Depending on your age, diet, level of physical activity, overall health, genetic makeup, as well as other factors, you may or may not experience stiffness of limbs and trunk. The young athlete as well as the healthy octogenerian may each have his own level of stiffness, in different body parts as well as for different reasons. If this is the case, what can we do to analyze our own individual level of stiffness in our muscles and joints, and what are the factors which predispose to this?
The answer may be simple or complex, just as the treatment and resolution for improvement may be as well. In the simplest case, the young athlete who is constantly in training and engaging in competition has usually learned that he can overcome the stiffness of muscles and joints by starting with a hot shower and progressing to a light workout, which includes stretching, easy motion, and an overall “warm-up” lasting 10-20 minutes or more.
Any tight muscles or joints may need extra attention, and if pain or discomfort occurs, taking an NSAID such as Aleve or Advil will usually help to resolve this so they can move on to full activity and performance. Horse trainers also know and use these techniques for race preparation. What a warm-up does is increase muscle temperature (which makes connective tissue more flexible), increases blood flow and oxygen consumption, and increases energy production in the cells. Ten minutes of exercise opens the small capillaries up to approximately 70 percent of maximum.
In more severe cases of muscle and joint stiffness, it is usually best to look for the causes so that specific attention may be given to treat and resolve them. It is almost a given that advancing age is one of the most commonly associated factors in the etiology of stiffness, since fibrosis of the tissue increases with each decade, but varies widely from person to person. For example, someone in their seventies who has maintained his lower body weight over the years and had a pattern of work or exercise to maintain flexibility will be more agile, stronger, and move better and easier than if they had gained weight, slowed down, and eaten too many of the wrong foods.
We also know that certain inflammatory problems—such as arthritis, myositis, viral or bacterial diseases (e.g., Lyme disease), gout, and traumatic events—lead to stiffness in most instances. The resulting inactivity and fibroses may be devastating in some cases and cause a true disability, with limited motion and subsequent muscle power being lost.
About half of all people over the age of 50 in our population have osteoarthritis, which is slow inflammatory joint degeneration. Along with the pain which accompanies this, muscle strength is lost, and there is increased muscle fibrosis with muscle stiffness. Prevention and treatment are major issues with all of these disease conditions noted, and adequate diagnosis is indicated. Even in the average case of stiff muscles and joints in the aging population, there are etiologic factors which play major roles in this. We all want to be a “good” 60 or 80, without limitation of motion or strength. When an older person falls, head injury or hip fracture can be a morbid event, and this risk can be lessened by nutritional and physical diligence as one ages.
As far as nutrition is concerned, certain by-products which are ubiquitous in foods and in our bodies can be reduced in quantity. These are Advanced Glycated End Products (A.G.E.S.), and result from a combination of fats, proteins, and sugars. A.G.E.S. are produced from cooking and also from metabolic processes in the body. HgA1c is measured as a routine lab test, indicates the blood sugar level over the preceding 2-3 weeks and directly measures the glycation of hemoglobin. This test is used in diabetics and those with vascular disease to measure therapeutic and dietary compliance and is able to predict prognosis to some extent.
Foods which have high levels of A.G.E.S. include fried meats, oils, grilled fish and meats, roasted nuts, and cheese. Foods with lower levels of A.G.E.S. include raw or steamed veggies and fruits, stewed or marinated meats and fish, milk, yogurt, raw or rare fish and meats, and spices like ginger, tumeric, cinnamon, and so on. Sugar, high fructose corn syrup, alcohol, refined carbs (bread, white flour), hydrogenated oils, gluten, and casein raise this level.
Testing for your level of A.G.E.S. can be done by SAF (skin auto fluorescence), HbA1c levels, C-reactive protein, and roughly correlates with excess fat in the body. Diabetes and all of the associated complications are strongly linked to this, both in etiology and severity.
Treatment for stiffness starts with eating nutritional food, avoiding higher risk foods and cooking methods, maintaining a constant level of activity in work and leisure, and treating any underlying disease process. Avoiding sugar, baked goods, fried foods, and hydrogenated fats are at the top of the list in importance. Supplements should include multivitamin with minerals, vitamin C, omega 3’s, and especially magnesium. Natural sources of the latter include raw nuts, wheat germ, beans, and garlic. Added supplements could include tumeric, curcumin, ginger, hops, and hyaluronic acid, all of which have the potential to help some.
As far as exercise and activity, gardening, low level exercise and stretching, and walking or jogging can keep the muscles and joints supple. Occasional bursts of intense activity such as running or heavy workouts may cause more stiffness and soreness and therefore could be counterproductive. Pilates and some forms of yoga are good to improve muscle excursion and joint range. Light massage is good for stiffness, but heavy massage is probably not.
If stiffness is a problem first thing in the morning, take a hot shower or bath with light exercise and stretching for quick relief. A trainer can help instruct in the best ways to improve joints and muscles, but actual muscle building for bulk probably is counterproductive. Lastly, if use of aspirin or NSAIDS is considered, try to comply with other ways to help first. Use anti-inflammatory drugs like a booster shot to feel better both during and after workouts. With attention to cause and treatment, you should not have to experience muscle and joint stiffness.
Dr. James Carraway is a plastic surgeon at the Cosmetic & Plastic Surgery Center of EVMS. Call 757-557-0300.