Help! I’m in my 50s and everything hurts
Gavin Newsham has reached his most painful decade yet. He speaks to experts about how to stay fit and healthy in midlife
By the time you read this I will be 51-years-old. I’ve just had a fifth operation on my right knee (the third within a year), ending any lingering hopes I had of making it in professional football. Mind you, Sir Stanley Matthews was still playing in his early 50s so you never know.
But it’s not the only issue. I’ve also had two steroid injections in an arthritic hip and one for a frozen shoulder. I’ve had denervation of the nerves in the base of my back, and I take naproxen for a stiff neck. One of my big toes doesn’t move much either.
Suddenly, that sense of invincibility I possessed in my 30s and early 40s, when I was still playing five-a-side and running around like I was 18, has vanished and any physical activity I’m asked to participate in generally requires a full risk assessment.
In an ideal world, I would have my knee and hip replaced but surgeons won’t consider it yet. It’s not often, at my age, that you’re annoyed when someone tells you you’re too young for something.
If you’re approaching 50, here are some of the problems that might be coming your way – and what you can do to manage, or stave them off.
Knees
Typically, fiftysomethings will suffer from a range of knee complaints, with bursitis, meniscal tears and osteoarthritis being the most common. “It’s an age thing and, for the most part, simple wear and tear,” says Mark Edmondson, an orthopaedic surgeon at Brighton and Sussex University Hospitals NHS Trust. “The shock absorbers in your knees tend to get dehydrated and more rigid with age and can be more easily damaged when put under normal stress.
“What starts with a localised pain and swelling of the joint will often develop into more mechanical symptoms where the knee gives way, buckles or just gets stuck when it’s bending.”
Long term, knee arthritis may require a knee replacement, be that partial or full. The average age of recipients is currently 70-years-old, but improvements in technology are allowing for artificial knee joints to last longer, says Ananda Nanu of the Royal College of Surgeons. “Whereas 15 years ago it was not uncommon for a patient of 65 to be told they were too young for a knee replacement, it’s not the case now.”
What to do about it: “When pain starts to happen people often avoid the movement that causes it, but then the joint just gets weaker, which ultimately makes things worse,” says personal trainer Matt Roberts, who has coached David
Cameron and celebrities such as Amanda Holden.
If you’re suffering with knee pain,
Roberts advises spending 10 minutes a day doing gentle stretches, such as a sitting leg extension. Sitting in a chair, straighten both legs, feeling the quads tighten, then release, and repeat 20 times. If the pain is marginal, you could try sitting against a wall. For those without pain, step ups, lunges and squats help keep the area strong.
Eyes
Throughout my life I’ve enjoyed 20/20 vision but in the last five years I’ve started wearing reading glasses. Idiotically, I’ve not been for another eye test in that time either, which now means I can’t read the really important things in life, like takeaway menus or instruction leaflets for power tools. Presbyopia – age-related long sightedness – is pretty unavoidable, even if, like me, you’ve never had any issue with sight before. Ageing causes the lens of the eye to harden and lose its elasticity.
What to do about it: “Presbyopia can be easily treated with glasses or contact lenses,” explains Daniel Hardiman-mccartney, of the College of Optometrists. “If you already wear glasses a switch to varifocals may be all that is required.”
Regular visits to the optometrist are essential and a healthy diet, covering a rainbow of colours, can help reduce the risk of age-related macular degeneration. Wearing high UV sunglasses in the sun may help protect against cataracts. Hips
Few things make you feel your age like a creaky, achy hip. The most common cause is osteoarthritis – the deterioration of cartilage leading to bone grinding on bone and painful inflammation. Along with ageing, genetics play a role, and obesity, too. It can also be caused by rheumatoid arthritis or arthritis caused by injury. “By the time people get to their 50s, if they haven’t carried over problems in their hip from earlier on in their life then they can start to feel pain from early degenerative change,” says orthopaedic hip and knee surgeon Majid Chowdhry. “This can be felt as increased stiffness or difficulties with duration, frequency or intensity of exercise.”
What to do about it: Keep moving. A 2019 study found arthritis sufferers can stave off disability with just a short walk of 10 minutes a day.
If you find yourself in pain even when resting, it’s possible you’ll need a hip replacement. The majority are carried out on patients between the ages of 60 and 80 (the average age in the UK being 69), as modern artificial hip joints are only designed to last 15 years. Roberts recommends glute bridges to strengthen the core and improve hip mobility. Lying on your back, with your feet flat on the floor, lift your bottom up until you have fully extended your hips, and squeeze your glutes when you reach the top. Slowly come back down to the starting position and repeat.
Mind
Those in their 50s can face a perfect storm of stress-triggers, including divorce, demanding careers, caring responsibilities and physical health worries – and that was true before Covid. Research from Samaritans volunteers taking calls during lockdown found middle-aged men were the group most at risk of suicidal feelings. This month, we learnt that nearly half of over-50s binge drink to cope with the stress of lockdown.
What to do about it: Acknowledge how you’re feeling – depression can manifest as anger and irritability as well as withdrawal and despair – and talk to someone, whether it’s your GP or a trusted friend or partner.
Exercise, cutting back on alcohol or
‘When pain starts people just avoid the thing that causes it, but then the joint just gets weaker’
‘People are starting to fall and break their wrists in their 40s, when it used to be the 60s’
young, so this decline in activity means we’re not building good nervous system integration. It’s also the time we lay down bone density and so that might be why we’re fracturing earlier.”
Rising levels of obesity are also thought to be behind the trend – being overweight affects stability and balance.
Diabetes is linked with a higher risk of falling, because the condition causes reduced sensations in the extremities, according to research by Dr Geeske Peeters at the Global Brain Health Institute.
Dr Peeters says falls prevention programmes should start earlier before issues take hold.
If you’re prone to car sickness, or feel dizzy if you turn your head too quickly, this can mean you’ll be more prone to balance issues.
An unexplained or unexpected fall is a clear warning sign your stability is decreasing. “If you have a couple of falls where you think, ‘How did that happen?’, you need to work on your balance,” says Prof Skelton.
Rather than waiting for an accident, an easy way to check your balance skills is to time how long you can stand on one leg.
Up to the age of 50, you should be able to manage one minute with your eyes open, or 12 seconds with your eyes closed, says Prof Skelton. (Do this next to a wall or in a doorframe in case you need to steady yourself).
Between the ages of 50 and 60 you should be able to manage 30 seconds with your eyes open and six seconds with them closed. (Don’t be shocked if you can’t do it, says Prof Skelton – most people can’t, but you’ll improve within a few weeks if you practice.)
Balance uses three types of sensory input, she explains. Firstly, visual information about our surroundings and where we are in relation to them, secondly signals from sensors in the joints, in the ankles, hips and knees, known as proprioceptors, and finally the signals from the semicircular, fluid-filled canals of the inner ears, known as the vestibular system.
“The brain has to coordinate all that information and decide what to do with it, for example put my hand out quickly to grab hold of something, or take a compensatory step, or lean back,” says Prof Skelton. “All these things are unconscious but the more sedentary you are, the
Give it a twirl: simple exercises can help to improve your balance and stop falls
less these are going to kick in when they need to.
“If you are sedentary, and therefore weaker, you might not get your foot out quickly enough to prevent a fall. Or if the vestibular system is stodgy, the information feeding into the brain won’t be as quick or accurate.”
Physical inactivity, for example through a stay in hospital or prolonged sitting, can cause a catastrophic loss of strength and balance, especially in older adults.
“You lose about 10 per cent of your strength for every day that you are in hospital,” says Prof Skelton. “Anyone who sits for more than eight hours a day is at 30 to 50 per cent greater risk of frailty later on in their life, which comes with falls and balance problems.”
It’s highly likely, then, that many Britons, stuck at home during lockdowns, are now at a higher risk of falls.
The good news is that you can retrain your balance “muscle” quite quickly – though lost bone density is harder to recoup.
We usually cope with poor balance by avoiding wobbly activities, but it’s better to keep challenging yourself as this is the only way it will improve, says Prof Skelton.
“If you can’t do the 30-second balance exercise, or the exercise with your eyes closed, you actually just need to just get out there and do as many twirling, swirling balance exercises as possible.”
‘Sitting for more than eight hours a day means a 30-50pc higher risk of frailty’