I'm just getting old
Do you have any idea how often I hear this in clinic? It's an excuse that many of you bring out to explain why you're stiff in the mornings, or to justify why you're in pain on a daily basis.
I had a 28yr old say this to me today in clinic. "It's just a sign that I'm getting old"
78yrs old and I might accept this. But 28yrs old?!!?!?!?
So why do you feel that you're getting old and can't do things the way you used to
1. You've stopped growing
Yup it's a sad truth but the final age when you stop growing is around 21yrs old. This is when all your bones fully calcify and you lose the benefit of the increased cell turnover that we get when we are growing. After 21 your rate of repair does decrease, and we do notice that this is typically the age that we start seeing patients more regularly in clinic.
2. Reservoir of Compensation
Oh, this is a good one. I once had it described to me that we all have a reservoir of compensation available to us. A resource our body can dip into, in times of trouble to help find a way to get out of the current problem it's facing. Over time, this reservoir gets depleted; fall off your bike last summer, that busy time at work requiring 12hr days, the stomach flu that hit you earlier this year. Eventually there comes a time when this reservoir of compensation runs dry. There are no more options left. No ways to absorb the stress. And you then get pain. Naturally with the injuries and illness we get as we age this reservoir gets depleted. If you don't fill it up again, of course it's going to run out.
3. Biopsychosocial model of health
Ok this basically says that pain/disease response is an interaction of biological factors (genetic, biochemical, etc), psychological factors (mood, personality, behavior, etc.), and social factors (cultural, familial, socioeconomic, medical, etc.).
Meaning the pain we feel can have very little to do with 'degeneration' and 'aging' and a lot more to do with the fact we think we are degenerating and old.
No matter how much we like to convince ourselves otherwise, we all have these sorts of limiting beliefs. "I'm too old to do that sort of thing", "I can't lift heavy anymore", "My back isn't as strong as it used to be".
Reasons your pain isn't due to old age
1. Does your pain vary?
Is your pain better on some days than others? Then surely we can identify the factors that are contributing to your good days and try and stabilise these? I, very sadly, learn't recently that high sugar intakes affect my back pain. I'd had decent spell of getting out of bed without pain in the morning. One night I ate an entire tub of Ben & Jerry's (DO NOT JUDGE ME!) and the next morning I was getting out of bed like an old lady again. Moral of the story - apparently high blood sugar and the associated inflammation affects me. So, um....avoid blood sugar fluctuations - don't blame it on old age!
2. Does your pain vary?
Yup I've already just spoken about this - but seriously if your pain varies throughout the day, in different situations etc THEN IT CAN'T BE OLD AGE! Don't get me wrong, you may be at a disadvantage if you are older but there clearly is a reason why your symptoms vary. They could be correlated with stress, hydration levels, overuse and/or hormones. All of which are factors we can look at and manage. Things may well become more difficult to control the older you get but simply giving up is not an option for us and our patients.
3, Have you gotten better or recovered from a previous episode of pain?
Right, then clearly if you've improved at some point (even if if took 30mins of stretching a day) then your symptoms are not an envitable consequence of age. You can sit and feel sorry for yourself (because being in pain SUCKS) but you can't sit there and think that it's because of age. When you were you feeling better? When were you feeling worse? What factors were in play when your pain was more managable? Has the pain always returned at certain times of year, or in certain circumstances?
4. Can you do some activities but not others?
Let me guess - things you don't enjoy, or are competitive about cause you pain? Or at the very least frustrate you that sometimes your body hurts and other times it doesn't? Also, if you take the time to think about it there are things that you are totally fine with. Maybe playing with the kids, frisbee, messing around climbing with your mates, or doing a yoga session. Just because your back hurts when you squat doesn't mean you're old. It means you're stressed about squatting. Because you're probably not enjoying training or hitting the numbers you feel you 'should'. Either way it's got nothing to do with you being OLD. It's this biopsychosocial model of health.
Anyway, rant over - just something for you to think about.