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Aging Muscles, Bones and Joints

12:32 | Labels: aging, bones, joints, muscles

Adam and Eve by Lucas Cranach the Elder

Q: You all have been writing a lot about muscles and bones lately. I was wondering, how exactly does aging affect our musculo-skeletal system? And how can we influence the aging process with yoga and our lifestyle choices?

A: The process of aging affects our musculo-skeletal system in several particular ways. As I have written about previously, as muscles age, especially after about the age of 50, we start to lose muscle mass in a process called sarcopenia (see Strength and Aging). Sarcopenia is considered a normal part of the aging process, one that can lead to visibly smaller skeletal muscles—the ones that move our body and limbs around—which are then also going to be weaker. It is usually a slow, gradual process, but unchecked could lead to a point in a person’s life when the weakness could negatively impact his or her daily activities. According to an article Aging changes in the bones – muscles – joints from the National Institutes of Health:

“Changes in the muscle tissue, combined with normal aging changes in the nervous system, cause muscles to have less tone and ability to contract. Muscles may become rigid with age and may lose tone, even with regular exercise.”

The body’s soft tissues tend to mostly made of water, and as we age, we also gradually experience a decrease in the amount of water in the muscles and the connective tissues (fascia and tensions) that surround the muscles and attach them to the bones, as well as the ligaments that connect bones to bones. As these changes occur, these structures become more brittle, less resilient and more likely to suffer injury, such as, strains and sprains. And because these structures don’t have a very good blood supply to start with, repair and recovery is typically slow, and slower as we get older. Other important soft tissue structures, such as the intervertebral discs between the vertebrae bones of the spine, and cushions, such as the meniscus in the knees and the labrum in the hip and shoulder joints, also suffer the same changes and the same potential for injury and degeneration.

The skeleton, which is made up of over 200 bones, also undergoes changes as we age. Most commonly, the joint surfaces between the mobile joints can suffer wear and tear over a lifetime of use. The connective tissue barrier known as cartilage that coats the ends of each bone to make it slippery and cushioned can gradually thin out and leave the underlying bone exposed and sensitive to inflammation. This is commonly referred to as osteoarthritis (see Yoga for Osteoarthritis), an extremely common aging-related problem that can actually start at about any age, especially in those who use their bodies intensely for sports and work activities.

Finally, the bones can begin to thin and lose density as we age, making them more vulnerable to fractures, which can then be slower to heal due to the abnormally thin bones. Thinning of the bones (osteoporosis) is extremely common in women over 65, with up to 50% developing it, and surprisingly common in men as well over 65, at 25% incidence. The bones of the thoracic spine (your mid spine) are at greatest risk for fracture, followed by the wrist bones and the femur bone (thigh bone) of the hip joint. Fractures from osteoporosis can lead to ongoing chronic pain, physical disability and, particularly with hip fractures, premature death.

These factors and others, such the connection between the muscles and the neurologic system, can also lead to changes in posture and balance, which can also increase the chances of injury over time. An increase in general stiffness and pain can also arise with combinations of the above changes.

On a brighter note, it has been noted in aging athletes, specifically long distance runners and cyclists, who maintain good cardio-vascular and respiratory function may see improved endurance in their sports compared to when they were younger! Here is a case where long term participation in physical activity pays off in improved function, not decline. This speaks directly to what we can do with regards to our lifestyle choices that can positively influence these changes of aging: stay active! Regular exercise, modified to accommodate body changes such as arthritic joints or thinning bones, can help to slow, stall and even reverse many of these conditions. And for our purposes here, yoga can be an ideal standalone practice for some conditions, such as sarcopenia, and great in combination with other health practices for others, such as with osteoporosis or arthritis (which might also require medications and mineral supplements, for example). Eating a healthy diet and drinking adequate amounts of water to fuel and hydrate the body, and by extension these parts of the musculo-skeletal system, is another wise choice.

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Yoga Tip Tuesdays: How to keep a straight leg without locking the knees

07:00 | Labels: knees, muscles, yoga tip tuesdays

On a previous Yoga Tip, a reader left the following comment: "I'd love some tips on how to keep a straight leg without locking the knees in balance poses."

This is an excellent question! Many of us have probably heard yoga teachers talk about the importance of not locking the knees in standing and balance poses. Without going into too much anatomical detail, this is important for the following reasons:

If your knee is locked in a balance pose, it means that the joint is holding the weight of the body, instead of the muscles. In the long run, this can wear down the protective cushioning around the knee (called the meniscus) and cause wear and tear on the joint, which can lead to pain, injury and possibly conditions like arthritis.
If your knee is locked in a weight-bearing standing pose, for example triangle pose, the joint is again at risk, but in addition, because you are now stretching as well as bearing weight, the ligaments and tendons surrounding the knee joint are also at risk of taking the strain of the stretch, instead of the muscles. Since ligaments and tendons are meant to stabilise, not to stretch, this can quickly lead to injury - and a torn or injured ligament takes far, far longer to heal than a similarly injured muscle.

So you might think that we should all just be doing yoga with bent knees all the time and avoid the problem all together. However, if your knees are always bent in standing poses, you are probably not getting the most out of a pose, nor are you stretching and strengthening the body in a balanced way - and you may actually be putting other types of strain on your knee. (**NB: If you are hypermobile or hyperflexible, see note at the bottom of the page).

So, here is a simple 2-step tip on how to keep the legs straight without locking the knee in standing or balancing poses.

Step 1: Build awareness

In the pose you are working with, lift your toes - just your toes! - off the mat.

Yep, that's it - try it! You'll find that it's pretty much impossible to lock the knee while lifting the toes at the same time, because lifting the toes creates muscular engagement, or "hugging in," that brings the weight of the body into the muscles instead of the joint.

Now of course, in the long run, you don't want to be going through your entire practice with your toes lifted up! It's just a "cheat" to get your muscles used to working in a new way. So once you have built an awareness of what that muscular engagement feels like, you should work towards a techinque called "isometric" or "static" muscular engagement - essentially, engaging a muscle from the inside, without actually moving the body. You might have heard yoga teachers cue this kind of engagement by talking about "hugging the muscles to the bone."

This is Step 2: Isometric engagement of the leg muscles.

To work on isometrically engaging the muscles in your legs, practice this simple sequence. As you move to each step, remember to keep the muscle engagement from the previous step! I find it's best to start practicing this in Tadasana (standing mountain pose), and once you have a good sense of how it feels, then you can apply the same sequence to all your other standing poses.

Begin in a standing pose with a neutral pelvis.
Establish an even weight distribution between the outer edge, inner edge, and heels of your feet, lifting your toes up to do so if it helps. Press strongly through the big toe mound in order to lift your arches.
Keep that engagement and then without moving your feet, try to engage your muscles as if you wanted your toes to lengthen forwards and your heels to draw back.
Next, imagine your shins drawing forward.
Now, engage your muscles as if to squeeze an imaginary yoga block or tennis ball in between your thighs, lifting your kneecaps upwards and drawing the thigh muscles up and back.
Finally, engage your muscles as if you wanted to lift your pelvis away from the tops of your femurs. This one is tricky - just visualise it, even if you can't feel anything happening.

These 6 steps can work to bring engagement to the subtle leg muscles in nearly every standing pose (and even in inversions!), which ultimately will strengthen your standing poses without putting your knee joint at risk.

Here is a quick graphic that you can use as a reminder of the main points:

(and do forgive me the not-so-great alignment of my pelvis in this picture!)

**NB: If you are hyperflexible or have hypermobile knee joints, you will probably need to work with a slight bend in the knee until you can really control the muscular engagement of your legs to fully protect the knee joint. Work with a yoga therapist or a knowledgeable teacher to determine the right way of working for you.

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If you've read this far, I'd love your feedback! Was this tip helpful? Is there anything else you'd like tips about? Leave a comment!

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Aging Muscles, Bones and Joints

Yoga Tip Tuesdays: How to keep a straight leg without locking the knees