As the population of aging individuals increases dramatically over the next decade, so will the number of aging athletes. Many of these athletes have been active all of their lives, while others became increasingly active over the years to improve their health and to maintain their strength and endurance.
Unfortunately, chronic and overuse injuries can stand in the way of an active lifestyle in older athletes. Wear and tear of joints, especially in the knee, accumulate and often worsen as we age.
"Because of an accumulation of injuries and general changes in their overall health, these athletes may require more personalized care than a 'one-size-fits-all' approach to sports injury care."
The Mass General Brigham Sports Medicine team of specialists is dedicated to treating aging athletes so that they can maintain a high level of activity—at any age.
"In many cases, we're talking about athletes who had college or professional sports careers or participated in sports activities when they were younger; now these individuals are in their 40s or 50s and want to remain very active at a high level," says Christian Lattermann, MD, co-chair of Mass General Brigham Sports Medicine and chief of the Division of Sports Medicine at Brigham and Women's Hospital. "Because of an accumulation of injuries and general changes in their overall health, these athletes may require more personalized care than a 'one-size-fits-all' approach to sports injury care."
Dr. Lattermann often refers to the aging athlete as "a young person with old knees."
"Our patients often have damaged joints in one, two, or all three compartments of the knee," he says. "We can offer these patients specialized procedures that help unload, repair or regenerate those compartments. Not all orthopaedic surgeons have this training or offer these options."
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Dr. Lattermann recommends a personalized and multidisciplinary treatment plan for aging athletes that combines athletic training, musculoskeletal physical therapy, imaging, as well as operative and non-operative orthopaedic care. These treatments aim to maximize an athlete's knee function and reduce injury complications as they return to sport. Some of the most common sports injuries in the older athlete include:
The anterior cruciate ligament (ACL) is one of four major ligaments that stabilize the knee joint, and it is engaged as athletes jump and pivot. It is often injured by suddenly stopping and twisting at the knee. Treatment may include nonsurgical approaches, such as ice packs, rest, and physical therapy, but in many circumstances an ACL injury may require surgical replacement. Notably, older patients can often cope with injured ACLs, and therefore ACL surgery is not always recommended. If an aging athlete with a serious injury is still highly competitive and unable to take an extended break from sport, they may be a candidate for ACL surgery.
Aging athletes' knee cartilage is likely to wear down over time, leading to joint pain, swelling, and/or stiffness in the affected area. Meniscus tears can also occur suddenly during a muscle sprain. Treatment may involve muscle strength exercises, medicine, and arthroscopy (a minor surgical procedure involving a small incision made to allow the surgeon to view the area with a small, fiberoptic television camera).
Sometimes referred to as "degenerative joint disease" or "wear-and-tear arthritis," osteoarthritis is a common challenge facing the aging athlete. As articular cartilage that covers the joint begins to degenerate, an athlete may feel pain and discomfort.
Osteoarthritis development is a slow process that can take years to surface and often results from an injury an athlete had years prior to feeling pain. Treatments for early osteoarthritis and later-stage osteoarthritis may differ. They include a range of nonsurgical options, such as physical therapy and low-impact exercises, anti-inflammatory medication or injections that control inflammation.
If these tactics don't work, arthroscopy, cartilage repair or smaller, partial replacement of sections of the joint may be necessary to treat the patient's symptoms. In some cases, it may be necessary to change the alignment of a knee using plates and screws.
The injuries of the aging athlete are often more complex than younger athletes, largely due to the fact that older athletes have longer medical histories but are highly treatable. As an aging athlete, it's important to practice preventative care as much as possible. This includes taking rest days when needed and incorporating a range of agility, flexibility and stretching exercises into your everyday workouts. Injury prevention training programs, such as our ACL Injury Prevention Program, are also great resources for the aging athlete hoping to avoid getting sidelined.
Dr. Lattermann reminds aging athletes to always seek medical advice as soon as an injury arises, instead of trying to "push through" pain or simply ignore it. Because aging athletes often have demands outside of training (such as family and careers), they may be less inclined to see a doctor or invest in preventative care. Our virtual care program offers immediate access to one of our sports medicine providers. Its convenience can help if time and distance are difficult to manage.