Getting Old Sucks: the march towards stenosis

My favourite part of being a physiotherapist is the perspective I gain by working with a broad array of people: young people, old people, active people, sedentary people, successful people and those just starting out.

Brent Stevenson

photo: susafri

My favourite part of being a physiotherapist is the perspective I gain by working with a broad array of people: young people, old people, active people, sedentary people, successful people and those just starting out.  I find it fascinating to try and see the world through these people's eyes as I get little glimpses into their lives during our thirty minute appointments each week.  The relationships people have with their own bodies are a very curious thing to me.

Some people literally behave like their bodies are simply vehicles to walk their heads around; they have little to no awareness of how or what they are doing physically and are blinded by cognitive factors like stress and anxiety.  Others treat their body like a temple and seek help when they detect even the slightest change from their normal, homeostatic state.  Many people's relationships with their bodies are a product of to their early childhood sports combined with their recent fitness endeavors.  Your early sport and movement experiences are responsible for molding your general postures while your more recent fitness endeavors will create the lens that you see your physical self through.

Some people choose personal trainers, others choose Yoga classes and some are determined to work out at home with programs like Foundation, or P90X.  Your choice of activity will affect your perception of what physical health means to you.  You may get focused on strength or flexibility or endurance or speed.  I see many people in my practice that were active teenagers, but are now in their early 40s with two kids and are trying to rediscover their bodies; unfortunately many people get hurt during this phase because their bodies are 10-20 years older than they physically remember and their choice of activity was based more on familiarity than need.

People tend to migrate towards what they are good at when it comes to exercise, but unfortunately the best results come from working on the things they are bad at.  When clients ask me what they should or shouldn't do exercise-wise after I have helped put them back together, my first question is typically 'what would you normally do?'  It is important to continue doing what you enjoy, but most people need to find a more efficient, realistic and body aware way to do it.  The main goal of physical exercise should be to challenge your body to move in ways you don't normally do in the regular course of the day: reach up, move sideways, twist, bend, lift something heavy, sweat, breathe deeply, etc.

The kicker is that the older you get, the more and more attention you need to pay to how you move.  Physical health and pain prevention as you age become more and more about body control and awareness than quantity of effort.  I have encountered numerous 60 year olds that had spent the previous 10 years doing the same daily stretching routine, but still couldn't touch their toes.  I loosened a couple things, taught them to move differently and viola one week later they email me astounded that they can touch their toes.  Awareness plus persistence yields far better results than stubbornness, but unfortunately that's what most people get as they get older….more stubborn about the thought of changing their postures and physical behaviours.

I teach old dogs new tricks every day.  It can be a very rewarding experience for me and an extremely eye opening and frustrating yet positive experience for my clients.  Our bodies are the cumulative product of everything we have put them through from birth to right now.  We start life with the trauma of being pushed, jammed and pulled through the birth canal, then learn how to walk and run in a phase when we have zero regard for our own well-being.  We continue to punish our bodies in our teenage invincible years while we are structurally still developing, but cognitively immature and impressionable.  By our mid-twenties to early thirties our bodies shift from developing to degenerating and it's then start hearing the all so common phrase in my office: 'getting old sucks 'When I hear 'getting old sucks' from a 31 year old, a 45 year old and a 84 year old in the same day it reminds me of how two separate and very experienced healthcare professionals that have influenced my career started their seminars.  Dr. Chan Gunn and Dr Shirley Sahrmann both started their multi-day courses with the statement/sentiment that 'life is a march towards stenosis.'  Stenosis is a fancy word for the narrowing of the holes in your spine where the nerves pass through as your spine degenerates over time.  It is a significant problem for many seniors in their 70s-90s, but an underestimated issue in 30-60 year olds.

Your brain and spinal cord are like your fuse box; they are your central control station to the network of nerves that connects every system in your body.  There are constant signals being transmitted out to your organs and muscles as well as back to your brain and spinal cord to help keep you functioning.  Unfortunately the protective casing of your fuse box has to deal with gravity and your attempts to deal with it all day and after about 25 years it starts slowly breaking down.  The discs in your spine that act as shock absorbers dry up little by little and the durability of your spine as a whole starts to diminish.  Particular joints in your spine get overly compressed or stretched due to years of less than perfect posture.  The car accident you had combined with the numerous falls or bangs have created alignment issues and further wear and tear.

Thinning of the discs and small levels of degeneration in the spine will typically not create significant symptoms for someone, but they will combine over time to create increased sensitization of your nervous system which can affect all of your systems.  Your nerves are the electrical wiring to your muscles, if they get annoyed as they pass through your spine, you will be prone to tightness and possibly pain.  Your nerves are also the wiring of your organs, so spinal issues can contribute to abdominal issues like irritable bowel or heartburn.  Your organs have vast connections to your brain and spine which is partly why digestive and emotional issues can be more prominent as you age (read my article on Visceral Manipulation for more detail).Long story short, your body starts physically breaking down when you are only about one third of the way through your life.  The speed at which that happens depends largely on how you have treated your spine up to now and how well you take care of it going forward.  There are a lot of important things in life, but they all start to seem less important when you can't move around very well.  Trust me I see it every half hour all day long.  You only get one body and you should learn how to use it well.

It does suck getting old and thinking about the reality of your body breaking down year by year, but that process is not set in stone in your DNA.  Your body will adapt to the forces you put on it so you are not necessarily destined to suffer the same fate as your parents, if you learn to work with what you've got.  Age is not an excuse for pain, but it is a factor.  If you want to live a healthy, active lifestyle with minimal pain for decades to come, learn to respect the diminishing tolerances of your body and find your sweet spot for quantity of exercise.  Too little may cause you to get weak and/or stiffen up.  Too much and you may stiffen up and get inflamed.  Everyone needs to find there zone in the bell curve of exercise and not push into their zone of diminishing/damaging returns.

My best advice for 30-65 year olds wallowing in the discomfort of aging is to strive to develop physical wisdom by means of body awareness and movement experience.  Create a connection with your body so you know when it is time to seek help.  Pay attention to how you and those around you stand, sit, walk and move.  Compare yourself physically to your parents and your kids and identify your habitual postures that are less than ideal.  If you get a bit more aware of your body every year, you will start to feel Younger Next Year.

Related articles:

Read my case study as an example for how to beat pain and improve posture

Movement: your body is the car and you are the driver

Why Things Hurt: explain pain

How your organs can be causing your pain: visceral manipulation

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