries are most prevalent starting as early as age 30. “I tell people that after 40, you should spend a little more time stretching and doing isometric exercises as opposed to power lifting.”

Peterson adds, “It’s important to stay in shape but also listen to your body. A lot of it is not overdoing it and hurting yourself.”


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