We all know the importance of maintaining bone strength as we get older, and the importance of bone strength in maintaining independence, and reducing our falls and fracture risk. But what about muscle strength?
In a previous blog, we discussed low bone density and its strong correlation to falls risk. In this blog, we will talk about the health of muscles and tendons and their role in our physical function.
Sarcopenia – What is it?
Sarcopenia is the generalised loss of muscle strength as we age – or specifically, reduced muscle mass and strength. It’s normal to experience some muscle loss as we get older; however sarcopenia is severe age related muscle loss. It’s estimated that sarcopenia affects almost a third of older adults living in the community, varying by age and ethnicity (Daly & Maier, 2019).
Sarcopenia more commonly affects older adults, but can also present itself earlier in life. Muscle mass starts to decline around the age of 30, but the loss of muscle tissue progresses more rapidly when a person reaches their 60s (Volpi, Nazemi, & Fujita, 2010).
Symptoms and Causes of Severe Muscle Loss
According to De Pietro (2017), while ageing is the predominant cause of sarcopenia, there are other contributing factors, for example:
- Inactivity. Living a sedentary lifestyle increases a person’s risk of developing sarcopenia
- Poor nutrition. Sufficient protein and calorie intake is important in maintaining muscle mass
- Hormonal changes. As a person ages, there are changes in the production of the sex hormone (testosterone) and growth hormones, which affects muscle growth and mass
People with sarcopenia generally experience weakness and loss of stamina, which hinders their ability to perform physical activities. And this decrease in physical activity leads to even further muscle loss (Thorpe, 2017) .
Why is maintaining muscle mass important?
Muscle loss is associated with a higher risk of fractures due to an increased likelihood of falling, as reduced muscle strength may influence the ability to control the body during the a fall (Hsu, Wei-Li et. al, 2014). Scientists have shown a close relationship between falls and muscle weakness of the buttock, thigh and ankle muscles (MacRae, PG et. al, 1992) (Hsu, Wei-Li et. al, 2014).
Sarcopenia can have a significant impact on a person’s everyday life, and affect their ability to perform basic tasks, such as climbing stairs, lifting objects, and walking.
How to fight age-related muscle loss
There are two main things we can do to fight Sarcopenia:
Proper nutrition is essential to treating sarcopenia, and can even prevent or delay the condition. In 2008, the Society for Sarcopenia, Cachexia, and Wasting developed nutritional guidelines for the prevention and management sarcopenia (Dorner & Posthauer, 2012).
The guidelines state that protein intake is an important dietary consideration – studies have shown the correlation between dietary protein and muscle mass. Some easy ways to increase your protein intake (Lillis, 2019), depending on food intolerances and choices, include:
- Introduce plant proteins to your diet, such as legumes and nuts
- Eat more dairy, such as cheese and Greek yoghurt
- Eat more lean meat
- Try a protein shake
Another recommendation from the guidelines is the supplementation of vitamin D, as low levels of vitamin D levels are associated with low muscle strength (Dorner & Posthauer, 2012).
Apart from the obvious benefits of exercise – feeling good, weight control, helping to boost energy, promoting better sleep and helping to prevent and manage a variety of health problems – the related improvements in strength and mobility help us to maintain independence. Additionally, exercise improves quality of life, especially in the areas of physical function such as balance and reducing pain related to musculoskeletal conditions (Hsu, Wei-Li et. al, 2014).
While both resistance and aerobic training can improve overall health and wellbeing, the only proven method for the prevention and management of sarcopenia is progressive resistance training. Resistance training focuses on exercising large muscle groups, using an external force. In a progressive training program, the challenge of the exercise including use of weights and number of repetitions are altered over time, based on your individual capabilities.
Examples of progressive resistance training are:
- Bodyweight exercises such as simple squats, lunges and step ups
- Exercises using external resistance such as hand weights or resistive bands
- Either strength and conditioning/gym type exercise or Pilates training
At Physiotec, one of our major areas of interest is rehabilitation of those with hip and pelvic pain and injury, who generally have associated muscle weakness around the hips and sometimes the whole legs. We are passionate about restoring healthy hip muscles and see first-hand the improvements in quality of life and functional capabilities of people who engage in a tailored exercise programme. One study has also found that there is an association between reduced size of the deeper hip muscles (gluteus medius and minimus) and the risk of bone fractures related to falls (Chi, AS et. al, 2015). There is also a relationship between muscle weakness, painful knee or hip osteoarthritis and an increased risk of falls (Doré, AL et. al, 2015).
A final thought..
We may not be able to stop the ageing process in its track, but with regular exercise and resistance training, as well as proper nutrition, people can prevent sarcopenia from developing, or slow the progression of the condition.
|Physiotec physiotherapists are able to develop a targeted and specialised program for you, using evidence from the most current research available. These programs are specifically designed to target individual areas of muscle weakness or other concerns such as falls risk or difficulty with everyday tasks or recreational/sporting activity. Our programs may incorporate posture and body awareness training along with balance and proprioceptive exercise aimed at reducing the risk of falls, joint overload and injury. For others, the focus may be on reconditioning after an injury or surgery and getting you back to all those things you need and love to do.
For more information about developing a program just for you, call 3342 4284 to book an appointment with one of our physios.
Chi, AS et. al. (2015). Association of Gluteus Medius and Minimus Muscle Atrophy and Fall-Related Hip Fracture in Older Individuals Using Computed Tomography. Journal of Computer Assited Tomography, 00, 1-5.
Daly, R., & Maier, A. B. (2019, July 9). The muscle-wasting condition ‘sarcopenia’ is now a recognised disease. But we can all protect ourselves. Retrieved from The Conversation: https://theconversation.com/the-muscle-wasting-condition-sarcopenia-is-now-a-recognised-disease-but-we-can-all-protect-ourselves-119458
De Pietro, M. (2017, July 21). Sarcopenia: What you need to know. Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/318501
Doré, AL et. al. (2015, May). Lower Limb Osteoarthritis and the Risk of Falls in a Community-Based Longitudinal Study of Adults with and without Osteoarthritis. Arthritis Care and Research, 67(5), 633-639.
Hsu, Wei-Li et. al. (2014). Balance control in elderly people with osteoporosis. Journal of the Formosan Medical Association, 113(6), 334-339.
Lillis, C. (2019, June 25). What are the best ways to eat more protein? Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/325552
MacRae, PG et. al. (1992). Physical performance-measures that predict faller status in community-dwelling older adults. Journal of Orthopaedic & Sports Physical Therapy, 16, 123-128.
Runge, CF et. al. (1999). Ankle and hip postural strategies defined by joint torques. Gait & Posture, 10(2), 161-170.
Thorpe, M. (2017, May 25). How to Fight Sarcopenia (Muscle Loss Due to Aging). Retrieved from healthline: https://www.healthline.com/nutrition/sarcopenia
Volpi, E., Nazemi, R., & Fujita, S. (2010). Muscle tissue changes with aging. Retrieved from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804956/